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La présence professionnelle : Juger de la couverture et du contenu

Décembre 2012

L’Association tient à remercier toutes les personnes qui ont participé au forum pour avoir exprimé leurs opinions personnelles de manière respectueuse et et en faisant preuve de perspicacité. Ce forum a été une occasion unique de regarder au-delà de l’uniforme, de juger de la couverture et du contenu, et de reconnaître la pratique de la présence professionnelle telle qu’elle se vit actuellement au Nouveau-Brunswick.

Présentatrice : Dr. Catherine Aquino-Russell, PhD

Directrice du programme de baccalauréat en sciences infirmières et chercheure à l’Université du Nouveau-Brunswick

L’Association tient à remercier toutes les personnes qui ont participé au forum pour avoir exprimé leurs opinions personnelles de manière respectueuse et et en faisant preuve de perspicacité. Ce forum a été une occasion unique de regarder au-delà de l’uniforme, de juger de la couverture et du contenu, et de reconnaître la pratique de la présence professionnelle telle qu’elle se vit actuellement au Nouveau-Brunswick.

Nous remercions sincèrement Catherine Acquino-Russell, Ph.D., d’avoir collaboré avec l’Association et animé avec succès le deuxième forum virtuel de l’AIINB. Surveillez le résumé final de Mme Aquino-Russell dans le numéro de mars d’Info Nursing.

Mot de la fin de Catherine:

À toutes les personnes qui ont affiché leur point de vue sur l’important sujet qu’est la présence professionnelle, MERCI. Votre opinion est révélatrice et jette de la lumière sur ce qu’est l’exercice de la profession dans la vraie vie au Nouveau-Brunswick. Vos descriptions étaient poignantes et, en les lisant, j’ai remarqué de nombreuses similitudes avec ce qu’on retrouve dans la littérature relativement aux possibilités et aux défis que représente vivre la présence professionnelle dans la pratique infirmière. Vous avez raconté des expériences passées en réfléchissant à comment les choses se faisaient avant et décrit les défis actuels auxquels vous faites face tous les jours devant l’indifférence des autres dans un milieu de soins de santé touché par les compressions budgétaires, alors que bon nombre d’entre vous ont imaginé comment NOUS pouvons influencer la mise en valeur de la présence professionnelle dans notre pratique infirmière pour l’avenir. Votre apport sera souligné dans un article qui paraîtra dans le numéro de mars d’INFO NURSING. Je termine mes remerciements en citant librement Gandhi, citation qui, je crois, émane de vos affichages : Vous devez être le changement que vous voulez voir dans ce monde.

Références

Commentaires archivés


Anonymous

There seems to be a lot of emphasis on professionalism these days or the lack of, and I do think the time has come to acknowledge the elephant in the room. Some nurses are “rude” and I’ll admit that I have reacted to rudeness by being rude myself or by being sarcastic – not to say caustic. There I said it, I admit to it. How have we become like this? How can we be caring in the patient’s room and behave like lionesses as soon as we step out into the nursing station? I don’t have an answer to my own question but I do think this is a form of un-professionalism that needs to be stopped in its track. If we turn our back to this reality, we are only enabling such behaviors. I don’t have the miracle solution but I know I’m part of the solution.


Anonymous

I agree with you whole heartly. How have we become like this… why have we as nurses become like this? We are « Care » providers yet we have diffculty in « being » nice. To me professional presence means being compentent protraying yourself in a manner that is respectful of others that values who you are as an RN. Showing pride in being a RN vauling what you do not just putting in the hours until the day is over. I know we all have bad days , diffcult work situtations but we need to step back and stand out not react to unprofessional people in unprofessional ways. It is easy to join loud negative conversations and not be different but we do ourselves and our patients/clients an injustice when we do. Can we say we are happy when we go along with the group do we enjoy our jobs feel like a professional??But if we begin to make an effort to really value nursing , our roles as RNs to project a postive pressence we will see a shift not only in ourselves but within our work places. I work in an orgainzation that really prides itself on professionalism however here have been situtations in which RNs have belittled one another and instead of celabrating acheivements of one another tried to demoralize one another in these times it is easy to lose sight of the bigger picture and join on the band wagon of negative vibes.We need to find ways to empower one another to take the higher road.


