PERSONAL & PROFESSIONAL

DEVELOPMENT IN NURSING
Rick Edison Espinosa
Kristine Klein G. Sagun
Personal Professional Development

■ Personal and professional development is often also called

continuous professional development (CPD). CPD is the
purposeful maintenance and improvement of a
professional’s knowledge and skills to remain competent in
their chosen profession for the benefit of themselves, their
patients or clients and the wider profession. CPD is
recognized as a commitment to being professional, keeping
up to date and continuously seeking to improve.
Personal Professional Development

■ CPD is intended to encourage the development of

professionals so that they reflect on their practice and its
quality, are able to adopt and assess new approaches to
their practice and develop better ways of working as a
result.
■ CPD acknowledges varying learning styles among
professionals and includes a wide range of formal and
informal learning activities.
Personal Professional Development

The key principles behind CPD are that it:

■ Is self-directed
■ Is based on learning needs identified by the individual
■ Builds on an individual’s existing knowledge and experience
■ Links an individual’s learning to their practice
■ Includes an evaluation of the individual’s development
Why is Personal Professional
Development Necessary?
■ CPD is a critical mechanism in ensuring that all members of the nursing
professions are able to deliver high quality nursing care and services and
keep pace with health care developments that affect their practice.
■ The knowledge needed to function effectively as a professional nurse
continues to expand and change while consumer demand and expectations
continue to increase.
■ Therefore, as registered health practitioners, nurses have a professional
obligation to maintain their competence and to aim for continuous
improvement in the standard of service they provide.
Professional and personal development is quite simply a means of
supporting people in the workplace to understand more about the
environment in which they work, the job they do and how to do it better.

It is an ongoing process throughout our working lives.

Professional and personal development provide a means whereby we can

keep in sync the changes, broaden our skills and become more effective
in our work.
It can be a part of an individual’s personal ambition to be a better
practitioner, enhance his/her career prospects or to simply feel more
confident about their work and make it more personally fulfilling. It can
be a step on the ladder to higher qualifications or enhanced job
prospects or be required by professional bodies to maintain professional
status. It can be part of meeting targets set by workforce performance
management schemes or an opportunity for individuals to change their
career paths.
 ETHICAL & MORAL
ASPECTS IN NURSING
Ethical & Moral Aspects in Nursing

■ The word ethics derived from the Greek term ethos, which means
“customs.”
■ Ethics is the attempt to identify norms or standards of right or good
behaviors.
■ Moral – personal/private interpretation from what is good and bad.
■ Code of Ethics – a specific set of professional behaviors and values
the professional must know and abide by, including confidentiality,
accuracy, privacy, and integrity.
Types of Ethics

Those of particular concern to the nurse are:

1. Bioethics – branch of ethics that studies moral values in the biomedical
sciences.
2. Clinical Ethics – concerned with ethical problems “at the bedside” that arise
within the context of caring for actual patients
Example: informed consent and how one ought to respond to requests for
assisted suicide
3. Nursing Ethics – study of ethical issues that arise in the daily practice of
nursing and of the analysis used by nurses to make ethical judgements
Example: cost-containment, breaches of patient’s confidentiality, illegal
practices of colleagues
Ethical Principles

AUTONOMY
■ It involves the right of self-determination or choice, independence and
freedom
Example: the purposes of the pre-op consent is to assure in writing
that the health care team respects the patient’s independence by
obtaining permission to proceed
NONMALEFICENCE
■ The duty not to harm/cause harm or inflict harm to others (harm may
be physical, financial or social)
Ethical Principles

BENEFICENCE
■ Promotes taking positive, active steps to help others; for the goodness
and welfare of the clients
– Example: a child immunization causes discomfort during
administration, but the benefits of protection from disease both
individual and for society outweigh the temporary discomfort
JUSTICE
■ Equality/fairness in terms of resources/personnel
■ It implies equal treatment of all clients
Ethical Principles

VERACITY
■ Telling the truth or intentionally deceiving or misleading the patient
FIDELITY
■ Faithfulness/loyalty to clients
■ Refers to the agreement to keep promises, commitments, and
responsibilities that one has made to one’s self and to others
Example: if you assess a pt for pain and then offer a plan to manage
it, this principle encourages you to do your best to keep the promise
to improve the pt’s comfort
Ethical Dilemma

