https://doi.org/10.14528/snr.2017.51.4.199
2017. Obzornik zdravstvene nege, 51(4), pp. 274–297.
ABSTRACT
Introduction: An occupation becomes a profession once it uses a systematic approach to generate new 
knowledge and transfer it directly into professional work. The aim of this paper is to show the attitudes of 
nursing care professionals towards the professionalization of nursing care and make a contribution by means 
of identifying the factors that are important for the development of the professionalization of nursing in 
Slovenia.
Methods: The group interview technique was used with two rounds. Participants responded to 15 open 
premises/questions. Purposive sampling was used and groups were comprised of professionals from all levels 
of clinical environments, secondary and higher education teachers and master's and doctoral degree students 
(n = 48).
Results: The results of the first round produced 3 themes, while the second round generated findings 
related to 4 themes. The synthesis of the findings from both rounds resulted in two overarching themes. 
The first is "National responsibility" which includes the responsibility of the nursing care management and 
the management of higher education institutions as well as the responsibility of the Nurses and Midwives 
Association of Slovenia for developing nursing care as a scientific discipline. The second theme is "National 
indicators for the realization of national responsibility" which includes (1) Classification of jobs in nursing care 
to reflect the 4 levels of nursing care competencies, (2) research and development as work tools in nursing 
care, and (3) the national institute for nursing care research.
Discussion and conclusion: The responsibility for the development of professionalization lies with several 
sectors. A clear and ambitious vision, and a strategy for the development of nursing care that should include 
responsibility for setting a new paradigm for the development of nursing care as a response to the needs of 
the society, occupation and science, are needed. The strategy should be supported by means of a planned 
distribution of means to facilitate its realisation. 
IZVLEČEK
Uvod: Stroka postane profesija, kadar s sistematičnim pristopom ustvarja novo znanje in ga prenaša 
v neposredno delo. Namen raziskave je bil preveriti stališča in razumevanje nekaterih elementov 
profesionalizacije med strokovnjaki ter prispevati k prepoznavanju dejavnikov pomembnih za razvoj 
profesionalizacije zdravstvene nege v Sloveniji. 
Metode: Uporabljena je bila tehnika skupinskega intervjuja. V dveh sekvencah so bili izvedeni štirje skupinski 
intervjuji, oblikovanih je bilo 15 odprtih izhodišč/vprašanj. Uporabljen je bil sistematični namenski vzorec, 
skupine so sestavljali strokovnjaki iz kliničnih okolij vseh ravni, učitelji srednješolskega in visokošolskega 
izobraževanja in študenti magistrskega in doktorskega študija (n = 48).
Rezultati: Rezultati prve sekvence dajo tri tematske ugotovitve, rezultati druge sekvence nadaljnje štiri. Sinteza 
spoznanj obeh sekvenc je podala dve nadtemi. Prva je nacionalna odgovornost, le-ta vključuje odgovornost 
menedžmenta zdravstvene nege, visokošolskih zavodov in Zbornice – Zveze za razvoj zdravstvene nege kot 
znanstvene discipline. Druga nadtema so nacionalni kazalniki uresničevanja nacionalne odgovornosti, le-ti 
vključujejo (1) sistematizacijo delovnih mest za štiri ravni kompetenc, (2) raziskovanje in razvoj kot orodje 
dela in (3) nacionalni inštitut za raziskave v zdravstveni negi.
Diskusija in zaključek: Odgovornosti za razvoj profesionalizacije so medsektorske. Potrebni sta jasna in 
ambiciozna vizija ter strategija razvoja zdravstvene nege, ki naj vključuje odgovornost za postavitev nove 
paradigme razvoja zdravstvene nege, ki bo odziv na potrebe družbe, stroke in znanosti. Strategija naj bo 
podprta z načrtno razdelitvijo sredstev za njeno uresničevanje.
Key words: management; 
competencies; research; science; 
systematization
Ključne besede: menedžment; 
kompetence; raziskovanje; 
znanost; sistemizacija 
Associate Professor Brigita 
Skela-Savič, PhD, MSc, BSc, 
RN, Research Counsellor; 
Angela Boškin Faculty of 
Health Care, Spodnji Plavž 3, 
4270 Jesenice, Slovenia
Correspondence e-mail/
Kontaktni e-naslov: 
bskelasavic@fzab.si
Original scientific article/Izvirni znanstveni članek
Development of nursing professionalization elements in Slovenia: the group 
interview technique
Razvoj elementov profesionalizacije v slovenski zdravstveni negi: tehnika skupinskih 
intervjujev 
Brigita Skela-Savič
The article is partially based on 
the results of a research project 
Nursing as a scientific discipline 
in Slovenia: an internationally 
comparable secondary and 
tertiary education system in 
nursing care as the foundation 
of research and scientific 
contribution to the sustainable 
development of society./
Članek je nastal na podlagi 
dela rezultatov raziskovalnega 
projekta Zdravstvena nega kot 
znanstvena disciplina v Sloveniji: 
mednarodno primerljiv sistem 
sekundarnega in terciarnega 
izobraževanja v zdravstveni negi 
kot temelj raziskav in prispevka 
znanosti k trajnostnemu 
družbenemu razvoju.
Received/Prejeto: 14. 10. 2017
Accepted/Sprejeto: 17. 11. 2017
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 275
Introduction
Many of those in Slovenia who are involved in the 
research and development of nursing feel that the 
professionalization of nursing has been developing 
too slowly. Therefore, the issue is how well do we 
understand the concepts related to professionalization 
and the related factors? Carvalho (2014) states that 
nursing is often referred to as a 'half profession' or 
a 'virtual' profession in the discourse related to the 
professionalization of healthcare occupations. 
Definitions
The concept of professionalization is an issue in 
many occupational groups and has a long history and 
social context. Consequently, several interpretations 
and definitions of this concept developed related to 
different use and needs (Demirkasimoğlu, 2010). An 
often-cited definition of professionalization states that 
professionalization is a social process that involves 
an institutionalised manner of preparing individuals 
for conducting professional tasks. During the process 
of professionalization, norms and qualifications for 
the representatives of the profession are established, 
and there is also responsibility for obtaining and 
transferring knowledge, certifying competencies, 
looking after relations among the members of the 
profession on the inside and on the outside (Wilensky 
& Harold, 1994). The Slovenian author Svetlik (1999) 
thinks that the process of professionalization of a 
certain occupation depends on several factors such as 
the area of work, the reasons for work, the resources 
that an occupation has available, as well as self-
awareness and self-regulation of the occupation. That 
is why professionalization of various professions also 
differs amongst each other themselves. 
Defining professionalization and professionalism 
in nursing
Many researchers have studied the professionalism 
of nursing through the years, so there are many 
definitions and descriptions of characteristics (Adams 
& Mikker, 2001; Manojlovich & Ketefian, 2002) 
and researchers use different methods and tools for 
evaluating it (Ghadirian, et al., 2014). 
Professionalization is a multi-dimensional concept that 
ensures nurses develop personally and professionally. 
This process requires knowledge, skills, development of 
the characteristics of a professional identity related to 
a particular profession and internationalization of the 
values and norms of the professional group (Alidina, 
2013). Professionalism is assessed according to 
individual characteristics and behaviour, relations with 
other individuals and the context of operation, as well as 
social dimensions such as social responsibility, morals, 
and political and economic responsibility. In addition, 
professionalism also includes following standards 
and competencies (Keeling & Templeman, 2013; 
Fantahun, et al., 2014). The concept of professionalism 
itself demonstrates dedication to the profession, so 
nurses are expected to educate themselves, publish 
their research, improve the practical and theoretical 
concepts of nursing and work independently (Çelik & 
Hisar, 2012). Their own professional perception and 
understanding of the concept of nursing, as well as their 
implementation in the social context, are of the utmost 
importance. Both their own professional perception and 
the understanding of the significance of nursing, affect 
the development and growth of nursing as a scientific 
discipline (Viitanen, 2007). 
Watkins (2011) describes professionalism as 
a concept by means of three variables. The first 
one is the formation of profession, that involves a 
professional group, defined knowledge of the area of 
operation, established self-regulation and a continuing 
development of professional knowledge and skills 
for continuous improvement of the quality of work. 
The second variable of professionalism is recognition 
of profession, that includes core components such 
as knowledge, independence, responsibility of a 
professional judgement and their joined effect on 
the effectiveness of clinical work. The third variable 
is success of the profession, that can only be achieved 
by means of formal education and must include 
knowledge obtained by systematic research and 
professional review that is formed through critical 
thinking and decisions based on evidence. Watkins 
(2011) states that education on the master's level is a 
key element that uses the findings of research studies 
on professionalization in order to reach it. The reason 
for this is that research increases trust in graduates' own 
work, so that it is meaningful: the abilities of graduates 
to make decisions and their other cognitive abilities 
contribute to the implementation of evidence-based 
practice, thus achieving professionalism. Carvalho 
(2014) has found that professions in healthcare differ 
the most in terms of research-obtained knowledge. 
However, some nurses understand new knowledge as 
moving away from nursing care and support the local 
context of knowledge in practice. 
Researching professionalization in Slovenia 
Professionalization of nursing has been researched 
by Slovenian authors in original scientific works such 
as a dissertation, scientific or professional monograph 
or original scientific article (Pahor, 1998; Cvetek, 1999; 
Starc; Starc, 2009, 2016). An important contribution 
to understanding the professionalization of nursing 
in Slovenia is the scientific monograph Medicinske 
sestre in univerza (Pahor, 2006) ('Nurses and the 
University' transl.) in which the author summarises 
and reflects on the development of nursing education 
since 1990, thus demonstrating an important part of 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.276
professionalization that, according to Watkins (2011), 
belongs to forming the profession. An important 
contribution to understanding the professionalization 
is a monograph by Starc (2014) that finds three main 
characteristics of nursing professionalization in 
Slovenia, which are knowledge, power and ethics. In 
a quantitative analysis, Starc defines the concept of 
professionalization as nursing independence, which 
participants understand as knowledge, education, 
training, competencies and life-long learning.
The research conducted by Skela-Savič and colleagues 
(2016a; 2017a) focuses on professionalization from 
the aspect of professional values, competencies and 
evidence-based practice. The research has shown that 
the established values in nursing can only be understood 
as (1) values of nursing care, trust and fairness, and (2) 
values of development, professionalism and activism. 
The research has shown that the values of development, 
professionalism and activism are less important, which 
explains the success of the implementation of evidence-
based practice. Nurses with a higher education degree in 
Slovenian hospitals understand competencies as "expected 
competencies for practical work" and as "competencies 
of development and professionalism". Knowledge and 
beliefs of evidence-based practice are present, but those 
included in the study are not convinced that they know 
evidence-based work well enough to incorporate it in 
practice. That is why evidence-based practice is rarely 
conducted . The causal non-experimental model shows 
that the beliefs and implementation of evidence-based 
practice may be explained by (1) values of development, 
professionalism and activism, (2) competencies of 
development and professionalism, (3) knowledge of 
research work, (4) knowledge of evidence-based practice, 
(5) education or training on evidence-based practice and 
(6) access to databases. 
Aims and objectives
The purpose of the study was to verify the 
attitudes and understanding of certain elements 
of professionalization among experts of nursing in 
Slovenia. The aim of the study was to make a contribution 
towards recognising the factors that are important for 
the development of the professionalization of nursing 
care and that can contribute to the strategic planning 
of its development. 
The research question: 
Which strategic factors are necessary in order to − 
develop elements of professionalization in nursing 
in Slovenia, in the areas of education, professional 
competencies, and research related to the development 
of the occupation and nursing science? 
Methods
A quantitative research paradigm was used and data 
was collected using a group interview technique and 
processed using a thematic analysis method, which is 
one of the approaches of analysing the content of a text 
(Gomm, 2008). A group interview is used when we 
wish to obtain data for strategic planning, whereby we 
are interested in opinions and answers to pre-prepared 
open questions. The group interview might be more 
successful if the participants know each other as the 
interaction between them and the host improves. 
The discussion is managed by the host who knows 
the topic of the discussion well (Kumar, 2011). Since 
the participants of the group interview also know 
the topic, Green and Thorogood (2004) refer to such 
a group as a natural group – a researcher can detect 
cultural dynamics on topics of interest and responses 
from practice, which forms the course of the group 
interviews and data processing. 
Description of the research instrument
A group interview was conducted in two rounds. 
The first one, entitled "Development of a competence 
model for all levels of education in nursing", was 
conducted in October 2016, while the second round, 
entitled "The national model of development and 
consolidating nursing as a scientific discipline", was 
conducted in March 2017. Seven days before both 
meetings, the participants were sent questions/
premises. The first round contained 5, while the second 
round was composed of 10 open questions/premises. 
A sample of open questions from the first round:
What is your attitude towards accepting the −	
competence model in nursing for Slovenia? 
What kind of changes do you propose with reference −	
to updating the standard of secondary education in 
nursing? 
What is your opinion about the aim of achieving a −	
high level of organisation across all levels of nursing 
education, to enhance the sustainability of the 
healthcare system? 
An example of open questions from the second 
round: 
What do you see as the key problem that should be −	
solved, so that nursing could develop as a scientific 
discipline? 
What kind of knowledge do you miss at your work −	
or the lack of what kind of knowledge hinders you 
in the development of the occupation that you are 
involved in? 
Generally, higher education teachers also work in −	
clinical settings, which means that such a teacher 
has two jobs within full-time 100% employment. 
What would a healthcare institution gain from such 
cooperation and vice versa, what would the faculty 
gain?
On the day of the study the participants were placed 
in two groups in order to secure better conditions for 
active participation. We ensured that each group was 
equally comprised of the different professional groups 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 277
attending. The discussion was held simultaneously 
in separate rooms, according to the schedule, for five 
hours with two breaks, alongside an introductory 
presentation of the starting points for the discussion, 
that were related to findings of previous parts of the 
research project (Skela-Savič, et al., 2017b) whose 
part is also formed by this study. Before starting, we 
notified all the participants about the anonymity of 
the data processing and the voluntary participation 
in the study. The participants gave a written consent 
alongside the recording of the discussion. The groups 
of the first and second round were hosted by higher 
education teachers that are involved in the scientific 
research of nursing care in Slovenia. They had a 
uniform previously designed protocol of managing an 
interview with defined open questions. The discussion 
in both rounds was conducted according to the same 
protocol. 
Description of the research sample
Kumar (2011) states that the selection of the sample 
in a group interview is the researcher's responsibility 
and that they should follow the purpose, which is 
addressing strategic themes. It is important that the 
professionals who are involved know the field and cover 
a wide spectrum of content that is related to the field 
of the discussion. In order to satisfy the conditions, we 
used a systematic purposeful sample of professionals 
(n = 48) that Green and Thorogood (2004) define as 
a prerequisite for obtaining representative data. The 
systematic feature of the sample was understood to 
mean ensuring an appropriate involvement of various 
sectors and other participants in the development 
of professionalization of nursing care. We included 
professionals from the following fields: secondary 
education (n = 8) and higher education in nursing 
(n = 15), healthcare institutions on all three levels of 
healthcare and other institutions (n = 17), students 
of master's and doctoral studies programmes that 
work in nursing (n = 3), and members of various 
professional bodies on the national level (n = 5). Those 
invited had operated at various levels of responsibility, 
from a professional leader of a certain area to a leader 
on the highest level of organisational management. 42 
women and 6 men participated and all the participants 
had at least a higher education professional study degree; 9 
(19 %) participants cooperated in both rounds of the study. 