Anonymous

I am glad to report that professionalism is strong and doing well. Not everyone has lost the passion for and value of our profession. I can say that the younger nurses can be role models when it comes to professional presence. Unfortunately, an unhealthy work environment and rubbing against individuals who lack professional presence can tarnish their enthusiasm and professional values in no time. Let’s all be more supportive of each other, it will make the team stronger thus the care to patients will benefit from it. Thank you NANB for continuing the discussion on this phenomenon.


Anonymous

La présence professionnelle, pour moi, c’est d’avoir une approche respectueuse envers le patient, sa famille et mes collègues. Les compétences et les connaissances sont nécessaires de même que l’approche humaine dans la profession infirmière. La réalité des milieux de travail avec une charge de travail élévée contribue aux défis d’être toujours consciente de la présence professionnelle. J’ai vu des infirmières qui malgré une charge élévée font toujours sentir le patient,la personne la plus importante au moment d’être en interaction avec. Je crois qu’il faut faire une réflection sur nos valeurs et croyancea afin de ne pas perdre de vue notre engagement en tant que professionnelle de la santé. J’aime mon travail,pas une journée ne se resemble mais chaqu’une d’entres elles contribuent à faire éviluer ma présence professionnelle. merci pour cette consultation en ligne.


Anonymous

PROFESSIONAL PRESENCE -the impact that a registered nurse has on the care of his/her patients and their families. -the subtle change in the tone and atmosphere surrounding a bedside experience with a difficult care challenge. -the realization on the part of the nurse that her/his presence, expertise, example, and coaching really changes things for the better and brings forth a resolution. The synchronicity that results and empowers colleagues. This is my living example of what PP is all about. As one’s nursing career expands and lengthens, the above scenario becomes an automatic, visceral response and, with time, a respected outcome. How fortunate that one time, long ago, we came to call it « nursing » We are now part of a larger health care team but our professional presence is no less needed. The challenge is always to rise above the mob and keep focused on why one signed up in the first place. Respecting oneself and having a solid circle of support outside the work situation helps to keep a nurse afloat when colleagues and bureaucrats think otherwise.


Anonymous

I applaud NANB for opening this forum on professionalism. I believe that Nurses are a trusted professional in the Public’s eye. Each and every nurse has a responsibility to uphold the trust that we have gained over many years. Nurses at the bedside, in the community, in schools, Nursing Homes and Institutions need to feel proud of the daily contributions that are made. It is imperative that Nurses support one another, stand up for what’s right and lead by example as many people are watching the actions of Registered Nurses. As a Profession in this difficult ecenomic climate that New Brunswick is undergoing, priority needs to be placed on; committment to continuing education, competent knowledge based practice, embracing the youth of our profession and of particular importance is to take ownership of the workplace environment. We all either positively or negatively affect the work force….which side do you want to be on?


Anonymous

I have many thoughts about what is professionalism, but what I would like to comment on, is how our professionalism is being lost in our profession. #1: We work under such dire circumstances, and unfortunately unsafe environments such as lack of staffing, beds in hallways, lack of time to even go to the bathroom much less complete all the nursing care thay we want to implement-make professionalism something we unfortunately only truly reflect upon as we are sitting home exhausted. Even taking the time to talk about the topic on this forum is soemthing that had to be scheduled in my timetable to do. If we want to give the opportunity to nurses to develop their professionalism and to « live professional prescence »- then we need to provide nurses with a professional environment in which to thrive. #2: I truly feel we have lost our professional voice as a distinct and respected profession. Our job is now so clouded and mixed in with other professions–namely LPN’s etc, that we have lost the clear picture of what a registered nurse is. If you ask most people on the street, I bet they would have great difficulty articulating what the difference is between us and other nursing professions. And to make it worse for the patients-they cant even tell by looking at us that we are registered nurses. Employees from the housekeeping staff, porters, xray staff, patient sitters and registered nurses all wear the Disney themed scrub tops with Pooh bear on them and if not a Disney character-we all wear the same colored scrubs–so we just look like we are all of the same profession. Dont get me wrong we could not function as a health care team withour each other–everyone is important and a valued team member-but we need distinction. We need to stand out as professionals! #3: We are in desperate need of registered nursing leaders—people who will stand up for our profession and help it to become the respected and distinct profession that it should be. #4: We need to stop « eating our young ». The nursing students of today need to hear why we love our jobs–not « oh man are you getting into the wrong profession » or « what are you thinking–change your minds while you can ». We need to reach down deep into why we initially went into the program ourselves and share with nursing students the positive aspects of our profession as well. Help students to be excited that they decided to be a nurse and let them live professionalism. Im proud to be a registered nurse and feel it is our responsibility to change what we want changed in our profession- otherwise the environments we work in, the vagueness of our profession, and the public’s lack of knowledge about our distinct profession will continue until we do something about it. Thank you for this opportunity to speak my voice.


