Undergraduate nursing students' adoption of the professional identity of nursing through social media use: A qualitative descriptive study

Social media quality in undergraduate medical education: A reconceptualisation and taxonomy

BACKGROUND

Social Media (SoMe) as a learning tool, though ubiquitous in society and popular within medical education, is often criticised as superficial. Its limitless output has been blamed for encouraging shorter attention spans and shirking in-depth reflection. The evidence base is itself superficial and lacking rigour or meaning. We aimed to consider a theoretical basis for how 'quality' learning may happen on such platforms. Our findings then informed the construction of a taxonomy for SoMe learning.

METHODS

We conducted a qualitative interview study of United Kingdom (UK) medical students using a theory-informed inductive study design. The research question was: 'How do medical students conceptualise quality of learning on social media?'. We purposively sampled participants from responses to a short survey collecting demographic and SoMe usage data. Interview data were analysed using framework analysis and informed by Blooms taxonomy, connectivism and communities of practice (CoP) theories.

RESULTS

We received survey responses from 118 medical students across 25 UK medical schools. From these, 13 participants were recruited to individual semi-structured interviews. We constructed three themes through framework analysis of interview data: cognitive hacking, professional identity reflection and safety, control and capital.

DISCUSSION

Quality SoMe learning may be conceptualised as a socially connected process, built upon constantly evolving networks but inexorably influenced by fluctuating hierarchy within learner-centric CoP. Educators and institutions may support high-quality learning for students through engagement which promotes community development, and safe, listening environments which foster professional identity formation.

Digital professionalism in preregistration nursing and midwifery students: A scoping review to explore perceptions of professionalism when using social media

AIM

This review aimed to scope the literature by examining preregistration nursing and midwifery students' perceptions regarding professional use of social media.

BACKGROUND

Digital professionalism refers to the competence required when interacting online, such as social network platforms by maintaining the values and attitudes which align with professional codes of conduct. With increasing social media platforms being used by nursing and midwifery students, there are concerns about professional behaviour and the implications for those who may not be clear on its use in the professional context of their profession.

DESIGN

Methodology included utilising best-practice guidelines for undertaking scoping reviews. The PCC framework (population, concept and context) was applied to this review; Population - preregistration nursing and/or midwifery students; Concept/s- professionalism when using social media platforms; and Context - preregistration (undergraduate) or entry level students studying either midwifery or nursing. The databases included in the review were MEDLINE, CINAHL, Embase (OVID) and Scopus due to their relevancy to health professional education, identifying 1087 articles up to May 2024, which were screened independently by two reviewers. Seventeen articles (17) met the inclusion criteria. Content analysis assisted with mapping of themes and subthemes.

RESULTS

The year of publication of the 17 primary studies ranged from 2012 to 2023. Twelve studies were cross-sectional, one was a randomised controlled trial, one was a retrospective analysis and three were qualitative designs. A wide number of countries were represented. Social media platforms included Facebook, Instagram, Twitter, WhatsApp, Snapchat, YouTube, WeChat, Ozone, QQ, Sina Weibo, TikTok and LinkedIn. Two major themes represented nursing and/or midwifery student views and experiences with their professional engagement when using social media, with a focus on digital professionalism: Professional Boundaries and Responsibility and Accountability.

CONCLUSIONS

There is a need to ensure nursing and midwifery students are aware of social media policies and procedures which must have a strong presence within preregistration curricula. Further research is required to co-design and facilitate clear guidelines and further education on digital professionalism.

Self-efficacy mediates the effect of professional identity on learning engagement for nursing students in higher vocational colleges: A cross-sectional study

BACKGROUND

Learning engagement is a crucial predictor of academic achievement. It is essential to understand the factors influencing learning engagement among nursing students, especially from the learner's perspective, which is notably scarce but vital for designing effective educational interventions.

OBJECTIVES

This study aims to investigate the mediating effect of self-efficacy on the relationship between professional identity and learning engagement for nursing students in higher vocational colleges.

DESIGN

A cross-sectional electronic survey was conducted.

SETTING

The study was conducted in four higher vocational colleges located in Guangdong Province, China.

PARTICIPANTS

A total of 944 first- and second-year nursing students participated in the study between October and November 2022.

