The Contemporary Image of Professional Nursing

1. The Contemporary Image of Professional Nursing

2. 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 Key Concepts

3. Magazines Television Movies Images of Nursing

4. 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 The Nursing Shortage

5. 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 The Nursing Shortage—cont’d

6. 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 Nursing in Art, Literature, and Architecture

7. Summary of Images Portrayed Advocates and protectors Untrained servants Soldiers Respected caregivers

8. Charles Dickens portrayed Sairy Gamp as drunken and uncaring Henry Longfellow portrayed Florence Nightingale as a heroine Victorian Image—Literature

9. 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 Florence Nightingale

10. Art—Images of war portrayed nurses as dedicated, heroic, and caring Architecture—Nursing school buildings symbolized nurses Early 20th Century

11. 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) The 1930s—Nurse as Angel of Mercy

12. 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 The 1940s—Nurse as Heroine

13. Media images and art Television — Nurse as background figure to physicians Movies — Nurse as power figure, cruel Canvas — Nurse as worried, angry Nursing in the Anti-Establishment Era of the 1960s

14. 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 Nurses in the 1960s (Reality)

15. Negative media image—Uncaring nurse in Mash • Positive media image—African-American nurse in TV series Trapper John, M.D. (importantbecause Louisiana was the last state to admit African-American nurses to the State Nurses Association in 1964) Nursing in the Sexual Revolution of the 1970s

16. Media—Movies 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 Nursing in the 1980s to 1990s

17. Usually absent in the media • Movies and television • Meet the Parents • ER • Trauma • Life in the ER The Image of Men in Nursing

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

19. 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 Imagemakers— cont’d

20. 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 Public Concern With Nursing

21. Modern health care institutions exist to offer nursing care • Public highly values the profession • Nursing’s 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 Reality of Contemporary Staff Nurse

22. 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 Clash Between Beliefs and Reality

23. 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 Nursing Practice Reality

24. 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 Why Is This Happening?

25. Communication • Understand the mysteries of medicine • Understand the effect of communication patterns on image • First name • Positioning • Allow interruptions Changing Physicians’ Image of Nursing

26. The Look of Nursing Inappropriate dress Deferential positioning Wearing nursing uniforms in public places Wearing nonwhite uniforms

27. Reserve term nurse for registered nurses Understand the legal scope of practice Avoid first names Increase comfort with proclaiming name, practice, and contributions Reclaiming the Name of Nurse

28. Reclaiming the name Reclaiming personal identity Reclaiming the birthright Reclaiming the practice Changing the song Valuing Nursing

29. On a Positive Note Nurses should tell everyone what nurses do well Nurses should confine disagreements and conserve energy for important issues

30. Consider the implications of the “entry into practice” issue How long can nursing justify withholding the benefits of science from patients? Valuing the Future of the Profession

31. 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 Creating a New Image

32. Each nurse forms the image of nursing every day Central Message for All Nurses

33. THANK YOU!