Contemporary Nurse

ISSN: 1037-6178 (Print) 1839-3535 (Online) Journal homepage: http://www.tandfonline.com/loi/rcnj20

Nursing as career choice: perceptions of Turkish nursing students Hatice Başkale & Pınar Serçekuş To cite this article: Hatice Başkale & Pınar Serçekuş (2015): Nursing as career choice: perceptions of Turkish nursing students, Contemporary Nurse, DOI: 10.1080/10376178.2015.1025469 To link to this article: http://dx.doi.org/10.1080/10376178.2015.1025469

Published online: 14 Jun 2015.

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Date: 12 November 2015, At: 21:39

Contemporary Nurse, 2015 http://dx.doi.org/10.1080/10376178.2015.1025469

RESEARCH ARTICLE Nursing as career choice: perceptions of Turkish nursing students

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Hatice Başkalea* and Pınar Serçekuşb a Department of Pediatric Nursing, Pamukkale University Denizli School of Health, 20160, Kinikli, Denizli, Turkey; bDepartment of Obstetrics and Gynecology Nursing, Pamukkale University Denizli School of Health, 20160, Kinikli, Denizli, Turkey

(Received 22 November 2013; accepted 11 February 2015) Students’ perceptions of nursing influence their choice of nursing as a career and whether they remain in the profession. The aim of this study was to explore the perceptions of entry-level male and female nursing students and the reasons for choosing nursing as a career. A qualitative approach was used by focus group interviews with 31 nursing students, and socio-demographic data were collected by questionnaire. Thematic content analysis was used to analyse the data, and findings were grouped into categories and themes. The first category was ‘choosing’, which included the themes of ‘desire to help’, ‘satisfactory income, and guaranteed employment’, ‘influence of family and friends’ and ‘being in a health-related profession’. The second category was ‘others’ reactions, which included the single theme ‘response’. The third category was ‘the image of nursing’ which included the themes of ‘job description’ and ‘gender’. The study concluded that although a growing amount of male students are enrolling in nursing programs, stereotypical ideas persist, and nursing is considered a female-dominated profession. There is further need to track student experiences during or after clinical practice and explore whether students’ perceptions change over time. Keywords: nurse gender; male nurses; choosing nursing; nursing in Turkey

Introduction The development of professional nursing in Turkey originated with the first Balkan and ItaloTurkish wars (1911–1912). After overcoming many challenges since then, contemporary nursing education in Turkey now compares favourably to international standards (Dal & Kitis, 2008). Nevertheless, the new Nursing Law of 2007 describes the responsibilities of professional nursing in legislation, and in specialised areas such as transplantation nursing, significant barriers to provision of universal quality care remain. These include inadequate amounts of nurses and unbalanced distribution (Cinar & Altun, 2010). Although there are previous studies on the overall image of nursing in Turkey, the Nursing Law of 2007 allowed males to enter the profession, and scientific studies of nursing education need to provide better understanding of barriers to entry and support required for male and female students. Despite modernisation in Turkey, students still have traditional perceptions about nursing. Existing societal perceptions against male nurses prevail. For example, most of the student participants in one study had difficulty accepting the image of men in nursing and

*Corresponding author. Emails: [email protected]; [email protected] © 2015 Taylor & Francis

