Descriptive Adjectives for Nurses: A Comprehensive Guide

In the dynamic and demanding field of nursing, precise communication is paramount. Adjectives, which describe the qualities of nouns, play a vital role in conveying specific information about patients, procedures, and professional attributes. Understanding and using descriptive adjectives effectively can enhance clarity, improve patient care, and foster a more professional environment. This guide provides a comprehensive overview of adjectives relevant to nursing, offering definitions, examples, and practical exercises to improve your command of this essential grammatical tool. Whether you are a nursing student, a practicing nurse, or simply interested in medical communication, this article will equip you with the knowledge and skills to use adjectives with confidence and accuracy.

Table of Contents

1. Introduction
2. Definition of Adjectives
3. Classification of Adjectives
4. Function of Adjectives in Nursing
5. Contexts of Adjective Use
6. Structural Breakdown of Adjectives
7. Positioning of Adjectives
8. Cumulative Adjectives
9. Coordinate Adjectives
10. Types and Categories of Adjectives for Nurses
11. Adjectives Describing Patient Condition
12. Adjectives Describing Nursing Tasks
13. Adjectives Describing Professional Qualities
14. Adjectives Describing Equipment and Supplies
15. Adjectives Describing Medical Settings
16. Examples of Adjectives in Nursing
17. Patient Condition Examples
18. Nursing Tasks Examples
19. Professional Qualities Examples
20. Equipment and Supplies Examples
21. Medical Settings Examples
22. Usage Rules for Adjectives
23. Agreement with Nouns
24. Comparative and Superlative Forms
25. Order of Adjectives
26. Common Mistakes with Adjectives
27. Misplaced Adjectives
28. Incorrect Comparisons
29. Unnecessary Adjectives
30. Practice Exercises
31. Exercise 1: Identifying Adjectives
32. Exercise 2: Choosing the Correct Adjective
33. Exercise 3: Ordering Adjectives
34. Exercise 4: Correcting Mistakes
35. Advanced Topics in Adjective Use
36. Participial Adjectives
37. Compound Adjectives
38. Limiting Adjectives
39. Frequently Asked Questions
40. Conclusion

Definition of Adjectives

An adjective is a word that modifies or describes a noun or pronoun. Adjectives provide additional information about the noun, such as its qualities, characteristics, or attributes. They answer questions like “What kind?”, “Which one?”, “How many?”, or “How much?” Adjectives enrich our language by adding detail and specificity to our descriptions.

Classification of Adjectives

Adjectives can be classified into several types based on their function and meaning. Some common classifications include:

• Descriptive Adjectives (Qualitative): These describe the qualities of a noun (e.g., tall, blue, intelligent).
• Quantitative Adjectives: These indicate the quantity or amount of the noun (e.g., many, few, some).
• Demonstrative Adjectives: These point out specific nouns (e.g., this, that, these, those).
• Possessive Adjectives: These show ownership (e.g., my, your, his, her, its, our, their).
• Interrogative Adjectives: These are used in asking questions (e.g., which, what, whose).
• Proper Adjectives: These are derived from proper nouns (e.g., American, Shakespearean, Victorian).

Function of Adjectives in Nursing

In nursing, adjectives serve a crucial function in precise and effective communication. They allow nurses to accurately describe a patient’s condition, document observations, and convey important information to other healthcare professionals. For example, instead of simply stating “the patient has pain,” a nurse might say “the patient has severe, sharp pain in their abdomen.” The adjectives “severe” and “sharp” provide a more detailed and informative description of the patient’s pain experience. Accurate use of adjectives can lead to better diagnoses, treatment plans, and ultimately, improved patient outcomes. Moreover, adjectives are essential in documenting nursing interventions, describing medical equipment, and detailing the characteristics of different healthcare settings.

Contexts of Adjective Use

Adjectives are used in various contexts within the nursing profession, including:

• Patient Assessment: Describing symptoms, vital signs, and overall physical condition.
• Documentation: Recording observations and interventions in patient charts and reports.
• Communication: Conveying information to doctors, other nurses, and patients’ families.
• Education: Teaching patients about their conditions and treatment plans.
• Research: Describing study participants and research findings.

Structural Breakdown of Adjectives

Understanding the structure of adjectives helps in using them correctly and effectively. Adjectives typically precede the noun they modify, but there are some exceptions.

