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Reply to this person in 250 words Alethea Clarke Feb 23 11:43pm | Last reply Feb 23 11:44pm Reply from Alethea Clarke The Millers Wheel of Professionalism is a framework developed by Barbara Miller to help nurses understand that behavior is essential to nursing professionalism, aside from simply holding a license. In the center of the wheel is labeled education and a scientific background in nursing, which represents the foundational knowledge of nurses, such as school and clinical learning. Deviating from the center of the wheel are eight spokes representing the activities and characteristics that maintain or expand it nursing. Each spoke of the wheel represents a specific behavior that nurses develop as they gain experience in practice. One important component of professionalism is ethical practice. The first spoke that will be discussed is the code of ethics for nurses. This is represented by nursing ethics, such as patient confidentiality/ HIPAA and advocating for their patients. In a novice nurse, this may look like following the rules and ensuring they uphold HIPAA. In a seasoned nurse, this is understanding why a patient is receiving certain care, making sure the care is appropriate for the condition, and advocating for the patient. In addition to ethical behavior, professionalism also involves clinical reasoning and evaluation of care. Theory: development, use, and evaluation may present in a novice nurse as completing tasks, following care plans exactly, and documenting what happens(Cao, 2023). An experienced nurse, however, evaluates whether the interventions worked, changes the care plan, reflects, and makes appropriate adjustments. For example, if a patient has pressure sores, a novice nurse may follow what was taught in nursing school by turning the patient every two hours and documenting it. An experienced nurse would also turn the patient every two hours but then evaluate if it helped the pressure sore. If skin redness is still present, the nurse would seek alternatives such as a pressure mattress or a nutrition consult to promote healing. Professional nursing also extends beyond the hospital setting and into the community. In the case of community service orientation, this refers to what nurses do for the community and how care extends beyond bedside treatment exhibiting altruism and care (Cao, 2023). For example, a novice nurse may attend a health fair with the hospital to fulfill a requirement. On the other hand, an experienced nurse may actively contribute to the community by volunteering to give vaccines, educating patients about disease prevention, and promoting healthy behaviors among patients. Another part of professionalism is maintaining competence through continued learning. Continuing education and competence describe the transition from learning a skill to mastering and understanding why the skill is performed. A novice nurse may know the step-by-step instructions on how to complete a skill safely but may not know how to respond if complications arise. An experienced nurse is more comfortable in the situation, attends additional training to further competency, responds effectively in emergencies, and recognizes early problems with the patient. Nurses must commit to lifelong learning through continuing education, self-study, and ongoing skill development in order to maintain competence and provide safe, effective patient care(Cao, 2023). As nurses gain competence, they also develop independence in decision-making. I think self-regulation and autonomy show one of the clearest differences between a novice and experienced nurse. A novice nurse often calls the provider for reassurance before making decisions. An experienced nurse uses clinical judgment and acts immediately to stabilize the patient safely. For example, if a patients oxygen saturation is falling below 93%, a novice nurse may call the doctor and ask what to do. An experienced nurse would first place the patient in Fowlers position, apply 2 liters of oxygen in nasal cannula, reassess oxygen saturation, document the interventions, and then notify the provider with an update and recommendations. Professionalism is not limited to bedside care but also involves contributing to the profession itself. Professional organization participation shows a shift from benefiting individually from the profession to contributing to the profession. Novice nurses may join professional organizations for job opportunities, requirements, or personal growth. An experienced nurse actively participates by attending conferences, serving on committees, and mentoring other nurses. Communication skills are another essential part of professional nursing practice. A novice nurse provides necessary discharge instructions and communicates primarily to complete assigned tasks. A seasoned nurse communicates based on understanding and emotional needs. The seasoned nurse educates families, may mentor students, and collaborates with the healthcare team. Finally, professionalism requires nurses to base care on research and proven practices. Research and the use of evaluation reflects evidence-based practice. Evidence-based practice allows nurses to provide care based on the best available research rather than outdated practice. The implementation of evidence-based nursing interventions improves patient safety and clinical outcomes (Cao, 2023). Therefore, engaging in evidence based practice show professional responsibility and supports the nurses role as a healthcare advocate. Cao, H., Song, Y., Wu, Y., Du, Y., He, X., Chen, Y., Wang, Q., & Yang, H. (2023). What is nursing professionalism? a concept analysis. BMC nursing, 22(1), 34. 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