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PubMed1983

What is a profession?

The Western world has long cherished the ideal and idea of professions, of groups who, because of the special nature of their activities, "profess" themselves dedicated to moral standards that oblige them to place the good of those they serve above their own self-interest. But for several decades this pristine ideal has undergone serious erosion, and the practical and moral consequences of this erosion for society are yet to be fully examined. Is there some justification for retaining the traditional idea of a profession? The author here argues that there is such a justification and that it can be found in the nature of the human needs the professions address and the human relationships peculiar to them. These are sufficiently distinct to warrant expectations of a higher morality and a greater commitment to the good of others than in most other human activities. The argument considers (1) the forces that have contributed to the erosion of the traditional notion, (2) what a true profession is not, (3) what distinguishes a profession philosophically from other activities, and (4) where in this schema the allied health and other "new" health professions fit.

Allied Health Personnel↗

PubMedDate not supplied

Nursing: profession in peril.

The number of nursing faculty experienced and skilled in research and scholarship is declining because of retirement and insufficient numbers of new scholars entering academia. This trend, alone, puts the future development of the nursing profession at risk. In addition, the increasing expectations placed upon the existing professoriate in the teaching and essential institutional service arenas necessitated by this shortage limit both the time and energy of senior faculty who are most qualified to advance the profession. The historical development of nursing as a profession is grounded in its affiliation with institutions of higher education that provided the support and opportunities for nursing scholarship. The viability of any profession is dependent upon the ongoing generation and dissemination of knowledge. In the current and predicted environments, nursing academic institutions and individual faculty must acknowledge the fundamental role of research and scholarship in the advancement of the profession and seek methods by which they can provide support. Strategies for institutional and individual action are offered so that the knowledge base of the profession will continue to develop.

Burnout, Professional↗

PubMed1988

Demographic profile of the veterinary profession in New Zealand, 1985.

The demographic characteristics of the veterinary profession in New Zealand are examined using information supplied by registered veterinarians to the Veterinary Surgeons Board in their applications for annual practising certificates in 1985. Comparisons are made with the veterinary professions in other similar countries, and with the medical and paramedical professions in New Zealand. In 1985 1308 registered veterinarians were working in New Zealand and 304 were overseas, whereas in 1976 the equivalent figures were 748 and 182. This represents an increase of 73% in the number of registered veterinarians in the last 10 years. Eighteen percent of veterinarians were female. The mean age of veterinarians was 38 years, but females in the profession were on average much younger (32 years) than males (42 years). Clinical practice provides employment for 70% of veterinarians: of these 59% work principally with farm animals and 41% with non-farm animals. The remaining veterinarians are employed by Government (22%), University (5%) and Industry (3%). The current demographic structure of the profession has been markedly influenced by the opening of New Zealand's only veterinary school at Massey University in 1963. Differences from other medical professional populations in New Zealand and overseas principally reflect the marked change in the number and sex ratio of graduates entering the veterinary profession since that time. It will take about another twenty years before the population reaches a stable age and sex structure, assuming that current graduation patterns persist throughout that period. Because the structure of the population is changing, considerable caution is needed in predicting future employment trends from data for a single year.

Journal Article↗

PubMed1996

The organization of clinical supervision within the nursing profession: a review of the literature.

There is a considerable amount of literature available on the subject of supervision within the nursing profession. However, there appears to be little structure regarding how this subject is organized within the professional literature. Thus, although the subject of supervision appears within the nursing literature as a fairly consistent theme, there has been little or no attempt by the profession to give structure to either its underpinning theory or its practice. It is apparent that the term 'supervision' within the nursing profession has different meanings for different individuals and groups. In an attempt to explore the literature relating to the United Kingdom, the author has developed a structure for the review, based upon his reading of the literature and his own experience within the profession. The review covers five areas. The first area is that of examining the need for clinical supervision within the practice of nursing. The second area of the review identifies the various ways in which the concept of supervision is used in practice, particularly identifying the variety of terminology. The third area of the review is that of the profession's perception of good practice regarding supervision. The fourth area of the review seeks to identify various models of supervision as they are used within the nursing profession. Lastly, the preparation and training for the role of supervisor is reviewed.

