The evolving professional nursing self-image of students in baccalaureate programs: a cross-sectional survey

Abstract

Background: We have previously examined the professional self-image of practicing nurses in Belgium and its association with various professional decisions, however there is limited knowledge about the professional self-image of nurses-to-be. Despite prior research on nursing students' perceptions of nursing or their self-esteem, students' professional image, defined as "the way students perceive themselves in their clinical practice environment and their anticipated work environment", has not been described nor compared to that of practicing nurses.

Objective: To describe the professional nursing self-image among students in their final year of baccalaureate education.

Design: Cross-sectional survey.

Settings: Nine geographically spread baccalaureate programs in the Flemish region of Belgium.

Participants: 427 evaluable students from 455 recruited from 663 potential.

Methods: Data collected in each school during regular hours using an adapted version of the BELIMAGE (Belgian professional self-image instrument for hospital nurses) including questions on personal demographics, education and competence, nursing care, team and practice environment. Voluntary participation with returned questionnaire deemed informed consent.

Results: Respondents identified several curricular components as contributing to their perceived competence. They also identified several skills deemed important to professional nursing, however did not feel competent in all of these. Important nursing care aspects included individualizing patient care, detecting care problems and potential complications, and promoting patient well-being; within a care environment with open interdisciplinary communication, where care problems could be discussed with nursing colleagues, where one cares for the same patient regularly, and led by a team leader with vision. Society's view of nursing was generally more negative than students'. Most students planned on working in nursing after their studies and many had thought about additional education at some point. Most were proud of becoming a nurse, would recommend nursing to others, and would choose nursing again as field of study.

Conclusions: Students' evolving professional self-image was positive, rich, and enthusiastic; and higher than that observed in working nurses in a prior study. There is a significant gap between nursing care aspects deemed important and perceived competence in these areas, which has implications for both educators and future employers. Once employed, students are likely to experience differences in their perceptions of professional self-image with those of senior colleagues; another area of attention for employers.