In this guide
Professionalism means something to everyone who works as a nurse or midwife.
Being an inspiring role model working in the best interests of people in your care, regardless of what position you hold and where you deliver care, is what really brings practice and behaviour together in harmony.
There are also responsibilities for those who employ nurses and midwives to ensure that practice environments support and encourage professional behaviours.
Enabling professionalism also identifies employer principles for providing practice environments that support and encourage professional behaviours and appropriate challenge.
Enabling Professionalism [PDF]
Introduction
Back to top
Good health and care outcomes are highly dependent on the professional practice and behaviours of nurses and midwives.
Nurses and midwives play a critical role in strategy, service redesign and improving health outcomes, actively enabling co-production and decision making at all levels of policy making and service provision. There is a strong evidence base to demonstrate the effectiveness of nurse and midwife led services.1,2,3,4
The nursing and midwifery professions want to facilitate change and improve outcomes for people. They have the clinical innovation to help meet the challenges facing the NHS and those they serve. Nurses and midwives want to celebrate good practice, support improving practice and challenge poor practice to uphold the standards of the professions for the good of the public. These changes are being realised without diminishing the importance of the fundamentals of care and indeed highlight the importance of compassion and caring as central to the distinct roles of every nurse and midwife.
In March 2015 the Nursing and Midwifery Council (NMC), the regulator for nurses and midwives, published and implemented the Code: Professional standards of practice and behaviour for nurses and midwives.5 The Code provides the professional standards to which nurses and midwives practice, and so it requires consideration by policy makers in order to mainstream the contribution of nurses and midwives.
Promoting the Code in practice is essential, to enable nurses and midwives to lead and support good quality care, implement change and support good standards of conduct, apply sound professional judgement, supported by environments that enable professional behaviours. Being the largest workforce provides the opportunity to enhance strong clinical leadership and to deliver high quality care and services to the people of the UK.
There are 688,927 nurses and midwives currently registered with the NMC, all of whom will use the Code to revalidate over the next three years. While revalidation is ultimately the responsibility of the individual nurse or midwife, employers have an important role to play in ensuring that nurses and midwives are prepared for the new process and work within supportive environments.
What is professionalism?
Back to top
Professionalism is characterised by the autonomous evidence-based decision making by members of an occupation who share the same values and education. Professionalism in nursing and midwifery is realised through purposeful relationships and underpinned by environments that facilitate professional practice. Professional nurses and midwives demonstrate and embrace accountability for their actions.
The purpose of professionalism in nursing and midwifery
The ultimate purpose of professionalism in nursing and midwifery is to ensure the consistent provision of safe, effective, person-centred outcomes that support people and their families and carers, to achieve an optimal status of health and well-being.
The achievement of this aim can be demonstrated through:
- Consistent outcomes of care and services
- Effective care that enables people to have the best health status and quality of life they can achieve
- Care settings that enable nurses and midwives to flourish
- People describing good experiences of care and services
- Individualised care and services evidenced through support for personal choices and increased involvement in decision making about planned care or services
- Better use of resources
- Improved health outcomes for populations
Maintaining professionalism
Registered nurses and midwives practising at graduate level are prepared with the behaviours, knowledge and skills required to provide safe, effective, person-centred care and services. They are professionally socialised to practise in a compassionate, inter-professional and collaborative manner. This is recognised through continuing a registered nurse or midwife status with the NMC. Practice and behaviour are underpinned by the Code and demonstrated through a number of attributes or pre-requisites of nursing and midwifery practice, namely:
Being Accountable
Practise effectively:
- Problem solving
- Able to challenge
- Reflective
- Evidence based
Being a leader
Promote professionalism and trust:
- Autonomous
- A coordinator
- Honest
- Innovative
- System thinking
Being an advocate
Prioritise people:
- Emotionally competent
- Resilient
- Impartial
- Compassionate
Being competent
Preserve safety:
- Technically competent
- Critically thinking
- Inquiring
Enabling professionalism
Back to top
Whether in community, hospital, social care, education or one of many other settings, the environments6 in which nurses and midwives work are pivotal in supporting professional practice and behaviours.
