Letter to the Editor
Article Outline
To the editor:
I read with interest the article by Dr. Kristine Gebbie, “20th century reports on nursing and nursing education: What difference did they make?” (Nursing Outlook 2009;57(2): 84–92). Although I think that Dr. Gebbie's careful review of previous reports on nursing education is of importance to the profession, I disagree with her conclusion that “nursing may remain in its rut until it can accept the recommendations for full professionalism.”1 She appears to be saying that nursing is to blame for not acting on the recommendations as did medicine, and suggests that this is because we are an oppressed group. I agree that nursing has a history of oppression and powerlessness, but would suggest that it is exactly because we have not had power and privilege that our history is different, not because there is something inadequate about us.
Of interest is that powerful foundations and benefactors funded the development of the medical schools chosen as having potential after the Flexner report called for closing marginal schools and improving those affiliated with major universities.2 Nursing did not have this level of privilege and financial assistance to assist in the change and, in fact, it can be argued there was resistance from the powerful forces, such as other professions, hospitals, and educational institutions to nursing becoming an empowered, educated profession.3 Many groups and institutions have benefited from a large, varied workforce of nurses with variable educational backgrounds.
My view is that nursing has fought vigorously over its history against many powerful forces who have benefited from keeping nursing powerless and under the control of other professions and hospitals. Lynaugh and Fagin have pointed out that nursing has much to be proud of when they learn the history of nursing: “This confluence of paradoxes, problems, and characteristics of nursing development can be responded to in two ways. One is to bewail our failures and accept the inevitability in the face of an historically hostile environment. The other is to wonder at and celebrate the accomplishments of nurses, mostly of the wrong sex and class, who have the wrong history and education, who persist and achieve in spite of being held back by some of the most powerful forces in our society.”4
I believe that Gebbie's conclusion risks bewailing our failures, instead of pointing out the multiple forces external to nursing that have pushed back against the efforts of nursing to progress in a way that she feels would be more beneficial. Those groups (ie, community colleges, manpower development agencies, other educational organizations, and hospitals) have benefited from having registered nurses (RNs) educated at multiple levels. The message of oppressed group behavior theory, as it relates to nursing and other historically powerless groups, is not to “blame the victim” but rather to promote analysis and understanding of the variables that have made it very difficult for dominated groups to make change on their own behalf. A more in-depth analysis of this history would benefit nursing's understanding of how to move forward into the future rather than reinforcing the myth that nursing is responsible for the lack of progress of the profession. I agree with Dr. Gebbie that more analysis of this history would greatly assist the progress of nursing education.
References
- . 20th century reports on nursing and nursing education: what difference did they make?. Nurs Outlook. 2009;57:84–92
- . American Medical Education. Westport, CT: Greenwood Press; 1976;
- . Oppressed Group Behavior: Implications for Nursing. Adv Nurs Sci. 1983;5(3):21–30
- . Nursing comes of age. Image. 1988;20(4):184–189
PII: S0029-6554(09)00144-4
doi:10.1016/j.outlook.2009.08.006
© 2010 Mosby, Inc. All rights reserved.