METHODS

Data were collected with questionnaires on general information, professional identity, self-efficacy, and learning engagement and analyzed with SPSS 26.0 and PROCESS v4.1 (Model 4), exploring relationships among professional identity, self-efficacy, and learning engagement through Pearson correlations, multivariate regression, and mediation analysis with 5000 bootstrap samples.

RESULTS

The participants exhibited moderate levels of professional identity (85.37 ± 13.52), self-efficacy (25.58 ± 5.74), and learning engagement (71.26 ± 16.17), which were all significantly correlated with each other (P < 0.01). In the model of the mediating effect, professional identity directly (β = 0.811, t = 27.484, P < 0.001) and indirectly [β = 0.112,95%CI (0.074-0.154)] significantly predicts college students' learning engagement; professional identity has a significant positive predictive effect on self-efficacy (β = 0.182, t = 14.459, P < 0.001) and self-efficacy significantly predicts learning engagement (β = 0.614, t = 8.292, P < 0.001). Furthermore, the direct effect of professional identity on learning engagement (0.699) and its mediating effect (0.112) account for 86.19 % and 13.81 % of the total effect (0.811), respectively.

CONCLUSION

Participants exhibited moderate levels of professional identity, self-efficacy, and learning engagement. Professional identity and self-efficacy are interconnected and positively correlated, influencing learning engagement among nursing students, which highlights the need to foster these qualities to enhance education and future practice.

The effects of profession-related films on the professional pride of nursing students: A randomised controlled trial

AIM

This study aimed to determine the effects of profession-related films on the professional pride of nursing students.

DESIGNS

The study was conducted with a randomised controlled experimental design.

METHODS

The sample of the study consisted of 102 students enrolled in the first year of the School of Nursing, Zonguldak Bulent Ecevit University in Türkiye in the 2022-2023 academic year. These students were randomly assigned to the experimental (n = 57) and control (n = 45) groups. The experimental group watched two documentaries and a film on YouTube with a one-week break. Self-administered online questionnaires were distributed via WhatsApp groups for pretests and posttests. Data were collected with a "Sociodemographic Data Form" and the "Nursing Professional Pride Scale (NPPS)" included in the questionnaire forms prepared on the Google Forms platform. Data were analysed using Spearman's rho, the Mann-Whitney U Test, and the Wilcoxon Signed-Rank Test.

RESULTS

The mean age of the participants was 18.80 ± 0.99 years, 80% of the participants were female, the place where 79.4% had lived for the longest duration in their lives was the city, 85.3% had information about the profession of nursing before they started university (36.8% from the internet, 34.6% from people around them). The experimental group had significantly higher NPPS scores than the control group after the intervention (p = 0.017). There was also a significant increase in the dimensions of professional feeling (p = 0.012) and desire to continue the profession in the experimental group (p = 0.002).

PATIENT OR PUBLIC CONTRIBUTION

Patients and public were not involved in this research.

Prevalence of Cyberbullying Perpetration and Cyberbullying Victimization among Nursing Students in Jordan

Introduction

Cyberbullying is a form of bullying or harassment carried out online with the intent to harm others mainly using social media sites.

Objective

To investigate cyberbullying prevalence and associated factors among nursing students in Jordan.

Methods

A descriptive, cross-sectional study was conducted. A convenience sample of 428 Jordanian nursing students from three private Jordanian universities was involved in the study. Data were collected in 2022 using the sociodemographic characteristics sheet, cyberbullying perpetration (CBP) scale; and cyberbullying victimization (CBV) scale. Multiple linear regression analysis was performed to identify variables associated with the CBP and CBV scores.

Results

About 30.1% of the students were not involved in any cyberbullying, while 8.6% were categorized as cyberbullying perpetrators only, 20.4% as victims only, and 40.9% were categorized as cyberbullying perpetrators and victims at the same time. Visual /sexual perpetration and verbal/written victimization were the most prevalent forms of cyberbullying among the studied nursing students. Increasing age was associated with a decreased CBP (P < 0.05) and CBV (P < 0.01), while male gender was associated with increased cyberbullying perpetration (P < 0.01).

Conclusions

The prevalence of cyberbullying among nursing students in the current study was alarming. The study showed that age was negatively associated with CBP and CBV while being male was associated with increased CBP. Future research may want to consider using a longitudinal research design with more testing variables and a more comprehensive examination of potential causes and impacts of cyberbullying in nursing students. The development of specific policies to combat cyberbullying among Jordanian nursing students is also recommended.

