National Autonomous University of Honduras

REGIONAL UNIVERSITY CENTER OF THE ATLANTIC COAST

CURLA
NURSING SCHOOL
“Dr. Maurice Campagna

Management applied to liberal

nursing practice
Professional exercise
Teacher:

Licda. Patricia Najera

 I. MANAGEMENT APPLIED TO THE LIBERAL NURSING PRACTICE
Nurse: is the professional responsible for nursing care, who promotes, preserves or
restores the health of the individual, the family and the community, in the maternal
and child area. Has knowledge and skills, appreciates and knows their abilities, and
integrates their academic and personal knowledge to practice nursing.
Liberal practice: performance of nursing professionals, independently and
autonomously, intellectually and financially, which generates their own economic
remuneration and professional stability.
The nurse with autonomy is the person who controls the functions in his or her
work environment; This implies independence, willingness to take risk and
responsibility for one's own actions, as well as self-determination and self-regulation.
The concept of professional includes legal and moral responsibility for the acts of the
individual, with the autonomy that gives him freedom and authority. You can make a
judgment to have good decisions in practice; that is, the autonomy of power
The performance of liberal nursing implies a high degree of responsibility, in a
competent and safe manner, in which the nurse can be legally responsible, if
unnecessary harm or suffering occurs. The nurse is legally responsible for his or her
actions; Therefore, it must be reasonable and prudent, according to the
circumstances; The more knowledge and experience you have, the greater the
responsibility should be.

Liberal work requires all the skills, abilities, abilities, attitudes and aptitudes
developed to the maximum, to achieve success in professional practice.
Furthermore, it is easy to assume that, in nursing, if a growing group of nurses are
able to perform liberally, a better body of knowledge will be gained, which in turn
would support the liberal ethos. She has spent several years in nursing, until
reaching the point where she is today, with a wealth of knowledge that contributes to
having a judgment and a foundation to modify actions according to situations.

The nursing profession has experienced important changes in its training and
orientation towards the labor market. Today it constitutes an essential factor for the
maintenance or recovery of the health of the individual, family or community in the
different stages of life in the health-disease process due to its participation as a
member of the interdisciplinary health team.

The new social security system: applies the criteria of privatization, decentralization,
targeting of benefits, cost efficiency, and the definition of a basic care package,
public hospitals become social enterprises of the state, governed by private law on
matters contractual and with the character of decentralized public entities, with legal
status, own assets and administrative autonomy.

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The crisis in public hospitals that is currently being experienced has highlighted the
negative effects of the reform due to cuts in public spending, the critical situation in
the health sector is aggravated by social conditions (Unemployment).
The negative effects are deepened by the traditional disdain of the Honduran state
towards the health sector since most hospitals do not have the appropriate
infrastructure and multiple aspects hinder development.
This context marks the situation of nursing as directly related to national and
international economic, social and political changes due to its constant flexibility to
these changes.
The economic, social and cultural environment in each country is unique,
generating particular conditions in each region, but the problems faced by the
development of nursing practice seem to be common worldwide.
Nursing functions
Nursing has been practiced as a profession for more than a century and the
delimitation of its functions according to its level of training is of vital importance if it is
taken into account that it is allied with other health professions through collaborative
activities, referral and coordination and In this way, its practice has been developed,
which is based on its own knowledge and knowledge of other sciences. Therefore, to
study the functions of nursing, it is necessary to delve into the theoretical aspects
that support it, a scientific approach to the functions of the nursing staff.
The functions of the nursing staff should be classified according to the degree of
judgment required in the decision-making power, the complexity of relationships with
other functions, the required level of technical qualifications, and the degree of
responsibility for the nursing services provided.

Its practice as a historical and social object arises from the division of labor in health
and includes the technical and auxiliary professional modalities, each of which, from
its level of training, must fulfill a series of basic functions that are carried out in
different social areas that are They can be classified in a general way from two
perspectives.

 Those that have been described by the degree of dependence on other

professionals.
 Those described didactically in four dimensions and that describe the main
performance areas of this staff.

The first group includes:

 Nursing functions.
Definition: are those that nursing staff execute in compliance with the
responsibilities of a profession for which they are trained and authorized.