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had gender stereotypes about carers (Kulakac, Ozkan, Sucu, & O’Lynn, 2009). These stereotyped views originate in traditional Turkish culture, which is highly patriarchal (Herdman & Badir, 2008). There are also embedded problems in the language. The word ‘nurse’ in Turkish, hemsire, means ‘sister’, and consequently, nursing in Turkey is considered a female profession, and the image of a nurse is considered feminine (Cinar & Altun, 2010; Karabacak, Uslusoy, Alpar, & Bahcecik, 2012). Understanding students’ perceptions about the image of nursing and why they choose the profession is therefore essential to increase student satisfaction and reduce attrition. Students’ perceptions of nursing are affected by societal images of the profession (Karaoz, 2004; Milisen, Busser, Kayaert, Abraham, & de Casterle, 2010). Several studies have investigated societal images in various cultures including Turkey (Karabacak et al., 2012; Kulakac et al., 2009), China (Wang et al., 2011), Belgium (Milisen et al., 2010) and Canada (Day, Field, Campbell, & Reutter, 2005). Al Jarrah’s Jordan study (2013) showed that students had positive perceptions, including pride in their professionalism, and that nursing was a prestigious and humane profession essential for society. Nurses assist patient recovery, prevent disease and implement treatment plans. According to this study, both societal and familial factors greatly impact student choice of nursing as a profession. A triangulation study in Bahrain (Eman, Seamus, & Edgar, 2012) indicated that nursing was perceived as a challenging profession that is not well accepted socially. Additional perceptions were that nursing duties included helping and caring for people, and as a humanitarian profession, it required good communication skills and patience. A critical issue concerning the image of nursing is gender, in which stereotypes of nurses as angels or sex objects are common, together with perceptions that nurses, as females, are subordinate to doctors (Jinks & Bradley, 2004; Meadus & Twomey, 2007; Mooney, Glacken, & O’Brien, 2008). These stereotypes pervade societal views, and consequently affect the amount of workers that remain in the profession (Fletcher, 2007) or leave it (McLaughlin, Muldoon, & Moutray, 2010). A Turkish study reported that ‘male students are negatively affected by societal images of nursing’ (Karabacak et al., 2012, p. 542). Another study found male nursing students in Turkey had difficulty accepting the image of men as nurses and had stereotypes about the role of carers (Kulakac et al., 2009). These results are consistent with a Canadian study, which showed that non-nursing male students perceived that ‘nursing is a more suitable career choice for women than men’ (Bartfay, Bartfay, Clow, & Wu, 2010, p. 5). Similarly, a study by Meadus and Twomey (2011, p. 269) revealed that males remain a minority in the profession because nursing is not perceived as a ‘suitable career choice for men’, and this perception resulted from a gender bias perceived in nursing education, practice areas and society in general. Students’ images of nursing play a role in their choice of nursing as a profession (Grainger & Bolan, 2006). Several studies have examined why students choose nursing. The primary reason is the desire to care for and help others (Buerhaus, Donelan, Norman, & Dittus, 2005; Dal, Arifoğlu, & Razi, 2009; Day et al., 2005; Eley, Eley, Bertello, & Rogers-Clark, 2012; Jirwe & Rudman, 2012; Mooney et al., 2008; Somers, Finch, & Birnbaum, 2010). Male participation is motivated by several factors primarily related to employment (Kulakac et al., 2009), job security and high income (Meadus & Twomey, 2007). Furthermore, Mooney et al. (2008, p. 387) proposed that ‘nursing instructors should have a clear idea about why students choose the profession and who or what is influential in these choices’. Despite these studies, it is still important to analyse and understand how perceptions and attitudes differ across cultures and individual values and beliefs. Perceptions of nursing students about nursing are also important for the development of the profession in Turkey. Since the adoption of the 2007 Nursing Law, male students entering the baccalaureate degree are challenged with adaption (Kulakac et al., 2009). More research is required concerning academic requirements, clinical experience and perceptions and attitudes of nursing

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by male and female students (Karabacak et al., 2012). The more educators understand student perceptions, the more easily they can satisfy student expectations and needs and employ effective strategies to develop the profession. These concerns motivated this qualitative study to understand the image of nursing in Turkish society by investigating student perceptions and the reasons students chose nursing as a career.

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Methods Design A qualitative approach using focus groups was chosen, as it is the most appropriate method to describe nursing students’ values, attitudes and behaviours. This method also allows students to express their feelings and perceptions freely and empowering them to use their own words (Cohen, Manion, & Morrison, 2011; Jayasekara, 2012). The focus group technique was also chosen because it is inexpensive, flexible, cumulative, elaborative, assistive in information recall and capable of producing rich data (Speziale & Carpenter, 2003). Focus groups are popular in health and nursing research (Jayasekara, 2012). Moreover, focus groups can clarify individual participants’ thoughts because they facilitate investigation by research questions, and listening to other participants can stimulate the memories, perceptions and experiences of all students in the group (Cohen et al., 2011).

