Nursing concepts: competence, compassion, professionalism

There are different views on the concepts of nursing. Nurses can have the same views on nursing concepts as patients do with only slight difference. But overall the concepts of competence, professionalism, and compassion are viewed very similarly between the nurse and patient interviewed for this paper. Competence plays a key role in the quality of patient care. Compassion is a basis of nursing that expresses empathy towards patients, and professionalism can sometimes be based on behavior or values. Both nurse and the patient recognizes the need for these three concepts in the nursing field to better provide a better health care environment for both individuals.

Nursing has four main concepts upon which it’s based open; client, health, environment, and nursing. Within these four basic concepts are a variety of nursing concepts ranging from ethics, religion, nurse’s role and many others. Though there is a long ongoing list, many of the concepts are viewed differently or similarly among nurses and patients.

Upon reviewing the experience of a patient and a nurse, I have found both individuals had the common concepts of competence, professionalism, and compassion. The patient expresses the need for the nurse to be competent, professional, and compassionate. However the nurse’s experience demonstrates her compassionate attitude, professionalism and competency. Altogether both individuals recognize the importance of the three components in nursing care, as will be discussed further in the paper. Brief Analysis of Interviews

E. J is currently an ER Nurse Educator who values being a competent nurse.

Her typical work schedule involves making sure everyone in the ER is functioning at high competence levels. Competence in the viewpoint of E.J is having continuous knowledge, and an education to be an effective nurse.
Patient J.A also views competence as an important aspect of nursing. She felt competency is apparent in the interaction between the patient and nurse and creates a lack of confidence and discomfort. However, for the patient being competent not only constitutes medical knowledge but also having experience both as a nurse and a patient as well. A competent nurse effectively creates a comfortable environment for the patient while caring for them physically is the approach taken by J.A. Moreover being culturally competent was also an important component from J.A’s substantial point of view. While being competent is important, both the nurse and patient responses revealed professionalism as another important concept in nursing. However the nurse appeared to have more concerns about a nurse’s professionalism than the patient. Maintaining practice expertise for the nurse also coincides with professionalism is one aspect perceived by E.J. J.A identifies being friendly, appropriately addressing patients’ needs, and correctly performing tasks as characteristics of a professional. Both individuals recognized the need for professionalisms at the basic level but the nurse view point takes in consideration of ethical principles and required standards that nurses should have.

Nurse Relation

As both individuals describe what was rewarding or memorable about their experiences, a common concept noted was compassion. E.J exhibited compassion while J.A received compassion during her care. Through her responses, E.J views compassion as a willingness to go the extra-mile to help others and always have a willingness to help even when out of context. Similarly, J.A characterizes compassion as having empathy and truly caring about her well-being and outcome. It involves the nurse doing everything within her power to help the patient without being judgmental. For J.A, compassion is treating the patient in the same manner as the nurse would treat herself or her loved ones, if in the same situation. Overall, being competent, professional, and compassionate can have similar meanings to the nurse and the patient, with slight differences. As mentioned above, R.N. E.J.’s competency is primarily the education and knowledge obtained to successfully carry out nursing tasks. However in J.A’s point of view, competence is simply more than just academic education. The nurse is aware of the professional boundaries that the patient themselves may not be fully aware of. For example the patient may perceive the friendliness as part of being a professional, while it might not full in line with the professional ethics of nursing. The importance of competence for the nurse is revealed when describing her daily tasks and role as a nurse educator. E.J states that daily tasks during his shift involves creating educational media, and assuring the staff in the ER department remains up to date on the many competencies required of the nurses such as consciousness sedation. He ensures the staff has the certifications necessary for the department. Making sure the nurse is knowledgeable and provides appropriate care for each patient is a key component. When describing the effects of being a nurse on her professional life, E.J recalls experiencing the death of a patient during her time as a pediatric nurse. E.J was caring for an infant 2 months old with a heart defect from birth, which whom was scheduled for surgery.

