Rita B., a 35-year-old charge nurse in a small community hospital, has the opportunity to advance into a supervisory position opening in the near future. However, the hospital administration has etated clearly the position will be filled with a professional nurse holding the BSN degree. Rita is a graduate of an associate degree program at the local community college and has had 10 years of experience as a staff nurse. The nearest college offering a baccalaureate degree in nursing is 50 miles from her home and requires full-time study. To complicate matters, Rita is married and has three children at home. She is gravely concerned to the point of anger, but feels confident she could successfully manage the new position; Rita is resentful she must complete a degree in order to be considered for the supervisory position.
The Catch-22 Syndrome strikes again. Rita has found herself caught in the middle of the technical nurse and professional nurse dualism. An ever increasing number of RNs who were trained in diploma or AD programs can testify to the anger, confusion, and fear Rita is experiencing. As Muzio and Ohaski (1979, p. 528) have observed, "the bacclauareate credential presents a formidable barrier to career development and mobility." And those who are able to break the barrier, do so at "great personal expense." Although the dualism will remain, there is no easy pathway for the non-degree RN to follow once a decision has been made to go for the degree.
After closely analyzing existing generic models for baccalaureate nursing, one may conclude these programs are inappropriate for the degree-seeking RN. Furthermore, new programs specifically designed for RNs appear to provide limited assistance to new students entering with varying degrees of knowledge and experience, patterns of thinking and socialization (Muzio & Ohaski, 1979). Modification in curriculum is needed to accommodate the degreeseeking RN. Either by restructuring generic programs or designing specific upper division programs, modifications must have a common goal: RNs must be resocialized.
BSN nurses are usually prepared to accept their role in a professional capacity. Therefore, the nurse must acquire the values and roles demanded by the profession. Styles (1978, p. 29), in her analysis of the socialization process, referred to this phenomenon as the "development of a professional soul." Within this professional soul, nurses will "act in an ethical, accountable, collective and scholarly fashion." Therefore, one may conclude in order for degree-seeking RNs to obtain these desirable traits, nursing programs must include within their conceptual framework an attempt to resocialize.
Special programs have been designed in an attempt to meet the financial and academic needs of the RN. Although these programs have experienced limited success, few, if any, have delineated the problem of resocialization and handled it appropriately. Woolley (1978) in an analysis of faculty perspectives, has concluded, "resocialization is the key to successful change - the taking on of new attitudes, concepts, and roles, not merely the accretion of new knowledge." But, how does this resocialization occur? Is it achieved by highly controlled external pressure or internal motivation for self-renewal?
John Gardner (1964) in bis examination of innovations and society stated:
Every individual, organization, or society must mature, but much depends on how this maturity takes place. A society whose maturing consists simply of acquiring more firmly established ways of doing things is headed for the graveyard ... in the ever-renewing society what matures is a system or framework within which continuous innovation, renewal and rebirth can control . . . renewal is not just innovation and change. It is also the process of bringing the results of change in line with our purposes. . .
Resocialization is no easy task. However, in order to achieve success, the RN student must go through the process. The degree of nursing success in resocialization can be correlated with the effectiveness of the implementation of the well-designed curriculum. In order to provide for the resocialization process for the RN, the objectives, philosophy, and conceptual framework of the nursing curriculum must be critically examined.
Most nursing curricula vary according to conceptual framework, In some instances one can find the medical-oriented model while others use biopsychosocial integrated nursing concepts. In other models, new approaches in problem solving have been introduced by employing the nursing process design. Still, other designs include an eclectic approach by integrating two or more models, However, few approaches encompass the personal development of the nursing student (Burgess, 1978). Being aware the conceptual framework of a curriculum "represents the faculty's notions or symbols that give structure to the curriculum, so that its parts can be fitted and united into the entire program" is of extreme importance when incorporating the resocialization process (NLN, 1974). Burgess (1978) compared the concept with a clothesline. She stated:
A conceptual framework may be likened to a clothesline to which all parts of the curriculum are attached in some fashion. The unifying central theme is, therefore, the mechanism by which the extraneous parts of a curriculum are tied together and articulated. Course objectives are the clothespins providing attachments to the central theme. The clothes (courses) themselves can be varied in color and size but the pins hold fast the content to an underlying (or overhanging) central concept which serves to unify the whole. . .
