{"paper_id":"0cde5bb6-3cfa-4df6-99ac-68030877abf3","body_text":"Nursing Professionalism, As Perceived By Nurses From Different Generations In Türkiye: A Qualitative Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Nursing Professionalism, As Perceived By Nurses From Different Generations In Türkiye: A Qualitative Study Filiz COŞKUN, Aytolan YILDIRIM This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8938964/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 5 You are reading this latest preprint version Abstract Background Nursing professionalism is a culturally embedded, dynamic, and multidimensional concept. It is well established that nursing professionalism is associated with years of service, workplace experiences, and age. In this context, the perspectives of nurses from different generations and with varying levels of experience provide unique insights into professionalization in nursing. Objective This study explored the perspectives of clinically experienced nurses from different generations regarding nursing professionalism, with the goal of contributing to its development and offering practice implications specific to Turkish society. Method A descriptive phenomenological design, one of the qualitative research approaches, was adopted. Maximum variation sampling was used to ensure a heterogeneous sample. Semi-structured interviews were conducted with 35 nurses from different generations working in private, public, and university hospitals in Istanbul, Türkiye’s most populous city, between November 2020 and April 2021. Data were analyzed using a thematic analysis approach, supported by MAXQDA software. Results The themes identified were education; scientific knowledge and its applicability; professional organization; societal perceptions of nursing; autonomy; and professional ethics. Conclusion This study provides insight into the current state of professionalization in nursing from the perspectives of nurses across different generations in Turkish society. It highlights the key aspects emphasized and most frequently articulated by each generation. Implications for nursing practice and clinical relevance: The perspectives of nurses from different generations may provide valuable guidance for aligning and strengthening the compatibility between existing models of nursing professionalism and diverse cultural contexts. Global recognition of nursing as a fully professional discipline can only be achieved through research findings and context-sensitive solutions that actively engage nurses, stakeholders, and societies across different countries. Nursing Professionalization Nursing Professionalism Generations Qualitative Study Figures Figure 1 Background Professionalization is a dynamic concept with a long history that continues to evolve ( 1 ). Over the years, sociologists, historians, and nurses have examined nursing professionalism and its defining characteristics ( 2 ). Miller conducted some of the earliest work on nursing professionalism and developed the “Wheel of Professionalism in Nursing” model, based on the ethical principles established by the American Nurses Association (ANA). This model identifies nine standards: educational preparation; adherence to a code of ethics; continuing education and competence; participation in professional organizations; communication and publication; autonomy and self-regulation; community service; use, development, and evaluation of theory; and participation in research ( 3 ). In addition to these core standards, researchers have emphasized attributes such as inquiry, creativity, research orientation, service to society, collaboration, and active involvement in professional organizations ( 4 ). Although professionalization is culturally embedded, several recurring attributes have been identified, including autonomy, collaboration, jurisdiction, membership in professional organizations, professional development, community and social service, adherence to nursing standards, and the implementation and evaluation of nursing practice ( 3 ). Collectively, these attributes and models illustrate the conceptual diversity inherent in nursing professionalism. However, given its dynamic nature—shaped by temporal, social, scientific, technological, contextual, and cross-cultural changes—professionalism remains difficult to define, quantify, or measure ( 5 , 6 ). Global interest in nursing professionalism has increased substantially in recent years, particularly in studies conducted in Asia and the Middle East ( 7 – 10 ). Nursing professionalism is influenced by context-specific sociocultural values and legal frameworks, necessitating a localized understanding of its defining characteristics ( 8 ). Alignment between existing theoretical frameworks and the realities of contemporary nursing practice can be achieved through culturally adapted assessment tools. Accumulating evidence indicates that nursing professionalism is culturally grounded, continuously evolving, and multidimensional ( 5 , 6 ). Hall argued that defining a profession and its core attributes should be achieved through consensus among members of that profession ( 11 ). In their concept analysis titled “ What is nursing professionalism? ”, Cao et al. ( 5 ) highlighted variations in the meaning of nursing professionalism across cultures and emphasized the need to consider national cultural characteristics in efforts to advance professionalism. As nursing professionalization is shaped by social, cultural, scientific, technological, and contextual changes, ensuring its validity and applicability requires ongoing re-examination ( 6 ). Previous studies have demonstrated associations between professionalization and improvements in nursing performance, critical thinking, reflective practice, empowerment ( 12 ), sense of belonging, and professional identity ( 13 ). Age has also been identified as a factor influencing nursing professionalism ( 14 ). In addition, years of service and workplace experiences are directly associated with levels of professionalism ( 15 , 16 ). In this context, the perspectives of nurses from different generations and with varying levels of experience offer unique and valuable insights into the professionalization process. The contemporary nursing workforce comprises three generations: Baby Boomers, Generation X, and Generation Y. A generation refers to a cohort of individuals born within a similar time frame who were exposed to common social, cultural, and political events and who therefore tend to share comparable values, attitudes, behaviors, and characteristics. Each generation undergoes developmental processes across the life course and is shaped by a distinct historical context that influences this trajectory ( 17 ). The perspectives provided by nurses from different generations constitute an important resource for examining intergenerational similarities and differences within their broader social and historical contexts and for understanding how these factors influence the professionalization of nursing. Recognizing that each nurse possesses unique personal characteristics, experiences, and life circumstances that collectively shape individual identity, a deeper and more nuanced exploration of nursing professionalism is warranted. Accordingly, this study aimed to evaluate nursing professionalism from the perspectives of clinically experienced nurses across different generations, to contribute to the development of a conceptual framework, and to provide practice implications for strengthening nursing professionalism in Turkish society. Methods Aims This study aimed to evaluate nursing professionalism from the perspectives of clinically experienced nurses across different generations, to contribute to the advancement of professionalization in nursing, and to provide practice implications specific to Turkish society. Study design A qualitative research design based on descriptive phenomenology was adopted ( 18 ). Data were analyzed using the thematic analysis approach described by Braun and Clarke ( 19 ). Semi-structured interviews were conducted between November 2020 and April 2021 with nurses from different generations working in private, public, and university hospitals in Istanbul, Türkiye’s most populous city. Participants and settings The study population comprised nurses from the Baby Boomer, Generation X, and Generation Y cohorts working in Istanbul. Maximum variation sampling was employed to ensure a heterogeneous sample. This sampling strategy aims to identify common or shared patterns across diverse cases and to illuminate different dimensions of the phenomenon under investigation ( 18 ). Among purposive sampling strategies, criterion-based sampling is particularly effective when selecting individuals who have direct experience with the phenomenon of interest ( 20 ). In the present study, inclusion criteria were determined in line with the study aim and research topic. The inclusion criteria were: ( 1 ) willingness to participate in the study; ( 2 ) currently working as a nurse; ( 3 ) at least one year of nursing experience; and ( 4 ) belonging to one of the following generations: Baby Boomers (1946–1964), Generation X (1965–1979), or Generation Y (1980–1999). The exclusion criteria were: ( 1 ) nurses who were not actively working in the hospital during the data collection period (e.g., due to sick leave, maternity leave, or vacation); and ( 2 ) nurses who had recently entered the profession and were still undergoing orientation training. Data collection To ensure consistency, all interviews were conducted by the same researcher. Prior to data collection, the researcher undertook an extensive and systematic review of the relevant literature. The interviewer completed a three-day face-to-face training course on qualitative research methods and qualitative interviewing techniques and obtained a certificate of competency. In addition, the researcher received guidance from experienced professors and conducted pilot interviews to refine interviewing skills. A semi-structured interview guide (Supplementary material 1), developed based on findings from previous research on the conceptual analysis of nursing professionalism, was used during the interviews. Interviews were scheduled by appointment and conducted at a time and place deemed appropriate by the participant, either during periods that did not interfere with unit workload or after working hours. Due to COVID-19 precautions, 15 of the interviews were conducted online. Written informed consent and permission for audio recording were obtained from all participants prior to data collection. To prevent data loss, face-to-face interviews were audio-recorded with participants’ permission, and online interviews were recorded digitally. All recordings were subsequently transcribed verbatim by the researcher. The interviews lasted an average of 34 minutes. Data analysis Braun and Clarke ( 38 ) argue that, in qualitative research, achieving data saturation requires a sample that provides sufficient data to allow comprehensive analysis of the phenomenon in line with the research aim. In the present study, recruitment was discontinued after 35 participants, as repetition of concepts was observed and no new themes emerged. A thematic analysis approach following the phases outlined by Braun and Clarke ( 21 ) was employed. The analysis consisted of six stages: ( 1 ) transcribing the interviews and becoming familiar with the data through repeated reading; ( 2 ) generating initial codes by systematically identifying meaningful data segments; ( 3 ) collating codes into potential themes and organizing all relevant coded extracts under each theme; ( 4 ) reviewing and mapping themes to ensure coherence with the coded data and the entire dataset; ( 5 ) refining and clearly defining theme names to ensure internal consistency and alignment with the overall analysis; and ( 6 ) selecting illustrative quotations and producing the final analytical report. In the first stage, the transcripts prepared by the researcher were read repeatedly to achieve immersion in the data. In the second stage, preliminary codes were generated from the dataset. In the third stage, initial codes were examined and organized under potential thematic categories. In the fourth stage, themes were reviewed and mapped to confirm that they were supported by the data. In the fifth stage, theme names were refined to ensure that they were conceptually distinct, internally coherent, and consistent with the dataset. Finally, representative quotations were selected and the analytical report was completed. Throughout these stages, MAXQDA software, a professional data analysis program designed for qualitative and mixed-methods research, was used to support data management and analysis. Ethics In order to conduct the study, ethical approval was obtained from the Istanbul University-Cerrahpaşa Faculty of Medicine Clinical Research Ethics Committee, Decision No. A-09, dated 05.11.2019 (Related file 1). Institutional permission for the participation of nurses in Istanbul was obtained from the Istanbul Branch of the Turkish Nurses Association (Related file 2). Participants who agreed to take part in the study were informed by the researcher about the purpose of the study, that the information they shared would be kept confidential and not shared with others, and that the use of the data would be limited to this research. Both verbal and written informed consent were obtained from the participants (Supplementary material 2). The study was conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki and national research ethics guidelines. Rigor Validity refers to the extent to which research findings are accurate and unbiased. In qualitative research, validity is associated with the degree to which the data collection tool accurately captures the phenomenon it is intended to explore ( 22 ). In this context, data obtained from the instrument should reflect participants’ lived experiences and thereby contribute to the credibility of the findings. To enhance internal validity, the interview guide developed by the researcher was reviewed by experts prior to its use. In addition, both written and verbal informed consent was obtained from all participants. To ensure external validity, the research design, methodology, data collection tools, data collection process, data analysis procedures, and the development of findings were described in detail. Findings A total of 35 participants were included in the study. Participants were coded sequentially from P1 to P35. Detailed demographic characteristics are presented in Table 1 . The six identified themes, their codes, and how intensely each generation expressed them are shown in Fig. 1 . These themes were: Education; Scientific Knowledge and Its Applicability; Professional Organization; Societal Perceptions of Nursing; Autonomy; and Professional Ethics. Table 1 Characteristics of participants interviewed Document name Gender Age Institution Years of service Generation Responsibility Education P1 Female 27 Public Hospital 4 Years Generation Y Operating Room Nurse Bachelor’s degree P2 Female 38 Public Hospital 14 Years Generation Y Operating Room Nurse Master’s degree P3 Female 62 Public Hospital 42 Years Baby Boomer Outpatient Clinic Nurse Bachelor’s degree P4 Male 33 Public Hospital 9 Years Generation Y Quality Unit Bachelor’s degree P5 Female 32 Public Hospital 13 Years Generation Y Quality Unit Master’s degree P6 Female 56 University Hospital 35 Years Generation X Charge Nurse Master’s degree P7 Female 47 University Hospital 31 Year Generation X Charge Nurse Master’s degree P8 Male 21 University Hospital 1 Year Generation Y Unit Nurse Bachelor’s degree P9 Female 46 Public Hospital 27 Years Generation X Assistant Head Nurse Master’s degree P10 Male 23 Public Hospital 1 Year Generation Y Intensive Care Nurse Bachelor’s degree P11 Male 23 Private Hospital 1 Year Generation Y Unit Nurse Bachelor’s degree P12 Female 26 Public Hospital 3 Years Generation Y Covid-19 Unit Nurse Bachelor’s degree P13 Female 45 University Hospital 25 Years Generation X Charge Nurse Bachelor’s degree P14 Female 40 University Hospital 20 Years Generation Y Infection Control Nurse Doctoral degree P15 Female 51 University Hospital 33 Years Generation X Outpatient Clinic Charge Nurse Master’s degree P16 Female 34 University Hospital 11 Year Generation Y Covid-19 Unit Nurse Master’s degree P17 Female 44 University Hospital 25 Years Generation X Charge Nurse Master’s degree P18 Female 45 University Hospital 25 Years Generation X Intensive Care Charge Nurse Master’s degree P19 Female 36 Private Hospital 14 Years Generation Y Head Nurse Master’s degree P20 Female 25 Private Hospital 3 Years Generation Y Education unit Bachelor’s degree P21 Female 39 Private Hospital 20 Years Generation Y Education unit Master’s degree P22 Female 39 Private Hospital 18 Years Generation Y Head Nurse Master’s degree P23 Male 27 Public Hospital 5 Years Generation Y Unit Nurse Bachelor’s degree P24 Female 23 Private Hospital 1 Year Generation Y Unit Nurse Bachelor’s degree P25 Female 38 Public Hospital 16 Years Generation Y Emergency Unit Charge Nurse Bachelor’s degree P26 Female 36 University Hospital 14 Years Generation Y Intensive Care Nurse Master’s degree P27 Female 43 University Hospital 21 Year Generation X Assistant Head Nurse Master’s degree P28 Female 56 Private Hospital 35 Years Generation X Head Nurse Bachelor’s degree P29 Female 40 Private Hospital 21 Year Generation Y Assistant Head Nurse Bachelor’s degree P30 Female 61 Private Hospital 40 Years Baby Boomer Charge Nurse Bachelor’s degree P31 Female 58 Public Hospital 38 Years Baby Boomer Outpatient Clinic Nurse Bachelor’s degree P32 Female 52 University Hospital 31 Year Generation X Infection Control Nurse Master’s degree P33 Female 49 University Hospital 28 Years Generation X Infection Control Nurse Master’s degree P34 Female 55 University Hospital 36 Years Generation X Charge