Description of the research procedure and data 
analysis 
In data analysis we followed the thematic text 
analysis approach according to Gomm (2008), and 
Green and Thorogood (2004), which means that the 
researcher searches for common characteristics in the 
entire set of interview data and forms themes based 
on a comparison between similarities and differences 
in the respondents' responses in the interviews. A 
researcher decides what will count as evidence in 
order to design themes. The final themes may also 
be inspired by the ideas of the researcher; most often 
originating from the previous research of the research 
problem in question. In doing so, a researcher should 
be capable of reflection. 
Based on the described guidelines we excluded the 
content that was unclear and could not be understood. 
We put all the forms in the female grammatical gender 
form as there were more women in both groups. We 
deleted all place names, names of institutions, bodies 
and communication fillers. In this way we secured 
anonymity of the respondent. The unit of coding was 
an uttered thought or opinion of a respondent about a 
specific topic. If a speaker talked about several themes, 
the uttered items were coded in several individual 
themes. In coding, the Thematic coding technique 
was used (Gomm, 2008), so we formed the codes with 
several words in order to describe the gist of what was 
said, which is called open descriptive coding. This 
enabled us to design categories such as hypernyms 
of the codes also in terms of content and to therefore 
come up with key findings based on the interviews that 
we presented in the form of themes. We conducted a 
secondary analysis of results and added some content 
and terminology in accordance with the research 
report by Skela-Savič and colleagues (2017b). In the 
data analysis we followed the processing guidelines 
according to Green (2004), as we wished to understand 
the connections between the attitude, behaviour 
and experience of the respondents in the field of the 
discussed themes. We also wished to understand the 
phenomenon of some elements of professionalization 
which the respondents used in their descriptions 
and, as a result of the study, we aimed at forming 
new ideas and a theoretical construct of findings for 
future research. The synthesis of findings from both 
rounds gave us the opportunity to better define the 
responsibility for the development of professionalism 
in nursing on a strategic level, which is also the purpose 
of the group interview technique. 
Results
Round 1: Development of the competence model 
for all levels of education in healthcare
As part of the analysis we formed 49 codes that 
were supported by 150 quotations by the respondents. 
Each quotation was used only once. From 47 codes we 
developed 14 hypernymic categories that form 3 final 
themes (Table 1), while two codes were not listed under 
any category. A few examples of the development of 
codes are presented below. The development of all 
codes is shown in the research report with reference 
to the project Nursing as a scientific discipline (Skela-
Savič, et al., 2017b). 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.278
As an example, the code "It is necessary to define 
the competencies depending on the level of education" 
was developed with three quotations: 
Quotation 14: I think that it is time that we agree on 
things, that this applies to the whole of Slovenia; that we do 
not ask ourselves who does what and what they should not 
be doing; that it is clear what the competencies of those with 
completed secondary school education are and of those who 
have completed the higher education programme. 
Quotations 15: /…/ that it has been clarified what the 
master's study entails. And of course, the first students 
have now enrolled in doctorate studies. I think that all 
of this has not yet been clarified or defined. And now 
that we are here, we have the chance to talk about these 
things. 
Quotation 16: I think that we have now reached the 
point when we need to precisely define the competencies 
of individual contractors. Otherwise, I feel that the levels 
have been well designed, so I don't see any issues here. 
As another example, the code "An awareness of 
exceeding competencies of healthcare assistants is 
present" was developed considering four quotations. 
Quotation 117: We educate at level V, but what 
happens at the employers' is no longer our concern. 
Quotation 118: When secondary school students 
attend work placement, they tell us what they have 
done and we worry because work placement seems not 
to be well designed. /.../ I'm not saying that we never 
learnt about this. I think this is where the difference is, 
namely what students learn at level V and what is then 
happening at work when these students start it. 
Quotation 119: Employees with secondary school 
qualifications exceed their competencies, which is a 
matter for the employer. 
Table 1: Results of the discussion on education and competencies in nursing care (Round 1)
Tabela 1: Rezultati razprave o izobraževanju in kompetencah v zdravstveni negi (sekvenca 1)
Codes/Kode Categories/Kategorije Themes/Teme
Better involvement in the discussion on education 
and competencies is necessary.
There are differences in opinion 
between representatives of 
secondary and higher education 
regarding education. 
Social responsibility of 
higher education to organise 
education on all levels and 
for the argumentation of the 
development of nursing as a 
scientific discipline. 
Agreement between those actively involved in 
education and their users is necessary. 
Fear of competencies being taken away is present. 
There are ongoing opposing views regarding the 
education in nursing care. 
Levels of education are badly connected on the 
system level.
Education is not systematically organised. 
The occupation is not uniform, neither 
systematically nor historically.
Secondary education is training to work in the 
profession, not to study.
A dilemma exists whether the 
vertical system in education for 
the development of science should 
include secondary education. 
Most students come from secondary school for 
healthcare.
A continuous vertical transition of secondary school 
students is expected. 
Training to work in the occupation should start in 
secondary school. 
Secondary schools promote the entire vertical system. 
The European directive assist in solving the issues in 
education. The occupation of a nurse regulated 
by the European Union requires 
at least a higher professional study 
qualification. 
The university study programme of nursing is 
needed.
The term nurse requires a higher education 
qualification. 
Study programmes should be comparable 
developments in the European Union. European comparability safeguards 
the development of nursing care. Interference of other occupations in the autonomy of 
education in nursing care must be stopped. 
Higher professional education programmes must be 
changed to university programmes. 
Sound general knowledge is needed 
to study nursing care. 
To enter higher education study programmes, sound 
general knowledge is needed. 
The higher education sector should respond to the 
lack of knowledge. 
Continues/Se nadaljuje
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 279
Round 2: The national model of development and 
consolidating nursing as a scientific discipline 
As part of text analysis we designed 20 codes that 
are justified with 101 quotations by respondents. 
Every quotation is used only once. We developed 7 
hypernym categories that form 4 completed themes 
(Table 2). Below we present a few examples of code 
development, which is shown in great detail in the 
research report of the project Nursing as a scientific 
discipline (Skela-Savič, et al., 2017b). 
As a further example, we developed the code "The 
interest in research skills is questionable" in reference 
to four quotations: 
Quotation 25: There is 30 min allocated to nurses with a 
higher education degree intended for reading just like doctors.
Codes/Kode Categories/Kategorije Themes/Teme
The title of healthcare assistant is not acceptable. 
It is expected that a healthcare 
assistant works independently. 
Systemic responsibility of 
the nursing management 
and national professional 
association to stop exceeding 
the competencies of healthcare 
assistants and to ensure 
placement of the required levels 
of competences in nursing into 
the healthcare system. 
Healthcare assistant is an independent worker in 
health care, and is more than an assistant. 
Nurses with a higher education degree have to do 
too much administrative work. A nurse with a higher education 
degree is not accepted as a 
responsible healthcare worker. Delegation and management performed by a nurse 
is not accepted. 
Awareness exists that the competencies of healthcare 
assistants are often exceeded. 
All the involved parties are aware 
of the fact that competencies of 
healthcare assistants are being 
exceeded in clinical environments. 
There is no exceeding of competencies in secondary 
schools. 
Clinical environments the competencies of 
healthcare assistants to be exceeded. 
Exceeding of competencies is a professional self-
approval for healthcare assistants. 
Exceeding the competencies of healthcare assistants 
is a complex problem. 
The informing of employees is insufficient.
Nursing management has a 
significant responsibility for 
classifying the levels of competencies 
and stop exceeding the competencies 
of healthcare assistants. 
Competencies should be determined based on the 
level of education. 
Changes of the collective agreement, systematisation 
and levels of competence are needed. 
A uniform understanding of the role of a master of 
healthcare is necessary. 
Interests of the profession should be balanced with 
the interests of employers. 
Exceeding the competencies of healthcare assistants 
is a serious problem. 
Responsibility of the management for exceeding the 
competencies of healthcare assistants. 
Vertical terms caregiver. The professional term 'caregiver' 
does not have good social standing. 
Defining a healthcare assistant 
as a co-worker on the team 
of nursing care on all levels of 
healthcare system and as a key 
performer in healthcare and 
social care in the community 
and long-term care. 
The term 'nurse' is traditional. 
Cooperation of several stakeholders is necessary for 
the development of a professional standard. 
The design of secondary school 
programmes is poorly understood. 
Unawareness of real professional titles through the 
course of changes in education is present. 
No distinction between professional titles and names 
for the level of qualification is also present. 
The name of the occupation does not include care 
and welfare.
The identity of the occupation of 
a healthcare assistant is lacking in 
terms of the competencies of social 
care. 
The needs for social competencies of healthcare 
assistants are expressed. 
The open curriculum must be unified. Secondary schools do not show that 
they are ready for changes in the 
curriculum. Changes on the open curriculum are not enough. 
Assistive workers should be part of the vertical 
system. 
There is a danger of overlapping 
competencies of a healthcare 
assistant and an assistive healthcare 
worker. 
There is a danger of overlapping the competencies of an 
assistive healthcare worker and healthcare assistant. 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.280
Quotation 26: It is up to an individual how much they 
will then educate themselves about a certain topic and 
whether they will look out for additional knowledge. 
Quotation 29: I think the main problem is that we do 
not know about the opportunity or wish for additional 
knowledge. 
Quotation 79: The management will decide, but she 
also has to venerate and be aware of the knowledge that 
she needs. 
The code "Nurses are not prepared to conduct 
research" was developed with five quotations: 
Quotation 3: A lot of knowledge, experience, but 
they don't know how to put this into words and write it 
down, which is a problem. 
Quotation 8: Because of all that, the majority of those 
who enrol in nursing are people who are practical and 
who like working with people etc. 
Quotation 30: And if you come with that idea to a 
clinical environment you get beaten.
Quotation 119: The problem lies in us as a professional 
group in the first place and then in our colleagues, especially 
doctors who won't allow us to develop. But, my personal 
opinion is that the problem is in our professional group, 
in our heads and our way of thinking. We say: "We are 
independent, we are autonomous," but if we take a look 
around at what goes on....subordination of nursing is...
Quotation 120: I strongly agree with my colleague 
and I think that the key problem is in us and in the fact 
that we underestimate intellectual work. That we should 
really identify what is necessary. 
Table 3, which shows a synthesis of content of 
the seven themes obtained in both rounds, points 
Table 2: Results of the discussion on the development and consolidation of healthcare as a scientific discipline 
(round 2)
Tabela 2: Rezultati razprave o razvoju in krepitvi zdravstvene nege kot znanstvene discipline (sekvenca 2)
Codes/Kode Categories/Kategorije Themes/Teme
The management must be considerate of the employees' 
professional qualifications. 
Management of healthcare 
institutions is responsible 
for the development of 
nursing as a scientific 
discipline. 
The responsibility of 
nursing management and 
management of faculties 
for the development of a 
scientific discipline at the 
level of each institution. 
Research and development must be supported by a systemization of 
job positions. 
With institutionalised organisation of research and development 
there are several issues.
Movement of employees between a higher education and healthcare 
institution as part of 100 % employment is necessary. 
Management does not take on sufficient responsibility for research 
and development. 
Cooperation between the higher education and healthcare 
institutions is necessary. 
Research groups should 
be organised between 
healthcare and higher 
education institutions. 
A research entity should be established between the higher 
education and healthcare institutions. 
Professional work and research  
must be connected. 
The point of research is 
the development of the 
occupation and benefits 
for the patient. 
Research and development 
of the field as a work 
commitment of nurses 
with higher education 
qualifications. 
The centre of the research and development work should be the 
patient.
Interest in knowledge of research is questionable. 
Research is seen as 
optional and not as a 
priority of nurses. 
Understanding of research and development as leisure time 
activities conducted by nurses. 
Nurses are not willing to do research. 
To build a scientific discipline, knowledge is necessary.
Disagree on the scope 
and type of knowledge 
for development of 
occupation and science. 
Implementation of 
Europian comparable 
knowledge and 
competencies for the 
development of the 
occupation and scientific 
discipline in Slovenia.
There is not enough training for research and development in the 
workplace.
Opinions vary on the scope of training in research and 
development which is necessary for the profession of a nurse.
An opinion that knowledge of research might be necessary in 
quality control was expressed. 
A national research institute is necessary. The responsibility for the 
national research and 
development institute 
should be taken by the 
National Nurses and 
Midwives Association. 
The National Research 
Institute as a formal 
connecting form for the 
development and research 
in nursing care in Slovenia. 
The National Research Institute should be under the auspices of the 
national professional association. 
The National research institute should have other development 
tasks. 
An influence on the policy makers should be exerted  
through a National Research Institute. 
The National Research 
Institute should influence 
the policy makers. 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 281
at factors that have, in the study, been found as 
important in constructing a national approach to the 
development of nursing as a scientific discipline in 
Slovenia. We have found two main themes that refer to 
national responsibility. The first one focuses on those 
responsible for the implementation of a competence 
model in practice and for the implementation of the 
development of nursing as a scientific discipline, while 
the second one refers to the indicators which we will 
use to follow the development of nursing as a scientific 
discipline. 
Discussion
The results of group interviews conducted in two 
rounds bring our attention to the seven themes and 
two umbrella themes. The responsibility of healthcare 
management and higher education institutions and the 
professional association that is the Nurses and Midwives 
Association of Slovenia is of major importance for 
the development of nursing as a scientific discipline. 
These responsibilities have been defined on the level 
of national responsibility for the development of 
professionalization of nursing in Slovenia. We have also 
defined three national indicators of the implementation 
of this national responsibility: systematization of job 
positions on four levels of competencies in nursing, 
research and development as a tool for working in 
nursing and the establishment of the national institute 
for research in nursing. 
The study has shown that we will only be able to 
talk about the real development of nursing care as a 
profession and scientific discipline when the key holders 
of responsibility, especially the nursing management 
in healthcare institutions, begin with systematization 
of job positions for four levels of competencies in 
nursing care and follow the internationally comparable 
conditions of qualifications for implementing 
competencies at a certain level. Two previous studies 
conducted by Skela-Savič and colleagues (2016b, 
2016c) have shown that experts agree on the achieved 
adjustments of competencies as recommended by the 
European Federation of Nurses Associations – EFN, 
however, realistically speaking, there is no model 
outlining the competencies and activities of nursing 
care for the four levels of providers of nursing care 
despite the fact that a professional master's degree has 
been offered for ten years. 
This study has shown that content and terminological 
implementation of the categories of providers of 
nursing care according to the EFN model (EFN 
Workforce Committee, 2014) into our education 
system, the system of national competencies and 
activities of nursing care is sensible, and its transfer 
into descriptions and systematization of job positions. 
Under the auspices of the project Nursing as a scientific 
discipline, matrix of the levels of competencies in 
nursing according to the model EFN (Skela-Savič, et 
al., 2017b) with the use of a quantitative and qualitative 
approach was verified. For the purposes of the article 
this matrix has been terminologically upgraded and 
conditions of qualifications were set and comparisons 
with the frameworks of qualifications have been made. 
The proposed model for Slovenia will be explained 
in detail in the future publications relating to this 
project. 
The proposed competence model of the level of 
providers of nursing care in Slovenia: 
Level 1: an employee on the nursing team and the − 
healthcare team – healthcare assistant ('tehnik/
tehnica zdravstvene nege'), education – secondary 
vocational school for nursing (5th level of the 
Slovenian framework of qualifications or 4th level of 
the European framework of qualifications); 
Table 3: Synthesis of rounds 1 and 2
Tabela 3: Sinteza tem sekvenc 1 in 2
Themes/Teme Themes synthesis/Sinteza tem
The responsibility of the nursing management and the management of faculties 
for the development of a scientific discipline on the level of each institution.
