a study in alienation by David Claerbaut the middle 1960s, with the rise of the Black Power movement, the passage of Civil Rights legislation, and the recent emphasis on Affirmative Action programs there has been a raising of consciousness in America concerning racial and ethnic minorities. Although minorities, especially blacks, have been the focus of a great deal of research during this period, black nurses and nursing students have received relatively little attention.
S
INCE
N U R S I N G FORUM
211
Miller ( 1972), Johnson ( 1974), Robinson ( 1972), and Smith (1975) all lament the dearth of black nurses and nursing students. This lack, it would appear, is not due to an absence of aspiration. Winder’s ( 1971) study of black high school girls and Miller’s findings among over one hundred black student nurses, clearly indicate a very positive outlook toward nursing as a potential career. Miller states that blacks are ideal candidates for recruitment but have been, and continue to be, excluded from nursing programs by discrimination as well as educational and economic deprivation. He cites a number of studies which document charges of discriminatory practices. Robinson also mentions the problem of conscious and unconscious racial bias on the part of many schools, reinforcing this point. The problems do not end once the individual graduates from the nursing program and enters the profession. Harris (1972) tells of the dual psychological life many black nurses are forced to live. On the job, the black nurse may be viewed as a professional, but off duty she is just another black woman encountering all the difficulties of being black in America. There are also on-the-job difficulties. Piero (1974) mentions the abuse black nurses incur from prejudiced white patients. Cofer (1974) reports on interviewing fifty black nurses, finding that they all felt they worked under stress and did not feel at ease. She also cites discrimination in promotion practices along with a general lack of respect for black nurses as issues of concern. Smith also discusses the loss of identity for black nurses and the lack of recognition for the contributions blacks have made to nursing as matters requiring attention. In summary, then, there is sufficient general evidence of a strain of alienation among black nurses and student nurses.
212
VOLUME X V
NO. 2
1976
A COMPARATIVE STUDY OF ALIENATION The following is a small comparative study of alienation as it affects a hitherto unresearched group: black nursing students at liberal arts colleges. It analyzes the degree and kind of alienation among the twenty black nursing students attending schools in a Midwestern college conference.
METHODS The population selected for this study was the black student population in a Midwestern college conference. The eight schools in the study range in size from 900 to 1,900 and are all liberal arts institutions. The 259 black respondents represent over 57 percent of the 449 black students enrolled in the eight schools in the study. The twenty nursing majors are spread among five of the colleges. The instrument used in this study was based on Middleton’s (1963) alienation scale. It consists of four statements each of which tests a specific component of alienation on the part of the respondent. The statements, and the components tested by each, are as follows: 1. “ I am not much interested in the TV programs, movies, or magazines that most people seem to like.” (Cultural Estrangement)
2. “1 often feel lonely.” (Social Estrangement)
3. “Things have become so complicated in the world today that I really don’t understand what is going on.’.’ (Meaninglessness)
4. ‘‘I don’t really enjoy most of the school work that I do, but I feel that I must do it in order to have the other
N U R S I N G FORUM
213
