Beyond Nurse Residency

Professional Identity in Nursing with Dr. Nelda Godfrey

• Nicole Weathers, MSN, RN, NPD-BC • Season 2 • Episode 2

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In this episode, we explore the concept of professional identity in nursing with Dr. Nelda Godfrey. Dr. Godfrey shares her insights on how professional identity is formed through education, residency programs, and reflective practices. She discusses the importance of intentional support for new graduate nurses, the role of language in defining professional identity, and strategies for fostering growth and leadership. The episode also covers the impact of social media on nursing perceptions and future trends in integrating professional identity into nursing education. Dr. Godfrey's extensive experience and research provide valuable perspectives on helping nurses develop a strong professional identity to thrive in their careers.

GUEST: Nelda Godfrey, PhD, ACNS-BC, RN, FAAN, ANEF, is Professor and Associate Dean, Undergraduate Programs and Department Chair for Family, Community and Health Systems at the University of Kansas School of Nursing, Kansas City, KS.  A thought leader in nursing innovation and nursing education, Dr. Godfrey writes often on new care delivery models that can be influenced by a stronger emphasis on the nurse within—researching and developing strategies to create the whole person experience in nursing practice going forward. Her work with the International Society for Professional Identity in Nursing is transforming the way nurses, health care professionals, and society understand what it means to “think, act, and feel like a nurse.”  This work offers new language and knowledge for the journey—helping nurses heal, flourish, and expertly care for others.

Email ispin@professionalidentity.org to ask to be part of the e-news distribution list!

Supporting nurses is our priority. Visit https://nursing.uiowa.edu/ionrp to explore our resources for new graduate nurses and beyond.

Nicole Weathers:

You're listening to the Beyond Nurse Residency podcast, an educational series where we interview experts on all topics related to the transition of new graduate nurses into practice and beyond. I'm your host, Nicole Weathers, director of the Iowa Online Nurse Residency Program. Thanks for joining us. Let's jump in.

Nicole Weathers:

As I reflect back on my first year as a nurse, I remember countless times when I ran into a problem or had a situation that needed attention and my first thought was I should get the nurse, only to be hit with the sudden realization that that was me, like anyone new. It took me some time to really begin to feel like those letters RN behind my name actually belonged there. This experience is common for nurses as they enter practice. Feeling, thinking and acting like a nurse doesn't happen overnight. It's part of the continuous growth and development that begins in academia and continues throughout a nurse's career.

Nicole Weathers:

In this episode, we will be discussing the concept of professional identity in nursing, what it is, where it came from, how it benefits individuals and organizations alike, the role of nurse residency programs and, ideally, some emerging trends for the future. My goal for this episode is for our listeners to walk away with a clear understanding of the concept and how nurse residency programs could be a catalyst for developing professional identity in the new graduate nurse. Today I have with me Dr Nelda Godfrey. While I've had the opportunity to hear about Dr Godfrey's work in this area, I only just had the opportunity to meet her this past fall and I am incredibly honored to have her here with us to share more about this topic. So, dr Godfrey, hello. How are you today?

Dr. Nelda Godfrey:

Well, I am just fine and please call me Nelda and I'm very happy to be here with you and with your listeners.

Nicole Weathers:

Excellent. Well, why don't we start off by having you tell our audience a little bit about yourself?

Dr. Nelda Godfrey:

Sure. So my name is Nelda Godfrey and I'm the Associate Dean for Undergraduate Programs and Department Chair for Family, community and Health Systems work at the University of Kansas. University of Kansas School of Nursing is a Tier 1 research-intensive university and I'm very proud to work there with fine colleagues and students. I've been involved in working with undergraduate student education for oh many decades and also I'm one of those nurses who always loved doing bedside care. So under my belt I have somewhere around 20 years full or part-time working directly with sick people in hospitals Pretty traditional in that regard. So my pleasure to be here with you.

Nicole Weathers:

Well, it is so great to get to see you again. I know we were at a conference here in August. That was the first time I got to hear you speak about the concept of professional identity in nursing and that's when I kind of had this realization that I think you'd be a perfect guest to have come on our podcast, because I really do believe that this topic is going to be instrumental in moving our profession forward. You know, I first encountered your work probably back in 2020, 2021.

Nicole Weathers:

We were in the midst of redesigning our nurse residency curriculum and I believe I kind of stumbled upon this concept and I had reached out to Dr Joseph here at the University of Iowa and she had sent me some of these articles that you guys have written about professional identity and nursing.

Nicole Weathers:

And as I read through these articles, it was kind of like I had the realization that this was something that I didn't necessarily have the language for for a long time, but it was kind of this concept of like we just really needed more nurses to embody this idea of being a nurse, I guess. And it was really like. Like I said, I don't think I had the language to really know what it was that I was talking about, but I could kind of see it, as I was working with new graduate nurses, that a lot of them were missing. Whatever this component was, why don't you first maybe start off by giving us a little bit of a history on professional identity? How did it first come to be? Who was involved as it began to emerge in our profession?