This includes fostering a positive environment to raise concerns when issues arise that could compromise safety, quality and experience. An environment that supports and enables professional practice and behaviours is one that:
Recognises and encourages nursing and midwifery leadership through:
- Valuing the evidence-based opinion of nurses and midwives
- Nurses and midwives occupying roles of leadership and influence across systems
- Shared governance and decision making
- Organisational risk assessment that accepts professional judgement as a basis for action
Encourages autonomous innovative nursing and midwifery practice through:
- Policies that support critical thinking in practice and decision making
- Flexibility to develop appropriate new roles
- Enabling practitioners to operate within the upper limits of scope of practice
- Providing access to expertise to support coaching models and practice learning
Enables positive inter-professional collaboration through:
- Partnership approaches to team working
- Clear lines of accountability
- Inter-professional learning and team working opportunities
Enables practice learning and development through:
- Pre-registration programmes that develop professionalism and resilience
- Regular supervision and a focus on reflective practice
- Provision of professional development opportunities and meaningful appraisal
Provides appropriate resources through access to appropriate:
- Staffing – including experience and skill mix
- Funding for learning and development
- Equipment including information technology devices and software
- Shared information and data
Upholding individual professionalism
In addition to the environmental considerations that can have an impact on the ability of a nurse or midwife to act professionally, the individual practitioner is responsible for upholding his or her own professional practice through:
Learning and developing continuously
- Making the most of opportunities through revalidation via existing supervision and appraisal systems
- Access to necessary resources to support professional development
- Promoting a learning culture for others
Being a role model for others
- Demonstrating and articulating clearly what professionalism looks like in practice
- Demonstrating positive behaviours and attitudes towards diversity
- Working within a clear professional career framework
- Supporting colleagues and students
- Celebrating personal success and that of others
- Developing people to take on senior roles and supporting those in senior roles
- Treating others with a positive regard
- Providing meaningful and constructive feedback to others
Supporting appropriate service and care environments
- Raising concerns when issues arise that could compromise safety, quality and experience
- Supporting others to raise concerns appropriately
- Defining and understanding clear referral pathways to support standards of professional practice
- Delegate tasks and duties safely
- Identifying appropriate professional support networks for self and others
Enabling person-centred and evidence-informed practice
- Incorporating up-to-date evidence in daily practice
- Sharing and disseminating evidence-informed practice
- Participation in the generation of new evidence and working innovatively
- Lobbying for change and improvement
Leading professionally
- Seeking connection to and support from professional bodies and organisations
- Developing self to lead strategically
- Developing others to lead strategically
- Supporting those in leadership
About Enabling professionalism
Enabling professionalism was produced under the commission of the four Chief Nursing Officers (CNOs) and supported by the Nursing and Midwifery Council. The work brought together nursing and midwifery leaders across all levels of practice to draw on their experience and knowledge of nursing and midwifery professionalism. Working forward from the considerable evidence on the subject and significant regional work across the four countries, the Project Board, under the chairmanship of Professor Charlotte McArdle CNO for Northern Ireland, supported by the Northern Ireland Practice and Education Council for Nursing and Midwifery (NIPEC), brought together a broad framework which was tested and further developed with care and service environments for utility.
Partners within the Project Board comprised representatives of the four CNOs, colleagues at the NMC, policy level, service users and education providers, service users, independent and voluntary sectors, staff-side and professional organisations.
1. Leary, A and Oliver, S. (2010) Clinical Nurse Specialists: Adding Value to Care. London, Royal College of Nursing.
2. Schadewaldt, V and Schultz, T. (2010) A systematic review on the effectiveness of nurse-led cardiac clinics for adult patients with coronary heart disease. Available for download at: http://www.joannabriggslibrary.org/jbilbrary/index.php/jbisrir/article/view/100 Accessed 8th March 2016
3. Sandall J, Coxon K, MacIntosh N, Rayment-Jones H, Locock L, Page L. (2016) Relationships: the pathway to safe, high-quality maternity care. Report from the Sheila Kitzinger symposium at Green Templeton College, October 2015. www.gtc.ac.uk/images/stories/academic/skp_report.pdf
4. Sandall J, Soltani H, Gates S, Shennan A, Devane D. (2016) Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD004667. DOI: owly/UDI3008BKPj
5. Nursing and Midwifery Council. (2015) The Code: Professional standards of practice and behaviour for nurses and midwives. London, NMC.
6. It is recognised that nurses and midwives work in a range of environments in organisations. It is the organisations that, in many cases, are responsible for systems and processes that enable professional practice, rather than individual practice areas.
