Nursing Professionalization:
Good, Bad, or Just Ugly?
Professionalizing nursing
would “standardize and raise” [Susan
M. Reverby, Ordered to Care: the Dilemma of American Nursing, 1850-1945.
Cambridge: Cambridge University Press, 1987,121-207] the educational requirements as well
as creating a greater amount of power and professional recognition for those
nurses who would also be part of a smaller pool of nurses thus increasing job
availability. However, there were many consequences for these advancements. Many women who had become nurses,
particularly working nurses, would find themselves excluded [Reverby, 121]. This
professionalization, which came with demands for higher wages and greater
respect in the work force, also created a dilemma of how to maintain their
status as ladies while still pushing for these changes. Such
professionalization also threatened the men of the hospitals who worked as
doctors, surgeons, and administrators because they feared that such
professionalization would create competition for them and would decrease their
relatively cheap work force of student nurses [Reverby 121].
A graduate nurse’s place
in the medical community was already unique and isolated before these pushes
were made. Professionalization seemed only to further alienate her from the
largely male members of the medical community as well as working nurses whose
goals and desires in regards to their nursing careers were vastly different
from that of the upper class graduate nurses who were organizing and directing
these professionalization attempts. This can be seen particularly in the
educational standards that were put forth by the upper class graduate nurses.
They pushed for requirements of high school diplomas and
tighter restrictions on the issuing of licenses. Yet they ignored reform issues
such as wages and forbade unionization because these actions seemed
unprofessional and shallow in contrast with the ideals that the upper class
graduates valued.
Because smaller schools often did not
meet these educational standards, graduates of those schools often found
themselves fighting the professionalization of nursing because they feared “to
have their status and standing lowered” [Reverby, 127] when the standards held
strong legal backing. Along with opposition from the small school graduates,
there was opposition from many of the state-nursing board members in regards to
the requirement of a high school diploma to be a registered nurse. This is not
altogether shocking when one considers that many of those members “were not
themselves high school graduates” [Reverby, 127]. In an ironic twist, as the nursing community was trying to
create an educational line to who was and was not a professional nurse, they
were fighting against physicians who didn’t want nursing to be professionalized
for the simple reason that they believed that “nurses are helpers and agents of
physicians; not co-workers or colleagues” [Reverby, 131].
The essential split in
these two groups of nurses seeking reform was that, “those eager for
registration and higher standards focused on entry requirements and nursing
education, whereas nurses already in the field were occupied with the
conditions they faced at work” [Reverby, 134]. So rather than a united community
of nurses taking on the medical community and gaining better pay, increased
avenues of employment, and greater respect in the workforce, these two factions
spent a great deal of time fighting against each other instead. Furthermore,
the working nurses felt alienated from the upper class nurses because “they
refused to accept the judgment that only those with pure noneconomic motives
could be true nurse” [Reverby, 131]. This was one of the largest points of
contention between the often upper class nurses from large schools that held
the positions of leadership within the nursing organizations. These working
nurses actually needed the funds from their work to support themselves and
often a family. Therein lies the difference, their motivations and backgrounds
were so very different that seeing eye to eye became nearly impossible.