Dr. Nelda Godfrey:

Sure, thanks so much. Well, the fact is that nursing our discipline is a very old function, old action, but it is a very young academic discipline and you mentioned not having enough language that we need. See, I think that's a subtext in this that we just don't. We are a young academic discipline. We do not have as much language as the discipline of psychology or medicine or law or clergy has. We haven't been around that long and we haven't put together the words that have the meaning that we need. So I would argue that we have to look at other disciplines and see whether they have anything to offer.

Dr. Nelda Godfrey:

And I can tell you that when you look back in the 1990s to the STEM disciplines science, technology, engineering and mathematics the professors in those areas realized if they did not do something to actively embody the professional identity formation of the students, the students would leave the major and go find something else because it was hard. Does this sound familiar for nursing? They also found that if it's not there in the work environment, if there's not somebody who picks up what the mantle of what it means to be a professional, to be an architectural engineer in a work environment or to be a mathematician, then you get lost and you go do something else. I mean we have to have this grounding in professional identity formation for us to grow. So it is a term that is new, so it really didn't appear much until the 90s, as I would say, and then early on, the medicine and other health professions started to pick up on this. So if you look at the medical literature you'll find that there is 25 years of research about professional identity formation and that grew very quickly from that to respiratory care, to pharmacy, to occupational therapy, physical therapy, speech therapy, and our partner disciplines in healthcare knew all about this and had been forming it and thinking and wrestling with it since the early 2000s.

Dr. Nelda Godfrey:

And part of the reason is I'll go ahead and explain this part of the reason is there are 152 medical schools in North America. You can get every dean in every medical school in the same room. There are 277 physical therapy programs in North America. You can get all of those people in the same room. But there are just short of 3,000 practical nursing and registered nursing programs in this country and you can never get everybody in the same room. Country, and you can never get everybody in the same room. So here we are turn the clock ahead to 2018 and nothing had been done in our field. We were left standing behind the door.

Nicole Weathers:

Well, I mean, I don't like to think of the nineties as being that long ago. So even even though it's it's really new to nursing, I mean it's still seems to me, in the scheme of things, like a newer concept.

Dr. Nelda Godfrey:

Oh, I think so. I think it is a newer concept overall. But if you would talk to pharmacists, physicians, occupational therapists and physical therapists, pre-pandemic and post-pandemic, you would find that our colleagues in these other disciplines were more whole following the pandemic than we were. And I would argue, as a researcher, as a philosopher in this area, I would argue that the acknowledgement and development of professional identity was a real key.

Nicole Weathers:

That's very interesting and I hope you tell us more about that. So let's so. You began research back in. You said 2018. So now that we know sort of where it started, let's talk more about the concept. So can you define professional identity and nursing?

Dr. Nelda Godfrey:

for us, this came out of a think tank that 50 people invited from all over the US came together and decided what the definition of professional identity in nursing would be, how you would describe it. Professional identity is described, defined as a sense of oneself in relationship with others that is influenced by characteristics, norms and values of the nursing discipline, resulting in an individual thinking, acting and feeling like a nurse. So that's too long to remember. But if you think about it as what does it mean to think, act and feel like a nurse? Any of us who live through the pandemic I keep going mean to think, act and feel like a nurse. Any of us who lived through the pandemic I keep going back to that. But any of us who lived through the pandemic, we know that that was at risk. In all of those situations, how does one think, act and feel like a nurse going forward? Because things were pretty rough? So that is actually part of the definition that was used by medicine. So we're borrowing all over with this and that's okay because we are healers and we have not quite situated ourselves as healers yet. But I think the day will come where nurses acknowledge that they are healers in the vast scope of what people need.

Dr. Nelda Godfrey:

In that think tank that we did in 2018, not only did we gather, so here's the composite we had equal amounts of people from regulation, practice and education. In nursing we almost never get a group like that. Usually you go to a group of educators or a group of practice people or a group of regulators. This was evenly distributed and we had a representative from every major nursing organization. We had undergrad students and graduate students and everyone had a voice and the whole think tank was done to gather the voice and in the group, I can remember the facilitator standing up in front of the group and saying, okay, we've got a definition. So what are the domains of this thing called professional identity in nursing? And they determined they iteratively determined that those four areas are values and ethics, knowledge, nurse as leader, and comportment. So values and ethics is not hard to imagine and knowledge is such a keystone, key cornerstone of what we do Nurse as leader. What's interesting about that for the practice people who are listening is our colleagues in practice said you can't call it leadership because you're only a leader if you have a formalized role. Well, those of us in education and with a broader view recognize that's not true at all. So we changed the term to nurse as leader, because all nurses are leaders and you're starting to see this show up in our language, in our ANA documents. All nurses are leaders.

