Professionalism and associated factors among nurses working in Hadiya zone public hospitals, Southern Ethiopia. A Facility based cross sectional study (quantitative and qualitative method)

In the world of healthcare, the skill to heal is only half the equation. The other half is professionalism: the quiet, consistent commitment to ethical behavior, continuous learning, and a deep sense of duty that defines a true professional. It is the difference between a worker who simply completes tasks and a caregiver who upholds the dignity of their vocation, advocates for patients, and strives for excellence even when no one is watching. When this standard slips, the entire system feels the strain; patients receive less safe care, trust erodes, and the workforce becomes unstable. Understanding what drives or hinders this professional spirit is not just an academic exercise; it is a matter of public health. In many parts of the world, nurses face immense pressure, often working with limited resources while carrying the weight of community expectations. The question remains: what conditions allow a nurse to thrive as a professional, and what forces pull them away from that ideal?

To answer this, a team of researchers traveled to the Hadiya Zone in southern Ethiopia, a region with a population spread across towns and rural villages, to examine the professional lives of nurses working in five public hospitals. They wanted to know how these nurses viewed their own professionalism and, more importantly, what factors in their daily lives helped or hurt that sense of duty. The team used a mixed approach, combining a survey of nearly four hundred nurses with in-depth conversations with hospital leaders and ward heads. They did not just ask if the nurses felt professional; they asked about their education, their salaries, their sense of achievement, and whether they belonged to professional groups. They also listened to the stories of those in charge, who described the realities of the workplace from the inside out.

The results painted a picture of a workforce that is largely dedicated but struggling against significant headwinds. The study found that a substantial portion of the nurses, roughly forty percent, perceived their own level of professionalism as low. This was not a reflection of a lack of care, but rather a symptom of the environment in which they worked. The researchers identified specific, tangible factors that made a clear difference. Nurses who held a bachelor's degree or higher were far more likely to report high professionalism than those with only a diploma. Similarly, those who had attended recent training sessions, felt a strong sense of personal accomplishment in their work, or were active members of a professional nursing association reported much higher levels of professional behavior. In fact, nurses who belonged to a professional organization were more than five times as likely to be in the highest category of professionalism compared to those who did not.

The conversations with hospital leaders added depth to these numbers, revealing the human side of the statistics. They spoke of a profession that feels undervalued by the government, noting that nurses often earn less than other health workers with similar years of schooling, despite working longer and more demanding hours. One leader described the frustration of being held solely accountable for mistakes while other professionals faced less scrutiny. The lack of basic medical supplies and equipment was another recurring theme; without the right tools, nurses feel unable to provide the standard of care they know is expected, which erodes their confidence and professional identity. The leaders also pointed out that the opportunity to upgrade one's education is scarce, leaving many nurses stuck in a system that does not support their growth.

Despite these challenges, the study highlighted clear pathways forward. The data suggested that when nurses are given the chance to learn, when they are treated with respect, and when they have a community of peers to support them, their professional spirit flourishes. The researchers concluded that simply expecting nurses to be professional is not enough; the system must actively cultivate the conditions that allow professionalism to grow. This means investing in higher education, providing regular training, ensuring fair compensation, and strengthening the role of professional associations. The findings serve as a roadmap for health officials in Ethiopia and beyond, showing that the path to better patient care begins with supporting the people who provide it. By addressing the specific barriers of salary, education, and institutional respect, the healthcare system can help its nurses reclaim the high standards of their profession.