Clinical Nursing Research↗

PubMed2004

Aggression towards health care staff in a UK general hospital: variation among professions and departments.

BACKGROUND: Aggression towards health care staff is an increasing problem and although many studies have examined psychiatric settings, few have considered general hospitals and in particular, variation among professions and locations. In addition, studies often fail to include all forms of aggression such as threatening behaviour and verbal aggression. METHODS: This study extends existing research by evaluating physical assault, threatening behaviour and verbal aggression from patients/visitors towards general hospital staff in the context of different professions and departments. RESULTS AND CONCLUSIONS: The survey of staff showed that aggression is widespread. Within the preceding year, 27% of the respondents were assaulted, 23% experienced threatening behaviour from patients and 15.5% experienced threatening behaviour from visitors. Over 68% reported verbal aggression, 25.7% experiencing it more regularly than monthly. By departments, over 42% of the medical department staff, 36% of the surgical staff and over 30% of the Accident and Emergency staff were assaulted. By profession, staff nurses and enrolled nurses reported the most assaults (43.4%) and doctors, the fewest (13.8%). Other nursing grades and health care professions all reported levels of physical assault in excess of 20%. Correspondingly high levels of threatening behaviour and verbal aggression were also reported although the patterns of victimization differed according to the various professions and departments. Independently, significant levels of assault, threatening behaviour and verbal aggression were reported. When aggregated they demonstrate the higher levels of victimization that general hospital staff experienced on a regular basis. RELEVANCE TO CLINICAL PRACTICE: Institutional averages actually obscure the much higher levels of aggression experienced by the particular professions in particular departments. This study helps to localize the problem and identify those at most risk, but more research is needed into the aetiology of the aggression and of vulnerability factors associated with victimization.

Adaptation, Psychological↗

PubMed1992

Creative achievement and psychopathology: comparison among professions.

This study was designed to determine (1) whether members of the 8 "creative arts" professions (i.e., architects, artists, musicians, composers, actors/directors, essayists, fiction writers, and poets) display greater rates of psychopathology than members of other professions, and (2) whether a significant relationship exists between creative achievement and mental disturbance. The final study sample (n = 1,005), constituting 18 separate professions, consisted of all appropriate individuals whose biographies were reviewed in the New York Times Book Review over a 30-year period (1960 to 1990). The results, in their entirety, suggest (a) that different patterns of psychopathology, if any, tend to be associated with different professions and at different periods in individuals' lives, (b) that different professions are associated with different levels of creative achievement, and (c) that certain types of psychopathology are associated with creative achievement across all professions.

Achievement↗

PubMed1991

Prospects and problems of women sanitarians justifying their inclusion in the environmental health profession: the Nigerian situation.

THE HISTORY of the Nigerian political arena, has vindicated the great political impact made by Nigerian women. This Nigerian 'Women Impact Continuum' did not terminate with the achievement of political independence 30 years ago. The inclusion of Nigerian women in what was hitherto men's special profession has already begun to yield tremendous fruitful socio-economic development dividends. Contemporary Nigeria is witnessing the emergence of a spectrum of women achievers who have excelled in their various professions. Women in the Environmental Health Profession may not be an exception. The paper opines that if the current 'women impact continuum' permeates the Environmental Health Profession female sanitarians could justify their inclusion in the Profession, if: (i) there is strength in their number; (ii) the Federal Government grants the Environmental Health Profession a statutory Regulatory Board; (iii) Women Sanitarians are given opportunities for in-service training; and (iv) the women's wing of the Association is recognized and integrated into the National Council of Women's Societies (NCWS) of Nigeria and shown a sense of belonging by the Better Life Programme for Rural Women (BELPRW).

Environmental Health↗

PubMed1994

Education and the health professions: explaining policy choices among the states.

