Nursing Professional Practice Model

At OHSU, we use the OnSomble Model of the Professional Role as a framework for understanding professional practice responsibilities.

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