Over the years, nursing has undergone a substantial transformation in its professional standing, evolving from a role primarily characterised by subservience to one that plays a vital role in healthcare delivery. This essay aims to analyse two pivotal factors outlined in the provided peer-reviewed journal article that significantly enhanced nursing's professional status. Employing the CRAP test, this discussion will also assess the credibility, relevance, authority, and accuracy of two additional peer-reviewed journal articles, which will further substantiate the significance of these factors and provide supplementary insights into their impact on the professional standing of nursing.
The article by Cingel and Brouwer (2021) explores the evolving professional identity of nurses and challenges stereotypes associated with the nursing profession. It emphasises that nursing is more than just a 'doing' profession and aims to shed light on the complex nature of nursing as a diverse, autonomous field. The article provides a comprehensive overview of the historical, social, and individual factors influencing the nursing profession's identity. The central concepts, such as compassion, nursing knowledge, and stereotypes, are clearly defined and discussed throughout the paper. The evidence presented is well-researched and supports the authors' arguments effectively. The article contributes to the existing literature by highlighting the need for a more complex and accurate portrayal of nursing. The writing is clear and concise, making the content accessible to a wide audience. Overall, the article effectively advances knowledge on the subject of nursing identity. It emphasises the vital role of compassion in motivating individuals to pursue nursing, highlighting the moral values that underpin the profession. The authors effectively challenge stereotypes associated with nursing, advocating for a more nuanced understanding of the profession. The article encourages a shift towards viewing nursing as a diverse, autonomous profession, promoting a more accurate representation of nurses' roles and responsibilities. While the article discusses the influence of stereotypes on the nursing identity, it could have provided more concrete examples or case studies to illustrate these points. The article could have delved deeper into the potential consequences of nurses conforming to stereotypes on an individual and societal level. The article briefly touches on the impact of gender-specific characteristics, but a more in-depth exploration of this topic could have been beneficial.
In the article by Cingel and Brouwer (2021), two distinct elements emerge as pivotal contributors to the current elevated professional status of nursing.
Throughout history, nursing has been closely associated with the compassionate care provided by religious individuals, both men and women. The historical context has deeply ingrained the perception of nursing as a vocation centred around aiding others. Florence Nightingale and her contemporaries played a pivotal role in elevating the status of nursing by advocating it as an honourable profession. The field advanced significantly due to Nightingale's emphasis on education, training, and standardised practises. Although nursing has been viewed as both a calling and a profession involving underappreciated, mundane tasks, it has struggled with this dichotomy. In the past, it was considered a profession dedicated to helping society's most vulnerable members, including those marginalised due to societal norms. Additionally, there is still a hierarchical dynamic between medicine and nursing in which doctors assign nurses tasks. This hierarchy is maintained by the gendered paradigm, which associates nursing with caring and feminine traits while portraying medicine as predominately male. Men considering careers in nursing are still discouraged by the fact that more and more women are working in medicine.
The professional identity of nursing is deeply rooted in principles of ethics and values. Nurses are entrusted with upholding ethical standards due to the compassionate nature of their decision-making, which directly impacts patients' values. The innate desire to aid and enhance the well-being of others often serves as the driving force for aspiring nurses and nursing students to enter the profession. Instances of moral conflicts arising from conflicting personal, societal, and professional values can potentially lead to a crisis of identity. Additionally, the perception of nursing by the public, influenced by stereotypes and societal attitudes, can exert an influence. Often, society holds a skewed or simplistic nursing perspective, in contrast to the more positive self-perception of nurses. The workplace environment, organisational values, societal norms, and individual experiences collectively contribute to the evolution of nurses' professional identities over time.
Two peer-reviewed research articles, McFarland and Wehbe-Alamah (2019) and Haghighat et al. (2020) were chosen based on the CRAP test evaluation criteria.
The development of the Culture Care Theory (CCT) by Dr. Madeleine Leininger has played a pivotal role in shaping the professional status of nursing today. (McFarland & Wehbe-Alamah, 2019). This theory emphasises the importance of nurses comprehending and respecting cultural values, beliefs, and lifestyles to provide culturally sensitive care to individuals, families, and communities (McFarland & Wehbe-Alamah, 2018a; 2018b). This theory's fundamental tenet emphasises the significant impact of factors like family ties, environment, economics, education, technology, political environment, and language on the interpretations, customs, and behaviours within various cultures (McFarland & Wehbe-Alamah, 2018a; 2018b). For instance, how immigrant Hmong people in northern California reacted to hepatitis screenings and vaccinations was significantly influenced by aspects of the healthcare system, the socio-cultural setting, and customary health beliefs (Fang & Stewart, 2018).
Leininger's contributions challenged the prevailing notion of nursing as a one-size-fits-all practice and, instead, emphasised the need for culturally sensitive and contextually appropriate care (Ulrich et al., 2018). Leininger also underscores the importance of ethnohistory, which involves studying the historical aspects, events, experiences, and occurrences of individuals, groups, cultures, and institutions (McFarland & Wehbe-Alamah, 2018b). Furthermore, Leininger's work underscored the interdisciplinary nature of healthcare, emphasising the integration of holistic, generic, and professional care knowledge.
The advancement of nursing as a respected profession depends on developing professional identity and moral principles. The study emphasises the critical connection between nursing students' moral competency acquisition and the forming of professional identities (Haghighat et al., 2020). The research underscores that moral competencies are fundamental for nurses to make ethical decisions, act upon them, and navigate complex situations based on internal moral principles (Ghanem & Castelli, 2019). These competencies are pivotal in ensuring the delivery of high-quality, safe care, especially in the face of evolving technological and technical challenges in healthcare.