Positioning of Adjectives

Most adjectives are placed directly before the noun they describe. This is known as the attributive position. For example:

• The elderly patient.
• A comfortable bed.
• The diligent nurse.

However, some adjectives can also be placed after a linking verb (such as be, seem, appear, become). This is known as the predicative position. For example:

• The patient is stable.
• The room seems clean.
• The nurse became tired.

Additionally, adjectives can follow the noun they modify in certain idiomatic expressions or poetic constructions. For example: “Heir apparent.”

Cumulative Adjectives

Cumulative adjectives build upon each other to provide an increasingly specific description. The order of cumulative adjectives generally follows a pattern based on their type. They don’t have commas between them. For example:

• A small, red blood cell.
• A heavy, metal instrument.
• A new, surgical mask.

In these examples, “small” and “red” are both descriptive adjectives that provide different aspects of the blood cell’s appearance. Similarly, “heavy” and “metal” describe different qualities of the instrument.

Coordinate Adjectives

Coordinate adjectives are adjectives that modify the same noun equally. They can be joined by “and” or separated by a comma. The order of coordinate adjectives can be changed without affecting the meaning. For instance:

• The patient was anxious, restless.
• The procedure was long and complicated.
• A caring, compassionate nurse.

In these examples, “anxious” and “restless” both describe the patient’s emotional state. “Long” and “complicated” both describe the nature of the procedure. “Caring” and “compassionate” both describe the nurse’s demeanor. Note the comma between coordinate adjectives.

Types and Categories of Adjectives for Nurses

Adjectives used in nursing can be categorized based on what they describe. These categories include patient condition, nursing tasks, professional qualities, equipment and supplies, and medical settings.

Adjectives Describing Patient Condition

These adjectives describe the physical, emotional, and mental state of a patient. They are crucial for accurate assessment and documentation. Examples include:

• Stable
• Unstable
• Critical
• Acute
• Chronic
• Alert
• Confused
• Anxious
• Depressed
• Responsive
• Unresponsive
• Febrile
• Afebrile
• Hydrated
• Dehydrated
• Painful
• Comfortable
• Weak
• Strong
• Edematous

Adjectives Describing Nursing Tasks

These adjectives describe the nature or quality of nursing interventions and procedures. They help to clarify the details of the care provided. Examples include:

• Routine
• Emergency
• Complex
• Simple
• Invasive
• Non-invasive
• Sterile
• Aseptic
• Painful
• Therapeutic
• Preventative
• Palliative
• Monitoring
• Administering
• Wound Care
• Respiratory
• Cardiovascular
• Neurological
• Gastrointestinal
• Genitourinary

Adjectives Describing Professional Qualities

These adjectives describe the attributes and characteristics of a competent and effective nurse. They reflect the values and standards of the nursing profession. Examples include:

• Compassionate
• Caring
• Empathetic
• Diligent
• Attentive
• Responsible
• Reliable
• Organized
• Efficient
• Knowledgeable
• Skilled
• Ethical
• Professional
• Respectful
• Patient
• Calm
• Assertive
• Collaborative
• Adaptable
• Resourceful

Adjectives Describing Equipment and Supplies

These adjectives describe the features and condition of medical equipment and supplies used in patient care. They are important for ensuring safety and proper functioning. Examples include:

• Sterile
• Clean
• Disposable
• Reusable
• Electronic
• Manual
• Portable
• Adjustable
• Accurate
• Calibrated
• Functional
• Defective
• Broken
• New
• Used
• Sharp
• Blunt
• Specialized
• Standard
• Medical-grade

Adjectives Describing Medical Settings

These adjectives describe the characteristics of various healthcare environments where nurses work. They help to create a clear picture of the setting. Examples include:

• Clean
• Sterile
• Modern
• Traditional
• Busy
• Quiet
• Large
• Small
• Rural
• Urban
• Well-equipped
• Understaffed
• Overcrowded
• Specialized
• General
• Emergency
• Intensive
• Outpatient
• Inpatient
• Comfortable

Examples of Adjectives in Nursing

The following tables provide examples of how adjectives are used in various nursing contexts. These examples demonstrate the importance of selecting the right adjective to convey precise and accurate information.

Patient Condition Examples

This table provides examples of using adjectives to describe a patient’s physical, emotional, and mental state. These are essential for accurate assessment and documentation.

