The Image of Nursing as a Profession Among Students of the Military Technical Nursing School in Alexandria

Nursing has considerable progresses towards becoming professional in recent decades in comparison with previous decades and produced a scientific base by academic preparing programs for it. Now, it is the time to be aware of the images that they draw as professionals for themselves and others. Since, these images are forming during study and probing the way of forming perceptions as image of profession and the effective factors on it had not been considered by students till now and since core concepts. So, this study has been done for detecting the profession's image among nursing students of the Military Technical Nursing School in Alexandria. This study is a descriptive one and aimed at determining the image of nursing as a profession among students in Military Technical Nursing School as well to propose changes in relation to students image of nursing as a profession. The participants of this study were 120 nursing students who were in 1 , 2 and 3 years. A structured interview questionnaire was developed by the researcher to collect data about the socio demographic characteristics of students and their parents as well to identify the image of nursing as a profession among students such as reasons of enrolling to the Military Technical Nursing School, image toward Military and Civilian hospitals, causes of positive and negative image and their suggestion for improving nursing image. The study results revealed that the highest percentages of students in Alexandria had a positive image of military nursing as a profession except the students who's residency is Mersa Matrouh City. This portrayed from the military uniform, a good chance for work with a good salary demonstrated a positive influence of their image to nursing as a profession. However, working in the afternoon and night shifts and on Fridays and vacations, doing non nursing duties, calling the nurse at any time, the method of punishment if mistakes occurred had a negative influence on the image of nursing among the highest percentages of students. The study recommended further investigation for the negative views of nurses. Military hospitals should modify working condition and promote friendly environments for students with greater flexibility in work shifts.


INTRODUCTION
Nursing has been identified as an emerging profession for at least 150 years.The image of professional Nursing continues to evolve and is significantly impacted by the media, community perception, women's issues and roles, and a high technology health care environment.It is directly related to what the profession offers society and the values placed on that service (1) .
Image is often defined as mental representation that influences how individual see all aspects of life, included nurses and nursing, as it helps them in making judgments and expressing themselves (1,2) .Nurses image contribute in define their confidence they have in their ability and influence how they behave (3) .

The army forces established the Military Hospital Technical Nursing
School in Alexandria in 1983, since social significance means the impact of the society's attitudes, assumptions, and point of view about nurses (4,5) .The image which students have of the nursing profession is influenced by and in turn influences how the public see them and the productivity of the nurses in their job is related to its image.It is the satisfaction of the nurse with their job, including all aspects whether financial, social prestige, respect, and sense of achievement that drives the instinct of a nurse to give more in her job (4) .
Nursing students represent the future nursing manpower.
Entering the profession gives one a various choice of type of work and opportunities to use their acquired knowledge and skills in area of choice (6) .Ligelkis (7) admitted the factors influencing image as a career such as; community image, media dissemination, philosophy of nursing profession, salary, and community needs.
The worldwide shortage of nurses has attracted much discussion within the nursing profession.) .
Unfortunately the conventional image persists and it is these images that prospective nursing students may retain when seeing themselves as nurses; this factor is of significance to this present study.Recent research, however, reports a change in how the public perceive nurses (6,9) .Nurses are now viewed as being well-educated and independent thinkers and this perspective may reflect that vision that the nurse is now a major player within a high-tech medical world.
Conversely, Cowin (2001) said that girls are moving away from the stereotypical female careers and are becoming more attracted to traditional male occupations.
If this was the case; the nursing profession may be losing a valuable opportunity to recruit future nurses (8) .As the Australian and global population age it is imperative that action is taken to attract more individuals to nursing and also act to reduce the attrition of future student and qualified nurses (Campbell and Dickson, 1996) (10) .
Recently, nursing profession is facing many crises due to lack of interest among the young to choose nursing as a career.In western societies such as Canada , USA , and the United Kingdom, nursing is one of the few occupations that is acceptable for women from all socio-economic class (11) .To the contrary, in other western societies, nursing has not been acceptable occupation in a number of countries (12) .
In Egypt , the reasons of nursing shortage includes negative and bad image of the nursing profession in the society, hard work profession which needs great effort, night shifts which is rejected by the family, low salary and lack promotion (13,14) .

Aim of the study
This study was carried out to determine the image of nursing as a profession among students in Military Technical Nursing School.

Material
Setting: The study was carried out in the Military Technical Nursing School in Alexandria.