things that I need and want.” (Estrangement from Work) FINDINGS The table, “Alienation by College Major or Anticipated Major” indicates that nurses’ responses were in sharp variance from the rest of the subjects on three of the components. Only 25 percent of the nursing students endorsed Item 1 (Cultural Estrangement), indicating little alienation on this component. Apparently, the entertainment tastes of this group do not greatly deviate from those of the larger society or the other black students in the study. However, lack of expressed cultural estrangement may not necessarily mean that these students find the popular media all that stimulating. It may well be the result of a “limited alternatives” phenomenon the necessity of having to turn to inexpensive, mass forms of entertainment owing to a variety of disadvantaging factors, including the absence of black peers and readily available means of transportation because of either low income or campus isolation. Responses to Item 2 (Social Estrangement) lend support to the foregoing hypothesis regarding a dearth of especially black nursing peers, as the nurses were the only group evidencing a high level of alienation on this component. Their 60 percent agreement level on this item was 20 percent higher than the humanities majors who were second. This paucity of fellow black nursing students, a problem regularly alluded to in the literature, is a special problem for this group with only 20 black nursing students among conference respondents. There may also be a work factor involved here. (Both black and white nursing students at one of the colleges consistently
214
V O L U M E XV
NO. 2
1976
(178)
(78)
Total
(42)
(68)
(21)
(46)
(59)
(20)
(256)
X2= 3.8302 p = S741
66.7 (28)
33.3 (14)
Other
61.8 (42)
76.2 (16)
38.2 (26)
(5)
23.8
76.1 (35)
Social Science
Humanities
23.9
(11)
Teaching
71.2 (42)
(5)
28.8 (17)
75.0
(15)
25.0
Business
Nursing
Total
(92)
39.0 (16)
36.2 (25)
40.0 (8)
30.4 (14)
28.3 (17)
60.0 (12)
A
7.4575 .I888
(164)
61.0 (25)
63.8 (44)
60.0 (12)
69.6 (32)
71.7 (43)
40.0 (8)
D
(256)
(41)
(69)
(20)
(46)
(60)
(20)
T
SOCIAL ESTRANGEMENT
CULTURAL ESTRANGEMENT
Percent Percent Agree Disagree
2
I
3
A
(61)
16.7 (7)
20.6 (14)
31.8 (7)
(10)
21.7
21.7 (13)
(10)
10.2164 .0693
(197)
83.3 (35)
79.4 (54)
(15)
68.2
78.3 (36)
78.3 (47)
(10)
50.0
D
53.8 (21) (160)
(258)
63.8 (44)
68.2 (15)
65.2 (30)
71.2 (42)
42.1 (8)
A
4
7.0242 .2 189
(94)
46.2 (18)
36.2 (25)
31.8 (7)
34.8 (16)
28.8 (17)
(11)
57.9
D
T
(254)
(39)
(691 . ,
(22)
(46)
(59)
(19)
ESTRANGEMENT FROM WORK
(42)
(68)
(22)
(46)
(60)
(20)
T
MEANINGLESSNESS
50.0
ALIENATION ITEMS
ALIENATION BY COLLEGE MAJOR OR ANTICIPATED MAJOR
indicated that the time and work demands of the nursing program are heavy, causing them to live rather tightlyregulated social and academic lives.) As necessary as a tightly-sequenced system is to the proper professional preparation of nurses it may well have the effect of separating them from other students, a peculiar problem for black students who, due to minority status, already experience a certain degree of isolation and estrangement. Nurses were again the most alienated group in terms of Item 3 (Meaninglessness). Fully 50 percent endorsed the item. Although this seems to be a rather curious finding and difficult to account for, it is possible that the nursing program is, in itself, so complex, both in terms of subject matter studied and the course sequence required, that it is alien to the experience of many of these black students. Moreover, the previously discussed social estrangement problem may also be a factor as relational deficits have consistently been pointed to by psychologists and sociologists as having the consequence of producing disorientation, confusion, and even identity crises. An encouraging finding emerges in the case of Item 4 (Estrangement from Work). With only 42.1 percent of the students agreeing with the component, nurses were the only major group not estranged from their work. Among the other stated major groups, the social science subjects were second with 63.8 percent - a difference of 21.7 percent. Although the work load may at times seem heavy, evidently, most of the nursing majors are enjoying their academic and professional preparation. The fact that they are studying material directly related to what they will be doing as professionals may be a large factor here. Indeed, irrelevance is not likely to be much of a problem in this curriculum. There is reason
216
VOLUME X V
NO. 2
1976
to hope that many of the students may be able to compensate for social estrangement by immersing themselves in their academic endeavors.