NATIONAL RESPONSIBILITY – responsible 
for the implementation of a competence 
model in practice and for the development of 
nursing as a scientific discipline:
(1) nursing management,
(2) management of higher education and 
(3) the national association of nursing 
Social responsibility of higher education for organisation of education on all 
levels and for argumentation of the development of nursing as a scientific 
discipline. 
Implementation of European comparable knowledge and competencies for the 
development of the occupation and scientific discipline in Slovenia.
Research and development of the occupation as a work commitment of nurses 
with a higher education degree. INDICATORS OF IMPLEMENTATION OF 
NATIONAL RESPONSIBILITY:
(1) systematization of job position on four 
levels of competences in nursing, 
(2) research and development as a tool for 
working in nursing, 
(3) establishment of a national institute for 
research in nursing
Systemic responsibility of the nursing management and the national professional 
association to end the exceeding competencies of healthcare assistants and 
introduction of levels of competences in nursing into the healthcare system.
Defining a healthcare assistant as a co-worker on the team of nursing care on all 
levels of healthcare system and as a key performer in healthcare and social care 
in the community and long-term care. 
The National Research Institute as a formal connection for the development 
and research of nursing care in Slovenia.
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.282
Level 2: provider of nursing care on the team of − 
nursing or healthcare team – general care nurse 
('diplomirani zdravstvenik/diplomirana medicinska 
sestra'; dipl. zn./dipl. m. s.), education – higher 
education professional study programme nursing 
cycle 1 of the Bologna study programme that 
has been harmonised with the current European 
directive for regulated professions (Level 7 of the 
Slovenian framework of qualifications and Level 6 
of the European framework of qualifications); 
Level 3: a specialist of a certain field in nursing – − 
specialist nurse ('diplomirani zdravstvenik/diplomirana 
medicinska sestra specialist/-ka'; dipl. zn. spec./dipl. 
m. s. spec.), education – postgraduate specialist 
education or postgraduate education 2nd cycle 
Bologna study programme (Level 7−8 of the 
Slovenian framework of qualifications and Level 
6−7 of the European framework of qualifications); 
Level 4: an expert for advanced forms of work in − 
nursing and healthcare proceedings – Master of 
Nursing ('magister/magistrica zdravstvene nege'; 
mag. zdr. nege), Doctor of Nursing or Healthcare 
Sciences – Advance Nurse Practitioner, education 
– postgraduate education of 2nd and 3rd cycle of 
the Bologna study programme (Level 8−10 of the 
Slovenian framework of qualifications and level 7−8 
of the European framework of qualifications).
In reference to the proposal of the presented 
competence model it should be emphasised that Level 
3 and 4 cannot be reached if Level 2 has not been 
reached, while Level 1 is not a pre-condition to achieve 
Level 2, which is in accordance with the conditions 
to enter the education programme for a regulated 
profession (Directive 2013/55/EU of the European 
Parliament and of the Council, 2013). 
The next significant step is to include all levels of 
competence into national human resource norms 
and into appropriate salary brackets. The study 
brings attention to the fact that developmental 
and research work in nursing is a tool for reaching 
evidence-based work. The respondents think that 
the implementation of research work in nursing 
may only eventuate through a national institute 
for research in nursing care whose founder is the 
Nurses and Midwives Association of Slovenia. The 
institute should be funded from membership fees 
and applications to tenders. The author of the article 
believes that waiting for other institutions to support 
nursing care considering the general current state of 
the healthcare policies in Slovenia is not sensible, but 
that rather the Nurses and Midwives Association of 
Slovenia should invest. Namely, the study has shown 
that a national research institute should implement an 
effect on healthcare policies. The following finding is 
that studies conducted by the new institute should be 
directed especially towards the needs of the patients. In 
this way, researchers of nursing care would contribute 
to forming new policies on the state level and broader, 
and would be more successful in obtaining research 
funding, which was mentioned by Büscher and 
colleagues (2009) in one of the studies. 
A thorough analysis of the research results shows an 
important emphasis on higher education management 
from the perspective of social responsibility for the 
argumentation of the development of nursing as a 
scientific discipline and organisation of education on 
all levels. This is a logical expectation as accumulation 
of knowledge from research is the highest at faculties 
since research work must be conducted in order for 
the faculty to offer and further develop high quality 
programmes, which is possible only if there is research 
on the occupation for which the faculty educates and, 
if it is connected with the occupation, also in direct 
contact work with the patients. It is highly significant 
to also involve the clinical setting into research work, 
which the study has confirmed by the obtained codes 
such as "Higher education and healthcare institutions 
must cooperate", "There should exist a common research 
entity between the higher education and healthcare 
institution" and "Professional and research work must 
be connected". More emphasis on these themes is 
recommended in nursing study programmes to provide 
better integration of research culture and paradigms 
of conducting research in clinical settings (Kelly, et 
al., 2013; Loke, et al., 2014). Our study has brought 
attention to the above-mentioned, especially from the 
perspective that in Slovenia building a research culture 
is challenging, as the respondents are indecisive about 
the type and scope of knowledge for the development of 
the professional field and science. There is also an issue 
referring to the fact that research does not belong to 
standard work commitments of nurses and that nurses 
themselves do not see it as a big enough priority.
The present state that has been found in this study will 
improve when the nursing management support the 
development of knowledge of research and knowledge 
of evidence-based work with their employees 
(Skela-Savič, et al., 2016a). In this way, despite the 
present belief that research and development are not 
compulsory nor are they a priority; motivation for 
developmental work will increase – the study has 
shown a low awareness of the needs of developmental 
work; interest in obtaining knowledge to conduct 
research and development will increase and awareness 
on the relevance of research for high quality work will 
increase. Kelly and colleagues (2013) and Loke and 
colleagues (2014) state that research is simply not yet 
a part of the professional identity of nurses, so it often 
happens that nurses do not apply research findings 
in their everyday practical work, which has also been 
shown by this and other studies conducted in Slovenia 
(Skela-Savič, et al., 2016a; Skela-Savič, et al. 2017a). 
The established present situation also supports the 
established concept of values and competencies that 
would support the development of nursing as the 
value system of the nurses' work in Slovenian hospitals 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 283
is directed especially at completing daily professional 
tasks rather than developmental tasks (Skela-Savič, 
et al., 2017). The latter can also be confirmed with an 
existing study when we define the issue of exceeding 
the level of professional competence by healthcare 
assistants and thus bring attention to the lack of 
systematised job positions for nurses with a higher 
education study degree who are the only ones to 
carry the responsibility for development tasks in 
nursing and that are listed as competence level 4. The 
International Council of Nurses (2008) states that 
to perform development tasks a master's degree in 
nursing is a requirement, however, in Slovenia these 
job positions have not yet been systematized. That is 
why the defined responsibility of nursing management 
in this and previous research is justified. 
A review of competencies written in the European 
Directive (Directive 2013/EU of the European 
Parliament and of the Council, 2013) clearly shows 
that the competence ability to analyse the quality of 
nursing care and consequently improvement of the 
professional work of nurses for general healthcare (listed 
under group H in the Directive) cannot be realised if 
the provider does not possess the basic knowledge on 
research and development and if they do not work 
according to the evidence-based concept. The fact that 
research and development should be included in the 
regular workload of nurses with a higher education 
study programme degree is logically a condition for 
realising the listed competences and consolidates the 
topic "implementation of knowledge and competencies 
for the development of the profession and science in 
Slovenia comparable to the European Union". Here 
it should be continuously explained that levels of 
competence should be implemented as our research 
has shown that there is indecisiveness present among 
the participants regarding the scope and levels of 
education, which means that the professional public 
does not yet understand the levels of education well 
and has difficulties trying to transfer them to a real 
clinical setting. It is also important to be aware of the 
fact that in developmental work in nursing we can 
come across many problems such as the time intended 
for research, a lack of research skills, insufficient 
support from the management and doctors, work 
processes and organisational culture that do not 
support research (Kelly, et al., 2013; Loke, et al., 2014; 
Yoder, et al., 2014). As regards nurses with a higher 
education study programme degree in Slovenian 
hospitals, it can be unfortunately said that there is a 
lack of knowledge and education and poor accessibility 
to professional and scientific literature (Skela-Savič, et 
al., 2016a, 2017a). All these findings make us consider 
the compulsory training courses to obtain a licence 
for work and whether this content is up to date in 
terms of knowledge necessary for the development 
of nursing in Slovenia and the qualifications of the 
nursing management, whose research has shown 
to be one of the key factors of the development of 
professionalization.
The research also draws attention to the discrepancies 
between secondary and higher education, as the 
expectations of secondary education, in the sense of 
uninterrupted vertical promotion for pupils of secondary 
schools for healthcare without the general school-
leaving exam 'Matura', hinder ambitions of faculties to 
develop university study programmes of nursing. In this 
way the expected vertical schooling system in nursing 
in secondary school might be an obstacle for university 
education of nursing, which is also the starting point 
of the academic studies of nursing as this is how the 
majority of the providers for the professionalization of 
nursing obtain their professionalization. 
The finding that competencies of healthcare assistants 
in clinical settingss are regularly being exceeded on a 
conscious level, which formally means that clinical 
setting disregards the fact that education for the 
occupation of a healthcare assistant in the education 
system does not compare with the competencies of 
nurses with a higher education degree. Namely, on 
a conscious level, healthcare assistants are expected 
to exceed their level of competencies. Similarly, 
participants of the secondary sector are bothered 
by a nurse who delegates and controls the work of a 
healthcare assistant because healthcare assistants are 
expected to be independent, which is the next obstacle 
in the professionalization of nursing in Slovenia. The 
established exceeding of competencies draws attention 
to the fact that employment of nurses should increase 
and that those healthcare assistants whose work 
interferes with the competencies of nurses with a higher 
education degree should be given an opportunity to 
train further. The nursing management is responsible 
for exceeding the levels of competencies of healthcare 
assistants because they fail to employ enough staff with 
a higher education degree. This is irresponsible towards 
patients and the occupation of nursing as it was also 
established by a study completed this year in Belgium, 
England, Spain and Finland by Linde Aiken (2017). The 
findings of this research state very clearly that if, in the 
nursing team who looks after 25 surgery patients and is 
composed of four nurses with a higher education degree 
and two caregivers with lower qualifications, we replace 
one nurse with a caregiver with lower qualifications, the 
probability for a patients' death increase by as much as 
21 %. Melnyk and colleagues (2012) state that research 
studies enable practice which is evidence-based. These 
studies increase the quality and reliability of healthcare 
treatment, improve the outcomes of the treatment and 
decrease the variations in the treatment and costs. That 
is why in Slovenia systematic research in relation to the 
connections between the level of education and the 
number of healthcare employees and the outcomes of 
the treatment of patients is needed on a national level. 
We can conclude that in nursing professionalization 
there are issues also in naming the occupation in 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.284
Slovenia, as the research has shown that "Professional 
name of a caregiver" is generally not very respected 
in the society and is considered as less valued or an 
inappropriate name for providers of nursing care. 
In addition, recognising new areas of operation 
of healthcare assistants such as social and care 
competencies by the representatives of the secondary 
school sector has not been accepted, which puts 
forward challenges for nursing as an occupation and 
scientific discipline. 
The limitations of the research relate to the selection 
of the paradigm as high quality research in the field 
of validity and reliability has several restrictions. 
Validity and reliability was ensured with the method 
of a hermeneutic circle (Mesec, 1998), as the data was 
obtained based on broadening the findings of previous 
research and sequential research was conducted. The 
respondents of the study were always informed with 
previous findings on which our questions for the group 
interviews were based. Therefore, in the first round 
the respondents were sent a report on the conducted 
quantitative research among secondary school students, 
students, healthcare employees, secondary and higher 
education on the competence model in nursing and the 
attitude towards research and development in nursing 
(Skela-Savič, et al., 2016b, 2016d). These results were 
presented orally before the beginning of the first round. 
In the second round the respondents were sent and 
orally presented the results of the first round (Skela-
Savič, et al., 2016c). Our research and the developed 
open questions are based on a research project that was 
previously conducted in Slovenian hospitals on a large 
sample (Skela-Savič, et al., 2016a; Skela-Savič, et al., 
2017b), which might be understood as legitimising the 
research, that is evidenced by long-term observation, 
triangulation of various research methods for 
researching nursing professionalization in Slovenia 
and by informing the respondents about previous 
findings of our research on this topic. As a final step in 
legitimising the validity of the conducted research we 
conducted a "scientific café" in 2017 to which we invited 
experts in nursing, higher education and research. At 
the meeting we presented the obtained themes of the 
research and discussed them with the invited guests 
from a strategic point of view and also from the point 
of view of planning the necessary changes. Green and 
Thorogood (2004) name this a consensual conference. 
It should also be noted that the author of this article is 
an advocate for the need for accelerated development 
of nursing professionalization in Slovenia and that she 
is also a higher education lecturer of research methods, 
evidence-based work and healthcare management, 
which may be reflected in the interpretation of the 
results that the author managed with a reflective stance 
and by informing the participants of the research with 
previous findings of research (Mesec, 1998) that formed 
the course of the group interview. For the purposes of the 
article, the author reviewed the obtained results for the 
second time with the secondary analysis technique with 
an aim to achieve clarity, transparency and precision. 
An inductive approach to research was used to 
identify some responsibilities for the development 
of the elements of nursing professionalization in 
Slovenia, which could be a challenge for researchers 
to verify the findings using a deductive approach to 
research. The research offers the basis for planning 
strategic guidelines for the development of nursing 
professionalization in the future, which was also the 
purpose of this study. 
 
Conclusion
Research with a qualitative approach brings attention 
to the factors that will play an important role in 
the development of nursing professionalization in 
Slovenia and its breakthrough in scientific research 
and placement of the level of competencies in clinical 
work. An occupation becomes a profession once it 
creates its own knowledge with a systematic approach 
and transfers it directly into professional work and 
when experts generate research problems that they 
resolve together with those who have the competencies 
for thorough scientific work. The tools of operation 
include systematic research, professional judgement, 
development of critical thinking and decision-making 
on the basis of evidence. That is why nurses with a 
higher education degree in Slovenia must be given 
access to knowledge for the development of values of 
activism and development, research skills and evidence-
based work, as in this way they will have a significant 
influence on the development of professionalization 
and nursing as a scientific discipline. Healthcare 
managers in key positions in various sectors must 
be trained to understand professionalization and for 
their responsibility in this area. A clear and ambitious 
vision is needed, as well as a development strategy 
for nursing that should include national guidelines 
for life-long professional training for healthcare 
institutions, professional sections, regional professional 
associations and management at all levels of nursing. 
The national professional association should assume the 
responsibility for the presentation of the new paradigm 
of the development of nursing that will be a response to 
the needs of the society, occupation and science, and to 
conduct a precise allocation of financial means in order 
to realise it. 
Slovenian translation/Prevod v slovenščino
Uvod
V Sloveniji imajo mnogi, ki se ukvarjajo z 
raziskovanjem in razvojem zdravstvene nege, občutek, 
da se profesionalizacija zdravstvene nege razvija 
prepočasi. Upravičeno se postavlja vprašanje, kako 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 285
dobro razumemo pojme, povezane s profesionalizacijo, 
in dejavnike, ki so z njo povezani? Carvalho (2014) 
navaja, da se zdravstvena nega v razpravah o 
profesionalizaciji zdravstvenih poklicev pogosto 
navaja kot »polprofesija« ali »navidezna« profesija. 