Nurse Bachelor’s degree P35 Female 59 Private Hospital 40 Years Baby Boomer Operating Room Nurse Bachelor’s degree Table 1 Characteristics of participants interviewed Education The theme of Education was articulated through the following codes: “ensuring educational standardization,” “improving the quality of education,” “integrated education system,” “the impact of postgraduate education,” and “employment of non-nurses in organizations under the title of nurse.” Ensuring Educational Standardization Compared with Baby Boomer nurses, participants from Generation X and Generation Y placed greater emphasis on the need for standardized educational preparation. Nurses stated that educational preparation should be standardized at the bachelor’s level and described this as a fundamental prerequisite for professionalization. However, they also emphasized that despite the introduction of the first bachelor’s program in Türkiye in 1955, this issue has yet to be fully resolved. “…I think our biggest problem comes from the fact that the education level in this profession isn’t unified. And that directly affects professionalization…” (P32, Generation X, Master’s degree, University hospital, Infection Control) “…The first step toward professionalization is having a standardized education level. Everyone in this profession should graduate at the same level…” (P25, Generation Y, Bachelor’s degree, Public hospital, Emergency Unit Charge Nurse) Improving the Quality of Education Baby Boomer and Generation Y nurses expressed stronger views on improving the quality of education compared with Generation X nurses. Baby Boomer nurses stated that although they had received education at the high school level during their training period, they considered themselves more competent than some newly graduated nurses who currently enter the profession with a bachelor’s degree. Generation Y nurses emphasized that, although the number of institutions offering undergraduate nursing education has increased, limited clinical practice opportunities prevent students from receiving high-quality training. “…When I compare these interns to myself—even back when I was trained at the high school level—they’re not even at that level…” (P3, Baby Boomer, Bachelor’s degree, Public hospital, Outpatient clinic) “…They’re opening nursing schools like supermarkets, unfortunately…” (P16, Generation Y, Master’s degree, University hospital, COVID-19 unit) “…Some students from very reputable universities haven’t even done an IV line—they’ve never actually saw it…” (P9, Generation X, Master’s degree, Public hospital, Assistant Head Nurse) Integrated Education System Although more frequently emphasized by Generation Y nurses, Generation X nurses also expressed views regarding the need for an integrated education system. Participants stated that a system integrating theory and practice is essential for professionalization in nursing. “…First of all, the academic world absolutely has to be integrated with the clinical field…” (P23, Generation Y, Bachelor’s degree, Public hospital, Inpatient unit) “…Academia and clinical practice need to be together—we have to work collaboratively if our profession is going to professionalize…” (P6, Generation X, Master’s degree, University hospital, Charge Nurse) The Impact of Postgraduate Education Generation Y nurses, more prominently, and Generation X nurses also expressed views regarding the impact of postgraduate education. Participants stated that specialization through postgraduate education is necessary for professionalization and emphasized that specialist nurses should be assigned according to their specific areas of expertise. “…I definitely think a master’s degree must be pursued; I absolutely believe it professionalizes and strengthens the profession…” (P32, Generation X, Master’s degree, University hospital, Infection Control) “…When you are pursuing or have completed a master’s degree, the attitude and respect of your colleagues in the team increase. Why? Because they no longer see you as an ordinary nurse; they say this nurse is trying to advance professionally and has goals…” (P2, Generation Y, Master’s degree, Public hospital, Operating Room) Employment of Non-Nurses in Organizations Under the Title of Nurse Generation Y nurses expressed views regarding the employment of non-nursing personnel under the title of nurse within organizations. Participants reported that, particularly in private institutions, the employment of nurse aides, emergency medical technicians, or operating room technicians under the title of nurse harms professionalization. “…After graduating from high school, nurse aides—who are not qualified to perform any medical or therapeutic interventions—are especially employed in the private sector as if they were nurses. Do you think this image can improve? Can this profession move toward professionalization? I think it’s very difficult, very difficult. Therefore, legal regulations and restrictions are needed…” (P2, Generation Y, Master’s degree, Public hospital, Operating Room) “…In hospitals, they can assign almost anyone—for example, a midwife—as a nurse in clinical settings; they can employ an anesthesia technician or an operating room technician as a nurse. Even if they are not authorized to perform certain procedures, they are told ‘this is how it’s done’ and made to do it, that’s all…” (P12, Generation Y, Bachelor’s degree, Public hospital, COVID-19 unit) Scientific Knowledge and Its Applicability The theme of scientific knowledge and its applicability was expressed by participants through the following codes: “knowledge remaining at a conceptual level,” “reflection of scientific knowledge in practice,” and “recurrent research topics.” Knowledge Remaining at a Conceptual Level Compared with Baby Boomer nurses, Generation X and Generation Y nurses expressed more views regarding knowledge remaining at a conceptual level. Participants stated that both the theoretical knowledge acquired during their education and the findings of research studies were not sufficiently reflected in clinical practice. “…I’m still relatively new in my professional life, yes, but when I was in school, I used to think these things were being reflected in practice. However, based on my observations, all that scientific knowledge is not actually implemented…” (P24, Generation Y, Bachelor’s degree, Private hospital, Inpatient unit) “…They don’t have any direct contact with patients, and because they can’t engage with patients or assess the needs of patients and clinical nurses, they end up conducting studies that remain entirely theoretical…” (P21, Generation Y, Master’s degree, Private hospital, Education unit) Reflection of Scientific Knowledge in Practice Although more frequently emphasized by Generation X nurses, Generation Y and Baby Boomer nurses also expressed views indicating that scientific knowledge is reflected in practice. Participants reported that, particularly in recent years, research findings have increasingly informed nursing practice and that they identify and implement nursing theories appropriate to patient care. “…I realized that nursing care can be delivered according to nursing models. For example, while working during COVID, when I was serving as a charge nurse, I provided nursing care based on the Activities of Daily Living model…” (P6, Generation X, Master’s degree, University hospital, Charge Nurse) “…There is a body of professional knowledge, and it is very important—it significantly affects the patient’s life…” (P10, Generation Y, Bachelor’s degree, Public hospital, Intensive Care Unit) Recurrent Research Topics Generation X and Generation Y nurses expressed views of similar intensity regarding recurrent research topics, whereas Baby Boomer nurses did not report views on this issue. Participants stated that, when reviewing the literature, they frequently encounter similar or repetitive topics. “…It has become really difficult to find truly original studies; when we look at it, there are always studies repeating one another…” (P2, Generation Y, Master’s degree, Public hospital, Operating Room) “…In a rather abstract sense, the same topic that has already been studied is repeatedly addressed by different people in different hospitals or institutions. I don’t think it’s extremely productive…” (P29, Generation Y, Bachelor’s degree, Private hospital, Assistant Head Nurse) Professional Organization The theme of professional organization was expressed by participants through the following codes: “insufficiency in professional organization,” “critical perspectives on professional associations,” and “the absence of a nurses’ union.” Insufficiency in Professional Organization Compared with Baby Boomer nurses, Generation X and Generation Y nurses expressed more views regarding insufficiency in professional organization. Participants emphasized that, despite the importance of professional organization in the professionalization process, membership rates in professional associations are inadequate. They also noted a substantial discrepancy between the total number of nurses in the healthcare sector and the proportion who are members of professional organizations, and stated that organizational insufficiency persists despite the long-standing existence of such associations. “…I think one of the main reasons we have not been able to professionalize is this lack of organization…” (P25, Generation Y, Bachelor’s degree, Public hospital, Emergency Unit Charge Nurse) “…As I mentioned, I am on the board of a professional association. We have more than ten thousand nurses, but unfortunately only a little over 800 are members of our association…” (P26, Generation Y, Master’s degree, University hospital, Intensive Care Unit) Critical Perspectives on Professional Associations Generation X nurses expressed more critical views regarding professional associations compared with Generation Y and Baby Boomer nurses. Participants stated that professional associations themselves have shortcomings in terms of professional organization, that they should adopt new approaches to reach members more effectively, and that they need to become more youthful, modern, and open to new ideas. “…For example, in every school that graduates nurses, there should definitely be a link with the association so that it can reach all of its graduates…” (P17, Generation X, Master’s degree, University hospital, Charge Nurse) “…I think the structures of associations need to become somewhat younger and more modern; they need to be open to new ideas…” (P22, Generation Y, Master’s degree, Private hospital, Head Nurse) The Absence of a Nurses’ Union Generation X and Generation Y nurses expressed views of similar intensity regarding the absence of a nurses’ union, whereas Baby Boomer nurses did not report views on this issue. Participants stated that uniting under a single umbrella organization would strengthen representation and advocacy for professional rights. “…If we could unite—not just as the Turkish Nurses Association but as Turkish nurses under one union—I believe we would have a stronger voice. If we had political influence, I truly believe that the rights of professional nurses would be defended and their voices would be heard…” (P2, Generation Y, Master’s degree, Public hospital, Operating Room) “…There is a chamber for engineers, there is a bar association—many professional groups are very active and can even influence the government in many areas…” (P5, Generation Y, Master’s degree, Public hospital, Quality Unit) Societal Perceptions of Nursing The theme of societal perceptions of nursing was expressed by participants through the following codes: “negative perception by society,” “increased professional prestige in society,” “increased prestige and visibility during the COVID-19 pandemic,” and “the COVID-19 pandemic period was not adequately utilized.” Negative Perception by Society Although more frequently emphasized by Generation Y nurses, Generation X and Baby Boomer nurses also expressed views regarding negative societal perceptions. Participants stated that other health professions are afforded greater respect than nurses and that nursing work is often perceived as easy or undervalued. “…In my opinion, society definitely does not see nurses as respectable at all; they view us in a very degrading way. How can I put it? They value a secretary more, they show more respect to hospital security staff, to the police—everyone except nurses. I don’t fully understand why, but there is no respect for nurses, not even the slightest…” (P12, Generation Y, Bachelor’s degree, Public hospital, COVID-19 unit) “…Nursing is seen by society as a very easy job. People think, ‘What do they even do? They just sit around all day,’ or they see it as simply carrying out the physician’s orders—give two medications, administer an injection, and that’s it…” (P1, Generation Y, Bachelor’s degree, Public hospital, Operating Room) Increased Professional Prestige in Society Although more frequently expressed by Baby Boomer nurses, Generation X and Generation Y nurses also reported that professional prestige in society has increased over time. Participants stated that, compared with previous years, nursing is now perceived as more professional and more respectable. “…If I compare the societal perception at the time I started my career with today, I would say that, from society’s perspective, we are in a better place now…” (P32, Generation X, Master’s degree, University hospital, Infection Control) “…The way society sees us is different now. Nurses are more respected compared with the past…” (P35, Baby Boomer, Bachelor’s degree, Private hospital, Operating Room) Increased Prestige and Visibility During the Covid-19 Pandemic Compared with Baby Boomer nurses, Generation X and Generation Y nurses expressed more views regarding increased prestige and visibility during the COVID-19 pandemic. Participants stated that the pandemic helped society recognize the critical role of nurses in the healthcare sector, observe the positive outcomes of nursing care either personally or through affected relatives, and perceive nurses as more professional. “…People who used to see nurses merely as assistants to physicians, especially during the COVID period, realized that nurses have their own expertise and professionalization in this field…” (P28, Generation X, Bachelor’s degree, Private hospital, Head Nurse) “…They would say, ‘Oh, do nurses even have professors?’ They had been saying that for a while, but at least they finally saw it. It was very positive that nurses appeared in prime-time news…” (P19, Generation Y, Master’s degree, Private hospital, Head Nurse) The COVID-19 Pandemic Period Was Not Adequately Utilized Generation X and Generation Y nurses expressed views to a similar extent regarding the idea that the COVID-19 pandemic period was not adequately utilized, whereas Baby Boomer nurses did not report views on this issue. Participants stated that such pandemic periods present opportunities to highlight the importance of the profession, but these opportunities were not sufficiently leveraged. “…I think we did not fully utilize it. COVID ends, something else begins—one disease ends, a social issue starts. Take vaccination, for example—it’s a serious issue. Migrants are arriving; you could use that. Do something for migrants, call the media. There’s social media; you don’t even need television…” (P17, Generation X, Master’s degree, University hospital, Charge Nurse) “…I think we did not represent ourselves well enough. Even before this, we could have consistently shared how valuable nurses are. We have struggled with so many issues in intensive care before—H1N1, Crimean-Congo hemorrhagic fever, postoperative patients, severely ill trauma cases. If people had seen those, they might have felt even more connected. But I think we have not sufficiently reflected this aspect of our profession…” (P26, Generation Y, Master’s degree, University hospital, Intensive Care Unit) Autonomy The theme of autonomy was expressed by participants through the following codes: “the influence of team members,” “the impact of experience and level of education,” “the influence of organizational culture,” and “ assignment to tasks outside defined duties, authority, and responsibilities.” The Influence of Team Members Baby Boomer and Generation Y nurses expressed views more frequently than Generation X nurses regarding the influence of team members. Participants stated that they are most often constrained by physicians, that this situation negatively affects professionalization, and that they remain dependent on another professional group. “…Other professional groups do not want us to use our scientific knowledge. We work in a highly disciplined environment, and physicians do not want you to generate knowledge…” (P33, Generation X, Master’s degree, University hospital, Infection Control) “…We cannot establish our own autonomy; we still seem to carry out all practices in a way that is dependent on physicians…” (P10, Generation Y, Bachelor’s degree, Public hospital, Intensive Care Unit) The Impact of Experience and Level of Education Generation X nurses expressed more views than Generation Y and Baby Boomer nurses regarding the impact of experience and level of education. Participants stated that, through experience and education, they become aware of their professional rights and responsibilities, are able to make independent decisions, and can evaluate the outcomes of those decisions. “…If you have worked in that specialty for a long time and have developed yourself well, you can make decisions. Even physicians respect the decisions we make—we can sometimes even guide them…” (P9, Generation X, Master’s degree, Public hospital, Assistant Head Nurse) “…For example, what I say now is taken more seriously because I am someone pursuing doctoral education…” (P32, Generation X, Master’s degree, University hospital, Infection Control) The Influence of Organizational