PROFESSIONALIZATIO

N IN NURSING

Becky Adams

Gwen Kibler

THE QUEST FOR PROFESSIONAL AUTONOMY

Professionalization

AUTONOMY

Recognize nursing as a separate profession

Independence from physicians Have their own organizations Monitor the education system Register graduates of nursing programs

PROFESSIONAL REFORM

Why was organization needed?

PROFESSIONAL REFORM

Standardize and raise the educational requirements

limit the number in nursing Seek professional recognition Power for nursing

DILEMMAS

Sacrifice and Service Can we have both?

1) Exalt womanly character

2) Emphasize the service ethic of nursing

3) Ability of act in own self-interest

4) Womanly art of nursing

a) Yet, not to appear unladylike

DILEMMAS

Best interest of nurses Best interest of physicians and hospitals

Demand higher wages for their skills

Denounce the misuse of nursing students

Professional autonomy

But not to appear commercial

Try to forge alliances with physicians and administrators who staff the hospitals with students

OPPONENTS OF REFORM

Physicians Hospital administrators Public Nurses

NURSES SPLIT INTO GROUPS Traditionalists-working in private duty

Emphasize character and spirituality as core of nursing

Worker nurses-also working in private duty

Focus on direct work-related reforms

Rationalizers-nurses working in hospital management positions

Focused on staffing without focusing on the trained nurse’s position

Professionalizers-members of nursing associations

Wanted to define the future of nursing

PROFESSIONAL REFORM

What was the beginning of reform?

REFORM BEGINNINGS1890, a national organization was

purposed to be called the “American Nurses’ Association”

1893, Isabel Hampton was instrumental in starting the National League of Nursing

1897,The society of superintendents created the Nurses 'Associated Alumnae(NAA) and the official journal was the American Journal of Nursing

The association was primarily concerned with raising nursing educational standards and a code of ethics

REFORM BEGINNINGS Membership was limited to

superintendents of larger training schools who gave two full years of training in general hospitals of 100 or more beds

1911, NAA name changed to American Nurses 'Association (ANA)

Organizational leaders differed from membership in class background and education

PROFESSIONAL REFORM

How are changes made?

REFORM CHANGES

Control who entered trainingRequire a high school graduationEliminate allowances

To have standard nursing trainingLimit hours for nursing students

Graduate from approved nursing schools Have state-mandated examining boards

for all who “nursed for hire”

REFORM CHANGES Women's right to vote Nursing differentiated from mothering Separate nursing from physicians

control Change public opinion about nurses and

the need for reform

OPPOSITION OPINIONS Differentiated nurses more by education

than practice Physicians argued that the market

would determine a good nurse not legislation

It forced training schools to expand their programs to meet requirements

Lack of resources caused inspectors to pass schools they had not visited

“CANDOR”THE WORKER-NURSE

POSITION

“Where there is one nurse with a

missionary spirit…there are 49 others

who are obligated to make the

humiliating confession: ‘I am a nurse

because I must earn a living for myself

and those dependent on me, because

my nursing is well-paid, honorable, and

to me interesting.’” –Trained Nurse

SIR HENRY C. BURDETT“THE HOSPITAL”

• English hospital leader• Editor of “The Hospital”• Founder of the Royal National Pension Fund of England• Foe of nurse registration•Proposed a national pension fund for healthcare workers in the US (part scheme/ part charity)

NURSES’ PROTECTIVE ASSOCIATION“NPA” Chief organizer: Celia R.

Heller New York nurses’ group Began in 1897 Goal: to seek a law in

the state of New York that would give licensure to small hospital and short course graduates

TRAINED NURSE

Magazine that supported private-duty nurses and small institution trained nurses

Editors believed character of nurses mattered above everything else

Editorials and letters were written to this magazine late 1800’s and early 1900’s by all forms of nursing

“in the selection of the nurse the supreme test should be character… not titles or degrees, not educational attainment, but a high grade of character.”

TWO SIDES

Annette Fiske (1873-1953)

Upper-middle class Episcopalian

A.B. and Master’s in the Classics from Radcliffe

Challenged professional views of the “bosses”

Student and then instructor at Waltham Training School of Nurses

Recording secretary of Massachusett’s Private Duty League (later Massachusett Nurses’ Association)

Nursing “traditionalist” view

Charlotte Aikens

Canadian born College Educated Ontario hospital trained Ward administration

trained in New York Articles in Trained Nurse

and National Hospital Record

Believed in improving nursing with hospital needs by raising standards

Vice-president of American Hospital Association

THE LAST STRAW

WHO: Nursing superintendents with a small group of nurses vs. working nurses

WHAT: Fight for/against professional nurse WHEN: Early 1890’s WHY: The group believed it was time to make

standards for nursing and claim professionalism while others (the working nurse) worried about their jobs

MERRY

CHRISTMAS