Study

1. Nursing status
&Image

2. Objectives
At the end of this lecture the learner will be able to
describe:
 Define Status & Image
 Define Nurse & Nursing
 Significance Of Status And Image In Any
Profession
 Dynamics Involved
 Concepts Of Nursing In Past
 Development Of Nursing
 Foundation Of Nursing
 Nursing Development With Passing Era

3. Cont..
Dimension Of Nursing
 Nursing Scope
 Nursing Knowledge And Education
 Nursing Practice And Skills
 Nursing Administration
 Nursing Research
 Maintenance of nursing image and status in
Pakistan
 Perspectives of nursing in future

4. Status & Image
Status : Relative social or professional
position;(standing, rank, ranking, position,
social position, station, level
Image : The general impression
that a person, organization, or
product presents to the public (public
perception, public conception, public
impression, persona, profile, face,
identity

5. Nurse & Nursing
Nurse: “A person trained to care for the
sick or infirm ,especially in a hospital.”
Nursing:“The unique function of
the nurse is to assist the individual, sick or
well, in performance of those activities
contributing to health or its recovery (or
peaceful death) that he/she would perform
unaided if he/she had the necessary strength,
will or knowledge..”

6. Introduction To Nursing Image
 Nursing image is very important for nursing
profession ,it is the way the profession
appears to others including to general public.
 Image of the nursing profession impacts to
the recruitment of students, the view of the
public ,funding for nursing education and
research, relationships with healthcare
administrators, other health care
professionals, government agencies and
ultimately, the profession self identity.
 Image is defined as a mental picture
representing a real object or a more or less
accurate likeness of a thing or person.

7. HISTORICAL DEVELOPMENT OF
NURSING IMAGE
 Credit is given to Florence nightingale for
the written history and development of
modern nursing.
 The image of nursing may also have its
roots in the Victorian Age during which she
lived .
 At the time nursing perceived as ‘’Women s’
Work ‘’.
 The expectations of nurses were altruism
,sacrifice, submission and its not just
encouraged but demanded

8. Periods Of Nursing Development
 Period 1: Angels Of Mercy
 Period 2: Girl Friday
 Period 3: Heroine
 Period 4: Mother
 Period 5: Sex Object
 Period 6: Careeist

9. PERIOD 1:ANGEL OF MERCY
(1854_1919)
 In the early 1900s nurses were
viewed as honorable ,moral,
spiritual ,self-sacrificing and
ritualistic.
 World war 1 media
representations continued the
“angel of MERCY “ image.
 Nurses appeared in a substantial
literary Endeavour's ,nurses
heroines were characterized as
being involved in dual search:
 success and meaning through
nursing.
 happiness and fulfilment through
love and marriage

10. PERIOD 2:
GIRL FRIDAY(19201929)
 Women’s entered in new domains
of professional endeavors and
activities .
 1918s influenza epidemic created
a vast need for nurses.
 As a results of all these factors
,efforts toward increased
regulation of nursing education
were hampered.
 Nursing students were exploited
as a cheap labor ,literally staffing
entire hospital.
 Nurses were described as faithful
,dependent ,cooperative ,long-
suffering and subservient.
 In films of this era ,nurse were not
cast as career nurses.

11. PERIOD 3:HEROINE(1930-1945)
 Nursing was acknowledged as
worthy and important profession
that enabled women to earn an
honorable living.
 Nurses were identified as educated
,courageous ,fearless, reasonable
,clear-headed and humanitarian.
 The only feature –length film ever
produced that focus entirely on the
nursing profession ,these film
stressed the education and work of
professional nurses.
 Film on nursing profession
,nominated for the 1934 Academy
Award for best picture ,the heroin of
the film reject a millionaire offer of
marriage to continue her career as
a nurse

12. PERIOD 4: MOTHER (1946-1965)
 It may have been natural
development after world war
2 that a major goal for many
American women was to say
home and care for children.
 Nurses during this period
were chronicled as maternal
,compassionate ,unassertive
,submissive and domestic.
 During the 1950s television
programs usually portrayed
nurses as worthy of respect
and appreciated for their
skills.

13. Period 5:Sex Object (1965-1983)
After 1966,mother image change of the nurse
change into sex image
Nurses were increasingly depicted as being
sexually, promiscuous,
 self indulgent, superficial and unreliable.
Nurses became “ sexual mascots” for health
care team and were seen in X rated movies.
Eventually nurses were portrayed as cord,
uncaring ,power hungry and unmotivated
person.
In films of these years, nurses were
undervalued and poorly represented, their
contribution to health care were not
addressed.

