Journal of Nursing Education

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Split Images: Compared Perceptions of Nursing Faculty

Gwen E Chute, RN, MS; Lois H Oechsle, RN, MS

Abstract

"He who can, does; he who cannot, teaches" (Shaw, 1966, p. 260). George Bernard Shaw's words were not intended for nurses, but they took on special meaning for us when, after working several years in service, we entered the world of academia. There, as we assumed our roles as teachers in a practice discipline, we encountered disturbing vestiges of just such an attitude among many of our staff nurse colleagues. Our experiences prompted us to undertake a pilot study of the images of nursing faculty in order to find out if staffs perceptions of nurse educators are, as they often seemed to us, inaccurate and stereotyped or different in some other way from those of faculty themselves. The purposes of the study were, first, to determine whether or not discrepancies exist between staff and faculty with regard to their perceptions of nurse educators and, second, to identify any major areas of difference.

Background

There is a long history of conflict between nurses inservice and education. Much of this disharmony seems to be related to ironies inherent in the profession itself. For example, most nurses would agree that the group of activities collectively called "patient care" constitutes the most important work of nursing. Strauss (1966) maintained that the strength of this belief causes many nurses to hesitate to take more prestigious positions in education or administration and, sometimes, even to demote themselves in order to remain directly involved in this aspect of their profession. Yet, nurses who provide patient care are afforded lower pay, status, and power than nurses in either education or administration.

Nurses who do move into academia gain the status and prestige associated with being leaders in their profession; however, as educators, they frequently have little power to influence decisions and events in patient care facilities. Instead, nursing faculty are often viewed as overeducated nurses "whose advanced training has taken [them} away from [their] proper place working with or near the patient" (Strauss, 1966). Such ironies within nursing result in intraprofessional relationships which are burdened with misunderstandings and tension. While most faculty have had at least some experience in the practice role, the reverse is seldom true, and even though the role of educator is carried out in both educational and service settings, most faculty do not work directly nor consistently with staffin the provision of patient care. Blurred, ambiguous perceptions of nurses in the faculty role potentially influence staff attitudes and behaviors toward educator colleagues. The result, for many faculty, is likely to be what Hardy and Conway (1978) call role conflict or role ambiguity - conditions in which demands or expectations of a position are difficult or impossible to meet. The ultimate effect may be to compromise the educator's ability to function effectively in the clinical setting.

Recognizing the impact of such barriers between education and service, a few nursing leaders have taken action to develop and test models for collaboration between staff and faculty. Over the past 15 years, models such as those at Case Western Reserve, Rochester, and Rush have become operational. Typical of these is The Millikin University model, which incorporates collaborative teaching, professional practice, and research between nursing faculty and Master's prepared clinical specialists (Westcot, 1981). The Robert Wood Foundation has taken increasing interest in funding innovative models for "unified" practice, and the American Academy of Nursing in 1979 endorsed a resolution for the cementing of service-education relationships. Additionally, the Midwest Alliance in Nursing has promoted collaborative efforts in 13 midwestern states (McPhail. 1983). In spite of these new efforts to promote unproved relationships, however, systematic research of factors which may underlie…

"He who can, does; he who cannot, teaches" (Shaw, 1966, p. 260). George Bernard Shaw's words were not intended for nurses, but they took on special meaning for us when, after working several years in service, we entered the world of academia. There, as we assumed our roles as teachers in a practice discipline, we encountered disturbing vestiges of just such an attitude among many of our staff nurse colleagues. Our experiences prompted us to undertake a pilot study of the images of nursing faculty in order to find out if staffs perceptions of nurse educators are, as they often seemed to us, inaccurate and stereotyped or different in some other way from those of faculty themselves. The purposes of the study were, first, to determine whether or not discrepancies exist between staff and faculty with regard to their perceptions of nurse educators and, second, to identify any major areas of difference.

Background

There is a long history of conflict between nurses inservice and education. Much of this disharmony seems to be related to ironies inherent in the profession itself. For example, most nurses would agree that the group of activities collectively called "patient care" constitutes the most important work of nursing. Strauss (1966) maintained that the strength of this belief causes many nurses to hesitate to take more prestigious positions in education or administration and, sometimes, even to demote themselves in order to remain directly involved in this aspect of their profession. Yet, nurses who provide patient care are afforded lower pay, status, and power than nurses in either education or administration.

