I. Introduction

According to the International Council of Nursing (ICN), nursing is a profession that helps to protect and improve the healthof the individuals, families and the society and contributes to heal and rehabilitate in case of illness. Educational Commission of Turkish Association of Nurses (1981) has defined nursing as follows: Nursing is a discipline in health sciences, composed of the science and art of planning, organisation, implementation and evaluation of nursing services aimed to protect and develop the health and well-being of individuals, families and the society as well as healing and rehabilitation in case of illness, and also responsible for the education of the personnel that will execute these services [1].

Thosewho graduate from the faculties and higher education schools of the universities in Turkey certified by Ministry of Health, providing bachelor degree education on nursing, as well as those who complete their education in a school overseas of which the equivalence approved by the State and having their diplomas certified by Ministry of Health, are granted the status of Nurse [2].

If we have a look at how the students define nursing, we can see that they define a nurse as a person helping and serving patients, assistant to physicians, a member of the healt team [3]. In a study in Greece conducted on both nursing students and nurses, the participants have defined nursing not as a science but as an art. Some participants have described nurse as “the right arm” of the physician [4]. Even the definition of the profession has not been fully understood by the students, and careerdecision is up to random choice or coincidences, which is observed to have adverse effects on the development of the nursing. For the nursing profession can improve and become higher in status, it is essential that this profession should be appropriately executed and implemented. For this reason, the ones making career decision for nursing should choose it consciously, very well recognize what it is, embrace it and love it. That’s how inappropriate or insufficient information regarding nursing as well as the source of such information can be determined and by means of adequate information and promotion, it might be possible to contribute to nursing becoming a desired and preferred career of choice

University allocations are mostly up to various coincidences, mostly unrelated to preferences and abilities[6]. In most of the studies on careerchoice, the families, the people in the neighbourhood having that profession, private tutoring institutions, their anticipations of finding a job, social status of the profession, threshold of points for that profession etc. play a role on the career decisions of the adolescents [3,6,7,8]. In nursing too, we observe a similar situation. Career decision on nursing too is observed to be the result of university entrance examination system rather than the preferences of the students, due to job guaranteee, and positive suggestions of the family [9]. In similar studies, it is seen that orientation by the private tutoring institutions was at the first line in making the students choose nursing [3].

This study was planned as descriptive type of study in order to determine the reasons why the nursing students prefer nursing branch.

II. Method

  1. A.

    Type of the Study:

    This is a descriptive type of study

  2. B.

    Setting:

    This study has been conducted in a university with the nursing students at bachelor level.

  3. C.

    Population and Sample:

    Bachelor level university students studying for nursing constitute the population of the research. After getting necessary approvals, the study data were collected in 2010 Fall semester. No certain sampling selection method was preferred in the study, rather a total of 261 nursing students who accept to participate in the study formed the population of the research. The students who accepted to participate were given an information on the purpose of the study and the forms, then the froms were distributed and students were asked to fill in the forms completely. Data collection took about 10 minutes for each individual.

  4. D.

    Data collection tools:

    Two survey forms were utilized in the study; one was the “Nursing Career Decision Scale”, developed by Zysberg ve Berry (2005) [10] and validity and reliability in Turkish conducted by Önler and Saraçoğlu (2010) [11] and the another was the “Sociodemographical Features Form”.

  5. E.

    Nursing Career Decision Scale:

    This was a scale developed by Zysberg and Berry in 2005, with a view to determine the factors influencing the career choice of nursing students. ThisLikert-type scale (between 0% and 100%) was composed of 20 items and two subscales. Each item was graded between 0% (no influence in my career decision) and 100% (most influential factor in my career decision). Total scale and subscale points were obtained by the sum of the points that participants gave to the scale, divided by the number of questions in the scale. Since this is not an identification scale, point ranges obtained were not significant. The factors influencing the career decision for nursing were compared in terms of independent variables with respect to the points received.

  6. F.

    Sociodemographical Features Form:

    This was the survey form created through literature search by the researchers [3,7,8] covering the factors that were thought to be influential in career decision of the students.

