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Nursing professionalism begins with you

By: Luci Bostain, MSN, RN-BC

All nurses are responsible for maintaining the public’s trust.

The public consistently ranks nursing as the most trusted profession. Maintaining that trust requires that nurses engage in professional behaviors of attitude, education, certification, mentoring, and advocacy. Let’s take a closer look at each.


Regardless of what’s happening in your life, you must remain positive and focused on caring for patients and their families. Failure to do so jeopardizes patient safety but also reflects poorly on the nursing profession. Years ago, nurses were required to recite the Nightingale pledge to publicly confirm their commitment to maintain the profession’s high ethical and moral values. The pledge is short and to the point, and the last sentence speaks volumes: “I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and family affairs coming to my knowledge in the practice of my calling, with loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.” Although some of the words are outdated, the meaning is clear: Nursing is a calling, not just a job; to answer that call, you must be dedicated to serve.

A more current guide is the American Nurses Association Code of Ethics for Nurses With Interpretive Statements (the Code), which clearly and concisely states nurses’ ethical responsibilities. These provisions state your commitment to society and yourself as well as your responsibility to maintain a professional appearance. I urge you to read the Nightingale pledge and to familiarize yourself with the Code.


Evidence indicates that nurses have the biggest impact on achieving high-quality patient outcomes, and that bedside nurses with at least a bachelor’s of science in nursing (BSN) further strengthen that impact. My personal experience illustrates how each step in my education path prepared me to confidently meet my patients’ needs.

I began my nursing education over 30 years ago. I started in an associate degree program that I had to leave due to illness. I then entered a vocational program and after completion practiced as a licensed vocational nurse. About that time, the nursing shortage was beginning and my role changed depending on supply and demand; one day I might be starting I.V.s and performing assessments and the next day only RNs could perform those duties. I decided to return to school to get my associate’s degree.

I was content in my career after that and didn’t plan to return to school. That all changed about 10 years ago when I was a charge nurse on a medical/surgical unit in a rural hospital. I loved my job, but as I began supervising more new graduate nurses with BSNs and new charge nurses were required to have a BSN, I knew I needed to return to school. My only regret is that I didn’t do it sooner. Getting a BSN has helped me do my job better in many ways, but three stand out:

  • As a charge nurse, one of my responsibilities was attending patient care rounds and advocating for patients. Many of the professionals from other disciplines participating in rounds had a minimum of a bachelor’s degree. After I got my BSN, I felt better prepared to advocate for my patients and collaborate with other team members.
  • Evidence-based research. Applying evidence-based research into bedside practice can help nurses achieve good patient outcomes. A BSN program should provide nurses with the skills they need to properly conduct research, analyze it, and apply it into practice.
  • Healthcare understanding. Getting my BSN has helped me better understand how healthcare organizations function. I don’t want to be a nursing manager, but the classes I took on healthcare finance and nurse budgeting have given me insight into how my organization works so I can better meet my patients’ needs.

Many affordable options are available to earn your BSN. Most can accommodate busy schedules, and your organization may offer some tuition assistance.


After I got my BSN, my nurse manager encouraged me to become certified as well. I thought that with 25 years of nursing under my belt (10 as a med-surg nurse) I knew everything there was to know. But when I took the practice test, I found out I had more to learn. So I began studying and now know a few things I wish I’d learned earlier in my career.

The most important reason to become certified in your area of nursing practice is the validation of specialized knowledge, which provides you with more tools to better serve patients. According to Yoder, taking the initiative to become certified demonstrates a nurse’s commitment to lifelong learning and strengthens the profession’s reputation. Certification also provides personal satisfaction and professional growth. Not all organizations offer reimbursement for certification, but the satisfaction you feel when you include your certification with your name may be worth the cost.


All nurses are teachers, not only to our patients but also to new nurses entering the profession. Both the Nightingale pledge and the Code state that the nurse has a responsibility to advance and sustain the profession. Experienced nurses serve as role models for new nurses, and that responsibility must be taken seriously to preserve the profession’s integrity. Leading by example is the most effective way to mentor other nurses and includes embracing and leading change, maintaining an open and positive mindset, and helping peers whenever you’re able.


You can take different roads to advocacy. Becoming a member of state and national nursing organizations is one. Many nurses question the value of membership, but remember, decisions about your practice and patient care are largely determined by local, state, and federal legislation. Most of the legislators making these decisions rely on nursing organizations to provide input. As a member, you can provide frontline knowledge to ensure legislation is in the best interests of patients and nurses.

But political involvement isn’t the only road to advocacy. Collaborate with other disciplines to meet patient and family needs or serve on committees working to improve care quality and the workplace environment at your organization.

Preserving professionalism

To preserve the nursing profession’s reputation, every nurse should be vigilant in the behaviors of attitude, education, certification, mentoring, and advocacy. The most important role of any nurse is to promote their patients’ health and protect their safety. That responsibility is enormous, but it’s obtainable when we maintain the professionalism nurses are known for.

Luci Bostain is a charge nurse on a progressive care unit at Baylor Scott & White Medical Center – Brenham in Brenham, Texas.


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Watson J. Advocacy every day. Texas Nursing Magazine. 2019:5.

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