Born female: the development of nursing in Thailand

Nursing was the first education-based occupational field for women in Thailand. In the brief span of 90 years since its beginning in hospital bedside care, it has become a professional field that has one of the greatest concentrations of women with doctoral degrees in the nation (n = 23). The academic evolution of nursing was instigated by the decisive contributions of two rich and powerful interests, the monarchy and private U.S.A.-based foundations. A cadre of doctorally prepared nurses has emerged. They, like members of other professions in Thailand, are predominantly from the urban privileged sector of society. The majority of today's nurses have followed a different course starting from petty bourgeoisie origins in towns and moving laterally through provincial bureaucratic channels. To date, lack of basic education has denied the poor and minority ethnic groups from the hill areas access to nursing. We describe the development of the nursing profession in three phases: the beginning of nurse training, 1896-1926; the creation of a small elite of nurses, 1926-1956; and the development of academic nursing, 1956 to the present. The future depends upon how the current polarization between the minority elite of university-prepared nurses and the majority lower middle class nurses proceeds. Since each group is governed and educated by separate government Ministries, and since women do not have access to higher government positions, nursing may have little control over its own development unless its new leaders take new leadership. One strategy is to recruit men into university nursing.