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Educated Caring: The Emergence of Professional Identity Among Nurses

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Abstract

This article examines the formation of occupational identity in a nursing program. The normative and ideological dimensions of this process are revealed in the program’s goals and the views of educators and students through qualitative data from observations and 30 in-depth interviews. Educators seek to socialize students toward professionalism to raise the occupation’s status by emphasizing the scientific and technical basis of nursing. Yet students uphold a gendered discourse by identifying a normative dimension of caring as central to their occupational identity. The dilemma between professionalism and caring is reconciled as students construct an occupational identity based on “educated caring,” where these two dimensions are equally valuable and significant.

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Notes

  1. All names used in this article are pseudonyms in order to protect the identity of the institution and all participants.

References

  • Abbott, A. (1988). The system of professions: An essay on the division of expert labor. Chicago: The University of Chicago Press.

    Google Scholar 

  • Abbott, P., & Meerabeau, L. (1998). The sociology of the caring professions. London: UCL.

    Google Scholar 

  • Acker, J. (1990). Hierarchies, jobs, bodies: A theory of gendered organizations. Gender and Society, 4(2), 139–158.

    Google Scholar 

  • Acker, J. (1992). Gendered institutions: From sex roles to gendered institutions. Contemporary Sociology, 21, 565–569.

    Google Scholar 

  • Apesoa-Varano, E. C., & Varano, C. S. (2004). Nurses and labor activism in the United States: The role of class, gender, and ideology. Social Justice: A Journal of Crime, Conflict, and World Order, 31(3), 77–104.

    Google Scholar 

  • Barger, S. (1998). Assessing school readiness for a practice arrangement using decision tree methodology. Journal of Professional Nursing, 14(6), 323–328.

    Google Scholar 

  • Beck, L. (1994). Reclaiming educational administration as a caring profession. New York: Teachers College Press.

    Google Scholar 

  • Becker, H., Geer, B., Hughes, E., & Strauss, A. (1961). Boys in white: Student culture in medical school. Chicago: The University of Chicago Press.

    Google Scholar 

  • Bellah, R., Madsen R., Sullivan W., Swidler A., & Tipton, S. (1996). Habits of the heart: Individualism and commitment in American life. Berkeley: UC Press.

    Google Scholar 

  • Benner, P., Tanner, C., & Chesla, C. (1996). Expertise in nursing practice: Caring, clinical judgement, and ethics. NY: Springer.

    Google Scholar 

  • Berger, B. (1981). The survival of a counterculture: Ideological work and everyday life among rural communards. Berkeley: University of California Press.

    Google Scholar 

  • Bloom, S. (1963). The doctor and his patient: A sociological interpretation. New York: Russell Sage Foundation.

    Google Scholar 

  • Bloom, S. (2002). The world as scalpel: A history of medical sociology. Oxford: Oxford University Press.

    Google Scholar 

  • Booth, R. Z. (1994). A Mandate for Nursing Education Leadership: Change. Journal of Professional Nursing, 10(6), 335–341.

    Google Scholar 

  • Bosk, C. (1979). Forgive and remember: Managing medical failure. Chicago: The University of Chicago Press.

    Google Scholar 

  • Bourdieu, P. (1984). Distinction: A social critique of the judgement of taste. Cambridge: Harvard University Press.

    Google Scholar 

  • Boykin, A., & Schoenhofer, S. (1993). Nursing as caring: A model for transforming practice. NY: National League for Nursing.

    Google Scholar 

  • Britton, D. (2000). The epistemology of the gendered organization. Gender and Society, 14(3), 418–434.

    Google Scholar 

  • Brown, W. (1984). Challenging bureaucracy. Women’s Review of Books, 2, 14–17 (November).

    Google Scholar 

  • Bucher, R., & Stelling, J. (1977). Becoming professional. London: Sage Publications.