Participants A purposive sampling method was employed to analyse the perceptions, attitudes, beliefs and cultural perspectives of those students entering the nursing program at the target nursing school. First-year students in their second week of the semester were invited to participate before they commenced the Fundamentals of Nursing course. Participants were selected according to their willingness to participate. An invitation was extended to all students, who were also informed that their participation or non-participation would not affect grades or progress. All participants were therefore volunteers, and a cohort of 31 students comprised the sample. The mean age of the participants was 18.58±0.88. Gender distribution was 64.5% female and 35.5% male. In regard to their first choice preference for tertiary education following the General University Entrance Exam, 48.4% preferred nursing; 12.9% preferred engineering, teaching and physiotherapy; 9.7% preferred medicine and 3.2% preferred the military academy. Concerning the participants’ socio-economic status, 35.5% described their family income status as lower, whereas 64.5% stated intermediate.

Ethical considerations Ethical approval was granted by the Pamukkale University Ethics Review Committee, and both verbal and written permission were obtained from participants by the first author before group interviews commenced. Students were informed that interviews would be tape-recorded, participation was voluntary, and that they could leave the study at any time. In the presentation of results, participant comments remain anonymous.

Data collection A semi-structured interview form was used as the data collection tool and included three initial open-ended questions: (1) Why did you choose nursing as a career?; (2) What did others

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(parents, relatives and friends) think when they learned you intended to be a nurse?; and (3) What do you think about nursing? During the interviews, unstructured prompts and probing questions were used, ‘How did you feel about that’ or ‘Can you tell me more about that?’ These questions helped to reduce both researcher and informant anxiety and elaborate important contextual details embedded in each participant’s narrative. Distractions and indications of approval or disapproval of responses by researchers were avoided (Cohen et al., 2011). During the interviews, the first author acted as a moderator, and the second author observed and recorded participant behaviour to enhance data reliability. To avoid bias, all student responses and researcher observations were recorded. Throughout the interview process, the researcher allowed students to speak freely and discuss ideas and thoughts. Socio-demographic data were collected using a questionnaire developed by the authors. It included questions about age, gender, educational preferences and socio-economic levels. Qualitative data were gathered using three focus group interviews. The focus groups comprised nine or 11 students, and sessions lasted no longer than 60 minutes. Each group included 4–5 males. Focus groups were conducted in a quiet, comfortable classroom after normal school hours. Seating was circular, so all students could see and hear each other easily. None of the participants opposed the tape recording of sessions, and tapes were immediately transcribed verbatim.

Data analysis The data were analysed using thematic content data analysis (Cohen et al., 2011). The transcription paper had a wide margin for coding and categorising, and observations included participant behaviour, laughter and notes about pauses and emphasis. While listening to the tape ‘who says what’ was noted. Paragraphs and sentences were coded, themes were determined, and categories were established. This process was repeated with each focus group interview, and the transcripts were compared. Two researchers experienced in qualitative research and nursing education analysed the transcripts independently, reached a view on the perceptions of students, and determined themes and categories. These conclusions were discussed, and final themes were determined. All statements within each theme were cross-checked for accuracy after content analysis.

Results The findings obtained from the interviews were grouped into three main categories of ‘choosing’, ‘others’ reactions’ and ‘the image of nursing’.

Category 1: choosing The most common motivation for choosing nursing was the desire to help individuals, satisfactory income and guaranteed employment, and the effect of family members and friends.

Desire to help Most of the participants expressed that the desire to help individuals motivated them to choose nursing. Participants (both genders) mentioned being helpful to others. For example, ‘I think only people who like helping others can do nursing. Additionally, I’m happy to help people. This was the biggest factor in my choice’ (Male).

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Satisfactory income and guaranteed employment Some of the participants stated they chose nursing because of the financial opportunity and that it did not require high scores in the University Entrance Exam, career prospects were good and it provided guaranteed employment. Nearly all male and a small amount of female students reported they chose nursing because they thought they would find a job easily. For example, ‘I had never wanted to be a nurse. I chose the profession just because its income is satisfactory and I did not want to be unemployed’ (Female).

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Effect of family members and friends Participants indicated that family members and friends believed nursing offered a good job opportunity and required low scores on the University Entrance Exam. Typical comments were, ‘My family encouraged me to become a nurse. Initially, I was unwilling … I was afraid of this profession. My family inspired me positively [about nursing]’ (Female). ‘My friends were the most significant factor in my decision. Most of them said that it had good career prospects and only required low scores’ (Male). Some parents encouraged or even forced their children to become a nurse because of their own positive nursing experiences in the past. Generally, female students reported that they chose nursing because of parental encouragement, ‘I thought that nursing was not for me. My parents forced me a little. They made the choice for me’ (Female). Some males were also reluctant, ‘My father chose nursing for me [said in a shy manner]. Nursing was a different and unknown profession for me. After some investigation, I then wanted, [it] too’ (Male).