  7. G.

    Evaluation of the data:

    Evaluation of the data was carried out by SPSS 17.0 software, numerical, percentage and variance analysis and by using t test.

  8. H.

    Ethical side of the research:

    Written approval was obtained from the institutions where the study was carried out as well as verbal informed approval from the participants. The research did not cause any material oremotional risks from the standpoint of the sample.

III. Results

Of the sample, 32.4% wasfrom 1st grade, and 27% from 2nd grade, 23.2% from 3rd grade ve 17.4% from 4th grade. The rate of male students was 38.2% while the girls was 61.8%. Majority of the students were the gratuates of standard high schools (72.2%) while 23.2% of Anadolu high schools and 4.5% from other high schools (science high schools, industrial vocational high schools, health vocational high schools etc). Moreover, more than half of the students (57.3%) were living in cities and big cities whereas 42.7% were living in towns and villages (Table 1).

Table 1. Some demographical features of the students
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In decision-making, 58.1% of the students have consulted to various sources such as family, tutoring institutions, close neighborhood, or friends, while 41.9% stated that they haven’t received any counselling service. Out of the students who received coulselling service, 40% have stated they had it from their family, 37.8% from tutoring institution, and 31% from friends and close neighborhood. Besides, 76.3% of the students have selected nursing as a career willingly and 23.7% unwillingly. Moreover, the rate of the students that were currently happy with their choice of studying for nursing was 61%, while the rate of unhappy students was 9.1%; and the part of the sample that was still undecisive if they were happy or not was 29.9% (Table 2).

Table 2. Counselling, preference and satisfaction status of the students
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According to the findings (Table 3), it was observed that average career decision making points in nursing were significantly higher in the 1st year students compared to the other classes (p< 0.001). Although average career decision making points in nursing were higher in girls with respect to male students, this was not statistically significant (p>0.05). Although average career decision making points in nursing were higher in standard and Anadolu high schools respectively, as compared to the other high schools, this was not statistically significant either (p> 0.05). Although the students living in villages and towns had higher points than the students living in the cities, this difference was not considered as significant (p> 0.05).

Table 3. Difference in Nursing Career Decision Scale points
Full size table

Average Nursing Career Decision Scale point was 122.602 for the students who received counselling whereas this point was determined as 111.788 for those who did not receive counselling and this point difference was significant (P<0.05). The student who received counselling when they made career preference, had a significantly higher average Nursing Career Decision Scale points compared to the student who did not receive counselling service. Although the average points of the student receiving from private tutoring institutions, with respect to the students receiving the service from families and other sources, this difference was considered as statistically insignificant (p>0.05). Average points of those who willingly selected nursing was 124.987, while this figure was 95.742 for those, selecting unwillingly. Therefore, average points of those who willingly selected nursing was significantly higher than those who selected unwillingly (p<0.001). Average points of those who were happy or undecisive with their selection was found to be higher than unhappy students and this difference was determined to be signficant (p<0.001) (Table 4).

Table 4. Difference in Nursing Career Decision Scale points with respect to counselling, preference and satisfaction for selecting nursing
Full size table

IV. Discussion

In this study, great majority (72.2%) of the students choosing nursing were graduates of standard high schools, while 23.2% was from Anadolu high schools, and 4.5% from other high schools (science high schools, industrial vocational high schools, health vocational high schools etc.) (Table 1). This data was also in accordance with the other studies, stating that great majority of the nursing students were the standard high school graduates [6,7,13]. Contrary to this, in the study of Çıtak Tunç et al. (2010) [3], standard high school graduates have preferred nursing less, compared to the graduates of other high schools.

More than half (57.3%) of the students in this study were living in cities and big cities, while only a part of 42.7% was living in towns and villages (Table 1). It can be seen also in similar studies that, majority of the students who have chosen nursing as career were residents in big cities or in the zones where big cities gather [3,12].