■ A situation is in which a choice must be made between

two equally undesirable actions.
Moral Principles

1. Golden Rule -- “Do unto others as you would have them do unto you”
is the idea (also called the law of reciprocity).
2. The Principle of Totality – the whole is greater than its parts
3. Epikeia – from the Greek word meaning “reasonableness.” Built on
the principles of human rights and dignity of man where there is
always an exemption to the rule.
4. One who acts through as agent is herself responsible – (instrument
to the crime)
5. No one is obliged to betray herself
Moral Principles

6. The end does not justify the means

7. Defects of nature maybe corrected
8. If one is willing to cooperate in the act, no justice is done to him

9. A little more or a little less does not change the substance of an act
10. No one is held to impossible
Tort Law
■ Is a civil wrong committed against a person or a person’s property
■ Is based on:
– ACT OF COMMISSION: something that was done incorrectly
– ACT OF OMMISSION: something that should have been done but
was not
■ Classification of Tort:
– Intentional Tort
– Unintentional Tort:
■ Negligence
■ Malpractice
INTENTIONAL TORT
• The act was done on PURPOSE or with INTENT
• No harm, injury, or damage is needed to be liable
• No expert witnesses are needed
UNINTENTIONAL TORT
• Does not require intent but does require the element of
HARM
1. Negligence
• Misconduct or practice that is below the standard expected of
ordinary, reasonable and prudent person
• Failure to do something due to lack of foresight or prudence
• Failure of an individual to provide care that a reasonable person
would ordinarily use in a similar circumstance.
• An act of omission or commission wherein a nurse fails to act in
accordance with the standard of care
2. Malpractice
• stepping beyond one’s authority
6 ELEMENTS OF NURSING MALPRACTICE:
1. Duty – the nurse must have a relationship with the client that
involves providing care and following an acceptable standard of
care.
2. Breach of duty
• the standard of care expected in a situation was not observed by the nurse
• is the failure to act as a reasonable, prudent nurse under the
circumstances
• something was done that should not have been done or nothing was done
when it should have been done
3. Foreseeability - a link must exist between the nurse’s act and the
injury suffered.
4. Causation – it must be proved that the harm occurred as a direct
result of the nurse’s failure to follow the standard of care and the
nurse should or could have known that the failure to follow the
standard of care could result in such harm.
5. Harm/injury –physical, financial, emotional as a result of the
breach of duty to the client Example: physical injury, medical
cost/expenses, loss of wages, pain and suffering
6. Damages – amount of money in payment of damage/harm/injury
ASSAULT
• An attempt or threat to touch another person
unjustifiably.
Example:
• A person who threatens someone with a club or closed
fist.
• Nurse threatens a client with an injection after refusing to
take the meds orally.
BATTERY
• Willful touching of a person, person’s clothes or something
the person is carrying that may or may not cause harm but
the touching was done without permission, without consent,
is embarrassing or causes injury.
Example:
• A nurse threatens the patient with injection if the patient refuses
his meds orally. If the nurse gave the injection without client’s
consent, the nurse would be committing battery even if the client
benefits from the nurse’s action.
INVASION OF PRIVACY
• Intrusion into the client’s private domain
• Right to be left alone
TYPES OF INVASION THE CLIENT MUST BE PROTECTED FROM:
• Use of client’s name for profit without consent – using one’s name,
photograph for advertisements of HC agency or provider without client’s
permission
• Unreasonable intrusion – observation or taking of photograph of the client
for whatever purpose without client’s consent.
• Public disclosure of private facts – private information is given to others who
have no legitimate need for that.
• Putting a person in a false/bad light – publishing information that is
normally considered offensive but which is not true.
CAREER PLANNING
Nurses with Post Graduate Education
and Specialization
Post Graduate Nursing Degrees:
■ Master’s Degree: MAN, MSN – prepares nurses for prepares nurses for more
independent role such as Independent Nurse Practitioner,independent, Nursing
instructor and Nursing SupervisorNursing instructor and Nursing Supervisor
■ Doctoral Degree: (PhD) prepares nurses to leadership roles within the profession,
conduct research impacts nursing practice and health care, and to teach at impacts
nursing practice and health care, and to teach at colleges and universities
. Doctorally-prepared nurses serve colleges and universities . Doctorally-prepared
nurses serve as health system executives, nursing school deans, nursing
administrators, researchers and policy analysts and administrators,and formulator
Career Planning
CONTINUING EDUCATION
■ Enrollment in formal degree programs
■ Pursuing certificates, accreditations or other credentials through
educational programs
PARTICIPATION IN PROFESSIONAL ORGANIZATIONS
■ Attending local, regional, national, and international meetings,
conferences and workshops sponsored by professional organizations
■ Presenting papers, workshops at conferences
■ Serving as an officer, board member, or committee member
■ Coordinating events sponsored by an organization
Career Planning

