Traditionally, females dominated the nursing profession and were easily recognised by their white hats and uniforms (Alomar, 2004). Nowadays, the white uniforms and hats have been replaced by bright coloured scrubs worn by both male and female nurses, as well as most of the other employees in the healthcare arena. Perceptions of nursing are said to be based on visual images that are often limited to bedside care and drug administration, instead images
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of a highly skilled and well-educated nursing professional who has an important role to play in healthcare (Alomar, 2004; Saied et al., 2016)
Al-Omar (2004) used a descriptive analytical research design to determine the knowledge, attitudes and intentions among Saudi students toward the nursing profession. Three male and three female schools located in all areas of Riyadh were selected and employed via stratified random sampling procedures. A total of 600 questionnaires were distributed, and 503 questionnaires were returned, of which 479 questionnaires were valid for analysis (79.8% response rate).
Students scored a reasonable level on the knowledge dimension but did not achieve high scores on the attitude dimension; however, they achieved low scores on the intention of considering nursing as a future career (5.2% of students indicated nursing as their preferred future job). Data analysis showed that attitude; having or not having a nurse friend; and knowledge was found to have a significant positive influence on students’ intention. Long working hours and high work load were found to have a significant negative influence. The results of this study indicated that more knowledge of and a positive attitude about nursing were associated with attracting students to the nursing profession. However, this study was conducted around the mid-1990s, and significant changes have occurred since then in the economy, life style, technology and education areas, so it is not known if and to what extent these attitudes remain today.
A recent study was conducted in the KSA with the aim to assess the motivation of Saudi nationals regarding entering nursing training and the magnetism of nursing as a career (Al- Mahmoud, 2013). In this study, 498 questionnaires were distributed (response rate = 100%), and where a low reflection toward nursing was evident. When participants were asked about if the Saudi community views nursing activities negatively, their responses were of the highest ‘mean’ agreement scores, and the agreement score for males was significantly higher than for females. Despite the students being engaged in nursing education and training, this response reflects the community view toward nursing. This supports earlier references that nursing is seen as a lower level career.
Many lay people have not spent time with a nursing professional or volunteered in a healthcare setting (Wieck, 2000). Therefore, the perception of the nursing profession appears to be ambiguous, and many people, especially students who are at the stage of deciding their career preferences are confused about the tasks and responsibilities of nurses.
As with many professions, high students form the core of recruits for nursing. In many instances, school is the stage where individuals make decisions about their potential careers. Therefore, understanding students’ perceptions of nursing can be influential in formulating curricula to empower students with career decision skills (Wieck, 2000). It would seem logical to suggest that individuals may be motivated to choose a profession to which they have an attraction to (Law & Arthur, 2003). This attraction may be derived from workers’ knowledge and understanding of the profession. Therefore, they build their image in relation to what they know.
Nursing faces competition from many other careers, which has made it more difficult to recruit students into nursing. Students are looking for high-status careers, and because students’ perceptions of nursing are limited to visible images instead of information about the profession, many currently view nursing as bedside care and taking orders from physicians (Wieck, 2000). Foskett et al. (2000) sought to develop an understanding of how students perceive nursing as a career at various stages in their education and how these perceptions affect students’ concerns about nursing. The study indicated that decisions about jobs are made at an early age, and that by late elementary school, students have often rejected jobs based on their perceptions. Thus, it is important to provide career information and experience to give well-defined perceptions about nursing.
Students are looking for innovative degrees and are often confused when it comes to academic pathways for nursing. These students are often discouraged by the lack of standardisation in nursing education and choose alternative curricula instead of nursing. Students also need to be aware of advanced degrees in nursing that can prepare them to achieve advanced educational opportunities (Law & Arthur, 2003).
Understanding why students choose or reject a nursing career is relevant when designing a recruiting program for students. Nurse educators face the challenge of providing students with a variety of information about nursing to help with career decision making. Students are currently formulating career decisions from a variety of sources but rarely from nurses;
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therefore, students may have vague, distorted or inaccurate images of nursing that result in dissatisfied career choices.
A study was conducted in the KSA, and it reported that the role of the nurse was perceived as an extension of the physician, having a limited or no role in disease detection and decision making (Al-Mahmoud, 2013). Moreover, Al Thagafi (2006) reported that nursing suffers from a poor image that prevents high school students from becoming nurses. Participants in this study stated that their perceptions were derived from the perceived community image of nursing. Data from these studies provide insight into the current perception of nursing as a potential career for Saudi nationals and give a direction for future concerns in the development of nursing by detecting the public’s image toward nursing.
For various reasons, it seems that the overall image of nursing is perceived to be negative, placing the country at risk of complications from culturally sensitive issues because of the expatriate nursing workforce (Al-Mahmoud, 2013). The next section goes into more detail about the image of nursing.