Perception on the Nursing Profession and Career Choice of High School Students Essay

According to Wieck (2006), the nursing workforce seems to be at an exciting crossroad of change, both in recruiting and in curriculum. The environment of healthcare has changed and so has nursing, resulting in students asking, â€Å"What is nursing?† This question creates a challenge for nurse educators. In order to attract and retain bright, capable students in nursing, there must be changes in the nursing curriculum to provide and assure accurate and definitive perceptions of nursing. Factors which currently contribute to students’ perceptions of nursing must be identified in order to establish and provide students with the career making skills necessary in choosing a nursing career, find job satisfaction following graduation, and remain in nursing as a career. Peterson (2006) stated that historically, nurses have been predominantly females who were easily recognized by a white hat and uniform making the professional and the profession more visible. Today, white uniforms and hats have been replaced by vivid colored scrub suits worn by both male and female nurses. Students’ perceptions of nursing are based on visual images that are often limited to bedside care and drug administration instead of that of a highly skilled and well-educated nursing professional with an important role to play in healthcare. Foskett and Hensley-Brown (2008) suggests that students’ career perceptions are highly individual, and are the product of contracted images of jobs they see for themselves, derived images from media, and delegated images from parents and friends. The U.S. Department of Labor, Bureau of Labor Statistics (2000) lists nursing as one of the top 40 growth jobs for the next ten years. But looking in today’s scenario, the number of students applying to baccalaureate nursing programs across the nation is decreasing. In the Philippines, according to CHED Executive Director Julito Vitriolo (2010), nursing is considered one of the country’s oversubscribed courses – programs that have continually rising enrolment rates in the face of dwindling job vacancies, leading to an oversupply of graduates. With the study, the researchers would like to know view of high school graduating students regarding nursing profession and their career choice in college, whether to take up nursing or not. As reflected in today’s reality, many notice that there is a continuous decline in students taking up nursing course and being taken by some to be their future job but not as a profession as it should be. The researchers hope that this study will help schools on how they will intervene with the nursing curriculum being offered. Statement of the Problem This study aimed to determine the perception of high school students on the nursing profession and their career choice. Specifically, this study answered the following questions: 1. What is the profile of the 4th Year high school students in terms of: 1.1 Sex 1.2 Family’s Monthly Income 2. What is the career choice of high school students? 2.1 Courses in the College of Commerce 2.2 Courses in the College of Aviation 2.3 College of Criminology 2.4 College of Theology 2.5 College of Law 2.6 Courses in the College of Science 2.7 Courses in the College of Engineering 2.8 Courses in the College of Medicine and Health Care 2.9 Courses in the College of Arts 2.10 Courses in the College of Computer Studies 2.11 Courses in the College of Education 2.12 Courses in the College of Architecture and Fine Arts 3. What are the reasons of 4th year high school students in their preferred courses? 4. What are the perceptions of 4th year high school students on the nursing profession? Theoretical Framework People have a way of seeing the world and interpreting what is experienced. When encountering new knowledge or an experience that cannot be integrated comfortably with current ways of seeing the world, one has a choice of rejecting the new information or revising previous views. Mezirow calls this â€Å"transformative learning†, which can be done by reading or hearing something new, taking a course, or by having a discussion with friends or colleagues. Transformative learning involves changing one’s perspective. Mezirow also uses the term â€Å"meaning perspective† to describe how one sees the world. One expects to see things a certain way because of past experiences. This frame of reference or perspective stems from the way an individual grew up, one’s culture, and knowledge that has been acquired. Mezirow describes meaning perspectives as values of culture that have been accepted without question (i.e. because one grew up with it). For example, nursing is commonly perceived as a female profession. The opportunity to influence students’ perspectives about nursing can influence whether accurate perceptions are used in making a career decision about nursing. Transformative learning about nursing can satisfy certain needs that many students may have in order to make a more informed career decision regarding nursing. Students’ meaning perspectives about nursing that are outdated or inaccurate and not redirected by providing transformative learning, can affect students’ interests in nursing. Frank Parsons’ Trait-and Factor theory maintained that an individual would be best satisfied with a career that was matched with the characteristics of the individual. Parsons wrote the first book on career decision-making early in the twentieth century entitled Choosing a Vocation. His conceptual framework for helping an individual select a career one liked and that matched one’s abilities provides a systematic plan for career guidance. Shadowing, volunteer experiences, and academia about nursing can provide a conceptual framework for prenursing students that will allow them to determine if nursing is a satisfying career choice and matches their strongest personal skills. Ginsburg, Ginsburg, Axelrod, and Herma developed the first approach of career development from individual developmental stages. These researchers viewed career choice as a life-long developmental process and cited three stages categorized by characteristics within age groups. First, fantasy period of childhood before age 11, purely a play orientation early in the stage, becoming more work-oriented near the end of the stage. Second, tentative period of early adolescence, ages 11-17, a period of gradual recognition of work requirements, interests, abilities, work reward, values, and time perspectives. Third, realistic period involves adolescents, age 17 to young adult. Within this age, individuals integrate