14. Period:6 Careerist(1983-present)
 The careerist has became the
new image for the mid 1980
and 1990s,portraying as
intelligent ,logical, progessive,
sophisticated, empathetic and
assertive.
 Men and women both are
dedicated to providing the
highest standards of
healthcare
 Each one of us holds the
responsibility and the
privilege of making this image
the common place awareness
in every household.

15. Cont…
 An international production of a
television series has helped nurses
connect with other nurse using the
media to assist in improving care.
 Collaborative practice.

17. Men And The Image Of Nursing
 The literature that the nursing
profession would benefit from a large
influx a large influx of men into the
profession , but if a man decides to
enter the profession he is plagued by
social stereotypes.
 Male nurse are often considered
social misfits , unable to fit into a “real
mans”job.

18. Cont…
 Men who choose a traditional female
oriented career are perceived as
socially demoted.
 Our understanding of the imageof
nursing has been mainly based on
other perspectives such as the public
or media rather than nurses
themselves.

19. Foundation of Nursing
Ancient civilizations through the renaissance;
Illness had supernatural causes women
delivered custodal care to family
Medicine men treated disease
As civilization grew priests were seen as
physicians
Male nurses vanished from profession
Home major locality for nursing care
Only poor hospitalized ,cared for by
prostitutes and female criminals

20. Significance of Nursing Image
 The image of nursing is important.
Public image creates a frame-work by
which others approach nursing as a
profession, as well as each nurse
individually. ... Presenting a balanced
view of the nurse's role and
contribution to healthcare is essential.
The impact of nursing's images comes
to bear in several important ways.

21. Image Building
 A Process Knowing Oneself Being
Positive About One’s Self Image,
Leading To A Better Chance Of
Increasing One’s Self-esteem &
Enjoying A Meaningful, Happy Life.
(Hugh Prather)

22. Image Building
Remember-
“… no one can make you feel
inferior without your consent…”
(Eleanor Roosevelt)

23. Two Views of Nursing
1. Internal Image
2. External Image

24. Two Views of Nursing
Internal Image
 how nurses
see themselves
as individuals
 how nurses
envision the
profession
External Image
 Views Presented To
Impress Potential
Students, Legislators,
the Public...

25. Will nurses want to improve their
self-image

26. Changing the Image of Nurses &
Nursing
 To change a large group requires a
concrete plan that is effective over
time
 The basic image of the nursing
profession has already been
established
 Changing the self-image of the
individual nurse

27. Do you think that nurses ...
nursing has image problems?

28. Components important for building
image
Experience
Heredity
Environment
Thoughts,Beliefs,Image&
ActionPerformance
Gender Socialization
Reference Groups

29. We always act like the person we
believe ourselves to be
Everything we do is consistent with our
self-image/self-concept. if you think it,
you can attain it?

30.  If Any Idea Enters Your Mind, You
Literally Have The Ability To
Accomplish It.
 The Only Factors That Stand Between
You And Your Goals Are
Perseverance, Hard Work, And A
Willingness To Take Risks.

31. Current image of professional
nursing
 Nursing shortage
 The average age of nursing graduate
is 33
 The average age of nursing Rn is 44
 Average age of faculty is 50
 By 2015, 50 % of the RNs are
expected to retire
 By 2016 , job opportunities are
increased by 21%

32. Image markers of nurse
 Nurses of America campaign
 Convey To The Public That The
Nurses Are The Expert Clinicians
 Raising Consciousness Of
Invisibility Of Nursing In The News
Media

33. Public concern with nursing
 What is the image of nursing being
created today?
 Saints vs. Sinner Image
 Can I trust my life this Rn nurse ?
 Public want to believe that
knowledgeable, caring , committed
and dedicated RNs will always be
available for them.

34. What the public believe about
nurses
 Rn ranked highest among all
professional standard of ethics and
honesty.
 Public seek advice in 4 areas
a. Self-care or immediate post op care
b. OTC health care products
c. Admin and SE of prescription drugs
d. Interpreting physician provided –
information

35. Why do RNs Deride themselves
in front of public
 Sloppy clothing
 Dirty,wrinkled
 childish symbol

36. Evolution of Nursing and
Health Care
 Nursing is art and science by which
people are assisted in learning to care
for themselves whenever possbile and
cared for y others when thry are
unable to meet their own needs .
 nursing 's early histroy was heavily
influenced by religious organization
and the need for nurses to care for
soldiers during wartime.

