Will an All Graduate Profession Empower Nurses - Essay Example

 Will an all graduate profession empower nurses? Introduction: The spontaneous will to serve people, who are suffering and social benevolence are two essential virtues that are considered most important for those, who want to develop themselves in the profession of nursing. Historical documents, from the early dawn of human civilization establish truth behind such observation. Social scientists and theorists, working on ethical principles of this profession, after analyzing philosophy behind development of this profession, have reflected that moral good and moral obligations are two integral features that act as core foundation to seek success in this profession. These theorists and social scientists have opined unanimously that nursing is “… a practice that seeks human well-being by promoting health, preventing illness, restoring health and alleviating suffering. Nurses have a primary responsibility to people who require nursing care and are obligated to promote their well-being, regardless of their health status” (Fry and Johnstone, 2002, p. 30). Change in social structure, though has introduced several alternations in the ideological backdrop of this profession but these core principles have remained unchanged. However, changes in socio-cultural and economic structures also introduced several transformations in the life of common people and their perception regarding different aspects of life at the same time. Nursing as a profession, not only remained saturated within the boundaries of ideological reflections only but changed perception of common people regarding professions related to medical field also casted considerable impact over nursing that practitioners of the profession were gradually becoming bound to think beyond realms of limited ideological perceptions. Attaining considerable knowledge about different disciplines of social and cultural life has gradually become important for empowering nurses and as an all graduate professional course provides sufficient knowledge about diverse aspects of contemporary social life, it is widely considered that an all graduate professional course will empower nurses to pursue their career in a more fruitful way. What Used to Be: Since early dawn of the healthcare practices in Western social discourse, right to receive proper treatment and social benevolence in this discipline have been provided with such importance that conjointly the entire issue has been elevated to the level of “inalienable right of every person” (Lupton, 2003, p. 1). Unfortunately, as the human civilization has made progress in every aspect of human life, continuous derogation in the field of medical assistance, especially in the context of moral support to patients, has disillusioned people regarding application of scientific medicines as the most important means to cure the suffering. Compared to the recent approaches of healthcare system, in the earlier times, equal emphasis used to be provided to patients in terms of nursing care, so that the suffering one receives adequate psychological support and respond to the treatment of physicians, accordingly. During the 1830s, which is considered an important period of time for development of nursing as a separate disciplines of profession, the conception of skilled or trained nurses, in terms of modern ideas, was absent. The only aspect that encouraged women to come into this profession was their spontaneous will to serve the needy. Additionally, general social conception about role of women that they only have the capacity for serving others and they are fittest in that role also played an important part in making women as most obvious choice for this profession. However, transformation of such role women from triviality to nobility has been done through sincere efforts of legendary characters like Sarah Gamp or Florence Nightingale (Davies, 1980, p. 43). Primarily, the evolution of departmental nursing practice did not happen naturally; rather private nursing practice was most obvious choice for women. According to observation of historians, engaged in historical evolution of nursing as a profession, private nursing practices is “…root of all other departments of nursing – hospital, workhouse, army, district nursing” (Davies, 1980, p. 43). Despite in the field of modern nursing system contribution of figures like Sarah Gamp or Florence Nightingale are recollected with great respect but Elizabeth Fry is actually the person, who pioneered the system of modern nursing. There is no denial of the fact that her main center of attention for catering nursing service was elite class families but due to her initiative, the importance for providing “skilled and trustworthy attendants” for needy people was realized (Davies, 1980, p. 43). She was perhaps the first individual, who provided special care in training women so that people start evaluating nurses beyond cotemporary apprehension of cruelty and maltreatment. Later on, with the help of other personalities like, Sarah Gamp and Florence Nightingale, the profession received sufficient refinement with which nursing is judged in recent times. Nightingale not only refined the level of sophistication, techniques of attendance and care among people related to this profession but she also elaborated the founding principles over which nursing as a profession stands. During that period of time, nursing was hardly