The influence of social media on student nurses: A systematic mixed-studies review

BACKGROUND

Social media usage has been ubiquitous and extensively integrated into the daily lives of student nurses. However, there exists a paucity of understanding regarding the influence of social media on student nurses' personal and professional development.

OBJECTIVE

To examine the influence of social media on student nurses' personal and professional values.

DESIGN

A systematic mixed-studies review.

METHODS

English language published studies were sourced from hand searches and seven electronic databases (PubMed, CINAHL, Embase, PsycINFO, ProQuest Dissertation and Theses Global, Scopus, and Web of Science) from the inception of each database to January 2023.

RESULTS

Twenty-six studies were included. Two main themes and eight subthemes were derived through thematic synthesis. The first main theme, Shaping Student Nurses into Nurses, included four subthemes: 1.1) Personal Development, 1.2) Professional Development, 1.3) Advocacy, and 1.4) Networking. The second main theme, Repercussions of Social Media Usage, included four subthemes: 2.1) Frustrations, 2.2) Discriminative Feelings, 2.3) Compulsive feelings, and 2.4) Consequences of Inappropriate Usage.

CONCLUSION

The ubiquitous utilization of social media among the current generation of student nurses, for personal, educational, and professional purposes, has precipitated transformative effects conducive to their holistic development. Notwithstanding the potential perils associated with privacy violation and inappropriate usage, educational institutions can develop pedagogical strategies and guidelines in collaboration with healthcare institutions and professionals, aimed at the incorporation of social media within the educational curricula and the prospective workplace environments of student nurses.

Social Media in Nursing Education: A Systematic Review

BACKGROUND

Although social media is emerging as an educational tool in health care professions, little is known about which social media platforms support nursing education in different situations.

METHOD

This systematic review examined and ranked the level of evidence that supports social media use in nursing education.

RESULTS

A total of 19 studies published between 2017 and 2022 were evaluated and described in an evidence table. Results revealed social media is used in a variety of settings and in different ways, including providing enhanced learning for hands-on skills, supporting course activities such as journal clubs, and creating a sense of community and belongingness.

CONCLUSION

Social media in health care education can address asynchronous learning management system issues; create community belongingness; and support student collaboration; however, such uses also may allow a loss of privacy. [J Nurs Educ. 2024;63(1):6-9.].

Effectiveness of health communication courses on professionalism and social media competence among nursing students: A randomized controlled trial

BACKGROUND

The shaping and cultivation of professionalism of nursing students is very important for the improvement and retention of nursing workers' quality. In the context of social media, it is challenging for nursing students to use social media for health education. Health communication course has the potential to cultivate professionalism and social media competence of nursing students, but its role still needs to be explored.

OBJECTIVE

To evaluate the effectiveness of health communication course intervention on improving the professionalism and social media competence of nursing students.

DESIGN

A randomized controlled trial.

METHODS

The recruited nursing students were randomly divided into the intervention group (N = 50) and the control group (N = 51). The control group received routine nursing education. Intervention group received routine nursing education and health communication education courses. Both groups were required to submit a health communication work on any topic. The Nursing Professionalism Scale、Social Media Self-efficacy Scale and Social Media Experience Scale were used to evaluate the professionalism and social media competence of nursing students. The primary analysis used linear mixed models and followed the intention-to-treat principle.

RESULTS

The professionalism, social media self-efficacy and social media experience of students in the two groups were significantly improved, and the improvement of nursing students in the intervention group was higher than that in the control group. After the intervention of health communication course, there were significant differences in professionalism (p < 0.001), social media self-efficacy (p = 0.006) and social media experience (p = 0.013) between the two groups. Social media self-efficacy have an effect on professionalism (ꞵ = 0.22, p < 0.001, 95 % CI 0.17-0.26).

CONCLUSION

The health communication course significantly improved social media competence and professionalism, which was significantly different from the control group, revealing the educational value of the intervention.

TRIAL REGISTRATION NUMBER

ChiCTR2200058425.

Live experience of nursing students with internship program: A phenomenological study

BACKGROUND AND AIM

The internship is a program for transition of nursing students to the clinical setting. This study was conducted to describe and interpret the experiences of nursing students from the internship program.