Being in a health-related profession In Turkey, students must achieve the required grade on the University Entrance Exam to enter their preferred discipline. In our study, less than 50% ranked nursing as their first preference; some preferred medicine but did not achieve the required grade. As a health-related profession closely related to biology, nursing was then preferred, ‘I had always wanted to study medicine, but, I failed. I chose nursing. It is also a health discipline’ (Female).

Category 2: others’ reactions Response The public image of nursing reflects itself in the reactions of students. A large proportion of female students’ parents reacted positively when their children gained the right to attend a nursing program. Male students’ parents initially reacted negatively but later supported their children. For example, ‘My father wanted me to study civil engineering. However, he was really happy when he learned that I was going to be a nurse. I had never expected he would be so happy’ (Male). Male students generally stated that friends and relatives were not pleased by the news they had qualified for a nursing program, and initially, they were confronted with disbelief and teasing. For example, ‘My circle of relatives was shocked. None of them believed it. They expected me to become an engineer. They told me to check if it was true or not, I told them it was, but they asked again since they could not believe it. Their first reaction was to laugh’. Another said, ‘When I first learned I had been accepted on to a nursing program, I went to my old school. When I told them, all the teachers started laughing and were surprised how a man like me could choose such a profession. I will never forget that moment … . My grandfather said ‘well

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done, you won [a place]’ … But, I understood what he really felt by his face. He underestimated [the profession]; he thought nursing didn’t suit me’. Some females reported similar responses, ‘Initially their faces … I mean … changed. They said “nursing?”’ Among the cohort of the study, parents of female students preferred their children to be a teacher, architect or doctor, whereas parents of male students preferred engineering, sports, teaching or medicine.

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Category 3: the image of nursing Two sub-categories emerged in themes related to the image of nursing: job description and gender.

Job description Participants described nursing as a caring, humanitarian and challenging profession. Participants also believed that although nursing was a respected and honourable profession crucial to the wellbeing of society, it required good character and perseverance. For example, ‘Nursing means helping individuals, [it requires] attention, patience, and self-sacrifice’ (Female); ‘In the city I live in, a nurse is respected more than a doctor … Nurses are always good-humored’ (Female). Participants also reported that bad experiences with some nurses affected their perceptions of them as sour-faced individuals who never smile, ‘There is a certain image … Nurses are strict, grumpy, indifferent, and battle-axes’ (Female). Concerning working conditions, students perceived that nursing was associated with challenges, risks and ‘dirty tasks’ because of exposure to disease and washing patients, and night shifts and long hours could lead to burnout. One participant said, ‘It seems that nurses have to address very dirty things since their subjects are patients and microbes’ (Female). Some participants stated that nurses were perceived as intermediate staff, and their contribution to patient care and therapeutic outcomes was undervalued, ‘Our society has intractable biases about nursing … Nurses are subordinate to doctors … they give injections as though they have no other duties’ (Female); ‘They do not get the respect they deserve’ (Male).

Gender Male participants were particularly concerned that gender issues regarding nursing were derived from the meaning of ‘nurse’ in Turkish, hemsire, (sister) because this meaning led to the perception that nursing is a female profession. Males reported this factor was the most disturbing aspect of entering the profession: Nurses are always women (laughing). ‘Nurse’ is feminine … Because of the name [hemsire] male students are the derided by other people … It is better to change the name. It will be the beginning of the future for males in the profession. (Male) Nursing is a female profession and males cannot become a nurse. For example, if a patient is waiting for a nurse, he would expect a female. When he finds it is a man (laughing) … he would be shocked. Maybe it would be funny to see the amazement on the face of the patient … but maybe I would feel anxiety in that situation. (Male)

Although most female participants did not comment on the issue of hemsire, some said that they were surprised at the amount of male students, ‘I was surprised. I thought one or two men would prefer nursing, but when I [arrived] at the classroom [ … ] nearly a quarter of the class was male.’