Culture Nurses from all three generations expressed views regarding the influence of organizational culture. Participants stated that their ability to act autonomously varies across institutions and that, particularly in private hospitals, financial concerns may take precedence over professional decision-making. “…They say, ‘This is how we do it here, and this is how it will continue,’ and unfortunately, sometimes you have to comply because of the institutional culture…” (P23, Generation Y, Bachelor’s degree, Public hospital, Inpatient unit) “…In private hospitals, as long as there isn’t a financial issue at stake, you can make more independent decisions…” (P28, Generation X, Bachelor’s degree, Private hospital, Head Nurse) Assignment to Tasks Outside Defined Duties, Authority, and Responsibilities Generation X and Generation Y nurses expressed views to a similar extent regarding assignment to tasks outside defined duties, authority, and responsibilities, whereas Baby Boomer nurses did not report views on this issue. Participants stated that they assume full responsibility for their units and are often required to deal with technical or administrative tasks instead of dedicating more time to patient care. “…When you arrive in the morning as a unit nurse or charge nurse, you are supposed to see all patients, plan their care, and ensure that everything is carried out during the day. But that’s not what happens, because we are constantly dealing with trivial issues…” (P14, Generation Y, Doctoral degree, University hospital, Infection Control) “…I deal with supplies, with people, with problems, with paperwork—I try to write reports; I handle so many things outside my actual role, unfortunately. Everyone has boundaries, but it seems we have none…” (P17, Generation X, Master’s degree, University hospital, Charge Nurse) Professional Ethics The theme of professional ethics was expressed by participants through the following codes: “approach consistent with ethical principles” and “approach inconsistent with ethical principles.” Approach Consistent with Ethical Principles Generation X and Baby Boomer nurses expressed more views than Generation Y nurses regarding an approach consistent with ethical principles. Participants stated that, compared with other professional groups, nurses are more sensitive to ethical principles and act in accordance with the principles of privacy, non-maleficence–beneficence, and justice. “…I think nurses are the most ethical group in the healthcare field; I believe they are the most principled group, because we place great importance on not harming the patient and on providing benefit…” (P14, Generation Y, Doctoral degree, University hospital, Infection Control) “…Nurses have been the group that most strongly considers the patient’s best interests; at times, this has even led to conflicts with other professional groups…” (P32, Generation X, Master’s degree, University hospital, Infection Control) Approach Inconsistent with Ethical Principles Nurses from all three generations expressed views, though to a lesser extent, regarding approaches inconsistent with ethical principles. Participants stated that ethical principles are not always sufficiently understood and that deviations may occur in practice. “…I used to think it was very important and that everyone was highly aware of it, because that was how it was presented to us. But in working life, I have seen that although efforts are made to adhere to ethical principles, I am not sure to what extent this is truly the case…” (P24, Generation Y, Bachelor’s degree, Private hospital, Inpatient Unit) “…Regarding ethical codes—although people say we act ethically, the boundaries and criteria can sometimes become blurred. For example, we experienced this several times in patient records, and afterward we introduced certain restrictions…” (P22, Generation Y, Master’s degree, Private hospital, Head Nurse) Discussion This study provides insights into nursing professionalization from the perspectives of clinically experienced nurses across different generations. By emphasizing the themes of education; scientific knowledge and its applicability; professional organization; societal perceptions of nursing; autonomy; and professional ethics, the findings offer implications that may contribute to the advancement of nursing professionalism in Türkiye. Professional education is the first issue encountered in the literature when examining the conditions, criteria, or processes required for a profession to achieve professional status. Undoubtedly, a profession must be grounded in a defined period of standardized education ( 23 , 24 ). However, one of the fundamental challenges nursing faces globally is the variability in practice and educational standards ( 25 ). In the present study, Generation X and Generation Y nurses more frequently emphasized the need to ensure educational standardization, whereas Baby Boomer and Generation Y nurses more frequently highlighted the importance of improving the quality of education. In countries such as India and South Africa, although legislation and regulations define nurses’ professional and educational status, inconsistencies or gaps affecting nursing practice and recognition remain evident ( 26 ). Similarly, in Türkiye, although Article 1 of the Nursing Law states that the title of nurse is granted to “those who graduate from faculties and schools providing undergraduate nursing education,” Provisional Article 3 allowed graduates of vocational health high schools to assume the title of nurse until 2017 ( 27 ). As a result, nurses with high school, associate degree, and bachelor’s degree qualifications continue to work under the same professional title in clinical settings. It can therefore be argued that educational levels among nurses in practice have not yet been fully standardized. The relatively lower prioritization of this issue by Baby Boomer nurses may be attributable to their long-term observation of ongoing attempts to establish this standard since the initiation of bachelor’s-level nursing education in Türkiye in 1955. In addition, Sönmez et al. ( 28 ) reported that more than half of the nurses in their study considered the theoretical and clinical education they received during university training to be insufficient. Similarly, Ejupi et al. ( 26 ) and Wang et al. ( 29 ) emphasized the critical role of high-quality educational programs in equipping nurses with the knowledge, skills, and tools necessary for nursing professionalism. Taken together, the findings and the existing literature suggest that careful consideration of all components contributing to the quality of nursing education—and the provision of appropriate educational opportunities to train competent nurses—are essential for advancing nursing professionalism. Generation X and Generation Y nurses more frequently expressed the view that knowledge remains at a conceptual level, whereas Generation X nurses most frequently emphasized that scientific knowledge is reflected in practice. As cited by Velioğlu ( 30 ), Getzels described this relationship as follows: “Theory without practice is like a roadless map—it is empty; practice without theory is like traveling without a map—it is blind.” Kalogirou, Chauvet, and Yonge ( 31 ), in a study examining the theory–practice gap through the perspectives of clinical managers, identified four themes: program entry; curriculum content, delivery, and structure; clinical recommendations; and stronger partnerships. Their findings indicated that strong academic–practice partnerships remain necessary and that deficiencies in communication and collaboration jeopardize the quality of students’ education and their transition into professional practice. Strengthening collaboration between academic and clinical nursing leaders may help bridge the theory–practice gap and better prepare newly graduated nurses. Similar findings were reported in a qualitative study conducted with nursing students in the United Arab Emirates ( 32 ). Nearly all participants described, either directly or indirectly, a gap between what they learned in theoretical courses and what they encountered in clinical education. One participant stated: “Perhaps we should focus more on clinical education or clinical placement. Instead of linking theory to clinical practice, we should link clinical practice to theory, because sometimes we cover many topics in theory that are not related to or up to date with clinical practice.” Nursing professionalism requires the profession to continuously build its body of knowledge and to enhance the quality of care in response to ongoing developments in technology, healthcare systems, and patient care ( 33 ). Doğan et al. ( 34 ) found that nurses’ attitudes toward evidence-based nursing practices were positive. When contemporary, scientific, and evidence-based nursing care is implemented collaboratively among all members of the profession, professionalization in nursing becomes inevitable ( 35 ). It may therefore be argued that prioritizing research findings that are effectively translated into practice is essential for strengthening nursing professionalism. Professional organization represents a structure through which members of a profession come together, safeguard their collective interests, contribute to the formation of professional laws and regulations, and gain a voice in political processes. It reflects a professional stance by ensuring supervision, regulation, and the maintenance of practice standards ( 36 ). In the present study, Generation X and Generation Y nurses more frequently expressed the view that professional organization is insufficient, whereas Generation X nurses most frequently articulated critical perspectives on professional associations. A review of the literature indicates that the inadequacy of professional organization in nursing has been similarly identified in numerous studies ( 37 , 38 ). However, existing research also demonstrates that nurses recognize the necessity of professional organization and are aware of its role in the professionalization process ( 36 ). These findings suggest that insufficient organization may not stem from a lack of awareness, but rather from other underlying factors that warrant further examination. The findings of this study indicate that nurses’ limited engagement in professional organization does not appear to be due to a lack of knowledge; instead, it may be associated with perceived qualitative shortcomings of professional associations and with the view that nursing organizations should be united under a single umbrella structure. In other studies, participants expressed views such as: “I do not believe they carry out truly meaningful work for the profession,” “If associations only talk without solving problems, what is the point of being a member?” and “Because associations are not active, they do not play an effective role in the professionalization process” ( 36 , 38 ). It may therefore be suggested that professional associations should take nurses’ evaluations of their qualitative performance into account, actively seek feedback from members, and create regular opportunities to engage with nurses either through meetings or field-based assessments—in order to support organizational self-evaluation and development. The professional status of a profession is closely associated with its public image within a given society, rendering societal perceptions of nursing particularly significant ( 39 ). Although perceptions of the profession have evolved over time, the prevailing view remains that a fully developed public image recognizing nursing’s scientific foundation and professional advancement has not yet been achieved ( 40 , 41 ). In the present study, Generation X and Generation Y nurses frequently emphasized the increased respect and visibility gained during the COVID-19 pandemic. Throughout the pandemic, nurses from all generations delivered frontline care in diverse settings, including family health centers, contact tracing teams, emergency departments, COVID-19 inpatient units, and intensive care units where advanced treatment and critical care were provided ( 42 – 44 ). As in many countries worldwide, this situation brought healthcare professionals—and nurses in particular—into greater public prominence in Türkiye ( 45 ). During this period, the Turkish Nurses Association issued public statements with the slogans “We will continue to touch you” and “ We are by your side,” reaffirming its commitment to nursing care. Through its official website and social media platforms, the Association sought to emphasize that nursing is grounded in scientific knowledge and professional expertise ( 44 ). A study conducted by Gündüz Hoşgör and Coşkun ( 46 ) demonstrated that, in Turkish society, perceptions of the nursing profession shifted positively during the COVID-19 pandemic. In the post-pandemic period, the scope of nursing competencies has expanded, and the significance of nursing care has become more widely recognized and valued. Nevertheless, to ensure the sustainability and further strengthening of this enhanced image, it may be beneficial to develop institutional and legal strategies aimed at consolidating these gains. It is well established that nurses’ ability to act autonomously in their professional practice directly contributes to the attainment of professional status in nursing ( 47 ). In the present study, Baby Boomer and Generation Y nurses most frequently emphasized the influence of team members on autonomy, whereas Generation X nurses most frequently highlighted the impact of experience and level of education. The literature identifies several factors that hinder autonomy in nursing practice: working in physician-dominated environments; the predominantly female composition of the nursing workforce; the characterization of nurses as compliant and obedient by colleagues and society; the perception of physicians as occupying a paternal role and nurses a maternal role within hospital settings; and the lack of standardized educational levels among clinical nurses ( 48 , 49 ). In Emiroğlu’s study ( 50 ), physicians were found to perceive themselves as the primary decision-makers and to lack awareness of nurses’ professional qualifications and independent functions. In Türkiye, the legal foundation enabling nurses to act autonomously is clearly articulated in the Nursing Law and related regulations, particularly through provisions concerning the “nursing diagnosis process,” “nursing care,” and “nurses’ duties, authorities, and responsibilities” ( 51 ). Nevertheless, several studies have concluded that nurses exercise autonomy at only a moderate level ( 48 , 52 , 53 ). Practices performed by members of a profession based on their own professional knowledge and skills are unique to that profession and can be defined only by its members. Nurses’ ability to make accurate and effective decisions is influenced by their professional knowledge, experience, and the structural characteristics of the work environment ( 54 ). Research indicates that as nurses’ years of experience increase, their knowledge within their area of practice and their self-confidence also increase, thereby enhancing their capacity for independent decision-making ( 48 , 55 ). In parallel with contemporary technological advancements, the scope of nursing practice has expanded and patient care has become increasingly complex. Decisions made in evidence-based nursing practice develop through clinical wisdom and repeated exposure to a sufficient number of cases ( 56 , 57 ). Beyond possessing legal authority to make decisions, nurses are expected to translate knowledge and scientific evidence into practice, implement evidence-based nursing care, and evaluate their own professional practices—thereby fulfilling their professional roles through autonomous action. It can be argued that autonomy remains one of the most challenging dimensions in the professionalization process of nursing. Generation X nurses most strongly emphasized that nursing practice reflects adherence to ethical principles. The fundamental human right of all individuals to receive equal, adequate, and qualified healthcare has, alongside rapid developments in the health sector, brought increasingly complex and critical practices—such as organ transplantation, resuscitation, enteral nutrition, genetic testing, and stem cell research—into routine care. In this context, ethical considerations have gained even greater importance ( 52 , 58 ). Acting in accordance with ethical principles in professional conduct and clinical practice is a fundamental requirement of being a profession ( 38 ). The literature indicates that neonatal intensive care nurses strive to provide care consistent with the principles of beneficence, justice, and equality, yet encounter difficulties in fulfilling these principles due to various constraints ( 59 ). It has been reported that nurses are aware of their ethical obligations and endeavor to deliver ethically grounded nursing care; however, they require institutional and professional support to do so effectively ( 59 , 60 ). Kahriman ( 38 ) found that nurses demonstrated high levels of ethical sensitivity, whereas other studies have reported moderate levels of ethical sensitivity among nurses ( 61 – 63 ). Some research has identified a weak but positive relationship between ethical decision-making and professional behavior ( 58 , 64 ). It may therefore be suggested that nurses make deliberate efforts to provide nursing care consistent with ethical principles, which constitutes one of the core criteria of professionalization in nursing. Conclusions This study provides insight into the evaluation of professionalization in nursing from the perspectives of nurses belonging to different generations and highlights factors influencing this process. It reveals specific dimensions that each generation particularly emphasized and articulated more intensively. To advance nursing professionalism, it may be recommended that professional organizations systematically evaluate feedback received from their members; that nursing care practices be made more visible in order to enhance the public reputation of the profession and foster a stronger perception of nursing as a profession; and that awareness-raising and supportive mechanisms be established to strengthen nurses’ understanding of their duties, authorities, and responsibilities, thereby enhancing professional autonomy. The findings obtained from this study may be utilized to assess nursing professionalism in Türkiye, to develop contextually appropriate strategies, and to design culturally adaptable evaluation instruments for use in cross-cultural settings. Limitations This study is the first qualitative investigation in Türkiye to evaluate professionalization in nursing from the perspectives of clinically experienced nurses representing different generations. The principal limitation of the study is that the interviews were conducted exclusively with nurses working in private, public, and state hospitals within a single province. To enhance the generalizability of the findings, future research should be expanded to include nurses from additional provinces, as well as nursing academics. Declarations Consent for publication: Not applicable. Competing Interest: The authors report no actual or potential competing interest. Fundings: The authors received no spesific funding for this work. Acknowledgments: The authors are grateful to all the inpatients who volunteered to participate in this study Data Availability: The authors confirmed that all relevant data are included in the article. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Ethical Approval: In order to conduct the study, ethical approval was obtained from the Istanbul University-Cerrahpaşa Faculty of Medicine Clinical Research Ethics Committee, Decision No. A-09, dated 05.11.2019 (Related file 1). Institutional permission for the participation of nurses in Istanbul was obtained from the Istanbul Branch of the Turkish Nurses Association (Related file 2). Participants who agreed to take part in the study were informed by the researcher about the purpose of the study, that the information they shared would be kept confidential and not shared with others, and that the use of the data would be limited to this research. Both verbal and written informed consent were obtained from the participants (Supplementary material 2). 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Supplementary Files Supplementarymaterial1.docx Supplementarymaterial2.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers invited by journal 25 Mar, 2026 Editor invited by journal 27 Feb, 2026 Editor assigned by journal 27 Feb, 2026 Submission checks completed at journal 27 Feb, 2026 First submitted to journal 22 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-8938964\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":612488612,\"identity\":\"dae4d3b2-69eb-4751-81f9-50b479b6bafc\",\"order_by\":0,\"name\":\"Filiz COŞKUN\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7ElEQVRIiWNgGAWjYBAC9mbmhgNgFg8Qf2AAsw3wauE5zIjQwjgDriUBj5YDjA0MMC3MPERpYWdsPPiDwU5OvueM2WObP3cSG9ibt0kw/riHWwsz0GESDMnGBmd7zI1z254lNvAcK5NgSCjGqcUepMWA4UDiBn4eM+nchsOJDRI5ZkAtuF0GtiUBqGV+P1CLxR+gFvk3RGg5ANTScLbHTJqBDWQLD2EtBxsMgH45c6xMsrftmXEbT1qxRUIaHi38hw9//FEBCrHkbRI//tyR7Wc/vPHGBxvcWiAAObrZQAQhDaNgFIyCUTAK8AMA9M1QUr1DDRgAAAAASUVORK5CYII=\",\"orcid\":\"\",\"institution\":\"University of Health Sciences,Türkiye\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Filiz\",\"middleName\":\"\",\"lastName\":\"COŞKUN\",\"suffix\":\"\"},{\"id\":612488613,\"identity\":\"a345f5b7-6bfc-439c-8afe-ba6c50b73ed1\",\"order_by\":1,\"name\":\"Aytolan YILDIRIM\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Atlas University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Aytolan\",\"middleName\":\"\",\"lastName\":\"YILDIRIM\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-02-22 12:08:36\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-8938964/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-8938964/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":105548312,\"identity\":\"f010a1b0-d9cf-43d2-963a-56e42dd84900\",\"added_by\":\"auto\",\"created_at\":\"2026-03-27 09:29:42\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":272284,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eThe themes, their codes, and how intensely each generation expressed them\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8938964/v1/2a2cfe420930b54c0013f830.png\"},{\"id\":105567229,\"identity\":\"8d60a4b6-78b0-44d9-959d-251e01f2b72f\",\"added_by\":\"auto\",\"created_at\":\"2026-03-27 12:58:43\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1641168,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8938964/v1/f8f7d4c0-722c-4d4f-a723-652f23136192.pdf\"},{\"id\":105548313,\"identity\":\"205d8f76-d38c-4dc9-9bfe-ca43aa249d99\",\"added_by\":\"auto\",\"created_at\":\"2026-03-27 09:29:42\",\"extension\":\"docx\",\"order_by\":1,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":17273,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Supplementarymaterial1.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8938964/v1/d10aba26558b7d500f861d11.docx\"},{\"id\":105548314,\"identity\":\"a01606d9-1858-4a15-9411-3f2017717b19\",\"added_by\":\"auto\",\"created_at\":\"2026-03-27 09:29:42\",\"extension\":\"docx\",\"order_by\":2,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":15784,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Supplementarymaterial2.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8938964/v1/ed1e8ca70e6f9d3eea6b4777.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Nursing Professionalism, As Perceived By Nurses From Different Generations In Türkiye: A Qualitative Study\",\"fulltext\":[{\"header\":\"Background\",\"content\":\"\\u003cp\\u003eProfessionalization is a dynamic concept with a long history that continues to evolve (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e). Over the years, sociologists, historians, and nurses have examined nursing professionalism and its defining characteristics (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). Miller conducted some of the earliest work on nursing professionalism and developed the \\u0026ldquo;Wheel of Professionalism in Nursing\\u0026rdquo; model, based on the ethical principles established by the American Nurses Association (ANA). This model identifies nine standards: educational preparation; adherence to a code of ethics; continuing education and competence; participation in professional organizations; communication and publication; autonomy and self-regulation; community service; use, development, and evaluation of theory; and participation in research (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e). In addition to these core standards, researchers have emphasized attributes such as inquiry, creativity, research orientation, service to society, collaboration, and active involvement in professional organizations (\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e). Although professionalization is culturally embedded, several recurring attributes have been identified, including autonomy, collaboration, jurisdiction, membership in professional organizations, professional development, community and social service, adherence to nursing standards, and the implementation and evaluation of nursing practice (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e). Collectively, these attributes and models illustrate the conceptual diversity inherent in nursing professionalism. However, given its dynamic nature\\u0026mdash;shaped by temporal, social, scientific, technological, contextual, and cross-cultural changes\\u0026mdash;professionalism remains difficult to define, quantify, or measure (\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eGlobal interest in nursing professionalism has increased substantially in recent years, particularly in studies conducted in Asia and the Middle East (\\u003cspan additionalcitationids=\\\"CR8 CR9\\\" citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e). Nursing professionalism is influenced by context-specific sociocultural values and legal frameworks, necessitating a localized understanding of its defining characteristics (\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e). Alignment between existing theoretical frameworks and the realities of contemporary nursing practice can be achieved through culturally adapted assessment tools. Accumulating evidence indicates that nursing professionalism is culturally grounded, continuously evolving, and multidimensional (\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e). Hall argued that defining a profession and its core attributes should be achieved through consensus among members of that profession (\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e). In their concept analysis titled \\u0026ldquo;\\u003cem\\u003eWhat is nursing professionalism?\\u003c/em\\u003e\\u0026rdquo;, Cao et al. (\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e) highlighted variations in the meaning of nursing professionalism across cultures and emphasized the need to consider national cultural characteristics in efforts to advance professionalism. As nursing professionalization is shaped by social, cultural, scientific, technological, and contextual changes, ensuring its validity and applicability requires ongoing re-examination (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003ePrevious studies have demonstrated associations between professionalization and improvements in nursing performance, critical thinking, reflective practice, empowerment (\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e), sense of belonging, and professional identity (\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e). Age has also been identified as a factor influencing nursing professionalism (\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e). In addition, years of service and workplace experiences are directly associated with levels of professionalism (\\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e). In this context, the perspectives of nurses from different generations and with varying levels of experience offer unique and valuable insights into the professionalization process.\\u003c/p\\u003e \\u003cp\\u003eThe contemporary nursing workforce comprises three generations: Baby Boomers, Generation X, and Generation Y. A generation refers to a cohort of individuals born within a similar time frame who were exposed to common social, cultural, and political events and who therefore tend to share comparable values, attitudes, behaviors, and characteristics. Each generation undergoes developmental processes across the life course and is shaped by a distinct historical context that influences this trajectory (\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e). The perspectives provided by nurses from different generations constitute an important resource for examining intergenerational similarities and differences within their broader social and historical contexts and for understanding how these factors influence the professionalization of nursing. Recognizing that each nurse possesses unique personal characteristics, experiences, and life circumstances that collectively shape individual identity, a deeper and more nuanced exploration of nursing professionalism is warranted.\\u003c/p\\u003e \\u003cp\\u003eAccordingly, this study aimed to evaluate nursing professionalism from the perspectives of clinically experienced nurses across different generations, to contribute to the development of a conceptual framework, and to provide practice implications for strengthening nursing professionalism in Turkish society.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eAims\\u003c/h2\\u003e \\u003cp\\u003eThis study aimed to evaluate nursing professionalism from the perspectives of clinically experienced nurses across different generations, to contribute to the advancement of professionalization in nursing, and to provide practice implications specific to Turkish society.\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eStudy design\\u003c/h3\\u003e\\n\\u003cp\\u003eA qualitative research design based on descriptive phenomenology was adopted (\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e). Data were analyzed using the thematic analysis approach described by Braun and Clarke (\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e). Semi-structured interviews were conducted between November 2020 and April 2021 with nurses from different generations working in private, public, and university hospitals in Istanbul, T\\u0026uuml;rkiye\\u0026rsquo;s most populous city.\\u003c/p\\u003e\\n\\u003ch3\\u003eParticipants and settings\\u003c/h3\\u003e\\n\\u003cp\\u003eThe study population comprised nurses from the Baby Boomer, Generation X, and Generation Y cohorts working in Istanbul. Maximum variation sampling was employed to ensure a heterogeneous sample. This sampling strategy aims to identify common or shared patterns across diverse cases and to illuminate different dimensions of the phenomenon under investigation (\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e). Among purposive sampling strategies, criterion-based sampling is particularly effective when selecting individuals who have direct experience with the phenomenon of interest (\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e). In the present study, inclusion criteria were determined in line with the study aim and research topic. The inclusion criteria were: (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e) willingness to participate in the study; (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e) currently working as a nurse; (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e) at least one year of nursing experience; and (\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e) belonging to one of the following generations: Baby Boomers (1946\\u0026ndash;1964), Generation X (1965\\u0026ndash;1979), or Generation Y (1980\\u0026ndash;1999). The exclusion criteria were: (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e) nurses who were not actively working in the hospital during the data collection period (e.g., due to sick leave, maternity leave, or vacation); and (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e) nurses who had recently entered the profession and were still undergoing orientation training.\\u003c/p\\u003e\\n\\u003ch3\\u003eData collection\\u003c/h3\\u003e\\n\\u003cp\\u003eTo ensure consistency, all interviews were conducted by the same researcher. Prior to data collection, the researcher undertook an extensive and systematic review of the relevant literature. The interviewer completed a three-day face-to-face training course on qualitative research methods and qualitative interviewing techniques and obtained a certificate of competency. In addition, the researcher received guidance from experienced professors and conducted pilot interviews to refine interviewing skills. A semi-structured interview guide (Supplementary material 1), developed based on findings from previous research on the conceptual analysis of nursing professionalism, was used during the interviews. Interviews were scheduled by appointment and conducted at a time and place deemed appropriate by the participant, either during periods that did not interfere with unit workload or after working hours. Due to COVID-19 precautions, 15 of the interviews were conducted online. Written informed consent and permission for audio recording were obtained from all participants prior to data collection. To prevent data loss, face-to-face interviews were audio-recorded with participants\\u0026rsquo; permission, and online interviews were recorded digitally. All recordings were subsequently transcribed verbatim by the researcher. The interviews lasted an average of 34 minutes.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec7\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eData analysis\\u003c/h2\\u003e \\u003cp\\u003eBraun and Clarke (\\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e38\\u003c/span\\u003e) argue that, in qualitative research, achieving data saturation requires a sample that provides sufficient data to allow comprehensive analysis of the phenomenon in line with the research aim. In the present study, recruitment was discontinued after 35 participants, as repetition of concepts was observed and no new themes emerged. A thematic analysis approach following the phases outlined by Braun and Clarke (\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e) was employed. The analysis consisted of six stages: (\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e) transcribing the interviews and becoming familiar with the data through repeated reading; (\\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e) generating initial codes by systematically identifying meaningful data segments; (\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e) collating codes into potential themes and organizing all relevant coded extracts under each theme; (\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e) reviewing and mapping themes to ensure coherence with the coded data and the entire dataset; (\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e) refining and clearly defining theme names to ensure internal consistency and alignment with the overall analysis; and (\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e) selecting illustrative quotations and producing the final analytical report.