capacities and interests, further develop values, specify occupational choice, and crystallize occupational patterns. The Realistic Period is the age group and period of the typical prenursing student. Ginsberg theorized that as career decisions were made during this period, other careers were no longer potential choices. Although this was later proven to be false, Ginsberg continued to stress earlier choices in the career decision-making process. Conceptual Framework Figure 1. Perception on Nursing Profession and Career Choice of Fouth Year High School Students The figure on the next page shows the profile of fourth year high school students namely sex, and family income. Each respondent would be asked to specify their gender and how much their family earns every month. The study would gather the courses preferred by fourth year high school students through a variety of courses list given by the researchers. The study would tackle the reasons behind the choice of course made by the students. The study would also tackle the number of students who have chosen nursing as a course for college, and the reasons for such preference for nursing. Lastly, the study will show how fourth year high school students view nursing as a profession regardless of their course preferences. Assumptions of the Study This part of the study aims to shows the perceived possible cause-and- effect relationship to simplify a complex analysis. Female Fouth Year high school students choose nursing as their course in college than male 4th year high students. Fouth Year high school students from high earner families choose nursing as a course than 4th year high school students from low earner families. Fouth Year high school students who have relatives or family members who are in the medical field tend to enroll in the nursing curriculum than 4th year high school students who have no relatives or family members in the medical field. Fouth Year high school students who have friends enrolling in the nursing curriculum follow the same course than students without friends enrolling in the nursing curriculum. Significance of the Study This part of the study aims to show where it is relevant and useful. It provides insight to the following institutions and individuals which will serves as benefactors of this study. Parents. The study will provide better understanding of the students’ perception on choosing a career, thus, parents can help their children in the hardest decision in choosing a career that would suit them. It will make them be aware with the perceptions of students about nursing as a profession and a life career. Nursing Schools. Determining students’ perceptions about nursing would provide Nursing Schools with a basis for curriculum development. Identifying these perceptions can lead to academic standards and healthcare experiences that could prove crucial to meeting students’ individual career development needs both now and in the future. Graduate Nurses/Registered Nurses. This research is also important because it could provide information related to current perceptions about the nursing profession that experienced nurses could address as they mentor students. Students who wish to enrolled in nursing need to have nurse role models that present positive and accurate characteristics about nursing, as well as the negative aspects of the profession. Knowledge of both types of factors can provide students the necessary skills to formulate quality perceptions for career decision making. Nurses in the Academe. The result of this research can serve as a tool for nurse educators in developing a challenging curriculum preparing nursing students to integrate seriously the career into their life. The result can also serve to be a basis for an improve way of education and promotion of nursing profession to the young generation. Future Researchers. For researchers who want to pursue the study, it will be a great contribution in taking up steps to find further answers and knowledge on the perceptions of students and the relevance of nursing as a profession. Furthermore, the study can be a guide to know an increase or a decline on the number of nursing enrollees for the future Scope and Limitation This research study was conducted on Fouth Year high school students. This research is limited only to the first section of graduating high school students that enrolled for the school year 2013-2014 at Notre Dame of Marbel University – Integrated Basic Education Department, Notre Dame of Sienna School of Marbel, and Koronadal National Comprehensive High School located in the City of Koronadal, South Cotabato. Definition of Terms This part of the study provides meaning of terms being used by the researchers to support the understanding of the readers. Perception on the Nursing Profession. This term refers to a mental image of a person to the nursing profession. Perception is a subjective mater affected by different factors that vary from person to person. A person perceives nursing profession based on his observations in his day-to-day living in the society. Nursing Profession. It is a kind of career that gives an opportunity in rendering care and service to others. People who are in this profession are persons who has knowledge and skills in promoting health and wellness among individuals, families and communities he or she cared for. Career. The occupation in which a person does for a period of time. This is an occupation which a person has the opportunity to progress and it is regarded as a long-term or lifelong activity Career choice. A decision made by an individual to choose a field to specialize in for progression of jobs. A decision to attain career goals set by an individual. College. This term describes an institution of higher learning that offers tertiary level of education and awards bachelor’s and sometimes master’s degrees. College offers courses of different fields for undergraduates to specialize in. Chapter II REVIEW OF RELATED LITERATURE This section presented a review of related literature based from different sources such as from previous studies that supported the reliability of the study. Historical Perspective of Nursing Since Florence Nightingale’s pioneering work, only five generations of nurses have set their footprints in history. In that short time, nursing has grown enormously in knowledge, skill, prestige, and value. Nursing needs to be recognized as a member of the scientific discipline that can make valuable contributions to healthcare (Mundinger, 2000). America witnessed nursing first in the 20th century in home visiting and community-based