In this issue of Changing Course we will reimagine professionalism. Professionalism in nursing has long been the cornerstone of our identity as a profession. We teach students to be caring, compassionate, and ethical nurses, but have we stopped to consider whether our approach to teaching professionalism still meets the needs of today’s nursing students? As burnout and mental health challenges surge across healthcare, perhaps it is time to ask a hard question: are we equipping our students to care for patients while neglecting to equip them to care for themselves?
We tell our students that professionalism is about showing up on time, following policies, communicating respectfully, and demonstrating accountability. Those are important, but what if professionalism also meant nurturing resilience, supporting wellness, and promoting self-compassion? In a time when nurses are leaving the profession at alarming rates, we need to look inward at how we are shaping the next generation of nurses and whether we are helping them thrive or simply survive.
Tradition and Transformation
For decades, nursing programs have emphasized professional comportment in ways that mirror clinical expectations. Students learn the dress code, the hierarchy of communication, and the standards of ethical conduct established by the American Nurses Association’s (ANA) Code of Ethics for Nurses. These values, accountability, respect, and commitment to patient well-being, remain essential. Yet, professionalism cannot be static; it must evolve with the context of nursing practice and the lived realities of nursing students.
The American Association of Colleges of Nursing (AACN) has long advocated for educational environments that uphold equity, inclusion, and belonging. Their 2023 statement on supporting diversity in academic nursing emphasizes the importance of creating learning environments that “value human differences, promote inclusion, and address inequities” (AACN, 2023). This shift invites educators to examine longstanding traditions that may inadvertently marginalize students, particularly those who are first-generation, from a minoritized group, or managing social determinants that impact their education (Bloomberg, 2024).
Policies designed to teach accountability, such as rigid attendance rules or punitive grading practices, may have unintended consequences. While structure can promote professionalism, it can also create fear, anxiety, and a sense of failure for students who already feel like outsiders. As Nye et al. (2023) argue, nursing education benefits from norm-critical reflection, an examination of whose values and experiences are centered in our teaching practices and whose are excluded. When we fail to ask these questions, we risk reinforcing systems that favor conformity over compassion.
The Cost of Doing Things the Way They Have Always Been Done
Many of us who teach nursing learned under rigid, hierarchical models. Faculty who “made it through” that system may view strict professionalism as a rite of passage. Yet research suggests that this approach can perpetuate stress and burnout rather than resilience. Dyrbye et al. (2015) found that stigma surrounding help-seeking behavior among medical and nursing students often prevents them from accessing mental health support. When policies create fear of failure instead of a growth mindset, students internalize distress rather than reaching out for help.
Burnout in nursing begins long before graduation. The ANA defines nurse burnout as a state of physical and emotional exhaustion caused by chronic workplace stress, leading to decreased effectiveness and detachment. Nursing students who experience constant stress and perfectionism are entering the workforce already depleted (ANA, n.d.). We must ask: what does it mean to teach professionalism in this context? Should it not include modeling self‐care, boundary‐setting, and mindfulness as professional skills?
A New Vision of Professionalism
A modern view of professionalism must include wellness, reflection, and the capacity for self-compassion. The AACN Essentials (2021) identifies professionalism and personal, professional, and leadership development as core domains of nursing education, emphasizing emotional intelligence, resilience, and self-awareness as key competencies (AACN, 2021). These outcomes require more than lectures on ethics, they demand an environment where students feel supported, seen, and valued. Moreover the ANA Code of Ethics for Nurses (2025) Provision 5 holds that nurses have an ethical obligation to promote their own health and well-being in order to provide safe, compassionate, and competent care to others.
Mentag (2022) explored the experiences of thriving nursing students and found that strong faculty relationships and psychological safety were central to their success. Similarly, Shen et al. (2024) highlight academic resilience as a protective factor that enables students to adapt and recover from adversity. Supporting resilience requires an institutional culture that prioritizes well-being, not just compliance. When we cultivate spaces that allow students to learn without shame or fear, we teach a deeper form of professionalism grounded in empathy and accountability.
Meeting Students Where They Are
Today’s students bring diverse strengths and challenges. Many balance jobs, family responsibilities, and financial pressures. Others are navigating disability or the stressors associated with being first-generation college students (Bloomberg, 2024). As educators, we must meet them where they are, not where we expect them to be. Lynam et al. (2024) emphasize that engagement and belonging are crucial predictors of academic success. When students feel they belong, they are more likely to persist and to embody the professional values we hope to instill.
Lane (2018) argued for “swinging the pendulum toward social emotional support” in education, reminding us that the human connection between teacher and student is fundamental. Professionalism cannot be divorced from caring; it is, in fact, an extension of it. The way we teach professionalism should mirror the same compassion and respect we expect students to extend to their patients.
Mary Ann Siciliano McLaughlin (2025) offers a timely perspective in her blog on how ethical infractions among nursing students may reflect unmet needs for reflection and support in educational environments. Such reflections underscore that professionalism is not simply about compliance with rules but about cultivating reflective practitioners who care for themselves and their colleagues as well as their patients.
From Compliance to Compassionate Accountability
Caring for our students is not about lowering standards; it is about modernizing them. We can maintain high expectations for ethical and professional behavior, while also recognizing the humanity of our learners. This might mean revisiting punitive policies, offering flexibility when appropriate, or integrating wellness practices into clinical and classroom settings. It might also mean rethinking assessment strategies that focus less on catching errors and more on cultivating growth.
Professionalism should not be a source of fear. It should be a source of pride, confidence, and purpose. Our role as educators is not to produce compliant graduates but compassionate, reflective professionals capable of sustaining long careers in a demanding field. If we continue teaching professionalism the way it has always been done, we risk losing both our students and the future of nursing itself. It is time for change.
Case Study
A nursing student, feeling unwell the night before a major exam, decides to take the test anyway. They fear that requesting an extension or missing the exam will label them as unreliable or unprofessional. Despite their determination, their performance suffers, and they fail the test. This scenario reveals how rigid, hierarchical models can create an environment where students feel pressured to sacrifice their well-being in order to appear committed.
Strict attendance and testing policies, though designed to uphold rigor and fairness, can unintentionally communicate that compassion and flexibility are weaknesses. Nursing education must continually reexamine the underlying messages it sends to students about worth, belonging, and humanity (Siciliano McLaughlin, 2025). When students internalize that asking for help or taking time for recovery is unacceptable, we risk reinforcing patterns that undermine both their academic and emotional resilience.
Shifting the Culture
Nursing students are human, navigating illness, caregiving, financial strain, and personal crises just as we do. When our structures fail to recognize that reality, we not only undermine belonging but also perpetuate inequities among those already carrying heavier burdens. Creating a culture of trust, empathy, and communication begins with a shift in mindset. It means designing policies that maintain rigor while allowing room for humanity. It also means ensuring that students see transparency, advocacy, and reflection as professional strengths, not risks.
Reflection
In closing, please consider:
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How might our course policies, tone, and classroom culture unintentionally reinforce fear or silence among students?
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What steps can we take to be more reflexive, ensuring that we embody the compassion, equity, and understanding that nursing itself demands?