Professional Comportment: The Missing Element in Nursing Practice

Professional Comportment: The MissingElement in Nursing PracticeDeborah A. Clickner, DNP, RN, NE-BC, and Maria R. Shirey, PhD, MBA, RN, NEA-BC, FACHE, FAAN

Deborah A. Clickner, DNP, RN, NE-BC, is Associate Director Patient Care/Nurse Executive, Providence VeteransAdministration Medical Center, Providence, RI; and Maria R. Shirey, PhD, MBA, RN, NEA-BC, FACHE, FAAN, is AssociateProfessor, Doctor of Nursing Practice Program, University of Southern Indiana College of Nursing and HealthProfessions, Evansville, IN.

KeywordsCivility, concept analysis,professional comportment,professionalism

CorrespondenceDeborah A. Clickner, DNP, RN,NE-BC, Providence VeteransAdministration Medical Center,Providence, RIE-mail: [email protected]

PURPOSE. The aim of this concept analysis of professional comportmentis to elucidate the dimension of nursing practice that fosters cooperation,collaboration, effective communication, and team cohesion amongnurses.BACKGROUND. Professional comportment is a concept that has notbeen developed or analyzed, and its integration into nursing practice isunclear and not specified. The body of knowledge concentrating on thespectrum of professional comportment, civility, and lateral violence ispresently incomplete. Analyzing and developing the concept of profes-sional comportment will satisfy a gap in the literature. A concept analysisof professional comportment will clarify for the nurse the power of words,behaviors, and communication needed to achieve effective communica-tion and civility.SOURCE. The Walker and Avant framework for concept analysis wasused to analyze the concept of professional comportment. An electronicreview of the literature through the Cumulative Index to Nursing andAllied Health Literature, Health Sources, Medical Complete, and Pro-Quest was conducted. This review rendered approximately 300 articles, ofwhich 85 were reviewed. Eighteen articles informed comportment as adefinition and are utilized in this analysis. The individual nurse is thelevel of focus in the analysis, not the organizational culture.CONCLUSION. Comportment is defined as a dignified manner orconduct. Professional comportment is critical in determining a nurse’seffectiveness in relating, communicating, and collaborating with col-leagues and members of the healthcare team. In the absence of profes-sional comportment, a culture of incivility, nurse aggression, andcompromised patient safety will emerge. Self-regulation and individualaccountability are sequelae to professional comportment. The personalassimilation of professional comportment promotes mutual respect,harmony, commitment, and collaboration. The nurse, patient, andhealthcare team are the beneficiaries of a nurse who demonstrates pro-fessional comportment.

Introduction

Professional comportment is a concept that has notbeen well developed or extensively analyzed, and its

integration into nursing practice is unclear and notspecified. The nursing literature contains few refer-ences to comportment and professional comportment.Positive individual behaviors would be representative

bs_bs_banner AN INDEPENDENT VOICE FOR NURSING

106© 2013 Wiley Periodicals, Inc.Nursing Forum Volume 48, No. 2, April-June 2013

of professional comportment; however, these are notaddressed in the literature. The prevalence and natureof lateral violence, horizontal violence, and nurse inci-vility are contrary concepts to professional comport-ment. Lateral and horizontal violence and nurseincivility are the negative behavior usually discussedand analyzed in the nursing body of knowledge (Abe& Henly, 2010; Baltimore, 2006; Embree & White,2010; Hutton, 2006). Strategies to address, eradicate,and prevent lateral violence among nurses are detailedin the literature (Hutchinson, Wilkes, Vickers, &Jackson, 2008; Öztung, 2006; Vessey, DeMarco,Gaffney, & Budin, 2009). The remedies and strategiesto address lateral violence assign responsibility to theorganization, culture, and environment. The organi-zation’s leadership is responsible for the organizationalculture and for ensuring a civil environment (Stanley,Martin, Michel, Welton, & Nemeth, 2007). A nurse’sbehavior, words, and communication are the respon-sibilities of an individual (Clark & Cardoni, 2010). Theownership, responsibility, and accountability for civil-ity and collaborative and caring relationships lie withthe nurse’s behavior and practice (Clark & Cardoni,2010). To date, accountability and responsibility of theindividual nurse to prevent lateral violence are notdefined.