care. Then, during World War II nurses cared for patients on the European front and ran hospitals in the United States while physicians were at war. Nurses were entrepreneurs for soup kitchens for the poor, directed individual and family counseling on dietetics and school health stations, and provided most community-based care with physicians seeing only the critically ill. Nurses shed their uniforms for coveralls in the war and worked with their medical colleagues in the indistinguishable teamwork of saving lives, only to return after the war to resume their prewar status (Mundinger, 2000). Associate degree (AD) hospital based nursing programs, which had been the education and clinical training centers for nurses and supplied its nursing workforce, began to decline. Baccalaureate nursing programs, which offered a bachelor of science in nursing (BSN) in addition to preparation for RN licensure became the focus for nursing education. The BSN degree began its ascendancy with emphasis on public health and leadership training, which resulted in advancing the BSN nurse as the hospital head nurse (Mundinger, 2000). Today NPs work in institutions and in private practice as clinical specialists where they see patients over an extended time period and across many settings and accountability in advanced nursing practice is growing. These advancements have fostered nurses with authoritative and complementary roles in team care with physicians (Mundinger, 2000). The valuable background of professional development of nursing is influenced by need, biomedical knowledge, and the economic and financial structure of the nation and its health care system. Among nursing’s greatest contributions are primarily counseling, teaching, disease prevention, and health promotion, which are much less riveting to the public than elegant technology and life-and-death medical situations that are often associated with the physician (Mundinger, 2000). Thus, nursing has struggled for recognition and independence as well as opportunity while often overshadowed by its partner, medicine. Mundinger further said that nursing has proven that it can advance its future by educational preparation, securing public recognition and access through research, and by developing a structure in the nation’s healthcare system that uses nursing services in a protected and focused way. Instead of preparing students for a specific job, literature suggests that nurse educators are equipped with knowledge, skills, and experiences that will allow them flexibility and an opportunity to advance throughout their careers (Moore, 2000). Key words to look for in nursing will be Advanced Nursing Practice (APN), Clinical Nurse Specialist (CNS), Nurse Practitioner (NP), and Nursing Role (Lynch, 2000). Image of Nursing Career images of nursing can be shaped by a number of influences. Data by researchers in a South Hampton, United Kingdom study involving secondary and college age students, confirmed the importance of career images and perceptions in shaping the career choices of individual students (Foskett and Hemsley-Brown, 2000). The word â€Å"perception† is defined as the â€Å"ability to perceive and the result of perceiving, to realize or become aware of something through the senses, an impression accompanied by an understanding of what it is† (Webster, 2000). Foskett and Hemsley-Brown (2000) state that gender images influence perceptions of nursing. Historically, nursing has been an occupation of women, as seen in all female nursing management, staffing, teaching, discipline, and organization. In fact, males under 10 years of age included in this study did not take the question about males in nursing seriously. The 17-year old males, however, were more conscious of being politically correct but still referred to the stereotypically feminine personality characteristics needed to be a nurse (i.e., patient, nice, caring). Additional data indicate that young men are unlikely to make a decision to enter nursing before age 21. College age males felt that male masculinity would be doubted if men chose a nursing career. Interestingly, the focus of a career as a physician centered around intellectual potential, whereas nursing focused around personality traits (Marshland, 2000). This could indicate a significance of role models and mentors as key factors influencing a student’s image of nursing. Students’ focus on the roles and tasks of nursing showed that younger students in the Foskett and Hemsley-Brown (2000) study saw nursing as very task oriented (i.e., related to visible tasks of patient care at the bedside). A greater percentage of older students appeared to perceive nursing as carrying out orders without responsibility, status, or authority. Foskett and Hemsley-Brown (2000) suggest that images of career progression and security are very important factors to students in formulating career perceptions. For example, most students in the research chose jobs they believed to offer greater career opportunities than nursing. These students chose jobs which were difficult to enter or highly selective, such as sports and acting. Understanding why students choose or reject a nursing career is relevant in designing a recruiting program for students. Nurse educators face the challenge of providing students with a variety of informative factors about nursing, which are important to students in career decision-making. Students are currently formulating career decisions from a variety of sources that do not include nurses; therefore, students may have vague, distorted, or inaccurate images of nursing that result in disillusioned career choices. A review of literature suggests that increasing numbers of students are making career decisions related to nursing based on a limited range of informational factors and deficient career making skills. The following data define how students presently view the nursing profession, at what age they begin to make decisions related to nursing, and some identified factors influencing students’ images of nursing. According to Kerstern, Barkwell, and Meyers’ (2001) students chose nursing related to five categories of reasons. In order of frequency students’ reasons stemmed from a desire to nurture, meet emotional needs, employment opportunities, financial opportunities, and interest in science/disease. Stevens and Walker (2003) reported the most frequent reason for collegebound students to choose nursing was the desire to help people, followed by wanting to do important work and the desire to work with all kinds of people. Kelly, Shoemaker, and Steele (2006) examined the motivational factors