distinguished from other forms of hospital works but she also clearly stated the kind of relation, which needs to prevail between these divisions and nursing. Development and refinement in the field of nursing as a profession, which commenced with the works of Elizabeth Fry, took a further concrete form with initiatives of Florence Nightingale. The latter, not only constructed nursing as an essentially feminine occupation but at the same time, for further development in the profession, emphasized over the fact that it is important to recruit educated women in this profession. It is due to her initiative, aftermath 1861 radical changes in this profession were introduced, namely, three year training system, basic training programs in nursing schools, regular hospital services, providing certificates and badges to students for their further encouragement (Davies, 1980, p. 50). Thus, if we compare the development of nursing as a profession with the earlier times, it becomes clear that having benevolence or willingness to serve are not the only factors that an aspirant for this field are required to possess. Changes in socio-cultural scenario and requirement of people from healthcare introduced several changes in the profession that people engaged in this field were bound to accept. Emergence of the new nurses and new nursing practices surely conflicted with traditional approach. Nursing practices, for a long time, was solely dependent over the virtue of womanliness but empowerment of the profession commenced as the new nurses introduced new dimensions of knowledge and nursing practice, “It is medical knowledge, and its changing understanding of the role of the immediate environment and of the practices that constituted the treatment of the patient, that is the cause of a change in the character of hospital nursing …” (Davies, 1980, p. 50-51). However, empowerment of nurses was happening only at the technical level but if we consider empowerment of nurses from the perspective of entire Western sociological scenario, it becomes quite poignant that nurses have always remained subservient in the hands of doctors. It is since the 16th century that the process of official documentation regarding nursing activities was stopped in Britain. In this context, while reflecting over the role of nurses in contemporary Britain, situation presented by the medical journals, magazines and pamphlets become most important resources. However, situation of healthcare in contemporary Britain, as is reflected from these sources clearly show that most of the magazines or journals were concerned about voicing condition of physicians and people related with the field of nursing practice almost had no say of their own except a limited number of sources that exclusively aimed at elaborating condition of people in this profession only. Almost for a period of thirty years (1840-70), common people of Britain were almost ignorant about condition of nurses in the country. Thus, the entire situation gives us a clear picture that nursing professionals were entirely dominated by doctors and philanthropists (Davies, 1980, p. 54) and they also had lowest designation in the entire healthcare system. Curing the problems of patients and provide them with proper medical assistance would not have been possible without proper assistance from nurses. Despite this fact, entirety of the focus regarding treatment is enjoyed by the physicians and in the modern situation, though there are numerous such evidences that physicians are responsible for misusing their power, such impression of such god-like stature of a physician has not entirely abolished from common human psychology. However, compared to the earlier times, increase in literacy rate among common people, social awareness and drastic changes at the level of common social perception has helped the patients to interpret role of doctors from a newer perspective. At the same time, alterations in the conventional ideas regarding class, society and social hierarchy has also led people related to different domains of healthcare profession, especially nursing professionals, to enjoy a better social recognition and rightful existence. What we have Now: The aspect of social constructionism and power politics plays an important part in the context of understanding sociology from the perspective of health and medicine. Such relevance has become more conspicuous during the 1980s and even in the early dawn of the 21sty century, it has remained quite an important source for realizing different layers of power politics in the postmodern social context. In the era of new human enlightenment social constuctionsim is receiving such a great deal of attention mainly due to the fact that this approach helps in understanding “…the existence of essential truths. What is asserted to be ‘truth’ should be considered the product of power relations, and as such is never neutral but always acting in the interests of someone. The social constructionist perspective argues … that all knowledges are inevitably the products of social relations, and are subject to change rather than fixed” (Lupton, p. 2003, 12). The conventional approach regarding knowledge asserts that knowledge is basically universal in nature and an “independent reality”, which remains unaffected due to the changes at apparent levels of society. Introduction of postmodernist and post stucturalist observation has questioned the very nature