Opredelitev pojmov
Koncept profesionalizacije se pojasnjuje v številnih 
poklicnih skupinah in ima dolgo zgodovino ter 
družbeno-socialni kontekst. Posledično so za različno 
rabo in različne potrebe nastale številne interpretacije 
in definicije tega koncepta (Demirkasimoğlu, 2010). 
Zelo pogosto citirana definicija profesionalizacije 
pravi, da je profesionalizacija družbeni proces, 
ki poteka kot institucionaliziran način priprave 
posameznikov na opravljanje poklicno usmerjenih 
nalog. V procesu profesionalizacije se vzpostavljajo 
norme in kvalifikacije za predstavnike profesije, skrbi 
se za vzpostavljanje in prenašanje znanj, potrjevanje 
sposobnosti, urejanje odnosov med člani profesije in 
le-teh navzven (Wilensky & Harold, 1994). Slovenski 
avtor Svetlik (1999) meni, da je proces profesionalizacije 
določenega poklica odvisen od številnih dejavnikov, 
kot so področje delovanja, potrebnosti delovanja, 
virov, s katerimi poklic upravlja, pomembna sta tudi 
samozavedanje in samoregulacija poklica. Tako se 
poti profesionalizacije različnih profesij med seboj 
razlikujejo. 
Opredelitev profesionalizacije oz. profesionalizma 
v zdravstveni negi
Skozi leta je profesionalizacijo v zdravstveni negi 
raziskovalo veliko raziskovalcev, nastalo je veliko 
definicij in opisov značilnosti (Adams & Mikker, 
2001; Manojlovich & Ketefian, 2002), raziskovalci 
uporabljajo različne metode in orodja za oceno in 
evalvacijo le-te (Ghadirian, et al., 2014). 
Profesionalizem je večdimenzionalni koncept, 
ki medicinskim sestram zagotavlja priložnosti za 
osebnostno in profesionalno rast. Ta proces zahteva 
znanje, veščine, razvoj značilnosti poklicne identitete 
profesije in internacionalizacijo vrednot in norm 
profesionalne skupine (Alidina, 2013). Profesionalizem 
se ocenjuje po individualnih značilnostih in obnašanju, 
odnosih z drugimi posamezniki in konteksti 
delovanja ter po socialnih dimenzijah, kot so 
družbena odgovornost, morala, politična in 
ekonomska odgovornost, profesionalizem vključuje 
tudi spoštovanje standardov in kompetenc (Keeling 
& Templeman, 2013; Fantahun, et al., 2014). Koncept 
profesionalizma sam po sebi pokaže na pripadnost 
profesiji, tako se od medicinskih sester pričakuje, da se 
izobražujejo, publicirajo svoje raziskave, izboljšujejo 
prakso in teorije zdravstvene nege ter da delujejo 
avtonomno (Çelik & Hisar, 2012). Pri tem je izjemnega 
pomena lastna poklicna percepcija in razumevanje 
pomena zdravstvene nege ter umestitev obojega v 
socialni kontekst. Oboje, lastna poklicna percepcija 
in razumevanje pomena zdravstvene nege, vpliva 
na razvoj in rast zdravstvene nege kot znanstvene 
discipline (Viitanen, 2007). 
Watkins (2011) profesionalizem kot koncept opiše v 
obliki treh spremenljivk. Prva je oblikovanje profesije, 
ki vključuje poklicno skupino, definirana znanja na 
področju delovanja, vzpostavljeno samoregulacijo 
ter kontinuiran razvoj profesionalnega znanja in 
veščin za nenehno izboljševanje kakovosti dela. Druga 
spremenljivka profesionalizma je priznavanje profesije, 
ki vključuje temeljne komponente, kot so znanje, 
avtonomija, odgovornost za profesionalno presojo 
in njihov skupni učinek na učinkovitost kliničnega 
dela. Tretja spremenljivka je uspešnost profesije, ki je 
lahko dosežena samo s formalnim izobraževanjem, ki 
mora vključevati znanje, pridobljeno s sistematičnim 
raziskovanjem, in strokovno presojo, ki se oblikuje 
z razvojem kritičnega razmišljanja in odločanja 
na osnovi dokazov. Watkins (2011) definira, da je 
izobraževanje na magistrski ravni ključni element, 
ki spoznanja raziskav o profesionalizaciji postavi v 
kontekst akcije za doseganje le-te. Pri diplomantih 
namreč poveča zaupanje v lastno delo, tako da le-to 
dobi smisel; sposobnosti diplomantov za odločanje in 
njihove druge kognitivne sposobnosti pa pripomorejo 
k uresničevanju na dokazih podprte prakse in s tem k 
doseganju profesionalizma. Carvalho (2014) ugotavlja, 
da profesije v zdravstvu med seboj najbolj loči prav 
znanje, pridobljeno z raziskovalnim delom. Toda 
nekatere medicinske sestre to novo znanje zaznavajo 
kot odmik od negovanja in podpirajo lokalni kontekst 
znanja v praksi.
Raziskovanje profesionalizacije v Sloveniji
Profesionalizacijo v zdravstveni negi so na ravni 
izvirnega znanstvenega dela, tj. z izdelavo disertacije, 
objavo znanstvene ali strokovne monografije ali 
izvirnega znanstvenega članka, raziskovali tudi 
slovenski avtorji (Pahor, 1998; Cvetek, 1999; Starc, 
2009, 2016). Pomemben prispevek k razumevanju 
profesionalizacije zdravstvene nege v Sloveniji 
predstavlja znanstvena monografija Medicinske sestre 
in univerza (Pahor, 2006), v kateri avtorica povzema 
in reflektira razvoj izobraževanja v zdravstveni negi od 
leta 1990 naprej ter tako prikaže pomemben segment 
profesionalizacije, ki po Watkins (2011) sodi v 
oblikovanje profesije. Naslednji pomembni prispevek k 
razumevanju profesionalizacije je monografija avtorja 
Starca (2014), ki ugotovi tri temeljne značilnosti 
profesionalizacije zdravstvene nege v Sloveniji, to 
so znanje, moč in etika. Koncept profesionalizacije 
Starc v kvalitativni analizi opredeli kot samostojnost 
zdravstvene nege, ki jo udeleženci raziskave razumejo 
kot znanje, izobrazbo, izobraževanje, kompetence in 
vseživljenjsko učenje. 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.286
Raziskava Skele-Savič in sodelavcev (2016a, 2017a) 
se osredotoča na profesionalizacijo z vidika 
profesionalnih vrednot, kompetenc in na dokazih 
podprtega dela. Raziskava pokaže, da je ugotovljene 
vrednote v zdravstveni negi mogoče razumeti kot 
(1) vrednote negovanja, zaupanja in pravičnosti 
ter kot (2) vrednote razvoja, profesionalizma in 
aktivizma. Raziskava je pokazala, da se vrednote 
razvoja, profesionalizma in aktivizma izkažejo kot 
manj pomembne, kar pomembno pojasni uspešnost 
implementacije na dokazih podprtega dela v 
praksi. Visokošolsko izobražene medicinske sestre 
v slovenskih bolnišnicah kompetence dojemajo kot 
»pričakovane kompetence za delo v praksi« in kot 
»kompetence razvoja in profesionalizma«. Znanja in 
prepričanja o na dokazih podprtem delu so prisotna, 
vendar vključeni v raziskavo niso prepričani, da na 
dokazih podprto delo poznajo dovolj dobro, da bi ga 
implementirali v svoje delo. Tako je implementacija 
na dokazih podprtega dela izjemno majhna in se 
izvaja le izjemoma. Vzročni neeksperimentalni 
model pokaže, da je prepričanja in implementacijo 
na dokazih podprtega dela mogoče pojasniti (1) z 
vrednotami razvoja, profesionalizma in aktivizma, 
(2) s kompetencami razvoja in profesionalizma, 
(3) z znanjem o raziskovanju (4) z znanjem o na 
dokazih podprtem delu, (5) z izobraževanjem oz. 
usposabljanjem o na dokazih podprtem delu in (6) z 
dostopom do podatkovnih baz. 
Namen in cilji
Namen raziskave je bil preveriti stališča in razumevanje 
nekaterih elementov profesionalizacije med strokovnjaki 
zdravstvene nege v Sloveniji. Cilj raziskave je bil 
prispevati k prepoznavanju dejavnikov, ki so pomembni 
za razvoj profesionalizacije zdravstvene nege in ki 
lahko pripomorejo pri strateškem načrtovanju njenega 
razvoja. 
Raziskovalno vprašanje: 
Kateri so strateški dejavniki za razvoj elementov − 
profesionalizacije v zdravstveni negi v Sloveniji na 
področju izobraževanja oz. kompetenc za poklic ter 
na področju raziskovanja za razvoj stroke in znanosti 
zdravstvene nege?
Metode
Uporabili smo kvalitativno raziskovalno paradigmo, 
podatke smo zbirali s tehniko skupinskega intervjuja 
in jih obdelali po metodi tematske analize, ki je 
eden od pristopov analize vsebine besedila (Gomm, 
2008). Skupinski intervju uporabimo, ko želimo 
pridobiti podatke za strateško načrtovanje; pri tem 
nas zanimajo mnenja in odgovori na že vnaprej 
pripravljena izhodiščna vprašanja. K uspešnosti 
skupinskega intervjuja pripomore, če se udeleženci 
med seboj poznajo, saj se tako poveča interakcija med 
njimi in moderatorjem. Razpravo vodi moderator, ki 
temo razprave dobro pozna (Kumar, 2011). Ker temo 
poznajo tudi udeleženci skupinskega intervjuja – tako 
skupino Green in Thorogood (2004) poimenujeta 
naravna skupina – raziskovalec lahko zazna kulturno 
dinamiko o obravnavanih temah in odzive iz prakse, 
kar oblikuje tudi potek skupinskega intervjuja in 
obdelavo podatkov. 
Opis instrumenta in poteka raziskave
Skupinski intervju je potekal v dveh sekvencah, 
prva z naslovom »Razvoj kompetenčnega modela za 
vse ravni izobraževanja v zdravstveni negi« je bila 
izvedena oktobra 2016, druga sekvenca »Nacionalni 
model razvoja in krepitve zdravstvene nege kot 
znanstvene discipline« marca 2017. Sedem dni 
pred obema srečanjema smo udeležencem poslali 
izhodiščna vprašanja oz. stališča. Za prvo sekvenco 
smo pripravili 5 in za drugo 10 odprtih izhodiščnih 
vprašanj oz. stališč. 
Primer izhodiščnih vprašanj v prvi sekvenci:
Kakšno je vaše stališče do sprejema kompetenčnega −	
modela v zdravstveni negi za Slovenijo?
Kakšne spremembe predlagate v okviru prenove −	
poklicnega standarda srednješolskega izobraževanja 
v zdravstveni negi?
Kakšno je vaše stališče do doseganja urejenosti −	
vseh posameznih ravni izobraževanja v zdravstveni 
negi za pozitiven vpliv na vzdržnost zdravstvenega 
sistema?
Primer izhodiščnih vprašanj v drugi sekvenci:
Kaj ocenjujete kot ključni problem, ki ga je treba −	
rešiti, da bi se zdravstvena nega lahko razvila kot 
znanstvena disciplina?
Katera znanja pogrešate pri svojem delu in vas −	
njihov primanjkljaj ovira pri uveljavljanju stroke, ki 
jo vodite ali kjer delujete? 
Praksa fakultet v tujini je, da visokošolski učitelji −	
delajo tudi v kliničnih okoljih, to pomeni, da ima tak 
učitelj dve zaposlitvi v okviru 100 % zaposlitve. Kaj 
bi zdravstveni zavod v Sloveniji pridobil od takega 
sodelovanja in obratno, kaj bi pridobila fakulteta?
Na dan raziskave smo udeležence zaradi omogočanja 
boljših pogojev za aktivno sodelovanje razvrstili v 
dve skupini, pri čemer smo v vsaki skupini zagotovili 
enakomerno zastopanost vseh področij, na katerih 
delujejo povabljeni strokovnjaki. Razprava je potekala 
po skupinah prostorsko ločeno in sočasno po 
načrtovanem urniku, pet polnih ur z dvema odmoroma 
in uvodno predstavitvijo izhodišč za razpravo, ki so bila 
povezana s spoznanji predhodnih delov raziskovalnega 
projekta (Skela-Savič, et al., 2017b), katerega del je 
tudi ta raziskava. Pred pričetkom dela smo sodelujoče 
seznanili z anonimnostjo pri obdelavi podatkov in 
prostovoljno vključenostjo v raziskavo. Sodelujoči 
so podali pisno strinjanje s snemanjem razprave. 
Skupine prve in druge sekvence so moderirali 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 287
visokošolski učitelji, ki se znanstveno ukvarjajo z 
razvojem zdravstvene nege v Sloveniji. Imeli so enoten 
predhodno izdelan protokol vodenja intervjuja z 
opredeljenimi izhodiščnimi vprašanji. Razprava je v 
obeh sekvencah potekala po enakem protokolu. 
Opis vzorca
Kumar (2011) pravi, da je izbor vzorca pri skupinskem 
intervjuju odgovornost raziskovalca, ki naj sledi 
namenu, to je obravnava strateških tem. Pomembno 
je, da vključeni strokovnjaki področje poznajo in da 
pokrivajo širok spekter vsebin, ki so s področjem 
razprave povezane. Da bi tem pogojem zadostili, smo 
uporabili sistematični namenski vzorec strokovnjakov 
(n = 48), ki ga Green in Thorogood (2004) utemeljujeta 
kot pogoj za pridobivanje reprezentativnih podatkov. 
Sistematičnost vzorca smo razumeli predvsem z 
ustrezno zastopanostjo različnih sektorjev in drugih 
akterjev pri razvoju profesionalizacije v zdravstveni 
negi. Vključili smo predstavnike z naslednjih področij: 
srednješolsko izobraževanje (n = 8) in visokošolsko 
izobraževanje v zdravstveni negi (n = 15), zdravstveni 
zavodi na vseh treh nivojih zdravstva in drugi zavodi 
(n = 17), študenti magistrskega in doktorskega študija, 
ki delajo v zdravstveni negi (n = 3), ter člani različnih 
strokovnih teles na nacionalni ravni (n = 5). Povabljeni 
so delovali na različnih nivojih odgovornosti, od 
strokovnega vodje določenega področja do vodje 
na najvišjem nivoju menedžmenta v organizaciji. 
Sodelovalo je 42 žensk in 6 moških, vsi udeleženci so 
imeli najmanj visokošolsko strokovno izobrazbo; 9 
(19 %) udeležencev je sodelovalo v obeh sekvencah 
raziskave. 
Opis obdelave podatkov
Pri obdelavi podatkov smo sledili pristopu tematske 
analize besedila po avtorjih Gomm (2008) ter Green 
in Thorogood (2004). Pri tem pristopu obdelave 
raziskovalec išče skupne vsebine v celotnem setu 
podatkov intervjujev in teme oblikuje na osnovi 
primerjav in nasprotij v povedanem s strani 
intervjuvancev. Raziskovalec se odloči, kaj bo štelo 
kot dokaz za oblikovanje tem. Končne teme so 
lahko inspirirane tudi z idejami raziskovalca, ki 
najpogosteje izhajajo iz predhodnega raziskovalnega 
dela obravnavanega raziskovalnega problema. Pri tem 
je potrebna reflektivna drža raziskovalca.