\\u003c/p\\u003e \\u003cp\\u003eIn the first stage, the transcripts prepared by the researcher were read repeatedly to achieve immersion in the data. In the second stage, preliminary codes were generated from the dataset. In the third stage, initial codes were examined and organized under potential thematic categories. In the fourth stage, themes were reviewed and mapped to confirm that they were supported by the data. In the fifth stage, theme names were refined to ensure that they were conceptually distinct, internally coherent, and consistent with the dataset. Finally, representative quotations were selected and the analytical report was completed. Throughout these stages, MAXQDA software, a professional data analysis program designed for qualitative and mixed-methods research, was used to support data management and analysis.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eEthics\\u003c/h2\\u003e \\u003cp\\u003eIn order to conduct the study, ethical approval was obtained from the Istanbul University-Cerrahpaşa Faculty of Medicine Clinical Research Ethics Committee, Decision No. A-09, dated 05.11.2019 (Related file 1). Institutional permission for the participation of nurses in Istanbul was obtained from the Istanbul Branch of the Turkish Nurses Association (Related file 2). Participants who agreed to take part in the study were informed by the researcher about the purpose of the study, that the information they shared would be kept confidential and not shared with others, and that the use of the data would be limited to this research. Both verbal and written informed consent were obtained from the participants (Supplementary material 2). The study was conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki and national research ethics guidelines.\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eRigor\\u003c/h3\\u003e\\n\\u003cp\\u003eValidity refers to the extent to which research findings are accurate and unbiased. In qualitative research, validity is associated with the degree to which the data collection tool accurately captures the phenomenon it is intended to explore (\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e). In this context, data obtained from the instrument should reflect participants\\u0026rsquo; lived experiences and thereby contribute to the credibility of the findings. To enhance internal validity, the interview guide developed by the researcher was reviewed by experts prior to its use. In addition, both written and verbal informed consent was obtained from all participants. To ensure external validity, the research design, methodology, data collection tools, data collection process, data analysis procedures, and the development of findings were described in detail.\\u003c/p\\u003e\\n\\u003ch3\\u003eFindings\\u003c/h3\\u003e\\n\\u003cp\\u003eA total of 35 participants were included in the study. Participants were coded sequentially from P1 to P35. Detailed demographic characteristics are presented in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e. The six identified themes, their codes, and how intensely each generation expressed them are shown in Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e. These themes were: Education; Scientific Knowledge and Its Applicability; Professional Organization; Societal Perceptions of Nursing; Autonomy; and Professional Ethics.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eCharacteristics of participants interviewed\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"8\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDocument name\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eGender\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eAge\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eInstitution\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003eYears of service\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eResponsibility\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eEducation\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e27\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e4 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eOperating Room Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e38\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e14 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eOperating Room Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e62\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e42 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eBaby Boomer\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eOutpatient Clinic Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e33\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e9 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eQuality Unit\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e32\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e13 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eQuality Unit\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e56\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e35 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eCharge Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP7\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e47\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e31 Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eCharge Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP8\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e21\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1 Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eUnit Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e46\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e27 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eAssistant Head Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e23\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1 Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eIntensive Care Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP11\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e23\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1 Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eUnit Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP12\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e26\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e3 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eCovid-19 Unit Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP13\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e45\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e25 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eCharge Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP14\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e40\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e20 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eInfection Control Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eDoctoral degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP15\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e51\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e33 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eOutpatient Clinic Charge Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP16\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e34\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e11 Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eCovid-19 Unit Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP17\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e44\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e25 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eCharge Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP18\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e45\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e25 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eIntensive Care Charge Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP19\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e36\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e14 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eHead Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP20\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e25\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e3 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eEducation unit\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP21\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e39\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e20 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eEducation unit\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP22\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e39\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e18 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eHead Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP23\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e27\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e5 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eUnit Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP24\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e23\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e1 Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eUnit Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP25\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e38\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e16 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eEmergency Unit Charge Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP26\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e36\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e14 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eIntensive Care Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP27\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e43\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e21 Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eAssistant Head Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP28\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e56\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e35 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eHead Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP29\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e40\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e21 Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration Y\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eAssistant Head Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP30\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e61\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e40 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eBaby Boomer\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eCharge Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP31\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e58\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePublic Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e38 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eBaby Boomer\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eOutpatient Clinic Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP32\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e52\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e31 Year\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eInfection Control Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP33\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e49\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e28 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eInfection Control Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eMaster\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP34\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e55\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eUniversity Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e36 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eGeneration X\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eCharge Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eP35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e59\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ePrivate Hospital\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e40 Years\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e \\u003cp\\u003eBaby Boomer\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eOperating Room Nurse\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eBachelor\\u0026rsquo;s degree\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003eTable\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e Characteristics of participants interviewed\\u003c/p\\u003e \\u003cdiv id=\\\"Sec11\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eEducation\\u003c/h2\\u003e \\u003cp\\u003eThe theme of Education was articulated through the following codes: \\u003cem\\u003e\\u0026ldquo;ensuring educational standardization,\\u0026rdquo; \\u0026ldquo;improving the quality of education,\\u0026rdquo; \\u0026ldquo;integrated education system,\\u0026rdquo; \\u0026ldquo;the impact of postgraduate education,\\u0026rdquo;\\u003c/em\\u003e and \\u003cem\\u003e\\u0026ldquo;employment of non-nurses in organizations under the title of nurse.\\u0026rdquo;\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec12\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eEnsuring Educational Standardization\\u003c/h2\\u003e \\u003cp\\u003eCompared with Baby Boomer nurses, participants from Generation X and Generation Y placed greater emphasis on the need for standardized educational preparation. Nurses stated that educational preparation should be standardized at the bachelor\\u0026rsquo;s level and described this as a fundamental prerequisite for professionalization. However, they also emphasized that despite the introduction of the first bachelor\\u0026rsquo;s program in T\\u0026uuml;rkiye in 1955, this issue has yet to be fully resolved.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I think our biggest problem comes from the fact that the education level in this profession isn\\u0026rsquo;t unified. And that directly affects professionalization\\u0026hellip;\\u0026rdquo; (P32, Generation X, Master\\u0026rsquo;s degree, University hospital, Infection Control)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;The first step toward professionalization is having a standardized education level. Everyone in this profession should graduate at the same level\\u0026hellip;\\u0026rdquo; (P25, Generation Y, Bachelor\\u0026rsquo;s degree, Public hospital, Emergency Unit Charge Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec13\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eImproving the Quality of Education\\u003c/h2\\u003e \\u003cp\\u003eBaby Boomer and Generation Y nurses expressed stronger views on improving the quality of education compared with Generation X nurses. Baby Boomer nurses stated that although they had received education at the high school level during their training period, they considered themselves more competent than some newly graduated nurses who currently enter the profession with a bachelor\\u0026rsquo;s degree. Generation Y nurses emphasized that, although the number of institutions offering undergraduate nursing education has increased, limited clinical practice opportunities prevent students from receiving high-quality training.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;When I compare these interns to myself\\u0026mdash;even back when I was trained at the high school level\\u0026mdash;they\\u0026rsquo;re not even at that level\\u0026hellip;\\u0026rdquo; (P3, Baby Boomer, Bachelor\\u0026rsquo;s degree, Public hospital, Outpatient clinic)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;They\\u0026rsquo;re opening nursing schools like supermarkets, unfortunately\\u0026hellip;\\u0026rdquo; (P16, Generation Y, Master\\u0026rsquo;s degree, University hospital, COVID-19 unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;Some students from very reputable universities haven\\u0026rsquo;t even done an IV line\\u0026mdash;they\\u0026rsquo;ve never actually saw it\\u0026hellip;\\u0026rdquo; (P9, Generation X, Master\\u0026rsquo;s degree, Public hospital, Assistant Head Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec14\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eIntegrated Education System\\u003c/h2\\u003e \\u003cp\\u003eAlthough more frequently emphasized by Generation Y nurses, Generation X nurses also expressed views regarding the need for an integrated education system. Participants stated that a system integrating theory and practice is essential for professionalization in nursing.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;First of all, the academic world absolutely has to be integrated with the clinical field\\u0026hellip;\\u0026rdquo; (P23, Generation Y, Bachelor\\u0026rsquo;s degree, Public hospital, Inpatient unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;Academia and clinical practice need to be together\\u0026mdash;we have to work collaboratively if our profession is going to professionalize\\u0026hellip;\\u0026rdquo; (P6, Generation X, Master\\u0026rsquo;s degree, University hospital, Charge Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec15\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eThe Impact of Postgraduate Education\\u003c/h2\\u003e \\u003cp\\u003eGeneration Y nurses, more prominently, and Generation X nurses also expressed views regarding the impact of postgraduate education. Participants stated that specialization through postgraduate education is necessary for professionalization and emphasized that specialist nurses should be assigned according to their specific areas of expertise.