of knowledge and projected it as “a participant in the construction of reality” (Lupton, 2003, p. 12). In the modern era of increasing use of biomedicine and novel “medico-scientific” methods, social constructionist theory emphasizes over states of “diseases, illness or bodily experiences” which “are known and interpreted via social activity and therefore should be examined using cultural and social analysis” (Lupton, 2003, p. 12). In this context evaluation of medical anthropologists becomes important because they interpret the experiences of an individual, related to illness, both physical and mental, as a product of their respective culture. According to such anthropological interpretation, the culture of a patient becomes a domain, within which the subject operates and also influences the experience of illness. Thus, from the postmodern social constructionist theory, experiences related to disease or illness becomes a medium or “a form of communication – the language of the organs – through which nature, society, and culture speak simultaneously” (Lupton, 2003, p. 15). Now, if we judge the entire scenario from the perspective of a physician or a professional, associated with nursing, we see that responsibility of a doctor ends with prescribing medicines to the sick and providing him with proper diagnostic approaches so that the person is cured from sickness. On the other hand, an individual in the field of nursing is responsible for monitoring the condition of the patient, his moral requirements from the service and catering him with that kind of facilities so that those lead him to his cure in terms of both physical and psychological condition of being sick. Thus, it understanding the form of communication or apprehending the language of the organs becomes essentially important for a nurse. At the same time it also becomes evident that having mere knowledge of nursing or empathy for condition of the patient is not sufficient to attain this objective. These aspects must also receive an adequate support from the professional’s overall understanding about society and radically changing scenario regarding existence in the contemporary world. Attaining this level of understanding is not possible unless a nursing professional receives proper support from educational background. In this context relevance of an all graduate profession becomes important, as the candidate from this background would not only have a considerable understanding about changing realties in the modern world but the flexibility to adopt with changing nature of existence accompanied by her empathy for the patient would churn out the best method of treatment. Such innovative method of treatment, quite contrary to stereotypical method would finally result in empowerment of professionals, associated with nursing. In this context of treating patients from the perspective of their different cultural backdrops and orientations, definition of body according to postmodern social constructionist approach, becomes inevitable. Definition of body according to the strict biological perspective has remained unchanged even in the era of deconstructionist intellectual evolution but the modern theories of sociology and political science are not much interested in cultivating over definition of body from strict scientific terms; rather these theories have provided more focus on the aspect that human body is an embodiment of “social structures and individual subjectivity” (Lupton, 2003, p. 22). Such observation about body receives a stronger foundation as Simon Johnson Williams, Jonathan Gabe and Michael Calnan have attempted to interpret body from sociological perspective. According to them, a body is constituted “at the intersection of an equilateral triangle composed of institutions, discourses and corporeality …. bodies are the foundation of both discourse and institutions as well as being their products” (2000, p . 8). Anthony Synnott has observed body not only as an accumulation of different organs or a mere organic entity but also an assimilation of different layers of meanings and ideas, “We have imposed layers of ideas, images, meanings and association on … biological systems which together operate and maintain our physical bodies. Our bodies and body parts are loaded with cultural symbolism, public and private, positive and negative, political and economic, sexual, moral and often controversial …” (1993, p. 1). Thus, considering these aspects, when it comes to treatment of a patient under the domain of modern social discourse, importance is not only provided only to their physical well-being but also to providing adequate moral support to patients. As women are traditionally considered embodiments of virtues like caring, support and empathy, they actually have the capacity to respect requirement of a patient, going beyond the realm of mere physical support. In the modern scenario, along with providing adequate physical support to patients, it also has become necessary for nursing professionals to view patients going not just organic entities but also as representatives of cultural, economic, political and social factors. Bodies of the patients, in the arena of modern healthcare system, not only remain mere physical entities but also as representation of an entire socio-cultural backdrop. Developing expertise in the context of catering nursing services is a major challenge for people related to this profession. Apart