for males choosing a career in the predominantly female dominated field. The results revealed that the choice of a career in nursing was influenced by the following: job security/availability; desire to help people, professional autonomy, and previous contact with the healthcare system (i.e. volunteering, working, family member, etc.), and family support. The foregoing studies revealed that most male and female students’ primary interest in nursing was not linked to cognitive understanding of nursing, but on emotional desires, such as helping people and the desire to nurture. In the three studies cited in examining students’ interests in nursing, at least two of the studies showed significant interest in each of the remaining areas. Students’ knowledge base of educational programs for nursing, nursing licensure, professional opportunities, or professional responsibilities were not indicated. (Foskett and Hemsley-Brown, 2000) Beck (2000) suggests that nurse educators need to use creative strategies and programs in career education to attract more applicants, and that first-hand knowledge of why students choose nursing as a career is basic and necessary. Three new pieces of important information on students’ reasons for choosing a nursing career that emerged through Beck’s study in the year 2000 were the powerful effect of observing nurses in action, feeling as though something was missing from their original career choice, and not gaining acceptance into medical school. Although Beck’s study cannot be broadly generalized, it does have implications for nurse educators. It confirmed a repetitive pattern among students entering nursing as a career, namely a strong desire to help people and to experience an idealized â€Å"one to one† relationship with patients. A student’s perception that the nursing profession reaps benefits for both patient and nurse are not always matched with the realities of today’s healthcare delivery. Consistently, a student’s strongest perception about nursing is that of a nurse’s one to one relationship with patients, which in today’s managed healthcare system is not a reality. One implication in general for nursing educators was that of not setting up students for disillusionment. Changes in nursing practice need to be made clear to students. Curriculum must be implemented to help students and new graduates adjust to realities of today’s healthcare. Importantly, students must still be able to realize satisfaction and pleasure in the career they have perceived as one of caring for others. Otherwise, students are more likely to drop out of nursing programs or leave the profession after entering the workforce. (Author) Why are students overlooking careers in nursing? The Journal of Vocational Education and Training (Foskett and Hemsley-Brown, 2000) sought to develop an understanding of how students perceive nursing as a career at various stages in their education, and how these perceptions affect students’ interests in nursing. The study indicates that decisions about jobs are being made at an early age and that by late elementary school students have often rejected jobs on the basis of perceptions. Thus, it is important to provide career information and experience for well-defined perceptions about nursing that can be developed for greater career decision-making skills. On many campuses, curriculum-based community â€Å"service learning,† as it is most frequently referred to rather than traditional co-curricular volunteerism, represents a real growth area to enhance career-making skills (Fisher, 2006). Bringle and Hatcher (2006) define service learning as a credit-bearing educational experience in which students participate in an organized service activity that meets identified community needs. Students reflect on the service to gain further understanding of the course content, a broader appreciation of the discipline, and an enhanced sense of civic responsibility. Overall, the data revealed that young people have a very limited and out-dated understanding of career progression of nursing and were unaware of changes in nurse education and training. Nurse educators have a responsibility not to set up students for disillusionment but instead to identify prenursing students’ perceptions about nursing, help them to formulate accurate perceptions of nursing, and to adequately prepare them to succeed in nursing education and the nursing workforce. Impending Nursing Shortage Nursing programs everywhere are using inventive tactics of tuition reimbursement, financial aid, high school â€Å"shadowing† programs, and opening doors to immigrant and minority students in order to attract the volume of students needed to provide the nursing workforce to care for the future population. Declining enrollment in baccalaureate nursing programs, an aging nursing workforce, the majority of nurse educators nearing retirement, and the current environment of healthcare are key factors underlying the current nursing shortage. (Benjamin, 2000) Although recruitment incentives are being offered, little is being done to influence a prenursing student’s image of nursing, career making skills, or factors that negatively affect students’ images of nursing. Sound images of nursing and more informed dimensional career opportunities in nursing could provide students significant skills for more informed career decisions. Developing improved career-making skills allows prenursing opportunities to explore career/job satisfaction in nursing. Locke (2009) states, â€Å"Job satisfaction is the pleasurable emotional state resulting from the appraisal of one’s job as achieving or facilitating the achievement of one’s job values.