However, on her next shift the once laughing baby became lifeless as the parents held the baby in their arms. Despite resuscitation efforts, the baby did not survive. E.J (Personal Communication, November 4, 2012) notes that often, “maintaining a level of professionalism is associated with not showing emotion around patients”, but in this scenario tears flowed down her cheeks and shared in the parents’ sorrow. For E.J (Personal Communication, November 4, 2012) “expressing that bit of emotion was a way of providing emotional support, and care which are components of professional nursing. E.J served in the military as a nurse and being able to travel coincides with compassion and use of her professionalism. On her account, the proudest she’s ever been about being a nurse was the ability to work with the humanity combat ER trauma unit. She traveled to Haiti with a reserve unit to treat and advise the citizens residing in the country’s capital Port-au-Prince. Despite knowing she would have to sleep in tents surrounded by poverty and leave her paying job, she was willing to step out of her comfort zone, and “lend a helping hand” to others in need. She states “every opportunity or chance she gets to take care of someone is a proud moment in her nursing career. E.J’s response demonstrates how the concept of compassion can and should in most cases be the driving force behind nursing care.

Patient’s Relation

Similar to the Nurse, the patient’s experience with the concepts were mostly positive. After being involved in an auto mobile accident, J.A (Personal Communication, November 4, 2012) was admitted to the hospital and doctors “discovered I had a mitral-stenosis valve” and needed a valve replacement. Therefore she had to be admitted for open heart surgery. During her stay at the hospital, which lasted almost two weeks, J.A recalls the surgeon going over the procedures with her carefully. The surgeon and nurses made sure she was aware of her options, and knew what to expect with each course of action she decides to take. Patient’s description and passionate voice as she talks denotes that she trusted the nursing staff and surgeon’s judgment and had confident in them, for they displayed a good level of competency. Furthermore J.A shares how every morning the surgeon would come to her room to share news on her progress. Professionalism is being emphasized as the patient recalls that the nurses really took priority in making sure she knew and understood what was going to take place. The health care team properly instilled veracity as part of what it means to be a professional nurse. Moreover, the nursing team was very friendly and valued her beliefs, as J.A is SDA (Seventh-Day Adventist) .She does not eat pork and one of the replacement valves offered was made with pig fat. The nurses that not withhold that information to her, but was made aware of it, so she was given the option to choose another valve made out of plastic.

Also the nurses “were more than willing” to pray with her and cater to her spiritual needs even though they themselves may not have been spiritual. “Their openness to participate in my belief in God is one aspect that helped with my full recovery”, states J.A(Personal Communication, November 4, 2012). Lastly, J. A recounts a stressful situation in which she encountered while being under the care of nurses. Each night during her hospital stay the nurses would randomly awaken her to check her blood pressure. Also she noted that on one occasion the nurse was unable to locate her veins while trying to draw blood. The nurse continuously tapped her arm and stated, “You have very tiny veins”. This response shows the patient view of the nurses’ lack of professionalism and competency. Ending the interview, J.A describes what she believes characterize a good nurse. According to her, a good nurse listens to your ailments, and pays attention to what the patient says. When the nurse listens to the patient, it is important since it allows the patient to feel they are a factor in their recovery and feel more comfortable being in the hospital environment. The nurse being able to accommodate the patient base on what they need physically, emotionally and spiritually, overall supports the idea of a nurse’s professionalism, competency and compassion from J.A’s view point.

Competence Nursing Article

The nursing article by Brazil K. et al focuses on the concept of competence used in care provided in long-term care homes for the elderly. It is a study to test knowledge and perceived competency among the RNs and a few LPNs as well. Lack of competence in skills such as pain management, advance care planning, care and adequate care has increased the death rate among older adults in the LTC homes (Brazil et al 2012, 77). Often this lack in competency is due to education in training of staff, and “absent communication problems among healthcare providers and family members”. The latter has resulted in bad “quality end-life care” (Brazil et al 2012, 77). The nurses were competent with coping skills of “dealing with death and dying but lack formal training in palliative care” (Brazil et al 2012, 77). This coincides with the same ideas present through the nurse educator E.J and patient J.A idea of competence. As here there is a need for continuous update of education to make sure that the nurses have current knowledge. Moreover the idea of needing cultural competence identified in the patient’s point of view is essential as well, for the nurses were not communicating successful with the relatives of the patient or the other healthcare providers. Being competent in communication skills is as import as competence in clinical skills. Though other factors acknowledged in the study, prove to contribute to difficulties in providing the necessary care, “staff competence in that field served as the major determinant in assuring quality care” (Brazil, Brink, Kaasalainen, Kelly, & McAiney, 2012, p. 79). Factors that affect or may influence “effectiveness of continuing education” to increase competency can also be important as discussed in the article (Brazil et al 2012, 79). Overall competency involves more than just one skill, and is often a major concept needed in all nurse weather Pediatric, emergency room, or home health care. However one must not overlook the fact that competency develops over time as more experience is gained. Competency also implies or portrays the importance of the concept of evidence-based nursing research, so that we can enhance the competency of nurses with new and better applications. Demonstrating competency or excellence is also a function of professionalism.