    Google Scholar 

  • Bullough, V. L., & Bullough, B. (1998). Should nurses practice therapeutic touch? Should nursing schools teach therapeutic touch? Journal of Professional Nursing, 14(4), 254–257.

    Google Scholar 

  • Cancian, F., & Oliker, S. (2000). Caring and gender. Thousand Oaks: Pine Forge.

    Google Scholar 

  • Chambliss, D. (1996). Beyond caring: Hospitals, nurses, and the social organization of ethics. Chicago: The University of Chicago Press.

    Google Scholar 

  • Choy, C. C. (2003). Empire of care: Nursing and migration in Filipino American history. Durham, NC: Duke University Press.

    Google Scholar 

  • Chua, W. F., & Clegg, S. (1989). Contradictory couplings: Professional ideology in the organizational locales of nurse training. Journal of Management Studies, 26(2), 103–127.

    Google Scholar 

  • Coombs, R. (1977). Mastering medicine: Professional socialization in medical school. New York: The Free Press.

    Google Scholar 

  • Coudret, N., Fuchs, P., Roberts, C., Suhreheinrich, J., & White, A. (1994). Role socialization of graduating student nurses: Impact of a nursing practicum on professional role conception. Journal of Professional Nursing, 10(6), 342–349.

    Google Scholar 

  • Davies, C. (1995a). Competence versus care? Gender and caring revisited. Acta Sociologica, 38(1), 17–31.

    Google Scholar 

  • Davies, C. (1995b). Gender and the professional predicament in nursing. Buckingham: Open University Press.

    Google Scholar 

  • Dietrich, M. (1977). Work values evolution in a baccalaureate student nurse population. Journal of Vocational Behavior, 10(1), 25–34.

    Google Scholar 

  • Dvorkin, E. (1981). Becoming a lawyer: A humanistic perspective on legal education and professionalism. St. Paul: West Publications.

    Google Scholar 

  • Elzinga, A. (1990). The knowledge aspect of professionalization: The case of science-based nursing education in Sweden. In R. Torstendahl, & M. Burrage (Eds.), The Formation of Professions: Knowledge, State and Strategy (pp. 151–173). London: Sage Publications.

    Google Scholar 

  • Emerson, R. M. (2001). Contemporary field research: Perspectives and formulations. Prospect Heights: Waveland Press, Inc.

    Google Scholar 

  • England, P., Budig, M., & Folbre, N. (2002). Wages of virtue: The relative pay of care work. Social Problems, 49(4), 455–473.

    Google Scholar 

  • Etzioni, A. (1969). The semi-professions and their organization: Teachers, nurses, and social workers. New York: The Free Press.

    Google Scholar 

  • Fetzer, S. J. (2003). Professionalism of associate degree nurses: The role of self-actualization. Nursing Education Perspectives, 24(3), 139–143.

    Google Scholar 

  • Finlayson, L., & Nazroo, J. (1997). Gender inequalities in nursing careers. London: Policy Studies Institute Report.

    Google Scholar 

  • Folbre, N. (2001). The invisible heart: Economics and family values. Albany: SUNY Press.

    Google Scholar 

  • Freidson, E. (1970a). Professions of medicine: A study of the sociology of the applied knowledge. New York: Dodd, Mead and Company.

    Google Scholar 

  • Freidson, E. (1970b). Professional dominance: The social structure of medical care. Chicago: Aldine Pub. Co.

    Google Scholar 

  • Freidson, E. (1973). The professions and their prospects. Beverly Hills: Sage Publications.

    Google Scholar 

  • Geison, G. (1983). Professions and professional ideologies in America. Chapel Hill: The University of North Carolina Press.

    Google Scholar 

  • Gibson, M., & Ogbu, J. (1991). Minority status and schooling: A comparative study of immigrant and involuntary minorities. NY: Garland.

    Google Scholar 

  • Goffman, E. (1959). The presentation of self in everyday life. Garden City: Doubleday.

