Chapter 02

Chapter 2
The Contemporary
Image of Professional Nursing
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

 Magazines
 Television
 Movies
 Statues
Images of Nursing
Copyright © 2014 by Mosby, an imprint of Elsevier Inc. 2

 Employment rate projected to increase by 22%;
projected to grow faster than all occupations
until 2010
 By 2025 the U.S. is projected to need 260,000
more RNs than will be available
 Number of foreign graduates is small
 Strategies to entice retired nurses back into
practice will produce little, because 84.8% of
licensed nurses are in practice
The Nursing Shortage

 Nurse Reinvestment Act funded at $20 million
was signed into law August 2002
 Nursing scholarships
 Public service announcements
 Faculty loan cancellation programs
 Geriatric training grants
 Nurse retention and enhancement grants
The Nursing Shortage (cont'd)

 Increased student loan amounts
 Provided $50 million/year to fund nurse managed health
centers
 Funded gerontology nursing fellowship programs
 Provided up to $40,000 in educational loan repayment
for nurse faculty and $80,000 for doctorally prepared
nurse faculty
 Strengthened Title VIII advanced nursing education
grants
 Graduate nursing demonstration grants to hospitals
providing clinical training for Advanced Practiced Nurses
Patient Protection and Affordable
Care Act (2010)

 Antiquity’s image of nursing
 Literature
• Earliest references to nursing are in the Bible and chronicle
the action of two nurse midwives in approximately 1900 BC
Nursing in Art and Literature
6Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

 Victorian image of nursing
 Literature
• Charles Dickens’ portrayal of Sairey Gamp, the drunken,
physically unkempt, and uncaring nurse who used nursing to
profit from the sick and dying
• Henry Longfellow’s portrayal of Florence Nightingale as
heroine
(cont'd)

 Florence Nightingale
• Created a positive image for nursing
• Her success in improving the health of British soldiers
against overwhelming medical obstacles was the beginning
of modern nursing
• One of the early users of statistics; developed the pie chart
8
(cont'd)
Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

 Early 20th century nursing
 Art: opportunities offered to nurses by war captured
the attention of artists and portrayed nurses as
dedicated, heroic, and caring
(cont'd)

 The 1930s: the nurse as angel of mercy
 Media images and art: radio programs, movies, and
sculpture portrayed nurses as dedicated, intelligent,
brave, and compassionate, and portrayed nursing as
a holy vocation
 In 1936, Warner Brothers’ movie The White Angel
chronicled the professional life of Nightingale; it was
endorsed by ANA in 1992
 In 1938 a tall, white, imposing statue, the Spirit of
Nursing was placed in Arlington National cemetery to
honor military nurses
(cont'd)

1. While one is visiting Arlington National Cemetery,
a large limestone statue, the Spirit of Nursing, can
be seen. This statue honors:
A. Florence Nightingale’s accomplishments in public
health.
B. Nurse Rivers, who advocated for victims of the
Tuskegee experiment.
C. Clara Maass, who found the cure for yellow fever
during World War II.
D. All military nurses for their bravery and
compassion.

 The 1940s: nurse as heroine
 Nurses were commemorated as war heroes through
movies, stamps, and the naming of a U.S. Navy
destroyer for a Navy nurse, the USS Higbee
 After significant contributions during WW II, nurses
found low salaries and poor working conditions at
home
 Glamorized in romance novels such as Cherry Ames
and Sue Barton series
(cont'd)

 Nursing in the antiestablishment era of the
1960s
 Media images and art
• Television shows: nurse as a background figure to
physicians
• Movies: nurse as a power figure who cruelly punished
patients
(cont'd)

 In reality, nurses were making significant
contributions to health care
• Served at the forefront of public health initiatives
• Central figures in the development of coronary care units and
the performance of hemodialysis
• First nurse practitioner programs began
• A U.S. Bureau of Labor study indicated that salaries of
nurses were woefully inadequate in comparison with other,
far less trained American workers
(cont'd)

 Nursing in the sexual revolution of the 1970s
• Media portrayed nurses negatively—uncaring nurse in
M*A*S*H
• One positive image was the commemorative stamp of Clara
Maass, who died after deliberately obtaining two carrier
mosquito bites so she could continue providing care to
soldiers with yellow fever during the Spanish-American War
(cont'd)