Professionalism Nursing Article

According to this article there are two aspects of professionalism in, “value-based’ and “behavioral-based”, needed to “support values and ideals” (Castell 2008, p.13). Professionalism in Nursing Practice by Francesca Costell (2008) compares and contrast the different views based on the aforementioned aspects. The value basis is principles that underlie what it means to be nurses while the behavioral basis are the behaviors “one must exhibit to act professionally” (Castell 2008, p.17). She further divides value based into the categories of clinical competency (excellence), humanism, and altruism. Behavior-based was also divided into Service and ethical conduct. From behavioral stand point, castell believes that humanism is a component of professionalism because the “interaction is vital for guiding the medical profession” (2008, p.13). As E.J mentioned above, showing your human side shoes respect for the patient and “signals the worth of the individual human being and his or her belief and value system” (2008, p.13). Castell view on professionalism coincides with E. J point of view as both acknowledge the need to sometime show emotion to connect with patients. Castell’s incorporates a key aspect of professionalism, ethical conduct. An unethical clinical example mentioned is of a student nurses preparing to care for an elderly patient and the experienced nurses’ warned of his obnoxious behavior and rudeness. This was an unprofessional as Castell believes “this could have compromised the care the students gave”, as it “form pre-conceived ideas” into their minds and would now care for him based on those ideals (Castell 2008, p.15). J.A as well identified this key ethical component of professionalism for she believed the nurse should carry out the appropriate care that is mandated of her. In general the core idea of being professional is acting “without being prejudice” and carrying out your duties as a nurse which can sometimes include displaying the humanistic side to provide efficient care.

Compassion Nursing Article

Exploring Compassion accredits Christianity with incorporating compassion into nursing care. Compassion in early nursing was from a Christian point of view and then became part of contemporary nursing. According to Straughair (2012), A nurse’s strive to alleviate the suffering of the sick is through the use of compassion (161). Failing to provide compassionate nursing care is failing to meet the required professional standards. Evidence shows that lack of compassion results in poor quality care on the part of the patient, and indicates a “disregard for their dignity” (Straughair, 2012 p.162). A lack of compassion affects the quality of healthcare as a whole whether the nurse is clinically competent.


Though all three concepts are interdependent of each other they function together as a whole along with many other concepts make nursing or nurses a success. Being competence itself consists of many sub categories as it is important to be competent in many skills or aspects as a nurse and not simply one. Competency as discussed in the paper is more than knowledge or cognitive skills and encompasses culture, communication, and many others of the like. Likewise professionalism has two facades as it can be mediated by values or behavior in the nursing feel. Even though the nurse and patient may have had slightly different views for each concept, it all came together to form a basis idea. Furthermore being compassion is the basic framework of nursing as it is having the genuine care for someone and showing patients empathy. It is treating others as you would treat yourself. Caring for patients with compassion can have a lasting impact on patients in help in a speedy recovery.


It is important for me as I progress through my nursing practice to remember that my competency level has to reach beyond simply checking off assessment on a checklist, or a test. As I will come across patients or situations of different nature, culture and need to be able to use skills that will cater to the specific situation or need at any given time. Competency in one area neglects to fulfill the needs of the patient overall and decreases quality of care. The same principle can be applied to professionalism, as I have to know what action is appropriate for nursing professional at any given time. But also judge whether my professionalism should be based on value or behavioral. This choice will be made base on what’s best for the patient, me, as well as others involves safety and well-being at the time.


Brazil, K., Brink, P., Kaasalainen, S., Kelly, M., & McAiney, C. (2012). Knowledge and perceived competence among nurses caring for the dying in long-term care homes. International Journal Of Palliative Nursing, 18(2), 77-83.

Castell, F. (2008). Professionalism in nursing practice. Nursing Journal, 1213-17.

Catalano, J. T. (2012). Nursing now: today’s issues, tomorrow’s trends (6th ed.). Philadelphia, PA: F.A. Davis Co.

Straughair, C. (2012). Exploring compassion: implications for contemporary nursing. Part 1. British Journal Of Nursing, 21(3), 160-164.

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