Recent calls for restructuring of the nation's health care system have highlighted the deficiencies in the current system of education for the health professions. Of particular concern are the dominance of specialization and hospital-based training and the tendency of new health care providers to settle in communities without substantial health needs. The states are the key actors in reforming health professions education, serving as a primary funding source for health professions schools, chief licensors and regulators of health professions, regulators of private health insurance, key providers of Medicaid, and architects of a variety of subsidy and regulatory programs providing incentives for health professionals to choose specialties and locations for practice. This article provides a taxonomy of state policies affecting health professions education reform and classifies the states according to the choices they have made. Findings show that few states take advantage of their policy options across the four policy types and that most tend to concentrate their efforts on a few policies--ignoring potential means of encouraging more primary care providers in underserved areas. Results from regression models explaining state choice of policy adoption highlight the political nature of policy choice and the highly variable nature of state response in health professions education reform.

Education, Medical↗

PubMed1992

Struggle and revolt in the Spanish health policy process: the changing role of the medical profession.

Many changes have taken place in the professional status and political role of the Spanish medical profession during the process of construction of the health care system (1940-1990). There is a strong correlation between the different characteristics of the several phases of construction of the national health care system and some of the changes in the status, organization, and political activity of the medical profession. The democratic transition coincided with changes in the orientation of the system brought about by financial imperatives, which forced readjustments in the survival and political projects of the profession. The creation of a democratic regime has allowed the medical profession to create its own independent mechanisms of interest representation and has given rise to a process of negotiation of the new political relations (and their mechanisms) between the State and the profession. The last 15 years have witnessed important transformations in some parameters of the profession, in its political organization, its political role, and its relation with the State.

Attitude of Health Personnel↗

PubMed2006

Task transfer: another pressure for evolution of the medical profession.

Since the 1960s, Australian society and the medical profession have undergone enormous change. Our society has moved from a relatively homogeneous and conservative community, supported by limited government services, to one that is multicultural, focused on the individual and consumerism, and supported by extensive government programs, with health care a top public and political priority. A defining feature of contemporary society is its mistrust of institutions, professionals, public servants and politicians. The medical profession has changed from a cohesive entity, valuing generalism and with limited specialisation, to one splintered by ultra-specialisation and competing professional agendas. The medical workforce shortage and efforts to maintain the safety and quality of health services are putting acute pressure on the profession. Task transfer or role substitution of medical services is mooted as a potential solution to this pressure. This has the potential to drastically transform the profession. How task transfer will evolve and change medicine depends on the vision and leadership of the profession and a flexible pragmatism that safeguards quality and safety and places patient priorities above those of the profession.

Australia↗

PubMed1999

Images within the allied health professions.

The purpose of this study was to identify the perceived images, understanding, and respect shared by employed members of six allied health professions and to determine the nature and extent of interactions these professions share as members of the hospital team. The results indicate a large variance in levels of understanding and respect among the professions. Most responded that they understood the other professions but the other professions did not understand them. The results also indicate that the professions interact on an average of no more than five hours per week, with their common interactive roles being peer relationships.

Allied Health Personnel↗

PubMed2002

[Choice of the profession and work satisfaction among nursing students from the Medical University of Gdansk].

The choice of the future profession is very important to every young person. The influence of this choice on future occupational satisfaction is significant. In the paper there is presented the connection between the choice of nursery profession and achieved occupational satisfaction. The material was based on information gathered by anonymous questionnaires. The whole group of second year students of Nursery Faculty of Medical University of Gdańsk were interviewed by the questionnaire. For 60% of them the choice of the profession was not done accidentally. The evaluation of motives for selecting the nursery profession and its influence on future occupational satisfaction were studied. The tendency of changing the profession according to the way of work was also analyzed. The results indicate the differences between achieved occupational satisfaction and the tendency of changing the profession depending on motives of taking up the studies. The results do not allow to estimate the quality of work of particular groups but can be the introduction of following more thorough research.

Adult↗

PubMed1979

Women in the health professions.