Sentence	Adjective(s)	Category
The patient is unresponsive to verbal stimuli.	unresponsive	Patient Condition
She reported severe pain in her left leg.	severe, left	Patient Condition
The patient appears anxious and restless.	anxious, restless	Patient Condition
His breathing is shallow and rapid.	shallow, rapid	Patient Condition
The wound is infected and inflamed.	infected, inflamed	Patient Condition
The patient’s skin is pale and clammy.	pale, clammy	Patient Condition
He has a persistent cough and a runny nose.	persistent, runny	Patient Condition
The patient is alert and oriented to time, place, and person.	alert, oriented	Patient Condition
She is experiencing intermittent episodes of confusion.	intermittent	Patient Condition
The patient’s blood pressure is elevated.	elevated	Patient Condition
He is febrile with a temperature of 102°F.	febrile	Patient Condition
The patient is dehydrated and requires IV fluids.	dehydrated	Patient Condition
Her urine is cloudy and has a strong odor.	cloudy, strong	Patient Condition
The patient’s edema is significant in both legs.	significant	Patient Condition
He is experiencing acute chest pain.	acute	Patient Condition
The patient has a chronic cough that has lasted for months.	chronic	Patient Condition
She is weak and unable to ambulate without assistance.	weak	Patient Condition
The patient is comfortable and resting quietly.	comfortable	Patient Condition
His mood is depressed following the surgery.	depressed	Patient Condition
The patient is stable and vital signs are within normal limits.	stable	Patient Condition
The patient is critical and requires immediate intervention.	critical	Patient Condition
The patient is responsive to pain.	responsive	Patient Condition
The patient is hydrated and skin turgor is normal.	hydrated	Patient Condition
The patient is painful and requires pain medication.	painful	Patient Condition
The patient is strong and able to perform ADLs independently.	strong	Patient Condition

Nursing Tasks Examples

This table provides examples of using adjectives to describe the nature and quality of nursing interventions and procedures, clarifying the details of care.

Sentence	Adjective(s)	Category
The nurse performed a routine assessment of vital signs.	routine	Nursing Tasks
An emergency tracheostomy was performed to secure the airway.	emergency	Nursing Tasks
Complex wound care was provided to prevent infection.	complex	Nursing Tasks
A simple dressing change was performed on the abrasion.	simple	Nursing Tasks
An invasive procedure, such as a central line insertion, carries risks.	invasive	Nursing Tasks
Non-invasive monitoring of blood pressure was initiated.	non-invasive	Nursing Tasks
Sterile technique was used during catheter insertion.	sterile	Nursing Tasks
An aseptic environment is essential for preventing infection.	aseptic	Nursing Tasks
A painful injection was administered with care.	painful	Nursing Tasks
Therapeutic communication was used to address the patient’s anxiety.	therapeutic	Nursing Tasks
Preventative measures were taken to avoid pressure ulcers.	preventative	Nursing Tasks
Palliative care was provided to improve the patient’s quality of life.	palliative	Nursing Tasks
Monitoring the patient’s heart rate is crucial after surgery.	monitoring	Nursing Tasks
Administering medication requires careful attention to dosage.	administering	Nursing Tasks
Wound care includes cleaning and dressing changes.	wound care	Nursing Tasks
Respiratory support was provided via mechanical ventilation.	respiratory	Nursing Tasks
Cardiovascular monitoring included continuous ECG readings.	cardiovascular	Nursing Tasks
Neurological assessments were conducted to evaluate brain function.	neurological	Nursing Tasks
Gastrointestinal management involved administering antiemetics.	gastrointestinal	Nursing Tasks
Genitourinary care included catheter maintenance and monitoring.	genitourinary	Nursing Tasks
A skilled nurse administered the medication smoothly.	skilled	Nursing Tasks
A careful assessment was performed to identify the cause of the patient’s distress.	careful	Nursing Tasks
The detailed documentation provided a clear picture of the patient’s progress.	detailed	Nursing Tasks
The gentle approach helped to calm the patient during the procedure.	gentle	Nursing Tasks
The thorough explanation helped the patient to understand the treatment plan.	thorough	Nursing Tasks

Professional Qualities Examples

This table provides examples of using adjectives to describe the attributes and characteristics of a competent and effective nurse, reflecting the values of the nursing profession.

