Welcome to Lisa Sundean, who is joining our team of bloggers!
WCCs originated in 1993 by the Arnold P. Gold Foundation. The purpose of the WCC is to symbolize the transition into the medical practice and to remind medical students of their promise to scientific, compassionate medical care. Since 1993, several other health professions have adopted the WCC as a professional milestone and transition for students. More recently, nursing schools have begun to adopt WCCs, endorsed and supported by AACN in partnership with The Arnold P. Gold Foundation (The Arnold P. Gold Foundation, 2013).
On the surface, the symbolism of the WCC for health professionals is honorable. However, one must question the utility and deeper meaning of the WCC for nurses. First, the WCC originated for the medical profession. Are nurses still so enamored by medicine that we cannot embrace our own professional symbolism and rituals? Second, nurses understand the struggle of the profession to rise up from more than a century of medical oppression and yet, we are willing to don the white coat of physicians as a symbol of achievement and transition in the nursing profession. Are we not cloaking our students in the very cloth of oppression we seek to emancipate from? Finally, as we face the critical need to transform healthcare, we fully understand the importance of interdisciplinary and interprofessional collaboration. Such collaboration capitalizes on the unique synergies of knowledge, skills, and expertise of various disciplines and professions. Is the WCC contrary to such collaboration? Does the WCC unconsciously invoke nurses to become more like physicians rather than the unique profession it seeks to become; a profession with a unique knowledge base, a unique skill set, a unique expertise, a unique contribution to health and healthcare, and a unique set of professional traditions?
The WCC is a new tradition for the medical profession. It is fair to respect the symbolism of the ceremony for physicians. However, adoption of the WCC for nurses is questionable. Nursing scholars encourage us to find our professional voice and establish our professional uniqueness (Kagan, Smith & Chinn, 2014). The quest for that uniqueness is a road paved with rigor, creativity, dedication, and commitment to the metaparadigm of nursing. With all due respect to The Arnold P. Gold Foundation, nurses, we can do better than allow ourselves to be seduced by a medical tradition to symbolize our unique profession and identity.
References
Kagan, P. N., Smith, M. C. & Chinn, P. L. (2014). Philosophies and practices of emancipatory nursing: Social justice as praxis. New York, NY: Routledge.
The American Association of Colleges of Nursing. (July 2015). Gold Foundation and AACN to fund 60 nursing schools for 2015 white coat ceremonies. Retrieved from http://ymlp.com/zwDmlO
The Arnold P. Gold Foundation. (2013). White coat ceremony. Retrieved from http://humanism-in-medicine.org/programs/rituals/white-coat-ceremony/
The problem is that since we gave up on white caps and uniforms – also symbols of our oppression – we haven’t replaced them with anything that automatically symbolizes Nurse either for our students or the general public. I agree that co-optting the white coat is not the way to go. Pinning ceremonies are nice but the importance of the pin is not part of our cultural imagination.
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I remember my pinning ceremony fondly. It was very clear to me that it represented a commitment to the values of nursing. Perhaps other traditions can be created by and for nurses to symbolize the transition into the profession. Thank you for responding.
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I loved this Lisa and am so happy that you are posting this important message. I struggled with these same concerns when our college implemented the White Coat Ceremony last year for our entering nursing students. I addressed these points at the ceremony and re-framed and reclaimed the white coat worn by many healthcare professionals as a symbol of compassionate care. Also read a poignant reminder about how the white coat can be a barrier to care because of the symbol of power over others. It was written by Donald Berman. Our students received lamps as well, another symbol honoring our Nightingale legacy. The students wrote their own pledge that reflected nursing values. I have to say that in spite of my concerns, so eloquently stated in your blog, it was a beautiful ritual of passage.
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Thank you for responding Marlaine. The power over potential is a concern whenever one group possesses knowledge that others do not possess. Our intentional practice to engage patients in their care is so important, and to understand their lives from their location. I like the idea of having students writing their own nursing pledge. Hopefully, it is something they will reflect on throughout their professional careers.
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The oppressed start acting like their oppressors. Unfortunately, we see this over and over again in nursing. Until we recognize and address our own oppression from a deeper professional level, we will continue to see nurses following behind medicine.
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Thank you for sharing your excellent comments on the WCC, Lisa. It is so important for nursing to maintain our own identity, as we extend into advanced practice and take up both leadership and participatory roles on interprofessional teams. By replicating a ceremony well-known as a rite of passage for another profession, we may be unconsciously diluting the uniqueness of nursing for our students.
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Lisa,
I was very excited to read your blog post after our thoughtful conversation during the academic year regarding this topic. The timing is rather ironic as just last week, after spending the past 15 years in hospital provided classic ceil-blue nursing scrubs, I donned the elusive and powerful white lab coat for five days while I covered the gestational diabetes program. It was my first ‘unofficial’ WCC and the experience served as a personal epiphany of sorts. I received a wide range of comments from co-workers related to my altered nursing presence, but none that dug deeper than a simple comment from one of my former undergraduate nursing students who said, “Look at you away from the bedside in a fancy white coat,” (insert visual of her forming the infamous Gen Y hashtag symbol with her hands) as she states, “whitecoatgoals.” Herein lies the problem of our future generation of nurses; they are being taught that true success requires transcending the bedside, which in turn, equates to the illusion of privilege and power yielded by the ‘white coat.’ I agree with Lisa that the WCC is honorable for the MD arena, but the white coat in the nursing world creates a figurative barrier to the core of the profession. If we continue to educate nurses who believe #whitecoatgoals translate to success we are doing a disservice to nursing. My ‘white coat experiment’ set me apart from my peers for an entire week. I am happy to return to the camaraderie, uniqueness, bonding, and creativity that are enhanced by my honorable ceil-blue scrubs.
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