Dr. Nelda Godfrey:

And the fourth area is called comportment, which is not necessarily a word we use a lot, but comportment means the professional behavior and how one's actions, one's words and one's presence. And just to give you an example, I told you I was a traditional nurse. So that would mean I would float the house when I would work part time at the medical center and if I would go on to a nursing unit for eight hours or 12 hours, I know because I know the listeners to this would say the same thing. I know that even on a 48 bed unit, I could change the tone of that unit in 8 to 12 hours. I could do it because we have that superpower. We nurses can change our environment. We can change how patients interact with us, how patients react to us. We've got that ability.

Dr. Nelda Godfrey:

So comportment is in fact that, and I don't think we've paid nearly enough attention to it, because it's really a superpower that we have. So, defining it, which is what you asked about, I've told you the definition think, act and feel like a nurse. And then the domains of this are values and ethics, knowledge, nurse as leader, and comportment. So I think, as you're listening to this, you're holding that up to the light, sort of, and saying, well, you know, that doesn't make sense, and what we have done is tested this with hundreds now hundreds of thousands actually, of people, of nurses, and these four domains hold. Moreover, we've been able to develop an instrument that measures values in ethics, knowledge, nurse as leader and comportment, and all four of those subscales hold, and this is an instrument that's now available for all nurses everywhere. That's quite an accomplishment.

Nicole Weathers:

Like I said, when I first learned about this, Dr Joseph had sent me some different articles and I printed them all off and I've got all my notes here right and I remember reading through this and looking at the different you called them domains right Of professional identity, and you know, next to the idea of values and knowledge, nurse's leader and professional comportment, writing that identity drives behavior.

Nicole Weathers:

So the way I sort of visualize it in my own brain is my values, my strengths, my knowledge are going to drive how I show up as a nurse, right, Whether I show up as a leader, how I carry myself as a nurse when I'm out there taking care of patients. Leader, how I carry myself as a nurse when I'm out there taking care of patients. And so it it makes so much sense, I think, when you spell it out in this way, Because we would say this about any type of behavior right, If I identify as a healthy eater, I'm going to eat healthier at the end of the day, and so I think that this really gives us, I think, some structure around this missing language, as I said at the beginning, of how we can maybe begin then to help our new nurses develop the professional identity, a stronger professional identity, I should say. So what are some things that we can do on the front end to drive the behavior that we want to see in the practice setting?

Dr. Nelda Godfrey:

Good. Thank you so much for that. Well, one thing I think we have to draw back to the term about conversation, about language, because as you look at the other disciplines, we fell behind in another area. We still pick up a very tired word and we try to use it, and that word is professionalism, and it doesn't help us. The definitions of it from an academic viewpoint do not help us. What the research says does not help us. It is a word that has to do with a much broader range. So let me give you a very simple example. We could put 30 nurses in a room, around the edge of the room, and we could ask them to say tell me what it means to be professional as a nurse, and everybody would say something. We'd all nod and we'd smile and we'd get done with that group of 30 and we still would have no common language. So we're bereft of the kind of language that we need. Further, today's undergraduate student, which matters to a number of us, new grads you talk about new grads. Their understanding of that word is nil. There is not an understanding of that term professional. We have a more diverse workforce. People don't know what in the world that means, and so it's useless.

Dr. Nelda Godfrey:

In fact, I would advocate dropping it. I think we need to go with professional identity formation as the philosophical root of this, follow our other colleagues in other disciplines and call it professional identity, because what our research shows us is that a strong professional identity makes all kinds of difference in a nurse's performance, in being in a safe work environment, in caring safely for patients and in caring for themselves. So we really need to bang the drums and get to this, because a feeling of being in a deficit position is not good for anyone, especially for our patients. So I think it's a bereft nature of a word that doesn't really help us, and I can guarantee you the 18 to 22 year olds don't have a clue what we're talking about when we talk about this. So we better bring them a new word or a new phrase that they can grab onto a little bit more and use. The second tiny story I will tell is that any time I have a chance to talk to a registered nurse or a licensed practical nurse about professional identity, give me five minutes, because in that five minutes, without question, every nurse I talk to knows exactly what I'm talking about and why. I don't have to go any further. They know that it's necessary, they know that it's needed, they know that it's a thing and they know that they want it.

Dr. Nelda Godfrey:

The big void is how. The big void is how? Well, clearly, we have to bring this to people's awareness. You don't know. You don't know a word until you don't know a word. Right, I mean, you don't know it until you're in a situation where people are using words you don't know and you're like, oh, what are they talking about? So we have to bring this forward and we have to make it part of our fabric. We need to use some common words that came out of the work we did. Those four domains for the next several years is we did a definition of each of the four domains, we did key elements, we created competencies, we created exemplars, we created videos and plays and ways to explain it. Again, when you're talking to registered nurses, they get it. They get what this is nurses, they get it.

