This paper examines how the nursing profession has transformed over the past fifty years, tracing the shift from a subordinate role to that of an independent, highly educated healthcare professional. Drawing on sources related to nursing education, workforce demographics, and policy involvement, the paper discusses improvements in academic training and leadership development, the persistent lack of racial and gender diversity in nursing faculty, changes in home nursing and medical education, and the growing role nurses play in healthcare decision-making. The paper argues that while the scope and skills of nursing have advanced significantly, demographic representation within the profession remains largely unchanged.
A nurse has traditionally been a person responsible for caring for sick individuals who need assistance in order to recover and return to health. Throughout history, there have been nurses who sacrificed a great deal of their personal lives to serve humanity; Florence Nightingale is perhaps the most celebrated example. While in earlier times a nurse was merely the subordinate of the physician — who held complete authority over the patient and assumed the right to direct the nurse's every action — today the nurse plays a far larger role and carries a much wider scope of responsibilities. Today, a nurse is a complete healthcare professional who provides holistic care to her patients. She is well educated, an independent thinker, and trained in management and leadership skills. She participates in all major healthcare decisions and exerts a positive influence on those in her care (Salemi, 2007).
As noted above, the face of nursing is changing gradually and for the better. Gone are the days when a nurse was stereotypically the figure in white who scurried behind the doctor, obeying his orders. Today, a nurse is an individual who can be described as a healthcare professional, a technology expert, and even a patient care manager. Today's nurse is a dedicated professional who is not only committed to maintaining the highest academic standards, but who also pursues continuing education while actively working. According to medical professionals, one significant factor driving this transformation is the expectation that nurses complete the Licensed Practical Nurse to Bachelor of Science in Nursing program, which has contributed to a fundamental change in the profession as a whole (Salemi, 2007).
Karen Daley, Assistant Professor of Nursing, argues that the variety of courses now available for nurse training — including programs in medical-surgical nursing, nursing practicums, and an increased focus on leadership and management skills — have resulted in dramatic improvements in nursing standards compared to the past fifty years. In her own words: "We moved away from teaching a medical model [memorizing diseases and treatments]. Now, we emphasize conceptual nursing so students can problem-solve and think critically in any situation. We encourage independent thinking, assertive communication, and professionalism" (Salemi, 2007). Because nurses are responsible for both short-term and long-term patient care, and because they make up more than half of all healthcare professionals today, improvements in their education, training, and leadership preparation represent a meaningful advancement for the profession as a whole (Salemi, 2007).
"Persistent racial and gender homogeneity in nursing"
"Home care shifts and medical education reform influence"
Nurses have remained at the frontline of healthcare, in large part because a nurse is the person most consistently in contact with the patient's friends and family, and it is the nurse who is said to "hold the pulse of the healthcare system on a day to day basis." In an ideal future — in contrast to the past, when nurses were simply subordinates expected to carry out a physician's orders — nurses must be given both the right and the authority to make their perspectives known in the formulation of healthcare policy. Nurses should also be given a meaningful voice in how the healthcare system as a whole is managed, particularly given that it is the nurse who is closest to the patient and most directly responsible for daily care and recovery. This would allow nurses to apply their education, leadership training, communication skills, and management abilities in the direct interest of their patients.
The International Council of Nurses in Geneva, Switzerland has summarized the expanding duties of nurses as they increasingly participate in important decision-making processes: "strategic planning, budgeting, efficient resource planning and utilization, and the planning, management and evaluation of programs and services" (Akinci, 2007). It is clear that today's nurse plays a far more significant role than ever before, and this is a reality that must be acknowledged and recognized by healthcare institutions and professionals everywhere.
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