The Benner Model or Stages of

Clinical Competence is designed to
emphasize the skill acquisition of
health care professionals. Patricia
Benner’s research was adopted from
the Dreyfus Model of Skill Acquisition
and applied to the nursing
profession. (Benner, 2001).
NOVICE TO EXPERT
BENNER’S STAGES OF CLINICAL COMPETENCE
NOVICE

■ A new practitioner’s practice is driven by rules and tends to provide

task-focused care.
■ Beginners have had no experience of the situations in which they are
expected to perform. Novices are taught rules to help them perform.
The rules are context-free and independent of specific cases; hence
the rules tend to be applied universally. The rule-governed behavior
typical of the novice is extremely limited and inflexible. As such,
novices have no "life experience" in the application of rules.
■ "Just tell me what I need to do and I'll do it."
ADVANCED BEGINNERS

■ Providers have developed safe practices but lack a strong knowledge

base for their practice and management skills.
■ Advanced beginners are those who can demonstrate marginally
acceptable performance, those who have coped with enough real
situations to note, or to have pointed out to them by a mentor, the
recurring meaningful situational components. These components
require prior experience in actual situations for recognition.
■ Principles to guide actions begin to be formulated. The principles are
based on experience.
COMPETENT PROVIDER

■ They find that they can prioritize and begin to use past experiences to form
their care.
■ Competence, typified by the nurse who has been on the job in the same or
similar situations two or three years, develops when the nurse begins to see
his or her actions in terms of long-range goals or plans of which he or she is
consciously aware.
■ For the competent nurse, a plan establishes a perspective, and the plan is
based on considerable conscious, abstract, analytic contemplation of the
problem. The conscious, deliberate planning that is characteristic of this skill
level helps achieve efficiency and organization.
COMPETENT PROVIDER

■ The competent nurse lacks the speed and flexibility of the proficient
nurse but does have a feeling of mastery and the ability to cope with
and manage the many contingencies of clinical nursing.
■ The competent person does not yet have enough experience to
recognize a situation in terms of an overall picture or in terms of which
aspects are most salient, most important.
PROFICIENT PROVIDER
■ Have a good sense of what their patient’s situation is and can prioritize needs
and routinely predict accurate outcomes.
■ The proficient performer perceive situations as wholes rather than in terms of
chopped up parts or aspects, and performance is guided by maxims. Proficient
nurses understand a situation as a whole because they perceive its meaning in
terms of long-term goals.
■ The proficient nurse learns from experience what typical events to expect in a
given situation and how plans need to be modified in response to these events.
The proficient nurse can now recognize when the expected normal picture does
not materialize. This holistic understanding improves the proficient nurse's
decision making; it becomes less labored because the nurse now has a
perspective on which of the many existing attributes and aspects in the present
situation are the important ones.
EXPERT PROVIDER

■ Confident, have an extensive knowledge base and is able to quickly

grasp complex patient situations.
■ The expert performer no longer relies on an analytic principle (rule,
guideline, maxim) to connect her or his understanding of the situation
to an appropriate action. The expert nurse, with an enormous
background of experience, now has an intuitive grasp of each
situation and zeroes in on the accurate region of the problem without
wasteful consideration of a large range of unfruitful, alternative
diagnoses and solutions.
EXPERT PROVIDER

■ The expert operates from a deep understanding of the total situation. The
chess master, for instance, when asked why he or she made a particularly
masterful move, will just say: "Because it felt right; it looked good." The
performer is no longer aware of features and rules; his/her performance
becomes fluid and flexible and highly proficient. This is not to say that the
expert never uses analytic tools. Highly skilled analytic ability is necessary for
those situations with which the nurse has had no previous experience.
Analytic tools are also necessary for those times when the expert gets a
wrong grasp of the situation and then finds that events and behaviors are
not occurring as expected. When alternative perspectives are not available to
the clinician, the only way out of a wrong grasp of the problem is by using
analytic problem solving.
EXPANDED ROLES FOR NURSES
SPECIALIZATION & ROLES OF NURSES IN DIFFERENT FIELDS
Advanced Practice Nurse (APN)

■ The most independent functioning nurse.