By designing the conceptual framework of the nursing program to meet the personal development of the RN student, many barriers can be overcome to achieve resocialization. Along with this new conceptual framework, program objectives and philosophy must be modified to include the concept of personal development. Objectives must include statements indicating an intent to individualize instruction which are congruent with the learning style of the student and professional socialization. The program's philosophy must evidence the belief of the faculty that every student is unique, complete with different nursing experiences, academic backgrounds, and social environments.
A common assumption with the design of a baccalaureate program for RNs would be to provide measures to effectively account for the difference between the RN's diploma school or associate degree training with the more holistic demands of nursing which are required of the BSN. Pretending this assumption is true, there must be a core component in the BS program which includes courses in the areas of nursing leadership, nursing research, the teachinglearning process, techniques for solving nursing problems, and implementation of holistic patient care. In addition, it is imperative to provide experiences, within the conceptual framework of the curriculum, for the student to reach higher levels of cognition such as the ability to analyze, synthesize, and evaluate theoretical concepts of nursing and their implications for nursing practice. Once the conceptual framework has been adapted to meet the demands of personal development of the nursing student, the resocialization process can begin.
The task of resocializing can be seen as a subconcept or vertical thread within the conceptual framework of the curriculum. This vital component should be interwoven throughout the nursing curriculum. Methods employed to aid in the resocialization process may include professional seminars, appropriate role models, and diversified experiences.
In professional seminars, Portnoy, BaIogh, Chasan, Devito, Dolloff, Flynn, Frazier, Okraska, Pemberton, Polito, Turell, Walker, and Wyler (1980) reported that in a seminar on professional issues, students openly stated their fears of the transition from RN to BSN. Problems and concerns included anxiety over re-entry into the health care system and the identification of attitudes and expectations which are associated with earning the baccalaureate degree in nursing. In addition, students were concerned with the communication process between instructor and student. By the completion of the course, many students felt they had made the transition and feelings of ambivalence were alleviated. New roles in leadership and more aggressive methods in dealing with problems assisted in the challenge of alleviating old identities within nursing. Nursing instructors can add seminar components within the framework of their own courses. Of greater benefit would be the inclusion of a professional issues seminar or course for resocialization in the beginning of the program.
Providing adequate role models appears to be an effective method in the resocialization process. Burgess (1978) implied that students many times mimic or adopt their teachers' behaviors, attitudes, and values. Therefore, teachers can serve as valuable models in bridging the gap between new theoretical concepts and higher levels of nursing practice. Some instructors in schools of nursing are "genuinely concerned about the personal development of their students," but many have been "slow to operationalize this objective." It appears by providing a good role model the teacher can be an effective tool in resocialization. At best it can serve as a guide, at worst it provides a concrete example of the instructor's intentions.
A third approach that can be used in the resocialization process is providing diversified experiences for the RN student. Woolley (1978), in a discussion of the Stockton State College baccalaureate program, stated:
In planning a change process for RNs · . · we must remember that what we really should be doing is increasing options, not merely substituting one defined set of behaviors for another. . .
The Stockton program appeared to be successful in implementing the change process. Wooley observed students were encouraged to be self-directed, self-sufficient individuals who would be more creative and critical in all phases of nursing, and the testing of nursing models was encouraged by the staff. Program objectives included a "major focus on physical, social, psychological, and cultural needs of clients." In addition, "instrumental role behavior, ideas, and practices related to specific goals and defined objectives" were expected by the faculty. In a methodological sense, students were removed from the hospital setting and assigned nursing positions within the community to reduce the reinforcement of traditional behaviors. Holistic approaches were emphasized in the areas of "attaining and maintaining health" and "prevention and rehabilitation." Observational types of experiences were eliminated. Difficult assignments were given which required both new approaches and responsibilities. Students were also required to "demonstrate use of theory in making nursing practice decisions."
