新的要素：护理专业的思考和发展机会

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When asked to describe nursing, what image comes to mind? Some may say caring men and women who help in times of need. Others may point to Florence Nightingale or more currently, our pandemic heroes. Others may think that one must wear scrubs to be a nurse—nurse educators, administrators or community-based nurses are not “real nurses.”

Take a few minutes to consider why you became a nurse, and what attracted you to this profession. Is there a disconnect between what you hoped to do and what you can actually do? Or perhaps the more important question to ask is if the connection remains between who you thought you would be as a nurse and your current state of being as a nurse. These thought-provoking questions and time for reflection do not happen enough but are important to consider.

As a profession, nursing can clearly articulate our skills and knowledge, by passing a national licensure exam and requisite clinical skills prior to graduating from an accredited curriculum. We check the boxes of an established body of knowledge, accreditation, licensure standards, self-regulation, commitment to lifelong learning and established ethical principles that are the hallmarks of a profession as cited by Greenwood (1957). We can now turn our focus from proving nursing is a profession, to further advancing our professional identity. The inclusion of Domain 9: Professionalism in AACN's (2021) The Essentials: Core Competencies for Professional Nursing Education and the move to competency-based education can certainly help us move forward with fostering our professional identity. However, identifying as a nurse and a competency-based education is more than just completing a checklist. We cannot simply check a certain number of boxes from each Essentials Domain and proclaim “I am a nurse.” This is an opportunity for and-both: we are skilled professionals AND knowledge workers. It is time to more clearly articulate to ourselves and others, what nursing is, AND what nurses do.

One beauty of nursing is the wide variety of roles, practice areas, and specialties, but this diversity also brings challenges in articulating the identity of nursing to ourselves and the general public.

We cannot expect the public to understand our profession if we ourselves have trouble describing nursing. As a profession, we cannot claim what we cannot name, and it is time that the profession of nursing claims their proper identity. Simply said, nursing is in the midst of an identity crisis.

Establishing a professional identity is a developmental task. As a professional discipline, nursing is relatively young, viewed as a profession separate from medicine in the early 1900s (American Nursing History, n.d.). So, this identity crisis is not unexpected. Think of your adolescent years, and the many different identities you tried on until you found the best “fit.” Nursing has progressed from physicians' handmaids and an apprenticeship model taught in hospital wards to an accepted member of the academy, with rigorous degree expectations and a theory-based body of knowledge. Our profession has developed over time; now it is time to advance our professional identity. Fully utilizing competency- based education is one way to accomplish this goal, but not if we hold tight to our previous ways of educating future professional nurses. We can, and must accomplish the deep, inter-connected learning espoused by the Essentials, AND maintain currency in skills and knowledge. Our new Essentials allow the fluidity and expansiveness to prepare students to do well on licensing exams, AND in the practice settings while learning to articulate our individual and collective professional identity.

What is professional identity in nursing? It is the “sense of oneself, and in relationship with others, that is influenced by characteristics, norms, and values of the nursing discipline, resulting in individual thinking, acting and feeling like a nurse” (Godfrey & Young, 2020, p. 363). These signposts are the glue that hold our profession together and that make a nurse a nurse, regardless of setting, education, or role. It is time to make these aspects, often considered part of the hidden curriculum, extant and visible, for those learning the profession and for those in practice.

The pandemic has challenged nursing in many ways. It also presents us with the unique opportunity to strengthen our professional identity. Historically, the public identifies nursing as the most trusted and respected profession (Gallup, 2022). With that trust and respects comes a responsibility to continue developing as a profession. Developing an individual identity is not an easy or quick process, and it comes with growing pains. However, the time is now for our profession to mature and self-determine their professional identity. The International Society for Professional Identity in Nursing (2022) (www.kumc.edu/ispin), and the new Essentials (AACN, 2021) can foster and facilitate this process. How will you contribute to working through our identity crisis and advance the profession of nursing?