† Job satisfaction and dissatisfaction are functions perceived by what we want and what we obtain. Periodic assessments are needed periodically to determine the changes of students’ desire and need in a career. Locke says students who make more informed career decisions tend to find greater satisfaction in a chosen career. Therefore, students who choose a nursing career based on a more informed career decision should find greater career satisfaction as a nurse. Although the U.S. Department of Labor, Bureau of Labor Statistics (2000) predicts a significant 21 percent job growth rate among RNs by 2006, the largest among all professions, fewer students are choosing careers in nursing. The American Association of Colleges of Nursing Media Relations (2000) states that with the steady decline of enrollment in baccalaureate nursing programs, the need to attract nursing students appears imperative. The Bureau of Health Professions, Division of Nursing (U.S. Department of Health and Human Services, 2000a), estimates that by 2010 the country will need 1.4 million RNs with a BSN, but will have only 635,000. Of the 532,000 nursing positions requiring a master’s degree or Ph.D., only 250,000 nurses will actually be available to fill the demand. Literature reflects the aging of the current nursing workforce, indicating the average age of RNs to be 44.3 years, with those under age 30 representing only 10 percent (Peterson, 2001). Alarmingly, one-third of these young nurses indicated that they plan to leave the nursing profession within the next year (Hagan, 2001). Most nurse educators are nearing retirement with an average age of 55.5 years. This will affect the future of nursing education and the supply of students to fill nursing vacancies according to the National Sample Survey of Registered Nurses Preliminary Findings (U.S. Department of Health Services, 2000a; Department of Labor, Bureau of Labor Statistics, 2000). Conversely, changes in financing and organization of healthcare delivery resulted in a decreased demand for nursing services through the 1990s. In addition, forced deteriorations in quality healthcare resulting from constant cutbacks have made it difficult for frustrated nurses to encourage students to become nurses (Peterson, 2001). The projected intersection of supply and demand to the current shortage of nursing is estimated to be 2010, when the supply of RNs will no longer exceed the need. The future supply and demand of RNs will show a widening gap unless measures are taken to attract students into nursing, reduce attrition rates, and retain nursing graduates (Peterson, 2001) Virtually everyone has been in contact with and experienced the importance of having a nurse care for them during one’s lifetime. Dicey Smith, MSN RN, an expert in the field says, â€Å"Nursing is the only profession I know that allows one to impact the lives of others from birth to the grave (Smith, 2001).† It is often referred to as the â€Å"heart and soul† of health care (Harris, 2000). Studies prompted by Congressional involvement showed a strong and consistent relationship between nurse staffing and important patient outcomes in acute care hospitals inpatient units (Needleman, 2001). The results of these studies indicated that patients cared for by a higher RN share of total staffing had a reduction in secondary infections and length of stay in hospital. Also, careful monitoring of in-home technology by nurses showed improved clinical outcomes (Compher, 2001). A number of related factors provide useful guidelines to indicate the increasing need for RNs. Study results indicate that older Americans compose a greater segment of the U.S. population than ever before. The U. S. Census Bureau (1995) and the U.S. Government Census (2000) report that since 1990, the percentage of Americans aged 65 and older has tripled, and the elderly population itself is getting older. Americans 85 and older, representing 4.0 million individuals, is 33 times larger. According to the Programs and Initiatives for Aging (U.S. Department of Health and Human Services, 2000b), one out of every six Americans, a total of over 89 million, will live to be 100 years old in the next 30 years (Peterson, 2001). An adequate nursing force will be needed to care for this aging population of â€Å"baby boomers,† who are living longer and healthier lives and are expected to live well into their 80s and 90s. Nurses oversee patient care in the community; provide primary care in a variety of non-acute settings, and highly technical care with acutely ill patients requiring hospitalization. Nurses are among a few health professionals responsible to their patients and profession to validate the safety and efficacy of healthcare practice. Over 50 million people a year are hospitalized, and because of the central role nurses plays in hospitals and nursing homes across the nation, the nursing shortage is everyone’s problem (Nursing World, 2000; Nevidjon and Erickson, 2001). Importance of Informed Career Decision-Making Studs Turkel stated, â€Å"A career is about daily meaning as well as daily bread. For recognition as well as cash, for astonishment rather than torpor; in short for a sort of life rather than Monday through Friday sort of dying. We have a right to ask about work that includes its meaning, recognition and astonishment, and life† (Byars, 2006). Many prenursing students are uncertain about what career opportunities nursing will offer them, and some have misconceptions about what a nurse actually does. Some students have just never considered nursing. Could informed career decision-making influence recruitment of students into nursing, lower attrition rates, and help retain nursing graduates in the workforce? Career development is a lifelong process, which incorporates education, occupational training, and work, as well as one’s social and leisure life (Zunker, 2000). Today, the changes in the work-world and new definitions of what a career is are challenging us to make sense of our careers and reassess their meaning in our lives. Traditional job definitions are vaporizing, and it is never too early to begin preparing for a life-long career (Alaniz, 20001). Career guidance and counseling are components of a total career education program. Students need to understand themselves in order to explore and plan a career. The School-To-Work Opportunities Act of 1994 states the strong need for career education and development programs for all students in order to provide students with information sharing, outreach, communication, career education, labor market information, job placement, work experience programs, counseling and assessment, and public relations (Cunanan, et. al, 2000). Developing accurate perceptions about the career in which a student is interested is one key to informed career decision-making. Recruiting students into nursing can begin with younger students as they formulate career goals and look to mentors as role models in careers they identify with. â€Å"Eyes to the Future† is an online multi-age magazine targeting middle school girls interested in math and science. It reaches them at an age when they are thinking about which career path they might take for the future. It also links middle school girls with high school girls interested in math and sciences who can be mentors and help the former make wise career choices (Little, 2000). The curriculum for an Introduction to orientation to nursing course could include placing prenursing students as mentors for younger students whose images of nursing are gradually increasing. A