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I definitely think a master\\u0026rsquo;s degree must be pursued; I absolutely believe it professionalizes and strengthens the profession\\u0026hellip;\\u0026rdquo; (P32, Generation X, Master\\u0026rsquo;s degree, University hospital, Infection Control)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;When you are pursuing or have completed a master\\u0026rsquo;s degree, the attitude and respect of your colleagues in the team increase. Why? Because they no longer see you as an ordinary nurse; they say this nurse is trying to advance professionally and has goals\\u0026hellip;\\u0026rdquo; (P2, Generation Y, Master\\u0026rsquo;s degree, Public hospital, Operating Room)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec16\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eEmployment of Non-Nurses in Organizations Under the Title of Nurse\\u003c/h2\\u003e \\u003cp\\u003eGeneration Y nurses expressed views regarding the employment of non-nursing personnel under the title of nurse within organizations. Participants reported that, particularly in private institutions, the employment of nurse aides, emergency medical technicians, or operating room technicians under the title of nurse harms professionalization.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;After graduating from high school, nurse aides\\u0026mdash;who are not qualified to perform any medical or therapeutic interventions\\u0026mdash;are especially employed in the private sector as if they were nurses. Do you think this image can improve? Can this profession move toward professionalization? I think it\\u0026rsquo;s very difficult, very difficult. Therefore, legal regulations and restrictions are needed\\u0026hellip;\\u0026rdquo; (P2, Generation Y, Master\\u0026rsquo;s degree, Public hospital, Operating Room)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;In hospitals, they can assign almost anyone\\u0026mdash;for example, a midwife\\u0026mdash;as a nurse in clinical settings; they can employ an anesthesia technician or an operating room technician as a nurse. Even if they are not authorized to perform certain procedures, they are told \\u0026lsquo;this is how it\\u0026rsquo;s done\\u0026rsquo; and made to do it, that\\u0026rsquo;s all\\u0026hellip;\\u0026rdquo; (P12, Generation Y, Bachelor\\u0026rsquo;s degree, Public hospital, COVID-19 unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec17\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eScientific Knowledge and Its Applicability\\u003c/h2\\u003e \\u003cp\\u003eThe theme of scientific knowledge and its applicability was expressed by participants through the following codes: \\u003cem\\u003e\\u0026ldquo;knowledge remaining at a conceptual level,\\u0026rdquo; \\u0026ldquo;reflection of scientific knowledge in practice,\\u0026rdquo;\\u003c/em\\u003e and \\u003cem\\u003e\\u0026ldquo;recurrent research topics.\\u0026rdquo;\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec18\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eKnowledge Remaining at a Conceptual Level\\u003c/h2\\u003e \\u003cp\\u003eCompared with Baby Boomer nurses, Generation X and Generation Y nurses expressed more views regarding knowledge remaining at a conceptual level. Participants stated that both the theoretical knowledge acquired during their education and the findings of research studies were not sufficiently reflected in clinical practice.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I\\u0026rsquo;m still relatively new in my professional life, yes, but when I was in school, I used to think these things were being reflected in practice. However, based on my observations, all that scientific knowledge is not actually implemented\\u0026hellip;\\u0026rdquo; (P24, Generation Y, Bachelor\\u0026rsquo;s degree, Private hospital, Inpatient unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;They don\\u0026rsquo;t have any direct contact with patients, and because they can\\u0026rsquo;t engage with patients or assess the needs of patients and clinical nurses, they end up conducting studies that remain entirely theoretical\\u0026hellip;\\u0026rdquo; (P21, Generation Y, Master\\u0026rsquo;s degree, Private hospital, Education unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec19\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eReflection of Scientific Knowledge in Practice\\u003c/h2\\u003e \\u003cp\\u003eAlthough more frequently emphasized by Generation X nurses, Generation Y and Baby Boomer nurses also expressed views indicating that scientific knowledge is reflected in practice. Participants reported that, particularly in recent years, research findings have increasingly informed nursing practice and that they identify and implement nursing theories appropriate to patient care.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I realized that nursing care can be delivered according to nursing models. For example, while working during COVID, when I was serving as a charge nurse, I provided nursing care based on the Activities of Daily Living model\\u0026hellip;\\u0026rdquo; (P6, Generation X, Master\\u0026rsquo;s degree, University hospital, Charge Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;There is a body of professional knowledge, and it is very important\\u0026mdash;it significantly affects the patient\\u0026rsquo;s life\\u0026hellip;\\u0026rdquo; (P10, Generation Y, Bachelor\\u0026rsquo;s degree, Public hospital, Intensive Care Unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec20\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eRecurrent Research Topics\\u003c/h2\\u003e \\u003cp\\u003eGeneration X and Generation Y nurses expressed views of similar intensity regarding recurrent research topics, whereas Baby Boomer nurses did not report views on this issue. Participants stated that, when reviewing the literature, they frequently encounter similar or repetitive topics.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;It has become really difficult to find truly original studies; when we look at it, there are always studies repeating one another\\u0026hellip;\\u0026rdquo; (P2, Generation Y, Master\\u0026rsquo;s degree, Public hospital, Operating Room)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;In a rather abstract sense, the same topic that has already been studied is repeatedly addressed by different people in different hospitals or institutions. I don\\u0026rsquo;t think it\\u0026rsquo;s extremely productive\\u0026hellip;\\u0026rdquo; (P29, Generation Y, Bachelor\\u0026rsquo;s degree, Private hospital, Assistant Head Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec21\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eProfessional Organization\\u003c/h2\\u003e \\u003cp\\u003eThe theme of professional organization was expressed by participants through the following codes: \\u003cem\\u003e\\u0026ldquo;insufficiency in professional organization,\\u0026rdquo; \\u0026ldquo;critical perspectives on professional associations,\\u0026rdquo;\\u003c/em\\u003e and \\u003cem\\u003e\\u0026ldquo;the absence of a nurses\\u0026rsquo; union.\\u0026rdquo;\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec22\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eInsufficiency in Professional Organization\\u003c/h2\\u003e \\u003cp\\u003eCompared with Baby Boomer nurses, Generation X and Generation Y nurses expressed more views regarding insufficiency in professional organization. Participants emphasized that, despite the importance of professional organization in the professionalization process, membership rates in professional associations are inadequate. They also noted a substantial discrepancy between the total number of nurses in the healthcare sector and the proportion who are members of professional organizations, and stated that organizational insufficiency persists despite the long-standing existence of such associations.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I think one of the main reasons we have not been able to professionalize is this lack of organization\\u0026hellip;\\u0026rdquo; (P25, Generation Y, Bachelor\\u0026rsquo;s degree, Public hospital, Emergency Unit Charge Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;As I mentioned, I am on the board of a professional association. We have more than ten thousand nurses, but unfortunately only a little over 800 are members of our association\\u0026hellip;\\u0026rdquo; (P26, Generation Y, Master\\u0026rsquo;s degree, University hospital, Intensive Care Unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cdiv id=\\\"Sec23\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eCritical Perspectives on Professional Associations\\u003c/h2\\u003e \\u003cp\\u003eGeneration X nurses expressed more critical views regarding professional associations compared with Generation Y and Baby Boomer nurses. Participants stated that professional associations themselves have shortcomings in terms of professional organization, that they should adopt new approaches to reach members more effectively, and that they need to become more youthful, modern, and open to new ideas.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;For example, in every school that graduates nurses, there should definitely be a link with the association so that it can reach all of its graduates\\u0026hellip;\\u0026rdquo; (P17, Generation X, Master\\u0026rsquo;s degree, University hospital, Charge Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I think the structures of associations need to become somewhat younger and more modern; they need to be open to new ideas\\u0026hellip;\\u0026rdquo; (P22, Generation Y, Master\\u0026rsquo;s degree, Private hospital, Head Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec24\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eThe Absence of a Nurses\\u0026rsquo; Union\\u003c/h2\\u003e \\u003cp\\u003eGeneration X and Generation Y nurses expressed views of similar intensity regarding the absence of a nurses\\u0026rsquo; union, whereas Baby Boomer nurses did not report views on this issue. Participants stated that uniting under a single umbrella organization would strengthen representation and advocacy for professional rights.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;If we could unite\\u0026mdash;not just as the Turkish Nurses Association but as Turkish nurses under one union\\u0026mdash;I believe we would have a stronger voice. If we had political influence, I truly believe that the rights of professional nurses would be defended and their voices would be heard\\u0026hellip;\\u0026rdquo; (P2, Generation Y, Master\\u0026rsquo;s degree, Public hospital, Operating Room)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;There is a chamber for engineers, there is a bar association\\u0026mdash;many professional groups are very active and can even influence the government in many areas\\u0026hellip;\\u0026rdquo; (P5, Generation Y, Master\\u0026rsquo;s degree, Public hospital, Quality Unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cdiv id=\\\"Sec25\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eSocietal Perceptions of Nursing\\u003c/h2\\u003e \\u003cp\\u003eThe theme of societal perceptions of nursing was expressed by participants through the following codes: \\u003cem\\u003e\\u0026ldquo;negative perception by society,\\u0026rdquo; \\u0026ldquo;increased professional prestige in society,\\u0026rdquo; \\u0026ldquo;increased prestige and visibility during the COVID-19 pandemic,\\u0026rdquo;\\u003c/em\\u003e and \\u003cem\\u003e\\u0026ldquo;the COVID-19 pandemic period was not adequately utilized.\\u0026rdquo;\\u003c/em\\u003e\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec26\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eNegative Perception by Society\\u003c/h2\\u003e \\u003cp\\u003eAlthough more frequently emphasized by Generation Y nurses, Generation X and Baby Boomer nurses also expressed views regarding negative societal perceptions. Participants stated that other health professions are afforded greater respect than nurses and that nursing work is often perceived as easy or undervalued.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;In my opinion, society definitely does not see nurses as respectable at all; they view us in a very degrading way. How can I put it? They value a secretary more, they show more respect to hospital security staff, to the police\\u0026mdash;everyone except nurses. I don\\u0026rsquo;t fully understand why, but there is no respect for nurses, not even the slightest\\u0026hellip;\\u0026rdquo; (P12, Generation Y, Bachelor\\u0026rsquo;s degree, Public hospital, COVID-19 unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;Nursing is seen by society as a very easy job. People think, \\u0026lsquo;What do they even do? They just sit around all day,\\u0026rsquo; or they see it as simply carrying out the physician\\u0026rsquo;s orders\\u0026mdash;give two medications, administer an injection, and that\\u0026rsquo;s it\\u0026hellip;\\u0026rdquo; (P1, Generation Y, Bachelor\\u0026rsquo;s degree, Public hospital, Operating Room)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec27\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eIncreased Professional Prestige in Society\\u003c/h2\\u003e \\u003cp\\u003eAlthough more frequently expressed by Baby Boomer nurses, Generation X and Generation Y nurses also reported that professional prestige in society has increased over time. Participants stated that, compared with previous years, nursing is now perceived as more professional and more respectable.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;If I compare the societal perception at the time I started my career with today, I would say that, from society\\u0026rsquo;s perspective, we are in a better place now\\u0026hellip;\\u0026rdquo; (P32, Generation X, Master\\u0026rsquo;s degree, University hospital, Infection Control)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;The way society sees us is different now. Nurses are more respected compared with the past\\u0026hellip;\\u0026rdquo; (P35, Baby Boomer, Bachelor\\u0026rsquo;s degree, Private hospital, Operating Room)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec28\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eIncreased Prestige and Visibility During the Covid-19 Pandemic\\u003c/h2\\u003e \\u003cp\\u003eCompared with Baby Boomer nurses, Generation X and Generation Y nurses expressed more views regarding increased prestige and visibility during the COVID-19 pandemic. Participants stated that the pandemic helped society recognize the critical role of nurses in the healthcare sector, observe the positive outcomes of nursing care either personally or through affected relatives, and perceive nurses as more professional.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;People who used to see nurses merely as assistants to physicians, especially during the COVID period, realized that nurses have their own expertise and professionalization in this field\\u0026hellip;\\u0026rdquo; (P28, Generation X, Bachelor\\u0026rsquo;s degree, Private hospital, Head Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;They would say, \\u0026lsquo;Oh, do nurses even have professors?\\u0026rsquo; They had been saying that for a while, but at least they finally saw it. It was very positive that nurses appeared in prime-time news\\u0026hellip;\\u0026rdquo; (P19, Generation Y, Master\\u0026rsquo;s degree, Private hospital, Head Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec29\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eThe COVID-19 Pandemic Period Was Not Adequately Utilized\\u003c/h2\\u003e \\u003cp\\u003eGeneration X and Generation Y nurses expressed views to a similar extent regarding the idea that the COVID-19 pandemic period was not adequately utilized, whereas Baby Boomer nurses did not report views on this issue. Participants stated that such pandemic periods present opportunities to highlight the importance of the profession, but these opportunities were not sufficiently leveraged.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I think we did not fully utilize it. COVID ends, something else begins\\u0026mdash;one disease ends, a social issue starts. Take vaccination, for example\\u0026mdash;it\\u0026rsquo;s a serious issue. Migrants are arriving; you could use that. Do something for migrants, call the media. There\\u0026rsquo;s social media; you don\\u0026rsquo;t even need television\\u0026hellip;\\u0026rdquo; (P17, Generation X, Master\\u0026rsquo;s degree, University hospital, Charge Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I think we did not represent ourselves well enough. Even before this, we could have consistently shared how valuable nurses are. We have struggled with so many issues in intensive care before\\u0026mdash;H1N1, Crimean-Congo hemorrhagic fever, postoperative patients, severely ill trauma cases. If people had seen those, they might have felt even more connected. But I think we have not sufficiently reflected this aspect of our profession\\u0026hellip;\\u0026rdquo; (P26, Generation Y, Master\\u0026rsquo;s degree, University hospital, Intensive Care Unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eAutonomy\\u003c/h3\\u003e\\n\\u003cp\\u003eThe theme of autonomy was expressed by participants through the following codes: \\u003cem\\u003e\\u0026ldquo;the influence of team members,\\u0026rdquo; \\u0026ldquo;the impact of experience and level of education,\\u0026rdquo; \\u0026ldquo;the influence of organizational culture,\\u0026rdquo;\\u003c/em\\u003e and \\u0026ldquo;\\u003cem\\u003eassignment to tasks outside defined duties, authority, and responsibilities.\\u0026rdquo;\\u003c/em\\u003e\\u003c/p\\u003e \\u003cdiv id=\\\"Sec31\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eThe Influence of Team Members\\u003c/h2\\u003e \\u003cp\\u003eBaby Boomer and Generation Y nurses expressed views more frequently than Generation X nurses regarding the influence of team members. Participants stated that they are most often constrained by physicians, that this situation negatively affects professionalization, and that they remain dependent on another professional group.