The study revealed poor knowledge about the nursing profession and distrust in Saudi caregivers. Surprisingly, about one third only preferred to get the nursing care by Saudis. Moreover, the rating of Saudi caregivers was deemed excellent by only 40%. In addition, nearly three quarters would be ashamed if they have a nurse in the family, and less than 50% of males prefer to marry a nurse. Also, the study highlighted numerous barriers including; mixed working environment, the delayed marriage of female nurses, and the negative effect of the nursing profession on social life.
The low preference for Saudi caregivers might reflect poor image and distrust in the national caregivers; this would be very distressing and de-motivating for Saudi nurses and for those who might consider a nursing career in the future. In addition, nearly three-quarters of participant agreed that they would be ashamed of having a nurse among their families. In accordance with our results, a Study in Saudi Arabia revealed that nursing as a childhood dream was not appealing, nor family support was influential [17]. Similarly, a study in China demonstrated that parents would not encourage their children to enroll in nursing education [25]. The observed positive perception of Omani university students about the nursing profession might reflect the overweight number of the nursing students in the study compared to students from other disciplines [26]. Secondly, other factors concerning the heath care policies to recruit nationals and media marketing of the nursing profession in Oman should not be ignored.
However, the preference of the study participants of females as caregivers stems from the perception that nursing is women’s occupation. In addition, cultural norms reject getting care by opposite gender especially for females.
Regarding the level of knowledge about the nursing profession, it is striking that most of participants in the present study viewed the role of nursing in health care settings as complementary to physicians, and about one third do not know the exact job title of graduates from nursing college or institutes. Additionally, they don’t know even the duration required to get a bachelor degree in nursing according to the Saudi nursing institutions. Previous studies confirmed the perceived attenuated role of nurses compared to physicians. These negative stereotypes view nurses as having no status and describe them as physicians' assistants and ancillary workers [23, 25, 27]. A study from Iran view nurses as having no status and described them as physicians' assistants and auxiliary workers [19]. In this study, students emphasized that the social status of nurses is not desirable, as they are considered handmaidens of physicians and dutiful hospital employees. Another student mentioned: “although nurses are sometimes perceived as educated, their main task is to obey and follow physicians' orders and their caring skills are not appreciated” [19].
Similarly, a recent study in Saudi Arabia which included over 700 participants of both genders, revealed that more than one-third of participants perceive nursing as a profession that is auxiliary and subservient to physicians, and therefore no need for higher academic qualifications [17]. This means that the community in Saudi Arabia doesn’t value the skills and competencies acquired through higher academic education.
Despite the sincere efforts of Saudization of the workforce in the KSA, expatriates remain to constitute a considerable proportion of the nursing workforce [22]. Saudi culture may regard the nursing profession unfavorable work atmosphere and hence discourage their children to pursue a nursing career The present study revealed that a considerable proportion of the study sample (64.5%) claim negative consequences of nursing on social life probably because of long working hours and night shifts, other barriers include delayed marriage and gender-mixed working environment. The observation that the overall perceived barrier score was significantly lower among less educated must be interpreted with caution.
It is likely that the global image of the nursing profession is negative. Previous studies demonstrated that nursing is viewed as a less desirable profession because of difficult working conditions, inadequate financial compensation, low level of autonomy, limited career opportunities, and being viewed as ancillary members of the healthcare team [21, 28].
Finally, this study demonstrates the community level of knowledge about the nursing career and reflects the public image of the nursing profession. Such information is paramount for effective interventions to raise community awareness and modify the negative image of the nursing profession. Hopefully, the nursing identity will be improved leading to recruitment of high achievers and retention of candidates into the nursing career.
Limitations of the study
Limited generalizability of the study results because of the study settings, as the study was conducted in a big city-the capital of Saudi Arabia, while sub-urban and rural communities are not represented. The convenient sampling technique, and the unequal gender representation are another limitations.