Na osnovi opisanih usmeritev smo pri prepisovanju 
posnetega intervjuja izločili vsebinsko nerazumljivo 
izrečeno besedilo. Zapis smo poenotili v žensko 
slovnično obliko, ker je bilo razmerje spolov v obeh 
skupinah v korist žensk. Izbrisali smo vse navedbe krajev 
in ustanov, različnih organov, za posameznikov govor 
značilna mašila ipd. S tem smo zagotovili anonimnost 
pri neposredni rabi izrečenega. Enota kodiranja je 
bila izrečena misel ali izrečeno stališče posameznega 
govorca na določeno temo. Če je govorec govoril o 
več temah, smo izrečeno kodirali pri več posameznih 
temah. Pri kodiranju smo uporabili tehniko 
tematskega kodiranja (Gomm, 2008), zato smo kode 
oblikovali večbesedno, s ciljem opisa ključne vsebine 
povedanega, kar imenujemo odprto opisno kodiranje. 
Le-to nam je omogočilo, da smo lahko kategorije, kot 
nadpomenke kod, ravno tako oblikovali na vsebinski 
ravni in iz njih razvili ključne ugotovitve intervjujev, 
ki smo jih podali v obliki tem. Pri pripravi članka smo 
izvedli sekundarno analizo dobljenih rezultatov in 
naredili nekaj vsebinskih in terminoloških dopolnitev 
glede na analizo v raziskovalnem poročilu Skela-Savič 
in sodelavci (2017b). Pri analizi podatkov smo sledili 
usmeritvam obdelave po avtorici Green (2004), saj smo 
želeli razumeti povezave med odnosom, vedenji in 
izkušnjami intervjuvancev na področju obravnavanih 
tem, prav tako smo želeli razumeti fenomen nekaterih 
elementov profesionalizacije, s katerimi so jo opisali 
intervjuvanci, kot rezultat raziskave pa smo želeli 
izoblikovati nove ideje in teoretični konstrukt 
spoznanj za nadaljnje raziskave. Sinteza spoznanj tem 
obeh sekvenc nam je dala možnost boljše opredelitve 
odgovornosti za razvoj profesionalizacije zdravstvene 
nege na strateški ravni, kar je tudi namen uporabe 
tehnike skupinskih intervjujev. 
Rezultati
Sekvenca 1: Razvoj kompetenčnega modela za 
vse ravni izobraževanja v zdravstveni negi
V okviru analize besedila smo oblikovali 49 kod, 
ki so utemeljene s 150 citati udeležencev. Vsak citat 
je uporabljen samo enkrat. Iz 47 kod smo razvili 
14 nadpomenskih kategorij, ki tvorijo 3 zaključene 
teme (Tabela 1), dve kodi se nista uvrstili v nobeno 
kategorijo. V nadaljevanju predstavljamo nekaj 
primerov razvoja kod. Razvoj vseh kod je natančno 
prikazan v raziskovalnem poročilu projekta 
Zdravstvena nega kot znanstvena disciplina (Skela-
Savič, et al., 2017b). 
Primer razvoja kode »Treba je določiti kompetence 
glede na ravni izobraževanja«, ki smo jo razvili s tremi 
citati: 
Citat 14: Jaz mislim, da je čas, da dogovorimo stvari, 
da je to enotno za celotno Slovenijo; da se ne sprašujemo, 
kaj kdo dela in kaj naj ne bi delali; da se točno ve, 
kakšne so kompetence tistih, ki končajo srednješolsko 
izobraževanje, ter kakšne so kompetence tistih, ki 
končajo visokostrokovni program.
Citat 15: /…/ da so razčiščene stvari, kako je na 
magistrskem študiju. In seveda, zdaj že imamo tudi 
vpise na doktorat. Jaz mislim, da te stvari res niso 
razčiščene in dorečene. In zdaj imamo možnost, ko smo 
tukaj skupaj, da se o teh stvareh pogovorimo.
Citat 16: Mislim, da smo zdaj prišli do tiste točke, da 
moramo samo opredeliti natančno, kaj so kompetence 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.288
Tabela 1: Rezultati razprave o izobraževanju in kompetencah v zdravstveni negi (sekvenca 1)
Table 1: Results of the discussion on education and competencies in nursing care (Round 1)
Kode/Codes Kategorije/Categories Teme/Themes
Potrebna je širša vključenost v razpravo o izobraževanju in 
kompetencah.
Med srednjim in visokim 
šolstvom so razhajanja in 
nezaupanje glede izobraževanja.
Družbena odgovornost 
visokega šolstva za ureditev 
izobraževanja na vseh 
nivojih in za argumentacijo 
razvoja zdravstvene nege 
kot znanstvene
discipline
Potrebna je uskladitev med akterji izobraževanja in le-teh z 
njihovimi uporabniki.
Prisoten je strah pred odvzemom kompetenc.
Glede izobraževanja v zdravstveni negi obstajajo stalna 
nasprotja.
 Nivoji izobraževanja so sistemsko slabo povezani.
Izobraževanje ni sistemsko urejeno.
Stroka je neenotna, tako sistemsko kot tudi zgodovinsko.
Srednjestrokovno izobraževanje je usposabljanje za poklic 
in ne za študij.
Obstaja dilema, ali naj vertikala v 
izobraževanju za razvoj znanosti 
vključuje srednjestrokovno 
izobraževanje. 
Večina študentov je iz srednjih zdravstvenih šol.
Pričakuje se neprekinjena vertikalna prehodnost dijakov 
srednjih zdravstvenih šol.
Izobraževanje za poklic naj se začne na srednji strokovni 
stopnji.
Srednje šole delajo promocijo za celotno vertikalo.
Evropska direktiva pomaga reševati probleme 
izobraževanja. Evropsko reguliran poklic 
medicinska sestra zahteva 
najmanj visokostrokovno 
izobrazbo. 
Potreben je univerzitetni študij zdravstvene nege.
Poimenovanje medicinska sestra je pogojeno z visokošolsko 
izobrazbo.
Študijski programi naj bodo primerljivi razvoju v Evropski 
uniji. Evropska primerljivost varuje 
razvoj zdravstvene nege. Poseganje drugih poklicev v avtonomijo izobraževanja v 
zdravstveni negi je treba preseči.
Visokostrokovne programe je treba preoblikovati v 
univerzitetne. Za visokošolski študij 
zdravstvene nege je potrebno 
dobro splošno znanje. 
Za vstop v visokošolsko izobraževanje je potrebno dobro 
splošno znanje.
Na primanjkljaj znanj naj se odziva visokošolski sektor.
Naziv zdravstveni asistent ni sprejemljiv.
Pričakovana je samostojna vloga 
poklica TZN. 
Sistemska odgovornost 
menedžmenta zdravstvene 
nege in nacionalnega 
strokovnega združenja 
za ustavitev preseganja 
kompetenc TZN in 
umestitev ravni kompetenc 
v zdravstveni negi v sistem 
zdravstvenega varstva 
TZN je samostojni izvajalec zdravstvene nege, je več kot 
asistent.
Diplomirane medicinske sestre opravljajo preveč 
administrativnega dela.
Diplomirana medicinska sestra/
zdravstvenik ni sprejet kot 
odgovorna nosilka zdravstvene 
nege. 
Delegiranje in nadzor diplomirane medicinske sestre se ne 
sprejema.
Prisotno je zavedanje o preseganju kompetenc TZN.
Preseganja kompetenc TZN v 
kliničnih okoljih se zavedajo vsi 
akterji. 
Prekoračitve kompetenc v srednjih šolah ni.
Klinična okolja dopuščajo prekoračitev kompetenc TZN.
Preseganje kompetenc je za TZN poklicna samopotrditev.
Preseganje kompetenc TZN je kompleksen problem.
Informiranje zaposlenih je pomanjkljivo.
Veliko odgovornost za 
razmejevanje kompetenc in 
ustavitev preseganja kompetenc 
TZN nosi menedžmentu 
zdravstvene nege.
Treba je določiti kompetence glede na ravni izobraževanja.
Potrebne so spremembe kolektivne pogodbe, sistemizacije 
in nivojev kompetenc.
Potrebno je enotno razumevanje vloge magistra zdravstvene 
nege.
Uravnotežiti je treba interese stroke in interese delodajalcev.
Preseganje kompetenc TZN je kompleksen problem.
Odgovornost menedžmenta za preseganje kompetenc TZN.
Se nadaljuje/Continues
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 289
posameznih izvajalcev. Drugače pa se mi zdi, da nivoje 
imamo kar dobro že začrtane, se mi zdi, da večjih težav 
tu ne vidim.
Primer razvoja kode »Prisotno je zavedanje o 
preseganju kompetenc tehnika zdravstvene nege 
(TZN)«, ki smo jo razvili s štirimi citati: 
Citat 117: Mi izobražujemo na peti stopnji, tisto, kar 
pa se dogaja pri delodajalcih, ni več naša zadeva.
Citat 118: Ko dijaki hodijo na praktično usposabljanje 
z delom (PUD), povedo, kaj so delali. Nas je kar malo 
strah, da ta PUD nekako ni dobro zasnovan. /…/ Ne 
rečem, da mi tega nismo nikoli učili. Mislim, da je tu ta 
razlika, kaj se uči na 5. stopnji in kaj se potem dogaja, 
ko dijaki po 5. stopnji gredo v službo.
Citat 119: Srednješolsko izobražen kader posega, 
prevzema kompetence, kar je stvar delodajalca.
Sekvenca 2: Nacionalni model razvoja in krepitve 
zdravstvene nege kot znanstvene discipline
V okviru analize besedila smo oblikovali 20 kod, ki 
so utemeljene s 101 citatom udeležencev. Vsak citat je 
uporabljen samo enkrat. Razvili smo 7 nadpomenskih 
kategorij, ki tvorijo 4 zaključene teme (Tabela 2). V 
nadaljevanju predstavljamo nekaj primerov razvoja 
kod. Razvoj kod je natančno prikazan v raziskovalnem 
poročilu projekta Zdravstvena nega kot znanstvena 
disciplina (Skela-Savič, et al., 2017b). 
Primer razvoja kode »Interes za znanje o raziskovanju 
je vprašljiv«, ki smo jo razvili s štirimi citati: 
Citat 25: Mi imamo v kolektivni pogodbi pol ure za 
diplomirane medicinske sestre, da je namenjeno branju, 
tako kot imajo zdravniki.
Citat 26: To je potem na strani posameznika, koliko se 
bodo sami o neki stvari izobrazili in pač neko dodatno 
znanje iskali.
Citat 29: Jaz vidim ključni problem v tem, da mi 
ne poznamo priložnosti oziroma želje po dodatnih 
znanjih.
Citat 79: Menedžment se bo odločal, pa tudi ona mora 
generirati, se zavedati tega znanja, ki ga potrebuje.
Primer razvoja kode »Pri medicinskih sestrah ni 
pripravljenosti za raziskovanje«, ki smo jo razvili s 
petimi citati: 
Citat 3: Veliko znanja, izkušenj, ne znajo pa to potem 
ubesediti in zapisati, to je problem.
Citat 8: Zaradi tega, ker vsi, ki se, velika večina/tistih/, 
ki se vpisuje/jo/ v zdravstveno nego, so to eni ljudje, ki so 
praktiki, radi imajo delo z ljudmi itd.
Citat 30: In potem prideš s tisto idejo v klinično okolje 
in te povozijo.
Citat 119: Problem je v nas, v poklicni skupini, v 
prvi vrsti; pa drugi naši sodelavci, predvsem zdravniki 
nas ne pustijo k razvoju. Ampak moje osebno mnenje, 
problem je v naši poklicni skupini, v naših glavah, v 
našem razmišljanju. Govorimo: »Smo samostojni, smo 
avtonomni«, ampak če gledaš okoli, kaj se dogaja, … 
podrejenost zdravstvene nege je ...
Citat 120: Jaz se močno strinjam s kolegico in se mi 
zdi, da je ključni problem v nas samih, podcenjevanje 
dela z glavo. To, da bi mi sami zares prepoznali, da je 
sploh potrebno.
V Tabeli 3 prikazana vsebinska sinteza sedmih tem, 
dobljenih v obeh sekvencah, pokaže na dejavnike, ki 
so v raziskavi ugotovljeni kot pomembni pri izgradnji 
nacionalnega pristopa razvoja zdravstvene nege kot 
znanstvene discipline za slovenski prostor. Ugotovili 
smo dve krovni temi, ki govorita o nacionalni 
odgovornosti. Prva govori o odgovornih za uveljavitev 
kompetenčnega modela v praksi in za uveljavitev 
razvoja zdravstvene nege kot znanstvene discipline, 
druga pa o kazalnikih, s katerimi bomo spremljali 
uresničevanje razvoja zdravstvene nege kot znanstvene 
discipline. 
Kode/Codes Kategorije/Categories Teme/Themes
Vertikalno poimenovanje negovalec, negovalka. Poklicno poimenovanje 
»negovalec, negovalka« nima 
družbenega ugleda. 
Definiranje TZN kot 
sodelavca v timu zdravstvene 
nege na vseh nivojih 
zdravstva in kot ključnega 
izvajalca zdravstveno-
socialne obravnave v 
skupnosti in v dolgotrajni 
oskrbi
Poimenovanja »sestra« ima tradicijo.
Za razvoj poklicnega standarda je potrebno sodelovanje 
različnih deležnikov.
Nastajanje srednješolskih 
programov je slabo razumljeno.
Prisotno je nepoznavanje dejanskih strokovnih naslovov 
skozi spremembe izobraževanja.
Prisotno je neločevanje med strokovnimi nazivi in 
poimenovanji stopnje dosežene izobrazbe.
Oskrbe in sociale ime poklica ne zajame. Identiteta poklica TZN je v 
dimenziji socialno oskrbovalnih 
kompetenc pomanjkljiva.Izražene se potrebe po socialnih kompetencah TZN.
Odprti kurikulum je treba poenotiti. Srednje šole ne kažejo 
pripravljenosti za spremembe v 
kurikulumu. Spremembe v odprtem kurikulumu ne zadostujejo.
Bolničar naj bo del vertikale.
Obstaja nevarnost prekrivanja 
kompetenc TZN in bolničarja. Kaže se nevarnost prekrivanja kompetenc bolničarja in 
TZN.
Legenda/Legend: TZN – tehnik/tehnica zdravstvene nege/healthcare assistant
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.290
Tabela 2: Rezultati razprave o razvoju in krepitvi zdravstvene nege kot znanstvene discipline (sekvenca 2)
Table 2: Results of the discussion on the development and consolidation of healthcare as a scientific discipline 
(round 2)
Kode/Codes Kategorije/Categories Teme/Themes
Menedžment mora biti orientiran v strokovno usposobljenost 
kadra.
Za razvoj zdravstvene nege 
kot znanstvene discipline 
je odgovoren menedžment 
zdravstvenih zavodov. 
Odgovornost 
menedžmenta 
zdravstvene nege in 
menedžmenta fakultet 
za razvoj znanstvene 
discipline na ravni 
posameznega zavoda 
Raziskovanje in razvoj je treba podpreti s sistematizacijo delovnih 
mest.
Pri institucionalnem organiziranju raziskovanja in razvoja prihaja 
do težav.
Potrebno je prehajanje zaposlenih med visokošolskim in 
zdravstvenim zavodom, in sicer v okviru 100-% zaposlitve.
Menedžment ne prevzema zadostne odgovornosti za raziskovanje 
in razvoj.
Nujno je sodelovanje med visokošolskim in zdravstvenim 
zavodom.
Na ravni med zdravstvenim 
in visokošolskim zavodom je 
treba zasnovati raziskovalna 
jedra.
Med visokošolskim in zdravstvenim zavodom naj se vzpostavi 
skupna raziskovalna entiteta.
