Professional Identity in Nursing Scale 2.0: A national study of nurses' professional identity and psychometric properties.

BACKGROUND: Professional identity is a relatively new concept in the nursing and health care literature. Using the definition of Professional Identity in Nursing (PIN) as its main construct, the authors developed and tested the second iteration of the Professional Identity in Nursing Scale (PINS 2.0) used to measure PIN from two perspectives, self and environment. PURPOSE: The purpose of this study was to evaluate the psychometric properties of the PINS 2.0. METHODS: To assess psychometric validity and reliability, a split-sample analysis was conducted. An exploratory factor analysis (EFA) was conducted on one half of the sample (n = 322) and a confirmatory factor analysis (CFA) was conducted on the other half of the sample (n = 312). Descriptive statistics were also performed and analyzed. RESULTS: According to the EFA pattern of parameter coefficients and CFA fit statistics (PINS-self: χ2(399) =1059.495, p < .001, CFI = 0.934, RMSEA = 0.072, SRMR = 0.032; PINS-environment: χ2(399) =929.019, p < .001, CFI = 0.946, RMSEA = 0.065, SRMR = 0.029), the PINS 2.0 shows adequate psychometric properties for measuring the concept of PIN with the following 4 constructs: 1) values and ethics, 2) knowledge, 3) leadership, and 4) professional comportment. Cronbach's alpha coefficients were: PINS 2.0-self = 0.97 and PINS 2.0-environment =0.98. CONCLUSION: We further advance the assessment of the psychometric properties of the PINS 2.0 to measure PIN from the perspective of self and environment.

A framework for transforming the professional identity and brand image of All Nurses as Leaders.

BACKGROUND: The professional identity and brand image of nurses as leaders have not kept pace with the roles and scope of contemporary nursing practice. PURPOSE: To provide a framework to transform the professional identity and brand image of nursing from a caring discipline to one of leaders. METHODS: A Consensus Development Workgroup (CDW) design was used between the International Society for Professional Identity in Nursing (ISPIN) and the Institute for Brand Image of Nursing (IBIN) to advance the concept of All Nurses as Leaders across all settings and the public domain. DISCUSSION: The goal is to occupy a position in the minds of all stakeholders that differentiates nursing in a manner that is positive, relevant, accurate, desirable, and consistent over time. CONCLUSION: Current outcomes are endorsements, evidence-based strategies, and a framework to deconstruct the current brand image and align it with the desired brand image of All Nurses as Leaders.

A Conceptual Model for Professional Identity in Nursing: An Interdependent Perspective.

The purpose of this initiative was to define the development, verification, and evolution of the conceptual model for Professional Identity in Nursing. This action research design occurred over two phases, utilizing observations, a modified Norris process for model development, and focus groups. Analysis consisted of conventional content analysis and the Fawcett method for conceptual model analysis and evaluation. The model was modified, and results are presented based on the model's philosophical underpinnings, content, socialness, and evolution. The model resonates with nurses both in the United States and internationally. The interdependency shown in the model encourages collaboration, accountability, and sustainability within the profession and society.

National Study of Nursing Faculty and Administrators' Perceptions of Professional Identity in Nursing.

BACKGROUND: Establishing a professional identity in nursing is integral to professional development, yet this area of inquiry remains understudied. PURPOSE: This segment of a multiphased national study measured nursing faculty's perceived level of importance regarding key components of professional identity in nursing using the newly developed Professional Identity in Nursing Survey (PINS). METHODS: Fifty subject matter experts from nursing education, practice, and regulation utilized the DeVellis scale development process to develop the PINS over the course of 2 years. Nearly 1200 nurse educators evaluated the importance of a 34-item scale relating to professional identity in nursing. RESULTS: At endorsement of 95% or greater, 28 items were found to be important components of nursing identity. Effective communication, integrity, and being trustworthy and respectful were reported as most important to nursing identity. CONCLUSIONS: Nurse educators identified the important items to assess professional identity in nursing. Item refinement and psychometric evaluation of the survey are the next phase of the multiphased study.