    Google Scholar 

  • Goffman, E. (1963). Stigma. Englewood Cliffs: Prentice Hall Publishers.

    Google Scholar 

  • Gordon, S., Benner, P., & Noddings, N. (1996). Caregiving: Readings in knowledge, practice, ethics, and politics. Philadelphia: University of Pennsylvania Press.

    Google Scholar 

  • Graham, H. (1983). Caring: Labour of love. In J. Finch, & D. Groves, (Eds.), Labour of Love: Women, Work, and Caring (pp. 13-30). London: Routledge.

    Google Scholar 

  • Granfield, R. (1992). Making elite lawyers: Visions of law at Harvard and beyond. NY: Routledge Press.

    Google Scholar 

  • Griffin, G. (1999). The education of teachers. Chicago: The University of Chicago Press.

    Google Scholar 

  • Guinier, L., Fine, M., & Balin, J. (1997). Becoming gentlemen: women, law school, and institutional Change. Boston: Beacon Press.

    Google Scholar 

  • Hammersley, M., & Atkinson, P. (2001). Ethnography: Principles in practice. London: Routledge.

    Google Scholar 

  • Hislop, S., Inglis, B., Cope, P., Stoddart, B., & McIntosh, C. (1996). Situating theory in practice: Student views of theory-practice in Project 2000 nursing programmes. Journal of Advanced Nursing, 23, 171–177.

    Google Scholar 

  • Hochschild, A. (1983). The managed heart: Commercialization of human feeling. Berkeley: University of California Press.

    Google Scholar 

  • Hoover, J. (2002). The personal and professional impact of undertaking an educational module of human caring. Journal of Advanced Nursing, 37(1), 79–86.

    Google Scholar 

  • Hupcey, J. E. (1994). Graduate education for nurse practitioners: Are advanced degrees needed for practice? Journal of Professional Nursing, 10(6), 350–356.

    Google Scholar 

  • Jackall, R. (1989). Moral mazes: The world of corporate managers. Oxford: Oxford University Press.

    Google Scholar 

  • Jacobs, L., DiMattio, M. J., Bishop, T., & Fields, S. (1998). The baccalaureate degree in nursing as an entry-level requirement for professional nursing practice. Journal of Professional Nursing, 14(4), 225–233.

    Google Scholar 

  • Kanter, R. M. (1977). Men and women of the corporation. NY: Basic Books.

    Google Scholar 

  • Kapborg, I., & Betero, C. (2003). The phenomenon of caring from the novice student nurses’ perspective: A qualitative content analysis. International Nursing Review, 50(3), 183–192.

    Google Scholar 

  • Kaplan Daniels, A. (1987). Invisible Work. Social Problems, 34, 403–415.

    Google Scholar 

  • Kinnear, M. (1995). In-subordination: Professional women 1870–1970. Montreal: McGill-Queen’s University Press.

    Google Scholar 

  • Koerner, J. (1992). Differentiated practice: The evolution of professional nursing. Journal of Professional Nursing, 8(6), 335–341.

    Google Scholar 

  • Kyle, T. (1995). The concept of caring: A review of the literature. Journal of Advanced Nursing, 21, 506–514.

    Google Scholar 

  • Lawrence, J., Wearing, A., & Dodds, A. (1996). Nurses’ representations of the positive and negative features of nursing. Journal of Advanced Nursing, 24(2), 375–384.

    Google Scholar 

  • Leidner, R. (1991). Serving hamburgers and selling insurance: Gender, work, and identity in interactive service jobs. Gender and Society, 5(2), 154–177.

    Google Scholar 

  • Leininger, M. (1995). Transcultural nursing: Concepts, theories, research, and practice. NY: McGraw-Hill.

    Google Scholar 

  • Lister, P. (1997). The art of nursing in a “postmodern” context. Journal of Advanced Nursing, 25, 38–44.

    Google Scholar 

  • Lowe, G., & Nelson Reid, P. (1999). The professionalization of poverty: Social work and the poor in the twentieth century. New York: Aldine de Gruyter.