The aim of this concept analysis of professionalcomportment is to elucidate the dimension of nursingpractice that fosters cooperation, collaboration, effec-tive communication, and team cohesion amongnurses. The individual nurse is the level of focus in theanalysis, not the organizational culture. The analysisof professional comportment will clarify for the nursethe power of words, behaviors, and communication toachieve effective communication and civility. Profes-sional comportment is a complex concept. The body ofknowledge concentrating on professional comport-ment and civility is presently incomplete. Analyzingand developing the concept of professional comport-ment will address gaps in the literature. Thus, thepurpose of this paper is to present a review of theliterature to determine the antecedents, definingattributes, and consequences of professional comport-ment in nursing.

Methods

The Walker and Avant framework for conceptanalysis was used to analyze the concept of profes-sional comportment (Rodgers & Knafl, 2000; Walker &Avant, 2005). An electronic review of the literature

through the Cumulative Index to Nursing and AlliedHealth Literature, Health Sources, Medical Complete,and ProQuest was conducted to ascertain the extent towhich the terms comportment or professional comport-ment emerged in the literature. Since a distinct defini-tion of professional comportment was not identifiedwith the initial literature review, the search wasexpanded to include the following terms: comport-ment, emotional intelligence, professional, behavior,and values. This review rendered approximately 300articles, of which 85 were reviewed. Eighteen articlesinformed comportment as a definition and are utilizedin this analysis.

The literature search terms were entered alone andin combination. Contrary terms, such as lateraland horizontal violence, incivility, and nurse–nurseaggression, were also searched. The medical, socialwork, health professions, psychology, and nursingliterature were included in the literature review. Psy-chiatric medical and law literature were excluded asthe review demonstrated that comportment is used inreference to drunkenness and medical diagnoses. Theaim of this concept analysis of professional comport-ment was to identify desired, positive, and construc-tive behaviors. The literature synthesis inclusive ofconcept definition follows along with a concept map(Figure 1).

Concept Definition

To date, the literature lacks a concept analysis ofprofessional comportment. Professional comportmentis a dimension of nursing practice that is of equalimportance as competently performing technicaltasks, and requires illumination and elucidation.

Comportment may be defined as dignified manneror conduct. It is a manner of behaving and a soundstate of mind. Additionally, comportment may bedefined as deportment, or the manner in which onebehaves or conducts oneself (Webster’s OnlineDictionary, 2010). Comportment is captured inRoach’s (2002) six Cs of human caring theoreticalframework: commitment, compassion, competence,comportment, confidence, and conscience. Comport-ment, as an attribute of caring, is defined as one’sbearing, demeanor, and agreement or harmony withself and others (Roach, 2002). Maintaining harmonybetween beliefs about intrinsic dignity of the self andothers, and congruence in the manner in which indi-viduals comport or carry themselves as a professional

D. A. Clickner and M. R. Shirey Professional Comportment


caregiver, exemplifies professional comportment(Roach, 2002).

Benner (1991) described ethical comportment associal adeptness in relating to others in a respectfuland supportive manner. Comportment includes thenurse’s words, intents, beliefs and values, stance,touch, physical presence, and actions (Benner, 1991).Ethical comportment was introduced in the contextof educating and socializing novice nurses into theprofessional aspects of nursing, and is reflective ofBenner’s novice to expert work (Benner, 1991; Benner,Sutphen, Leonard, & Day, 2010). The assimilation ofabilities, knowledge, interpersonal effectiveness, and

communication with members of the healthcare teamand patients defines ethical comportment (Benneret al., 2010). The nurse who embodies ethical comport-ment is confident in practice and decision-reasoning.Listening and attuned relational skills are manifestedthrough ethical comportment (Benner et al., 2010).Ethical comportment is a critical element in the social-ization and formation of an experienced professionalnurse (Benner et al., 2010). Communication andsocialization are processes that a new nurse uses togrow from a novice to expert nurse (Benner, 1991).Benner integrates ethical comportment in the contextof professional nurse education, development, and skill

Figure 1. Professional Comportment Concept Map

ANTECEDENTS

Capacity for compassion

Confidence

Emotional intelligence

Human dignity

Reflection

Regulation

Self-awareness

Values and beliefs

THEORETICAL DEFINITION: A nurse’s

professional behavior that integrates value,

virtues, and mores through words, actions,

presence, and deeds.