Anonymous

We have all been lucky enough to have known some very professionally present nurses in our lifetimes. We all strive to be professionally present. Unfortunately, nursing practice has had the bubble burst on it more than enough times. We want to be there for our patients and families. We are professional,empathetic and full of knowledge. We treat others with respect. Financial constraints placed upon us(working « short »)and negativity (both from other nurses and healthcare staff), have affected many of us in unhealthy ways. Stress builds and erodes our confidence and optimism. Working long hours under stressful conditions without support is the « new normal ». « Do more with less. » « The budget……. » We are posting anonymously because we are hurting and ashamed of our profession in one way or another. Each of us speaks of negativity and the harm done by it. We do not all partake in trying to hurt other nurses, but some do. Why? I think by bringing professional presence to the forefront, we may encourage some of the discouraged to find the strength to take each day at a time, striving to be what we all want to be. Professionally present. We need to bring back our role models.


Anonymous

Professionalism…..hmmmm. I have been mentored by wonderful professionals from all walks of the healthcare team and it makes me sad to say that in our efforts to be professional we seem to have forgotten the very people that are relying on us to speak for them. I find myself frustrated by the very people who are supposed to be speaking on my behalf. No where have I read that NANB has come out against the erosion of the RN being present at the bedside. Where is my professional body on the layoffs that are going on in the health care system and removal of RNs where they can do the best work? Best practice has shown that there is lower mortality where Registered Nurses practice but all I see is an ever increasing presence of LPNs and unregulated workers and fewer RNs and critical incidents on the rise. Perhaps it’s time to look at Nurse-Patient Ratios. I’m tired of reminding unregulated workers that they are misrepresenting themselves when they tell patients that they are their nurse today. I am the RN not them and I worked very hard to become an RN. I love nursing and after 34+ years in this profession it saddens me to hear RNs gripe about doing bedbaths and making beds. That is when I used to have the best converstions with my patients about their lives and their homes and families. I often discovered bits of information that gave me clues on whether or not there was support for my patient at home. Instead, I find RNs hiding behind computer screens and charts and trying to get away from the patient. It embarasses me to hear RNs tell physicians that « That’s not my patient. » Perhaps it’s time for RNs to buy into a distinct uniform that states, « I am an RN. » We had caps and black bands and yes I am aging myself but my patients knew who the RN was and so did everyone else.


Anonymous

We have all worked with that professional nurse that makes the worst shift, a not so bad one. It is the way they walk into a room and you relax, smile and the stress in your lower back goes away, that tells you, you like to work with her/him. She/he moves around patients and co-workers with grace and style. They let you be yourself and they are so comfortable with whom they are. You feel respected and heard when she/he listens to you. You feel valued. The professional nurse makes her co-workers, patients and patients family feel this way with ease. Un-professionalism needs to addressed but if persists needs to be reported so this behavior doesn’t ever become accepted as okay or « the normal ». This is a very difficult thing to do because you have to continue to work with them, but it needs to be done. I can not change others, but I can let them know I will not let them treat me in an unprofessional way. Who would ever of thought I would of had to tell another RN that she could not tell me to F off any time she wanted, but I have had to do this. In 30 years of nursing I have made mistakes but hope I have learned from them and admire the four professional nurses I get to work with each day.


