The contemporary debate in the field of nursing about the role of the nurse in the hospital setting and in society is only one aspect of the nationwide debate over the role of women in general in our occupational structure. In one occupation after another it is increasingly evident that the role of the woman worker is changing. As nursing continues to seek recognition as a profession, the issue of what the nurse's role should be has become critical.
There have been many indications in recent years of the widening gap between the tradition-oriented nurse who is committed to bedside nursing and the profession-oriented nurse who envisions herself as functioning on a broader scale with a longer period of professional education, increased specialization, improvement of and involvement in professional organizations, professional recognition by the general public, and other professional goals.
Deutscher and Montague * suggest that as an occupation moves toward a more professional status, humanitarian values must be reduced and a new group of "technicians" is needed in order to fill the gap left by those whose responsibilities have moved upward and outward- in this case, the profession-oriented nurse.
Studies by Christ 2 and by Reissman and Rohr 3 point up the duality of the nursing role, i.e., bedside care and the supervision of care personnel, and the fact that this dual role is a source of strain. Most women enter nursing because of their desire to help sick persons get well. A study conducted among nurses in seven greater Boston hospitals by Benne and Bennis 4 revealed that the nurse whose image of a nurse was centered around bedside care of the patient was sharply jolted by the "discontinuity between her selfimage of nursing and the actualities of work life."
The education of a student nurse is an important factor in her attitude toward her future work. Nursing education attempts to give the student not only the necessary technical skills for her future work, but also certain atti tudes and values about nursing as a vocation and as a way of life. This article is a summary of a study conducted by the authors, who investigated the attitudes of nursing students toward their careers and considered the implications of the findings in relation to nursing education and the field of nursing in general.
The Subjects and the Method of Investigation
The subjects for the study were senior nursing students in two schools of nursing: (1) a four-year program leading to a Bachelor of Science degree in nursing in a state university setting, and (2) a three-year diploma program offered under the auspices of a sectarian hospital.
The three instruments employed to collect data for the study were: (1) a questionnaire designed to elicit information concerning the socioeconomic background of the student, (2) a professionalization scale and assignment of tasks scale developed by Sister Madeleine Vaillot, 5 and (3) a questionnaire to measure commitment to nursing and satisfaction with the educational program.
The results of the socioeconomic background questionnaire were analyzed by the chi square statistical text, and no significant differences were found between the two groups of senior nursing students in terms of the education and occupations of their parents.
A comparison of the two groups of senior nursing students and their satisfaction with their training programs and their attitude toward nursing is shown in Table 1.
The statistical t- text used to compare the results of the attitudes of the two groups on the professionalization and task assignment scales revealed that: (1) no significant differences existed between the two groups in general task orientation, commitment to nursing, or professional outlook, and (2) student nurses in a degree program were significantly more satisfied with their education than were student nurses in a diploma program. Although there were no significant differences between the two groups in commitment to nursing or in professional outlook toward the nursing field, both groups of student nurses revealed low commitment and low professional outlook.
Discussion of Findings
The findings of this study reveal that a relatively low percentage of both degree and diploma senior nursing students feel a high commitment to nursing, which corroborates the findings of Powers. 6 In Sister Eleanor Frances Powers' study, only 30 percent of the nursing students in a sectarian degree program planned to work more than 10 years in nursing. On the other hand, 30 percent of the nursing students in sectarian schools and 50 percent of the nursing students in nonsectarian schools planned to stay in nursing for a period of five years or less.
The seemingly low commitment to nursing revealed by these and other studies continues as one of the major problems in the nursing field in its continuing efforts toward professional status. Since one of the prerequisites of a profession is the relatively lifelong commitment of its members to the occupation, the prevailing attitude of low commitment held by nursing students should be reexamined if nursing can realistically expect to reach its goal of recognition as a profession. The challenge to educators implied by the body of research about the attitudes of student nurses toward nursing therefore becomes apparent: How can nursing education engender appropriate attitudes to student nurses?
The first step in meeting this challenge to nursing education must be for educators to develop an adequate set of generally accepted professional attitudes for themselves. A recent survey by Pox et al7 of 23 basic programs in nursing schools revealed that only 16 percent of the typical faculty had been teaching for 10 years or more, 34 percent from 1 to 3 years, and 26 percent for less than 1 year. Furthermore, although 61 percent of the faculty members indicated that they were content in their work, a sizeable minority of 39 percent indicated that they had some doubts about their choice of occupation. Interestingly enough, 78 percent of the nursing faculties who were dissatisfied in their vocation indicated that they would still select nursing if given the choice again.
Table 1. Satisfaction with Educational Program and Professional Attitude
Occupational attitudes are learned, and nursing education plays an important role in inculcating these attitudes. In light of the above and other pertinent research, it seems highly probable that nursing school faculties are transmitting a significant portion of the attitudes held by student nurses toward the field of nursing.
Nursing education would seem to be at the crossroads and must resolve several crucial dilemmas. First, it is not quite evident that contemporary nursing must fulfill a number of basic roles in the hospital setting, e.g., provide bedside care, perform administrative duties, supervise, teach, and so forth. Second, it is equally apparent that women enter nursing with a desire to help the sick but without any longterm commitment to do so. The dilemma arises from a necessity for the nurse to change her self-image once she moves from the academic setting into the hospital or work setting. Once in the work setting, she faces the tradition-oriented versus the professionoriented working conditions not as a hypothetical problem but as a potential source of difficulty and frustration.
If nursing is eventually to achieve professional status with the twofold responsibility of bedside care and administration, then the contemporary challenge for nursing education is to provide the student nurse with a broader perspective in preparation for her future work. A portion of her academic preparation should, therefore, focus upon administrative responsibilities and duties. The critical dimensions of the problem include both skills and attitudes and challenges nursing education to provide academic study and to inculcate appropriate attitudes concerning the future role of the nursing student in the hospital setting and in society.
- 1. Deutscher, Irvin, and Anne Montague: "Professional Education and Conflicting Value Systems: The Role of Religious Schools in the Aspirations of Nursing Students," Social Forces, 35:125-131, 1956.
- 2. Christ, Edwin: Nurses at Work, Columbia, Missouri, University of Missouri Press, 1956.
- 3. Reisman, Leonard, and John Rohren Change and Dilemma in the Nursing Profession, New York, Putman Press, 1957.
- 4. Benne, K. D., and W. Bennis: "Role Confusion and Conflict of Nursing," The American Journal of Nursing, 59:381, 1959.
- 5. Vaillot, Sister Madeleine Glemenc« Commitment to Nursing, Philadelphia, J. B. Lippincott Company, 1962.
- 6. Powers, Sister Eleanore Francis: "Professionalization and Career Hans: A Study of Nursing Students in Sectarian and Non-Sectarian Baccalaureate Degree Programs," The Journal of Nursing Education, 3:17-25, 1964.
- 7. Fox, David, et al.: "Characteristics of Basic Nursing Faculty," Nursing Outlook, 12:40-43, 1964.
Table 1. Satisfaction with Educational Program and Professional Attitude