OPERATIONAL DEFINITION: A nurse’s

set of defining behaviors that integrates

consistently between values and actions, and may

be measured in the form of professional conduct,

appearance, and collaborative practice.

CRITICAL ATTRIBUTES

Mutual respect Beliefs and actions are harmonious and consistent

Commitment Collaboration

PROFESSIONAL COMPORTMENT

CONSEQUENCES

Caring and respectful words

Positive communication

Professional attire

Respectful behavior

Effective relationships with

patients and colleagues

Self-regulation

Accountability

EMPIRICAL REFERENTS

Nurse–nurse collaboration

Professional Comportment D. A. Clickner and M. R. Shirey


acquisition and formation as a professional being(Benner, 1991; Benner et al., 2010).

The context of comportment occurs in the act ofnurses providing care to patients, and in ways that theycommunicate with patients and colleagues in everyencounter. Rizk and Bofinger (2008) assert that profes-sionalism is described in association to a nurse’s image,conversation, and behavior. Professional com-portment may be interpreted as “one’s physical appear-ance and conduct that is congruent with professionalnorms” (Roach & Maykut, 2010, p. 23). Comportmentis the dimension of the nurse’s interaction that includespresence, appearance, communication, courtesy, andrespect (Roach, 2002). The concept of the professionalnurse was reviewed in the context of effective commu-nication skills as an essential quality for a nurse topossess and demonstrate. The professional nurse’scommunication skill set in healthcare interactions ischaracterized by collaboration, credibility, compassion,and coordination (Apker, Propp, Ford, & Hoffmeister,2006). These characteristics embody the professionalbehavior of professional comportment. Credibilityembraces the use of specific words and accurate lan-guage, confidence, respect, and assurance (Apker et al.,2006). A nurse’s behavior that demonstrates compas-sion, trust, support for team members, respect, asser-tiveness, self-regulation, and awareness is consistentwith desired professional comportment (Anbu, 2008;Apker et al., 2006; Catlett & Lovan, 2011).

Within the literature, professionalism is describedin relationship to image and conduct. The personaland public images of the nurse are facets that areintertwined with professional comportment. Self-image is an aspect of comportment that is representa-tive of thoughts and belief, and the consequences,words, communication, appearance, behavior, andrelationships that a nurse exhibits (Fletcher, 2007).The nurse’s appearance, behavior, dress, and commu-nication will project the presence or absence of a pro-fessional image (LaSala & Nelson, 2005). The publicand personal images of nursing have been compro-mised through dress and language, and highlight thesignificance of defining professional comportment inthe nursing profession (Fletcher, 2007).

Concept Analysis

Antecedents

Antecedents are behaviors or events that precedethe appearance of the concept (Walker & Avant,

2005). The antecedents to professional comportmentinclude the capacity for compassion, human dignity,values and beliefs, emotional intelligence, self-awareness, reflection, regulation, and confidence.Possessing a capacity for compassion is a relevant ante-cedent for professional comportment in nursing prac-tice. Compassion was consistently cited in the contextof professional behavior, and behavior that fosterseffective relationships with patients and colleagues(Apker et al., 2006; Austgard, 2008; Benner, 1991;Benner et al., 2010; Gallagher, 2007; Roach, 2002; M.S. Roach, personal communication, August 27, 2010;Thupayagale-Tshweneagae & Dithole, 2007). Absenceof compassion would likely result in the absence ofprofessional comportment.

Additionally, dignity was an equally relevant ante-cedent. Human dignity and the preservation of dignityare complex and interwoven into the behavior ofa nurse demonstrating professional comportment(Benner et al., 2008; Clark & Cardoni, 2010;Gallagher, 2007; Rassin, 2008; Roach, 2002). Dignityrepresents preserving privacy and core values, and isthe expression of harmony with one’s beliefs aboutthe dignity of people (Gallagher, 2007; Roach, 2002).The antecedent self-reflection fosters the developmentof a right relationship with self and others, and facili-tates an ongoing process of harmony (Hentz &Lauterbach, 2005).