There is a very great diversity at international level with regard to the percentage of women in each of the three professions considered. As time goes on, however, this diversity appears to be slowly diminishing, partly as a result of an overall rise in the rates. Apart from a few cases, of which the most striking is that of physicians in the USSR, the proportion of women in the health professions increased, sometimes considerably, during the 1960s. In most cases, this growth was dependent on the following processes: --after the age of 50, the number of women at times declined less quickly than that of men, perhaps as a result of excess male mortality, --after the age of 35 and up to the age 50, the number of women in some cases declined less quickly than that of men, in particular as a result of a return to the profession by mothers once their children had grown up, --under the age of 35, the number of women in almost all cases increased much more rapidly than the number of men. The first two of these three processes were only of secondary importance, and in some cases, indeed, of no importance. The third was the one with the most pronounced effect on overall growth in the degree to which women were represented in the three professions considered by the study. This degree did not seem at any given time, to be linked to the proportion of members of the profession in the population (as expressed by the ratio of members of the profession to the population) nor to the proportion of women in gainful occupation (expressed as the female activity rate) nor to the national level of economic development (expressed as the national per capita income). It did, on the other hand, appear to be directly affected by each country's own policy decisions and academic traditions.

Dentists, Women↗

PubMedDate not supplied

Higher education and health professions education: shared responsibilities in engaging societal issues and in developing the learned professional.

Higher education and, in turn, health professions education are being buffeted by a multiplicity of external and internal forces. Issues related to fiscal constraints, higher education's crisis of values and the teaching/research and educational outcomes dilemmas are explored. The increasing accountability of higher education by its public, including measures of institutional effectiveness exacerbate these forces. Health professions education programs and their parent universities and colleges must take better advantage of their respective resources and become united around central educational paradigms and outcomes. The ability of higher education and health professions education to engage and connect to societal issues is critical to the appropriate education of the student and to institutional survival. By interweaving the philosophy and culture of the university or college setting in the fabric of health professions education and particularly dental education, an environment could be created that results in a true learning institution. That is, one in which students and faculty learn together in all settings. The outcomes of such engagement are shared responsibilities and the creation of the learned professional, one who is connected to the world and is not trapped by parochial knowledge. Thus, the continuum of health professions education transcends technical and cognitive achievement but addresses core societal values as well. This paper then explores some of the factors impacting upon higher education and assesses their influence on the nation's health professions schools, and, specifically, colleges of dental medicine.

Education, Dental↗

PubMedDate not supplied

Is dental hygiene a profession? A literature review.

From a literature review of theories of professionalism, the historical development of the attributes of a profession are discussed. This paper then discusses various theories of professionalism and specifically examines the extent to which the criteria developed by Greenwood are fulfilled by dental hygiene. Greenwood's model, which discusses certain attributes that a profession should possess, is selected to provide a broader model to analyze the current professional status of dental hygiene. Greenwood's model states that a profession has acquired: 1) systemic theory, 2) authority, 3) community sanction, 4) ethical codes, and 5) a culture. The author will conclude by suggesting possible steps the dental hygiene profession could continue to take to acquire these attributes and thereby recognition as a profession by other professions, governments and the public.

Canada↗

PubMed2000

Guidelines in professions allied to medicine.