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;Other professional groups do not want us to use our scientific knowledge. We work in a highly disciplined environment, and physicians do not want you to generate knowledge\\u0026hellip;\\u0026rdquo; (P33, Generation X, Master\\u0026rsquo;s degree, University hospital, Infection Control)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;We cannot establish our own autonomy; we still seem to carry out all practices in a way that is dependent on physicians\\u0026hellip;\\u0026rdquo; (P10, Generation Y, Bachelor\\u0026rsquo;s degree, Public hospital, Intensive Care Unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec32\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eThe Impact of Experience and Level of Education\\u003c/h2\\u003e \\u003cp\\u003eGeneration X nurses expressed more views than Generation Y and Baby Boomer nurses regarding the impact of experience and level of education. Participants stated that, through experience and education, they become aware of their professional rights and responsibilities, are able to make independent decisions, and can evaluate the outcomes of those decisions.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;If you have worked in that specialty for a long time and have developed yourself well, you can make decisions. Even physicians respect the decisions we make\\u0026mdash;we can sometimes even guide them\\u0026hellip;\\u0026rdquo; (P9, Generation X, Master\\u0026rsquo;s degree, Public hospital, Assistant Head Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;For example, what I say now is taken more seriously because I am someone pursuing doctoral education\\u0026hellip;\\u0026rdquo; (P32, Generation X, Master\\u0026rsquo;s degree, University hospital, Infection Control)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cdiv id=\\\"Sec33\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eThe Influence of Organizational Culture\\u003c/h2\\u003e \\u003cp\\u003eNurses from all three generations expressed views regarding the influence of organizational culture. Participants stated that their ability to act autonomously varies across institutions and that, particularly in private hospitals, financial concerns may take precedence over professional decision-making.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;They say, \\u0026lsquo;This is how we do it here, and this is how it will continue,\\u0026rsquo; and unfortunately, sometimes you have to comply because of the institutional culture\\u0026hellip;\\u0026rdquo; (P23, Generation Y, Bachelor\\u0026rsquo;s degree, Public hospital, Inpatient unit)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;In private hospitals, as long as there isn\\u0026rsquo;t a financial issue at stake, you can make more independent decisions\\u0026hellip;\\u0026rdquo; (P28, Generation X, Bachelor\\u0026rsquo;s degree, Private hospital, Head Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec34\\\" class=\\\"Section3\\\"\\u003e \\u003ch2\\u003eAssignment to Tasks Outside Defined Duties, Authority, and Responsibilities\\u003c/h2\\u003e \\u003cp\\u003eGeneration X and Generation Y nurses expressed views to a similar extent regarding assignment to tasks outside defined duties, authority, and responsibilities, whereas Baby Boomer nurses did not report views on this issue. Participants stated that they assume full responsibility for their units and are often required to deal with technical or administrative tasks instead of dedicating more time to patient care.\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;When you arrive in the morning as a unit nurse or charge nurse, you are supposed to see all patients, plan their care, and ensure that everything is carried out during the day. But that\\u0026rsquo;s not what happens, because we are constantly dealing with trivial issues\\u0026hellip;\\u0026rdquo; (P14, Generation Y, Doctoral degree, University hospital, Infection Control)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I deal with supplies, with people, with problems, with paperwork\\u0026mdash;I try to write reports; I handle so many things outside my actual role, unfortunately. Everyone has boundaries, but it seems we have none\\u0026hellip;\\u0026rdquo; (P17, Generation X, Master\\u0026rsquo;s degree, University hospital, Charge Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eProfessional Ethics\\u003c/h3\\u003e\\n\\u003cp\\u003eThe theme of professional ethics was expressed by participants through the following codes: \\u003cem\\u003e\\u0026ldquo;approach consistent with ethical principles\\u0026rdquo;\\u003c/em\\u003e and \\u003cem\\u003e\\u0026ldquo;approach inconsistent with ethical principles.\\u0026rdquo;\\u003c/em\\u003e\\u003c/p\\u003e\\n\\u003ch3\\u003eApproach Consistent with Ethical Principles\\u003c/h3\\u003e\\n\\u003cp\\u003e Generation X and Baby Boomer nurses expressed more views than Generation Y nurses regarding an approach consistent with ethical principles. Participants stated that, compared with other professional groups, nurses are more sensitive to ethical principles and act in accordance with the principles of privacy, non-maleficence\\u0026ndash;beneficence, and justice.\\u003c/p\\u003e \\u003cp\\u003e\\u003cem\\u003e \\u0026ldquo;\\u0026hellip;I think nurses are the most ethical group in the healthcare field; I believe they are the most principled group, because we place great importance on not harming the patient and on providing benefit\\u0026hellip;\\u0026rdquo; (P14, Generation Y, Doctoral degree, University hospital, Infection Control)\\u003c/em\\u003e\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;Nurses have been the group that most strongly considers the patient\\u0026rsquo;s best interests; at times, this has even led to conflicts with other professional groups\\u0026hellip;\\u0026rdquo; (P32, Generation X, Master\\u0026rsquo;s degree, University hospital, Infection Control)\\u003c/em\\u003e \\u003c/p\\u003e \\u003cdiv id=\\\"Sec37\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eApproach Inconsistent with Ethical Principles\\u003c/h2\\u003e \\u003cp\\u003e Nurses from all three generations expressed views, though to a lesser extent, regarding approaches inconsistent with ethical principles. Participants stated that ethical principles are not always sufficiently understood and that deviations may occur in practice.\\u003c/p\\u003e \\u003cp\\u003e\\u003cem\\u003e\\u0026ldquo;\\u0026hellip;I used to think it was very important and that everyone was highly aware of it, because that was how it was presented to us. But in working life, I have seen that although efforts are made to adhere to ethical principles, I am not sure to what extent this is truly the case\\u0026hellip;\\u0026rdquo; (P24, Generation Y, Bachelor\\u0026rsquo;s degree, Private hospital, Inpatient Unit)\\u003c/em\\u003e\\u003c/p\\u003e \\u003cp\\u003e \\u003cem\\u003e\\u0026ldquo;\\u0026hellip;Regarding ethical codes\\u0026mdash;although people say we act ethically, the boundaries and criteria can sometimes become blurred. For example, we experienced this several times in patient records, and afterward we introduced certain restrictions\\u0026hellip;\\u0026rdquo; (P22, Generation Y, Master\\u0026rsquo;s degree, Private hospital, Head Nurse)\\u003c/em\\u003e \\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThis study provides insights into nursing professionalization from the perspectives of clinically experienced nurses across different generations. By emphasizing the themes of education; scientific knowledge and its applicability; professional organization; societal perceptions of nursing; autonomy; and professional ethics, the findings offer implications that may contribute to the advancement of nursing professionalism in T\\u0026uuml;rkiye.\\u003c/p\\u003e \\u003cp\\u003eProfessional education is the first issue encountered in the literature when examining the conditions, criteria, or processes required for a profession to achieve professional status. Undoubtedly, a profession must be grounded in a defined period of standardized education (\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e). However, one of the fundamental challenges nursing faces globally is the variability in practice and educational standards (\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e). In the present study, Generation X and Generation Y nurses more frequently emphasized the need to ensure educational standardization, whereas Baby Boomer and Generation Y nurses more frequently highlighted the importance of improving the quality of education. In countries such as India and South Africa, although legislation and regulations define nurses\\u0026rsquo; professional and educational status, inconsistencies or gaps affecting nursing practice and recognition remain evident (\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e). Similarly, in T\\u0026uuml;rkiye, although Article 1 of the Nursing Law states that the title of nurse is granted to \\u0026ldquo;those who graduate from faculties and schools providing undergraduate nursing education,\\u0026rdquo; Provisional Article 3 allowed graduates of vocational health high schools to assume the title of nurse until 2017 (\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e). As a result, nurses with high school, associate degree, and bachelor\\u0026rsquo;s degree qualifications continue to work under the same professional title in clinical settings. It can therefore be argued that educational levels among nurses in practice have not yet been fully standardized. The relatively lower prioritization of this issue by Baby Boomer nurses may be attributable to their long-term observation of ongoing attempts to establish this standard since the initiation of bachelor\\u0026rsquo;s-level nursing education in T\\u0026uuml;rkiye in 1955. In addition, S\\u0026ouml;nmez et al. (\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e) reported that more than half of the nurses in their study considered the theoretical and clinical education they received during university training to be insufficient. Similarly, Ejupi et al. (\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e) and Wang et al. (\\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e29\\u003c/span\\u003e) emphasized the critical role of high-quality educational programs in equipping nurses with the knowledge, skills, and tools necessary for nursing professionalism. Taken together, the findings and the existing literature suggest that careful consideration of all components contributing to the quality of nursing education\\u0026mdash;and the provision of appropriate educational opportunities to train competent nurses\\u0026mdash;are essential for advancing nursing professionalism.\\u003c/p\\u003e \\u003cp\\u003eGeneration X and Generation Y nurses more frequently expressed the view that knowledge remains at a conceptual level, whereas Generation X nurses most frequently emphasized that scientific knowledge is reflected in practice. As cited by Velioğlu (\\u003cspan citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e), Getzels described this relationship as follows: \\u0026ldquo;Theory without practice is like a roadless map\\u0026mdash;it is empty; practice without theory is like traveling without a map\\u0026mdash;it is blind.\\u0026rdquo; Kalogirou, Chauvet, and Yonge (\\u003cspan citationid=\\\"CR31\\\" class=\\\"CitationRef\\\"\\u003e31\\u003c/span\\u003e), in a study examining the theory\\u0026ndash;practice gap through the perspectives of clinical managers, identified four themes: program entry; curriculum content, delivery, and structure; clinical recommendations; and stronger partnerships. Their findings indicated that strong academic\\u0026ndash;practice partnerships remain necessary and that deficiencies in communication and collaboration jeopardize the quality of students\\u0026rsquo; education and their transition into professional practice. Strengthening collaboration between academic and clinical nursing leaders may help bridge the theory\\u0026ndash;practice gap and better prepare newly graduated nurses. Similar findings were reported in a qualitative study conducted with nursing students in the United Arab Emirates (\\u003cspan citationid=\\\"CR32\\\" class=\\\"CitationRef\\\"\\u003e32\\u003c/span\\u003e). Nearly all participants described, either directly or indirectly, a gap between what they learned in theoretical courses and what they encountered in clinical education. One participant stated: \\u0026ldquo;Perhaps we should focus more on clinical education or clinical placement. Instead of linking theory to clinical practice, we should link clinical practice to theory, because sometimes we cover many topics in theory that are not related to or up to date with clinical practice.\\u0026rdquo; Nursing professionalism requires the profession to continuously build its body of knowledge and to enhance the quality of care in response to ongoing developments in technology, healthcare systems, and patient care (\\u003cspan citationid=\\\"CR33\\\" class=\\\"CitationRef\\\"\\u003e33\\u003c/span\\u003e). Doğan et al. (\\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e34\\u003c/span\\u003e) found that nurses\\u0026rsquo; attitudes toward evidence-based nursing practices were positive. When contemporary, scientific, and evidence-based nursing care is implemented collaboratively among all members of the profession, professionalization in nursing becomes inevitable (\\u003cspan citationid=\\\"CR35\\\" class=\\\"CitationRef\\\"\\u003e35\\u003c/span\\u003e). It may therefore be argued that prioritizing research findings that are effectively translated into practice is essential for strengthening nursing professionalism.\\u003c/p\\u003e \\u003cp\\u003eProfessional organization represents a structure through which members of a profession come together, safeguard their collective interests, contribute to the formation of professional laws and regulations, and gain a voice in political processes. It reflects a professional stance by ensuring supervision, regulation, and the maintenance of practice standards (\\u003cspan citationid=\\\"CR36\\\" class=\\\"CitationRef\\\"\\u003e36\\u003c/span\\u003e). In the present study, Generation X and Generation Y nurses more frequently expressed the view that professional organization is insufficient, whereas Generation X nurses most frequently articulated critical perspectives on professional associations. A review of the literature indicates that the inadequacy of professional organization in nursing has been similarly identified in numerous studies (\\u003cspan citationid=\\\"CR37\\\" class=\\\"CitationRef\\\"\\u003e37\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e38\\u003c/span\\u003e). However, existing research also demonstrates that nurses recognize the necessity of professional organization and are aware of its role in the professionalization process (\\u003cspan citationid=\\\"CR36\\\" class=\\\"CitationRef\\\"\\u003e36\\u003c/span\\u003e). These findings suggest that insufficient organization may not stem from a lack of awareness, but rather from other underlying factors that warrant further examination. The findings of this study indicate that nurses\\u0026rsquo; limited engagement in professional organization does not appear to be due to a lack of knowledge; instead, it may be associated with perceived qualitative shortcomings of professional associations and with the view that nursing organizations should be united under a single umbrella structure. In other studies, participants expressed views such as: \\u003cem\\u003e\\u0026ldquo;I do not believe they carry out truly meaningful work for the profession,\\u0026rdquo; \\u0026ldquo;If associations only talk without solving problems, what is the point of being a member?\\u0026rdquo;\\u003c/em\\u003e and \\u003cem\\u003e\\u0026ldquo;Because associations are not active, they do not play an effective role in the professionalization process\\u0026rdquo;\\u003c/em\\u003e (\\u003cspan citationid=\\\"CR36\\\" class=\\\"CitationRef\\\"\\u003e36\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e38\\u003c/span\\u003e). It may therefore be suggested that professional associations should take nurses\\u0026rsquo; evaluations of their qualitative performance into account, actively seek feedback from members, and create regular opportunities to engage with nurses either through meetings or field-based assessments\\u0026mdash;in order to support organizational self-evaluation and development.\\u003c/p\\u003e \\u003cp\\u003eThe professional status of a profession is closely associated with its public image within a given society, rendering societal perceptions of nursing particularly significant (\\u003cspan citationid=\\\"CR39\\\" class=\\\"CitationRef\\\"\\u003e39\\u003c/span\\u003e). Although perceptions of the profession have evolved over time, the prevailing view remains that a fully developed public image recognizing nursing\\u0026rsquo;s scientific foundation and professional advancement has not yet been achieved (\\u003cspan citationid=\\\"CR40\\\" class=\\\"CitationRef\\\"\\u003e40\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR41\\\" class=\\\"CitationRef\\\"\\u003e41\\u003c/span\\u003e). In the present study, Generation X and Generation Y nurses frequently emphasized the increased respect and visibility gained during the COVID-19 pandemic. Throughout the pandemic, nurses from all generations delivered frontline care in diverse settings, including family health centers, contact tracing teams, emergency departments, COVID-19 inpatient units, and intensive care units where advanced treatment and critical care were provided (\\u003cspan additionalcitationids=\\\"CR43\\\" citationid=\\\"CR42\\\" class=\\\"CitationRef\\\"\\u003e42\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR44\\\" class=\\\"CitationRef\\\"\\u003e44\\u003c/span\\u003e). As in many countries worldwide, this situation brought healthcare professionals\\u0026mdash;and nurses in particular\\u0026mdash;into greater public prominence in T\\u0026uuml;rkiye (\\u003cspan citationid=\\\"CR45\\\" class=\\\"CitationRef\\\"\\u003e45\\u003c/span\\u003e). During this period, the Turkish Nurses Association issued public statements with the slogans \\u003cem\\u003e\\u0026ldquo;We will continue to touch you\\u0026rdquo;\\u003c/em\\u003e and \\u0026ldquo;\\u003cem\\u003eWe are by your side,\\u0026rdquo;\\u003c/em\\u003e reaffirming its commitment to nursing care. Through its official website and social media platforms, the Association sought to emphasize that nursing is grounded in scientific knowledge and professional expertise (\\u003cspan citationid=\\\"CR44\\\" class=\\\"CitationRef\\\"\\u003e44\\u003c/span\\u003e). A study conducted by G\\u0026uuml;nd\\u0026uuml;z Hoşg\\u0026ouml;r and Coşkun (\\u003cspan citationid=\\\"CR46\\\" class=\\\"CitationRef\\\"\\u003e46\\u003c/span\\u003e) demonstrated that, in Turkish society, perceptions of the nursing profession shifted positively during the COVID-19 pandemic. In the post-pandemic period, the scope of nursing competencies has expanded, and the significance of nursing care has become more widely recognized and valued. Nevertheless, to ensure the sustainability and further strengthening of this enhanced image, it may be beneficial to develop institutional and legal strategies aimed at consolidating these gains.