Critical Attributes

Critical attributes represent mutual respect,harmony in beliefs and actions, commitment, andcollaboration. Respect is a defining attribute charac-teristic of a nurse demonstrating professional com-portment (Apker et al., 2006; Austgard, 2008; Benner,1991; Benner et al., 2010; Clark & Cardoni, 2010;Gallagher, 2007; Rassin, 2008; Roach, 2002; M. S.Roach, personal communication, August 27, 2010;Roach & Maykut, 2010; Thupayagale-Tshweneagae &Dithole, 2007). The nurse’s respect for the work andpractice specialty of colleagues is observed in profes-sional comportment (Thupayagale-Tshweneagae &Dithole, 2007). In a study completed in Taiwan, thenurses reported that patients expect respectful caringattitudes from them (Shih et al., 2009).

The critical attribute harmony in beliefs and actions isdescribed as fostering positive relationships and avoid-ing unnecessary conflict (Konishi, Yahiro, Nakajima, &Ono, 2009; Roach & Maykut, 2010). Additionally, arelationship exists between nursing care and moral



values (Austgard, 2008; Shih et al., 2009). Commit-ment is a nurse’s sense of responsibility to patientsand colleagues. It evidences human dignity, equalityfor patients, and the prevention of human suffering(Rassin, 2008). Commitment is one of the six Cs inRoach’s theoretical framework for human caring(Roach, 2002).

The critical attribute collaboration is consistent withpositive exchanges in interpersonal relationships(Shih et al., 2009). Apker et al. (2006) identified col-laboration as a necessary communication skill that theprofessional nurse assimilates for effective healthcareteam interactions. Collaboration requires communica-tion of critical information accurately and timely, andis essential for problem solving with colleagues (Apkeret al., 2006). Collaboration, as a critical attribute ofprofessional comportment, is described as providingaccurate information, assisting and guiding teammembers, and providing positive reinforcement to col-leagues (Apker et al., 2006).

Consequences

Consequences, as described by Walker and Avant(2005), are the events that occur in the presence of theconcept. The professionally comported nurse useswords and language that reflect caring, respect, andclinical expertise, and that elicit trust and confidencefrom patients and colleagues (Apker et al., 2006;Benner et al., 2010; Roach, 2002; Roach & Maykut,2010). Effective communication is critical to ensurepatient safety, and embodies listening with intention,supportive comments, and accurate and timely com-munication (Clark & Cardoni, 2010; Fletcher, 2007). Anurse’s appearance and dress are symbolic of an atti-tude that is in harmony or disharmony with a caringpresence, and communicate significance and value ofthe work or event (Bednarski & Rosenberg, 2008;Roach, 2002; Roach & Maykut, 2010). The nurse’sability to develop, foster, and maintain effective rela-tionships with patients and colleagues is a hallmark ofprofessional comportment. Relationships are the coreof the nurse’s duty and work in the provision ofpatient and healthcare delivery.

Empirical Referents

The final step of the concept analysis is identifyingthe empirical referents (Walker & Avant, 2005). In thisanalysis, the critical attributes and empirical referents

are similar (Walker & Avant, 2005). Empirical refer-ents are “classes or categories of actual phenomenathat by their existence or presence demonstrate theoccurrence of the concept itself” (Walker & Avant,2005, p. 73). The Nurse-Nurse Collaboration (NNC)Scale measures the presence of professional comport-ment’s critical attributes (Dougherty & Larson, 2010).Mutual respect and collaboration are specific compo-nents of the subdomains for item construction of theNNC Scale. Shared processes, professionalism, andconflict management are subdomains within the NNC,and reflect a nurse’s commitment and harmoniousand congruent actions.

Cases

Model Case

A model case is described as an exemplar of theworking definition of the concept being analyzed(Rodgers & Knafl, 2000). The professionally com-ported nurse will demonstrate commitment, account-ability, mutual respect, and collaboration. The Smithcase is an example of a model case.

Ms. Smith arrives to work on time, appearingrefreshed, neat, and organized. She greets each staffmember by name and inquires about the well-being ofeach individual. Ms. Smith approaches a newly admit-ted patient and introduces herself as Ms. Smith, andinquires how the patient would prefer to be addressed.She assesses the patient, engaging him in a dialogueabout his concerns, feelings, level of pain, and goalsfor the hospitalization. Ms. Smith reassures Mr.Patient and answers questions. Together they developan initial plan of care. As Ms. Smith departs the room,she informs the patient that she will return aftermeeting with the team members. She meets with theinterdisciplinary team, sharing pertinent informationand listening to and acting on the input of the teammembers.

