Fall 1993 Vol 6 No 1
ISSN 1049-2259
PROFESSIONAL S OCIALIZATION AND STUDENT CULTURE 1N HOSPITAL-BASED NURSING SCHOOLS IN ~ADELPlllA
KAREN EoENES, RN, EnD The first generation of hospital-based schools of nursing were established between 1873 and 1893, when there were fewer than 200 hospitals in the United States. By 1910, 4,000 hospitals had opened. Over one fourth of these established their own nursing schools. In lhese hospitals, sludems provided most of lhe patient care. Although refonns in nursing education and changes in health-care delivery resulted in the hiring of graduate n urses, student nurses continued to work ill both staff and supervi Pi positions through Ule early 1950s. As late as 1974, 76 per cent of all active nurses beld diplomas from bospital nursing schools. The apprentic ship training ultimately outlived its usefulness. But it also had spe cial strengths. In the hospital nursing schools, young women learned responsi bil ity and commitmenlto their profession. Through the pow rful shared experience of " nurses' training," students were initiated into a "w rk cultur .. with disti n t social mores, traditions, and valu s. The training school experience bad a profound impact on tlleir practice of professional nursing.
ProfessIonal Socialization of Nursing Students The tenn "socialization" refers to the process whereby an individ ual comes to in ternalize the behaviors, knowledge, skills, and values considered necessary by those offering instruction or inOuence. Through fonnal socialization processes that i.nclude A lice Fisher Society Historical Scholar Karen Egenes reward and punishment, and imitation of (right) and Lillian Sholtis Brunner SWllmer Fellow Janna role mod Is, Ute sch 01 transfonns the indi Dieckmann (left) . vidual into one who possesses an identity and confidence in the perfonnance o f an expected role. I StudenL,> arc professionally socialized by means of institutional ri tuals, such as rules, ceremonies, and symbols. Many historians have explored Ute role of these rituals.
Center for The Study of The History of Nursing UNlVERSITY OF PENNSYLVANIA
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OOL OF Nu~ rNG
Rules Kalisch and Kalisch descdbe me importance of training-s hool rules in the so cialization of student nurses.2 For example, "hospital etiquette" fonned a centrdi theme of early ethics manuals; the prescribed rules represented a sign of respect for authority and an indication of the nursing student' s seriousn s and responsibility .) Nursing education was viewed as moral initiation: "The drilling and disciplining of the woman inside tlle nurse, the development of a right mind and right habits of life, are the most difficult as well as the most important part in the making of a nurse."4 Melosh asserts that trdining school superintendents "maintained strict con (continued on page 6)
Lillian ShoLtis Brunner SummeT Fello w Janna Dieckmann presents her slimmer research to readers o/The Chronicle on page 3.