This document discusses the significance of nursing education and the historical influences on the nursing profession. It outlines both facilitators and barriers to nursing education. Some key facilitators include an autonomous work environment and opportunities for professional growth and development. Barriers include the cost of furthering education and work overload. The document also examines nursing as an occupation versus a profession using Miller's Wheel of Professionalism. It emphasizes the importance of education, commitment, autonomy, and accountability in defining nursing as a true profession.

1. Significance of Nursing
Education
Heather Hollister, RN
Castleton University

2. Facilitators vs. Barriers
 Dominated by women although the number of men in nursing has increased by 50% between 2000-
2008 (U.S. Department of Health and Human Services, 2010)
 Increasing age of the nursing workforce >50
 Racial and ethnic minorities are underrepresented in the nursing profession
 Difference in educational requirements amongst entry level nurses causing a lack of
professional outlook
 Cost of programs to further education for a Bachelor’s degree
 Work overload
 Importance of personal beliefs and values
 Autonomous work environment
 Ability/opportunities to grow professionally with the use of clinical ladders for advancement
 Improved patient outcomes
 Multiple different fields of interest including telehealth nursing, informatics nursing, hospice
and palliative nursing, school nursing, occupational and environmental health nursing, etc.

4. Historical Influences throughout Nursing
History
 Florence Nightingale (1820-1910): The most notable nursing figure of the mid 19th Century in England.
Against her parents wishes, she became a nurse in Kaiserswerth, Germany. During the Crimean War,
she and 38 other nurses provided care to wounded soldiers. She also founded the first training school
for nurses at St. Thomas’ Hospital in London in 1860. Notes on Nursing: What It Is and What It Is Not,
published in 1859 became her most famous publication (Black, 2017).
 Lillian Wald (1867-1940): A nurse and social activist, she began the first formalized public health
nursing practice. She also is the founder of the Henry Street Settlement which as established in 1893
on the Lower East side of New York and is still in operation today.
 Other notable historical figures Margaret Sanger, Jessie Sleet Scales, Mary Breckinridge

5. Internal Conflicts
Tensions amongst nurses related to the variability of degrees and education from diploma
to bachelor’s prepared
Membership to professional organizations such as the ANA. With much of the nursing
population not being a part of these groups, it hinders their ability to set standards and
lobby effectively (Black, 2017).
External Conflicts
 Collaboration between
nurse and Physicians
and other members of
the healthcare team
rather than competing
for autonomy and
decision making
 Increasing responsibilities of
nursing professionals has
created tension between
nursing and medicine. More
lobbying efforts to protect
and ensure scope of practice
amongst nurses.

6. Occupation vs. Profession
Miller’s Wheel of Professionalism in Nursing

7. What is an Occupation?
 On the job training usually occurs and length of training may vary
 Manual work is the main characteristic of an occupation
 Decisions are largely made by experience or trial and error
 Beliefs and values are not largely part of preparation
 Commitment and personal identification varies causing frequent change in
positions or job transitions.
 Employees are supervised which causes less autonomy
 Motivation is greatly influenced by material reward
 Employer is primarily the accountability holder

8. What is a Profession?
 Education occurs in a
College or University
 Education is
prolonged and
ongoing
 Work involves
creativity mentally
and autonomy where
accountability rests
on the individual
 Decision making is
on best Evidence
Based Practice
Principles
 Beliefs and values are
and important part of
practice
 Commitment and
personal identification
amongst peers is an
integral part
 Those in a profession are
unlikely to change to a
different profession
which means more
consistency
 Commitment to your
profession tends to
transcend material
rewards

9. To Be a Professional….
Be respectful
Be ethical
Be honest
Be the best
Be consistent
Be a communicator
Be accountable
Be collaborative
Be Forgiving
Be current
Be involved
Be a model nurse
Be responsible for
your own
personal learning
Be prepared