BACKGROUND: Clinical practice guidelines aim to reduce inappropriate variations in practice and to promote the delivery of evidence-based health care. OBJECTIVES: To identify and assess the effects of studies of the introduction of clinical practice guidelines in nursing (including health visiting), midwifery and other professions allied to medicine. SEARCH STRATEGY: We searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE (1975 to 1996), EMBASE, Cinahl and Sigle to 1996, the NHS Economic Evaluations Database (1994 to 1996), DHSS-Data (1983 to 1996), the Database of Abstracts of Reviews of Effectiveness (1994 to 1996) and reference lists of articles. We also hand searched the journal Quality in Health Care, made personal contact with content experts and contacted libraries identified by an expert panel. SELECTION CRITERIA: Randomised trials, controlled before-and-after studies and interrupted time series analyses of the introduction of interventions comparing 1. Clinical guidelines plus dissemination and/or implementation strategies versus no guidelines; 2. Guidelines plus dissemination and/or implementation strategies versus guidelines plus alternative dissemination and/or implementation strategies; and 3. (post hoc) Guidelines used by professions allied to medicine versus standard physician care. The participants were nurses, midwives and other professions allied to medicine. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed study quality. MAIN RESULTS: Eighteen studies were included involving more than 467 health care professionals. The reporting of study methods was inadequate for all studies. In all but one study, nurses were the targeted professional group; one study was aimed solely at dieticians. The various behaviours targeted included the management of hypertension, low back pain and hyperlipidaemia. Nine studies were identified for comparison 1. Three out of five studies observed improvements in at least some processes of care and six out of eight studies observed improvements in outcomes of care. Only one study included a formal economic evaluation, with equivocal findings. Three studies were identified for comparison 2 but it was difficult to draw firm conclusions because of poor methods. Six studies were identified for comparison 3 (post hoc). These studies generally supported the hypothesis that there was no difference between care given by nurses using clinical guidelines and standard physician care. REVIEWER'S CONCLUSIONS: There is some evidence that guideline-driven care is effective in changing the process and outcome of care provided by professions allied to medicine. However, caution is needed in generalising findings to other professions and settings.

Allied Health Personnel↗

PubMed2002

[Psychiatry as a profession].

With reference to Max Weber's timeless analysis of science and politics as a profession, the present paper describes the philosophical background and historical development of the tasks and tools, institutionalization, and socialization of psychiatry as a profession. In the mid twentieth century, psychiatrists' emergence from ideological confinement in asylums, where they were separated from urban culture and medicine in general, finally allowed them to benefit from accumulating knowledge and technological progress in the field of medicine. After its transition from a custodial to a therapeutic discipline, psychiatry has acquired a variety of new fields of action and duties that require a high degree of expertise on psychological and biological levels. At the same time, people have increasingly come to expect relief not only from disease, but also from manifold problems of everyday life. As a consequence, there has been an inflationary growth of professional psychiatric and psychotherapeutic and nonprofessional services. The professional requirements that psychiatrists should meet have also increased quantitatively and qualitatively in the wake of the historical change from a caring, paternalistic attitude towards the mentally ill to a therapeutic partnership. To a greater degree than physicians working in other medical fields, psychiatrists get personally involved with their patients. As a consequence, the mental burden of their profession is at times immense. For this reason, the ethics of a medical profession has special implications for psychiatrists. The fascinating advances in therapeutic methods, neurobiological knowledge, and the increasingly differentiated diagnostic tools, e.g., noninvasive investigation of the morphology and functioning of the brain, have turned psychiatry into one of the most interesting contemporary professions. Psychiatry is now facing an enormous challenge of meeting the standards of expertise.

Biological Psychiatry↗

PubMed1982

Oaths given by U.S. and Canadian medical schools, 1977: profession of medical values.

Ninety-four percent of U.S. and 63% of Canadian medical schools administered an oath to their graduating students in 1977. This making a 'profession' of the values of the medical profession has undergone a continuous and striking increase since at least 1928. The only factors which may be related to a U.S. school not giving an oath are its being located in a North Central State and its having a large number of basic science doctoral students (perhaps a reflection of the school's commitment to basic science research). It is argued that it may be legitimate to consider that those values which are more frequently noted in the oaths are those which are held to be more important than those which are less frequently mentioned. Based on this assumption, a comparison of the oaths given in 1958 with those given in 1977 suggests that there has been a decline in the importance that medical schools and/or graduating students hold certain values which have been traditionally ascribed to physicians-in-service-to-others (e.g. confidentiality, welfare of patient, and avoidance of injury) while at the same time there has been no change in the importance of values associated with physicians-in-relation-to-the-medical--profession (e.g. concern with the status of the physician and respect for teachers). This, then, raises the possibility of there existing the interesting paradox that, although at this level of the medical profession, the profession is talking more, they are promising less.

Canada↗