1. Witt, Catherine L.

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Why did you decide to be a nurse? Was it because you liked taking care of others? Were you interested in science or what made the human body work? Perhaps, you knew someone who was in nursing or another healthcare field. Maybe, it was because of the variety of opportunities in nursing: patient care, education, or research. Or, maybe, it was the simple fact that you would probably always be able to find a job, the flexible hours, or the idea of working 12-hour shifts. I suspect, for most of us, it was a mixture of these. Whatever the reason, you have probably discovered that nursing is more rewarding, yet much harder, than you anticipated.

Figure. Catherine L.... - Click to enlarge in new windowFigure. Catherine L. Witt

I recently read a reprint of an article that was originally written in 1962.1 I was fascinated and a bit dismayed to note that most of it applied to nursing today. The author discusses the shortage of nurses and spends a fair amount of time talking about the increasing costs of healthcare and the debate about whether healthcare is a right or a privilege. It is a bit disheartening to realize that we are still talking about this issue nearly 50 years later. She also talks about the advances of scientific knowledge and the need of nursing to keep up. Practice of nursing could not, and cannot be, simple because our jobs are not simple. Professional nursing requires a level of maturity and competence that can be accomplished only by taking our education and our jobs seriously.


Yet, I wonder how seriously we are taking our profession. Less than half of us belong to professional nursing organizations. Only a few of these attend professional conferences. Nursing organizations often have difficulty acquiring volunteers for committees, board positions, and other activities. Is your downtime at work spent designing an individualized care plan, researching your patient's disease process, or serving on a hospital committee? If you do not think these things matter, consider what it says in the Neonatal Nursing Scope and Standards of Practice published by the National Association of Neonatal Nurses (NANN).2 In addition to the usual standards of patient assessment, planning, implementing, and evaluating care, there are 9 standards for professional performance for neonatal nursing. These standards include things such as evaluating the quality and effectiveness of nursing practice (quality improvement committee anyone?). These include professional practice evaluations, meaning that we need to be seeking feedback and doing self-assessment of our practice on a regular basis, and being familiar with current standards of care. These include collegiality and collaboration with other team members. Ethics, research, research utilization, and leadership are also included.


All of these things should be considered job requirements. These are part of being a professional nurse. Assuming that you did not enter nursing merely to work 12-hour shifts or because you like to work on holidays, professional practice is what we should all strive for. If NANN standards are not enough to remind you of your responsibilities, consider the American Nurses Association (ANA) Code of Ethics for Nurses With Interpretive Statements.3 Provision number 7 states, "The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development."3(p22) This means contributing to nursing through activities such as leadership or mentoring roles, fostering a professional work environment, maintaining an intellectual curiosity with ongoing scholarly activities, and other contributions. Lest you think that because you are not a member of the NANN or ANA you are not responsible for living up to these expectations, you are. Ask anyone who has had to give a legal deposition. The first questions are often about which organizations you belong to and which journals you read and education offerings you have attended.


We did not, or should not, become nurses because it is a job that we can work a minimal number of days a week. We are nurses because we want to be a part of a profession that does everything we can to provide the best possible care to our patients and their families. We want to help students and new graduate nurses do the same. Patricia Benner defines an expert nurse as one who has a wealth of experience and an intuitive grasp of changes in patient condition. She also notes that experts teach, coach, are involved in quality improvement, seek knowledge, and manage their emotions.4 Not everyone becomes an expert, not because of lack of skill or knowledge but because of lack of effort and lack of desire. You are not an expert just by putting in time and being assigned the sickest baby in the unit. You become an expert because you are continually trying to do things better, to obtain new knowledge, and to share that knowledge with others.


Nursing does have a wealth of opportunities. There are endless ways to become involved, to grow, and to stay interested. Neonatology is an exciting field that changes constantly, and we cannot afford to be complacent and spend our days merely showing up and doing a good enough job with patient care. We have to contribute!! Next time that student nurse is standing at the desk hoping someone will agree to having a shadow for the day, step up. Volunteer for a hospital committee. Be a peer reviewer or write an article. Look something up. Vow to spend an entire shift without complaining about the nurse manager (unless you are willing to step up and do that job yourself). Nursing is a calling and is not for the faint of heart. Let us hope that in 50 years, a reprint of the same article will no longer be relevant.




1. Mullane MK. A glance back in time. Proposals for the future of nursing. Nurs Forum. 2000;35(4):41-45. [Context Link]


2. National Association of Neonatal Nurses. Neonatal Nursing Scope and Standards of Practice. Washington DC: American Nurses Association; 2004. [Context Link]


3. American Nurses Association. Code of Ethics for Nurses With Interpretive Statements. Silver Springs, MD: American Nurses Association; 2001. [Context Link]


4. Benner P. From Novice to Expert. Excellence and Power in Clinical Nursing Practice. Commemorative Edition. Upper Saddle River, NJ: Prentice Hall; 2001. [Context Link]