Borderline Case

A borderline case is one that lacks clarity as anexemplar case (Rodgers & Knafl, 2000). A case thatrepresents most of the defining attributes is a border-line case (Walker & Avant, 2005). This type of case isinconsistent in some way or manner with the exem-plar case (Walker & Avant, 2005). An example of aborderline case is that of Ms. Dodd.



Ms. Dodd, RN, arrives to the unit early to reviewand organize her assignments for the shift. Aboutthree hours into the shift, Ms. Dodd observes Mr.Kane, RN, not answering patient call lights, spendingtime surfing the Internet, and chatting with a femaleresident. Ms. Dodd, RN, answers the call lights, andadministers the care and medications to Mr. Kane’sassigned patients. Ms. Dodd is stomping up and downthe hallway, not communicating her frustration withnurse colleagues. She is pleasant, considerate, andcaring when approaching the patients. She completesthe assignment and impeccably documents the careprovided. At the end of the shift, she snips to Ms.Smith, the charge nurse, “Next time you take chargeand spare Mr. Kane of doing any work so he can flirt,don’t bother to give me an assignment. I have raced allaround this unit doing the work of two!” Ms. Doddcharges into the break room and tells Mr. Kane he is alazy flirt. Ms. Dodd, RN, was comported when caringfor the patients; however, the interactions, and thenonverbal and verbal behaviors, relating to colleaguesdemonstrated poor self-control, incivility, and disre-spect. Ms. Dodd failed to discuss her concerns directlyand timely with Mr. Kane. Professional comportmentis demonstrated by Ms. Dodd’s arrival to work in atimely fashion and her respectful caring for patients.Ms. Dodd, however, did not approach or communicatewith colleagues in a polite or effective manner.

Contrary Case

A contrary case does not possess any of theattributes or antecedents related to the concept.Accordingly, this is a contrary case and demonstratesthe absence of professional comportment (Walker &Avant, 2005). The critical attributes commitment,accountability, mutual respect, and collaboration are notpresent in a contrary case. An example of a contrarycase is Mr. Hampton, and his behavior does not meetthe critical attributes of professional comportment,which are commitment, accountability, mutualrespect, and collaboration.

Mr. Hampton is an experienced critical care nurseand is the assigned preceptor for Ms. Avery, an expe-rienced critical care nurse new to Granite Hospital. Mr.Hampton proceeds to tell Ms. Avery how terrible theleadership is at Granite Hospital. Mr. Hampton andMs. Avery care for Mr. Armstrong, who is well knownto the staff. The patient has a long history of diabetes,kidney failure, hypertension, obesity, and alcoholabuse, and has a full thickness wound. Mr. Armstrong

is crying and writhing in pain. Mr. Hampton states toMs. Avery in the presence of the patient that Mr.Armstrong is a drug abuser and is just trying to getdrugs. The patient addresses Mr. Hampton, pleading tobe medicated for pain. The patient states that he needsto relieve himself, and Mr. Hampton tells him to justgo to bed. Mr. Hampton proceeds to treat Ms. Avery asa novice nurse, challenging her practice and telling herthe way it is done “here.”

Conclusion

Professional comportment, a concept integral tonursing practice, has been defined, described, and ana-lyzed. The analysis of professional comportment pro-vides guidance for defining, assessing, and regulating anurse’s communication, interaction, and presence.Professional comportment is critical in determining anurse’s effectiveness in relating, communicating, andcollaborating with colleagues and members of thehealthcare team. In the absence of professional com-portment, a culture of incivility, nurse aggression, andcompromised patient safety will emerge. Analysis ofthe concept of professional comportment providesnurses with an understanding of an aspect of theirpractice essential for competent and effective practice.

Professional comportment is a nurse’s bearing,demeanor, and harmony with self and others (Roach,2002). Maintaining harmony between beliefs aboutintrinsic dignity of self and others, and congruence inthe manner in which individuals comport or carrythemselves as a professional caregiver, exemplifiesprofessional comportment (Roach, 2002). Professionalcomportment is the ability to relate to others in arespectful and supportive manner (Benner, 1991).Comportment includes the nurse’s words, intents,beliefs and values, stance, touch, physical presence,and actions (Benner, 1991). The assimilation of pro-fessional comportment into an individual’s practicepromotes the critical attributes of professional com-portment that include mutual respect, harmony, com-mitment, and collaboration. The nurse is responsibleand accountable for ensuring that professional com-portment is valued and integrated into practice.