MATERIALS AND METHODS

This was an interpretative phenomenological study following Van Menen's approach in six steps. Twelve nursing students were selected from 12 different universities in Iran from April to August 2020. Data was collected through 15 in-depth interviews (three supplementary interviews) over the course of 25-90 min and verbatim transcriptions. Data were analyzed with MAXQDA version 10 software. The researcher used four Guba and Lincoln criteria to obtain a rigorous study.

RESULTS

In this study, three main themes and eight subthemes were extracted. The main themes included "professional identity development," "moving toward professional self-efficacy," and "developing coping strategies for workplace adversities." The subthemes were "promoting the cognition of profession," "acceptance among colleagues as a nurse," "accepting professional roles," "self-awareness of weaknesses in patient care," "self-reliance," "advancing clinical skills," "adopting effective coping strategies," and "avoiding tension in clinical settings."

CONCLUSION

Nursing internship students have experienced moving toward professionalization with professional identity and self-efficacy development, and they succeeded in clinical challenges by learning coping approaches.

Social media usage of chinese nursing students: Attitudes, motivations, mental health problems, and self-disclosure

BACKGROUND

Excessive self-disclosure online may risk the reputations, mental health problems, and professional lives of nursing students. This study investigated nursing students' usage of social media, their attitudes towards social media, mental health problems and self-disclosures, and the relationships of these variables.

METHODS

A cross-sectional study was conducted online (n = 1054) with questionnaires of Fear of Missing Out (FoMO), Social Media Fatigue (SMF), Students' Uses and Views of Social Media (SUVSM) and self-disclosure in social media which included self-information shown on social media and information viewed by others.

RESULTS

Although most of them held positive attitudes towards social media, 17.4% of the participants acknowledged that they had posted inappropriate contents online and 37.6% witnessed improper posts from schoolmates or teachers online. SMF was affected by familiar with relevant regulations on the social media usage (β = -.10, p < .001), FoMO (β = .41, p < .001), and SUVSM (β = .17, p < .001). Additionally, nearly 1/3 participants reported their net-friends could view following information: gender, age, occupation, education level and location. Self- disclosure in social media was positively influenced by education (β = .10, p < .001), sharing moments or Weibo, etc. (β = .009, P = 0.009), time spent on social media daily (β = .11, p < .001), accepting stranger's "friend request" (β = .06, P = 0.047), FoMO (β = .14, p < .001) and SMF (β = .19, p < .001). Furthermore, effect of SUVSM on self-disclosure in social media was mediated by FoMO and SMF.

CONCLUSION

Inappropriate contents are posted and witnessed by appreciable proportions of nursing students. Positive attitude towards social media may strengthen FoMO and SMF, which may increase self-disclosure in social media in turn.

The effect of inadequately conducted compulsory distance education on the professional identity development process from nursing students' perspective: A phenomenological qualitative study

PURPOSE

This study was conducted to explore the effect of inadequately conducted compulsory distance education on the professional identity (PI) development process from nursing students' perspective.

DESIGN AND METHODS

The study used a qualitative design based on Heidegger's hermeneutic phenomenological approach. The data were analyzed by using Van Manen's thematic analysis.

RESULTS

The themes of the study were: (1) an inadequate, compulsory, uncertain, and difficult experience, (2) negative impact on PI development.

PRACTICE IMPLICATIONS

It is important for educators to realize that the PI development of nursing students is affected during the distance education process. In this context, students can be included in clinical practice in small groups before graduation in addition to online learning in terms of PI development.

Professional Identity Scale for Male Nursing Students Using the Rasch Model and Latent Regression on Gender and Background Variables

This study developed a professional identity (PI) scale and compared the scores of male and female nursing students. Few studies have focused on male nursing students to understand their PI vis-à-vis related background variables relative to female ones. We recruited 384 male nursing students in Taiwan to construct the PI scale based on the Rasch model with 12 items and 3 factors, namely cognitive, emotional, and behavioural identity. The PI scale showed a good model fit in confirmatory factor analysis, with factor loadings ranging from 0.56 to 0.73. Cronbach’s alpha coefficients ranged from 0.72 to 0.79 for the three subscales and 0.88 for the entire scale. The results of the multiple latent regression analyses showed that male nursing students had higher PI in the total scale and its three factors than did female ones. Having mothers with medical or nursing-related jobs may help promote the cognitive PI of male nursing students. Experiences of caring for family members can help promote PI among female nursing students but not among male ones. Future research should focus on decreasing loss in behavioural PI for both genders after graduation and on reinforcing the association between behavioural PI and interest in nursing among male nursing students.