CONCLUSIONS In short, the student nurses’ responses deviated sharply from those of the black students as a whole. In a positive vein, they were the only stated major group not estranged from their work. However, they were the most alienated of all the groups in terms of meaninglessness and social estrangement. This response pattern suggests that nursing students may require specific study and analysis and should not be viewed as typical of the larger black student population at liberal arts colleges. It also suggests that nurses may be subject to a rather dualistic educational experience - an academic one which is generally pleasant and satisfying, and a social one characterized by loneliness, isolation, and alienation. There is, then, cause for both optimism and concern here. That the academic dimension is reasonably well appreciated by the students is laudable; however, in view of the problems raised in the literature as well as the findings of this case study, attention needs to be focused on sources of social alienation. For maximally effective steps to be taken, more research is needed. While relatively little is known of black nursing students in general, there is almost no knowledge about the ever-growing number of black students in nursing programs at liberal arts colleges. Further research concerning basic attitudes and problems of these students through the use of interviews, observations, conversations, questionnaires, and so on could be very helpful in the task of developing a more
NURSING FORUM
217
harmonious, interracial atmosphere - one which is consonant with the humane ideals of the nursing profession.
REFERENCES Cofer, Audre, “Autobiography of a Black Nurse,’’ American Journal of Nursing, Vol. 74, October 1974, pp. 1836-38. Harris, Lottie Ozias, “Where is the Black Nurse?” American Journal of Nursing, Vol. 72, February 1972, pp. 282-84. Johnson, Walter L., “Admissions of Men and Ethnic Minorities to Schools of Nursing 1971-72,” Nursing Outlook, Vol. 22, January 1974, pp. 45-49. Middleton, Russell, “Alienation, Race, and Education,” American Sociological Review, Vol. 28, December 1963, pp. 97377. Miller, Michael H., “On Blacks Entering Nursing,” Nursing Forum, Vol. I I , No. 3, pp. 248-63. Piero, Phyllis, “Black-White Crisis,” American Journal of Nursing, Vol. 74, February 1974, pp. 280-8 1. Robinson, Alice M., “Black Nurses Tell You: Why So Few Blacks in Nursing,” R N , Vol. 35, July 1972, pp. 35-41, 7374, 76. Smith, Gloria R., “From Invisibility to Blackness: The Story of the National Black Nurses’ Association,” Nursing Outlook, Vol. 23, April 1975, pp. 225-29. Winder, Alvin F., “Why Young Black Women Don’t Enter Nursing,” Nursing Forum, Vol. 10, No. 1, 1971, pp. 56-63.
218
V O L U M E XV
NO. 2
1976
S
INCE
N U R S I N G FORUM
211
Miller ( 1972), Johnson ( 1974), Robinson ( 1972), and Smith (1975) all lament the dearth of black nurses and nursing students. This lack, it would appear, is not due to an absence of aspiration. Winder’s ( 1971) study of black high school girls and Miller’s findings among over one hundred black student nurses, clearly indicate a very positive outlook toward nursing as a potential career. Miller states that blacks are ideal candidates for recruitment but have been, and continue to be, excluded from nursing programs by discrimination as well as educational and economic deprivation. He cites a number of studies which document charges of discriminatory practices. Robinson also mentions the problem of conscious and unconscious racial bias on the part of many schools, reinforcing this point. The problems do not end once the individual graduates from the nursing program and enters the profession. Harris (1972) tells of the dual psychological life many black nurses are forced to live. On the job, the black nurse may be viewed as a professional, but off duty she is just another black woman encountering all the difficulties of being black in America. There are also on-the-job difficulties. Piero (1974) mentions the abuse black nurses incur from prejudiced white patients. Cofer (1974) reports on interviewing fifty black nurses, finding that they all felt they worked under stress and did not feel at ease. She also cites discrimination in promotion practices along with a general lack of respect for black nurses as issues of concern. Smith also discusses the loss of identity for black nurses and the lack of recognition for the contributions blacks have made to nursing as matters requiring attention. In summary, then, there is sufficient general evidence of a strain of alienation among black nurses and student nurses.
212
VOLUME X V
NO. 2
1976
A COMPARATIVE STUDY OF ALIENATION The following is a small comparative study of alienation as it affects a hitherto unresearched group: black nursing students at liberal arts colleges. It analyzes the degree and kind of alienation among the twenty black nursing students attending schools in a Midwestern college conference.