Nurses who do move into academia gain the status and prestige associated with being leaders in their profession; however, as educators, they frequently have little power to influence decisions and events in patient care facilities. Instead, nursing faculty are often viewed as overeducated nurses "whose advanced training has taken [them} away from [their] proper place working with or near the patient" (Strauss, 1966). Such ironies within nursing result in intraprofessional relationships which are burdened with misunderstandings and tension. While most faculty have had at least some experience in the practice role, the reverse is seldom true, and even though the role of educator is carried out in both educational and service settings, most faculty do not work directly nor consistently with staffin the provision of patient care. Blurred, ambiguous perceptions of nurses in the faculty role potentially influence staff attitudes and behaviors toward educator colleagues. The result, for many faculty, is likely to be what Hardy and Conway (1978) call role conflict or role ambiguity - conditions in which demands or expectations of a position are difficult or impossible to meet. The ultimate effect may be to compromise the educator's ability to function effectively in the clinical setting.

Recognizing the impact of such barriers between education and service, a few nursing leaders have taken action to develop and test models for collaboration between staff and faculty. Over the past 15 years, models such as those at Case Western Reserve, Rochester, and Rush have become operational. Typical of these is The Millikin University model, which incorporates collaborative teaching, professional practice, and research between nursing faculty and Master's prepared clinical specialists (Westcot, 1981). The Robert Wood Foundation has taken increasing interest in funding innovative models for "unified" practice, and the American Academy of Nursing in 1979 endorsed a resolution for the cementing of service-education relationships. Additionally, the Midwest Alliance in Nursing has promoted collaborative efforts in 13 midwestern states (McPhail. 1983). In spite of these new efforts to promote unproved relationships, however, systematic research of factors which may underlie and contribute to the problems between service and education have not been pursued.

Hypothesis

This study tested the hypothesis that there would be a significant difference between faculty and staff nurses with regard to perceptions of the nurse educator and her role.

Definitions

Significance: The level of significance was set at .05. We predicted that over half of the study items would produce discrepancies which would be significant at this level.

Staff: Throughout this paper, the word "staff" refers to the entire group of staff RNs who participated in the study. We included nurse administrators at the level of Head Nurse and above, as well as RNs involved in direct patient care, both in specialty units and on general adult care services.

Method

Subjects: The convenience sample consisted of 38 faculty at our baccalaureate degree college of nursing and 358 staff RNs at the hospital where most of our students have their practicums. The fact that most of the faculty supervise students in that setting assured staffs familiarity with nursing faculty and their roles. Twenty-seven faculty and 172 staff participated in the study, representing an overall return rate of 50%, (71% for faculty and 48% for staff). Of the 172 staff RNs, 130 were general staff and 42 held administrative positions. The mean age was between 36 and 40 years for the faculty group and between 26 and 30 years for staff.

Procedure: A written survey method was used. We developed a questionnaire using a combination of original items and items adapted with permission from an unpublished dissertation by Norma Chaska (1975). Two nursing faculty and two nursing staff were asked to critique the questionnaire for face and content validity, and their suggestions were incorporated into a revised draft of the instrument. Approval for conducting the study was obtained from both the university and the hospital human subject committees. Questionnaires were then distributed to potential subjects via mailboxes or at staff meetings. A letter accompanying each questionnaire explained the study's purpose and assured confidentiality of responses. Completed questionnaires were returned by means of drop boxes placed on each unit. Responses were not identified by any means, thus assuring anonymity for the participants.

Instrument: The questionnaire consisted of three sections. The first two sections contained items related to the study questions, while the third section pertained to various demographic characteristics of the sample.

The 22 items which comprised Section 1 were statements describing characteristics associated with faculty and the educator role. Content of these items included competence in both practice and teaching, compensation, personal characteristics, and various aspects of faculty role. For example, the item "Nurse educators know a lot about nursing theory but little about nursing practice," focuses on competence as a nursing practitioner, while an item such as "Nurse educators carry a heavy workload" focuses on the difficulty of the faculty role. Subjects were asked to rate their reaction to each of the statements on a six-point Likert scale ranging from strongly agree, which was given a score of 6, to strongly disagree, given a score of 2. "Don't know" was given a score of 1.

Section 2 consisted of 14 phrases which completed the question, "How important is it for nurse educators to . . ."The content of these items consisted of various professional and personal characteristics, as well as some behaviors associated with the faculty role. Respondents rated the relative importance of the characteristics on a six point Likert scale which ranged from very important (6) to very unimportant (2). A "dont know" response was given a score of 1.

Analysis: In order to simplify the compilation of data, "don't know" and "neutral" responses were not included in the analysis. Thus, the groups were compared on the basis of "Agree"/Hstrongly agree" and "disagree"/"strongly disagree" responses. The Mann-Whitney U Test and the KruskalWallis 1-way ANOVA were used for data analysis. Item-by-item analysis was conducted in order to identify the areas of most significant difference. Demographic factors, including age, position, practice or teaching area, experience, full- or parttime employment, and academic preparation were examined for possible relationship to the study variables.

Results

Section 1: Item-by-item analysis revealed significantly different responses from the two subject groups (p =£ .05) for 18 or 82% of the 22 possible items. Areas of greatest discrepancy were those of competence, compensation, and the faculty role.