The relationship between social media usage by undergraduate nursing students and development of their professional identity: A correlational study

BACKGROUND

How nursing students perceive themselves as potential nurses in the future is defined as their nursing professional identity. Many undergraduate nursing students present positive attitudes regarding the use of social media. However, the influence of social media usage by undergraduate nursing students on the development of their professional identity is yet to be determined.

OBJECTIVE

To determine the relationship between social media usage by undergraduate nursing students and the development of their professional identity.

DESIGN

Descriptive, correlational, cross-sectional study.

SETTING(S)

Two universities in western Saudi Arabia.

PARTICIPANTS

Undergraduate nursing students who used social media.

METHODS

An online questionnaire was designed, and its contents were validated. It was then distributed via a Qualtrics link to students' email addresses and via social media between 4th September 2019 and 28th October 2019. Descriptive analysis including frequencies, percentages, medians, and interquartile ranges were reported. Additionally, a number of non-parametric tests were conducted to investigate the relationships in question.

RESULTS

In total, 484 questionnaires were included in the analysis. The participants who used social media for educational (p = 0.004), or for professional purposes (p = 0.015) had high scores on the PI scale. The professional identity scores were also positively associated among the participants who followed nurses (p < 0.001), shared their nursing experiences (p < 0.001), and acted as societal educators about the nursing profession (p < 0.001) on social media platforms.

CONCLUSIONS

Engagement with social media positively influenced undergraduate nursing students in the development of their professional identity. However, it is notable that the pedagogy of nursing education has been slow to adopt social media into nursing curricula. Nursing students require guidance in terms of how to use social media for their professional development.

Pre-registration nursing students' perceptions of their baseline digital literacy and what it means for education: A prospective COHORT survey study

BACKGROUND

To build complex digital skills and capability required by digitally-driven work environments, we must first understand nursing students' baseline digital literacy if educators are to develop a fit for purpose curriculum underpinned by digital health technologies.

OBJECTIVE

To determine first-year pre-registration nursing students' perceived baseline digital literacy before their first clinical placement.

DESIGN

Prospective cohort study.

SETTINGS

Two universities in Australia in 2020.

PARTICIPANTS

Students enrolled in pre-registration nursing programs at Bachelor's and Master's level.

METHODS

Participants (N = 205) completed an online 27-item survey composed of a Likert-type scale, forced-choice items, and open-ended questions. Data were analyzed with descriptive statistics.

RESULTS

Participants engaged with digital technology early in life, with 49.75% students using some form of digital technology before ten years of age. Students reported the highest daily use of technology to search the internet for information (92%), online social networking (68.3%) and watching videos (67%). Most students expressed the least confidence in identifying different types of portable storage devices (24.1% Master's students; 41.7% Bachelor's students), describing the advantages of a digital camera (39.3% Master's students; 48.3% Bachelor's students), and totaling numbers in spreadsheets (22.8% Masters students; 48.3% Bachelor's students). No statistical differences were observed between the two universities or the two cohorts in terms of perceived confidence in using technology and software applications to support their learning. Interestingly, 24.7% of participants expressed high confidence in using electronic medical records without prior training, which may reflect positive attitude towards engaging with unknown digital technologies.

CONCLUSIONS

Nursing students are frequent internet and social media users. However, despite positive attitudes to digital technology and widespread presence of digital technology in students' lives, deficits in students' confidence in using digital technology and software required for learning persist. Targeted digital literacy education interventions are needed as part of foundational nursing studies to improve nursing students' baseline digital literacy before commencing clinical placement. These should be scaffolded across the program to ensure an effective transition to nursing practice in evolving digitally-driven healthcare environments.

Professional identity and supporting willingness of nurses during the COVID ‐19 epidemic in China

Aim

To investigate the professional identities and the willingness of nurses to respond to the call for support during the COVID‐19 epidemic.

Background

The COVID‐19 epidemic has resulted in nearly 300 million cases worldwide, causing more than five million deaths. However, the professional identities and the willingness of nurses to provide support during the COVID‐19 epidemic in China remain unclear.

Methods

A total of 1,505 eligible nurses from 120 hospitals during the COVID‐19 outbreak in China were included. Questionnaires were used to evaluate the willingness of these nurses to participate in epidemic control efforts. The Nurses' Professional Identity Scale was used to measure their sense of professional identity.