Sentence	Adjective(s)	Category
A compassionate nurse can provide comfort during difficult times.	compassionate	Professional Qualities
Caring nurses build strong relationships with their patients.	caring	Professional Qualities
An empathetic approach helps nurses understand their patients’ feelings.	empathetic	Professional Qualities
A diligent nurse ensures that all tasks are completed accurately.	diligent	Professional Qualities
Attentive nurses notice subtle changes in a patient’s condition.	attentive	Professional Qualities
Responsible nurses take ownership of their actions and decisions.	responsible	Professional Qualities
Reliable nurses can be counted on to fulfill their duties.	reliable	Professional Qualities
Organized nurses manage their time and resources effectively.	organized	Professional Qualities
Efficient nurses provide high-quality care in a timely manner.	efficient	Professional Qualities
A knowledgeable nurse is well-informed about medical conditions and treatments.	knowledgeable	Professional Qualities
Skilled nurses perform procedures with competence and precision.	skilled	Professional Qualities
Ethical nurses adhere to the highest standards of conduct.	ethical	Professional Qualities
A professional demeanor is essential for maintaining trust.	professional	Professional Qualities
Respectful nurses value the dignity and rights of all patients.	respectful	Professional Qualities
A patient nurse can handle challenging situations with grace.	patient	Professional Qualities
A calm nurse can reassure patients during stressful moments.	calm	Professional Qualities
An assertive nurse can advocate effectively for their patients.	assertive	Professional Qualities
Collaborative nurses work well with other healthcare professionals.	collaborative	Professional Qualities
Adaptable nurses can adjust to changing circumstances quickly.	adaptable	Professional Qualities
Resourceful nurses find creative solutions to problems.	resourceful	Professional Qualities
The experienced nurse handled the crisis with skill and confidence.	experienced	Professional Qualities
The dedicated team worked tirelessly to improve patient outcomes.	dedicated	Professional Qualities
The supportive environment encouraged professional growth.	supportive	Professional Qualities
The motivated staff embraced new challenges with enthusiasm.	motivated	Professional Qualities
The courageous nurse spoke up about safety concerns.	courageous	Professional Qualities

Equipment and Supplies Examples

This table shows examples of using adjectives to describe the features and condition of medical equipment and supplies, ensuring safety and proper functioning.

Sentence	Adjective(s)	Category
Sterile gloves are essential for preventing infection.	sterile	Equipment and Supplies
Clean equipment should be used for each patient.	clean	Equipment and Supplies
Disposable syringes should be discarded after use.	disposable	Equipment and Supplies
Reusable instruments must be properly sterilized.	reusable	Equipment and Supplies
An electronic thermometer provides accurate temperature readings.	electronic	Equipment and Supplies
A manual blood pressure cuff requires careful technique.	manual	Equipment and Supplies
Portable oxygen tanks are useful for transport.	portable	Equipment and Supplies
An adjustable bed can improve patient comfort.	adjustable	Equipment and Supplies
An accurate scale is needed for weight monitoring.	accurate	Equipment and Supplies
Calibrated equipment ensures reliable measurements.	calibrated	Equipment and Supplies
Functional equipment is necessary for providing effective care.	functional	Equipment and Supplies
Defective equipment should be taken out of service immediately.	defective	Equipment and Supplies
Broken equipment poses a safety hazard.	broken	Equipment and Supplies
New equipment is often more efficient and reliable.	new	Equipment and Supplies
Used equipment should be inspected carefully before use.	used	Equipment and Supplies
Sharp instruments must be handled with caution.	sharp	Equipment and Supplies
Blunt needles can cause unnecessary pain.	blunt	Equipment and Supplies
Specialized equipment is needed for certain procedures.	specialized	Equipment and Supplies
Standard supplies are readily available in most healthcare settings.	standard	Equipment and Supplies
Medical-grade materials are designed for healthcare use.	medical-grade	Equipment and Supplies
The advanced technology improved patient monitoring capabilities.	advanced	Equipment and Supplies
The essential supplies were always stocked and ready for use.	essential	Equipment and Supplies
The reliable equipment ensured accurate and consistent results.	reliable	Equipment and Supplies
The innovative device streamlined the medication delivery process.	innovative	Equipment and Supplies
The lightweight design made the equipment easy to transport.	lightweight	Equipment and Supplies

Medical Settings Examples

This table provides examples of using adjectives to describe the characteristics of various healthcare environments, creating a clear picture of the setting.

