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Change For The Best?

by Anne Bartlett RN

      John F. Kennedy said, “Change is the law of life” (Best Quotes Poems, 2007). Nursing has changed. Change is inevitable but generally it is viewed with suspicion and negativity. There have been many changes in nursing even in the almost thirty years since I graduated. Appearances have changed; we no longer dress in the white uniform and hat. Education has changed; graduates are from university based rather then hospital based programs, with opportunities to move on to Masters or Doctorate levels. Attitudes have changed; we don’t see our role as subservient to the medical staff but as vital members of the health care team.

      Have all these changes advanced the profession?  Were things better in the “good old days”?  These questions have been the cause of some heated debate between all interested parties such as patients, medical staff, and nurses themselves. The present climate of economic, resource, and technological challenges really left the profession with little choice; change was necessary. But as a result, I feel nursing has evolved with more autonomy, and increased career options for modern nurses.

Appearances

      Uniforms are often an issue with patients; most find the array of fashions worn in today’s healthcare confusing. The traditionally the white uniforms and hats were to identify and set apart the nurses from the general staff of the hospitals. Over the years the white hat and uniform were shed for articles that were more practical and comfortable. Also, as educated individuals, nurses felt they had the right to make decisions about their apparel and needed to be recognized for their abilities rather then their apparel. Current infection control issues, such as MRSA and VRE, ensure that starched uniforms and hats will continue to be replaced with items that are both durable and washable. However the issue of patient confusion remains and some facilities are attempting to resolve this with some form of mandatory identification ie., wrist bands, color coded scrubs, or badges (University of Saskatchewan, 2009; R. Byrd, 2008 ).

Education

      Nurses traditionally were women and were educated in hospital settings. The programs were based on the needs of the hospitals with the students utilized as unpaid labour. There were efforts even in the 1920’s to move nursing education out of the hospitals and into the universities but there was opposition to women receiving a university education in preparation for a career. Many saw nursing as a “calling” that only required good character and the ability to take direction from a doctor. There was resistance to recognizing nursing as a profession. It was considered a subservient role with no expectations that the nursing staff could perform without the explicit direction of the medical staff (N.Aranda, 2007; Ministry of Health and Long-Term Care [MOHLTC], 2006).

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