NURSING is widely recog nised today as a profession---a profession which is complementary to medicine. The qualified nurse works alongside the doctor as a professional colleague filling a separate and distinct role.
Some might say that these statements represent aspirations rather than the facts of the situation. What evidence is there in support of these claims?
First, nursing has its own Royal College just as the various branches of the ancient profession of medicine have their own Royal Colleges. Secondly, nursing is now established in the university setting.
Manchester University offers a degree in nursing. Edinburgh University has this year established a Chair in Nursing, and an outstanding nurse with appropriate academic qualifications has been appointed as Professor of Nursing.
To turn from the academic field and to seek justification for this claim in the practice of nursing, a quotation from a World Health Organisation report published in 1950 is relevant.
It states: "It is interesting to note, however, that, in countries where medicine is highly developed and nursing is not, the health status of the people does not reflect the advanced stage of medicine. Nursing is essential to the vitalisation of the health programme."
This endorses the essential nature of the nursing contribution in the health care of the community.
Within the National Health Service of this country nurses constitutes the largest professional group, and it is nurses who provide the 24-hour professional service in the care of the patient. The doctor comes and goes; he diagnoses and prescribes. The nurse carries out the treatment, observes changes in the condition of the patient, reports and takes the necessary action; and always she is responsible for the total nursing care.
Nursing care goes beyond treatment: it is concerned with the psychological, social and spiritual needs of the patient
as well as with physical needs.
This emphasis on nursing as a profession may be regarded by some as regrettable, as being as variance with the concept of nursing as a vocation. This is not so; rather it depends on what is meant by "a vocation." A profession is defined in the Concise Oxford Dictionary as. "a vocation, calling, especially one that involves some branch of learning or science."
Science and art
Using the same source, a vocation is defined as "divine call to, sense of fitness for, a career or occupation, . . . employment, trade, profession." It can be seen, therefore, that the two have much in common.
To emphasise that nursing is a profesion is to recognise that the knowledge and skills required of the qualified nurse demand a basic education and training which takes account of the fact that nursing is both a science and an art. To emphasise that nursing is a vocation can imply that high motivation is enough, the ability to pursue satisfactorily a course of education and training is of secondary importance.
Each of these positions gives an inadequate picture because the term "nursing" encompasses so wide a range of activities that there is scope for all, with the necessary inclinations and aptitudes, to play a part in the provision of a comprehensive nursing service.
At one end of the spectrum of nursing the mother cares for her infant child, and for members of her family in sickness, often with no preparation for her task. At the other end of the spectrum the professionally qualified nurse provides an expert service in a situation which demands knowledge of the basic sciences—physical, psy
chological, social in order to give safe care and treatment and to meet the total needs of the patient.
Within the nursing services there is a place for those who wish to study nursing and the relevant sciences in depth and to develop their knowledge and skills to a high level, perhaps through an undergraduate system of education and training.
There is a place for those who wish to undertake a less academic form of training to equip them for positions of responsibility in the ward team. But there is also opportunity for, and need of, those who want to help, the sick but who are willing or able to follow any formal course of training.
Leader of team
From this analysis can be recognised the Registered Nurses, a small percentage of whom are prepared through university or university-linked programmes while the majority follow courses in schools of nursing associated with hos
pitals;, the Enrolled Nurses, who follow a formal training but with less theoretical content, and the nursing auxiliary assistants who should receive— but regrettably do not always do so—some in-service preparation for the work.
The Registered Nurse is the leader of the team; the Enrolled Nurse carries considerable responsibility as a trained member of the team; the nursing auxiliary assistant works under the supervision of a trained nurse. But each plays an important part in meeting the total needs of the patient.
Still the question remains unanswered: "Is nursing a vocation?" To return to the definition of a vocation—a divine call to, a sense of fitness for, a career or occupation . • profession—it must be acknowledged that only a relatively small proportion of the large number who practise nursing do so because they are conscious of a "divine call."
But there must be a sense of fitness for the task—usually expressed in terms of a desire to help people. This desire is well tested in the training of the nurse, in the patient care situation, and only those who have a sincere desire to care for people are able to succeed in nursing.
In these terms nursing is a
vocation and the Christian nurse will always draw strength and inspiration from the knowledge that in her work she is ministering to Christ through his sick.
For those whose attraction to nursing is confirmed by experience in nursing there can be no more satisfying or rewarding occupation. The nurse is "stretched" intellectually, mentally, physically; all her abilities have full play in providing the type of service required in this age of advanced medical and scientific knowledge, of complex treatments and highly technical equipment.
Respect for beliefs
But above all the nurse must respond to the patient as a person. She must anticipate his fears, understand his concerns and be ready with reassurance and constructive help.
She must have knowledge of his family background, of his anxieties for those at home, and must ensure that as necessary, the resources of the social services are made available to him. And because man is a spiritual being his spiritual needs must also be met.
The patient who is a convinced Christian can be greatly helped by the priest or clergyman of his religious denomination, but many patients .today are of non-Christian faiths or have no religious beliefs. A respect for the beliefs of the individual, whatever these may be, is a tenet of nursing and no situation requires more delicate handling than that of responding to the often unexpressed spiritual needs of the patient.
The popular image of the nurse is in the hospital situation caring for the patient in the ward, working in the operating theatre or in the casualty or outpatient department. But this is a very incomplete picture of nursing.
The nurse may work in the community caring for patients in their homes, or, after further preparation, she may become a health visitor responsible for health teaching, for helping to keep people well through preventive medicine. Or she may choose to become an occupational health nurse working in industry.
She may opt for nursing in the Armed Services, for nursing overseas through one of the voluntary organisations or by direct employment. The qualified and experienced nurse can take further preparation to become a nurse teacher or a nurse manager responsible for administering the nursing services.
While all the references to the nurse would seem to imply that the nurse is usually a woman, this is not the case; an increasing number of men are entering nursing and finding in it a worthwhile career.
No profession could offer greater opportunities for a varied and rewarding career than nursing, Much is demanded of the nurse but in return she also receives much —in terms of satisfaction of doing a worthwhile job.
It is a job of intense interest and of constant variety, involved with people who are dependent on her knowledge and skills and who look to her for understanding and compassion.
Yes, nursing is both a profession and a vocation because only those who have a sense of fitness for the task can respond to what is required of them; and those who cannot respond cannot continue—nursing asks too much of them.