Sentence	Adjective(s)	Category
A clean environment is crucial for preventing infections.	clean	Medical Settings
A sterile environment is required for surgical procedures.	sterile	Medical Settings
A modern hospital incorporates the latest technology.	modern	Medical Settings
A traditional nursing home provides long-term care.	traditional	Medical Settings
A busy emergency room can be chaotic.	busy	Medical Settings
A quiet recovery room promotes rest and healing.	quiet	Medical Settings
A large hospital can offer a wide range of services.	large	Medical Settings
A small clinic may provide more personalized care.	small	Medical Settings
A rural health center serves remote communities.	rural	Medical Settings
An urban hospital is often located in a densely populated area.	urban	Medical Settings
A well-equipped facility has the necessary tools for advanced care.	well-equipped	Medical Settings
An understaffed hospital can lead to increased workload.	understaffed	Medical Settings
An overcrowded emergency room can delay treatment.	overcrowded	Medical Settings
A specialized unit focuses on specific medical conditions.	specialized	Medical Settings
A general hospital provides care for a wide variety of patients.	general	Medical Settings
An emergency department provides immediate care for critical patients.	emergency	Medical Settings
An intensive care unit (ICU) provides advanced monitoring and support.	intensive	Medical Settings
An outpatient clinic provides care for patients who do not require hospitalization.	outpatient	Medical Settings
An inpatient unit provides care for patients who are hospitalized.	inpatient	Medical Settings
A comfortable environment can reduce patient anxiety.	comfortable	Medical Settings
The new wing of the hospital offered state-of-the-art facilities.	new	Medical Settings
The renovated space provided a more welcoming atmosphere for patients.	renovated	Medical Settings
The private rooms offered patients more privacy and comfort.	private	Medical Settings
The advanced technology improved diagnostic capabilities.	advanced	Medical Settings
The dedicated staff provided exceptional care to all patients.	dedicated	Medical Settings

Usage Rules for Adjectives

Adhering to usage rules ensures clarity and correctness in using adjectives. Key rules involve agreement with nouns, comparative and superlative forms, and the order of adjectives.

Agreement with Nouns

Adjectives in English do not change form to agree with the noun they modify in terms
of number or gender, unlike in some other languages. The adjective remains the same regardless of whether the noun is singular or plural.

• Correct: The tall nurse.
• Correct: The tall nurses.

Comparative and Superlative Forms

Adjectives have comparative and superlative forms to show different degrees of quality. Comparative adjectives compare two things, while superlative adjectives compare three or more things.

• Comparative: Formed by adding “-er” to the adjective or using “more” before the adjective.
• Example: This patient is stronger than the other.
• Example: This procedure is more complex than the previous one.
• Superlative: Formed by adding “-est” to the adjective or using “most” before the adjective.
• Example: She is the tallest nurse on the team.
• Example: This is the most effective treatment for this condition.

Note that some adjectives have irregular comparative and superlative forms (e.g., good, better, best; bad, worse, worst).

Order of Adjectives

When using multiple adjectives to describe a noun, there is a general order to follow to ensure clarity and natural-sounding language. The typical order is:

1. Quantity or Number: (e.g., one, two, several)
2. Opinion: (e.g., beautiful, ugly, delicious)
3. Size: (e.g., large, small, tiny)
4. Age: (e.g., old, new, ancient)
5. Shape: (e.g., round, square, triangular)
6. Color: (e.g., red, blue, green)
7. Origin: (e.g., American, French, Italian)
8. Material: (e.g., wooden, metal, plastic)
9. Purpose: (e.g., surgical, cleaning, writing)

For example:

• A small, new, surgical instrument.
• Several beautiful, large, red roses.

Common Mistakes with Adjectives

Even with a good understanding of adjectives, it’s easy to make mistakes. Common errors include misplaced adjectives, incorrect comparisons, and unnecessary adjectives.

Misplaced Adjectives

A misplaced adjective is an adjective that is positioned in a sentence in such a way that it seems to modify the wrong noun. This can lead to confusion and misinterpretation.

Incorrect Comparisons

Incorrect comparisons occur when adjectives are not properly used in their comparative or superlative forms, or when comparisons are made between incomparable things.