from this aspect, orienting and executing their performances by triumphing over patriarchal system of medical care is another major challenge that women professionals are also encountering. The feminist perspective of modern healthcare system points out mainly at two limitations, “First, it is often claimed that the delivery of health services is dominated by men. Second … there is criticism of the way in which the health care system, and in particular, the medical profession, view female patients and their health problems” (Baggott, 1994, p. 66). The traditional social structure provided sufficient scope for women to establish themselves in the “role of healer” but with gradual development, such process of taking care of patients took a professional turn and male counterparts received an upper hand over women in controlling their actions in this field. Despite efforts of legendary figures like Florence Nightingale, the aspect of male authority in the arena of health care services cannot be denied. The Midwives Act, 1902 is a bright example in this context. This Act was implemented in order to control the continuous battle between midwives and male doctors regarding control of childbirth. Implementation of the Act clearly provided further rights to male doctors for controlling childbirth, while role of midwives were restricted. In the same manner, in latter half of the 19th century, despite nurses received a great deal of professional recognition, compared to the earlier times, but execution of their role in the professional field remained in the hands of doctors (Baggott, 1994, p. 67). Several scholars in the field of medical profession have expressed their concern regarding the fact that such undisputed male supremacy in the field of catering medical care can put the aspect of health care for women at risk. Numerous such evidences can be witnessed since the Victorian era as on several occasions care to health problems of women have been provided by male doctors in the form of deducting their “sexual and reproductive organs” (Baggott, 1994, p. 67). The main reason behind happening of such unfortunate incidents is that conventional outlook of the male dominated society towards their female counterparts. Even the era of intellectual and scientific advancement, women patients are viewed by doctors from a particular angle of judgment that “men are normal and women are abnormal in respect of intellect, emotion and physical functioning…. Doctors assume that motherhood and the maternal instinct is the main driving force in women’s lives, and that a denial of this instinct causes depression and so on” (Baggott, 1994, p. 67). Thus, what the actual scenario leads us to is that when it comes to treatment of female patients by male doctors, in most of the cases women only remain as mere physical entities and their emotional or factors that have helped in construction of their personality do not attract much attention of physicians. Thus, in such a situation, the modern concept of observing patient as an embodiment of socio-cultural factors fails. However, as nurses remain as subservient in the hands of doctors, thus, despite having capacity to provide better treatment to women, they often do not receive the opportunity. The discussion over limitation of nurses by the male dominant health care system receives further elaboration as Anne Witz points out two most important factors which are dominated by males. According to her observation, the two most essential aspects of current nursing occupation are “occupational control and practitioner autonomy” (Witz, 1994, p. 24). Despite the development that have occurred in the field of health care profession, “the traditional doctor-led model of health care” has remained unchanged and due to this factor, maintaining a proper relationship between nursing and medicine is becoming increasingly problematic (Witz, 1994, p. 24). The modern theories of nursing profession often emphasize over the aspect of providing “patient centered model of nursing” (Witz, 1994, p 26). However, continuous male domination over practitioners of the profession, and limitation over “occupational control and practitioner autonomy” are surely proving to be great hindrances in terms of achieving this aim. If we look deeper into the problem of conflict between male dominance over nurses, it would not only remain as a conflict between two professions; rather it would receive the eternal sociological conflict between genders. Rob Baggott observes, “Medicine is male-dominated: nursing (which is 90 per cent female) and other non-medical health professions are predominantly female” (1994, p. 67). The conflict between genders has so integrally been fused with the Western socio-cultural discourse that male doctors always regard women nurses as essentially their subordinates and they receive a kind of typical taste of superiority by exercising authority over them. The feminist critics have pointed out two important aspects in the context of gender factor in the field of sociology of nursing, “First, the gendering both of the content of nursing work and of the context … within which it is accomplished; and second, the gendering of professional projects themselves” (Witz, 1994, p. 26). Thus, the scope of nursing professionals for functioning has been limited by the patriarchal domination and it has also been determined by the existing social power politics that if nurses need to develop in