    Google Scholar 

  • Lowell, B. L., & Gerova, S. G. (2004). Immigrants and the healthcare workforce: Profiles and shortages. Work and Occupations, 31(4), 474–498.

    Google Scholar 

  • MacIntosh, J. (2003). Reworking professional nursing identity. Western Journal of Nursing Research, 25(6), 725–741.

    Google Scholar 

  • Mackintosh, C. (2000). Is there a place for “care” within nursing? International Journal of Nursing Studies, 37, 321–327.

    Google Scholar 

  • MacLeod, J. (1987). Ain’t no makin’ it: Leveled aspirations in a low-income neighborhood. Boulder: Westview Press.

    Google Scholar 

  • Manninen, E. (1998). Changes in nursing students’ perceptions of nursing as they progress through their education. Journal of Advanced Nursing, 27, 390–398.

    Google Scholar 

  • Martin, P., & Collinson, D. (2002). “Over the pond and across the water:” Developing the field of “gendered organizations.” Gender, Work, and Organization, 9(3), 244–265.

    Google Scholar 

  • McCance, T., McKenna, H., & Boore, J. (1997). Caring: Dealing with a difficult concept. International Journal of Nursing Studies, 34, 241–248.

    Google Scholar 

  • McCance, T., McKenna, H., & Boore, J. (1999). Caring: Theoretical perspectives of relevance to nursing. Journal of Advanced Nursing, 30(6), 1388–1395.

    Google Scholar 

  • McCaugherty, D. (1991). The theory-practice gap in nurse education: Its causes and possible solution. Findings from an action research study. Journal of Advanced Nursing, 16, 1055–1061.

    Google Scholar 

  • McHugh, M., Duprat, L., & Clifford, J. (1996). Currents in practice: Enhancing support for the graduate nurse. The American Journal of Nursing, 96(6), 57–62.

    Google Scholar 

  • Melia, K. (1984). Student nurses’ construction of occupational socialization. Sociology of Health and Illness, 6(2), 132–151.

    Google Scholar 

  • Melia, K. (1987). Learning and working: The occupational socialization of nurses. London: Tavistock Publications Ltd.

    Google Scholar 

  • Melosh, B. (1982). “The physician’s hand:” Work culture and conflict in American nursing. Philadelphia: Temple University Press.

    Google Scholar 

  • Melosh, B. (1989). “Not merely a profession:” Nurses and resistance to professionalization. American Behavioral Scientist, 32(6), 668–679.

    Google Scholar 

  • Merton, R., Reader, G., & Kendall, P. (1957). The student-physician: Introductory studies in the sociology of medical education. Cambridge: Harvard University Press.

    Google Scholar 

  • Muff, J. (1982). Socialization, sexism, and stereotyping: Women’s issues in nursing. Toronto: The C. V. Mosby Company.

    Google Scholar 

  • Myers, L. (1982). The socialization of neophyte nurses. Ann Arbor: UMI Press.

    Google Scholar 

  • National League for Nursing (1977). Socialization and resocialization of nurses for professional nursing practice. New York: National League for Nursing.

    Google Scholar 

  • National Sample Survey of Registered Nurses (NSSRN) (2000, 2004). US Department of Health and Human Services, Health Resources and Services Administration.

  • Neil, R., & Watts R. (1991). Caring and nursing: Explorations in feminists perspectives. New York: National League for Nursing.

    Google Scholar 

  • Noddings, N. (2003). Caring: A feminine approach to ethics and moral education. Berkeley: University of California Press.

    Google Scholar 

  • Oermann, M. (1998). Role strain of clinical nursing faculty. Journal of Professional Nursing, 14(6), 329–334.

    Google Scholar 

  • Ogbu, J. (2003). Black American students in an affluent suburb: A study of academic disengagement. Mawah, NJ: Erlbaum Associates.