Diversified experiences can have twofold benefits in the resocialization of the degree-seeking RN. First, diversified experiences require the RN to learn new methods and attitudes in nursing during the actual transition process. Second, newly attained skills and role modifications will enable the graduate to continue growing as a professional nurse. Hillsmith (1978, p. 101), a recent BSN graduate, warned that many nurses in the transformational stages have difficulty in seeing nursing as a "whole, apart from task-oriented work or technical skills." Therefore, many of these new graduates will "cling to old loyalties, semantics, and values, whether diploma school or AD graduate." It appears that without proper diversified experiences to permit student internalizations of these newly acquired skills, attitudes, and values, resocialization does not occur.
Other approaches to assist the resocialization process are available. One such procedure is role playing or simulation. By acting out perceived problems, communication can be clear and barriers can be crossed successfully. McGrath and Bacon (1979) have determined that many RNs interested in baccalaureate education are motivated by fear - "the fear that one day the entry level for the registered nurse may be at the baccalaureate level" (p. 41). If this is the case, many of these students will feel pressured and have high anxiety levels. Simulation and role playing may help them vent some of their hostilities. Another technique that instructors may find helpful is the use of peer counselors. These counselors could be upper level RN students nearing the completion of their program. By effectively using these students as role models and peer consultants, many first year RN students may find the transition more tolerable. A third approach which could be used in conjunction with either of the above techniques is having open sessions for counseling, advising, or receiving grievances from the students. The major concept here is to keep all communication channels open. Problems, conflicts and controversy can be dealt with more readily in an open forum, and solutions may be discovered before detrimental effects of high student attrition or program failure occur.
Evaluation of the resocialization process and its relationship to the curriculum must be complete and objective. Numerous examples of models for evaluation are available and can be used to adequately measure the success of the program. However, one major factor to analyze in the evaluation of the resocialization process is, "Did the RN degree-seeking student become resocialized?"
Questionnaires which measure perceptions of the program and the resocialization process can be given before and after the program and then statistically analyzed. Observation techniques used to measure higher level nursing tasks, leadership and research abilities can be designed and implemented. And probably of greatest assistance would be a follow-up study to evaluate the levels of change and resocialization maintained once the graduate BSN enters the world of professional nursing.
In the final analysis, major changes in the nursing profession have been proposed. This has been especially true in the nation's colleges and universities. Gross Í1976) pointed out that alternatives in higher education have become academic reality. He believes that higher education has attempted "to facilitate higher learning for people of all ages and conditions of life, relevant to their highly individual goals and restraints."
For the decade of the 1980s change is evident, whether by legal legislation or professional persuasion. Therefore, it is imperative that nursing schools offering a baccalaureate program for the degree-seeking RN critically analyze the philosophy, objectives, and conceptual framework of the program and have as an interwinding thread the concept of resocialization.
- Burgess G. (1978). The personal development of the nursing student as a conceptual framework. Nursing Fbrum, 1 7(1), 97-99.
- Gardner, J. (1964). Self-renewal; The individual and the innovative society. New York: Harper and Row.
- Gross, R. (1976). Diversity in higher education: Reform in the colleges. Bloomington, Indiana: Phi Delta Kappa Education Foundation, Fastback Publication No. 69.
- Hillsmith, K (1978). From RN to RSN: Student perceptions. Nursing Outlook, 26(2), 101.
- McGrath, B.J., & Bacon T.J. (1979). Baccalaureate nursing education for the RN: Why is it so scarce? Journal of Nursing Education, 18(6), 41.
- Muzio, L.G., & Ohaski, J.R. (1979). The RN student - unique characteristics, unique needs. Nursing Outlook, 27(8), 528.
- Portnoy, EL., Balogh, E., Chasan, P., Devito, J., Dolloff, J., Flynn, J., Frazier, B., Okraska, C, Pemberton, J., Polito, M., Turell, ?., Walker, ?., & Wyler, W. (1980). RN students analyze their experiences. Nursing Outlook, 28(2), 112-115.
- Styles, MM. (1978). Why publish? Image, /0(2), 29.
- Today's conceptual framework: Its relationship to the curriculum development process. (1974). New York: National League for Nursing, Publication No. 15-1529.
- Wcolley A.S. (1978). From RN to BSN: Faculty perceptions. Nursing Outlook, 26(2), 103-108.