Nursing students often are asked why they chose to pursue nursing. Their responses reflect personal experiences with nurses or nursing care, relatives who are nurses, or a proclivity to care for others. Some indicate that nursing is a calling-that they were predestined to become nurses. Increasingly, some come to the profession later in life or as a second career. Was it a long-suppressed calling to serve or some other compulsion that drew these nurses? Is nursing a choice or a calling?
Religious and secular ideas have permeated the interpretation of service as a calling or choice. A calling traditionally referred to a Christian belief that one received a spiritual calling by God, mainly to a religious life of dedication and service (Carter, 2014). In ancient times, men and women came to nursing through religious orders guided by Christian doctrine (Donahue, 1985). Florence Nightingale received a calling to service that seems to have originated from early life experiences (Fitne, 1990; Selanders, 2018).
After the Protestant Reformation in the 16th century, a calling or vocation came to mean a personally fulfilling or socially significant occupation that can hold spiritual significance (Dik & Duffy, 2009). Thus, a calling is transcendent, originates beyond the self, and is a pathway that infuses meaningfulness into work and life roles. Scott (2007) explored the religious nature of a calling and found that it is a means to serve God by serving others in tangible ways, enhanced by an inner conviction and passion. Since the Reformation, calling has taken on a secular perspective, in that earthly occupations could be ascribed a spiritual significance (Emerson, 2017). As a result, individuals can have a sense of purpose in helping others and making the world a better place.
In recent centuries, caring was considered a central self-sacrificing service to family and others specifically relegated to women (Reverby, 1989). Thus, caring (aka nursing) became a duty or obligation rather than an altruistic calling. As nursing emerged as a formal profession, specific women were called to minister to the sick. In the late 19th century, nursing evolved from midwifery to modern nursing, requiring self-sacrificing commitment to the service of others (Kreiser, 2015). Although the nurse became a paid professional, the nurse's selfless dedication required an altruistic commitment born of a moral disposition and passion to serve (White, 2002).
IS VOCATION OUT OF VOGUE?
Vocation, Latin for calling, is likely to indicate a job or choice of occupation (Placher, 2005). A 21st century view is that the vocation or purpose for one's life work is preordained, regardless of the work or job chosen (White, 2002). Because calling is associated with a theistic worldview, the term seems to offer a different conception, focused on an inner drive to self-fulfillment (Emerson, 2017). Those who are averse to identifying nursing as a calling, because it implies subservience or subjugation rather than professional independence, prefer the idea of a chosen vocation. This suggests that the individual determines whether he/she has a special calling to an occupation. However, the question remains: How is the choice made to pursue nursing?
Reverby (1989) notes nursing is shaped by an obligation to care. A calling to serve the poor has been described as a factor that sustains a student to complete a nursing program or to sustain a nurse throughout his or her career (Emerson, 2017; Fowler & Norrie, 2009). Prosocial motivation to contribute to society also has been identified as a common stimulus for entering nursing but may not support long-term commitment to nursing (Nesje, 2015). The personal fulfillment and social significance of a calling is what can support the pursuit and preserve the passion of a career in nursing (Dik & Duffy, 2009).
Men and women come into nursing by divergent paths. Implicit in the role is an expectation of compassion and caring, born of a strong desire to care for others. The primacy of caring is essential and should be present regardless of motives. The sensitivity and responsiveness to patient's specific needs is founded in a personal and moral attitude of caring (White, 2002). This suggests that a call to care could become a call to nursing.
The status of nursing, nursing education, and the shifting politics of healthcare have impacted the image of nursing (Carter, 2014) and notions of calling and vocation. The autonomous, professional standing of nursing is in contrast with ideas of subservience and humility implied by calling. Professionalism requires a leader who is competent, educated, and self-governing. Thus, adding competence and dedication to quality to the view of nursing as calling would elevate, rather than diminish, professional status.
SEEDS OF NURSING
So, what is the seed that propagates a pursuit of nursing? Because nursing provides multiple options for practice, it is realistic to assume numerable motives for the choice of nursing. Is it life experiences, personal drive, altruism, or something else? For some, the choice follows a seminal event; some see the incredible opportunities in nursing, whereas others feel a strong desire to make a difference. Sometimes nursing was not the first career choice but came later in life. In the long run, introspection, self-awareness, personal experiences, and a desire to find meaning in life are the antecedents of a calling that seem to predict satisfaction and engagement in nursing (Duffy, Bott, Allan, Torrey, & Dik, 2012; Emerson, 2017).
There are as many reasons to pursue nursing as there are career directions. Many professions require a dedication to caring and service, but few offer the kind of personal intimacy and human connection afforded to nurses. Nursing involves a holistic approach to care and treatment, which necessitates an appreciation for the physical, spiritual, social, and psychological aspects of being. Such commitment requires integrity and altruism (Carter, 2014). The testimony to this commitment is implicit in the consistently high rating of nursing by the public.
According to the 2018 Gallup poll, "More than four in five Americans (84%) again rate the honesty and ethical standards of nurses as 'very high' or 'high,' earning nurses the top spot among a diverse list of professions for the 17th consecutive year" (Brenan, 2018, para 1).
CONCLUSION
The pursuit of nursing appears to be both a choice and a calling; a calling can be a choice and a choice can become a calling. Motives, values, and attitudes matter in society, no matter what the era. Caring is the underlying altruistic foundation of nursing that can transform the choice of nursing as a career into a calling to care or convert a calling to care into a choice of career (Carter, 2014). A career in nursing provides the gratification of service and the fulfillment of a call to caring.