全文翻译（仅供参考）

当被要求描述护理时，你会想到什么样的形象？有人可能会说，有爱心的男人和女人在需要的时候提供帮助。其他人可能指的是佛罗伦萨·南丁格尔（Florence Nightingale），或者目前更为流行的英雄。其他人可能认为，要成为护士，必须穿上磨砂服。护士教育工作者、管理者或社区护士不是“真正的护士”

花点时间思考一下你为什么成为一名护士，以及是什么吸引了你从事这个职业。你希望做的事和你实际能做的事之间有脱节吗？或者更重要的问题是，你认为你会成为一名护士，而你目前的护士状态之间是否存在联系。这些发人深省的问题和反思的时间不够，但值得考虑。

作为一个专业，护士可以通过国家执照考试和必要的临床技能，在从认可课程毕业之前清楚地表达我们的技能和知识。我们勾选了Greenwood（1957）所引用的作为职业标志的知识体系、认证、许可标准、自律、终身学习承诺和既定道德原则。我们现在可以将注意力从证明护理是一种职业转向进一步提升我们的职业身份。在AACN（2021）的《要点：专业护理教育的核心能力》中纳入领域9：专业精神，并转向以能力为基础的教育，无疑可以帮助我们培养职业认同。然而，识别护士和基于能力的教育不仅仅是完成一份清单。我们不能简单地从每个Essentials Domain中勾选一定数量的方框并宣称“我是一名护士”。这是一个机会，也是一个机会：我们是熟练的专业人员和知识工人。现在是时候更清楚地向自己和他人阐明什么是护理，护士做什么了。

护理的一个优点是角色、实践领域和专业的多样性，但这种多样性也给我们自己和公众阐明护理的身份带来了挑战。

如果我们自己难以描述护理，我们就不能指望公众了解我们的专业。作为一个职业，我们不能声称我们不能说出的名字，是时候让护理专业声称自己的身份了。简单地说，护理正处于身份危机之中。

建立职业身份是一项发展任务。作为一门专业学科，护理相对年轻，在20世纪初被视为独立于医学的专业（《美国护理史》，新泽西州）。因此，这场身份危机并非出乎意料。想想你的青春期，以及你尝试过的许多不同身份，直到你找到了最“适合”的人。护理已经从医生的女佣和在医院病房里教授的学徒模式发展到了被认可的学院成员，有着严格的学位要求和基于理论的知识体系。我们的专业随着时间的推移而发展；现在是时候提升我们的职业身份了。充分利用以能力为基础的教育是实现这一目标的一种方式，但如果我们坚持以前培养未来专业护士的方式，那就不行了。我们能够而且必须完成精要课程所倡导的深度、相互关联的学习，并保持技能和知识的流通。我们的新Essentials使学生能够在驾照考试和实践环境中表现出色，同时学习表达我们的个人和集体职业身份。

什么是护理专业认同？正是“自我意识以及与他人的关系，受到护理学科的特点、规范和价值观的影响，导致个体的思维、行为和感觉像一名护士”（Godfrey&Young，2020年，第363页）。这些路标是将我们的职业结合在一起的粘合剂，使护士成为护士，而不管环境、教育或角色如何。现在是时候让这些方面，通常被认为是隐藏课程的一部分，对那些学习该专业的人和那些在实践中的人来说，都是现存的和可见的。

大流行在许多方面对护理提出了挑战。它还为我们提供了一个独特的机会，以加强我们的专业身份。历史上，公众认为护理是最受信任和尊重的职业（盖洛普，2022年）。有了这种信任和尊重，我们就有责任继续发展自己的职业。发展个人身份不是一个简单或快速的过程，它伴随着成长的痛苦。然而，现在是我们的职业成熟和自我确定其职业身份的时候了。国际护理专业身份学会（2022）（www.kumc.edu/ispin）和新要素（AACN，2021）可以促进和促进这一过程。你将如何帮助我们克服身份危机，提升护理专业？

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