Strokovno delo in raziskovanje morata biti povezana. Smisel raziskovanja je razvoj 
stroke za koristi pacienta. Raziskovanje in razvoj 
stroke kot delovna 
obveza visokošolsko 
izobraženih 
medicinskih sester 
Središče razvojno-raziskovalnega dela naj bo pacient.
Interes za znanje o raziskovanju je vprašljiv. Raziskovanje je videno 
kot neobvezna, in ne 
kot prioritetna aktivnost 
medicinskih sester. 
Prisotno je razumevanje raziskovanja in razvoja kot prostočasnih 
aktivnosti medicinskih sester.
Pri medicinskih sestrah ni pripravljenosti za raziskovanje.
Za izgradnjo znanstvene discipline je potrebno znanje.
Glede obsega in vrste znanj 
za razvoj stroke in znanosti 
njeni pripadniki niso enotno 
odločeni.
Uveljavitev evropsko 
primerljivih znanj in 
kompetenc za razvoj 
stroke in znanosti v 
Sloveniji
Izobraževanja za raziskovanje in razvoj na delovnem mestu je premalo.
Mnenja o tem, kakšen obseg izobraževanja o raziskovanju in razvoju 
je potreben za poklic medicinske sestre, so različna.
Izraženo je stališče, da je znanje o raziskovanju morda potrebno pri 
spremljanju kakovosti.
Potreben je nacionalni raziskovalni inštitut. Odgovornost za nacionalni 
raziskovalni in razvojni inštitut 
naj prevzeme Zbornica – 
Zveza. 
Nacionalni 
raziskovalni inštitut 
kot formalna 
povezovalna oblika za 
razvoj in raziskovanje 
v zdravstveni negi v 
Sloveniji
Nacionalni raziskovalni inštitut naj bo pod okriljem Zbornice – 
Zveze.
Nacionalni raziskovalni inštitut naj ima tudi druge razvojne naloge.
Preko nacionalnega raziskovalnega inštituta naj se izvaja vpliv na 
politiko.
Nacionalni raziskovalni inštitut 
naj izvaja tudi vpliv na politiko. 
Tabela 3: Sinteza tem sekvenc 1 in 2
Table 3: Synthesis of rounds 1 and 2
Teme/Themes Sinteza tem/Themes synthesis
Odgovornost menedžmenta zdravstvene nege in menedžmenta fakultet za 
razvoj znanstvene discipline na ravni posameznega zavoda
NACIONALNA ODGOVORNOST – odgovorni za 
uveljavitev kompetenčnega modela v praksi in za 
uveljavitev razvoja zdravstvene nege kot znanstvene 
discipline:
(1) menedžment zdravstvene nege,
(2) menedžment visokega šolstva v zdravstveni negi in 
(3) nacionalno združenje v zdravstveni negi 
Družbena odgovornost visokega šolstva za ureditev izobraževanja na 
vseh nivojih in za argumentacijo razvoja zdravstvene nege kot znanstvene 
discipline
Uveljavitev evropsko primerljivih znanj in kompetenc za razvoj stroke in 
znanosti v Sloveniji
Raziskovanje in razvoj stroke kot delovna obveza visokošolsko 
izobraženih medicinskih sester KAZALNIKI URESNIČEVANJA NACIONALNE 
ODGOVORNOSTI:
(1) sistematizacija delovnih mest za 4 ravni 
kompetenc v zdravstveni negi, 
(2) raziskovanje in razvoj kot orodje dela v 
zdravstveni negi, 
(3) ustanovitev nacionalnega inštituta za raziskave 
v zdravstveni negi
Sistemska odgovornost menedžmenta zdravstvene nege in nacionalnega 
strokovnega združenja za ustavitev preseganja kompetenc TZN in umestitev 
ravni kompetenc v zdravstveni negi v sistem zdravstvenega varstva
Definiranje TZN kot sodelavca v timu zdravstvene nege na vseh nivojih 
zdravstva in kot ključnega izvajalca zdravstveno-socialne obravnave v 
skupnosti in v dolgotrajni oskrbi
Nacionalni raziskovalni inštitut kot formalna povezovalna oblika za razvoj 
in raziskovanje v zdravstveni negi v Sloveniji
Legenda: TZN – tehnik/tehnica zdravstvene nege/healthcare assistant
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 291
Diskusija
Rezultati skupinskih intervjujev, izvedenih v dveh 
sekvencah, nas opozorijo na sedem vsebinskih tem 
in dve krovni temi. Ključnega pomena za razvoj 
zdravstvene nege kot znanstvene discipline se izkaže 
odgovornost menedžmenta zdravstvene nege in 
visokošolskih zavodov ter strokovnega združenja 
Zbornice – Zveze, le-te smo tako opredelili na ravni 
nacionalne odgovornosti za razvoj profesionalizacije 
v zdravstveni negi v Sloveniji. Opredelili smo tudi 
tri nacionalne kazalnike uresničevanja te nacionalne 
odgovornosti, le-ti so: sistemizacija delovnih mest za 
štiri ravni kompetenc v zdravstveni negi, raziskovanje 
in razvoj kot orodje dela v zdravstveni negi in 
ustanovitev nacionalnega inštituta za raziskave v 
zdravstveni negi. 
Raziskava pokaže, da bomo o uresničevanju 
razvoja zdravstvene nege kot profesije in znanstvene 
discipline lahko govorili šele takrat, ko bodo ključni 
nosilci odgovornosti, zlasti menedžment zdravstvene 
nege v zdravstvenih zavodih, pričeli s sistematizacijo 
delovnih mest za štiri ravni kompetenc v zdravstveni 
negi in upoštevali mednarodno primerljive pogoje 
usposobljenosti za izvajanje kompetenc določene ravni. 
Dve predhodni raziskavi Skele-Savič in sodelavcev 
(2016b, 2016c) namreč pokažeta, da je med strokovnjaki 
doseženo strinjanje s prilagoditvami kompetenc, ki jih 
je priporočila Evropska federacija združenj medicinskih 
sester (European Federation of Nurses Associations – 
EFN) (EFN, 2014), vendar realno gledano, v Sloveniji 
modela kompetenc ali aktivnosti zdravstvene nege za 
štiri ravni izvajalcev zdravstvene nege še nimamo, in 
sicer ob dejstvu, da na ravni strokovnega magisterija 
izobražujemo že deset let. 
Pričujoča raziskava pokaže, da so smiselni vsebinska 
in terminološka implementacija kategorij izvajalcev 
zdravstvene nege po modelu EFN (EFN Workforce 
Committee, 2014) v naš izobraževalni sistem, sistem 
nacionalnih kompetenc in aktivnosti zdravstvene 
nege in prevedba le-tega v opise in sistematizacijo 
delovnih mest. V okviru projekta Zdravstvena 
nega kot znanstvena disciplina je bila z uporabo 
kvantitativnega in kvalitativnega pristopa preverjena 
matrika ravni kompetenc v zdravstveni negi po 
modelu EFN (Skela-Savič, et al., 2017b), ki smo jo za 
namen tega članka terminološko dopolnili, oblikovali 
pogoje usposobljenosti in naredili primerjave z 
ogrodji kvalifikacij. Predlagani model za Slovenijo bo 
vsebinsko natančneje pojasnjen v naslednjih objavah 
omenjenega projekta. 
Predlagani kompetenčni model ravni izvajalcev v 
zdravstveni negi v Sloveniji: 
Raven 1: sodelavec/sodelavka v timu zdravstvene − 
nege in zdravstvenem timu – tehnik/tehnica 
zdravstvene nege (TZN) (ang. healthcare assistant), 
izobrazba – srednješolsko strokovno izobraževanje 
smeri zdravstvena nega (5. raven slovenskega 
ogrodja kvalifikacij (SOK) ali 4. raven evropskega 
ogrodja kvalifikacij (EOK));
Raven 2: nosilec/nosilka zdravstvene nege v timu − 
zdravstvene nege in zdravstvenem timu – diplomirani 
zdravstvenik/medicinska sestra (dipl. zn./dipl. m. s.) 
(ang. general care nurse), izobrazba – visokošolsko 
strokovno izobraževanje smeri zdravstvena nega 1. 
bolonjske stopnje, ki je usklajeno z aktualno veljavno 
evropsko direktivo za regulirane poklice (7. raven 
SOK ali 6. raven EOK);
Raven 3: specialist/specialistka določenega področja − 
v zdravstveni negi – diplomirani zdravstvenik/
medicinska sestra specialist/-ka (dipl. zn. spec./
dipl. m. s. spec.). (ang. specialist nurse), izobrazba 
– podiplomsko specialistično izobraževanje ali 
podiplomsko izobraževanje 2. bolonjske stopnje 
(7.–8. raven SOK ali 6.–7. raven EOK); 
Raven 4: strokovnjak/strokovnjakinja za napredne − 
oblike dela v zdravstveni negi in zdravstveni obravnavi – 
magister/magistrica zdravstvene nege (mag. zdr. nege), 
doktor/doktorica zdravstvene nege ali zdravstvenih 
ved (ang. advance nurse practitioner), izobrazba – 
podiplomsko izobraževanje 2. in 3. bolonjske stopnje 
(8.–10. raven SOK ali 7.–8. raven EOK).
Pri predlogu prikazanega kompetenčnega modela 
je treba poudariti, da ravni 3 in 4 ni mogoče doseči, 
če ni dosežena raven 2, medtem ko raven 1 ni pogoj 
za doseganje ravni 2, kar je skladno s pogoji za vstop v 
izobraževanje za reguliran poklic (Directive 2013/55/EU 
of the European Parliament and of the Council , 2013).
Naslednji pomemben korak je vključitev vseh ravni 
kompetenc v nacionalne kadrovske normative in na 
plačni ravni v ustrezne tarifne skupine. Raziskava 
opozori, da naj bo razvojno delo in raziskovanje v 
zdravstveni negi orodje za uresničevanje na dokazih 
podprtega dela. Intervjuvanci menijo, da se prizadevanja 
in uveljavljanje raziskovalnega dela v zdravstveni negi 
lahko uresniči skozi nacionalni inštitut za raziskave 
v zdravstveni negi, katerega ustanoviteljica naj bo 
Zbornica – Zveza. Inštitut naj se financira iz članarin 
članov in iz prijav na razpise. Avtorica članka meni, 
da čakanje, da bi zdravstveno nego pri tem podprle 
druge institucije, glede na trenutno stanje zdravstvene 
politike v Sloveniji ni smiselno. Potrebna je investicija 
virov Zbornice – Zveze. Raziskava namreč pokaže, da 
je vpliv na zdravstveno politiko možno pričakovati 
preko nacionalnega raziskovalnega inštituta. Naslednja 
ugotovitev je, da morajo biti raziskave novega inštituta 
usmerjene predvsem v potrebe pacientov. Na ta način bi 
raziskovalke zdravstvene nege prispevale k oblikovanju 
politik na nivoju države in širše in bi bile bolj uspešne 
pri pridobivanju raziskovalnih sredstev, na kar v eni od 
raziskav opozori tudi Büscher s sodelavci (2009). 
Poglobljena analiza rezultatov raziskave pokaže 
pomemben poudarek na visokošolskem menedžmentu 
z vidika družbene odgovornosti visokega šolstva 
za argumentacijo razvoja zdravstvene nege kot 
znanstvene discipline in ureditev izobraževanja na 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.292
vseh nivojih. Le-to je logično pričakovanje, saj je 
akumulacija znanja o raziskovanju na fakultetah 
največja, tam mora biti prisotno raziskovalno delo, 
saj fakulteta lahko kakovostno izvaja in posodablja 
študijske programe le, če stroko, o kateri izobražuje, 
raziskuje in če je s stroko povezana pri neposrednem 
delu s pacienti. Pomembno je vključevanje kliničnega 
okolja v raziskovalno delo, kar v raziskavi potrdimo 
tudi z dobljenimi kodami, kot so »Nujno je sodelovanje 
med visokošolskim in zdravstvenim zavodom«, 
»Med visokošolskim in zdravstvenim zavodom naj se 
vzpostavi skupna raziskovalna entiteta«, »Strokovno 
delo in raziskovanje morata biti povezana«. Za 
večjo integracijo raziskovalne kulture ter paradigem 
raziskovanja v kliničnih okoljih se priporoča večja 
pozornost na teh vsebinah v študijskih programih 
zdravstvene nege (Kelly, et al., 2013; Loke, et al., 2014). 
Na slednje opozori tudi naša raziskava, predvsem z 
vidika, da je v Sloveniji izgradnja raziskovalne kulture 
zahtevna, saj intervjuvanci izražajo neodločenost 
glede vrste in obsega znanja za razvoj stroke in 
znanosti, prav tako se izkaže problem, da raziskovanje 
ne sodi v delovno obvezo medicinskih sester in da mu 
same medicinske sestre ne pripisujejo dovolj velike 
prioritete. 
V tej raziskavi ugotovljeno stanje se bo izboljšalo, 
ko bo menedžment zdravstvene nege pri zaposlenih 
podprl razvoj znanj iz raziskovanja in znanj iz na 
dokazih podprtega dela (Skela-Savič, et al., 2016a). 
S tem se bo presegla ugotovljena miselnost, da sta 
raziskovanje in razvoj zgolj neobvezni, in ne prioritetni 
aktivnosti medicinskih sester; povečala se bo 
motivacija za razvojno delo – v tej raziskavi se namreč 
kaže nizko lastno zavedanje o potrebah po razvojnem 
delu; povečal se bo interes za pridobivanje znanj za 
vzpostavitev raziskovanja in razvoja ter nenazadnje, 
vzpostavilo se bo zavedanje o pomenu raziskav za 
kakovostno delo. Kelly in sodelavci (2013) ter Loke in 
sodelavci (2014) opozarjajo, da raziskovanje preprosto 
še ni del profesionalne identitete medicinskih sester, 
zato se pogosto zgodi, da medicinske sestre tudi 
ne aplicirajo raziskovalnih izsledkov v vsakdanje 
praktično delo, kar pokaže tudi ta raziskava in druge v 
slovenskem prostoru že izvedene raziskave (Skela-Savič 
et al., 2016a, Skela-Savič, et al., 2017a). Ugotovljeno 
stanje podpira tudi ugotovljeni koncept vrednot 
in kompetenc, ki bi podpirale razvoj zdravstvene 
nege, saj je vrednostni sistem delovanja diplomirane 
medicinske sestre v slovenskih bolnišnicah usmerjen 
predvsem v uresničevanje dnevnih strokovnih nalog 
in ne razvojnih nalog (Skela-Savič, et al., 2017). Slednje 
potrdimo tudi z obstoječo raziskavo, ko opredelimo 
problematiko preseganja poklicnih kompetenc 
na strani TZN in s tem posledično opozorimo na 
pomanjkanje sistematiziranih delovnih mest za 
visokošolsko izobražene medicinske sestre, ki so edine 
lahko nosilke razvojnih nalog v zdravstveni negi, ki 
sodijo na četrto raven kompetenc. Mednarodni svet 
medicinskih sester (International Council of Nurses, 
2008) opredeli, da je za razvojne naloge treba imeti 
izobrazbo magistra zdravstvene nege, v Sloveniji pa 
teh delovnih mest še niti nismo sistematizirali. Zato je 
opredeljena odgovornost menedžmenta zdravstvene 
nege v tej in predhodnih raziskavah utemeljena. 
Že samo vpogled v kompetence, zapisane v direktivi 
za regulirane poklice Evropske unije (Directive 
2013/55/EU of the European Parliament and of the 
Council, 2013), jasno kaže, da kompetence sposobnost 
za analizo kakovosti zdravstvene nege in posledično 
izboljševanje lastnega strokovnega dela medicinskih 
sester za splošno zdravstveno nego (v direktivi zapisano 
v skupini H) ni mogoče uresničiti, če izvajalec nima 
bazičnih znanj o raziskovanju in razvoju in če v praksi 
ne uporablja na dokazih podprtega koncepta dela. 
