看護とケアのジャーナル

Professional Ambivalence: Understanding of the Eminence of Advanced Clinical Nursing Specialization in the Philippines

Abstract

Marica Guevarra Estrada and Crestita Tan

As the practice of nursing continuously evolves, the registered nurses’ role has expanded from basic practice to advanced nursing practice over the last 100 years. Following the demands of healthcare organizations worldwide, Philippines adopted the Nursing Specialty Program that aims to promote presence of clinical nurse specialists in the country. Cognizant of this challenging role, this phenomenological inquiry has eidetically captured their collective experiences as clinical nurse specialists. A series of semi-structured, in-depth, one on one interview was conducted. Driven by the central question, “What describes the acceptance and utilization of CNS in the health care institution?” Field text were transcribed and subjected to phenomenological reduction via cool and warm analyses. Four clusters of themes delineated the participant’s collective experiences namely: (a) Inspired to perform a new role (b) Blinded acceptance of embodied role (c) Narrowed opportunities to practice area of specialization and (d) Divided to one’s own achievements. An experience of “professional ambivalence” greatly characterized the narrowed response of the community and healthcare professionals that led to the feelings of ambivalence to one’s own achievements, from being fulfilled to frustrated, dissatisfied and uncertain to practice confidently and independently. The Filipino clinical nurse specialists are initially motivated to improve one’s practice and the nation’s health but, unfortunately enjoy sparingly the eminence and appreciation as foreign nurse specialists do. To be able to empower more Filipino nurses to struggle for professional growth and for advanced nursing practice in the Philippines to continue to flourish, it is imperative that nursing leaders must begin to organize a unified vision of advanced nursing practice by amending the existing law, delineating the scope of their practice, reviewing the existing requirements for certification to meet global standards and making the healthcare community mindful of the existence and value of such professionals.