Unnecessary Adjectives

Using too many adjectives can make your writing wordy and unclear. Choose adjectives that add significant meaning and avoid those that are redundant or obvious.

Practice Exercises

Test your understanding of adjectives with these practice exercises. These exercises cover identifying adjectives, choosing the correct adjective, ordering adjectives, and correcting mistakes.

Exercise 1: Identifying Adjectives

Identify the adjectives in the following sentences:

1. The attentive nurse noticed the subtle changes in the patient’s condition.
2. The sterile gloves were used during the surgical procedure.
3. The patient reported severe pain in his left knee.
4. The organized team provided efficient and compassionate care.
5. The portable monitor displayed accurate vital signs.

Answers:

1. attentive, subtle
2. sterile, surgical
3. severe, left
4. organized, efficient, compassionate
5. portable, accurate

Exercise 2: Choosing the Correct Adjective

Choose the correct adjective from the options provided to complete each sentence:

1. The patient is (stable / unstably) and does not require immediate intervention.
2. The (skilled / skill) nurse administered the medication smoothly.
3. The (clean / cleanly) environment is essential for preventing infections.
4. The (therapeutic / therapy) communication helped to reduce the patient’s anxiety.
5. The (responsible / responsibly) nurse documented all observations accurately.

Answers:

1. stable
2. skilled
3. clean
4. therapeutic
5. responsible

Exercise 3: Ordering Adjectives

Rearrange the adjectives in the correct order:

1. instrument / surgical / small / new – A _______________ instrument.
2. roses / red / beautiful / several – _______________ roses.
3. patient / elderly / frail – The _______________ patient.
4. building / modern / tall – A _______________ building.
5. mask / surgical / blue – The _______________ mask.

Answers:

1. A small, new, surgical instrument.
2. Several beautiful, red roses.
3. The frail, elderly patient.
4. A tall, modern building.
5. The blue surgical mask.

Exercise 4: Correcting Mistakes

Identify and correct the mistakes in the use of adjectives in the following sentences:

1. The nurse gave the medicine to the patient quick.
2. This treatment is more better than the other.
3. The patient reported a painful burning on her skin.
4. The round circle was drawn on the paper.
5. The experience nurse handled the situation calmly.

Answers:

1. The nurse gave the quick medicine to the patient.
2. This treatment is better than the other.
3. The patient reported a burning pain on her skin.
4. The circle was drawn on the paper.
5. The experienced nurse handled the situation calmly.

Advanced Topics in Adjective Use

Beyond basic usage, there are advanced topics in adjective use that can further enhance your communication skills. These include participial adjectives, compound adjectives, and limiting adjectives.

Participial Adjectives

Participial adjectives are adjectives that are formed from verbs and act as adjectives. They can be either present participles (ending in “-ing”) or past participles (usually ending in “-ed” or “-en”).

• Present Participle: Describes a quality or state of being.
• Example: The comforting words eased the patient’s anxiety.
• Past Participle: Describes a state or condition resulting from an action.
• Example: The treated wound showed signs of healing.

Compound Adjectives

Compound adjectives are adjectives made up of two or more words, often connected by a hyphen. They function as a single adjective to modify a noun.

• Example: The patient received short-term care.
• Example: The nurse provided around-the-clock monitoring.
• Example: The hospital had a state-of-the-art facility.

Limiting Adjectives

Limiting adjectives restrict or specify the noun they modify. They include articles (a, an, the), demonstrative adjectives (this, that, these, those), possessive adjectives (my, your, his, her, its, our, their), and quantitative adjectives (some, many, few).

• Articles: The patient needed a nurse.
• Demonstrative: This medication is more effective.
• Possessive: Her patient was very grateful.
• Quantitative: Some patients require more attention.

Frequently Asked Questions

Conclusion

Mastering the use of adjectives is essential for nurses to communicate effectively, document accurately, and provide the best possible patient care. By understanding the different types and categories of adjectives, adhering to usage rules, and avoiding common mistakes, nurses can enhance their professional communication skills. Continuous practice and attention to detail will further refine your ability to use adjectives with confidence and precision, ultimately contributing to improved patient outcomes and a more professional healthcare environment. Embrace the power of descriptive language, and let your words reflect the care and expertise that define the nursing profession.