Nursing
The Profession as a Career

Introduction

Nursing is a universal profession that is practiced in its present form all over the civilized world. It touches human life from conception to death. Fewer careers in this world offer the satisfaction, stimulation, and variety of opportunities and rewards as nursing. But sometimes young men and women pay more attention to the sacrifices nurses have to make rather than the rewards. Therefore, I am writing this little piece to highlight the joys of being a nurse. Nursing education is so comprehensive that it can make you an expert hands-on caregiver, scientist, educator, administrator, policy maker, legal investigator and in the nearest future an astronaut—if you let it catch you young.

I feel very proud to inform you that the nursing profession had been rated top of the list among all similar professions in terms of honesty and ethical behavior consistently over the past five years, according to the Gallop Organization (2005). The poll annually asked Americans to rate the honesty and ethical standards of members of the selected 21 professions. The professions included medical doctors, pharmacists, high school teachers, policemen, clergy and fire fighters.

The polls asked respondents to rate on a five-point scale that ranges from "very high" to "very low". In the 2005 poll, 6 professions have majority high ethical ratings. Nurses scored 82%, pharmacists 67%, medical doctors, 65%, high school teachers, 64%, policemen 61% and clergy 61%. Since 1999, when nursing was first included on the list, it had consistently been rated highest except in the year 2001 when firefighters outranked nursing in the wake of September 11 terrorist attacks. The rating of nurses by the public as number one in honesty and ethics reveals how much trust the public places in the nursing profession.

Nursing Education

Nursing had taken some giant steps in the educational preparation of its practioners. Like the older professions, nursing education started with the apprentice type of educational preparation. Florence Nightingale has been credited as the founder of modern nursing. She actually started the process of formal education at Saint Thomas Hospital in London, England. As a prolific writer she spoke eloquently about the education and practice of nursing. Nightingale viewed nursing as more than the understanding of disease. She was quoted as having said, "Pathology teaches the harm that disease has done, but teaches nothing more" (Nightingale, 1969). Her nursing orientation focused on health as a broad and encompassing issue that requires an understanding of human nature and the ability of that nature to affect individual health. Nightingale's thinking that nurses need to have an understanding of the science and art of human existence has continued to guide nursing education from its original hospital-based training programs to its current degree-granting educational programs.

Modern nurse educators following the footsteps of Florence Nightingale went further to design educational programs that matched the professional model described above. They have provided nursing with the theoretical foundation for educational philosophies, mission statements and contents that have focused on the nature of human beings, the needs of the society and the practice of nursing. The focus on human beings and the society is a reflection of the aims of traditional and professional education that date back to Hellenic times, when education examined and desired to understand both human nature and the nature of the society. (Brubacher & Rudy 1976).

Whichever nursing education program you may consider as your choice for entering into the profession, had been designed, according to Bevis (1989a) to have considered the following:

• A determination of the desired characteristic of the graduates of the program
• The identification and structure of knowledge that is critical to nursing practice
• The understanding of the culture of nursing as it relates to roles, ethics, and acceptable practice parameters
• An articulation of nursing's role in society in general and health care in particular
• An identification of curriculum content that will foster and further nursing's contribution to society
• The identification and organization of health care problems that graduates will be dealing with, both in the reality of the present and the possibilities of tomorrow
• Identification of teaching and learning strategies that will foster critical thinking, inquiry, and the ability to meet one's learning needs
• The ability to assist students in developing the context (both within and outside of nursing) in which to understand the discipline of nursing

There are three types of nursing educational programs in existence currently. This situation is an attempt to allow multiple entry points in to nursing and a reaction to the needs of the society and professionalization process of nursing.

The three basic entry programs are similar because they considered the above characteristics enumerated above in the configuration of the courses and course content. The three programs are as follows:

1. The Diploma Programs

   This is the oldest organized educational program developed for the training of nurses in the late nineteenth and early twentieth centuries. Initially they were based in and run by hospitals, but many of today's diploma schools of nursing are affiliated with institutions of higher education. Diploma programs prepare technical nurses who provide direct patient care in a variety of health care settings. Typically, the curriculum is designed to be completed in 3 years and put an emphasis on clinical practice. General education courses in the biological and social sciences are provided through affiliation with a local college or university. The college courses can be applied towards a baccalaureate degree in nursing if the student elects to continue his or her education.