METHODS The population selected for this study was the black student population in a Midwestern college conference. The eight schools in the study range in size from 900 to 1,900 and are all liberal arts institutions. The 259 black respondents represent over 57 percent of the 449 black students enrolled in the eight schools in the study. The twenty nursing majors are spread among five of the colleges. The instrument used in this study was based on Middleton’s (1963) alienation scale. It consists of four statements each of which tests a specific component of alienation on the part of the respondent. The statements, and the components tested by each, are as follows: 1. “ I am not much interested in the TV programs, movies, or magazines that most people seem to like.” (Cultural Estrangement)
2. “1 often feel lonely.” (Social Estrangement)
3. “Things have become so complicated in the world today that I really don’t understand what is going on.’.’ (Meaninglessness)
4. ‘‘I don’t really enjoy most of the school work that I do, but I feel that I must do it in order to have the other
N U R S I N G FORUM
213
things that I need and want.” (Estrangement from Work) FINDINGS The table, “Alienation by College Major or Anticipated Major” indicates that nurses’ responses were in sharp variance from the rest of the subjects on three of the components. Only 25 percent of the nursing students endorsed Item 1 (Cultural Estrangement), indicating little alienation on this component. Apparently, the entertainment tastes of this group do not greatly deviate from those of the larger society or the other black students in the study. However, lack of expressed cultural estrangement may not necessarily mean that these students find the popular media all that stimulating. It may well be the result of a “limited alternatives” phenomenon the necessity of having to turn to inexpensive, mass forms of entertainment owing to a variety of disadvantaging factors, including the absence of black peers and readily available means of transportation because of either low income or campus isolation. Responses to Item 2 (Social Estrangement) lend support to the foregoing hypothesis regarding a dearth of especially black nursing peers, as the nurses were the only group evidencing a high level of alienation on this component. Their 60 percent agreement level on this item was 20 percent higher than the humanities majors who were second. This paucity of fellow black nursing students, a problem regularly alluded to in the literature, is a special problem for this group with only 20 black nursing students among conference respondents. There may also be a work factor involved here. (Both black and white nursing students at one of the colleges consistently
214
V O L U M E XV
NO. 2
1976
(178)
(78)
Total
(42)
(68)
(21)
(46)
(59)
(20)
(256)
X2= 3.8302 p = S741
66.7 (28)
33.3 (14)
Other
61.8 (42)
76.2 (16)
38.2 (26)
(5)
23.8
76.1 (35)
Social Science
Humanities
23.9
(11)
Teaching
71.2 (42)
(5)
28.8 (17)
75.0
(15)
25.0
Business
Nursing
Total
(92)
39.0 (16)
36.2 (25)
40.0 (8)
30.4 (14)
28.3 (17)
60.0 (12)
A
7.4575 .I888
(164)
61.0 (25)
63.8 (44)
60.0 (12)
69.6 (32)
71.7 (43)
40.0 (8)
D
(256)
(41)
(69)
(20)
(46)
(60)
(20)
T
SOCIAL ESTRANGEMENT
CULTURAL ESTRANGEMENT
Percent Percent Agree Disagree
2
I
3
A
(61)
16.7 (7)
20.6 (14)
31.8 (7)
(10)
21.7
21.7 (13)
(10)
10.2164 .0693
(197)
83.3 (35)
79.4 (54)
(15)
68.2
78.3 (36)
78.3 (47)
(10)
50.0
D
53.8 (21) (160)
(258)
63.8 (44)
68.2 (15)
65.2 (30)
71.2 (42)
42.1 (8)
A
4
7.0242 .2 189
(94)
46.2 (18)
36.2 (25)
31.8 (7)
34.8 (16)
28.8 (17)
(11)
57.9
D
T
(254)
(39)
(691 . ,
(22)
(46)
(59)
(19)
ESTRANGEMENT FROM WORK
(42)
(68)
(22)
(46)
(60)
(20)
T
MEANINGLESSNESS
50.0
ALIENATION ITEMS
ALIENATION BY COLLEGE MAJOR OR ANTICIPATED MAJOR