Additionally, developing a professional identity is ongoing, with a significant portion taking place during the college years (Ranjbar et al., 2018). The importance of nursing education in forming the values, attitudes, and beliefs of future nurses is brought home by this. Among nurses, it promotes self-assurance, a sense of community, and effective interpersonal communication (Enderle et al., 2018). Nursing schools can aid in the development of well-rounded and morally capable professionals by instilling strong professional values at a young age.
The evolution of nursing's professional status has been significantly influenced by historical and social factors, as well as the cultivation of a strong professional identity rooted in moral values. The contributions of figures like Florence Nightingale and the development of the Culture Care Theory by Dr. Madeleine Leininger have reshaped the perception of nursing, emphasising its diverse and compassionate nature. Moreover, the integration of cultural sensitivity and ethical care provision has elevated nursing to a respected profession. The continuous development of professional identity, instilled through nursing education, further solidifies nursing's crucial role in healthcare.
CRAP TEST ELEMENTS |
DESCRIPTION |
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JOURNAL 1 |
JOURNAL 2 |
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CURRENCY |
The study by McFarland & Wehbe-Alamah, 'Leininger's Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future' , was published in 2019 in the Journal of Transcultural Nursing, which is updated every year. |
The article titled "Is there a relationship between moral competencies and the formation of professional identity among nursing students?" published in BMC Nursing by Haghighat et al. (2020) appears to be a well-structured and thorough research study. The article was published in June 2020 in the journal, which is updated every year. |
RELIABILITY |
The research leverages recent publications like articles, books, and book chapters to offer pertinent examples, enriching scholarly comprehension and practical application of theoretical concepts. The credibility of the sources is firmly established. The author employs clear language to present persuasive arguments and outlines future pathways, advocating for the utilisation of the Culturally Competent Toolkit (CCT) to guide research in both discovery and translational projects, ultimately advancing evidence-based nursing practice. |
The study is based on a descriptive-correlational design, which is a commonly accepted research methodology in nursing studies. The sample size of 221 nursing students is adequate for this type of study. The research tools, including the Moral Development Scale for Professionals (MDSP) and Professional Identity Scale for Nursing Students (PISNS), are well-established instruments in the field. |
AUTHORITY |
Marilyn R. McFarland, PhD, RN, FNP-BC, CTN-A, from the School of Nursing at The University of Michigan, serves as the corresponding author. The co-author is Hiba B. Wehbe-Alamah, PhD, RN, FNP-BC, CTN-A. |
The authors of the study, Sahar Haghighat, Fariba Borhani, and Hadi Ranjbar, are affiliated with Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Science. |
PURPOSES |
This study aims to offer a comprehensive historical account of Leininger's Theory of Culture Care Diversity and Universality, encompassing the progression of the Sunrise Enabler. |
The study seeks to explore the link between moral competencies and the development of professional identity in nursing students. It endeavors to enhance comprehension of how these elements interact within the realm of nursing education. |
Cingel, M., & Brouwer, J. (2021). What makes a nurse today? A debate on the nursing professional identity and its need for change. Nursing Philosophy, 22(2). https://doi.org/10.1111/nup.12343
Enderle, C. de F., Silveira, R. S. da, Dalmolin, G. de L., Lunardi, V. L., Avila, L. I., & Dominguez, C. C. (2018). Teaching strategies: promoting the development of moral competence in undergraduate students. Revista Brasileira de Enfermagem, 71(suppl 4), 1650–1656. https://doi.org/10.1590/0034-7167-2017-0704
Fang, D. M., & Stewart, S. L. (2018). Social-cultural, traditional beliefs, and health system barriers of hepatitis B screening among Hmong Americans: A case study. Cancer, 124(Suppl. 7), 1576-1582. https://doi.org/10.1002/cncr.31096
Haghighat, S., Borhani, F., & Ranjbar, H. (2020). Is there a relationship between moral competencies and the formation of professional identity among nursing students? BMC Nursing, 19(1). https://doi.org/10.1186/s12912-020-00440-y
Ghanem, K., & Castelli, P. (2019). Accountability and moral competence promote ethical leadership. Journal of Values-Based Leadership, 12(1). https://doi.org/10.22543/0733.121.1247
Ranjbar, H., Joolaee, S., Vedadhir, A., Abbasszadeh, A., & Bernstein, C. (2018). An evolutionary route for the moral development of nursing students. Journal of Nursing Research, 26(3), 158–167. https://doi.org/10.1097/jnr.0000000000000224
Ulrich, B., Barden, C., Cassidy, L., & Varn-Davis, N. (2019). Critical Care nurse work environments 2018: findings and implications. Critical Care Nurse, 39(2), 67–84. https://doi.org/10.4037/ccn2019605.
McFarland, M. R., & Wehbe-Alamah, H. B. (2018b). Leininger’s Sunrise Enabler to Discover Culture Care. In M. R. McFarland & H. B. Wehbe-Alamah (Eds.), Leininger’s Transcultural Nursing Concepts, Theories, Research, & Practice (4th edition; p. 47). New York, NY: McGraw-Hill Education.
McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future. Journal of Transcultural Nursing, 30(6), 540–557. https://doi.org/10.1177/1043659619867134.
McFarland, M. R., & Wehbe-Alamah, H. B. (Eds.). (2018a). Leininger’s transcultural nursing: Concepts, theories, research, and practice (4th ed.). New York, NY:
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