Student Nurses' Perceptions About the Culture of Nursing and Why it Matters to Nursing Education

Introduction: A fair amount of literature exists on the socialization process to the profession of nursing (Brown, Stevens, & Kremode, 2013) yet problems still exist with the socialization process, as evidenced by the culture shock and transition to practice difficulties new nursing students experience (vanRooyen, Jordan, ten Ham-Baloyi, & Caka, 2018). Viewing socialization as enculturation to a professional culture is an alternative and beneficial way to view the socialization process, giving credence to the social-cultural factors impacting this vital aspect of nursing education (Strouse & Nickerson, 2016). However, little is known about the current culture of nursing, last fully explored by Leininger in 1994. This is problematic for those seeking enculturation to this professional culture, creating difficulties for nursing students, nursing faculty, health care organizations (VanCamp & Chappy, 2017), and the profession (Book, Aitken, Webb, MacLaren, & Salmon, 2019). Previous studies have examined the culture of nursing and perceptions about learning that culture from the faculty (Strouse & Nickerson, 2016) and preceptor (Strouse, Nickerson, & McCloskey, 2018) perspectives, with both groups experiencing divergent thoughts and difficulty in expressing the unique culture of nursing and the best way to learn that culture.

Purpose: The purpose of this focused ethnography study is to gain insights into how pre-nursing and senior nursing students view the culture of nursing and how they best learn this professional culture. The research question for this study is “how do students describe the profession of nursing, and how do they perceive they best learn that professional culture?”

Methods: This study occurred at three different accredited baccalaureate nursing programs in diverse areas of a single Midwestern state. Data collection included semi structured focus group interviews with pre-nursing or senior nursing students. Data analysis followed Lininger’s four phases of data analysis (1991) for each group of students, followed by a final synthesis of themes.

Results: The final two themes are 1) Nursing is a challenging, unique, but multidimensional and relationship based profession that is not easily defined, and 2) Learning the culture of nursing is influenced by formal and informal processes,

Conclusion: Findings from this study have implications for nursing education and the nursing profession. A better understanding of the culture of nursing is necessary for an intentional enculturation process. Faculty need to facilitate this process in addition to teaching the knowledge and skills required for licensure, which aligns with Benner, Sutfin, Leonard and Day’s (2010) call for a radical transformation of nursing education. A better understanding of the culture of nursing also eases the transition of new nurses to practice, decreasing the culture shock experienced after graduation (VanCamp & Chappy, 2017) that contributes to nurses leaving the profession. A clearer understanding of the culture of nursing will have a strong impact on those considering joining the profession, nursing education, and the profession in general, allowing nurses to be advocates and game changers for their patients, their profession and health care in general.