The Evolution of Professional Nursing Culture in Italy: Metaphors and Paradoxes.

We explored the perceptions of Italian nurses regarding their developing culture as a health profession. We sought to understand the ongoing evolution of the nursing profession and the changes that were central to it becoming an intellectual discipline on par with the other health professions in Italy. In 2010, the Regulatory Board of Nursing established a center of excellence to build evidence-based practice, advocate for interdisciplinary health care, and champion health profession reforms for nursing. In this study, focus groups-involving 66 nurse participants from various educational, clinical, and administrative backgrounds-were utilized to better ascertain how the profession has changed. Six themes, three of them metaphors-"vortex," "leopard spots," and "deductive jungle"-explain nurses' experiences of professional change in Italy between 2001 and 2011 and the multiple dimensions that characterize their professional identity and autonomy.