Anonymous

I believe that professional presence begins by putting ourselves in our patients/families shoes. How would each one of us like to be treated if we were lying in that hospital bed? Yes, the work environment is fast paced and stressful. We are often working short; but as professionals we must keep in mind that we are constantly being challenged and we must rise up to those challenges. This is the true nature of a professional. Those difficulties can be looked upon as annoying or irritating, or we can choose to see them as opportunities for leadership, and personal growth. Those moments that push our boundaries are when our true character comes out. Another important aspect of being a professional is taking care of ourselves outside of the workplace, so we can be at our best during work hours. Making time for « self-care »; reflecting and dealing with stress and situations that are bothering us, exercising, having some fun, and dealing with our own baggage, so we are clear and calm when we are at work. One’s presence, attitudes and especially actions are true indicators of professionalism. If we desire to maintain a professional presence, then we must each take responsibility for our words and actions to maintain our own integrity, and be an example for others.


Anonymous

La présence professionnelle signifie d’être là «Ici et Maintenant» lors de soins physiques ou psychologiques aux patients. C’est d’avoir des comportements professionnels avec les collègues de travail et gestionaires. #1. la présence professionnelle se manifeste sous diverses formes en tout moment. Et ce malgré le manque de ressources infirmiers, la lourdeur de soins, le travail en surtemps. Elle doit se manifeste avec tous les membres des équipes de travail ( IAA, II, préposé) et l’équipe multidiciplinaire (physi, ergo,médecin..pharmacien..) sans oublié le personnel de soutient. #2.Elle se manifeste en moi, avec toute mon intégrité,l’honnêteté la compassion et de continuer la mise à jour de la formation continue. Elle se manifeste par mon engagement dans la profession infirmière à titre de membre du comité local de L’association et probablement siéger sur le conseil administratif de L’AIINB à l’automne 2013 #3 Le ressentie de la présence professionnelle doit être une expérience agréable et une ressource inépuissable . Les règles de bases des normes professionnelles et du code de déontologie sont primordiales. Tout est dans la façon de communiquer, notre approche et notre atittude. Lors de période de mentorat en soins infirmiers, la présence professionnelle est une qualité essentielle et recherchée chez nos mentors cliniques envers nos infirmières novices(mentorées).Il est important de leurs fournir un bel accueil, du support émotionnel, et de travailler en colllaboration entre les collègues #4. Oui malheureusement, il y a des lacunes de professionnalisme dans nos milieux de travail. Il ne faut pas se le cacher. Comme piste de solution, il y a un programme de formation régionale sur le leadership/mentorat. Plusieurs modules y sont offerts dont celui intitulé «culture de respect et comportement professionnelle» Il se sousdivise en 4 leçons dont l’un a comme objectif d’identifier les exemples de comportement professionnel qui favorise une culture de respect. Il n’y a pas de solution miracle , l’importantc’est d’en parler au bon moment avec les bonnes personnes afin de promovoir une présence professionnelle afin de donner des soins compatissants et conforme à l’éthique Merci de ce forum


Anonymous

Professionalism in nursing is not dead but it is dying. I see many young RN’s who no longer like what they do for many reasons. I have been fortunate to be a RN for the past 33 years. When I see RN’s responding to patients, families or clients with a  » I don’t care  » attitude, it makes me wonder why they are even in the profession. Taking the extra 2 minutes to respond to a question or concern does not cost the professional anything, but it leaves your client, patient, family member with the feeling that they are being listened to , not merely tolerated. maybe we need to go back to our basics of CARING for our clients, patients , families and showing them that we care. Too often you overhear comments by the public about the nurse who just grunted at them or didn’t even acknowledge their presence. If we want to be seen as professionals we need to start acting as professionals, stop talking about the party where we got « so drunk » or who the next boyfriend is. Our personal lives should not even be part of a workplace discussion, let alone a discussion where those we are caring for are within earshot.


Anonymous

communication has to come back into our profession. Our patients are not being communicated with and our health care surveys have confirmed this. RNs are busy sitting in front of computers doing workload measurements, documentation, completing assessment tools, charting and charting and charting, it is so sad to see the hours of work spent on validating hours of work. Are we not professional enough to be trusted we are completing our duties in the most effecient time we can. We used to have time to do patient and family teaching in the afternoon when family visited, this kept the patient up to date on his treatment plan, a lot of motivational interviewing was done before the term was invented, smoking cessation, exericsing, healthy eating was promoted while communicating with patients and their significant others. Nurses shared thier knowledge to prevent illness , promote wellness and autonomy. The afternoons are now spent documenting, documenting and documenting, there are more computers than bedpans on most units and this is very sad. LPNs are important in the team care but we need to continue to deliver our expert care more of the time. NANB and our National Association is so remote from the bedside nurse that these issues are left to continue to create problems. nurses should have become vocal about work load documentation long ago but we remain silent and let this condition change our scope of practise,…very very sad.