Section 2: Results in Section 2 were unremarkable; there were few discrepancies with regard to which characteristics were perceived as important for the nurse educator, suggesting less disagreement about an ideal image than about the real one.

Discussion

Discrepancies between faculty and staff with regard to perceptions of faculty competence both in the areas of practice and teaching were quite dramatic. The faculty group clearly perceived themselves to be competent both as teachers and as practitioners, while the staff response indicated a relatively low level of confidence in the competence of faculty for either role.

Other areas of difference were related to the nurse educator's role. In general, staff seemed to perceive that role as "easier" and better compensated than did faculty. That is, staff expressed less agreement than faculty with items stating that the educators workload is heavy, that her hours are long, and that she is undercompensated for her work. In addition, relatively low percentages of the staff group indicated awareness of the fact that faculty are salaried (and are, therefore, not paid overtime) or that expectations for research and publishing are part of the educatore role. Staff also expressed less agreement than faculty with the idea that nurse educators have a high status. However, neither group indicated a very high rate of agreement with the status item. In spite of the fact that the faculty role is thought to be associated with a high status within the profession, this particular faculty group apparently did not perceive that they are awarded the status that one might expect to accompany that role.

One other group of items in this section elicited significantly different responses from the two subject groups. These were items which focused on characteristics of the nurse educator. Some of the items included stereotypical traits such as being "ivory towerish" or "bookish and idealistic," while others contained more positive traits such as leadership ability. Descriptors which produced the highest degree of discrepancy were the terms "bookish and idealistic," 'leadership ability," and "interest in quality patient care."

One demographic factor, position, was found to have a possible relationship to results in this section. When the responses of general duty staff and RN administrators were analyzed as separate groups, significant differences were found for 16 of the 22 items. Responses of the administrator group were, for all but one of those items, between those of the general staff and the faculty. This indicated that, if we had not included administrators in the staff sample, the differences between staff and faculty would have been even greater than they were.

Limitation

A major limitation of this pilot study is that its results cannot be generalized. Although our findings were obtained from a limited and non-random sample, we were able to tentatively identify areas of major discrepancy. Thus, further examination of these questions is indicated.

Implications

The setting in which this pilot study was conducted is a fairly traditional one, in that faculty and staff roles are altogether separate. Although some faculty work as staff during summers or midsemester breaks, most do not. Many of the faculty conduct practicums with students in the hospital facility, but they do not, for the most part, become involved with staff in providing direct care. Therefore, staffs perceptions are formed through observation rather than through direct interaction. This is not to say, however, that no effort is being made to promote faculty-staff cooperation. On the contrary, faculty and staff meet frequently to discuss mutual goals, concerns, and problems. Service on various joint committees brings added exposure to each others abilities and concerns. Nevertheless, at the "grass roots" level, there apparently is still, within this setting, a high degree of discrepancy regarding the image of nursing faculty. We surmise that this must also be the case in other traditional facilities paralleling our own. Perhaps in those settings where new faculty practice models have been adopted, such differences would not exist. Comparative studies of faculty in both traditional and alternative models need to be conducted. If such studies corroborate the findings of this pilot project, more widespread efforts should be directed toward implementing innovative models for faculty functioning which will help to correct inaccurate perceptions and increase cooperation and cohesiveness among nurses in all segments of their profession.

Summary

This pilot study confirmed the existence of wide differences between a group of nursing faculty and a group of staff RNs with regard to the way in which faculty and their roles are perceived. Fewer differences were evident with regard to which characteristics were viewed as important for nursing faculty to possess. We suggest that comparable discrepancies may be present in other settings similar to ours; furthermore, we believe that such differences may contribute to the gap between service and education, and we therefore recommend further study.

References

  • Chaaka, N. (1975X Status consistency and status inconsistency: Expectations and perceptions of role performance among nurses. Unpublished manuscript, Boston University.
  • Hardy, M. & Conway, M. (1978). Role theory: Perspectives for health professionals. New York: Appleton-Century-Crofts.
  • McPhail, J. (1983). Collaboration/unification models for nursing education and service. In N.L. Chaska (Ed-X The nursing profession: A time to speak (pp. 637-649). New York: McGraw Hill.
  • Shaw, G.B. (1966). Maxims for Revolutionists. In Man and Superman (pp. 257-272). Baltimore: Penquin Books (original work published 1903).
  • Strauss, A. (19661 The structure and ideology of American Nursing: An interpretation. In F. Davis (Ed.), The nursing profession (p. 84). New York: John Wiley and Sons.
  • Westcot, L. (1981). Nursing education and nursing service. A collaborative model. Nursing and Health Care 11(7): 376-379.

10.3928/0148-4834-19860401-09

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