Dejstvo, da morata raziskovanje in razvoj postati 
del delovne obremenitve diplomiranih medicinskih 
sester, se logično postavi kot pogoj za uresničevanje 
navedene kompetence in utrdi v raziskavi dobljeno 
temo »uveljavitev evropsko primerljivih znanj in 
kompetenc za razvoj stroke in znanosti v Sloveniji«. 
Ob tem je treba nenehno pojasnjevati, zakaj je treba 
uvesti ravni kompetenc, saj naša raziskava pokaže, da 
je med udeleženci prisotna neodločenost o obsegu 
in ravneh izobraževanja, kar pomeni, da strokovna 
javnost ravni izobraževanj še ne razume najbolje ali 
jih težko preslika na realno klinično okolje. V mislih 
je treba imeti tudi spoznanja, da lahko pri razvojnem 
delu v zdravstveni negi naletimo na številne težave, kot 
so čas namenjen raziskovanju, pomanjkljivo znanje za 
izvajanje raziskovanja, nezadostna podpora s strani 
vodilnih in zdravnikov, procesi dela in organizacijska 
kultura, ki ne podpirajo raziskovanja (Kelly, et al., 2013; 
Loke, et al., 2014; Yoder, et al., 2014). Za diplomirane 
medicinske sestre v slovenskih bolnišnicah žal 
namreč lahko potrdimo tudi pomanjkljivo znanje 
in izobraževanje ter slabo dostopnost do strokovne 
in znanstvene literature (Skela-Savič, et al., 2016a; 
2017a). Vsa ta spoznanja nas vodijo v premislek, kaj so 
obvezne vsebine izobraževanj za pridobitev licenc za 
delo in ali so te vsebine aktualizirane glede na znanja, 
potrebna za razvoj zdravstvene nege v Sloveniji, in 
kakšna je usposobljenost menedžmenta zdravstvene 
nege, katerega raziskava pokaže kot enega ključnih 
dejavnikov razvoja profesionalizacije. 
Raziskava opozori tudi na razhajanja med srednjim 
in visokim šolstvom, saj pričakovanja srednjega šolstva 
v smislu neprekinjene vertikalne prehodnosti za dijake 
zdravstvenih šol brez splošne mature ovirajo ambicije 
fakultet za razvoj univerzitetnega študija zdravstvene 
nege. Tako se lahko pričakovana vertikala v zdravstveni 
negi na strani srednjih zdravstvenih šol izkaže kot ovira 
za univerzitetno izobraževanje v zdravstveni negi, s 
katerim se tudi začne akademizacija zdravstvene nege, 
saj z njo dosežemo večinsko usposobljenost izvajalcev 
za profesionalizacijo zdravstvene nege. 
Poseben problem predstavlja ugotovitev, da je preseganje 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 293
kompetenc TZN v kliničnih okoljih na zavedni ravni, 
kar pomeni, da po formalni plati izobraževanje za 
poklic TZN v izobraževalnem programu ne daje 
kompetenc diplomiranih medicinskih sester, vendar 
tega klinično okolje ne upošteva. Na zavedni ravni 
od TZN namreč pričakujejo preseganje kompetenc. 
Prav tako je za udeležence iz srednješolskega sektorja 
moteče delegiranje in nadzor diplomirane medicinske 
sestre nad delom TZN, pričakujejo namreč 
samostojno vlogo poklica TZN v zdravstvenem 
sistemu, kar je naslednja ovira v profesionalizaciji 
zdravstvene nege v Sloveniji. Ugotovljeno preseganje 
kompetenc opozarja na dejstvo, da je potrebno 
povečano zaposlovanje diplomiranih medicinskih 
sester in omogočanje šolanja tistim TZN, katerih 
delo posega v kompetence diplomiranih medicinskih 
sester. Za preseganje kompetenc TZN je odgovoren 
menedžment zdravstvene nege, ki ne zaposli dovolj 
visokošolsko izobraženega kadra. To je neodgovorno 
ravnanje do pacientov in stroke, na kar je opozorila 
tudi v Belgiji, Angliji, Španiji, Švici in na Finskem letos 
zaključena raziskava Linde Aiken (2017), ki zelo jasno 
pove, da če v timu zdravstvene nege, ki skrbi za 25 
kirurških pacientov in ga sestavljajo štiri diplomirane 
medicinske sestre in dva nižje izobražena izvajalca 
zdravstvene nege, nadomestimo eno diplomirano 
medicinsko sestro z nižje izobraženim izvajalcem 
zdravstvene nege, povečamo verjetnost za smrtnost 
pacientov za kar 21 %. Melnyk in sodelavci (2012) 
pravijo, da so raziskave tiste, ki omogočajo izvajanje na 
dokazih podprte prakse. Le-te povečujejo kakovost in 
zanesljivost zdravstvene obravnave, izboljšujejo izide 
zdravstvene obravnave in zmanjšujejo variiranje v 
zdravstveni obravnavi in stroških. Zato je v slovenskem 
prostoru treba na nacionalni ravni pristopiti k 
sistematičnim raziskavam o povezavah med stopnjo 
izobrazbe in številom zaposlenih v zdravstveni negi 
ter izidi zdravstvene obravnave pri pacientih. 
Zaključimo lahko, da imamo pri profesionalizaciji 
zdravstvene nege v Sloveniji težave tudi s 
poimenovanjem poklica, saj raziskava pokaže, da 
»Poklicno poimenovanje »negovalec, negovalka« nima 
družbenega ugleda« in se ga šteje kot manj vredno in 
neprimerno poimenovanje za izvajalce zdravstvene 
nege. Tudi prepoznavanje novih področij delovanja 
TZN, kot so socialno-oskrbovalne kompetence, s strani 
predstavnikov srednješolskega sektorja ni sprejeto, kar 
zdravstveni negi kot stroki in znanosti nalaga izzive, 
kako v prihodnosti razumeti in odgovoriti na nove 
potrebe družbe. 
Omejitve raziskave so v izboru paradigme, saj ima 
kvalitativno raziskovanje na področju veljavnosti in 
zanesljivosti več omejitev. Veljavnost in zanesljivost 
smo zagotavljali z metodo hermenevtičnega kroga 
(Mesec, 1998), saj smo podatke pridobivali na 
osnovi širitve spoznanj predhodnih raziskav in 
izvedli sekvenčno raziskovanje. Udeležence raziskave 
smo vedno seznanili s predhodnimi spoznanji, 
na katerih so temeljila naša izhodiščna vprašanja 
za skupinski intervju. Tako smo v prvi sekvenci 
intervjuvancem poslali pisno poročilo o izvedeni 
kvantitativni raziskavi med dijaki, študenti in 
zaposlenimi v zdravstvu, srednjem in visokem šolstvu 
o kompetenčnem modelu v zdravstveni negi in 
odnosu do raziskovanja in razvoja v zdravstveni negi 
(Skela-Savič, et al., 2016b, 2016d). Te rezultate smo 
pred začetkom prve sekvence tudi ustno predstavili. 
V drugi sekvenci smo intervjuvancem poslali in ustno 
predstavili rezultate prve sekvence (Skela-Savič, et 
al., 2016c). Naše raziskovanje in razvita izhodiščna 
vprašanja temeljijo na raziskovalnem projektu, 
predhodno izvedenem v slovenskih bolnišnicah na 
velikem vzorcu (Skela-Savič, et al., 2016a; Skela-Savič 
et al., 2017b), kar lahko razumemo kot utemeljevanje 
veljavnosti raziskovanja, ki se kaže z dolgotrajnimi 
opazovanji, s triangulacijo različnih raziskovalnih 
metod za raziskovanje profesionalizacije zdravstvene 
nege v Sloveniji in s seznanjanjem udeležencev 
s predhodnimi spoznanji našega raziskovanja te 
tematike. Kot zaključni korak pri utemeljevanju 
veljavnosti izvedene raziskave smo septembra 2017 
izvedli »znanstveno kavarno«, na katero smo povabili 
strokovnjake v zdravstveni negi, vodilne v zdravstveni 
negi, v visokem šolstvu in na področju raziskovanja. Na 
tem srečanju smo predstavili dobljene teme raziskave 
in o njih s povabljenimi razpravljali s strateškega vidika 
in z vidika načrtovanja potrebnih sprememb. Green 
in Thorogood (2004) to poimenujeta konsenzualna 
konferenca. Pomembno je tudi povedati, da je 
avtorica članka zagovornica potreb po pospešenem 
razvoju profesionalizacije zdravstvene nege v 
Sloveniji in da je visokošolska učiteljica raziskovalnih 
metod, na dokazih podprtega dela in zdravstvenega 
menedžmenta, kar se lahko odraža v interpretaciji 
rezultatov, ki jo je avtorica obvladovala z reflektivno 
držo in seznanjanjem udeležencev raziskave s 
predhodnimi spoznanji raziskav (Mesec, 1998), ki 
so oblikovala tok skupinskega intervjuja. Avtorica je 
za potrebe objave članka ponovno preverila dobljene 
rezultate s tehniko sekundarne analize s ciljem 
razumljivosti, transparentnosti in natančnosti. 
Z induktivnim raziskovalnim pristopom smo 
prepoznali nekatere odgovornosti za razvoj elementov 
profesionalizacije v zdravstveni negi v Sloveniji, ki 
so lahko izziv raziskovalcem, da spoznanja preverijo 
po deduktivni poti raziskovanja. Raziskava daje 
izhodišča za načrtovanje strateških usmeritev razvoja 
profesionalizacije zdravstvene nege v prihodnosti, kar 
je bil tudi cilj naše raziskave. 
 
Zaključek
Raziskava s pomočjo kvalitativnega pristopa 
opozori na dejavnike, ki bodo odigrali pomembno 
vlogo pri razvoju profesionalizacije zdravstvene 
nege v Sloveniji in pri njenem preboju na področju 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.294
znanstvenoraziskovalnega dela in umeščanja ravni 
kompetenc v klinično delo. Stroka postane profesija 
takrat, kadar s sistematičnim pristopom ustvarja svoje 
lastno znanje in ga prenaša v neposredno strokovno 
delo in ko strokovnjaki generirajo raziskovalne 
probleme, ki jih rešujejo skupaj s tistimi, ki imajo 
kompetence za temeljno raziskovalno delo. Orodje 
delovanja so sistematično raziskovanje, strokovna 
presoja, razvoj kritičnega razmišljanja in odločanje 
na osnovi dokazov. Zato je visokošolsko izobražene 
medicinske sestre v Sloveniji treba opolnomočiti z 
znanji za razvoj vrednot aktivizma in razvoja, z znanji 
o raziskovanju in o na dokazih podprtem delu, saj bodo 
s tem pomembno vplivale na razvoj profesionalizacije 
in razvoj zdravstvene nege kot znanosti. Menedžerji na 
ključnih položajih zdravstvene nege v vseh sektorjih 
delovanja morajo biti usposobljeni za razumevanje 
profesionalizacije in za svojo odgovornost na tem 
področju. Potrebni sta jasna in ambiciozna vizija ter 
strategija razvoja zdravstvene nege, ki naj vključuje 
nacionalne usmeritve za vseživljenjsko profesionalno 
izobraževanje za zdravstvene zavode, strokovne 
sekcije, regijska strokovna društva in menedžment na 
vseh nivojih zdravstvene nege. Nacionalno strokovno 
združenje mora prevzeti odgovornost za predstavitev 
nove paradigme razvoja zdravstvene nege, ki bo 
odziv na potrebe družbe, stroke in znanosti ter izvesti 
načrtno razdelitev sredstev za uresničevanje le-te. 
Acknowledgements/Zahvala
The article is a presentation of a part of the results of a 
larger research project Nursing as a scientific discipline 
in Slovenia: An internationally comparable secondary 
and tertiary education system in nursing care as the 
foundation of research and scientific contribution to the 
sustainable development of society, which was in 2015 
selected as a two-year research project at the Slovenian 
Research Agency and the Ministry of Education, 
Science and Sport. Several independent research 
projects were conducted with separately gathered date 
and mixed research design. The article presents one of 
the conducted research studies. The leading partner of 
the project was Angela Boškin Faculty of Health Care, 
while project partners included the Faculty of Health 
Sciences of the University of Primorska, Educational 
Research Institute, Faculty of Health Sciences of the 
University of Maribor, International School for Social 
and Business Studies and the National Institute of Public 
Health. We would like to thank the entire research 
project team who cooperated well and productively 
in realizing the project aims. The author of the article 
would like to thank the members of the project team 
who ensured that the materials were collected in a 
way to enable a systematic data processing. Dr. Eva 
Klemenčič participated in transcribing the recorded 
interview of the conducted research. The first reading 
and editing of the text were conducted in a team 
composed of (in the alphabetical order): Assist. Prof. 
Simona Hvalič Touzery, Assist. Prof. Katja Pesjak, 
Senior Lecturer Dr. Vesna Čuk, Senior Lecturer 
Sanela Pivač, Lecturer Sedina Kalender Smajlovič and 
Lecturer Marta Smodiš. I would also like to thank 
Assist. Prof. Dr. Branko Gabrovec, who participated 
in managing a group interview in the first round and 
Assoc. Prof. Dr. (United Kingdom and Northern 
Ireland) Majda Pajnkihar, who cooperated in managing 
the group interview in the second round./Članek je 
predstavitev dela rezultatov večjega raziskovalnega 
projekta Zdravstvena nega kot znanstvena disciplina v 
Sloveniji: mednarodno primerljiv sistem sekundarnega 
in terciarnega izobraževanja v zdravstveni negi kot 
temelj raziskav in prispevka znanosti k trajnostnemu 
družbenemu razvoju, ki je bil leta 2015 izbran kot 
dvoletni ciljno raziskovalni projekt na Javni agenciji 
za raziskovalno dejavnost Republike Slovenije 
(ARRS) in Ministrstvu za izobraževanje, znanost in 
šport Republike Slovenije (MIZŠ). Izvedenih je bilo 
več samostojnih raziskav z ločeno zajetimi podatki, 
uporabljeni so bili mešani raziskovalni dizajni. V 
prispevku predstavljamo eno od izvedenih raziskav. 
Nosilka projekta je bila Fakulteta za zdravstvo Angele 
Boškin, partnerji projekta pa Fakulteta za vede o 
zdravju Univerze na Primorskem, Pedagoški inštitut, 
Fakulteta za zdravstvene vede Univerze v Mariboru, 
Mednarodna fakulteta za družbene in poslovne 
študije in Nacionalni inštitut za javno zdravje. Zahvala 
gre celotni raziskovalni skupini projekta, ki je tvorno 
sodelovala pri realizaciji ciljev projekta. Avtorica 
članka se zahvaljuje članom projektne skupine, ki so 
pripomogli, da je bilo gradivo zbrano tako, da je bila 
mogoča sistematična obdelava podatkov. Pri prepisu 
posnetega intervjuja izvedene raziskave je sodelovala 
dr. Eva Klemenčič. Prvo branje in čiščenje prepisa 
besedila je bilo izvedeno v delovni skupini, v kateri 
so sodelovale (navedeno po abecednem redu) doc. 
dr. Simona Hvalič Touzery, doc. dr. Katja Pesjak, viš. 
pred. dr. Vesna Čuk, viš. pred. Sanela Pivač, pred. 
Sedina Kalender Smajlovič in pred. Marta Smodiš. 