\\u003c/p\\u003e \\u003cp\\u003eIt is well established that nurses\\u0026rsquo; ability to act autonomously in their professional practice directly contributes to the attainment of professional status in nursing (\\u003cspan citationid=\\\"CR47\\\" class=\\\"CitationRef\\\"\\u003e47\\u003c/span\\u003e). In the present study, Baby Boomer and Generation Y nurses most frequently emphasized the influence of team members on autonomy, whereas Generation X nurses most frequently highlighted the impact of experience and level of education. The literature identifies several factors that hinder autonomy in nursing practice: working in physician-dominated environments; the predominantly female composition of the nursing workforce; the characterization of nurses as compliant and obedient by colleagues and society; the perception of physicians as occupying a paternal role and nurses a maternal role within hospital settings; and the lack of standardized educational levels among clinical nurses (\\u003cspan citationid=\\\"CR48\\\" class=\\\"CitationRef\\\"\\u003e48\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR49\\\" class=\\\"CitationRef\\\"\\u003e49\\u003c/span\\u003e). In Emiroğlu\\u0026rsquo;s study (\\u003cspan citationid=\\\"CR50\\\" class=\\\"CitationRef\\\"\\u003e50\\u003c/span\\u003e), physicians were found to perceive themselves as the primary decision-makers and to lack awareness of nurses\\u0026rsquo; professional qualifications and independent functions. In T\\u0026uuml;rkiye, the legal foundation enabling nurses to act autonomously is clearly articulated in the Nursing Law and related regulations, particularly through provisions concerning the \\u0026ldquo;nursing diagnosis process,\\u0026rdquo; \\u0026ldquo;nursing care,\\u0026rdquo; and \\u0026ldquo;nurses\\u0026rsquo; duties, authorities, and responsibilities\\u0026rdquo; (\\u003cspan citationid=\\\"CR51\\\" class=\\\"CitationRef\\\"\\u003e51\\u003c/span\\u003e). Nevertheless, several studies have concluded that nurses exercise autonomy at only a moderate level (\\u003cspan citationid=\\\"CR48\\\" class=\\\"CitationRef\\\"\\u003e48\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR52\\\" class=\\\"CitationRef\\\"\\u003e52\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR53\\\" class=\\\"CitationRef\\\"\\u003e53\\u003c/span\\u003e). Practices performed by members of a profession based on their own professional knowledge and skills are unique to that profession and can be defined only by its members. Nurses\\u0026rsquo; ability to make accurate and effective decisions is influenced by their professional knowledge, experience, and the structural characteristics of the work environment (\\u003cspan citationid=\\\"CR54\\\" class=\\\"CitationRef\\\"\\u003e54\\u003c/span\\u003e). Research indicates that as nurses\\u0026rsquo; years of experience increase, their knowledge within their area of practice and their self-confidence also increase, thereby enhancing their capacity for independent decision-making (\\u003cspan citationid=\\\"CR48\\\" class=\\\"CitationRef\\\"\\u003e48\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR55\\\" class=\\\"CitationRef\\\"\\u003e55\\u003c/span\\u003e). In parallel with contemporary technological advancements, the scope of nursing practice has expanded and patient care has become increasingly complex. Decisions made in evidence-based nursing practice develop through clinical wisdom and repeated exposure to a sufficient number of cases (\\u003cspan citationid=\\\"CR56\\\" class=\\\"CitationRef\\\"\\u003e56\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR57\\\" class=\\\"CitationRef\\\"\\u003e57\\u003c/span\\u003e). Beyond possessing legal authority to make decisions, nurses are expected to translate knowledge and scientific evidence into practice, implement evidence-based nursing care, and evaluate their own professional practices\\u0026mdash;thereby fulfilling their professional roles through autonomous action. It can be argued that autonomy remains one of the most challenging dimensions in the professionalization process of nursing.\\u003c/p\\u003e \\u003cp\\u003e Generation X nurses most strongly emphasized that nursing practice reflects adherence to ethical principles. The fundamental human right of all individuals to receive equal, adequate, and qualified healthcare has, alongside rapid developments in the health sector, brought increasingly complex and critical practices\\u0026mdash;such as organ transplantation, resuscitation, enteral nutrition, genetic testing, and stem cell research\\u0026mdash;into routine care. In this context, ethical considerations have gained even greater importance (\\u003cspan citationid=\\\"CR52\\\" class=\\\"CitationRef\\\"\\u003e52\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR58\\\" class=\\\"CitationRef\\\"\\u003e58\\u003c/span\\u003e). Acting in accordance with ethical principles in professional conduct and clinical practice is a fundamental requirement of being a profession (\\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e38\\u003c/span\\u003e). The literature indicates that neonatal intensive care nurses strive to provide care consistent with the principles of beneficence, justice, and equality, yet encounter difficulties in fulfilling these principles due to various constraints (\\u003cspan citationid=\\\"CR59\\\" class=\\\"CitationRef\\\"\\u003e59\\u003c/span\\u003e). It has been reported that nurses are aware of their ethical obligations and endeavor to deliver ethically grounded nursing care; however, they require institutional and professional support to do so effectively (\\u003cspan citationid=\\\"CR59\\\" class=\\\"CitationRef\\\"\\u003e59\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR60\\\" class=\\\"CitationRef\\\"\\u003e60\\u003c/span\\u003e). Kahriman (\\u003cspan citationid=\\\"CR38\\\" class=\\\"CitationRef\\\"\\u003e38\\u003c/span\\u003e) found that nurses demonstrated high levels of ethical sensitivity, whereas other studies have reported moderate levels of ethical sensitivity among nurses (\\u003cspan additionalcitationids=\\\"CR62\\\" citationid=\\\"CR61\\\" class=\\\"CitationRef\\\"\\u003e61\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR63\\\" class=\\\"CitationRef\\\"\\u003e63\\u003c/span\\u003e). Some research has identified a weak but positive relationship between ethical decision-making and professional behavior (\\u003cspan citationid=\\\"CR58\\\" class=\\\"CitationRef\\\"\\u003e58\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR64\\\" class=\\\"CitationRef\\\"\\u003e64\\u003c/span\\u003e). It may therefore be suggested that nurses make deliberate efforts to provide nursing care consistent with ethical principles, which constitutes one of the core criteria of professionalization in nursing.\\u003c/p\\u003e\"},{\"header\":\"Conclusions\",\"content\":\"\\u003cp\\u003eThis study provides insight into the evaluation of professionalization in nursing from the perspectives of nurses belonging to different generations and highlights factors influencing this process. It reveals specific dimensions that each generation particularly emphasized and articulated more intensively. To advance nursing professionalism, it may be recommended that professional organizations systematically evaluate feedback received from their members; that nursing care practices be made more visible in order to enhance the public reputation of the profession and foster a stronger perception of nursing as a profession; and that awareness-raising and supportive mechanisms be established to strengthen nurses\\u0026rsquo; understanding of their duties, authorities, and responsibilities, thereby enhancing professional autonomy. The findings obtained from this study may be utilized to assess nursing professionalism in T\\u0026uuml;rkiye, to develop contextually appropriate strategies, and to design culturally adaptable evaluation instruments for use in cross-cultural settings.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec40\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eLimitations\\u003c/h2\\u003e \\u003cp\\u003eThis study is the first qualitative investigation in T\\u0026uuml;rkiye to evaluate professionalization in nursing from the perspectives of clinically experienced nurses representing different generations. The principal limitation of the study is that the interviews were conducted exclusively with nurses working in private, public, and state hospitals within a single province. To enhance the generalizability of the findings, future research should be expanded to include nurses from additional provinces, as well as nursing academics.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eConsent for publication:\\u003c/strong\\u003e Not applicable.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompeting Interest:\\u003c/strong\\u003e The authors report no actual or potential competing interest.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFundings:\\u0026nbsp;\\u003c/strong\\u003eThe authors received no spesific funding for this work.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgments:\\u0026nbsp;\\u003c/strong\\u003eThe authors are grateful to all the inpatients who volunteered to participate in this study\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData Availability:\\u003c/strong\\u003e The authors confirmed that all relevant data are included in the article. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEthical Approval:\\u0026nbsp;\\u003c/strong\\u003eIn order to conduct the study, ethical approval was obtained from the Istanbul University-Cerrahpaşa Faculty of Medicine Clinical Research Ethics Committee, Decision No. A-09, dated 05.11.2019 (Related file 1). Institutional permission for the participation of nurses in Istanbul was obtained from the Istanbul Branch of the Turkish Nurses Association (Related file 2). Participants who agreed to take part in the study were informed by the researcher about the purpose of the study, that the information they shared would be kept confidential and not shared with others, and that the use of the data would be limited to this research. Both verbal and written informed consent were obtained from the participants (Supplementary material 2). The study was conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki and national research ethics guidelines.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor Contributions\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003e\\u003cem\\u003eStudy Conception:\\u003c/em\\u003e\\u003c/strong\\u003e FC, AY; \\u003cstrong\\u003e\\u003cem\\u003eStudy Design:\\u003c/em\\u003e\\u003c/strong\\u003e FC, AY; \\u0026nbsp;\\u003cstrong\\u003e\\u003cem\\u003eSupervision:\\u003c/em\\u003e\\u003c/strong\\u003e FC, AY; \\u0026nbsp;\\u003cstrong\\u003e\\u003cem\\u003eMaterials:\\u003c/em\\u003e\\u003c/strong\\u003e FC, AY; \\u0026nbsp;\\u003cstrong\\u003e\\u003cem\\u003eData Collection and/or Processing:\\u003c/em\\u003e\\u003c/strong\\u003e FC, AY; \\u0026nbsp;\\u003cstrong\\u003e\\u003cem\\u003eStatistical Analysis and/or Data Interpretation:\\u003c/em\\u003e\\u003c/strong\\u003e FC, AY; \\u003cstrong\\u003e\\u003cem\\u003eLiterature Review:\\u003c/em\\u003e\\u003c/strong\\u003e FC, AY; \\u003cstrong\\u003e\\u003cem\\u003eManuscript Preparation:\\u003c/em\\u003e\\u003c/strong\\u003e FC, AY; \\u003cstrong\\u003e\\u003cem\\u003eCritical Review:\\u003c/em\\u003e\\u003c/strong\\u003e FC, AY;\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eGhadirian F, Salsali M, Cheraghi MA. 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Acta Bioeth. 2014;20(2).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFiliz\\u0026ouml;z B, Mesci G, Aşcı A, Bağcıvan E. Nurses\\u0026rsquo; ethical sensitivity: Research on central public hospitals in Sivas province. Turkish J Bus Ethics. 2015;8(1):47\\u0026ndash;66.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSabancıoğulları S, Kol EU, Arslantaş AT, Toğantemur F, \\u0026Uuml;lker F. Examination of the Relationship between Ethical Decision Making Levels and Professional Self-Concepts of Nurses\\u0026rsquo;. J Nurs Effect. 2018;11(2):105\\u0026ndash;12.\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-nursing\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"nurs\",\"sideBox\":\"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/nurs/default.aspx\",\"title\":\"BMC Nursing\",\"twitterHandle\":\"@BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Nursing, Professionalization, Nursing Professionalism, Generations, Qualitative Study\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-8938964/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-8938964/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground\\u003c/h2\\u003e \\u003cp\\u003eNursing professionalism is a culturally embedded, dynamic, and multidimensional concept. It is well established that nursing professionalism is associated with years of service, workplace experiences, and age. In this context, the perspectives of nurses from different generations and with varying levels of experience provide unique insights into professionalization in nursing.\\u003c/p\\u003e\\u003ch2\\u003eObjective\\u003c/h2\\u003e \\u003cp\\u003eThis study explored the perspectives of clinically experienced nurses from different generations regarding nursing professionalism, with the goal of contributing to its development and offering practice implications specific to Turkish society.\\u003c/p\\u003e\\u003ch2\\u003eMethod\\u003c/h2\\u003e \\u003cp\\u003eA descriptive phenomenological design, one of the qualitative research approaches, was adopted. Maximum variation sampling was used to ensure a heterogeneous sample. Semi-structured interviews were conducted with 35 nurses from different generations working in private, public, and university hospitals in Istanbul, T\\u0026uuml;rkiye\\u0026rsquo;s most populous city, between November 2020 and April 2021. Data were analyzed using a thematic analysis approach, supported by MAXQDA software.\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e \\u003cp\\u003e The themes identified were education; scientific knowledge and its applicability; professional organization; societal perceptions of nursing; autonomy; and professional ethics.\\u003c/p\\u003e\\u003ch2\\u003eConclusion\\u003c/h2\\u003e \\u003cp\\u003eThis study provides insight into the current state of professionalization in nursing from the perspectives of nurses across different generations in Turkish society. It highlights the key aspects emphasized and most frequently articulated by each generation.\\u003c/p\\u003e\\u003ch2\\u003eImplications for nursing practice and clinical relevance:\\u003c/h2\\u003e \\u003cp\\u003eThe perspectives of nurses from different generations may provide valuable guidance for aligning and strengthening the compatibility between existing models of nursing professionalism and diverse cultural contexts. Global recognition of nursing as a fully professional discipline can only be achieved through research findings and context-sensitive solutions that actively engage nurses, stakeholders, and societies across different countries.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Nursing Professionalism, As Perceived By Nurses From Different Generations In Türkiye: A Qualitative Study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-03-27 09:29:36\",\"doi\":\"10.21203/rs.3.rs-8938964/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2026-03-25T10:27:09+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvited\",\"content\":\"\",\"date\":\"2026-02-27T13:36:34+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2026-02-27T10:47:01+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2026-02-27T10:46:49+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"BMC Nursing\",\"date\":\"2026-02-22T11:55:11+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-nursing\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"nurs\",\"sideBox\":\"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/nurs/default.aspx\",\"title\":\"BMC Nursing\",\"twitterHandle\":\"@BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"21da7be6-3ea4-4dbd-a135-7223f729d255\",\"owner\":[],\"postedDate\":\"March 27th, 2026\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"under-review\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-03-27T09:29:36+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-03-27 09:29:36\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-8938964\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-8938964\",\"identity\":\"rs-8938964\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}