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Most male participants reported that the image of nurses, as attractive mini-skirted females, was created by the media, especially in film and music clips. These perceptions have adverse effects on male students. Whereas Turkish films about hospitals have focused on male doctors, male and female students reported they only saw nurses in the media as stereotyped females on music clips. As one male said, ‘My friends and family found it strange that I wanted to become a nurse. Especially [the] dress code. They asked, “Will you wear a cap? Will you wear a skirt?”’. A female also commented on sexualised images of nurses in video clips, ‘Nurses show their décolletage, wear mini-skirts, and hold syringes in their hands.’ Additional perceptions of gender issues concerned characteristics believed to be inherent in males and females. Students said that nurses were perceived as more suited to nursing because they were considered attractive, caring and self-sacrificing. One male remarked on the physical strength of males, ‘Females are a bit fragile. When lifting and turning patients (males) will in the foreground … While working, you have to be available for everything.’

Discussion This qualitative study was conducted to explore the perceptions of nursing as a profession and what motivated students to choose nursing as a career.

Category 1: choosing The primary reasons for choosing nursing were the desire to help, satisfactory income and job security. We found that altruistic motivations, which include curing patients, making a difference in patients’ lives and experiencing efficacy that comes from helping others, were consistent with previous studies (Eley et al., 2012; Eman et al., 2012; Somers et al., 2010). Other participants chose nursing because it is a health-related profession in the same category as medicine, and this finding is consistent with Dal et al. (2009). Financial motivation, availability of work and job security were also common motives for pursuing nursing as a career (Demiray, Bayraktar, & Khorshid, 2013; Kulakac et al., 2009). Students in Bahrain also perceived nursing as a caring and humanitarian profession (Eman et al., 2012). However, Jirwe and Rudman (2012, p. 1618) classified different motives for entering the nursing profession as ‘genuine interest’, ‘practical reasons’ and ‘default choice’. The authors interpreted ‘practical reasons’ as a more controlled motive than ‘genuine interest’. This perception is important because the authors found that whether motivation is autonomous or controlled affects professional development and health. All participants in our cohort stated that they were from low or intermediate socio-economic levels, and this practical motivation influenced their choice. Access to employment was an important factor in determining the choice of nursing as a profession in this lower socio-economic cohort. Moreover, we considered that the perception in Turkey that nursing is a low-status profession acted as a deterrent for attracting students from upper-level socio-economic backgrounds. This view is consistent with Karabacak et al. (2012, p. 543), who in their qualitative study in Turkey, found that ‘nursing students experienced problems arising from the low-status perception’ of the profession. According to Herdman and Badir (2008), given the low status of women in Turkey, it is not surprising that nursing is perceived as a low-status profession. Another practical motivation by participants in our study was choosing nursing because it did not require high entry scores. As Day et al. (2005) found, people commonly perceive that nursing has low entry requirements. Although the majority of participants in our study identified the desire to care for others as one of the factors in their choice of nursing, fewer than 50% selected nursing as a first career choice. Most stated that nursing was a default choice. Participants’ first choices

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were engineering, teaching, physiotherapy, medicine and the military, which is consistent with other studies (Kulakac et al., 2009; Mooney et al., 2008). Concerning autonomy of choice, our study showed that family and friends were very powerful motivators. This finding is consistent with a Jordanian study, which showed that society and family greatly impacted students’ choice of nursing as a profession (Al Jarrah, 2013). In our study, encouragement from fathers was especially important. Despite the gender bias against males who chose nursing, fathers were motivated to recommend it because, in a country where finding work is difficult, nursing offers secure employment and the barriers to entry are low. Unlike Sweden, where the opinions of family members have little impact on student preferences for nursing (Jirwe & Rudman, 2012), fathers in Turkey have a great impact on student choice, and this factor can be advantageous to male students because Turkey is a patriarchal society. The major factor that motivated autonomy in choice was from relatives or friends who are nurses or in a health-related discipline. This finding is consistent with studies in other countries (Dal et al., 2009; Day et al., 2005; Mooney et al., 2008).