Nurse–nurse collaboration represents a professionalcomportment empirical referent. The significance ofthe concept of professional comportment is as it relatesto nurse–nurse collaboration. First, professional com-portment is the dimension of nursing practice and theattribute of caring that promotes collaboration andeffective relationships with patients and members of



the healthcare team (Roach, 2002). Second, the pro-fessional nurse is ultimately accountable and respon-sible for words, behaviors, appearance, andrelationships, which are integrated into professionalpractice. Third, collaboration and civility foster anenvironment that supports a professional practiceenvironment and patient safety.

The concept analysis of professional comportmentprovides specificity to the requisite behaviors of aprofessional nurse. Integration of professional com-portment concepts into academic curriculum and con-tinuing education programs elucidates the desiredwords, actions, presentation, and dress of a profes-sional nurse. Professional comportment is the indi-vidual anecdote in promoting collaboration andpreventing lateral violence among nurses in practice.

Visit the Nursing Forum blog at http://www.respond2articles.com/NF/ to create, comment on, orparticipate in a discussion.

References

Abe, K., & Henly, S. (2010). Bullying (ijime) among Japanesehospital nurses: Modeling responses to the revised Nega-tive Acts Questionnaire. Nursing Research, 59(2), 110–118.doi:10.1097/NNR.0b013e3181d1a709

Anbu, J. (2008). Developing intelligent feelings. NursingStandard, 22(29), 52. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=6783d00d-02ef-45f5-bb9d-fafcc0ec01ea%40sessionmgr113&vid=7&hid=123

Apker, J., Propp, K. P., Ford, W. S. F., & Hoffmeister, N.(2006). Collaboration, credibility, compassion, and coor-dination: Professional nurse communication skill sets inhealth care team interactions. Journal of ProfessionalNursing, 22, 180–189. doi:10.10164/j.profnurs.2006.03.002

Austgard, K. I. (2008). What characterizes nursing care?A hermeneutical philosophical inquiry. ScandinavianJournal of Caring Sciences, 22, 314–319. doi:10.1111/j.1471-6712.2007.00526.x

Baltimore, J. (2006). Nurse collegiality: Fact or fiction?Nursing Management, 37(5), 28–36.

Bednarski, D., & Rosenberg, P. (2008). Nurses’ uniformsand perceptions of nurse professionalism [Abstract].Nephrology Nursing Journal, 35(2), 169. Retrieved fromhttp://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=a41506b8-d021-4c26-b4af-f350d7ab306f%40sessionmgr111&vid=5&hid=123

Benner, P. (1991). The role of experience, narrative,and community in skilled ethical comportment. Advancesin Nursing Science, 14, 1–21. Retrieved from http://www.cinahl.com/cgi-bin/refsvc?jid=120&accno=1992136796

Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010).Educating nurses: A call for radical transformation. SanFrancisco: Jossey-Bass.

Benner, P., Sutphen, M., Leonard-Kahn, V., & Day, L.(2008). Formation and everyday ethical comportment.American Journal of Critical Care, 17(5), 473–476. Retrievedfrom http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=28b8cd2f-ef63-440a-80b7-8d3d76447c6e%40sessionmgr114&vid=18&hid=123

Catlett, S., & Lovan, S. (2011). Being a good nurse and doingthe right thing: A replication study. Nursing Ethics, 18(1),54–63. doi:10.1177/0969733010386162

Clark, C., & Cardoni, C. (2010). What students can do topromote civility. Reflections on Nursing Leadership, 36(2).Retrieved from http://web.ebscohost.com.lib-proxy.usi.edu/ehost/detail?vid=3&hid=10&sid=12692c46-3270-41dd-a287-4392412d1ca5%40sessionmgr4&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=c8h&AN=2010752436

Dougherty, M. B., & Larson, E. L. (2010). The nurse to nursecollaboration scale. Journal of Nursing Administration, 40,17–25. doi:10.1097/NNA.0b013e3181c47cd6

Embree, J., & White, A. (2010). Concept analysis: Nurse-to-nurse lateral violence. Nursing Forum, 45(3), 166–173. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=3&sid=fb37b446-086d-4e32-ade6-c8c2ec5415f3%40sessionmgr111&hid=126

Fletcher, K. (2007). Image: Changing how women nursesthink about themselves, literature review. Journal ofAdvanced Nursing, 58, 207–215. doi:10.1111/j.1365-24648.2007.04285.x

Gallagher, A. (2007). The respectful nurse. Nursing Ethics, 14,360–371. doi:10.1177/0969733007075874

Hentz, P. B., & Lauterbach, S. S. (2005). Becoming self-reflective: Caring for self and others. International Journalfor Human Caring, 9, 24–28.