their professional career, they have to remain “within the structural parameters of patriarchy, or a gender order of male dominance and female subordination, which, just as it limits and constrains nursing’s aspirations to re-evaluate the content of nursing work, renegotiate the relation between nursing and medicine, and assert the autonomy of nurses in matters of nurse education and practice” (Witz, 1994, p. 26). Nursing for Future: How the situation can be developed Social constructionist approach, evolution of feminist movement clearly pointed out that to which extent nursing as a profession has remained ignored in the field of health care and random increase in the factor of gender discrimination has also played a major part in limiting the scope of nurses, when it comes to execution of their choice making. However, it is also evident that changing the condition of nurses is not possible immediately from hands of such patriarchal oppression. Thus, the feminists have opined that only way to change the situation is to strengthen the position of women in the society. More specifically, when it comes to nursing and health care, the situation can be changed for women through increasing participation in “medicine and medical decision-making”. The situation for women in the health care profession, specifically in nursing can also be changed if the shift of power can more be tilted towards those professions, where women play dominating role (Baggott, 1994, p. 68). However, in the same context, it must also be mentioned that level of expertise, knowledge and efficiency should not be compromised as the health care system aims at ensuring better treatment to a large number of people. However, the methods of new nursing and practitioner autonomy provide a more rational approach towards solving the problem of nursing in the future. These two approaches mainly aim at providing certain degree of freedom to a nurse so that she can execute her tasks in self-oriented ways and she also regularly evaluates the basic duties for nursing. Through this process of continuous self-evaluation, she finally learns to do betterment with the assignment, which has been provided to her, “The nursing process attempts to replace a routinised, task-oriented approach to care with a problem-solving, patient-centered one, to replace an intuitive approach to nursing with a more systematic and analytic one, which consist of four stages involved in nursing care: assessment, planning, implementation and evaluation” (Witz, 1994, p. 30). Thus, what finally comes out is that a professional in nursing profession needs to take care of several aspects apart from mandatory lessons of nursing, such as, taking personalized care of the patient by giving proper respect to his/her socio-cultural upbringing, the factor of gender discrimination in profession, the kind of autonomy that has been granted to her and playing proper attention to it and finally to the aspect of self-evaluation. Conclusion: The above discussion clearly suggests that progress in the field of heath care and medicine has surely opened up new dimensions in the context of scientific or technological application. However, there has surely been a sharp decline when it comes to catering proper nursing services to patients. At the same time, nursing as a profession, has become subject to encounter several problems, namely, gender obstruction, limitation of nurses in addressing the problems of patients, subservience to male doctors and lack of empathy toward patients when it comes to providing personalized service, taking care of the socio-cultural factors of the patient’s personality. Changes in modern sociological approaches have surely widened the scope for perceiving an individual from different perspectives but obstacles for professionals in nursing are surely preventing them to perceive human beings considering different dimensions of their respective personality. An all graduate profession, in this context, will definitely help nursing as it is encompasses within its scope several issues that are important for understanding the ongoing trends of the society and how these trends affect an individual. A person from an all graduate profession is expected to have the flexibility that would contribute in adopting herself with modern trends of nursing as a profession. The amount of freedom, scope for evaluation and autonomy has been granted to her, she will also learn to respect that and more people in this profession will learn to respect the new trends of new nursing system, candidates from all graduate profession will keep on empowering nursing. References Baggott, R. (1994). Health and health care in Britain. Edition: 2. Basingstoke (UK): Palgrave Macmillan Calnan, M. Gabe, J. and Williams, S.J. (2000), Health, medicine, and society: key theories, future agendas. London: Routledge Davies, C. (1980). Rewriting nursing history. New York: Taylor & Francis Foucault, M. (2003). The Birth of the Clinic. Edition: 3. London: Routledge Fry, S.T. and Johnstone, M. (2002). Ethics in nursing practice: a guide to ethical decision making. Edition: 2. Oxford: Wiley-Blackwell Lupton, D. (2003). Medicine as culture: illness, disease and the body in Western societies. Edition: 2. London: SAGE Synnott, A. (1993). The body social: symbolism, self, and society, Part 9. London: Routledge Williams, G. Kelleher, D. and Gabe, J. (1994). Challenging medicine. London: Routledge Read More