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 The function of nursing is to help the healthy or sick individual to carry out
those activities that contribute to their health or recovery or their peaceful
death as a task that the individual performs for themselves if they have the
willpower or the necessary knowledge and all of this so that the individual
feels capable of carrying it out as soon as possible.

 Slope or derivative functions

Definition: are those activities carried out by nursing staff in collaboration with
the rest of the health team.
 Interdependent Functions
Definition: are those activities carried out by the nursing staff in collaboration
with the rest of the health team,

They are all those procedures or ways of acting that are carried out by the nursing
staff in collaboration with the rest of the health team independently without a medical
order with the purpose of alleviating, improving, eliminating the patient's problem in
the shortest possible time (Maricela Torres I hope in 2009).
The role of the professional nurse must change, from a passive and dependent role
to a role that projects intellectual capacity, an attitude skill with which nursing can
contribute to the solution of health problems, to fulfill this purpose of differentiating
The work of the non-professional professional is defined by profiles and includes five
levels of mastery in order from lowest to highest depending on academic preparation.

Likewise, each level contains a general description, the academic training

requirements, the attitudes that define their participation in the care of healthy or sick
individuals in a communicative hospital environment, The work location corresponds
as well as the classic functions in care, administrative, teaching and research itself
that can be classified as substantive or adjective depending on the priority property it
has for each of the levels.

The functions are in turn broken down into interventions; considered as treatment
based on the knowledge and judgment generated by a nursing professional for the
benefit of users. The interventions include both direct and indirect care aimed at
people, family and community that have a different connotation, depending on the
degree of responsibility and decision-making or autonomy in the care that the subject
who performs it has, which is what is called dependent, interdependent and
independent.

Independent, autonomous or private practice.

It is the exercise of the professional that is independent of the administrative

economic control by his peers in the profession and, except in the association, other
legal restrictions.

Nursing staff with independent practice can have a consultation in which they see
patients and collect fees (liberal professionals do not receive salaries but fees)
throughout the nursing responsibility, state provisions define aspects of the practice
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that must be carried out only under the supervision of the other person, in the liberal
profession the exercise of intellect that you do that has been recognized by the state
and for whose exercise the skill of an academic degree is required.

Autonomy in professional practice implies freedom to make clinical judgments

and decisions within the scope or scope of professional practices. By the state and
for the exercise of which the skill of an academic degree is required.

Autonomy in professional practice implies freedom to make clinical judgments and

decisions within the scope or scope of professional practices. For Tapp-et al.(2015).

Liberal practice has been related to assertive, coherent decision-making, with the
ability to solve problems with authority and responsibility in each of its interventions,
as well as the freedom to act in what must be done and the ability to perform
functions. independently.

Another important element of liberal practice is membership, defined as the set of

components that identifies that a profession can be practiced by its members and
that the law and society recognizes them as such (Fernández et; al 2007).
Membership occurs through the training process that the educational institution
establishes, being the bearer of a title with official validity, exercising the profession
called to offer community service and having the tangible document that accredits the
training process, which accredit as a member of the scientific community or
professional organization.

Factors involved in professionalization.

A series of factors always intervene in the formation of an activity, which in the case
of the nursing profession can be considered twofold; formal and sociological, both
being decisive for the recognition of nursing as a profession.

 Formal factors.

The main characteristics of the formal factors were the creation of professional
organizations that fought and continue to do so to raise the quality of the profession.
The most important professional association is the International Council of Nurses
(ICN), founded at the end of the 19th century. The CIE was the first association that
was interested in the ethical and legal aspects of the profession, culminating in the
establishment of the first code of ethics for nurses, approved at the 1953 congress,
held in Brazil. Other associations that stand out for the quality of their organization
and work are:
o American Nurses Association (ANA), founded in 1890.
o In the United Kingdom, the Royal College of Nursing (RCN), founded in 1916.
o In Spain, the Professional Association is the Nursing Council that brings
together the different official associations.

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Education, which is another factor that is considered influential in professionalization.
A profession has to have its own body of knowledge that it constantly increases.

Legislation: the recognition of the training and social function of a profession must
be established at a legislative level to guarantee its compliance.

 Sociological factors.