   Since the advent of other programs based in higher institutions, the number of diploma programs has been dwindling in past twenty years. According to the National League for Nursing Accreditation Committee, there are only 68 accredited Diploma schools in the U.S today.

2. Associate Degree Programs

   Mildred Montag first developed associate degree nursing programs in 1952 in response to the critical shortage of nurses in that decade. The original intent of the associate degree programs was to produce in 2 years a technical nurse, who would provide direct patient care in acute settings under the supervision of a professional Registered Nurse (Dillon, 1997).

   The program later became the elite program of the junior colleges. National Boards of Nursing allowed the graduates to take the RN licensing examination. Despite the call for the preparation of nurses at the degree level like other professions, the associate degree is still popular.

   Associate degree programs are commonly located in community or vocational colleges, but may be located in 4-year colleges and universities. The typical curriculum requires 2 academic years to complete and consists of approximately 30 credit hours of general education courses in the biological and social sciences and 38 credits hours of nursing courses. The graduates are prepared to practice in acute and long-term health care setting. They can apply general education credits to the baccalaureate degree programs if they wished.

3. Baccalaureate Degree Programs

   Baccalaureate degree programs (BSN, BS, and BA) are offered by 4-year colleges and universities. The graduates of a baccalaureate nursing program is prepared to deliver care to individuals, families, groups and communities in institutional, home, and community settings. The educational contents contain all specific nursing areas from birth to death. In addition, baccalaureate curricula include concepts related to management, community health, nursing theory and research, sociology and professional issues. Health promotion, illness prevention and health education are also emphasized. The programs are based on a strong foundation of liberal arts and sciences. The faculty must also consider in designing the curriculum, issues related to their mission, philosophy of life and that of the mother institution and theories of nursing and education. Thus, baccalaureate nursing programs are professional educational designs in the true sense of it. That is why a degree in nursing is so versatile that it can be applied to go into higher degrees in many other professional fields, such as law, medicine, forensic science and education.

4. Graduate Education in Nursing

   As nursing moved into the colleges and universities from the hospital-based training programs, it needs to develop a discipline within the academy. Therefore, there is need for higher education in nursing. There is need for preparing nursing faculty at the graduate level to teach those who earned the first degree. The first doctoral program in nursing, an EdD, was offered at Teachers Columbia University in New York in 1924, fro the purpose of preparing educators and administrators of nursing schools (Peplau 1966). Since then, many other types of graduate education programs had been developed offering PhD, DNS, (Doctor of Nursing Science) and recently DNP, (doctor of nursing practice) for advanced nursing clinical practice.

What Can You Do with Your Nursing Education?

When you might have graduated from any of the basic nursing education programs, you need to pass the licensure examination (NCLEX) conducted by the National League for Nursing. This will qualify the graduates of nursing schools to be registered by the Boards of Nursing of each state where the individuals intend to practice as a professional nurse.

One of the unique things about nursing is that no one career path. Once you receive an RN license, many career paths are open to you and there is virtually no limit to the number of pathways you can travel. The nursing field extends a number of opportunities to a very important part of the health care team. Nursing involves direct patient contact and varied skills and abilities. Often, a nurse is the first person a sick or troubled patient will see in a health care setting. A nurse has a unique opportunity to ensure that a patient's comfort and needs are cared for, and can make a difference in every patient's life. Careers in nursing are demanding, but are extremely rewarding.

