Professional or Practitioner: What’s in a name?

Dr Deborough Macbeth from Gold Coast Univerity Hospital and a leader in professional ICP practice in Australia was asked to write a blog for our site. Deb has written a thought provoking blog that we hope generates some discussion.  Thank you Deb

Brett

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In 2008 the Association of Professionals in Infection Control (APIC) announwhat-is-in-a-name-2ced a change in the title of its members from ‘Infection Control Professionals’ to ‘Infection Preventionists’. The justification for this change reported in Infection Control Today by Kath Wayre, APIC’s CEO at the time, was that the new title “clearly and effectively communicates who our members are and what they do”.[1] In Australia, where the title ‘Infection Control Practitioner’ had been common for many years, news of this change filtered through prompting discussion and debate about our own title.

A range of issues informed this discussion and debate at that time in the Australian context. For me, two were particularly relevant. First, the establishment of a new nursing role titled Nurse Practitioner. The Nurse Practitioner role carried expanded practice rights including prescribing with specific additional educational requirements. Concerns were raised amongst the membership of the then College, known as the Australian Infection Control Association, around the ongoing use of ‘practitioner’ in our title and the possibility of other health professionals and members of the general public confusing our role with that of the Nurse Practitioner. These are used interchangeably in the literature, by members of the College and other health professions, without formal impediment or official restriction.

The second issue related to the increasing need to recognise non-nursing members of our profession. Once the Nurse Practitioner role was established in Australia, use of the term practitioner in our title tended to link the role exclusively to nursing. Ultimately the decision was made to adopt the title Infection Control Professional but what does this title mean?

Over the years I have reflected on these issues and question, leading me down a number of paths. The first is my recollection of when I was offered a chance to work in infection control for the first time, in 1993. I jumped at the opportunity for a number of reasons. I had just completed a secondment in sexual health where my main role had been working with patients who had Human Immunodeficiency Virus (HIV). That specific role involved a significant focus on education of both health professionals as well as the general public. As a consequence I had developed educational skills and had a firm grasp of infection control concepts including ‘Universal Precautions’ (now called Standard Precautions) and Transmission-based Precautions. I had also provided counselling in relation to testing for blood-borne viruses and treatment in terms of hepatitis B vaccination. While these experiences augmented my previous nursing knowledge and experience, it was my belief that I should have no difficulty filling the infection control role because after all, infection control is a key component of all roles in healthcare.

Of course, it took no time at all in my new role to discover the vast difference between a basic understanding of infection control principles and the professional practice of infection control. It can be compared to the difference between the amateur golfer who plays once a week and Tiger Woods or some other professional golfer.

Tiger Woods no longer simply plays golf. He tests and endorses golf clubs and assorted equipment, he designs golf courses that others pay to play. He could write the handbook on golf and people would be willing to pay large sums of money to have him teach them how to play. This is the divide we cross when we call ourselves Infection Control Professionals. Did you think of that when you took on your first role in infection control? I certainly did not.

Stepping away from the sporting analogy, consideration of what constitutes a professional creates in my mind thoughts of a body of knowledge that is evidence-based. The professional is aware not only of the principles, but also the evidence that underpins those principles and the professional practice it informs.

The professional can respond to challenges and work in unfamiliar contexts simply through the application of those same principles. Furthermore, the professional identifies the unknown and seeks to make it known through scientific inquiry and research. In this regard the professional generates new knowledge, adding to the evidence base and paving the way for those who come afterwards.

The professional is someone whom others consult looking for answers to complex problems. In this sense our work may be compared to architects or engineers. Ours is a deep understanding of all the elements at work in a specific scenario. We can see the competing tensions and strike the correct balance: safe and practical; simple and elegant.

The professional is constantly learning and refining his/her knowledge and skills. He/she undertakes formal education and gains extensive experience, recognising his/her limitations but also continues to push the boundaries of those limitations.

The professional seeks out and consults with other professionals. They develop networks for collaboration and support. These networks become formalised over time into professional bodies and through consensus, standards of practice are developed for the protection of the professional and those they serve. As the profession matures it becomes self-regulating, clearly defining who its members are, their scope of practice, and what it takes to be a professional in that context.

All these considerations underpinned my decision to adopt the title Infection Control Professional (ICP). These considerations direct my daily practice and my commitment to and involvement in the Australasian College of Infection Prevention and Control (ACIPC) as the professional body that represents me. These considerations sustain and nourish my desire to light the path for those who follow, clearly illuminating the way forward. These considerations give form and function to the new ACIPC credentiallinacipc-credentiallingg framework that provides a mechanism for acknowledgment not only of the expert ICP but those in various stages of their professional journey.

When I consider what it means to be an ICP, I continue to challenge myself to move beyond the petty trials and tribulations associated with my work each day and focus instead on the sleek and shining edifice of professionalism we are building. Those who went before us laid the foundations and we have built upon them. Although arguably we are still stretching our wings and finding the limits of our strength, others will come after us and push the boundaries further still.

When I refer to myself as an Infection Control Professional I do so based on all these considerations. It isn’t just a title I have adopted. For me it has deep meaning and carries great responsibility. It enables me to challenge myself about who I am, what I stand for, and who I’m claiming to be when I call myself a ‘professional’. What does it mean for you?

Deb Macbeth

 

References

[1] Infection Control Today July 11, 2008. http://www.infectioncontroltoday.com/news/2008/07/apic-announces-new-name-for-infection-control-pro.aspx

 

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