10. Where do you fall on the ever-changing nursing
continuum?

11. Just a stage of learning…..Models of
Socialization Patricia Benner, RN, Ph. D., FAAN, FRCN: Describes nursing practice in five stages through her
1984 book, From Novice to Expert
 Novice, Advanced Beginner, Competent practitioner, Proficient practitioner, and Expert
Practitioner
 Advancing to each stage is gradual as the nurse gains experience
 Benner’s model has been tested and shown to apply to any adult learning situation
 Cohen (1981) also proposed a model for nursing in four stages basing her work off of
developmental theories and students attitudes towards nursing
 Unilateral dependence, Negativity/independence, Dependence/mutuality, Interdependence
 She felt that each student must experience each stage in a particular order to be comfortable
in the professional role
 This model is less tested than that of Benner’s model

12. Baccalaureate Growth in Nursing
The Brown Report also known as Nursing for the Future by Lucille
Brown, published in 1948. Fundamentally recommends basic schools
of nursing be placed in universities and colleges
The position paper published in 1965 by the ANA created conflict
and division in nursing but also had a significant influence on
baccalaureate education
Lysaught Report also know as An Abstract for Action, 1970, made
recommendations concerning the supply and demand for nurses,
nursing roles and functions and nursing education
National League for Nursing (NLN)affirms that the BSN should be
the minimum education level for professional nursing practice

13. Why a BSN?
Increased job offer rates with those who graduate with a BSN at 70% and
74% for MSN graduates
BSN prepared nurses are prepared for the NCLEX exam at time of
graduation and ultimately may hold leadership positions in any health care
setting
Smooth transition into long term advancement program towards an
advanced practice role (MSN, PhD, specific certifications)
Higher demand for BSN nurses in today’s profession as many hospitals are
moving towards Magnet status
Accessibility of external degree programs where students do not have to
attend physical classes and can complete online. Fall back is there are not
always clinical experiences required to complete the degree

14. Social Media and the effect on the Nursing
Profession and Image
 Publics image of nursing
 Images are powerful and may be the first and lasting
impression that people have of nursing
 Nursing caps that transitioned out of date by the late 1970’s
 Several providers involved in patient care making it difficult
to distinguish wo is an RN
 Introductions are powerful
 Nurses rated the highest amongst professions on honesty
and ethics according to a report released in 2014
 Woodhull Study 1997 found that nurses and the nursing
profession are essentially invisible to the media which in turn
makes them invisible to the American public
 The Johnson & Johnson Campaign 2002 established to
enhance the image of the nursing profession
 The Truth about Nursing is a nonprofit organization
established to raised awareness to the public of the nurse
role in modern health care

15. Things we can do to take action and promote
our profession….
The nursing profession is mainly responsible to improve its image
and this occurs one nurse-patient encounter at a time
Contact those responsible for the negative image being portrayed
Contact the company that sponsors those responsible
Contact editors of newspapers, articles or magazines who present
nursing in a negative image
Do not support programs, films, organizations or products that do
not portray a positive nursing image
Contact those who positively effect the way nurses are seen through
the media
Be a part of professional organizations that promote nursing

16. Empowering The Nursing Image
**Double click on black image and YouTube video should load for your viewing

17. References
• American Association of Colleges of Nursing. (2016). Employment of New Nurse Graduates and
Employer Preferences for Baccalaureate-Prepared Nurses.
• Benner, P., From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo Park,
California. 1981. Addison-Wesley.
• Black, B.P. (2017). Professional Nursing; Concepts & Challenges (8th ed.). St. Louis, MO: Elsevier, Inc.
• Bruhn J. G., Being good and doing good: The culture of professionalism in the health professions.
Health Care Management. 19 (4): 47-58, 2001.
• Cohen HA: The Nurse’s Quest for Professional Identity. Menlo Park, California. 1981. Addison-
Wesley.
• Miller, B. K., Just what is a Professional? Nurse Success Today. 2 (4): 21-27. 1985.
• Smith, A. (2016, March 16). The Image of Nursing. [Video File]. Retrieved from
https://www.youtube.com/watch?v=nAJDDKQxmCU.
• Black, B.P. (2017). Professional Nursing; Concepts & Challenges (8th ed.). St. Louis, MO: Elsevier, Inc.
• Nursing Shortage. Creativity in Healthcare. Wordpress.com. 8 Janurary 2009. 17 September 2017.
https://creativityinhealthcare.com/2009/01/08/nursing-shortage/