37. Scope of Nursing Practice
 The scope of nursing practice is the
range of roles, functions,
responsibilities and activities which a
registered nurse is educated,
competent and has authority to
perform. Nursing practice is
underpinned by values that guide the
way in which nursing care is
provided”.

38. Scope of Nursing Practice
Nursing provide three types of care:
 Individual
 Family
 Community
Nursing practice involves four areas:
 Promotion of health and wellness
 Prevention of illness
 Restoration of health
 Care of dying person

39. Nurses workplaces
Nurses work in:
 Hospitals
 Acute care units
 Home care, and long-term care facilities
 Care for patients with general medical
conditions, including
 Infectious diseases,
 Asthma and
 Pneumonia.

40. Nursing education

41. History of Nursing
Development

42. The Theoretical Foundation Of
Nursing
 Nursing theories provide the
theoretical foundation of the
professional .
 Theory define what the nursing is
,what it does and the goals or
outcomes of the nursing care.
 Nursing is synthesis or many theories
.

43. Nursing education
The three traditional educational avenues that
prepare men and women for registered nursing are:
1.Hospital-based diploma programs,
2.Associate degree programs (primarily found at
junior and community colleges),
3 .Baccalaureate programs (offered at 4-year
colleges and universities). It is also possible for
students to begin their nursing education in
programs that culminate in a master’s degree, and
several programs now exist in which a student can
earn a doctorate before being eligible to write the
state licensing examination for registered nursing.

44.  At least two other
groups of caregivers
are identified with
nursing: the nursing
assistant, who may be
certified, and the
practical (vocational)
nurse, who is licensed
through a separate
and different
examination from that
taken by the RN. We
begin with a
discussion of those
roles.

45. Nursing education
 Diploma nursing
 Associate degree nursing
 Baccalaureate Education
 Master’s and Doctoral Pre-licensure
Programs
 Doctoral Studies
 Articulated Programs
 Distance Education

46. Diploma Education
The earliest type of nursing education in the
United States took place in diploma programs
administered by hospitals, also referred to as
hospital-based programs. The early
development of these schools is synonymous
with development of nursing as a whole.
 Development of Hospital-Based Diploma
Nursing Programs
The first hospital with a nurse
training school was the New England Hospital
for Women, which accepted five probationers
on September 1, 1872.

47. CONTINUE…….
By the late 1940s and early 1950s, many hospital-based
nursing schools had affiliated with nearby colleges and
universities; these schools adopted general education
requirements, such as:
 Anatomy
 Physiology
 Sociology
 Psychology
As part of the curriculum. During this time,
the national league of nursing education—later to become
two organizations, the national league for nursing (NLN)
and the national league for nursing accrediting commission
(nlnac)—assumed an active role in curriculum guidance
and accreditation

48. Cont…
Hospital-Based Programs Today
These programs vary in length from 27 to 36 months.
Many diploma schools are affiliated with a college or
university so that college credit can be awarded formally.
Graduates are provided with a foundation in the biologic
and social sciences and may have taken some courses in
the humanities.
There is a strong emphasis in diploma programs on client
experiences.
The course of study includes experience in nursing
management (e.g., being in charge of a nursing unit).
Graduates work in acute, long-term, and ambulatory
healthcare facilities, fulfilling the responsibilities
established by the scope of practice for RNs as defined by
the state in which they are licensed.

49. CONTINUE…..
 The elimination of hospital-based
programs has occurred because
hospitals could not sustain the costs of
supporting the programs and because
students became more attracted to
programs located in colleges and
universities.

50. Associate Degree Nursing
Education
 The movement toward associate degree
education began in 1952. Today,
associate degree nursing programs
prepare more graduates for licensure as
RNs than do any of the other programs
and comprise over one half of all
students enrolled in prelicensure RN
programs (NLN, 2009). Associate degree
programs have helped to solve the
nursing shortages of the 1960s, 1980s,
and today.

51. Cont..
Characteristics of Associate Degree Education
In a typical program, approximately 40% of the credits
needed for the associate degree must be fulfilled by
general education courses such as English, anatomy,
physiology, speech, psychology, and sociology; the rest
are to be fulfilled by nursing courses. Clinical learning
experiences are carefully selected to correspond with
the content delivered in classroom lectures; the
preconferences and postconferences help to reinforce
the relationship between the two. Some modifications in
this structure are occurring, as associate degree
educators strive to meet the expectations of employers
and the community while remaining true to the concept
of associate degree education

52. Baccalaureate Education
 Baccalaureate degree nursing education occurs in a 4-year
college or university and is championed by many to provide
the minimum educational preparation for professional
practice.
Development of Baccalaureate Education in Nursing
The first school of nursing to be established in a university
setting was started at the University of Minnesota in 1909 as a
quasi-autonomous branch of the university’s school of medicine.
The program was not very different from the 3-year hospital-
based program operating at that time; nothing was required in
the way of higher general education, and graduates were
prepared for the RN certificate only. Education took place
predominantly through apprenticeship, and students provided
service to hospitals in exchange for education. However, nursing
education did become a part of an academic organization, with
16 colleges and universities developing programs by 1916.

