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Sylva Bártlová PRESTIGE OF THE NURSING PROFESSION IN THE CZECH REPUBLIC The role of the nurse underwent a complicated development in the past but even today it has been changing considerably. After entering into EU a lot of changes are required within the nursing profession in the Czech Republic. In non-medical health professions regulated by EU especially harmonisation of the legislation is required which includes also standardisation at national level. The structural standards include among others also the educational standard. Ever growing stress is being laid upon increasing of the quality of nursing education programs which will provide the nurses with the possibility of free movement and comparability, for instance within the European Union. Higher degrees of education are usually associated with increased prestige of the profession. Adopting the role and adaptation to new functions and responsibilities and to new patterns of behaviour depend to a considerable extent on social evaluation of the profession. In the research made by the Centre of Empirical Research of the Academy of Sciences of the Czech Republic in cooperation with the Institute of Theory and History of Science in Prague in 1990 which investigated and evaluated prestige of 50 professions, the nurse ranked ninth (10th place: miner, 13th place: research engineer, 14th place: lawyer, 18th place: designer). Ranking the nurse before university educated and art professions and before all technical and blue-collar professions is quite surprising. On the other hand, in the international scale of prestige where all the professions were given from 100 to 0 points the nurses are in the middle of the scale together with journalists, teachers and computer programmers (they were given 53–55 points). It is obvious that based on these searches it is not possible to draw simplified conclusions concerning real social prestige. Their reliability should be verified by further research. Presumably, the social evaluation of the nursing profession has been changing due to changes taking place within the health care system. Also the way how the nurses themselves evaluate the prestige of their profession is important. Perception of social evaluation of one’s own profession is an important indicator of the relation to the profession. This is the reason why in our research “Changes in the nursing profession at the beginning of the new millennium” we focused, among others, on the issue of prestige of nurses in the Czech Republic. Methods The field investigation was made using the technique of structured interview of the inquirer with the respondent. The data collection was made by a group of inquirers INRES-SONES. Altogether 384 inquirers were involved in the research all over the Czech Republic. They were given a detailed instruction prior to the beginning of the research. Statistical processing of the data was made using the SPSS programme. The first stage of classification was processed as well as the contingency tables of the second stage of classification. The rate of dependency of the selected characteristics was determined based on chí square test and other test criteria (according to the type of the characteristic). Altogether 1040 nurses from all over the Czech Republic were included in the research sample. They were selected using a proportional random sampling method. The composition of the sample regarding the region and place of work was chosen so that it might correspond to the structure of the basic population of nurses in the CR. The parameters of the sample were constructed based on the data from the Institute of Health Information and Statistics of the Czech Republic valid as of 31st December 2002. According to the methodology of the Institute of Health Information and Statistics of the Czech Republic, the sample of nurses included the following categories: general nurses, paediatric nurses, gynaecologic nurses (midwives), dieticians, physiotherapists and others. The sample did not include public health assistants, health laboratory technicians, pharmacy laboratory technicians, radiology technicians and dental technicians. As the basic characteristic of representativeness of the sample, the number of nurses in the individual regions of the Czech Republic was taken. The regions were defined based on the administrative division valid since 1st January 2001. Within the research the nurses from all regions of the CR were addressed and their representation proportionally corresponds to the structure of the basic population of nurses. We may say that the deviation from the basic population does not exceed 0.5%. The conclusions of the research are representative for the nurses in the Czech Republic in term of the individual regions. The second characteristic where representativeness was followed was the type of the workplace where the nurses work. From this point of view the sample consisted of the nurses working in hospitals (both university hospitals and others), in out-patient facilities and other facilities (health spas, sanatoriums, home care). The structure of the sample according to this characteristic is given in table I. Table I. Composition of the sample of nurses according to the type of their workplace
