The element of vocation in nursing has been overshadowed by the quest for professional recognition. Aileen Walsh argues why the best traditions from our past should not be forgotten
I recently heard the eminent scientist James Lovelock commenting on the radio that science had become a career choice rather than a vocation, just like nursing.
Unpopular as I might be in stating this, I cannot help feeling he might have a point worth considering. I remember during my own Project 2000 education programme that the idea of nursing as a vocation was explicitly expelled from the classroom. This reflects the feminist slant that has influenced the academic development of nursing in the UK, as the word “vocation” has too much of a religious connotation, an association with a history where nurses were perceived as subservient to doctors.
But what exactly does a vocational attitude to work mean? A Google search leads to the conclusion that a vocation is something for which people feel a strong inclination to do. It involves a sense of commitment and purpose that extends psychologically deeper than merely satisfying our own needs.
Csikszentmihalyi and Nakamura (2007) identified that exceptionally creative people from a variety of professions had a strong sense of vocation similar to the idea of religious vocation. They identified that these people had a sense of duty to do “excellent work as defined by the traditions and current standards of the particular activity in which they are engaged”.
In reading this I was struck at how a sense of connection with people’s professional past, an appreciation of the excellence previously achieved, is so significant in attaining excellence in the present and projecting into the future. Has something been lost in nursing with the bid for professional recognition?
“Nursing will never be an autonomous profession. Our relationship to doctors will always be subservient”
Much of what I have read about nursing history has been negative; examples such as the tidy wards and regimented discipline are now laughed at and seen as irrelevant. The modern fallacy is that nursing can be an autonomous profession. But nursing was never and will never be an autonomous profession, except, of course, in the delivery of nursing care. Our relationship to doctors will always be subservient. Nurses have always and will always find ways to deal with this power difference; but let us not reward those nurses who take on “autonomous” roles more than those who provide excellent essential frontline care.
As I have considered these issues, I have begun to change my own practice in the classroom. I have begun to introduce some of the discipline that I have heard my mother and retired colleagues speak about in their own work. During skills sessions I have stopped students, to consider how their posture and language can communicate a sense of being a trustworthy person to their patients. I have asked them to walk around the room and observe what untidy procedure trolleys communicate and how their competence might be affected by such untidiness.
I hope that nurses in practice might consider doing the same, if they do not practise in this way already. The discipline and attention to detail that nursing history has so often been laughed at for, looked at through a different lens, could surprisingly help to cure some of the problems we now face in ensuring that patients receive excellent attention to their most essential and immediate needs.
By remembering our sense of purpose, by remembering and taking the best from our professional history, perhaps we can reawaken our sense of vocation and regain some of the esteem with which our profession was held in the past.
AILEEN WALSH is senior lecturer, Faculty of Health and Social Care, Anglia Ruskin University
Csikszentmihalyi M, Nakamura J (2007) Creativity and responsibility. In: Gardner H (ed) Responsibility at Work: How Leading ProfessionalsAct (Or Don’t Act) Responsibly. San Fransisco: Wiley Imprint.