In the study, 58.1% of the students consulted their families, tutoring institutions or close friends and neighbours when choosing nursing school, whereas 41.9% have stated that they have not received any counselling service (Table 2). Out of the students who received counselling service, 40% consulted their families, 37.8% their private tutoring institution, 31% their friends and close neighborhood. This data was also supported by various studies. In a study of Çıtak Tunç et al. (2010) [3], private tutoring institutions for preparation to university entrance test were orienteering in a greater part of the vocational decision, followed by suggestions of the families in the second order. In the study of Şirin et al. (2008) [18], 28.0% of the students have stated that their own will was the most influential factor when choosing nursing as a career, 14% stated their families, 25% stated being able to study at a university, 32.9% have indicated the concern of being easily able to find job. In the study of Gözüm (2004) [7], when the factors of preference for nursing were analysed, 43.3% have stated thier concern for the possibility of being left with no career, 31.2% health related career, 7.2% nursing was the ideal career of his/her dreams, others coincidencesand family recommendations.

In this study, 76.3% of the students have stated that they have selected nursing willingly, while 23.7% stated to have selected unwillingly (Table 2). Besides, the rate of the students currently studying for nursing and happy with their selection was 61% while the unhappy ones were 9.1%. The other studies too have obtained results supporting our study [6,7,8,12,13]. Great majority have selected nursing willingly and those who have selected unwilllingly have expressed that they were happy with their decision throughout their studies.

In this study, when the differences between career decision making in nursing was analysed with respect to some variables, we observed that the points of the first year students were significantly higher than points of the students of the other classes (Tablo 3). According to this data, we can say that the attitudes of the first year students towards nursing was more positive than that of the other classes. This can be explained due to the reasons that job opportunities of nursing may be more compared to the other professions, and maybe due to the fact that they might have received counselling. As for the feelings towards the profession, in a study of Şirin et al. (2008) [12] it was observed that the upper the grade was, the students had more tendency to love their profession even more. The reason for that may be due to the facts that they have had more close relations with the society as well as professional backgroundand self confidence normally improved as the grades increased. In the study, no statistically significany difference was found within career decision making points in nursing with respect to the variables such as gender, place of residence, status of graduation (Table 3).

According to the findings of this study, statistically signficant difference was found for Nursing Career Decision Scale points with respect to status of counselling, status of willful preference, and status of satisfaction of career decision (Table 4). As for the source of counselling however statistically signficant difference was not found (Table 4). In the study conducted by Çıtak Tunç et al. (2010) [3], they have revealed that, the contribution of high school/equivalent schools in the career decision making was limited though, the nursing and health technician students having received career counselling services from the private tutoring institutions that they attended for university entrance examinations, and the information they had within these services had actually oriented them to choose a branch in line with the points they got in the entrance examination.

This very data of our study was considered quite essential, which indicated that, in various instiutions such as high schools and tutoring schools at the first place, the student must definitely be provided counselling services; besides, nursing should be promoted as a profession. Many other studies also support these data [6,7,8,12,13]. Furthermore, this data also reveals the results that the families too must be informed by the universities and nursing associations, since the role of the families is too important in career decision making, to neglect.

V. Conclusions

It has been determined that;

  • great majority of the students choosing nursing were graduates of standard high schools and coming from big cities,

  • nearly half of the students did not receive counselling in career decision making, and out of the ones who received counselling, have been determined to choose nursing by the orientation of the families and private tutoring institutions,

  • substantial part of the students did not prefer nursing willingly,

  • substantial part of the students were not (or unsure if they were) satisfied with studying nursing,

  • Nursing Career Decision Scale in average points were significantly higher among first year students that the other classes,

  • there was no difference between the Nursing Career Decision Scale points with respect to gender, place of residence and graduation status,

  • The Nursing Career Decision Scale average points of the students who have received counselling service, those who have willingly chosen nursing and the ones who were happy with their selection were higher than that of those who did not receive counselling service, those who unwillingly choose nursing and the ones who were unhappy with their selection.

VI. Recommendations

We recommend that,

  • nursing as a profession in secondary education should better be promoted, since receiving counselling service in making career decision has a positive influence on career selection as well as professional satisfaction,

  • the factors should be investigated that influence the professional satisfaction of the students who are not happy with or not sure if they are happy with studying nursing.