Hutchinson, M., Wilkes, L., Vickers, M., & Jackson, D.(2008). The development and validation of a bullyinginventory for the nursing workplace. Nurse Researcher,15, 19–30. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=8a54ae96-a9bf-426b-aa1b-08b76c153c52%40sessionmgr112&vid=4&hid=123

Hutton, S. (2006). Workplace incivility: State of the science.Journal of Nursing Administration, 36, 22–27.

Konishi, E., Yahiro, M., Nakajima, N., & Ono, M. (2009). TheJapanese value of harmony and nursing ethics. NursingEthics, 16, 625–636. doi:10.1177/0969733009106654

LaSala, K. B., & Nelson, J. (2005). What contributesto professionalism? MEDSURG Nursing, 14(1), 63–67.Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=28b8cd2f-ef63-440a-80b7-8d3d76447c6e%40sessionmgr114&vid=31&hid=123

Öztung, G. (2006). Examination of incidents of workplaceverbal abuse against nurses. Journal of Nursing CareQuality, 21, 360–365. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?vid=4&sid=0366d8fe-16ff-4580-b803-4620cabd08b4%40sessionmgr114&hid=120

Rassin, M. (2008). Nurses’ professional and personalvalues. Nursing Ethics, 15, 614–630. doi:10.1177/0697733008092870



Rizk, K., & Bofinger, R. (2008). Chapter 10. Florence night-ingale versus Dennis Rodman: Evaluating professionalimage in the modern world. Annual Review of NursingEducation, 6, 189–204. Retrieved from http://search.proquest.com/docview/216909309/fulltextPDF/13CDB6A91B03EE9D685/10?accountid=30095

Roach, M. S. (2002). Caring the human mode of being: A blue-print for the health professions (2nd ed.). Ottawa, ON: Cana-dian Health Press.

Roach, M. S., & Maykut, C. (2010). Comportment: Acaring attribute in the formation of an intentionalpractice. International Journal for Human Caring, 14(4),22–26. Retrieved from http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=ffcce1d6-ebb1-4f0d-9434-9af2a637469f%40sessionmgr115&vid=4&hid=121

Rodgers, B. L., & Knafl, K. A. (2000). Concept development innursing (2nd ed.). Philadelphia: Saunders.

Shih, F., Lin, Y., Smith, M., Liou, Y., Chiang, H., Lee, S., &Gau, M. (2009). Perspectives on professional valuesamong nurses in Taiwan. Journal of Clinical Nursing, 18,1480–1489. doi:10.1111/j.1365-2702.2008.02728.x

Stanley, K. M., Martin, M. M., Michel, Y., Welton, J. M., &Nemeth, L. S. (2007). Examining lateral violence in the

nursing workforce. Issues in Mental Health, 28, 1247–1265.doi:10.1080/016128407001651470

Thupayagale-Tshweneagae, G., & Dithole, K. (2007). Unityamong nurses: An evasive concept. Nursing Forum, 42,143–146. Retrieved from http://search.proquest.com/docview/195030432/fulltextPDF?accountid=30095

Vessey, J. A., DeMarco, R. F., Gaffney, D. A., & Budin, W. C.(2009). Bullying of staff registered nurses in the work-place: A preliminary study for developing personal orga-nizational strategies for the transformation of hostile tohealthy workplace environments. Journal of ProfessionalNursing, 25, 299–306. doi:10.1016/j.profnurs.2009.01.022

Walker, L. O., & Avant, K. C. (2005). Strategies for theoryconstruction in nursing (4th ed.). Upper Saddle River, NJ:Prentice Hall.

Webster’s Online Dictionary. (2010). Retrieved fromhttp://www.websters-online-dictionary.org/definitions/comportment?cx=partner-pub-0939450753529744%3Av0qd01-tdlq&cof=FORID%3A9&ie=UTF-8&q=comportment&sa=Search#922



Documents

Professional Comportment: The Missing Element in Nursing Practice