The Contemporary Image of Professional Nursing

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The Contemporary Image of Professional Nursing
Insert Chapter 2 opening illustration
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Key Concepts

• Factors contributing to nursing shortage
• Image of art, media, literature, and architecture
  over time
• Nursing actions that convey a negative image of
  nursing
• Strategies to enhance the image of nursing

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Images of Nursing

• Magazines
• Television
• Movies

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The Nursing Shortage

• Average ages
• Nursing graduate 33 years
• Community college graduate 44 years
• By 2015 more than half of U.S. RNs are predicted
  to retire
• New career opportunities for women
• Declining number of students
• Effect of media images of nurses

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The Nursing Shortagecontd

• By 2006 the U.S. Bureau of Labor Statistics
  predicts that jobs for RNs will have increased by
  21 in comparison to 14 for all other
  occupations
• By 2020 the need for hospital RNs will have
  increased by 36
• Hospitals are competing with medical groups,
  insurers, and dot-com companies

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Nursing in Art, Literature, and Architecture

• Antiquity image of nursing
• Literature
• Earliest references are in the Bible two nurse
  midwives
• Art
• 16th century BC statuettes portrayed midwives
• 11th century AD hospitalers portrayed as
  soldiers
• 12th century AD religious order or person of
  wealth

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Summary of Images Portrayed

• Advocates and protectors
• Untrained servants
• Soldiers
• Respected caregivers

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Victorian ImageLiterature

• Charles Dickens portrayed Sairy Gamp as drunken
  and uncaring
• Henry Longfellow portrayed Florence Nightingale
  as a heroine

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Florence Nightingale

• Created a positive image for nursing through her
  success in improving the health of British
  soldiers
• Her work was the beginning of modern nursing
• Early user of statistics developed the pie chart

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Early 20th Century

• ArtImages of war portrayed nurses as
  dedicated, heroic, and caring
• ArchitectureNursing school buildings symbolized
  nurses

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The 1930sNurse as Angel of Mercy

• Nurse portrayed as the angel of mercy
• Nurse portrayed as dedicated, heroic, and caring
• 1936 movie The White Angel chronicled the
  professional life of Florence Nightingale
  (endorsed by the American Nurses Association
  ANA in 1992)

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The 1940sNurse as Heroine

• Nurses commemorated as war heroes through movies
  and stamps
• U.S. Navy destroyer named for a Navy nurse
• After World War II, nurses had low salaries and
  poor working conditions

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Nursing in the Anti-Establishment Era of the 1960s

• Media images and art
• TelevisionNurse as background figure to
  physicians
• MoviesNurse as power figure, cruel
• CanvasNurse as worried, angry

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Nurses in the 1960s (Reality)

• Served in the forefront of public health
• Central in development of CCUs and performing
  hemodialysis
• First nurse practitioner programs began
• Salaries inadequate compared with those of other
  less trained American workers

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Nursing in the Sexual Revolution of the 1970s

• Negative media imageUncaring nurse in Mash
• Positive media imageAfrican-American nurse in
  TV series Trapper John, M.D. (important because
  Louisiana was the last state to admit
  African-American nurses to the State Nurses
  Association in 1964)

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Nursing in the 1980s to 1990s

• MediaMovies portrayed nurses as nonjudgmental,
  caring, knowledgeable, and heroic
• Advertisements portrayed nurses as sex objects
• Art portrayed nurses as caring
• Architecture portrayed the importance of nursing
  through impressive buildings for schools of
  nursing

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The Image of Men in Nursing

• Usually absent in the media
• Movies and television
• Meet the Parents
• ER
• Trauma
• Life in the ER

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Imagemakers

• Public roles
• Dr. Carolyn Davis, RNAppointed by President
  Reagan to head Health Care Financing
  Administration (HCFA)
• Dr. Shirley Chater, RNAppointed by President
  Clinton as Commissioner for Social Security
  Administration

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Imagemakerscontd

• Nurses of America Campaign conveyed to the public
  that nurses are expert practitioners
• Goal of the campaign Make nurses aware of
  invisibility in the media

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Public Concern With Nursing

• Too few RNs
• Inappropriate use of unlicensed assistive
  personnel (UAP)
• Honesty and ethics
• Feminine, nurturing characteristics
• Knowledgeable, essential
• Hears nurses negative messages
• Seeks nursing advice

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Reality of Contemporary Staff Nurse

• Modern health care institutions exist to offer
  nursing care
• Public highly values the profession
• Nursings heroic image is etched in stone, glass,
  and canvas
• Surveys indicate one in four nurses plans to
  leave
• 40 of nurses would not recommend their practice
  setting

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Clash Between Beliefs and Reality

• Nurses marketed as caring, individualistic,
  holistic, yet unable to meet patient expectations
• Patient advocates who cannot fix the system
• Unrealistic understanding of health care reform

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Nursing Practice Reality

• 20 to 50 of RNs being replaced with
  multiskilled, unlicensed workers
• Nurses doing more with less
• Patients angry about early discharge
• Nurse practitioners battling for full acceptance
  as primary care providers

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Why Is This Happening?

• Patients are indirectly buying nursing care
• Buyers seek to purchase services at lower costs
• Profession has failed to use power
• No control over enrollments
• Fewer than 8 belong to professional organization

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Changing Physicians Image of Nursing

• Communication
• Understand the mysteries of medicine
• Understand the effect of communication patterns
  on image
• First name
• Positioning
• Allow interruptions

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The Look of Nursing

• Inappropriate dress
• Deferential positioning
• Wearing nursing uniforms in public places
• Wearing nonwhite uniforms

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Reclaiming the Name of Nurse

• Reserve term nurse for registered nurses
• Understand the legal scope of practice
• Avoid first names
• Increase comfort with proclaiming name, practice,
  and contributions

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Valuing Nursing

• Reclaiming the name
• Reclaiming personal identity
• Reclaiming the birthright
• Reclaiming the practice
• Changing the song

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On a Positive Note

• Nurses should tell everyone what nurses do well
• Nurses should confine disagreements and conserve
  energy for important issues

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Valuing the Future of the Profession

• Consider the implications of the entry into
  practice issue
• How long can nursing justify withholding the
  benefits of science from patients?

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Creating a New Image

• Take the role seriously and dress the part
• Be highly visible to patients, families, and
  physicians
• Avoid negative comments
• Be active in professional organizations
• Value caring, health promotion, and health
  teaching
• Recognize the value of illness care
• Supervise UAP to ensure excellent care

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Central Message for All Nurses

• Each nurse forms the image of nursing every day