Category 2: others’ reactions Participants in our study encountered negative reactions from relatives and others. Male participants in particular encountered teasing. This finding is consistent with Mooney et al. (2008) who reported that teasing of male students is widespread and that male students have a sense of inferiority and shame. Due to traditional perceptions of nursing as a female profession, male students can be confronted by reactions of surprise or shock (Karabacak et al., 2012; Wang et al., 2011). Wang et al. (2011) showed that male students encountered social pressures, and participants reported feelings of loneliness and psychological stress. Meadus and Twomey (2007, p. 13) concluded that ‘sexual stereotypes, no history of men in nursing, textbooks referring to the nurse as “she”, lack of male role models in the media and patients’ preferences for female nurses are some barriers male nurses encounter during their educational life’. Studies also showed that these barriers may result in males leaving the program (McLaughlin et al., 2010; Meadus and Twomey, 2007). Kulakac et al. (2009) found that teasing is a result of the perceived image of nursing.

Category 3: image of nursing Consistent with other studies, although students reported that nursing is a respected profession and important to society (Eman et al., 2012; Wang et al., 2011), negative perceptions remain. As Eman et al. (2012) found, nursing is also considered a tough job and is not well accepted socially with cultural issues impacting the values attached to nursing as a career. This perception is important because as Milisen et al. (2010) found in a Belgium study, the public perception of nurses is negative, and students are negatively affected, frustrated and disturbed by this image. Students in our study reported that nurses were still stereotypically perceived as ‘intermediate staff or the doctor’s handmaidens’, and this view reflects societal prejudices. Other studies have reported that nurses are perceived as individuals responsible for the care-related requirements of patients, helping doctors and obeying their orders (Al Jarrah, 2013; Day et al., 2005; Kulakac et al., 2009). Karabacak et al. (2012, p. 540) found the societal perception that ‘nurses are doctors’ assistants’. Karaoz (2004, p. 131) determined that nursing students perceived that they were ‘bound to doctors’ and define nursing duties ‘as taking blood, giving medication and applying treatments suggested by the doctor’. Concerning gender, students in our study agreed that media typecasting of nurses influence societal perceptions of nurses as ‘attractive, mini-skirted women’ – ‘a woman with a syringe in her hand’. This finding is consistent with

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Karabacak et al. (2012). Bartfay et al. (2010) also found that nursing and non-nursing students of both sexes cited media portrayal of nurses as female discourages men from entering the profession. As in other countries, societal perceptions and gendered stereotypes towards male nurses as carers prevail (Bartfay et al., 2010; Kulakac et al., 2009; McKinlay, Cowan, McVittie, & Ion, 2010). For example, despite a large population of available males in China, Wang et al. (2011) indicated that it is not socially acceptable for men to enter the nursing profession. Of particular concern to male students in Turkey is the word hemsire (sister). Kulakac et al. (2009) also found that students suggested that the name be changed to something more masculine. Turkey follows a patriarchal culture, and nursing is primarily seen as a female-dominant profession (Ozdemir, Akansel, & Tunk, 2008). However, unlike other studies (Kulakac et al., 2009), participants in our study did not consider that it would be inappropriate for a male nurse to care for their female relatives. As McKinlay et al. (2010) found, students can choose to reproduce or challenge stereotypical constructions of male nurses by challenging gender-based perceptions that are problematic to male nursing. Gender-based perceptions of masculinity can also work against Turkish men because it is believed that men are physically stronger than women. Some male students reported that their strength would assist in providing better patient care (Ozdemir et al., 2008). This view is problematic because a Canadian study showed that ‘participants felt discriminated against by nursing staff solely because of their gender as “muscle” to lift or move patients and at times to offset or control potential violent situations’ (Meadus & Twomey, 2011, p. 275). The introduction of the Nursing Law of 2007 is a positive advance for nursing in Turkey. The acceptance of males by nursing schools requires the profession to better understand societal perceptions.

Limitations of the study A limitation of the study is that its qualitative findings cannot be generalised to all nursing schools in Turkey. Another limitation is that the sample was limited to volunteer nursing student participants. The study focused on student perceptions at the beginning of the course before they had studied the philosophy of nursing or psychomotor skills for nursing. We also did not identify male students’ experiences and perceptions during or after clinical practice. Finally, the selfreporting nature of the study could have led to bias because participants might have responded in a socially desired manner.