Zahvala gre doc. dr. Branku Gabrovcu, ki je sodeloval 
pri vodenju skupinskega intervjuja v prvi sekvenci, in 
izr. prof. dr. (Združeno kraljestvo Velike Britanije in 
Severne Irske) Majdi Pajnkihar, ki je sodelovala pri 
vodenju skupinskega intervjuja v drugi sekvenci.
Conflict of interest/Nasprotje interesov
The author declares that no conflicts of interest 
exist./Avtorica izjavlja, da ni nasprotja interesov.
Funding/Financiranje
The research was financed by Slovenian Research 
Agency and the Ministry of Education, Science and 
Sport, project Nursing as a scientific discipline in 
Slovenia: An internationally comparable secondary 
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 295
and tertiary education system in nursing care as the 
foundation of research and scientific contribution to the 
sustainable development of society (V5-1507, od 15. 
10. 2015 do 14. 10. 2017). The project was awarded in 
the tender Public tender for the selection of research 
projects related to Target research programme "CRP 
2015" in 2015 (URL RS, no. 53/2015, as of 17. 7. 2015)./
Raziskava je bila financirana s strani ARRS in MIZŠ, 
projekt Zdravstvena nega kot znanstvena disciplina v 
Sloveniji: mednarodno primerljiv sistem sekundarnega 
in terciarnega izobraževanja v zdravstveni negi kot 
temelj raziskav in prispevka znanosti k trajnostnemu 
družbenemu razvoju (V5-1507, od 15. 10. 2015 do 
14. 10. 2017). Projekt je bil pridobljen na razpisu 
Javni razpis za izbiro raziskovalnih projektov Ciljnega 
raziskovalnega programa "CRP 2015" v letu 2015 (URL 
RS, št. 53/2015, z dne 17. 7. 2015).
Ethical approval/Etika raziskovanja
Permission to conduct the research was obtained 
from the Committee for research and development of 
the Angela Boškin Faculty of Health Care. The study 
was conducted in accordance with the Helsinki-Tokyo 
Declaration (World Medical Association, 2013) and 
the Code of Ethics for Nurses and Nurse Assistants 
of Slovenia (2014)./Dovoljenje za izvedbo raziskave 
smo pridobili na Komisiji za znanstveno raziskovalno 
in razvojno dejavnost Fakultete za zdravstvo 
Angele Boškin. Raziskava je pripravljena v skladu z 
načeli Helsinško-Tokijske deklaracije (World Medical 
Association, 2016) in v skladu s Kodeksom etike v 
zdravstveni negi Slovenije (2014).
Author contributions/Prispevek avtorjev
The author was the head of the project. She designed 
the research plan and the research instrument as well 
as the research sample. She participated in managing 
the group interview to collect data in both rounds, 
performed data processing of the final transcribed 
interview (codes, categories, themes) and secondary 
analysis of data for the purposes of the article, described 
results, conducted a synthesis of the obtained themes of 
the four interviews, discussed the obtained results and 
designed recommendations for further research and 
developmental work./Avtorica je bila vodja projekta. 
Naredila je načrt raziskave, oblikovala instrument 
in vzorec raziskave, v obeh sekvencah sodelovala pri 
vodenju skupinskega intervjuja za zajem podatkov, 
naredila obdelavo podatkov prečiščenega besedila 
prepisa posnetega intervjuja (kode, kategorije, teme) 
in sekundarno analizo podatkov za potrebe članka, 
opisala rezultate, naredila sintezo dobljenih tem 
štirih intervjujev, razpravljala o dobljenih rezultatih 
in oblikovala priporočila za nadaljnje raziskovanje in 
razvojno delo. 
Literature/Literatura
Adams, D. & Miller, B., 2001. Professionalism in nursing 
behaviors of nurse practitioners. Journal of Professional Nursing, 
17(4), pp. 203–210. 
https://doi.org/10.1053/jpnu.2001.25913 
PMid:11464342
Aiken, L.H., Sloane, D., Griffiths, P., Rafferty, A.M., Bruyneel, 
L., McHugh, M., et al., 2017. Nursing skill mix in European 
hospitals: cross-sectional study of the association with mortality, 
patient ratings, and quality of care. BMJ Quality & Safety, 26(7), 
pp. 559–568. 
https://doi.org/10.1136/bmjqs-2016-005567 
PMid:28626086; PMCid:PMC5477662
Alidina, K., 2013. Professionalism in post-licensure nurses in 
developed Countries. Journal of Nursing Education and Practice, 
3(5), pp. 128–137.
Büscher, A., Sivertsen, B. & White, J., 2009. Nurses and 
midwives: a force for health. Survey on the situation of nursing 
and midwifery in the member states of the European Region of 
the World Health Organization. Copenhagen: WHO Regional 
Office for Europe.
Carvalho, T., 2014. Changing connections between professionalism 
and managerialism: a case study of nursing in Portugal. Journal of 
Professions and Organization, 1(2), pp. 176‒190. 
https://doi.org/10.1093/jpo/jou004 
Çelik, S. & Hisar, F., 2012. The influence of the professionalism 
behaviour of nurses working in health institutions on job 
satisfaction. International Journal of Nursing Practice, 18(2), 
pp. 180‒187.
https://doi.org/10.1111/j.1440-172X.2012.02019.x 
PMid:22435982
Cvetek, S., 1999. Profesionalnost in profesionalizacija v 
zdravstveni negi v spreminjajočem se kontekstu zdravstvenega 
varstva. Obzornik zdravstvene nege, 33(1–2), pp. 19‒23. 
Available at:
http://www.obzornikzdravstvenenege.si/1999.33.1.19 [2. 12. 2016].
Demirkasimoğlu, N., 2010. Defining teacher professionalism 
from different perspectives. Procedia Social and Behavioral 
Sciences, 9, pp. 2047–2051.
https://doi.org/10.1016/j.sbspro.2010.12.444 
Directive 2013/55/EU of the European Parliament and of the 
Council, 2013. Official Journal of the European Union, L354/132. 
Available at: 
http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELE
X:32013L0055&from=EN [2. 12. 2015].
EFN Workforce Committee, 2014. EFN Matrix on the 4 
Categories of the Nursing Care Continuum. Brussels: EFN 
Workforce Committee.
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297.296
Fantahun, A., Demessie, A., Gebrekirstos, K., Zemene, A. & 
Yetayeh, G., 2014. A cross sectional study on factors influencing 
professionalism in nursing among nurses in Mekelle Public 
Hospitals, North Ethiopia, 2012. BMC Nursing, 13(10), pp. 10‒17.
https://doi.org/10.1186/1472-6955-13-10 
PMid:24708544; PMCid:PMC3992135
Ghadirian, F., Mahvash, S. & Mohammad Ali, C., 2014. Nursing 
professionalism: an evolutionary concept analysis. Iranian 
Journal of Nursing and Midwifery Research, 19(1), pp. 1–10.
PMid:24554953; PMCid:PMC3917177
Gomm, R., 2008. Social research methodology: a critical 
introduction. 2nd ed. New York: Palgrave Macmillan, 
pp. 239–267.
Green, J., Thorogood, N., 2004. Qualitative Methods for Health 
Research. London, New Delhi: Sage Publications, pp. 107–129, 
173–200. 
International Council of Nurses, 2008. Nursing Care Continuum 
and Competencies. Geneva: ICN.
Keeling, J. & Templeman, J., 2013. An exploratory study: student 
nurses' perceptions of professionalism. Nurse Education in 
Practice, 13(1), pp. 18‒22. 
https://doi.org/10.1016/j.nepr.2012.05.008 
PMid:22652324
Kodeks etike v zdravstveni negi in oskrbi Slovenije in Kodeks etike 
za babice Slovenije, 2014. Ljubljana: Zbornica zdravstvene in 
babiške nege Slovenije - Zveza strokovnih društev medicinskih 
sester, babic in zdravstvenih tehnikov Slovenije.
Kelly, K.P., Turner, A., Gabel Speroni, K., McLaughlin, M.K. 
& Guzzetta, C.E., 2013. National survey of hospital nursing 
research, part 2: facilitators and hindrances. The Journal of 
nursing administration, 43(1), pp. 18‒23.
https://doi.org/10.1097/NNA.0b013e3182786029 
PMid:23207718
Kumar, R., 2011. Research methodology: step-by-step guide for 
beginners. 3rd ed. London, etc.: Sage Publications, pp. 123–129, 
171–173.
Loke, J.C.F., Laurenson, M.C. & Lee, K.W., 2014. Embracing 
a culture in conducting research requires more than nurses' 
enthusiasm. Nurse education today, 34(1), pp. 132‒137.
https://doi.org/10.1016/j.nedt.2012.09.006 
PMid:23031532
Manojlovich, M. & Ketefian, S., 2002. The effects of organizational 
culture on nursing professionalism: Implications for health 
resources planning. Canadian Journal of Nursing Research, 
33(4), pp. 15–34. 
PMid:11998192 
Melnyk, B.M., Fineout-Overholt, E., Gallagher-Ford, L. & 
Kaplan, L., 2012. The state of evidence-based practice in US 
nurses: critical implications for nurse leaders and educators. 
Journal of Nursing Administration, 42(9), pp. 410–417.
https://doi.org/10.1097/NNA.0b013e3182664e0a 
PMid:22922750
Mesec, B., 1998. Uvod v kvalitativno raziskovanje v socialnem 
delu. Ljubljana: Univerza v Ljubljani, Visoka šola za socialno 
delo, pp. 470. Available at:
https://sites.google.com/site/kvalitativnametodologija/
kvalitativna-metodologija/uvod-v-kvalitativno-raziskovanje-
v-socialnem-delu-knjiga- [2. 5. 2017].
Pahor M., 1998. Razlogi za prehod izobraževanja za zdravstveno 
nego na univerzitetno raven in njihove značilnosti. Obzornik 
zdravstvene nege, 32(1–2), pp. 5–19. Available at:
http://www.obzornikzdravstvenenege.si/1998.32.1.5 [2. 5. 2017].
Pahor, M., 2006. Medicinske sestre in univerza. Domžale: Izolit, pp. 6–11.
Skela-Savič, B., Babnik, K., Dermol, V., Klemenčič, E., Pesjak, K. 
& Hvalič Touzery, S., 2016d. Predstavitev rezultatov raziskave DP 
2.2: Razumevanje trenutnega položaja zdravstvene nege in potreb 
po spremembah izobraževanja in raziskovanja v zdravstveni negi 
na vzorcu osnovnošolske, srednješolske in visokošolske mladine 
: zaključno poročilo za vzorec učencev zadnje triade osnovne 
šole ter preliminarni rezultati raziskav, izvedenih na vzorcu 
srednješolcev in dodiplomskih študentov smeri Zdravstvena nega. 
Jesenice: Fakulteta za zdravstvo Jesenice, pp. 1–86.
Skela-Savič, B., Babnik, K., Trunk Širca, N., Pajnkihar, M., Klemenčič, 
E., Gabrovec, B., and colleagues, 2017b. Zaključno poročilo ciljno 
raziskovalni projekt: »Zdravstvena nega kot znanstvena disciplina v 
Sloveniji: mednarodno primerljiv sistem sekundarnega in terciarnega 
izobraževanja v zdravstveni negi kot temelj raziskav in prispevka 
znanosti k trajnostnemu družbenemu razvoju«. Jesenice, etc.: 
Fakulteta za zdravstvo Angele Boškin, etc., pp. 1–226.
Skela-Savič, B., Hvalič-Touzery, S. & Pesjak, K., 2017a. 
Professional values and competencies as explanatory factors 
for the use of evidence-based practice in nursing. Journal of 
advanced nursing, 73(1), pp. 1910–1923.
https://doi.org/10.1111/jan.13280 
PMid:28205259
Skela-Savič, B., Pesjak, K. & Lobe, B., 2016a. Evidence-based 
practice among nurses in Slovenian hospitals: a national survey. 
International nursing review, 63(1), pp. 122–131.
https://doi.org/10.1111/inr.12233 
PMid:26748610
Skela-Savič, B., Pesjak, K., Hvalič Touzery, S. & Dermol, V., 
2016b. Predstavitev rezultatov raziskave DP 2.1: Razumevanje 
potreb po spremembah izobraževanja in raziskovanja v 
zdravstveni negi – vidik izvajalcev izobraževanja in delodajalcev. 
Jesenice: Fakulteta za zdravstvo Jesenice, pp. 1–36.
Skela-Savič, B., 2017. / Obzornik zdravstvene nege, 51(4), pp. 274–297. 297
Skela-Savič, B., Pivač, S., Hvalič Touzery, S., Čuk, V., Kalender 
Smajlović, S., Smodiš, M., et al., 2016c. Prenova srednješolskega 
modela izobraževanja in razvoj kompetenčnega modela za vse 
ravni izobraževanja v zdravstveni negi : tehnika skupinskega 
konsenza : rezultati raziskave DP 3 in DP 4 projekta "Zdravstvena 
nega kot znanstvena disciplina" (CRP, 2015–2017). Jesenice: 
Fakulteta za zdravstvo Angele Boškin, pp. 1–33.
Svetlik, I., 1999. Sodobni izzivi profesionalizmu. Knjižnica, 
43(2/3), pp. 7–18. Available at: http://revija-knjiznica.zbds-
zveza.si/Izvodi/K9923/SVETLIK.pdf [2. 5. 2017].
Starc, A., 2009. Nursing professionalism in Slovenia: knowledge, 
power, and ethics. Nursing science quarterly, 22(4), pp. 371–374.
https://doi.org/10.1177/0894318409344758 
PMid:19858518
Starc, A., 2014. Profesionalizacija zdravstvene nege za kakovostne 
zdravstvene storitve. Univerza v Ljubljani, Zdravstvena fakulteta, 
pp. 171–179. 
Starc, A., 2016. Professionalization in healthcare chain. Journal 
of applied health sciences, 2(2), pp. 69–86.
https://doi.org/10.24141/2/2/1 
Viitanen, E., Wiili-Peltola, E., Tampsi-Jarvala, T. & Lehto, J., 2007. First-
line managers in university hospitals – captives to their own professional 
culture? Journal of Nursing Management, 15(1), pp. 114–122.
https://doi.org/10.1111/j.1365-2934.2006.00656.x 
PMid:17207015
Yoder, L.H., Kirkley, D., McFall, D.C., Kirksey, K.M., StalBaum, 
A.L. & Sellers D., 2014. Staff nurses' use of research to facilitate 
evidence-based practice. The American journal of nursing, 
114(9), pp. 26–37.
https://doi.org/10.1097/01.NAJ.0000453753.00894.29 
PMid:25121949
Watkins, D., 2011. The influence of master's education on the 
professional lives of British and German nurses and the further 
professionalization of nursing. Journal of Advanced Nursing, 
67(12), pp. 2605–2614.
https://doi.org/10.1111/j.1365-2648.2011.05698.x 
PMid:21615461
Wilensky, H.D., Harold, L., 1994. The Professionalization 
of Everyone? The American Journal of Sociology, 70(2), 
pp. 137–158. 
World Medical Association, 2013. World Medical Association 
Declaration of Helsinki: ethical principles for medical research 
involving human subjects. Journal of the American Medical 
Association, 310(20), pp. 2191–2194. 
https://doi.org/10.1001/jama.2013.281053 
PMid:24141714
Cite as/Citirajte kot: 
Skela-Savič, B., 2017. Development of nursing professionalization elements in Slovenia: the group interview technique. Obzornik 
zdravstvene nege, 51(4), pp. 274–297. https://doi.org/10.14528/snr.2017.51.4.199