Anonymous

Waving the flag of « Professional Presence » will not magically restore what has been eroded over the past twenty years, but it might encourage each Registered Nurse in this province to take back the title of « Nurse » from those who do not have the right to use it according to the New Brunswick Nurses Act. If the general public and government decision makers cannot identify the Registered Nurse (RN) from the Licensed Practical Nurse (LPN)at present, then « Professional Presence » is a moot point. Where are the leaders within our professional body? Who are be the symbols of « Professional Presence » for the public and the government decision makers to identify with? Who will lead this professional body back to holistic, critical thinking, professional patient focused nursing care? « Professional Presence » – two great words with too little meaning in current healthcare climate.


Anonymous

LA PRESENCE PROFESSIONELLE POUR MOI EST LA SECURITÉ, VIVRE LA PRESENCE PROFESSIONEL EST UN BIEN ETRE ENVERS LE PT MON EXPERIENCE ON TANT QUE PRESENCE PROFESSIONELLE EST LOSQUE JE VOIT LE PATIENT EN CLINIQUE ET ME DIT QU IL ME FAIT CONFIANCE ET QUE JE SUIS LEUR ANGE, ET QUE LORSQU IL M APPELLE POUR DE L INFORMATION EN ACCROCHANT JE RESSENT QU ILS ONT UNE SECURITÉ


Anonymous

When I think of professional presence, I think of someone who has enough confidence to assure that they know what they are doing but not an arrogant attitude that is not approachable. I think of someone who can do the high tech skills while being ‘with’ the patient as demonstrated in reassuring language, or positive body language. I think professional presence starts on the inside and is exhibited on the outside in appearance. I believe it is more than image, but image is a part of it. When I think of memorable moments of professional presence, I think of moments when I treated the patient with respect, did my job well and and communicated either with words or with a reassuring touch. For me, professional presence is a blending of education, technical skill and basic human communication. It is listening, respecting, and sharing professional knowledge. It is doing my best and acknoweldging to myself when I have not done my best, so I can learn from it.


Anonymous

As I read the comments posted for this discussion, I felt both sad and hopeful. Sad because of the recurrent theme of lost professionalism…but hopeful because so many are motivated to ‘take back’ the professionalism that once defined the nurse. Like so many who have posted before me, I yearn for the past in many ways: for times when skill mix and economic burden were not such factors in my practice; for the days when the culture in organizations did not support nurses wearing hoodies at the bedside!; for shifts when I spent my time ‘with’ patients and families learning about what their illness experience meant to them. The current healthcare environment, with its many players in patient care, promotes task-driven, fragmented care and inhibits the RN from the ability to truly care for those whom we serve. The role of the nurse is changing…and we cannot stop that. We are not going to go back to the days of primary care or have unrestricted budgets with which to operate. We must find a way to be professionally present in this current healthcare context. Nurses must embrace what makes them different from other healthcare providers and strive to enact those differences every day in our work environments. We need to find ways to work with the resources we have (both finiancial and human resources) in the best way – a way that allows the RN to be at the bedside doing the things that only the RN can do: counselling, developing meaningful relationships that faciliate caring for the whole person, higher level patient/family teaching, helping those in our care to find meaning in their current situation. I am proud to be a Registered Nurse and have never regretted my career path. I am hopeful that discussions like these can motivate us to make postive change in the way that we practice. Nurses need opportunities like this to voice their feelings and problem-solve for a better tomorrow for our profession. Discussions like these need to take place with the people we work with every day. I have had success with an evening journal club for important discussions like this and have seen how nurses can effect change when given the chance to talk together and consider possibilities for positive change. I truly believe that it is possible to be professionally present – even in this challenging healthcare environment. Don’t give up on nursing!