American Career College 8

Professional Identity & Professionalism

  • Definition of Professional Identity:
    • How a nurse conducts themself within the work environment ("comportment" = behaviour)
  • American Nurses Association (ANA) definition of nursing:
    • “The protection, promotion, and optimization of health and abilities; prevention of illness and injury; facilitation of healing; alleviation of suffering through diagnosis & treatment of human response; and advocacy in the care of individuals, families, groups, communities, and populations.”
  • Core elements of professional identity:
    • Values & ethics
    • Knowledge (nursing‐specific theory + evidence‐based practice)
    • Leadership skills
    • Professional comportment (appearance, punctuality, tone, language)
  • Why professionalism matters:
    • Builds patient trust
    • Keeps communication open with inter-professional team
    • Creates accountability
    • Improves clinical environment & patient outcomes
    • Example: A calm, organised nurse can de-escalate an agitated patient ("de-escalation" recognised as a hallmark professional skill)

Observable demonstrations of professionalism

  • Punctuality & respect for time
  • Maintaining calm demeanour in chaotic situations
  • Active listening & therapeutic communication
  • Respectful conflict resolution
  • Evidence-based decision-making

Challenges faced by professional caregivers

  • Long hours & physical demands of bedside care
  • Workplace hazards (needlestick injuries, exposure to chemotherapeutics, infectious disease, etc.)
  • Bullying & harassment (horizontal and vertical violence)
  • Nursing shortages → higher workloads, moral distress
  • Rapidly evolving technology & electronic health records (EHR) hurdles
  • Stress & professional burnout; social isolation in shift work
  • Mandatory overtime & unpredictable scheduling
  • Workplace violence (verbal/physical threats from patients or families)
  • Moral distress when patient wishes or institutional policies conflict with nurse’s ethical compass

Client-Centred Care (CCC)

  • Core principle: Care should revolve around client preferences, needs, and values → patient is an active partner.
  • Essential CCC domains discussed:
    • Client preferences & informed decision-making
    • Access to care (geographic proximity, transport, insurance coverage)
    • Emotional support (family, friends, counselling)
    • Continuity & transitions (smooth handoff home or to another facility; example: caring for the same patient 3 consecutive nights for richer rapport)
    • Physical comfort (pain control, positioning, hygiene)
    • Coordinated inter-professional care (PT, OT, social work, case management, dieticians, spiritual care)

Social Determinants of Health (SDOH)

  • Definition: Non-medical social factors that influence health outcomes.
  • Instructor emphasised: “Know this for the exam.”
  • Key determinants highlighted:
    • Geographic location (urban vs rural, proximity to pollution, wildfire zones, traffic)
    • Access to healthcare & insurance (financial burden, wait times > 1–2 months)
    • Occupation & work conditions (hazardous exposures → cancer, respiratory disease)
    • Socio-economic status (income, housing security, homelessness)
    • Level of education & health literacy (ability to understand instructions, medication regimens)

Class-generated local examples in Los Angeles area

  • Heavy traffic → chronic stress → cardiometabolic disease
  • Homelessness (ties to geographic location & socio-economic status) → limited shelter, hygiene, follow-up
  • Air quality & wildfire smoke (geographic hazard) → respiratory morbidity
  • Difficulty securing timely primary-care appointments (access barrier) → increased 911 utilisation for non-emergent needs
  • Hazardous job sites (construction, factories) → occupational illness

Nursing Advocacy

  • Nurse as patient advocate = promoting rights & best interests, tailored to individual.
  • Advocacy actions:
    • Patient education (empowerment)
    • Referrals (orthopaedics, PT, social services)
    • Active listening to capture unvoiced needs
    • Therapeutic communication to relay concerns to team
    • Holistic assessment (physical, psychosocial, cultural, spiritual)
  • Ethical anchor: Golden Rule—treat patients as you’d wish your family treated.
  • Scenario prompt: Patient experiencing sudden dyspnoea wants reassurance + action, not dismissal (“I see this all the time; you’re fine”).

Patient & Family Education

  • Value of tailored education:
    • Increases patient engagement & self-management
    • Reduces complications & readmissions
    • Promotes self-sufficiency
    • Must match patient’s health-literacy level, language, cultural background
  • Frequent nurse-led teaching opportunities:
    • New diagnoses & medication regimens
    • Device/therapy use (e.g., inhalers, insulin pens)
    • Discharge instructions & follow-up plan

Classroom activity (practice developing teaching tools)

  • Topics provided: smoking cessation, healthy weight management, good sleep hygiene, hand-washing.
  • Students to form groups of 3, review CDC handouts, then create a patient-education brochure using evidence-based info + plain-language principles.