Conclusion and implications for nursing practice Consistent with other studies, students’ perceptions of the image of nursing and the reasons they choose to enter the profession in Turkey have positive and negative aspects. Some aspects of particular concern in Turkey may be relevant to other countries. Stereotyped images of nurses as subordinate females are grounded in cultural prejudice. Increasing amounts of male nurses and educators will strengthen the status of the profession. However, the discipline should continue to challenge gender-biased perceptions. For male and female nurses to be successful, they should have a clear idea of their role. Nurse instructors should continue to analyse why students choose or do not choose nursing and accordingly devise curricula to meet these requirements. Nurse educators should continue to examine students’ perceptions of nursing so they can equip them to change public perceptions. Although the participation of males will positively affect this image, the contribution of male nurses requires a higher profile. For advancement in nursing to contribute further to the health system in Turkey, further research is recommended to better understand how perceptions of the profession affect the

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recruitment and retention of male and female students. Research should be broadened to identify the male student experience during and after clinical practice.

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References Al Jarrah, I. A. T. (2013). Associate nursing students’ perceptions toward nursing profession in Jordan. European Scientific Journal, 9, 147–166. http://eujournal.org/index.php/esj/article/view/822 Bartfay, W., Bartfay, E., Clow, K., & Wu, T. (2010). Attitudes and perceptions towards men in nursing education. Journal of Allied Health Sciences and Practice, 8, 1–7. http://ijahsp.nova.edu Buerhaus, P. I., Donelan, K., Norman, L., & Dittus, R. (2005). Nursing students’ perceptions of a career in nursing and impact of a national campaign designed to attract people into the nursing profession. Journal of Professional Nursing, 21, 75–83. doi:10.1016/j.profnurs.2005.02.001 Cinar, N., & Altun, I. (2010). Nursing in Turkey: Its advances and challenges. Revista Eletrônica de Enfermagem [Internet], 12, 233–234. doi:http://dx.doi.org/10.5216/ree.v12i2.10226 Cohen, L., Manion, L., & Morrison, K. (2011). Research methods in education (7th ed.). New York: Routledge. Dal, U., Arifoğlu, B. C., & Razı, G. S. (2009). What factors influence students in their choice of nursing in North Cyprus? Procedia – Social and Behavioral Sciences, 1, 1924–1930. doi:10.1016/j.sbspro.2009. 01.338 Dal, U., & Kitis, Y. (2008). The historical development and current status of nursing in Turkey. OJIN: The Online Journal of Issues in Nursing, 13(2). doi:10.3912/OJIN.Vol13No02PPT02 Day, R. A., Field, P. A., Campbell, I. E., & Reutter, L. (2005). Students’ evolving beliefs about nursing: From entry to graduation in a four-year baccalaureate programme. Nurse Education Today, 25, 636–643. doi:10.1016/j.nedt.2005.09.003 Demiray, A., Bayraktar, D., & Khorshid, L. (2013). Erkek hemşirelik öğrencilerinin hemşireliği seçme nedenleri ve bu mesleği seçme nedeniyle yaşadıkları sorunlar (The reasons for choosing nursing profession and experienced problems of male nursing students). International Journal of Human Sciences, 10, 1440–1455. (Original work published in Turkish). http://www.j-humansciences.com/ojs/ index.php/IJHS/article/view/2439#.Uk6nt55rOPw Eley, D., Eley, R., Bertello, M., & Rogers-Clark, C. (2012). Why did I become a nurse? Personality traits and reasons for entering nursing. Journal of Advanced Nursing, 68, 1546–1555. doi:10.1111/j.1365-2648. 2012.05955.x Eman, T., Seamus, C., & Edgar, A. (2012). A triangulation study: Bahraini nursing students’ perceptions of nursing as a career. Journal of Nursing Education and Practice, 2, 81–92. doi:10.5430/jnep.v2n3p81 Fletcher, K. (2007). Image: changing how women nurses think about themselves. Literature review. Journal of Advanced Nursing, 58, 207–215. doi:10.1111/j.1365-2648.2007.04285.x Grainger, P., & Bolan, C. (2006). Perceptions of nursing as a career choice of students in the Baccalaureate nursing program. Nurse Education Today, 26, 38–44. doi:10.1016/j.nedt.2005.06.004 Herdman, E., & Badir, A. (2008). Gender equality or patriarchal dividend: Structural change in Turkish nursing. Nursing and Health Sciences, 10, 159–163. doi:10.1111/j.1442-2018.2008.00384.x Jayasekara, R. S. (2012). Focus groups in nursing research: Methodological perspectives. Nursing Outlook, 60, 411–416. doi:10.1016/j.outlook.2012.02.001 Jinks, A. M., & Bradley, E. (2004). Angel, handmaiden, battleaxe or whore? A study which examines changes in newly recruited student nurses’ attitudes to gender and nursing stereotypes. Nurse Education Today, 24, 121–127. doi:10.1016/j.nedt.2003.10.011 Jirwe, M., & Rudman, A. (2012). Why choose a career in nursing? Journal of Advanced Nursing, 68, 1615– 1623. doi:10.1111/j.1365-2648.2012.05991.x Karabacak, U., Uslusoy, E., Alpar, S. E., & Bahcecik, N. (2012). Image of nursing held by nursing students according to gender: A qualitative study. International Journal of Nursing Practice, 18, 537–544. doi:10.1111/ijn.12008 Karaoz, S. (2004). Change in nursing students’ perceptions of nursing during their education: The role of the Introduction to nursing course in this change. Nurse Education Today, 24, 128–135. doi:10.1016/j.nedt. 2003.10.010 Kulakac, O., Ozkan, I. A., Sucu, G., & O’Lynn, C. (2009). Nursing: The lesser of two evils. Nurse Education Today, 29, 676–680. doi:10.1016/j.nedt.2009.02.012 McKinlay, A., Cowan, S., McVittie, C., & Ion, R. (2010). Student nurses’ gender-based accounts of men in nursing. Procedia Social and Behavioral Sciences, 5, 345–349. doi:10.1016/j.sbspro.2010.07.102