    Google Scholar 

  • Ondrack, D. (1975). Socialization in professional schools: A comparative study. Administrative Science Quarterly, 20(1), 97–103.

    Google Scholar 

  • Paley, J. (2001). An archeology of caring knowledge. Journal of Advanced Nursing, 36(2), 188–198.

    Google Scholar 

  • Phillips, S., & Benner, P. (1994). The crisis of care: Affirming and restoring caring practices in the helping profession. Washington, DC: Georgetown University Press.

    Google Scholar 

  • Pierce, J. L. (1995). Gender trials: Emotional lives in contemporary law firms. Berkeley: University of California Press.

    Google Scholar 

  • Porter, S., & Ryan, S. (1996). Breaking the boundaries between nursing and sociology: A critical realist ethnography of the theory-practice gap. Journal of Advanced Nursing, 24, 413–420.

    Google Scholar 

  • Powell, W., & DiMaggio, P. (1991). The new institutionalism in organizational analysis. Chicago: The University of Chicago Press.

    Google Scholar 

  • Reskin, B., & Roos, P. (1987). Status hierarchies and sex segregation. In Bose, C., & Spitze, G. (Eds.), Ingredients for women’s employment policy (pp. 3–21). Albany: SUNY Press.

    Google Scholar 

  • Ressner, U. (1986). The feminist case against bureaucracy. Economic and Industrial Democracy, 7, 130–134.

    Google Scholar 

  • Ressner, U. (1987). The hidden hierarchy. Aldershot: Gower.

    Google Scholar 

  • Reverby, S. (1987). Ordered to care: The dilemma of American nursing, 1850–1945. Cambridge: Cambridge University Press.

    Google Scholar 

  • Roach, S. (1987). The human act of caring. Ottawa: Canadian Hospital Association Press.

    Google Scholar 

  • Salzinger, L. (2003). Genders in production: Making workers in Mexico’s global factories. Berkeley: University of California Press.

    Google Scholar 

  • Sargent, P. (2001). Real men or real teachers? Contradictions in the lives of men elementary school teachers. Harriman: Men’s Studies Press.

    Google Scholar 

  • Savage, M., & Witz, A. (1992). Gender and bureaucracy. Cambridge: Blackwell Publishers.

    Google Scholar 

  • Schleef, D. (2000). “That’s a good question!” Exploring motivations for law and business school choice. Sociology of Education, 73(3), 155–174.

    Google Scholar 

  • Scoones, I. (1995). Investigating difference: Applications of wealth ranking and household survey approaches among farming household in Southern Zimbabwe. Development and Change, 26, 67–88.

    Article  Google Scholar 

  • Simpson, I. H. (1967). Patterns of socialization into professions: The case of student nurses. Sociological Inquiry, 37, 47–54 (Winter).

    Google Scholar 

  • Simpson, I. H. (1979). From student to nurse: A longitudinal study of socialization. Cambridge: Cambridge University Press.

    Google Scholar 

  • Smith, P. (1992). The emotional labour of nursing. London: Macmillan.

    Google Scholar 

  • Smyth, E., Acker, S., Bourne, P., & Prentice, A. (1999). Challenging professions: Historical and contemporary perspectives on women’s professional work. Toronto: UT Press.

    Google Scholar 

  • Spouse, J. (2000). An impossible dream? Images of nursing held by pre-registration students and their effect on sustaining motivation to become nurses. Journal of Advanced Nursing, 32, 730–739.

    Google Scholar 

  • Stacey, M. (1981). The division of labour revisited or overcoming the two adams. In P. Abrams, R. Deem, J. Finch, & R. Rock (Eds.), Practice and progress: British sociology, 1950–1980 (pp. 172–190). London: Allen and Unwin.

    Google Scholar 

  • Stacey, C. (2005). Finding dignity in dirty work: The constraints and rewards of low-wage home care labor. Sociology of Health and Illness, 27(6), 831–854.