indicated that the time and work demands of the nursing program are heavy, causing them to live rather tightlyregulated social and academic lives.) As necessary as a tightly-sequenced system is to the proper professional preparation of nurses it may well have the effect of separating them from other students, a peculiar problem for black students who, due to minority status, already experience a certain degree of isolation and estrangement. Nurses were again the most alienated group in terms of Item 3 (Meaninglessness). Fully 50 percent endorsed the item. Although this seems to be a rather curious finding and difficult to account for, it is possible that the nursing program is, in itself, so complex, both in terms of subject matter studied and the course sequence required, that it is alien to the experience of many of these black students. Moreover, the previously discussed social estrangement problem may also be a factor as relational deficits have consistently been pointed to by psychologists and sociologists as having the consequence of producing disorientation, confusion, and even identity crises. An encouraging finding emerges in the case of Item 4 (Estrangement from Work). With only 42.1 percent of the students agreeing with the component, nurses were the only major group not estranged from their work. Among the other stated major groups, the social science subjects were second with 63.8 percent - a difference of 21.7 percent. Although the work load may at times seem heavy, evidently, most of the nursing majors are enjoying their academic and professional preparation. The fact that they are studying material directly related to what they will be doing as professionals may be a large factor here. Indeed, irrelevance is not likely to be much of a problem in this curriculum. There is reason
216
VOLUME X V
NO. 2
1976
to hope that many of the students may be able to compensate for social estrangement by immersing themselves in their academic endeavors.
CONCLUSIONS In short, the student nurses’ responses deviated sharply from those of the black students as a whole. In a positive vein, they were the only stated major group not estranged from their work. However, they were the most alienated of all the groups in terms of meaninglessness and social estrangement. This response pattern suggests that nursing students may require specific study and analysis and should not be viewed as typical of the larger black student population at liberal arts colleges. It also suggests that nurses may be subject to a rather dualistic educational experience - an academic one which is generally pleasant and satisfying, and a social one characterized by loneliness, isolation, and alienation. There is, then, cause for both optimism and concern here. That the academic dimension is reasonably well appreciated by the students is laudable; however, in view of the problems raised in the literature as well as the findings of this case study, attention needs to be focused on sources of social alienation. For maximally effective steps to be taken, more research is needed. While relatively little is known of black nursing students in general, there is almost no knowledge about the ever-growing number of black students in nursing programs at liberal arts colleges. Further research concerning basic attitudes and problems of these students through the use of interviews, observations, conversations, questionnaires, and so on could be very helpful in the task of developing a more
NURSING FORUM
217
harmonious, interracial atmosphere - one which is consonant with the humane ideals of the nursing profession.
REFERENCES Cofer, Audre, “Autobiography of a Black Nurse,’’ American Journal of Nursing, Vol. 74, October 1974, pp. 1836-38. Harris, Lottie Ozias, “Where is the Black Nurse?” American Journal of Nursing, Vol. 72, February 1972, pp. 282-84. Johnson, Walter L., “Admissions of Men and Ethnic Minorities to Schools of Nursing 1971-72,” Nursing Outlook, Vol. 22, January 1974, pp. 45-49. Middleton, Russell, “Alienation, Race, and Education,” American Sociological Review, Vol. 28, December 1963, pp. 97377. Miller, Michael H., “On Blacks Entering Nursing,” Nursing Forum, Vol. I I , No. 3, pp. 248-63. Piero, Phyllis, “Black-White Crisis,” American Journal of Nursing, Vol. 74, February 1974, pp. 280-8 1. Robinson, Alice M., “Black Nurses Tell You: Why So Few Blacks in Nursing,” R N , Vol. 35, July 1972, pp. 35-41, 7374, 76. Smith, Gloria R., “From Invisibility to Blackness: The Story of the National Black Nurses’ Association,” Nursing Outlook, Vol. 23, April 1975, pp. 225-29. Winder, Alvin F., “Why Young Black Women Don’t Enter Nursing,” Nursing Forum, Vol. 10, No. 1, 1971, pp. 56-63.
218
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NO. 2
1976