Dr. Nelda Godfrey:

They get what this is. They just don't know how to provide it for others.

Nicole Weathers:

So when we talk about what comes to mind for you, what comes to mind for you when I say that, so instantly I'm like, what do I need to be doing in our nurse residency program?

Nicole Weathers:

Because I think you know you come from academia, you know this is something that I think and maybe not, but I think in maybe our undergraduate programs, maybe faculty, are a little bit more intentional about helping to grow this in students, in students, but I don't know that that is necessarily happening in such an intentional manner once they arrive in practice.

Nicole Weathers:

I think a lot of times leaders think that it just happens by osmosis, that just with experience, eventually you'll be able to get there and you'll be able to think and feel and act like a nurse. But we know that we can't wait for osmosis to make it happen, right, that we need to be intentional because we need them to develop this quicker than if we just leave it up to chance. So I would love to pick your brain here. You know, specifically when it comes to new graduate nurses and the development of professional identity, first is, maybe what are some challenges that new grads face as they're entering practice with this professional identity formation? And then where do you see residency programs coming into place. Are there specific actions that we could be taking to help these new grads?

Dr. Nelda Godfrey:

Sure, sure, thanks. Well, the challenges are real and anyone who's listening again to this podcast knows that these challenges are very real for new people coming in. It's also real in other disciplines. Let's not forget that there is a learning curve, a very steep first year learning curve, for people who become elementary teachers and are managing a classroom of 20 kids and figuring out what to do. Or engineers on their first project with another mentor engineer, but really it's their work that they're doing.

Dr. Nelda Godfrey:

This is always a challenge to begin this. So it's the fact that it's tough that first year. It's tough for every new graduate that comes out. So I think we should kind of link arms and act like we're all going through that same thing. One of the things you will find in those other disciplines or law or clergy, or I can think of all kinds of other ones is they have people that shepherd the new grads and say, oh well, yeah, you're working really hard, but let's take a little time here or let's evaluate what's going on.

Dr. Nelda Godfrey:

Or reflection is a very important tool and I find in our busy practice environments we don't leave enough time for reflection.

Dr. Nelda Godfrey:

So I don't know the intricacies of the nurse residency program you work with Nicole, but I would bet you dollars to donuts that you need to think about a little bit more reflection, because this is tough, this transition is tough. An extra added thing for nursing is that we come to the table knowing we could hurt some other human being, and that's a big fear. I think we don't pay enough attention to what that's like for people and we probably need to provide more reflection and support. As a result of that, I had someone ask me, after I'd shown the research that we'd done on nearly a thousand nurses, about what the failure to form a strong professional identity yielded, and this nurse, who's probably 50, said I'm looking at your diagram and this makes perfect sense to me. I see this every day. I see this every day. What can we do? Well, my answer to her was what do we nurses always do we provide support. So if we've got institutional structures that fail to provide us the opportunity to provide support to people, we need to recraft our institutional milieu.

Nicole Weathers:

So you're talking about what happens if we don't develop a strong professional identity, and you said that you had an experienced nurse that says well, this makes perfect sense. I see this every day, but maybe you can explain to our listeners a little bit about that diagram that she was looking at and what does happen if we fail to help new graduates develop this.

Dr. Nelda Godfrey:

Well, there's a failure to form a value system, there's a failure to feel supported, there's a failure to develop confidence, there's the sense of anxiety, bullying, poor work environment, ineffective delivery of care, harm to patients, harm to nurses. You can hear my themes in that, and these are themes that we've heard and themes that some of your listeners have experienced. So, not so surprising, but we need to think about oh, you could call it a vaccine, I guess, or fortifying. Somehow we need to come in the door with a stronger sense of professional identity in nursing.

Nicole Weathers:

Well, and some of those problems that you talked about. So you know, adverse events, bullying in the workplace, lack of confidence, anxiety at work these are things that we are constantly working to, you know, create solutions to fix right or avoid. And so it's interesting that if a lack of professional identity leads to these things, if maybe the solution, instead of creating one more tool, one more process, one more policy, one more, whatever it is, is the solution actually going back to the beginning or preemptively focusing on this professional identity formation, and some of these other challenges could work themselves out, or maybe not completely or 100%, but maybe they wouldn't be the challenge that they are today.

Dr. Nelda Godfrey:

Nicole, if you and I had all the time in the world, I would love to play with this.

Dr. Nelda Godfrey:

What if we put together language that would reflect a strong professional identity in nursing and language that reflects the failure to form a strong professional identity in nursing?