■ Has a master’s degree in nursing, advanced education in
pharmacology and physical assessment, and certification
and expertise in specialized area of practice.
Clinical Nurse Specialist

■ Nursing expertise in a specialized area of practice

– Example: medical-surgical nursing, psychiatric and
mental health nursing, pediatric nursing, community
health nursing, gerontologic nursing.
Nursing Administrator

■ Manages client care and the delivery of specific nursing

services within a health care agency.
■ Begins with positions such as charge nurse, or assistant
nurse manager, then nurse manager of a specific patient
care area.
Nurse Researcher

■ Investigates problems to improve nursing care and to

further define and expand the scope of nursing practice.
■ Employed in an academic setting, hospital, or independent
professional or community service agency.
School Health Nurse
■ Goal – Superior educational success by enhancing school
health.
Functions:
– Direct caregiver
– Case finder
– Consultant
– Counselor
– Health educator
– researcher
Occupational Health Nurse

■ Specialty practice that provides for and delivery of health and

safety programs and services to workers, worker population
and community groups.
Functions:
– Promotion and restoration of health
– Prevention of illness and injury
– Protection from work-related and environmental hazards.
Parish Nurse
■ The role that gathers in churches, cathedrals, temples, mosques, and
acknowledges common faith traditions.
■ Responds to health and wellness needs within the context of
populations of faith community.
– Functions:
– Provider of spiritual care
– Health counselor
– Health advocate
– Health educator
– Facilitator of support groups
Public Health Nurse

■ A registered nurse with special training in community health.

– Function:
– Health advocate
– Care manager
– Referral resource
– Health educator
– Direct primary caregivers
– Communicable disease control
– Disaster preparedness
Private Duty Nurse

■ A registered nurse or a licensed practical nurse who provide

nursing services to patients at home or any other setting in
accordance with physician orders.
Home Care Nurse

■ A nurse who provides periodic care to patients within their home

environment as ordered by the physician.
– Functions:
– Health maintenance
– Education
– Illness prevention
– Diagnosis and treatment of disease
– Palliation and rehabilitation
Hospice Nurse

■ Provides a family centered care and allows clients to live and remain
at home with comfort, independence and dignity, while alleviating the
strains caused by terminal phase.
– Functions:
– Pain & symptom control
– Spiritual care
– Family conferences
– Coordination of care
– Bereavement care
Rehabilitation Nurse

■ A nurse who specializes in

assisting persons with
disabilities and chronic
illness to attain optimal
function, health, and adapt
to and altered lifestyle.
Nurse Epidemiologist

■ Monitors standards and procedures for the control and

prevention of infectious diseases and other conditions of
public health significance including nosocomial infections.
Public Health Nurse/Community Health
Nurse/Community Health Nurse
■ Community health nursing is defined as“synthesis of nursing theory
and public“synthesis of nursing theory and publichealth practice
applied to promoting andhealth practice applied to promoting
andpreserving the health of populations”preserving the health of
populations”
■ Population: individuals, groups, family andPopulation: individuals,
groups, family andcommunitycommunity
■ Community health settings: ambulatoryCommunity health settings:
ambulatoryhealth clinics, home health care, pre natalhealth clinics,
home health care, pre nataland well baby clinics, rural health units
andand well baby clinics, rural health units andcity health offices
 Goals