greater number of students may choose careers in nursing if provided with better decision-making skills and positive perceptions at a younger age, before negative images of nursing are shaped. There are many challenges for nursing to develop programs to interest students in nursing. Primary Care Resource Initiative for Missouri (PRIMO) is an example of a career development program designed to remedy the shortage of nurses by placing students in grades 7-12 in summer â€Å"shadowing† health-related professional programs. PRIMO serves as a successful career decision-making tool for students interested in health careers, and encourages students in high school through post-graduation education to remain and practice in Missouri (Northeast Missouri Area Health Education Center, 2000). Some nursing programs encourage or require a volunteer or â€Å"shadowing† experience for admission. This experience helps students to see firsthand what a career in nursing has to offer (Benjamin, 2000). A introduction to Nursing course that is designed to acquaint students with professional nursing could provide students further opportunities to explore the academia of nursing, as well as clinical images, before a career choice is made. If bright, capable students are uncertain or have not made a decision about a career, the orientation class may provide them with insight into an excellent and promising career of nursing. Foskett and Hemsley-Brown’s study (2000) indicates that the main reason individuals desire to become a nurse is helping people. Indifference is the main reason for not wanting to enter nursing; therefore, many students had not rejected a nursing career but instead had not given it any consideration. Identifying students’ perceptions about nursing academia can indicate to nurse educators, advisors, and recruiters whether or not students’ perceptions are based on accurate information from professional sources. Also, by linking students’ images of clinical nursing in the setting with facts, nurse professionals can help students to develop accurate perceptions, which can determine career goals now and in the future. To provide an adequate nursing workforce and to replace waning numbers of nurse educators, it is important to understand factors contributing to students’ current career decision-making skills (Beck, 2000). This researcher’s findings could provide data to professional nurses related to current student expectations about the nurse workforce. Recently, career opportunities for women have escalated and the mostly female dominated profession of nursing is facing stiff competition in career choice alternatives. Schools of nursing, nurse advisors/recruiters, and nurse mentors could utilize information related to current student perceptions of nursing in understanding what students are looking for in making career choices. Prenursing students could make more informed career decisions about a career in nursing if their perceptions were clearly understood by professionals and those who educate nursing’s future practitioners. (Marshland, 2000) Little research has been done to determine prenursing students’ academic and clinical perceptions regarding nursing. It is the researcher’s intent to determine what these students’ perceptions are, and to identify any factors that may have influenced their development. Data collected can then be used by nurse educators to develop a curriculum that will address student’s needs, which may affect recruitment and/or retention of prenursing students. Identifying images that may affect the perceptions of nursing can also provide data for improving or developing a new curriculum in career education for prenursing students. Questions that can be targeted in an Introduction to Nursing course may include: What are the reasons students are not choosing a nursing career, what are students’ perceptions of a professional nurse, or what can one do with a degree in nursing, and can students be recruited into the nursing profession through career education/development? These questions need to be answered in order to address the current shortage of baccalaureate nursing students in our universities and in the nursing workforce. (Hinshaw, 2001) Teenagers see nursing as working irregular shifts, taking orders from doctors, and bedside care probably forever (Sherrod, 2001). Many students still see nursing and think of bedpans and needles. Although this certainly can be part of nursing care, the role of the registered nurse today is a team coordinator of healthcare providers assuring quality care for all patients (Corcoran, 2001). Alaniz (2000) says that nursing students will need to possess the qualities: motivator, savvy, and team player. They will need to speak several languages and understand the cultures from which those languages come; master the Internet and know how to navigate its sea of information to find the precise data needed; feel at ease with all of the latest medical technology; be knowledgeable of all medical insurance policies and legal and ethical codes (state and federal) related to healthcare; and understand the human 32 psyche. Nurses must also be excellent communicators and maintain clear communication with all colleagues, doctors, and patients defusing all interpersonal conflicts in a flash. The nurse of the future must anticipate healthcare trends years away and train for them now. A nurse will marry and raise a family, coach children’s sports teams, care for aging parents, and finish graduate degrees while completing research. If that is not enough, they will be on the cutting edge in telemedicine and consulting on several committees and boards. The nursing profession and America must be sensitive to the needs of providing career development to students and adults, formulating well-defined perceptions about professional nursing in the 21st century. In the study conducted by Rasmussen (2001), he mentioned that high school students of today want some adventure in their lives and some travel in their careers as cited by Diane Mancino, Ed.D. RN, executive director of the National Student Nurses Association (NSNA). The NSNA has recently produced a youth recruitment video, â€Å"Nursing: The Ultimate Adventure,† targeting youth at the high school level in promoting modern images of nursing. The video creates a sense of excitement about the field and discusses the emotional effect a nurse can have on patients. It shows interviews with students who want to go into nursing, and new images of career opportunities in nursing such as, research, the pharmaceutical industry, technology, and law, and the ability to