    Google Scholar 

  • Sullivan, W. (1995). Work and integrity: The crisis and promise of professionalism in America. New York: Harper Business.

    Google Scholar 

  • Suominen, T., Kovasin, M., & Ketola, O. (1997). Nursing culture: Some viewpoints. Journal of Advanced Nursing, 25(1), 186–190.

    Google Scholar 

  • Thielens, W. (1980). The socialization of law students: A case study in three parts. New York: Arno Press.

    Google Scholar 

  • Tronto, J. (1996). Care as a political concept. In N. Hirschmann, & C. De Stefano (Eds.), Revisioning the political: Feminist reconstructions of traditional concepts in Western political theory (pp. 139–156). Oxford: Westview Press.

    Google Scholar 

  • Ungerson, C. (1990). Gender and caring: Work and welfare in Britain and Scandinavia. New York: Harvester Wheatsheaf.

    Google Scholar 

  • Valenzuela, A. (1999). Subtractive schooling: U.S.–Mexican youth and the politics of caring. Albany: SUNY Press.

    Google Scholar 

  • Waerness, K. (1992). On the rationality of caring. In A. Showstack-Sassoon (Ed.), Women and the State (pp. 207–234). London: Routledge.

    Google Scholar 

  • Walby, S., Greenwell, J., Mackay, L., & Soothil, K. (1994). Medicine and nursing: Professions in a changing health service. London: Sage Publications.

    Google Scholar 

  • Warelow, P. J. (1996). Is caring the ethical ideal? Journal of Advanced Nursing, 24, 655–661.

    Google Scholar 

  • Watson, J. (1979). Nursing: The philosophy and science of caring. Boston: Little Brown.

    Google Scholar 

  • Watson, J. (1985). Nursing: Human science and human care: A theory of nursing. NY: National League of Nursing Press.

    Google Scholar 

  • Watson, J. (1999). Postmodern nursing and beyond. Edinburgh: Churchill Livingstone.

    Google Scholar 

  • Watson, R., & Lea, A. (1997). The caring dimensions inventory (CDI): Content, validity, reliability, and scaling. Journal of Advanced Nursing, 25, 87–94.

    Google Scholar 

  • Watson, R., Deary, I., & Lea, A. (1999). A longitudinal study into the perceptions of caring and nursing among student nurses. Journal of Advanced Nursing, 29(5), 1228–1237.

    Google Scholar 

  • Waugaman, W., & Lohrer, D. (2000). From nurse to nurse anesthetist: The influence of age and gender on professional socialization and career commitment of advanced practice nurses. Journal of Professional Nursing, 16(1), 47–56.

    Google Scholar 

  • Weiss, R. S. (1994). Learning from strangers: The art and method of qualitative interview studies. New York: The Free Press.

    Google Scholar 

  • Wilkes, L., & Wallis, M. (1998). A model of professional nursing caring: Nursing students’ experience. Journal of Advanced Nursing, 27, 582–589.

    Google Scholar 

  • Williams, C. (1995). Still a man’s world: Men who do women’s work. Berkeley: UC Press.

    Google Scholar 

  • Witz, A. (1992). Professions and patriarchy. London: Routledge.

    Google Scholar 

  • Woodward, V. (1997). Professional caring: A contradiction in terms? Journal of Advanced Nursing, 26, 999–1004.

    Google Scholar 

  • Wuest, J. (1994). Professionalism and the evolution of nursing as a discipline: A feminist perspective. Journal of Professional Nursing, 10(6), 357–367.

    Google Scholar 

  • Wyatt, J. F. (1978). Sociological perspectives on socialization into a profession: A study of student nurses and their definition of learning. British Journal of Educational Studies, 26(3), 263–276.

    Google Scholar 

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Apesoa-Varano, E.C. Educated Caring: The Emergence of Professional Identity Among Nurses. Qual Sociol 30, 249–274 (2007). https://doi.org/10.1007/s11133-007-9069-6

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