A think tank in action: Building new knowledge about professional identity in nursing.

A notable body of research regarding professional identity development and formation in nursing currently exists. Unfortunately, no one definition has guided a plan to build new knowledge within the profession. The think tank methodology used with professional identity in nursing has successfully brought together international leaders in education, regulation, and practice to begin to think, plan, study, and disseminate the findings of the professional identity in nursing initiative. This article briefly explains the state of the science regarding professional identity and discusses in depth a think tank methodology. This approach produced important outcomes about professional identity in nursing, showing how a well-constructed think tank offers clarity and an understanding about the next steps needed to build new knowledge and language within a discipline.

Advocating for Early-Career Nurse Innovators: Modeling the Institute of Medicine Report.

The Future of Nursing: Leading Change, Advancing Health was published by the of Medicine (IOM) of the National Academies in 2011. The Missouri Nurses Foundation and Missouri nurses modeled a sustainable project, the Early Career Nurse Innovator Project, exemplifying the intent of that report. The Missouri Nurses Foundation Executive Board comprises experienced nurses, nurse educators, nurses in other leadership roles, retired nurses, public members of the board, and administrative support staff. This article describes a project that was developed, implemented, and evaluated to recognize and encourage early-career nurses who have designed and led innovations to improve and promote the health of Missourians. Five of these early-career nurses were the recipients of monetary awards to encourage future innovations; the second recognition cycle is in the planning phase. Through the work of the Missouri Nurses Foundation, the scholarship of bedside nurses was recognized.

Breakthrough Thinking in Nursing Education: The Baccalaureate Big 5.

A deliberate emphasis on breakthrough thinking led to a radically new, evidence-based model for baccalaureate generalist nursing education known as the Baccalaureate Big 5. This semistructured brainstorming process then led to wider application in other settings, creating new nursing education and practice opportunities state wide and nationally. How this was accomplished and how it can be duplicated by others is the intent of this publication.

Senior student nurse proficiency: A comparative study of two clinical immersion models.

This study focused on identifying the best clinical learning model that would support nursing practice readiness following each immersion experience. Practicum preceptors completed surveys in which evaluated student preparation/readiness by assessing clinical knowledge, technical skills, critical thinking, communication, professionalism, management of responsibilities, and overall performance. The study results yielded no statistical significance when comparing both models. Future research is needed to analyze the impact of clinical hours offered in the senior immersion experience along with the curriculum content differences among various models of clinical experiences in undergraduate nursing programs to ensure practice readiness of nursing graduates.

The baccalaureate big 5: what Magnet® hospitals should expect from a baccalaureate generalist nurse.

The Association of Colleges of Nursing Baccalaureate Essentials outcomes in an organizing framework, called the Baccalaureate Big 5, can have a similar effect in clearly communicating the scope and expectations of baccalaureate generalist nursing education.

From the inside out: a new approach to teaching professional identity formation and professional ethics.

Professional identity formation is a dynamic process that begins in undergraduate nursing education and continues to develop throughout one's professional career. In recent decades, nursing educators emphasized the social dimension of professional identity formation in which professionalization is achieved through following rules, codes, and standards set by the profession. Character or psychological development and the proper use of virtues like integrity, compassion, or courage are often part of the hidden curriculum. The purpose of this article is to introduce a recently developed conception of professionalism that is grounded in virtue ethics and integrates both social and character development into a professional identity that is dynamic, situated, and lifelong. The conception is operationalized through the Framework for Nurse Professionals (FrNP) and the Stair-Step Model of Professional Transformation. The FrNP and the Stair-Step Model promote a robust and morally resilient professional nursing identity that will foster professional growth throughout one's career.

Baccalaureate outcomes met by associate degree nursing programs.