Downloaded by [Chinese University of Hong Kong] at 21:39 12 November 2015

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McLaughlin, K., Muldoon, O. T., & Moutray, M. (2010). Gender, gender roles and completion of nursing education: A longitudinal study. Nurse Education Today, 30, 303–307. doi:10.1016/j.nedt.2009.08.005 Meadus, R. J., & Twomey, J. C. (2007). Men in nursing: Making the right choice. Canadian Nurse, 103, 13– 16. http://www.canadian-nurse.com/ Meadus, R. J. & Twomey, J. C. (2011). Men student nurses: The nursing education experience. Nursing Forum, 46, 269–279. doi:10.1111/j.1744-6198.2011.00239.x Milisen, K., Busser, T. D., Kayaert, A., Abraham, I., & de Casterle, B. D. (2010). The evolving professional nursing self-image of students in baccalaureate programs: A cross-sectional survey. International Journal of Nursing Studies, 47, 688–698. doi:10.1016/j.ijnurstu.2009.11.008 Mooney, M., Glacken, M., & O’Brien, F. (2008). Choosing nursing as a career: a qualitative study. Nurse Education Today, 28, 385–392. doi:10.1016/j.nedt.2007.07.006 Ozdemir, A., Akansel, N., & Tunk, G. C. (2008). Gender and career: Female and male nursing students’ perceptions of male nursing role in Turkey. Health Science Journal- International Journal of Nursing Research and Review, 2, 153–161. http://www.hsj.gr/volume2/issue3/5GENDER_AND_CAREER_ 153_161.pdf Somers, M. J., Finch, L., & Birnbaum, D. (2010). Marketing nursing as a profession: Integrated marketing strategies to address the nursing shortage. Health Marketing Quarterly, 27, 291–306. doi:10.1080/ 07359683.2010.495306 Speziale, H. J. S., & Carpenter, D. R. (2003). Qualitative research in nursing, advancing the humanistic imperative. Philadelphia: Lippincott Williams & Wilkins. Wang, H., Li, X., Hu, X., Chen, H., Gao, Y., Zhao, H., & Huang, L. (2011). Perceptions of nursing profession and learning experiences of male students in baccalaureate nursing program in Changsha, China. Nurse Education Today, 31, 36–42. doi:10.1016/j.nedt.2010.03.011

Nursing as career choice: perceptions of Turkish nursing students.

Students' perceptions of nursing influence their choice of nursing as a career and whether they remain in the profession. The aim of this study was to...
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