A series of sociological factors have contributed to the transition from nursing as a

vocational technical activity to a profession based on scientific knowledge, in that
aspect they are motivating factors of change. The conception of the human being,
the changes in aspects, is what is called an integral point of view, so that it is
considered from three aspects: physiological, psychological and social.
Contemplating the human being in these three aspects is what is called point of view.
comprehensive view.

Factors that limit the liberal exercise of the profession.

 Nursing care process, not applied, can be taught when analyzing the
diagnostic assessment phase, evaluation being the latter almost forgotten and
the last two almost incongruent or unconscious.
 Excessive work in hospital centers resulting in limitations in independent
nursing care, being those that, through the staff's own initiative and
knowledge, contribute to the comprehensive care of the person. And apart
from nursing staff who have adopted a routine system based only on
dependent care.
 Nurses of silence, afraid to speak serve five parking.
 Indifference is the biggest problem in care-sensitive managerial health
services.
 The academic level.
 The promotion of the institution for independent activities.

II. METHODOLOGY
Procedure: Professional nurses were interviewed based on a work guide
that was given to this group for later application. (See interviews in
annexes).
Study area : the interviews were carried out in different institutions such
as; Atlántida General Hospital, E. S. Metropolitan, Regional University
Center of the Atlantic and Manuel Bonilla Institute Clinic.
Sample: the point of view of 14 professional nurses was taken as a
reference.
Observation; Only 14 nursing graduates were interviewed, because in the
ES Metropolitana, it was not possible to specify the minimum total of
interviews due to the Visit of the Vice-Minister of Health in said center.

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 III. ANALYSIS

In summary, from the results obtained from the interviews applied, we were able to
observe that despite the limitations to which nursing professionals are subjected or
exposed in their different areas of work, they are capable of:
 To have initiative.
 Give suggestions.
 Manage.
 Good Aptitude.
 Good behavior.

To be able to resolve the difficulties that arise in the workplace. And acquire
leadership based on improving the work environment.
We observe that the factors that limit the performance of liberal nursing practice are:
 Lack of compromise.
 Workload.
 Lack of staff.
 Lack of equipment and supplies.
 Politics.

The practice areas that the nursing graduate can perform:

 Educational areas
 Administration area.
 Clinical areas.
 maquilas
 Schools.
 All areas in the different health programs.

It is considered that scientific and technical mastery: academic preparation is the key
in the practice of nursing to keep up with the accelerated changes that occur in the
practice of the profession. Nursing education, especially in countries like ours, has
limited teaching materials, is scarce and there is little investment in skills, but
currently the nursing student in Honduras has knowledge based on the latest
evaluations and forecasts of the needs of our country in terms of health and the
nursing services required to satisfy them.

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Mechanisms used to articulate self-employment: Make contacts with other health
organizations, seek contacts at the government and international level, learn about
government health regulations and experience gained through monthly interest and
work.
Visualization of the nurse: a comprehensive person, to know and work in all fields,
up-to-date research nurses who know how to handle statistical program packages,
health promoters through radio and television programs. Not being a desk nurse.
IV. CONCLUSIONS

1. We identified that the majority of nursing graduates have the ability to solve
problems or adversities that arise with patients, as well as those related to
administration such as the lack of necessary supplies and workload.

2. Among the factors that limit the liberal performance of the nurse, the most
mentioned were: workload, lack of personnel, politics, lack of supplies and lack of
commitment. But in the end the limitations cease to be obstacles due to the capacity
of the nurse who carries out liberal practice through decision making to solve these
problems.

3. The theory mentions that a liberal nurse must have: attitude, aptitude, skills and
abilities. But according to the interviews, it was observed that in some of the nursing
graduates there is a lack of initiative and management aspect.

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V. BIBLIOGRAPHY

 BIBLIOGRAPHYLeddy, S., & Pepper, J. (1989). Bases conceptuales de la enfemería profesional.

En 1ra edición en español. New York: Organización Panamericana de la Salud .

 Velandia, A. L. (2002). Ejercicio liberal de la enfermera(o) en el área materno infantil.

www.Scielo.com, 1,2.

 Gómez Serrano, Consuelo. Tendencia de la profesión de enfermería, Asociación

Colombiana de Facultades de Enfermería, memorias del I Congreso Nacional de
Actualización en Enfermería, pp. 205-210, septiembre, 1992.

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Illustration1 Interview Licda. Claudia Lozano

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