Sample
All students enrolled in the 1 st , 2 nd and 3 rd grades of the Military Technical Nursing School of the academic year 2006 -2007 were included in the study.
They came from different back ground of 6 cities.All students were girls .The total number of students were 120 as follows: • 30 students of the 1 st grade.
• 28 students of the 2 nd grade.
• 62 students of the 3 rd grade.
All students were welling to participate in the present study.

Statistical analysis
The statistical analysis was done using SPSS V. 9 of Windows package.
Frequencies, percentages and Pearson X 2 were calculated.Mean Score Percent and Standard Deviation were used as an index of measurement.The threshold of significance was less than 5%.

RESULTS
Table

DISCUSSION
Nursing is a vital component in every country's health care system (14) .
According to Mansour (1992) (15) ( 11,12,16,17,18) .On the other hand, the minority of the sample mentioned that enrollment of the military nursing school is the decision of their parents only.heath P.(2001) (19) , stated that young students may be applying to nursing programs responding to parent's dream instead of their own.

Military nursing school in
In the contrary, the minority of the sample stated that they enroll to the Military nursing school because they have social problems and the school is indoor.
Military nursing as an appreciated profession was perceived by the majority of students.These findings may be due to the military working system which is based on loyalty, displine and accuracy.
These findings were similar to those of May et al (1991) (20) , who found that nursing as an appreciated profession was perceived by a few of nursing students.On the other hand, the minority of students had a negative image of nursing in military hospital & they said that it is like the servant's job.In this respect, El Gilany and Al Wehady (2001) (21) , found that nursing was perceived by nursing students in Saudi Arabia as a servant's job.These findings were similar to these of Snow Antle (1984) (22) , Kaler et al (1989) (23) , and Mansour (1992) (15) , who found that nurses were perceived by students and their parents to be much lower than reported by other study on governmental nursing school (23) .
In this respect, Domrose (2002) (24) , and Losee (2004) (25) , indicated that there are certain realities of nursing that make it hard work: the complexity of patient care and the need for coverage on nights, weekends, and holidays (19)(20) .
While  (26) declared that, the problems of women shift workers are particularly difficult to resolve because the major burden of house hold work falls usually on them.Also, Stephen (27) mentioned that, most of shift workers find that late hours interfere with normal family and social life.
The majority of the sample viewed that the society has a positive image toward working in the military hospital because its privileges as treatment of the nurse and her family in the military hospitals, obtaining a flat and a car from the Army forces as well as, the financial reward are appropriate for choosing a carrier in military nursing.Contrary to this positive view Findings from the study also support previous research (6) on how the media can influence individuals who might be considering nursing as a career.

CONCLUSION AND RECOMMENDATIONS
The result of the present study revealed

Technical---
study -A structured interview questionnaire was developed by the researcher based on reviewing current related literature.The questionnaire was used to collect data about the socio demographic characteristics of students and their parents, the place of origin and residency as well to identify the image of nursing as a profession among students such as reasons of enrolling to the Military A permission to conduct the study was obtained from the Director of the technical nursing school of the military hospital.All grades of study were included to portray the image about nursing of newly admitted students in grade one and those in grade 2 and 3 who get various experience and became more realistic after studying and practicing nursing in the technical school and at the Military hospital.-A pilot study was carried out on 15 students of different grades in order to ensure clarity of the questions and to estimate the time needed to fill the questionnaire.The needed modification was made prior data collection.The structured questionnaire was answered by students in a time period of 20 minutes -Data were collected in February 2007.
physicians.Concerning job promotion, the majority of the sample has a positive image for working in military hospitals because job promotion, while, the minority has a negative image and this due to inability to continue their university studies in the faculty of nursing after finishing study in the military school.Regarding working conditions, the present study revealed that the highest percentages among students were negatively influenced by working in night shift duty.It may be due to that working of the females during nights is not accepted in Egyptian Society, specially to those who live in the rural and countryside's.Also, working in the weekends and public holidays calling at any time to work, marking a lot of clerical work and the ways of punishment when mistake were done.The same result was ,(71.61%) of the student have a positive image toward working in the military hospitals because it has recent machines and more advanced medical sets.The findings indicated that the majority of students at the military nursing school have a negative image toward military nursing.They mentioned that the afternoon and night shifts will not help them to enroll with any study, to share in social activities, to work in a private clinic to increase their income and to live in a stable life, with their husbands.Moreover they mentioned that working long hours affect on their house duties.McDonald and Doyle

Students and their Parents Personal Characteristics.
Table1: