2. Facilitators and Barrier to
Professionalism in Nursing
Variability in Nursing Education
Diploma Nurse
3 year program with in hospital training
ADN
2 year program with RN licensure after NCLEX
BSN
4 year program with RN licensure after NCLEX
3. Gender Specific Stereotypes
Gender stereotypes have affected the field of nursing for 160
years
Modern nursing began in the 1800’s
The women’s role was to be a caretaker
Did not work outside of the home
First US Nursing schools attracted “respectable” women (p.38)
Training was task oriented
Women in training did not make decisions or think for
themselves, and this continued for many years
4. Gender Specific Stereotypes
11th, 12th and 12th centuries say the entrance of men in
nursing usually in the military or religious orders
Florence Nightingale
Saw men as strength and control for patients
Did not recognize them for their contributions to
nursing
No admission of men in nursing programs
This set up the discrimination of gender with the
exception of psychiatric nursing and the need for
strength
5. Gender Specific Stereotypes
Today, 11% of nursing students are men
American Assembly of Men in Nursing (AAMN)
Formed to address issues in male nursing
In a 2015 study showed that male RN’s earn higher wages
across all specialties
Women’s movement helped nursing expose poor working
conditions and an inequality in pay
6. Historical Influences
Florence Nightingale 1820-1910
Crimean War collected data on morbidity and mortality on soldiers,
effectively using supporting evidence to reform British Army
“Nightingales influence today extends beyond her undeniable impact on the
field of modern nursing to the areas of infection control, hospital
epidemiology and hospital care” (Black, 2017, p.26)
Founded the first training school for nurses in London
Famous publication
Notes on Nursing: What It Is and What It Isn’t
Noted for hospital reform, upgrading conditions for the sick, and training
schools for the development of nursing
7. Historical Influences
Mary Seacole 1805-1881
Jamaican nurse and businesswoman
“Greatest Black Briton”
Refused by Nightingales request to join the team in Crimea
Established hotel for injured soldiers and visited battlefields
Called ”Mother Seacole” by British Soldiers, heroine, compassionate,
fearless and determined
Mary Ann “Mother” Bickerdyke
Worked as an herbalist creating alternative treatments
Set up field hospitals along the Mississippi River
Not a formally trained nurse, but provided much needed nursing services
8. Historical Influences
Clara Barton
Copyist in U.S Patent Office campaigning to provide relief for soldiers
Set up makeshift field hospitals caring for the wounded and dying
“Angel of the Battlefield” founded the American Red Cross
Mary Eliza Mahoney 1845-1926
First educated and professionally trained African American nurse
Practiced mainly of private duty
Mary Mahoney Award established by National Association of Colored Graduate
Nurses, an organization combined with ANA
Isabel Hampton Robb
Founded a group that became ANA
Mission to enhance collaboration among practicing nurses and educators
9. Historical Influences
Lillian Wald 1867-1940
Nurse and social activist
Founded Henry Street Settlement and National Association for the
Advancement of Colored People (NAACP)
Margaret Hanger
Radical activist devoted her life to the birth control movement and
education
Jessie Sleet Scales
Visionary African American nurse
First to bring community health nursing principles to New York City
10. Internal and External Conflicts
Internal Conflicts
Fragmentation of professional nursing subgroups and dissension
Competition of nursing organization for members diminish nursing
influence
Less than 10% of RN’s belong to the ANA, lack of professional organizations
Lack of the ability for self governance, set standards, lack of collective
bargaining power for autonomy
External Conflicts
Tension between nursing and medicine rising with more highly educated
nurses
Lobbying efforts to ensure legal scope of nursing is protected and reflects
current training
Nurses must strive for collaboration with physicians and health care
providers
11. Ethical Issues
Florence Nightingale first promoted ethical standards
Code of Ethics
Written public document explaining the responsibilities and obligations of
the professions practitioners
Three purposes
1. Ethical values, obligations, duties and professional ideals of nursing
2. “Nonnegotiable ethical standard “
3. Shows nurses understanding and commitment to society
12. General Types of Ethics
Metaethics
The development of ethical principles
Normative Ethics
Moral standards and regulation of behavior
Applied Ethics
Difficult issues
13. Characteristics of a “Profession”
Flexner’s list of criteria for a profession
Intellectual not physical with a high degree of responsibility
Based on knowledge that is learned, refined through research
Practical and theoretical
Taught through specialized education
Strong internal organization of members
The practitioners have a desire to help other and are community focused
14. Hall’s Five Attributes of a Profession
1. Professional organization for point of reference
2. Public service
3. Self regulation
4. Commitment to profession beyond financial incentives
5. Autonomy in practice
The three constant criteria that appear are:
1. Service/altruism
2. Specialized knowledge
3. Autonomy/ethics
15. Professionalism Continuum: Miller’s Wheel of
Professionalism in Nursing
Education in a university setting and scientific background in nursing
Research, development, use and evaluation
Self-regulatory, autonomy
Professional organization participation
Publication and communication
Adherence to Code of Nurses
Theory, development, use, evaluation
Continuing education, competence
16. Influences on the Growth of
Baccalaureate Education
Esther Lucille Brown- Brown Report 1948
Basic schools of nursing to recruit men and minorities in colleges and
universities
ANA position paper 1965
Created conflict and division in nursing
Lysaught Report 1970
Recommendations for supply and demand of nurses, roles and functions of the
nurse and education in nursing
National League of Nursing (NLN) 1982
Affirmation of the NSM as the minimum level for professional nurse and AND or
diploma for technical nursing
AACNM 1996 Position Statement
Supports ADN to BSN degree
17. Media Images of Nursing Transformed
through Professional Education
Images of nurses has varied from men and women in
scrubs with stethoscopes and clipboards to women in
white with nursing caps. The sexualized photo of a short
white dress with plunging neckline. The best photo is that
of a nurse talking to a patient in bed
”Nurse Ratched” worst image portraying cold uncaring
nurse
Woodhull Study on Nursing and the Media 1977
Found that the nursing profession is not visible in health care media
coverage
In 2000 health articles, only 4% of the cited material was by nurses
Many of the articles would have been better with nursing references
18. Media Images of Nursing Transformed
through Professional Education
Johnson & Johnson campaign on the Future of Nursing
2002
Used to recruit, retain and enhance the image of nursing
Used print, TV, scholarships and research
The Truth about Nursing is a nonprofit organization that
increases public knowledge on the image of nursing and
their role in today’s society
Nurses are responsible for portraying a positive image
19. References
Black, B. P. (2017). Professional nursing: Concepts & challenges (8th ed.). St. Louis, MO: Elsevier.