make autonomous decisions on a moment-to moment basis in healthcare delivery. Byars (2000) says that exploring careers is essential for youth to understand the world of work, but it must also include career education that will inform youth of challenges of adult life. Reaching one’s career goals does not guarantee happiness, success, and personal fulfillment. Synthesis of the Review of Related Literature As times goes on, Nursing as a profession must need to recognized as one of the important professions aligned with scientific discipline that always make valuable contributions to the society. In early times, nurses were already known as individuals who gave care to the sick and they were the assistants of physicians in treating those ill and sick persons. Today, in these modern times, nurses work in institutions and in private practice as clinical specialists where they see patients over an extended time period and across many settings and accountability in advanced nursing practice is developing. Theses advancements offered nurses to have authority and complementary roles as members in the health team with physicians. Indeed, nursing is a profession that our society needs. This is because each of us should have knowledge about diseases so that we will be able to manage if certain diseases will attack our health and then because our healthcare system is suffering from economic and financial constraints. Expert says that one factor that influences perception on nursing profession is the gender criterion. Many people see nursing as a profession only for female. They are only few males who take up nursing than females. Another is, people see nursing as very task oriented profession. There should be that appropriate career image of nursing so that people will be guided to what is nursing really about. Also, understanding why students choose or reject nursing as their career is relevant in designing an recruiting program for students especially for those nursing schools. There must be an instillitation to the students’ minds about basic and appropriate information regarding the nursing profession so that they will be guided appropriately in perceiving nursing as a profession and in choosing nursing as their career. A study showed that students chose nursing because they have the desire to nurture, to meet their emotional needs, because of employment opportunities, financial opportunities, and because they have an interest to science and diseases. Some says they chose nursing as their career because they have the willingness to help people and the desire to work with all kinds of people. Chapter III METHODOLOGY This chapter presents the methodology, the setting, the respondents involved, the instruments used which will be validated to establish reliability of the questionnaires, and summary of the data obtained to be interpreted. Research Design Generally, the study is a descriptive study; descriptive research designs that provided researchers with information about the perception of Fourth Year high school students on the nursing profession. This will further describe their views. Their career choice and the reasons for the course preferences and preference for nursing. Research Instruments A questionnaire-type instrument was chosen, the researchers aim to have accurate results on the career choice of Fourth Year high School students, their perception on nursing profession, and their reasons for their course preference. The instrument was subjected to evaluation and validation by panel of experts. It was subjected to a pre-test to evaluate its appropriateness to the study. To test validity, the method Content Validity. The questionnaire was criticized and evaluated by a group of experts to validate reliability and accuracy of questionnaire. Target Population and Sampling Procedures The target population of the study was the Fourth Year high school students. This fourth year high school students were taken from Notre Dame of Marbel University – IBED, Notre Dame Sienna School of Marbel, and Koronadal National Comprehensive High School located in Koronadal City, South Cotabato. It is limited to the Fourth Year high school students enrolled for School Year (S.Y) 2013 – 2014) and belonged to the first section of the three (3) schools mentioned above located in Koronadal City, South Cotabato. The first section was chosen because of the following characteristics: Nursing grade standards. Thus, convenience sampling was adopted as the sampling method of the study. Setting of the Study The study was conducted in three different High Schools of Koronadal City, South Cotabato. The researchers entered the firsts sections of each school and conducted the study. Chapter IV FINDINGS This chapter includes the presentation analysis and the interpretation of the data gathered about the perception of fourth year high school students presents the interpretation of the data gathered about The Perception on the Nursing Profession and Career Choice of High School Students. Table 1.1 shows the sex distribution of the respondents of the study. Out of one hundred twenty eight (128) total respondents of the study, eighty eight (88) were females and forty (40) were males. Table 1.2 shows the sex distribution of the respondents that chose nursing as their career. Out of seven (7) who chose nursing, all are females. Table 1.3 shows the family’s monthy income of the respondents of the study. Among the given projected monthly family income, above fifty thousand one pesos (50,001php) is the highest monthly family income and below ten thousand (10,000) being the lowest. Out of one hundred twenty eight (128) total respondents of the study, fourteen (14) respondents have a family income of below ten thousand pesos (10,000php) per month, thirty-four (34) respondents have ten thousand one to twenty thousand pesos (10,001 – P20,000php) per month, twenty-four (24) have twenty thousand one pesos to thirty thousand (20,001 – 30,000php), ten (10) have thirty thousand one pesos to forty thousand pesos (30,001 – 40,000) monthly family income, fourteen (14) have forty thousand one pesos to fifty thousand pesos (40,001 – 50,000php) monthly family income, thirty-two (32) have a family income of above fifty thousand one pesos (50,001php). Table 1.4 shows the family monthly income of the respondents that chose nursing as their career. Out of seven (7) students that chose nursing, the distribution are as follows: Below ten thousand pesos (10,000php) (0); ten thousand one pesos to twenty thousand pesos (10,001 – 20,000) (2); twenty thousand one to thirty thousand pesos (20,001 – 30,000php) (2); thirty