Career Opportunities in Nursing:

• Registered Nurse in acute hospital unit
• Head nurse on the unit after some experience
• Private Duty Nurse
• Office Nurse in Doctor's Clinics
• Occupational Health Nurse
• School Health Nurse
• Community Health Nurse
• Intensive care nurse
• Operating Room Nurse

With further education, training and experience, sometimes requiring a Master's degree or a higher Diploma, an RN can become a:

• Nurse Administrator (Director of Nursing)
• Nurse Educator, from Instructor to the Level of Professor or Dean Nurse Anesthetist
• Family Nurse Practitioner
• Psychiatric Nurse Practitioner
• Nurse-Midwife
• Pediatric Nurse Practitioner

There other new and emerging careers into which qualified are been reprocessed to follow. Some examples of these include:

• Forensic Nursing
• Legal Nurse Consultant
• Correctional Nursing
• Nursing Informatics
• Genome and Genetic Nursing
• Nurse Epidemiologist

In early 2004, the White House announced a plan that envisioned humans returning to the moon by 2020, ultimately using this as a springboard to Mars and perhaps beyond. NASA today employs many occupational health and aerospace nurses who care for astronauts and their families, and other space program employees. Its RNs also contribute to research activities.

In 1991, the Space Nursing Society was founded by nursing theorist Martha Rogers, RN, PhD, who is famous for her science of unitary human beings, or SUHB, which views people as energy fields interacting with their environment. The organization is open to nurses and students and is working on developing a space nursing specialization. With this specialized training, a member of the profession may be chosen not only to participate in research, but also to serve as an astronaut on a mission to the moon or beyond (Langone, 2005).

Men in Nursing

Another issue I want to bring to your attention is that men are wanted and needed in nursing. There were periods in history that men were more or equal in number to women in nursing. After the industrial revolution, more factory jobs became available to men, and those jobs were thought to be too difficult for women. Men were also drawn into big business, public administration and the military, thus leaving room for women to dominate nursing. The constitution and laws actually prohibit discrimination on the basis of sex in all sectors of the economy. Maybe it is the men themselves that are not man enough to be nurses because research shows that female nurses and the clients (patients) overwhelmingly expressed positive attitudes to working with men or men caring for them once they are trained and competent.

McRae (2003), in a study of the role of male nurse in obstetrical nursing, selected a sample of 331 female nurses, 599 male nurses and 130 pregnant women. The study surveyed their preferences for and attitudes about male nurses working in their labor and delivery. Of the 33 females nurses, 23% expressed negative attitudes, 5% neutral attitudes, while the remaining 72% expressed positive attitude. Of those female nurses who had previously worked with male nurses, 25% expressed that men did not belong in the area, but the female nurses who had previously worked with male obstetrical nurses overwhelmingly thought men belong in obstetric (98.5%) approval, as long as they were trained and competent in the area.

Notably, only 16% of the pregnant women said that they would reject a male obstetric nurse, while 67% indicated that they value experience and skill over gender-surprisingly, in the male nurses survey (63%) that indicated that they would not consider obstetrics as a specialty.

While female professional colleagues and the clients (patients) overwhelmingly accept males in the most intimate and invasive specialty in nursing, it is the male nurses themselves that expressed negative attitude, maybe because of the wrong assumption that patients may refuse them.

For young people to enjoy all the above variety of opportunity and rewards that the nursing profession offers, they are advised that it would be wise to continue their education at the college level and develop their science and research skills that could put them in demand for all these specialized areas in nursing. Nursing counts on you for its future!

Editorial provided by Adebisi O. Fabayo, RN. PhD. MRSH, FWACN, of the Department of Nursing at Albany State University in Albany, GA.

References:

• Bevis, E.D & Watson, J (1989a) Towards a Caring Curriculum: A new Pedagogy for Nursing. New York NLN.
• Brubacher J.S & Rudy W (1976) Higher Education in transition: A history of American colleges and universities. 1636-1976: NY Harper & Rowe.
• Dillon P (1997) The future of associate degree nursing N&HC: Perspectives on community, 18 (1) 20-24. Gallop Organization (2005) Princeton, New Jersey.
• Langone, M.M (2005) The Care up there: A Career in Space nursing? It is not pie in the sky. Nursing Spectrum. Retrieved 10/12/06 http://community.nursingspectrum.com/magazineArticles
• McRae M.J (2003) Men in Obstetrical nursing: Perception of role. American Journal of Maternal Child Nursing, 28(3) 167-170.
• Nightingale F. (1969) Notes on Nursing. New York: Dover Publications.
• Peplau H, (1966) Nursing: Two routes to doctoral degrees. Nursing Forum 5(2) 57-67.