53. CONTINUE…….
Characteristics of Baccalaureate Education
A baccalaureate nursing program is termed a basic or
generic program when it is a prelicensure program leading
to eligibility to take the NCLEX-RN. It includes an upper
division (junior and senior years) nursing major that is built
upon 2 years of liberal arts and science courses taken
during the freshman and sophomore years.
Changes in Baccalaureate Education
In recent years, the nature of baccalaureate education has
changed. Many baccalaureate nursing programs have
taken steps to respond to the need for more RNs prepared
for licensure at the baccalaureate level. Innovative
methods include the development of accelerated programs
and external degree programs.

55. Master’s and Doctoral
Prelicensure Programs
Most of the graduates of these programs
are engaged in teaching and research.
Such programs reflect the thinking of
some nursing leaders that the minimum
preparation for professional nursing should
be the master’s degree. The programs also
provide a higher degree to those people
who possess basic baccalaureate
preparation in another area of study.

56. CONTINUE….
Master’s Preparation
Master’s preparation is recommended for
leadership positions in nursing, for clinical
specialization, and is generally the
minimum preparation required to teach
nursing. The AACN has outlined roles for
graduates at the various educational levels.
Their vision is for a generalist at the
baccalaureate level and an advanced
generalist at the master’s level that
includes the clinical nurse leader.

57. Doctoral Studies
Before doctorates in nursing were offered, doctoral
study in other fields allowed nurses to benefit from
post-master’s preparation. A doctorate outside the
area of nursing was often the only doctorate
available to persons seeking further education;
doctorates in nursing are relatively new to the
educational milieu.
Doctoral programs in nursing offer various degrees,
such as:
 The doctor of nursing science DNS),
 The doctor of science in nursing (DSN),
 The doctor of nursing education (DEd),
 The more traditional doctor of philosophy in
nursing (PhD)

58. Cont…
Non-nursing doctorates are available to nurses, such as:
 The doctor of education (ED)
 The doctor of public health (DPH).
 In 2004, the AACN proposed a doctor of nursing practice
degree (DNP).
 The DNP is designed for nurses seeking a terminal degree in
advanced nursing practice, as opposed to working in
research (AACN, 2006a).
 The DNP was developed with the premise that the challenges
of today’s healthcare demanded a higher level of preparation
for advanced practice nurses (APNs) who could design and
assess care and provide leadership. Some universities are
changing their nurse practitioner programs from master’s
degree programs to this type of clinical practice doctorates.

60. Nursing Responsibilities
 Recognize that an image problem
does not exist and that each individual
nurses has a responsibility to improve
the profession image
 Become politically active and
politically knowledgeable ,nurses
should run for office.
 Document activities.
 Write and submit features stories on
nurses for local media.

61. Cont…
 Demand that nurses authors to
considered for editing health columns.
 Provide technical assistances to
media.
 Provide ongoing public services
announcement.
 Create a public forums, "spend a day
with a nurses”.

62. Cont..
 Share the positive aspects of the
nursing profession with other.
 Learn to describe alternative nursing
education programs.
 Continue to develop alternative
nursing education programs.
 crtically asses the action you take ,
that might impact the image of
nursing.

63. Cont..
 Remember nursing image is you.
 Be self-confident, self-confident
behavior respect.
 Increase staff involvement in
scholarly activities .
 Be positive.

64. Strategies For Improving The
Image Of Nursing
 The nursing profession faces some
difficult issues and challenges as it
related to image building.
 Collective bargaining.
 Computer technology .
 Elimination of internal sexism .
 Development of internal media.
 External media committees
 Education

65. Nurses Image of Itself
 Our greatest advocate is the cilent ,as
we reach out to care for them heart to
heart, they will reach out to work with us
hand in hand.
 Collectively, these individuals nurses
attitude ,behavior and interaction
constitute nursing self image.
 Nurses who verbalize comments such as
“I am only a staff nurse”I was just
following the physician order ,are not
improving the image of nursing

66. Cont…
 It is the challenge for each nurses to
extend the best image possible and
offer the utmost by substantiating the
value of that service.