Dr. Nelda Godfrey:

So I'm going to throw some phrases out at you and see whether you think that they might fit so in the failure to form a strong professional identity.

Dr. Nelda Godfrey:

Perhaps it is the oh, I'm sorry, oh I didn't think of that, oh I forgot that, oh, I need to do a better job, or it's not speaking up, or it's treating people socially instead of professionally. It's where our language goes versus. So what if, instead of saying oh I'm so sorry, you said indeed, or good to know, or we talk about our nursing discipline as an indeed a discipline in the academy and in practice, and we talk about the patients for whom I care rather than my patients or my students, we take the pronouns out and quit making it so personal, when in fact it's a professional endeavor, that we use words like values and ethics and knowledge, and nurse as leader and comportment, and we think about how to embody those things? I think addressing language issues might be something that would be so interesting to figure out. So tell me what you think about that. You and I haven't talked about this yet, but I'd love to know what you're thinking.

Nicole Weathers:

Well, I mean, when you start talking about how much language matters, I 100% agree with that, and I remember I don't know if it was a article or something, maybe out on LinkedIn that I had read about how language matters, and one of the terms that comes up for me over and over and over again is this concept of not in practice, of non productive time, right? So anytime we're providing education, we're doing professional development, going to meetings, whatever, we classify that as non productive time, and in my brain, I would argue that non productive time is when the most production really happens, right, Like if it wasn't for non productive time, we would be stagnant forever, we would never become better, we would never make change, we would never do any of these things. And so I 100% agree with the idea that language does matter, and we do need to be very intentional about the language that we use when we're talking about our profession.

Dr. Nelda Godfrey:

Yes, I think it's critical, and I'm going to point to one area that, in those four domains, is particularly critical and new, I guess, is this idea of nurse as leader. For some reason it's not something, it's not the mantle we put on as nurses to think of us as leaders. And yet if you have ever been the patient or the loved one of a patient in a healthcare system, you know how much power and influence and leadership is exerted by any licensed nurse in the environment, by any licensed nurse in the environment. So we need to be adopting that as much as we can.

Nicole Weathers:

Well and that's something that we really hit on with our new grads is the idea of being a nurse. If we're working at the bedside, you know leading from the bedside and what does it mean to be a nurse leading from the bedside? You might not have that formal leadership title right, but that does not mean that you aren't a leader and you have the opportunity to identify problems, suggest solutions, become a part of the committees and the work groups that are working to actively improve the care that you're providing. It's not somebody else's job. The person who's closest to these problems at the bedside. They are the ones that are going to probably be closest to the solution, and so we need to really begin to empower our new grads to see themselves in that light, and I think this idea of nurse as leader is really kind of again the language for that concept that we're really trying to work on with our new grads.

Dr. Nelda Godfrey:

There's a lot going on in the literature and in the research literature about nurses brand image and it is tied tightly with the idea of nurse as leader. So if any of your listeners would like to engage in this, search out nurse as leader in Nursing Outlook and perhaps some other journals, because there's a lot going on and this is an action that a nurse could take on his or her own that could lead to quick and tangible results Because people who are at the bedside, they get to see the fruits of their labors every single day. If you, that nurse, would start to embrace this idea of nurse as leader, you would be profoundly impressed with how much power you would have in the practice environment if you started to use this more effectively. This is yours to lose.

Nicole Weathers:

So talk to us a little bit about this brand image that you brought up.

Dr. Nelda Godfrey:

So Judy Godsey, from now at University of Kentucky, has worked with a business professor who is highly skilled in how to develop a brand. So, like for Pepsi or any product, how do you develop a brand? And what their research has shown is that the public does not see nurses as leaders. They see them as caregivers and competent and lots of other things, but not as leaders. And then, in extension of that, they've done extensive research with nurses. Nurses want to be seen as leaders because they know what kind of power they wield in these environments. The environments, though, in turn, do not foster that.

Dr. Nelda Godfrey:

So, you know, sometimes we're dead in the water as far as moving that forward, but I think it's so much more. I mean, we cannot depend on our institutions to define us. For heaven's sakes. We need to figure out how to build that leadership skill as a new grad.

Dr. Nelda Godfrey:

As a new grad and I remember doing that I remember working really hard to work with some of our top surgeons that I was working with in my first year out of school to develop credibility and the ability to communicate and anticipate for what their patients needed, and I was able, as many of you know, to gain great respect, and it formed the rest of my career. So it can all be done in that first job and in that first year. If you step forward and say I am knowledgeable in this. I don't know everything, but I am knowledgeable and I can bring this forward from a care perspective. And secondarily, I would mention, I do remember when I would talk with physicians about what was needed and realizing that I was asking them for things that had to do with nursing and not medicine, so they of course wouldn't respond. I'm thinking, wait a minute, this is in the nursing domain. I need to be making sure this happens. They don't. That's not their thing, it's my thing and I need to mobilize that.

