Introduction
We often discuss how to prepare students for the NCLEX exam. However, our true responsibility as nurse educators goes much deeper than that.
We are helping students become nurses, not just in terms of skills and knowledge, but also in how they think, act, and respond during critical moments.
Professional identity isn’t something to be checked off a list or memorized. It’s something that students need to learn to embody every day, especially in moments of uncertainty, pressure, and responsibility, including when things don’t go as planned.
In nursing, those moments are not merely theoretical; they are very real.
Student Transformation
The transition from student to nurse involves more than just acquiring knowledge—it signifies a deeper transformation. As students start to think, feel, and act like nurses, their professional identity begins to take shape, influenced by the values, expectations, and realities of the nursing field.
We often describe this identity using positive terms such as:
- Integrity
- Advocacy
- Emotional intelligence
- Leadership
- Moral courage
These are the qualities we hope every graduate will bring into their practice. However, professional identity is not only revealed in ideal situations; it becomes most apparent during challenging moments.
It is in those instances when:
- Something goes wrong
- A decision leads to consequences
- A mistake cannot be reversed
These are the moments where one’s identity is not just talked about—it is truly lived.
Learning from the Mistakes of Others
As I began reflecting on professional identity, one story kept coming to mind—the case of RaDonda Vaught. A tragic medication error resulted in the death of a patient, Charlene Murphy. This is a case that many nurses are familiar with, and it is difficult to confront.
What stood out to me was not just the error itself, but what happened afterward. RaDonda immediately:
- Acknowledged her mistake
- Took responsibility
- Notified the appropriate individuals
- Expressed genuine remorse
She acted with honesty and transparency in a moment when fear, shame, and self-protection could easily have taken over.
The situation that followed was complex and controversial. Systems failed. Reporting mechanisms failed. Support was inadequate. Even as the consequences intensified—including the loss of her job, public scrutiny, and legal action—RaDonda continued to display something we say we value in nursing: moral courage.
This is where professional identity becomes real.
Not when everything goes right. But when everything goes wrong, the nurse still chooses to act with courage and integrity.
What Are We Forming?
As nurse educators, this raises an important question:
What are we truly forming and preparing students for?
Are we preparing them to select the correct answer on an exam?
Or to navigate real clinical situations with accountability, judgment, and courage?
Because students will not remember every lecture.
But they will carry how we taught them to respond under pressure.
This is where learning experiences matter.
When students engage in:
- Authentic unfolding case studies
- Realistic clinical decision-making
- Situations that require ethical reflection and accountability
They begin to practice not just what to do, but how to be.
At KeithRN, this is the belief that drives everything:
Nursing must be taught the way it is actually practiced.
Our Think Like a Nurse Membership was created to support educators who want to make this shift without adding more to an already full workload.
You’ll find access to hundreds of authentic unfolding case studies designed to help students:
- Strengthen clinical judgment
- Navigate complex, real-world scenarios
- Engage with the values and ethics that define our profession
If you’ve been looking for a way to help students connect knowledge to practice in a more meaningful way, this may be a helpful place to start.
You can explore the membership and receive 50% off your first month using code: 50THINK
Professional identity is not established when everything goes well. It is revealed in how a nurse reacts when something goes terribly wrong.
Take a moment to reflect on the following questions:
- In your course, where do students practice responding to mistakes, instead of just trying to prevent them?
- How do students experience accountability, rather than just focusing on being correct?
- Are we creating an environment where discussions about moral courage can take place, and where it can be modeled and developed?
- Most importantly, would our students know how to respond—both clinically and professionally—if they made a serious error?
Closing Thoughts
Nurses are human, and humans are fallible. Despite our best efforts, errors can and do occur in healthcare. What truly defines us, and the nursing profession, is how we respond to these errors when we make them.
Nursing has consistently been recognized as one of the most trusted professions. This trust is not based on perfection; instead, it is built on honesty, accountability, and the willingness to do what is right, even at great personal cost.
To prepare practice-ready nurses, we must teach beyond just tasks and tests. We need to help students become the kind of nurses who can maintain their integrity in challenging situations. Because that is what patients deserve, and developing integrity and the values our profession is built upon must be embodied and lived out from day one.
References
Cruess, R.L., Cruess, S.R., Boudreau, J.D., et al. (2014). Reframing medical education to support professional identity formation. Academic Medicine, 89(11), 1446–1451.
Godfrey, N., & Young, E. (2020). Professional identity. In Giddens, J. F. Concepts of Nursing Practice (3rd ed.). Elsevier.
Merton, R. K. (1957). Some preliminaries to a sociology of medical education. In The Student Physician. Harvard University Press.
Maria Flores-Harris, DNP, RN, CNE
Dr. Flores-Harris, Nurse Educator Consultant for KeithRN, is an accomplished registered nurse with experience in clinical, academic, and business settings. She received her Bachelor’s of Science and Master’s of Science in Nursing with a Geriatric Nurse Practitioner focus from Clemson University. She remains loyal to her Clemson Tigers!
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