The Professionalization of Nursing: New Zealand as a Case Study

Nursing has often been regarded by sociologists, the medical profession and even nurses themselves, as an occupational grouping which is semi - rather than fully - professionalised. This study is concerned with recognising the ‘professional project’ that has been undertaken by New Zealand nurses and assesses their progress towards professionalization by addressing two key research questions. Firstly, what are the historical and contemporary mechanisms by which nursing has attempted to secure professional status in New Zealand? Secondly, how do nursing organisations and nurses themselves seek to maintain and enhance their professional status? This study presents a review of historical and sociological literature with regard to nursing to portray its evolution from the colonial settlement of New Zealand until the present. Within the New Zealand context the professional project undertaken by nurses appears to have a proud history, and New Zealand nurses were the first in the world to achieve legislated registration. Despite this early recognition, progress towards achieving full professional status by this female dominated occupation has historically faced challenges from its male dominated counterpart in the form of the medical profession. The strength of nursing organisations and the establishment of formal nursing education have been two of the historical means by which professionalization for New Zealand nurses has been advanced. In order to examine contemporary perceptions about the processes through which nursing has been professionalized and how professional status is maintained, a series of eight semi-structured interviews were undertaken with a purposive sample of key informants from the state sector, nursing organisations and nursing educators. A qualitative analysis of the data collected showed that both nursing organisations and tertiary level qualifications had contributed to the achievement of professional status. The professional project had also been accelerated through working partnerships between nursing organisations and external stakeholders, as well as the establishment of standards that defined scopes of practice and codes of ethics. A diminishing public health budget and the increased presence of unregulated health workers were considered to be key threats to maintaining the professional status of nursing. This research concludes that despite the impression given by the international sociological literature that nursing is a semi-profession, nurses in New Zealand fulfil the claim to full professional status through their association with an exclusive body of knowledge, their ability to self-regulate and operate with a high degree of professional autonomy, as well as external recognition as a profession. However, professional status is dynamic, rather than fixed, and nurses will continue to strategically maintain and renegotiate their status in the face of future challenges