Nicole Weathers:

But I do think somewhere along the way and I've said this before, I think as a new grad especially, I didn't necessarily see myself as a leader. I saw myself as somebody who was there to carry out the physician orders. Truly, and looking back, that's very sad. I think that that was kind of like I'm here to do what the doctor tells me to do. But I don't think I'm probably alone in thinking that, especially as a new nurse.

Dr. Nelda Godfrey:

But I think the system is set up to do that. That's the way that the system is set up, so your task list takes inordinate precedence over other things, right?

Nicole Weathers:

And I think, though, like when you, when I again thinking back to some of those early days, one day I had the realization about nursing care plans. Like you know, when you're going through school, you're like, if I have to write one more nursing care plan, and then I had the realization, I don't know a couple of years in, probably that well, this is taking credit for the nursing things, right, the things that we're already doing. We're doing because this is what nurses do, but the nursing care plan was really sort of the nursing orders to do the things that we know that we needed to be doing for the patient. And I think that was maybe when I probably began to see myself less as the person who's just there to carry out the physician orders and the nurse who knows what it is that my patients need how we think, act and feel.

Dr. Nelda Godfrey:

as a nurse and my own experience tells me the physicians really don't want to do that either. I mean, they're happy doing their stuff and I should be fully doing my stuff. You know, if I'm working on a Sunday and there's a need for a wound care consult, then by golly activate it. Don't wait and have somebody do that on Monday. Get it done now. That's why they have the system set up to be able to have that happen. We are so. We're so powerful in a very good sense, and I'm not sure that we recognize that. And I can tell you the generation 10 more years from now, nurses won't be where they are today. They will be doing a ton more in terms of establishing their contribution, their sense of professional identity, their work. Because if we don't do that, no one's going to be doing it. Because we don't help ourselves when we reduce ourselves to a task list. It's a real problem. It's a real problem.

Nicole Weathers:

So I want to go on a tangent for a minute and ask you a question about your perspective of the influence social media has on the nursing brand, Because I'm out there on, you know I'm not on a bunch of social media, but I'm out on LinkedIn, Instagram, some of those things and in some of those spaces, the nurse influencers that are out there putting out content isn't always positive, and so I have been thinking a lot about for our new grads that are coming out and maybe they are very active in some of those spaces and they are being sort of bombarded with things that aren't always pro-nursing or positive in nursing. How does that impact their professional identity?

Dr. Nelda Godfrey:

Well, I think it does impact their professional identity, especially if they're looking for external locus of control rather than internal locus of control. So, number one, it's pretty important for us in education to tamp this in place early on and to be not just saying oh, when you get to the hospital, it won't be like that. No, no, no, no, no. When you get to the hospital it won't be like that. No, no, no, no, no. Remember, 55% of nurses in this country work in acute care, meaning that 45% do not. So this idea of immediately going to the hospital and that's where you're going to be, that's not a reality. People do many other things than that. So I think that's one key part. I also think that, well, I do.

Dr. Nelda Godfrey:

I am involved in social media and I think it's rare or absent to find somebody who communicates what I would like them to communicate about this discipline of nursing. Okay, I think if we had that many naysayers about people who had psychology degrees or that many naysayers about people who had engineering degrees, they would feel the impact of that. Secondly, I think we have to recognize maybe you have to do this on your own, I don't know, but the reason that social media grabs you is about three reasons. One, it's got enough drama to it. Two, it's really really funny. Or three, it creates fear. So what is it about us that wants to be emotionally wrong with those things, about a discipline that we spend our time in? So I think more discerning colleagues are going to dump social media or go past the posts about the discipline.

Dr. Nelda Godfrey:

I don't know about you, nicole, but it's been a long time since I have watched a TV show about medicine, because it just drives me crazy, because it's all inaccurate. I'm like that isn't the way to pronounce it, that's not the way things work, that's not what you would do. So I don't even get involved in using that as entertainment because it's not entertainment to me. And there is a recent article out by Heather Nelson Brantley and I think it's in Journal of Nursing Administration that talks about nurses' use of social media. So there's some research to support what's going on with that. I think we have to be more discerning. And does it make a difference? Darn right, it makes a difference. We're seeing open spots in nursing schools all over our state of Kansas that are not being filled and people are not looking at it as a career opportunity. And what a sad thing, because it's really way cool to get to do the things that we get to do.

Nicole Weathers:

Excellent. So back to new grads intentionally growing professional identity in the new grad in the residency program. You talked about using reflection and support as a tool for that. Are there specific things that we should have them reflecting on? Do you have any specific, I guess, activities or things that you have seen work really well for getting kind of the attention of the new grad? Or I mean, these could be things that you're doing in academia that would translate to practice as well.