thousand one pesos to forty thousand (30,001 – 40,000php) (0); forty thousand one pesos to fifty thousand pesos (40,001 – 50,000php) (1); above fifty thousand one pesos (50,001php) (2). Communication, Public Relations and Communications, Journalism, Political Science, Legal Management, Philosophy, Specialization in Software Technology, Specialization in Network Engineering, Information and Communication Technology Management, Specialization in Instructional Systems Technology, Management Information Systems, Home Economics, Nutrition and Dietetics, Library Science, Child Development and Education, Music, Special Education, Advertising, Arts Management, Creative Writing, Industrial Design, Fashion Design and Merchandising, Music/Music Production got none. Table 3.1. Shows the reasons behind students’ preference for nursing as their career. Among the seven (7) students who chose nursing, four (4) said that they preferred nursing because of their desire to nurture, interest in science and disease, and their previous contact with healthcare system (relatives, peers, etc.). Three (3) out of seven also said that they chose nursing to meet their emotional needs, and because of their desire to work with all kinds of people. And one (1) said that she chose nursing because of employments/financial opportunities. Table 3.2. Shows the reason of Fourth Year high school students for their preference for other courses. Out of one hundred twenty-one students who chose other courses, eighty-eight said that they chose their desired course because of their own personal interest; twenty-nine (29) said that it was because their course of choice is aligned with their proficiency; twenty-six (26) said that it’s for certainty of employment; twenty-four (24) said that it is their parents/benefactors’ choice; brother’s choice, high salary, and family background got one (1) each. Table 4. Shows the perception of Fourth Year high School students to the nursing profession provided by the said respondents. Among the one hundred twenty-eight respondents, the perception of Fourth year high school students are as follow: nursing means providing care (27); nursing is a hard/difficult profession (24); nursing provides less job opportunities (17); nurses are overpopulated (11); nursing as a preparatory course for medicine (10); nursing means helping others (6); nurses save lives (4); nursing is not aligned to their interest (3); nursing deals with the health of people (2); nursing is an important aspect of the society (2); a nurse is someone who would specialize in different medical aspect (2); nursing is an important and a risky job (1), nursing is a way abroad (1); courageous job(1); tiresome job (1); very common job (1); boring job (1); nursing profession is enjoyable (1); nursing is a profession to be proud of (1); nursing tackles sciences and diseases’ information (1); no idea (1). Chapter V SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS Summary The researchers found out that the most students perceive nursing as â€Å"providing care†, and that majority of fourth year high school students prefer to take other courses than nursing because of their personal interest, certainty of employment, alignment with their proficiency, and the choice of their parents/benefactors. The main objective of this study is to find out the perception of fourth year high school students studying in Koronadal on the nursing profession and their career choice. Specifically, the study answered questions about what fourth year high school students prefer to take as a course on college and the different reasons for the preference for such courses, and the reasons for the preference to take nursing. The study used the Descriptive Survey Method and the main tool used was the research-made or self-made type of examination (questionnaire), including the record sheet as instrumentally utilized for the 128 students as selected respondents in the fourth year. Majority of students, 26 students or 20.30% prefer Accounting over other courses followed by Medical Technology (14 students/10.9375%). The reasons for choosing these courses are their personal interest, certainty of employment, alignment with their proficiency, and the choice of their parents/benefactors. Seven (7) or 5.46875% students prefer nursing over other course, the top three (3) reasons for this are their desire to nurture, interest in science and diseases, and their previous contact with healthcare system. The researchers found out that majority of students (27 students) perceive nursing profession as â€Å"providing care†; followed by â€Å"nursing is hard/difficult profession† (24 students); and â€Å"nurses are over populated† (11 students). Conclusion Based on the results, the researchers concluded the following: Therefore, the respondents that choose nursing as their career were all females. Therefore, the respondents that choose nursing as their career mostly have fifty thousands (50,000 Php) and above family income. Therefore, the top reasons why students choose to take up nursing were their desire to nurture, they have an interest in sciences and disease, and they had previous contact with health care system. Therefore, the top reason of students for choosing other courses instead of nursing were their personal interest lies to their chosen course. And therefore, the respondents perceive nursing profession mostly as a profession that provides care. Recommendation Based from the result of the study, the researchers recommended the following: For nursing schools, that they will offer more high quality curriculum to attract more nursing enrollees and to have more proper dissemination of information about what the nursing profession truly is. For the Commission in Higher Education of the Philippines, that they will continuously monitor nursing schools in the country in delivering high quality nursing curriculum to produce skillful, knowledgeable and with good attitude professional nurses. For the parents, that they should always become a good support system for their sons and daughters in choosing their career in life. For students, in choosing a career, they must first assess their capacities, skills, personalities and abilities if it is really suited on the career they will choose. And for the future researchers, that they will conduct more studies with wider scope regarding the perception on nursing profession and career choice of high school students to obtain a more accurate and up-to-date results and interpretation. Recom: further studies why no male choose nursing Recom: career choice; in-demand courses (reasons)