In a statewide study of nurse educators from nationally accredited ADN programs, 42 of 109 baccalaureate outcomes were reported met in their programs. Those outcomes clustered in 3 areas: information management and application of technology, professionalism and professional values, and generalist nursing practice. The 67 outcomes that were not met were in the categories of liberal education, organizational and systems leadership, evidence-based practice, healthcare policy, finance and regulatory environments, interprofessional collaboration, and population health. This research provides important evidence from which to construct an outcomes-based associate degree to baccalaureate curriculum.

Preparing nursing students to be effective health team partners through interprofessional education.

This article will provide an overview of recent significant activities related to interprofessional education to promote care quality through teamwork and collaboration, followed by a discussion of what nursing schools can do to develop the knowledge, skills, attitudes, and values to enhance health care team performance and care outcomes.

Of courage and leaving safe harbors.

If the health care system in the United States is to be sustainable, dramatic changes that result in better outcomes, lower costs, and improved quality are needed. As the largest group of health care providers, successful change will depend, in part, upon nursing practitioners, leaders, visionaries, advocates, and educators who are courageous enough to make difficult decisions and to follow through with actions. This philosophical inquiry addresses the nature of courage, types and motivations for courageous actions, and the complex psychological manifestations of thinking courageously. The inquiry concludes with educational and practical goals to promote proper use of courage in clinical practice.

The importance of being humble.

Scholarly work in philosophy, positive psychology, and other applied disciplines reconceptualize humility as an important element of reflection, change, and growth, but the change has not been mirrored in the nursing literature. Humility has a rich heritage and may be an implicit but fundamental construct in nursing. The value of humility for nursing education and practice rests in its conceptual basis for strategies that are currently being used. It is on the ground of humility that self-reflection, response to weaknesses and accomplishments, and our orientation to relationships should rest.

Nurses' responses to ethical dilemmas in nursing practice: meta-analysis.

AIM: This paper is a report of a study to explore nurses' responses to ethical dilemmas in daily nursing practice. BACKGROUND: Concern about nurses' ethical competence is growing. Most nurses perceived that there were barriers in their work environment to ethical practice, compromising their ability to perform ethically. Since most research focuses on contextual barriers to nurses' ethical practice, little is known about how nurses involve themselves in ethical decision-making and action in daily care. METHOD: A meta-analysis of nurses' ethical behaviour was conducted using data from nine studies in four countries (n = 1592 registered nurses). In all studies, the Ethical Behaviour Test was used to measure nurses' ethical responses, based on an adapted version of Kohlberg's theory of moral development. Data were analysed using random-intercept regression analysis. FINDINGS: All groups, except the expert group, displayed a uniform pattern of conventional ethical reasoning and practice. When nurses were faced with ethical dilemmas, they tended to use conventions as their predominant decision-guiding criteria rather than patients' personal needs and well-being. CONCLUSION: Conformist practice (following conventions rather than pursuing good for the patient) constitutes a major barrier for nurses to take the appropriate ethical actions, as creativity and critical reflection are absent. There is an urgent need to find ways to promote nurses' ethical development from conventional to postconventional ethical practice. More research is needed to strengthen existing empirical evidence.

Being a good nurse and doing the right thing: a qualitative study.

Despite an abundance of theoretical literature on virtue ethics in nursing and health care, very little research has been carried out to support or refute the claims made. One such claim is that ethical nursing is what happens when a good nurse does the right thing. The purpose of this descriptive, qualitative study was therefore to examine nurses' perceptions of what it means to be a good nurse and to do the right thing. Fifty-three nurses responded to two open-ended questions: (1) a good nurse is one who...; and (2) how does a nurse go about doing the right thing? Three hundred and thirty-one data units were analysed using qualitative content analysis. Seven categories emerged: personal characteristics, professional characteristics, patient centredness, advocacy, competence, critical thinking and patient care. Participants viewed ethical nursing as a complex endeavour in which a variety of decision-making frameworks are used. Consistent with virtue ethics, high value was placed on both intuitive and analytical personal attributes that nurses bring into nursing by virtue of the persons they are. Further investigation is needed to determine just who the 'good nurse' is, and the nursing practice and education implications associated with this concept.