Dr. Nelda Godfrey:

Sure, I don't think we should diminish the importance of touchstone words for us. So, for instance, I'm an adult geroclinical nurse specialist. I've spent a lot of time with older people and people who are dying and I know that I have and am a much better provider of nursing care because I read about Elizabeth Kubler-Ross's stages of grieving. I know that there is something called anger or denial, or acceptance. I know those words and they helped me be better attuned to what I was seeing with the patients and families I was caring for. Similarly, as our new grads are growing, laying down the foundation of their discipline that they'll probably stay in the rest of their lives 84% of nurses in Kansas are actively working. People aren't off doing other things, they're working in the field. But as you lay down that foundation, why not use those four domains values and ethics, knowledge, nurse as leader, and comportment. And maybe in one season you're going to need a lot more knowledge because you're getting ready to do ECMO and you know how hard that is and you're going to have to learn some things in that area. Or another case you're charging now and so you need to be a nurse leader, regardless of whether that was your first choice or not? So what skills do you need to bring and what kind of habitus do you need to bring forward to make that work? So I think having those four domains as touch points are really important. They can be a place for reflection. They can be a counterpoint to the reductionistic view of I've got these tasks to do, because there are days when you go home after being overloaded with so many tasks that you wonder how come I'm such a smart person and this is what I spent my day doing. So I think it's words, I think it's touchstones, it's reflection.

Dr. Nelda Godfrey:

Residency program coordinators have the chance to lay a different kind of foundation for those new grads and not just provide the support of oh, I know it's tough, I know it's tough, it needs to be. Yep, I know it's tough, but have you thought about it in this way? Have you thought about it in this way? And what are examples of where you were able to move up and out of that particular situation and demonstrate your talents of thinking, acting, feeling like a nurse at a professional level, and how are you able to influence others?

Dr. Nelda Godfrey:

One of the things about our work in this area and there are a number of publications we have done a lot on DEI, a lot on DEI, and so how do we honor people's professional identity in the DEI space? Also, you might be surprised to know this that the Professional Identity in Nursing Initiative is for all nurses who are licensed, so that's LPNs and RNs, and it does not matter if you have ADN preparation or BSN preparation out the gate, because our research shows us that it is equal in this. The capacity and the demonstration of professional identity in nursing for new grads is equal, depending on no matter where you've graduated from.

Nicole Weathers:

That's great, and we that was just as you're talking about this you know we in the last probably three years or so, have added in what we call our clinician well-being topics and part of that. You know, it started as kind of just four or five different things and we've added as we've went. But we've added in a section in our curriculum where they actually spend some time identifying what their strengths are. What do they know really well, what are their values when it comes to work? What are their values? Those are all going to be important things as we make decisions in our professional career.

Nicole Weathers:

And I guess you know, as it was just a light bulb sort of went off that as you're talking about these things, it's like, well, we actually are spending some time already having them reflect on what their values and their knowledge are, having them identify what are some things they're interested in or passionate about. And you know, these are the places where you really have that opportunity to show up, I think, as a leader, because I think it does take a certain level of interest or passion to really make you want to be in that sort of space where you are leading. So you know, I think again, just just as you're kind of talking about this. It's like, oh, maybe we do have some of these good things already sort of built into the curriculum and maybe we again haven't been using the language of professional identity as we described that, and so maybe that's a tweak that we could make. But I think some of we've got a lot of the good nuts and bolts sort of already in place.

Dr. Nelda Godfrey:

It might be helpful to think about well-being as being one part of the platform and then the next level up on that pyramid, if you want to build it like a Maslow's hierarchy. The next part is professional identity. That's where the leadership grows, values and ethics get expressed, the knowledge and comportment. We've got to have basic needs met first, but I think our new grads are doing this. I think they're very clear about wanting a work-life balance of some sort, that they tend to tend to that, and now, in our young academic discipline, it's our time to bring forward this idea of professional identity in nursing and help them add more to what they are doing so that they can have a long and fulfilling career in the field.

Nicole Weathers:

Absolutely. So. I know we're getting short here on time. I got a couple more questions for you. So, as we look forward to the future, how do you see this concept of professional identity and nursing evolving? I mean, do you see it evolving? Are there any emerging trends or challenges you anticipate, and how can maybe we begin to prepare to address?

Dr. Nelda Godfrey:

it. The first step in our work has been to create awareness. The second step has been to create support, or develop support for this. I think in five years, three years, I think all nurses and in nursing programs are going to know what professional identity in nursing is and what those four domains are, and I think all students are going to know that as well. It's now part of our accrediting language and it is a part of now so many things. So hold tight.