 Nursing in the 1980s and 1990s
 Media images
• Movies portrayed nurses as nonjudgmental, caring,
knowledgeable, and heroic—Miss Evers’ Boys, The English
Patient, Love and War, Paradise Road
 Artistic portrayals of nursing focused on caring
• Advertisements portrayed nurses as sex objects
• Vietnam War Women’s Memorial
(cont'd)

 Millennial media
 The image of men in nursing
• Usually absent in the media
• Movies and television: Meet the Parents, ER, Grey’s
Anatomy, Scrubs, House, HawthoRNe
 Media campaigns for nursing
• Sigma Theta Tau International (STTI) study of 20,000
articles published in newspapers, magazines, and other
health care publications (1998) indicated that nurses were
cited only 4%
(cont'd)

 NSNA Image of Nursing Program
 Center for Nursing Advocacy
 Nurses for a Healthier Tomorrow
 Campaign for Nursing’s Future—Johnson and
Johnson; $30 million
Nursing’s Response

2. What company invested 30 million dollars in a
campaign to reduce the nursing shortage?
A. Pfizer
B. Merck
C. Johnson and Johnson
D. Kellogg

 Nurses of America Campaign: A 1990 campaign
implemented by the Tri-Council with funding
from the Pew Foundation, which was designed
to:
 Convey to the public that nurses are expert
practitioners who are able to interpret technical data
and coordinate and negotiate health care
 Make nurses aware of the invisibility of nursing in the
news media
Nursing’s Response (cont'd)

 What the public believes about nursing:
 Gallup Polls ranked nurses first for having honesty
and ethics
 2001 World Trade Center attacks resulted in the
public viewing firemen and nurses as heroes
The Enduring Public
Concern with Nursing

 Reality
 Modern health care institutions exist to deliver
nursing care
 The public highly values the profession
 Nursing’s heroic and noble public image is etched in
stone, glass, and canvas
 Nurses have a high sense of satisfaction with their
profession
The Reality of the
Contemporary Staff Nurse

 Graduates are entering the profession at younger ages
 More than half of nurses practice in a hospital
 40% of all health care professionals are RNs
 American Assembly of Men in Nursing is dedicated to
positively influencing factors that affect men in nursing
 In a female-dominated profession, 41.1% of CRNAs are
male
 Ethnic nurses are most likely to attain graduate degrees
The Reality of the
Contemporary Staff Nurse (cont'd)

Creating the Image of the
21st Century
 Nursing is knowledge work
 Failure to rescue data documents human and
financial loss when nursing judgment is not available
 Improving the RN/LPN skill mix and increasing RN
hours decreases adverse outcomes

 Understanding the mysteries of medicine
 In exchange for hospital privileges, physicians agree
to abide by a set of medical staff bylaws that include a
disciplinary process
 Nurses who work with a physician whose practice is
substandard may wrongly believe that the problem is
a nursing problem; in reality, the problem must be
addressed through medical staff bylaws
 Communication is an ongoing problem for nurses and
physicians; both disciplines need to be respectful of
these issues
Changing Nurse-Physician
Interactions

 The look of nursing
 Nurses engage in numerous self-sabotage activities
• Inappropriate dress
• Inking and tattoos
• Deferential positioning in meetings and during collaborative
activities
• Wearing nursing uniforms in public places
Why Is This Happening?

 On a positive note:
 Nurses should tell everyone what nurses do well and
should keep disagreements in-house
 Nurses should think carefully before disagreeing with
each other and should conserve energy for
important issues
Creating a New Image

 Value nursing; project it daily
 Nurses should take themselves seriously and dress
the part
 Recognize the benefit of membership in the
American Nurses Association, Sigma Theta Tau
International, National League for Nursing, and
specialty organizations
 Portray the profession positively
Creating a New Image (cont'd)

 Be highly visible to patients, families, and physicians
 Make negative comments only to other colleagues
 Be active in professional organizations
 Recognize the value of nursing’s contributions
 Value caring, health promotion, and health teaching
Creating a New Image (cont'd)

Chapter 02

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Editor's Notes