■ Improve the over all health of theImprove the over all health of
thecommunitycommunity
■ Health promotionHealth promotion
■ Health maintenanceHealth maintenance
■ Health educationHealth education
■ ManagementManagement
■ Continuity and coordination of careContinuity and coordination of
care
 Nurse Educators
■ Nurse educators are responsible forproviding quality educational experiencesproviding
quality educational
experiencesthat prepare future generations of nursesthat prepare future generations of nurs
esto provide quality patient care, and at theto provide quality patient care, and at thesame
time ensuring competence andsame time ensuring competence andadvancement of
practicing nursesadvancement of practicing nurses
■ Their work involve: lesson planning, Their work involve: lesson planning,instructing,
evaluating learning, helpinginstructing, evaluating learning, helpingstudents to solve learning
problems andstudents to solve learning problems anddifficultiesdifficulties
■ They design, implement, evaluate and They design, implement, evaluate andrevise academic
and continuing educationrevise academic and continuing educationprograms for
nursesprograms for nurses
Independent Nurse
PractitionerPractitioner
■ Independent = self employed
■ Provides professional nursing services to clients/patients and their families
clients/patients and their families
■ Community based clinics /near hospital.
■ Offers services rather than expect clients to seek their help
■ Perform both independent and collaborative roles
■ Scope of nursing practice: health care assessment, formulating plans for health,
prevention strategies, continuation of supportive activities in critical and complex health
problems
■ Make referrals and collaborate with physicians and collaborate with physicians and other
discipline as needed.
■ nurse practitioners
who deliver front-line primary and acute in community clinics,
schools, hospitals, and other settings,and perform such
services as diagnosing and treating acute illnesses and
injuries, providing immunizations,physical exams, and
managing high blood pressure, diabetes,and other chronic
problems;
■ certified registered nurse anesthetists
who administer, more than 65 percent of all anesthetics given
to patients each year and are the sole providers of anesthesia
in approximately one-third of U.S. hospitals
 HOW TO BALANCE
PERSONAL AND
PROFESSIONAL NEEDS
■ WORK-LIFE BALANCE means bringing work, whether done on the job
or at home, and leisure time into balance to live life to its fullest. It
doesn't mean that you spend half of your life working and half of it
playing; instead, it means balancing the two to achieve harmony in
physical, emotional, and spiritual health.
■ In today's economy, can nurses achieve work-life balance? Although
doing so may be difficult, the consequences to our health can be
enormous if we don't try. This article describes some of the stresses
faced by nurses and tips for attaining a healthy balance of work and
leisure.
Burnout and other health issues

■ Burnout is defined as a state of continual physical and mental exhaustion; it can

result in workers being disconnected from both work and home because they don't
have enough energy for either. Dissatisfaction at the workplace, especially if
conditions can't be improved, can lead to burnout. Exhaustion and being
disconnected can increase the incidence of mistakes and accidents at both work
and home. A frequent complaint is that a job well done isn't recognized.
■ As a result of increased stress and burnout, a new personality type, type D, may be
emerging. A type D person is distressed and often exhibits certain personality traits
including negativity, pessimism, depression, anxiety, and loneliness, and a
decreased ability to relax and enjoy leisure time.
Home life and beyond

■ Pressures at home can include economic problems, marital discord, daily chores,
children's activities, ongoing adult education, and elder care. Responsibilities at
home need to be balanced with responsibilities at work
■ Leisure activity shouldn't be confused with sitting in front of the TV and tuning out.
Leisure activity is enhanced when we engage, explore, and are challenged in ways
that stimulate us, such as when we spend time with friends, work on hobbies,
perform volunteer work, or practice a spiritual life.
■ An autotelic personality describes someone who lives in the moment and can get
the most out of life, from work to leisure. To be more autotelic, practice setting
challenging goals that maintain your interest and excitement in life. Become
immersed in leisure activities by avoiding distractions such as TV. In other words, be
in the moment finding enjoyment, relaxation, and inner peace so that you literally
lose track of time. Relaxation and leisure activities may not come easily for
everyone—some of us may have to “work” at it—but in the long run, the balance we
achieve in our lives will be well worth the effort.
Self-awareness is key

■ Know who you are. Periodically evaluate yourself to be sure that you know your own
goals, desires, likes, wants, and needs. When you don't know who you are and what
you want, it's difficult to achieve balance, let alone happiness and inner peace.
When you assess and reevaluate yourself, readjust the demands of work and home
as much as you can.
■ Work and home life are both necessary, but they should be fulfilling and satisfying.
To achieve not only balance but also peace, fulfillment, and happiness in your life,
know yourself, take action, and maintain as much control over both work and home
as possible.