Nursing Professional Practice Model

Onsomble’s™ professional practice model

Here at OHSU, we’ve taken the ANA Nursing Scope and Standards, along with examining our Patient Safety Incidents and patient outcomes, and used Onsomble’s™ professional practice model to create our own OSHU Nursing Professional Practice Model. From 2017-2019, clinical RNs reviewed, reimagined, and updated the model and have created Rubrics (Level 1, 2, and 3) to include behaviors that are more relatable to nurses’ everyday practice. Nurses at OHSU compare their practice to these rubrics at least once a year (called GROW PLUS), to determine strengths and potential gaps in their practice and create meaningful goals to facilitate life-long learning and growth.

Meet some OHSU RNs and read their thoughts on being a nurse, reflecting against standards, and our GROW PLUS process


“It's nice not to have to think in professional jargon, things are easier to understand {with the RN Role Rubric}. I have a much easier time coming up with examples {of my actions relating to the professional practice model} with the current language, than I ever did with the previous lofty language… I felt like I actually was able to reflect well on my practice and focus on some points that I need to work on in my practice”
– Fiona Thornhill, RN, 9K

“I felt like {the RN Role Rubric} was not only a great way to focus my thoughts but, it also really helped remind me what my expectations as a nurse are. I find that as we practice longer, we get comfortable with our personality in nursing and who we are at the hospital. This rubric really helped with focusing on our real expectations, which are bigger than daily job expectations, and can remind people what true professionalism looks like, as well as respects the barriers {some nurses may face} while keeping one on-track. I really like it and appreciate it.”
- Destiny Covington, RN, Poison Center

“As we know, nurses have a hard time talking about ourselves, our goals, and what we do well. We are so eager to criticize ourselves… This format, the GOALS section, was really helpful to keep the topic on track. I have had difficulty in the past with sections that ask us to talk ourselves ‘up’. Nurses aren’t typically good at that. Speaking in terms of our goals and where we might be in that process, is MUCH easier.”
- Amber Webb, Home Infusion Pharmacy

“A professional, as well as pertaining to the role of being a professional nurse, is not about what to do or what needs to be done but rather it’s an integrative way of being. It’s about embodying the role and adhering to the standards of practice that govern that role. A professional has the obligation of being a decision maker and wanting to be do their professional best in order to make a difference in the lives of others. Lastly, it’s about reflecting and seeing personal areas for growth and being motivated to seek opportunities to learn and improve so that you can be better at what you are and what you do.”
- Kaitlyn Riplinger, RN, 11K/7C

“I’ve been a nurse for over 15 years, and {the RN Role Rubric} is finally helping me understand how my everyday practice is found in the professional practice model”
- Peds OR RN

Interview above with Renee Sells, RN, 10K

So why a Professional Practice Model?

A profession is defined as an occupation with special power and prestige granted by society because of the occupation's competence in esoteric bodies of knowledge that are linked to the central needs and values of the social system.

  • Professional Role: The performance in a profession that is associated with a set of expectations based on the tenets of that profession, professional standards of that practice, legal scope of practice, expectations that produce an individual who had the capacity to be self-directed, use theory, transfer knowledge, and provide care. (O'Rourke, 2006)
  • Professional Role Accountability: a set of expectations associated with the individual in a profession which are based on the basic tenets of a profession, professional standards of practice, legal scope of practice and that produce an individual who has the capacity to:

Leader: Seeking and synthesizing information , thinking critically, question the current patient information and plan of care, and identify how self or other team members could be a risk to the patient's recovery…. DO all this in order to make a self-directed,independent decision about the patient's risks, problems, and evidence-based plan for recovery

  • EXERCISE Decision Making Authority that ensures role and standards based practice
  • CONTROL the Recovery Process from one's discipline specific perspective
  • CONTROL Care Coordination from one's discipline specific perspective

Scientist: develop and contribute to an evolving body of knowledge specific to each discipline's social contract = questioning, developing new hypotheses, testing, and identifying new evidence based practices that are translated into practice when you are PRACTITIONING. (Uncertainty theory… knowing is never static…e.g. remember "the world is flat"!)

Nursing's Social Contract

Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and population. –Nursing' Social Policy Statement, 2nd ed

  • MONITOR & EVALUATE role and standards based practice
  • MEASURE professional role expertise &role-based practice excellence
  • LINK professional role competency with clinical, service and financial outcomes

Transfer or of Knowledge: Collegiality, Hand-offs, Continuity of Care

  • ACT in a manner that promotes dialogue, open communication & positive interdisciplinary working relationships
  • ENSURE coordination, integration &management of pertinent information
  • PREVENT any interference with the transfer of information

Practitioner: Actual performance, doing practice… have to observe in action to evaluate

  • DIRECT and MANAGE all situations in a THERAPEUTIC manner
  • INSPIRE others to transform care/service
  • TRANSFORM the practice culture through application of discipline specific work in a manner that ensures best practiceis used in the provision of care/service