1) including out-patient departments in hospitals Also from this point of view the structure of the sample corresponds to the composition of the basic population of nurses (maximum deviation being 1.0%), thus the results of the research are representative for the nurses in the Czech Republic according to the type of facility where they work. Other social and demographic characteristics identified among the nurses within the research were not determined as representative. Evaluation of the social prestige of the nursing profession Prestige is usually defined as a specific manner of positive evaluation, appraisal and esteem which is paid to persons, objects, social positions, etc. In contemporary sociology, prestige is usually derived from a profession which is pursued by a group of persons. Sometimes, especially in Anglo-Saxon literature, esteem is distinguished from more gene-ral, sociologically more relevant and more abstract prestige. Esteem is linked with a concrete person and expresses how people evaluate behaviour of another individual in his/her social position and in playing his/her social roles. Perception of social prestige of one’s own profession is an important indicator of the relation to the profession. As part of the research we investigated the attitude of nurses to social prestige – respectability of the nursing profession in the Czech Republic. The nurses evaluated the prestige using the standard scale with the following responses: very high, rather high, average, rather low, very low. Overwhelming majority of nurses think that social prestige – respectability of the nursing profession in the Czech Republic is average (48.4%) or rather low (34.7%). The mode and the median have the value of 3, the weighted mean is 3.4 – it means that nurses incline rather to the evaluation “lower average” and more often choose those values on the scale which negatively appraise the social prestige of their profession. Fig. 1. Opinions concerning the social prestige of the nursing profession N = 1037. [not available online] It is interesting that younger nurses aged 18–34 more often choose the evaluation rather high while the nurses aged 45–59 more often label the social prestige of their profession as average. As far as the length of practice is concerned, the nurses with practice shorter than 3 years more often perceive the social prestige of their profession as rather high. For perception of the prestige of one’s own profession it is important neither in which type of a health care facility (hospital, health spa, sanatorium, doctor’s office, etc.) the nurse has been working, nor at which department she is employed. No statistically significant differences in evaluation of prestige of their profession were found between the nurses working in state-owned and private health care facilities. The level of education has no influence upon perception of social prestige of the nursing profession either. The evaluation of social prestige of the profession statistically significantly corresponds to the evaluation of one’s own standard of living. The relations found are very strong. It is true that the higher standard of his/her own living the nurse mentions the higher he/she ranks the social prestige of his/her profession, and vice versa: if the standard of living of the nurse is perceived to be low also the social prestige of the nursing profession is specified as low. A similar research, though not representative, was conducted within the framework of the grant task “Transformation of the Health Care System – Monitoring of Selected Problems”. It also dealt with the prestige of nurses, namely the nurses in Pøíbram and Písek in comparison with a sample of nurses from Brno. The question in this questionnaire was as follows: “How in your opinion do other citizens evaluate the nursing profession?” The nurses ranked themselves similarly (more than 90%) as in our research. Other investigations have not been conducted yet. Conclusion In conclusion we may say that the social prestige – respectability of the nursing profession in the Czech Republic is perceived by the nurses themselves prevailingly as average or lower. In a more positive way the prestige is perceived by younger nurses practising in the profession less than 3 years and the nurses who perceive their own standard of living to be higher. Other statistically relevant relations between perception of the social prestige and social and professional characteristics were not found. The effort to increase the prestige of nurses as a social group is very closely related to the demand for university education of nurses. New conception of education of nurses according to the Czech Law No. 96/2004 Coll., which is in accordance with the EU strategy and takes into account the global trends, is led by the effort for professionalisation of the nursing profession which is connected with higher prestige of the profession. Some authors, like Freidson (1988), even maintain that nursing started to organise its education too overtly with the only intention to gain higher status in society. It is certain that nursing has increased its status as a profession and continues in it. The public and often also the health care professionals do not realise that the need for higher education of nurses has been stimulated especially by the development of medicine and by formation of new relations – it demands restructuring of the tasks of the individual members of the health care team. Also professional activities, competencies and responsibilities of the nurses are changing. The nurse is increasingly an independent expert and should be an efficient member of the health care team. REFERENCES 1. Freidson, E.: The Profession of Medicine: A Study of the Applied Sociology of Knowledge – With a New Afterword. Chicago, IL: University of Chicago Press 1988. 2. Opinions on Privatisation in the Health Care System. (Research Report) Prague: USLOZ, 1991. 3. Transformation of the Health Care System – Monitoring of Selected Problems. IGA MZ CR No. 2928–2932, Prague: Association for Research of the Health Care System, 1997.
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Professionalism and Responsibility
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Aby cytowaæ ten artyku³/To cite this article: Bártlová, S., Prestige of the nursing profession in the Czech Republic, [in:] Niebrój L., Kosiñska M., Health Care: Professionalism and Responsibility, Katowice: Wyd. ŒAM 2005, p. 45-48 |