Dr. Nelda Godfrey:

Within the next two or three months, we will have a DAISY category for professional identity in nursing, and doesn't that make sense? And so, rather than having a DAISY category for I have, nurse well-being seems to me like we maximize it and talk about professional identity for more of it. You can have someone who does this work in ethics or in quality and safety, but professional identity in this field that desperately needs this platform. We can be part of that. And I guess that's my question back to you as you administer and influence a nurse residency program and many nurse residency programs across the country what can you all do to build this as a thing, as something that we know will help our nurses flourish? The new code of ethics for nursing. I served on the committee to help put that together. One of the phrases that's dominant in that document now is human flourishing, and I would argue, sort of as a closing statement, that human flourishing and professional identity in nursing are very closely aligned.

Nicole Weathers:

Well, I think you need, in order to have human flourishing right, like you have, to be thriving in your professional role. I don't think you could have one without the other, because your work is such a huge part of your everyday life.

Dr. Nelda Godfrey:

Exactly.

Nicole Weathers:

Well, that's very exciting to hear that about. You know the Daisy Award and some of the changes that you see coming. You talked about you've developed some of these tools already. You talked about the evaluation tool that's available to use. Is there a place we can go and see that? Do you have a website or where would we go find more information on this?

Dr. Nelda Godfrey:

Sure, the website is professionalidentityorg and there are several places you can go. Join our mini symposium, which is in about a week, a three-hour mini symposium on professional identity, to do a deep dive into the research and the findings that we have so far and the progress and plans for the future. We'll have an in-person symposium in October and then we have our list of all of our articles and that sort of thing. You can email me, nelda Godfrey, my email is ngodfrey at kumcedu, and I'd be glad to talk with you more about it. We're moving past the individual contact. We're looking to influence systems and now that's going to be so exciting. The daisy thing is not completely set, but we're close, ok. So I want to make sure I'm presenting this accurately, but we're certainly looking toward that and that will be a good thing for this as well.

Nicole Weathers:

Excellent. Well, we will be sure to link that website in the show notes and we can also leave your email address if we have your permission to do that so anybody could reach out if they needed more.

Nicole Weathers:

Oh my goodness, nelda, we have talked about so many great things today and, like I said, this topic.

Nicole Weathers:

I love the fact that I now have language to use and I think our team is going to be working here in 2025 to review our curriculum and I think, while we've got some of these things sort of in our curriculum already, I don't think we've been using the proper language to describe some of these things.

Nicole Weathers:

So I think one thing that I know we will most certainly do is make sure that things are up to date with what this research is and the concepts and domains of professional identity in nursing. I think it's going to be important that we are speaking the same language as what you are, so, as we go into the future and as these nurses are coming out of school with this language, that they know exactly what it is that we're talking about as well. So so many, so many good things, but before we go, I have one last question. I ask this of all of our guests when it comes to our topic today of professional identity, what is one thing you see organizations doing that you think makes a significant difference in the development of this that you wish more people were doing.

Dr. Nelda Godfrey:

So there is a healthcare system that has strong nursing leadership, that has decided, as they've contemplated, how to help their nurses grow and flourish following the pandemic. This system has determined that building out a stronger sense of professional identity is the way through the briar patch, and I think they're right, because what it does it's not just what the organization does, but it's what the individual does, and together we can do anything.

Nicole Weathers:

I love that. Well, that sounds like a great place to end this episode. So, Nelda, I really want to just reiterate how much I appreciate you taking the time today to share all your great expertise and knowledge in this concept, or about this concept of professional identity. I look forward to continuing to you know read about this, to getting on the website, to taking a look at those tools and seeing how we can incorporate more of this into our nurse residency program.

Dr. Nelda Godfrey:

Thank you so much for the opportunity, Nicole. This has been lovely.

Nicole Weathers:

Wait. Before you go, I want to make sure you know all about our suite of resources you can use to support your new graduate nurses. This includes our Academy, a coaching program designed for organizations as they prepare for the implementation and ongoing sustainability of a nurse residency program. Work one-on-one with residency program experts to make sure your organization is residency ready. Our Clinician Wellbeing course is an asynchronous online course that aims to enhance the well-being and resiliency of healthcare professionals, equipping them with the necessary psychological capital to navigate challenges inside and outside of work.

Nicole Weathers:

Supporting Nurses is another asynchronous online course for preceptors, mentors and coaches to learn the skills they need to support any new hire. Both of these offerings can be used as a standalone professional development opportunity or to augment any nurse residency program. And we can't forget about the program that started it all the online nurse residency program. This includes a comprehensive curriculum designed to support new graduate nurses, applying all the knowledge they learned in school to their practice. We focus on professional skills, personal well-being, competencies, and new graduate nurses even get the opportunity to create real change in their own organization. Offered completely online and in a blended format, this program is highly adaptable to all clinical practice settings. You can learn more about all of these programs and more of what we offer using the links in the show notes below.