Results

About 90% of the nurses were willing to lend support in Hubei Province during the epidemic. The most common reason (93.84%) was found to be their beliefs as medical personnel in helping others in need. Nearly 10% of the nurses were unwilling to go to Hubei, primarily due to family reasons. The average total score of the Professional Identity Scale for all nurses reached a moderate to high level as indication of professional identity (116–125). Nurses who were willing to go to Hubei had a significantly higher total score than those who were not.

Conclusions

The professional identity of nurses in China improved during the epidemic, and those with higher professional identities were more likely to respond to calls for support during the epidemic.

Nursing Professional Pride Scale: Turkish adaptation and psychometric properties

PURPOSE

This study established the Turkish validity and reliability of the Nursing Professional Pride Scale (NPPS).

DESIGN AND METHODS

The study was a descriptive and cross-sectional conducted in Turkey. The sample consisted of 301 nurses with at least one year of work experience. Data were collected online between August and September 2020 and analyzed using the SPSS 25.0 and LISREL 8.80. Confirmatory factor analysis, linguistic and content validity, and reliability analyses were performed.

FINDINGS

The Turkish version of the Nursing Professional Pride Scale (NPPS-TR) had a content validity index of 0.95 and Cronbach's alpha of 0.89 and a five-factor structure with acceptable psychometric properties (χ ² /df = 2.85, RMSEA = 0.079, CFI = 0.92, SRMR = 0.08).

PRACTICE IMPLICATIONS

The NPPS-TR is a valid and reliable measure of professional pride in Turkish nurses.

The role of self-efficacy in mediating between professional identity and self-reported competence among nursing students in the internship period: A quantitative study

AIM

This study explored the relationship between self-efficacy, professional identity and competence among nursing students and analyzed the mediating role of self-efficacy in the relationship between professional identity and competence.

BACKGROUND

Increasing attention has been paid to the cultivation of competence among nursing students; however, few studies to date have analyzed its related factors and examined their relationship.

DESIGN

A quantitative study with a descriptive design was performed in this study, adopting an online survey with convenience and snowball sampling. A cross-sectional sample of 887 nursing students in the internship period of their education program in mainland China was recruited from November to December 2020.

METHODS

The Nursing Students Competence Instrument, Professional Identity Questionnaire for Nurse Students and General Self-efficacy Scale were distributed online. Descriptive statistics, Pearson's correlation, structural equation modeling (SEM) and the bootstrap method were employed in data analysis.

RESULTS

Competence was significantly and positively correlated with professional identity (r = 0.598; P < 0.01) and self-efficacy (r = 0.692; P < 0.01). SEM analysis revealed that professional identity (β = 0.31; P < 0.01) or self-efficacy (β = 0.31; P < 0.01) could have a positive impact on competence. Meanwhile, self-efficacy played a mediating role in the relationship between professional identity and competence, with an indirect effect of professional identity creation through self-efficacy accounting for 52% of the total effect.

CONCLUSIONS

Self-efficacy mediates the relationship between professional identity and competence to some extent. School educators and clinical tutors should pay greater attention to students' professional identity and self-efficacy to improve students' competence.

The construction of contemporary nursing identity from narrative accounts of practice and professional life

OBJECTIVE

To explore the contemporary narrative of nursing identity in Spain.

METHOD

This qualitative study was conducted between 2018 and 2020. Eleven registered nurses were interviewed. The conversations were recorded in audio, were semistructured, and held in a mental health clinic affiliated with a Catholic institution. Narrative analysis of the data was carried out.

FINDINGS

Two themes were identified: How do I construct my professional life?, with the subthemes 'Training and initiation in care practice', 'Ways of living the professional care experience', 'The sculpting of care' and 'Self-image and future projection'; and What do I know about my practice?, with the subthemes 'Nursing experience: shift, days, years', 'Strategy in the field of nursing care', 'Some foundations of caregiving practice', 'The specificity of the gesture of care' and 'Voice and recognition of nursing within the institution'.

CONCLUSION

Contemporary nursing identity is built in reflections on the epistemology of care, confronting the weight of tradition and breaking into new modes of self-image where the profession is legitimized and projected from historical consciousness. This claim can be used to support reflective practice in academic and healthcare settings as well as to promote a paradigm shift.