The nursing profession has always attempted to put forward a positive, clean and healthful image. Throughout history the nursing industry has tried to portray nurses as angels of mercy, and as ethically upstanding, helpful healthcare professionals, just a few steps down from doctors in terms of medical needs. But lately the images of nurses has changed and not always for the best. This paper critiques the images of nurses through a review of the available literature.
The highly respected Gallop Poll ranks nurses at the top of the list of several important professions in terms of "honesty and ethical standards" (Gallup, 2010). In a 2010 polling project by Gallup eighty-one percent of respondents rated nurses "Very High" or "high"; number two below nurses was "military officers" (73% rated them "very high" or "high"; number three was "druggists or pharmacists" (71% rated them "very high" or "high"; and number four on the list was "grade school teachers" (67% rated them "very high" or "high") (Gallup, 2010).
In 2008 nurses ranked at the top of the list of professions with 84% of respondents rating nurses "very high" or "high" and in 2009 83% of respondents rating nurses "very high" or "high" (Gallup, 2010). So one can see that while nurses are ranked at the top of professions for honesty and ethical behavior, that percentage has been slipping a little, from 84%, to 83% and down to 81% in 2010.
In an American Nurse Today article (Cohen, 2007), the author mentions the fact that nursing has been in the top 10 "most honest and ethical organizations" list in the Gallup Poll. But, Cohen wonders, is being a top-ranked profession in the eyes of others really "…relevant to the concern" nurses have about their image? (p. 1). The author asks, what truly matters to patients and caregivers and what do nurses "care about and look for in our colleagues?" (Cohen, p. 1). Moreover, what impact do these perceptions have on the image of nurses? The nuts and bolts of this article concerns the need for nurses to adjust their image -- and wearing clothing (produced by people outside the nursing field, like scrub manufacturers) that is "adorned with cartoon characters" like Sponge Bob and Snoopy demeans the profession, according to Cohen and image consultant Sandy Dumont (p. 1).
What must be done to improve the image of nurses? Cohen lists several steps that nurses should use for their own accountability: a) leaders must define "unacceptable workplace behaviors" and hold nurses accountable; b) nurses need to be taught to say, "My name is Shelly, and I am your registered nurse today"; c) the proper appearance of the nursing staff should posted in written guidelines "and followed through with consequences for those who don't comply"; d) the staff should be involved in developing the list of unacceptable behaviors; e) the staff should be writing "health-related articles in the [local] newspaper"; f) nurses should be going out into the community to speak to groups about what nursing is and what it does; and g) nurses should be trained in good communication skills so they can "respond to negative colleagues in a manner that confronts and stops behaviors that affect nurses' image" (Cohen, p. 2).
How do nurses perceive themselves? An article in the Journal of Advanced Nursing explains that nurses are very concerned about their public image; the article's authors sampled the opinions of 346 Australian nurses and found that nurses "…rated their aptitude for leadership" in a more positive light than they believed the public viewed them (Takase, et al., 2006, p. 333). The authors assert that the public has had a "stereotypical view of nursing" and that view tends to be one that regards nurses "as less intelligent than doctors, dependent on doctors, powerless and underpaid" (Takase, 334).
The point of this study was to determine how nurses perceive their public image compared with their self-image -- and the question posed is, does the relationship between how nurses see themselves contrasted with how they perceive their public image affect their job performance? The results of the 346 questionnaires that were returned to the authors show that nurses perceived themselves as caring leaders, and believe that the public sees them as "feminine and caring professionals" but not as "leaders or professionals who were independent in their practice" (Takase, 340). In a separate focus group of nurses that were approaching the same issues, the consensus was that the public has "a fuzzy image" of nurses. The quote that came out of the focus group showed the nurses' concern about their image in the public: "They [the public] don't necessarily have an appreciation for what we actually do for the patients… I just don't necessarily think people really do know what we do…" (Takase, 340).
Another article in the Journal of Advanced Nursing (Spouse, et al., 2000, 730) the authors conducted a longitudinal study of eight nurses from the time they pre-registered for nursing school through their four-year program. At the conclusion of the study, even of the eight students reported that their "preconscious & #8230; guiding images that influenced their actions as nurses" appeared to be not something they learned along the way, but rather part of their personality (Spouse, 734). This "knowledge" wasn't the same kind of knowledge that came with the basic practical "know-how" that comes with having learned the "technical tasks" of nursing, Spouse continued (734). The conclusion to this study reflects that the "interpretative frameworks" that nursing students bring to their learning situations have an influence on the achieving of their career goals. And so their perception about what nurses actually do while on the job "…inform not only their career choice[s] but also the way in which they will engage…" in their careers (Spouse, 737). In this case, students' images of what good nursing practices are "were congruent with those of the curriculum" and their images of exactly how they intended to practice the role of nursing "informed their attitudes and their relationships with patients" and directly impacted the way in which they practiced nursing, Spouse explained (737).
Nursing isn't just a "vocation" or a "profession" or even a "job," according to an article in the journal Nursing Ethics (de Araujo Sartorio, et al., 2010). Nursing is "by nature" is a "moral endeavor," and most if not all nursing professionals strive to be seen as a "good nurse" -- hence the authors of this nursing article set out to interview and test 18 nursing instructors at a university nursing school in Brazil. The results are straight forward; the five different perspectives that these 18 instructors agreed upon were: a) good nurses fulfill their duties properly; b) nurses are "proactive patient advocates"; c) competent nurses are always prepared and available to welcome others as persons, not just patients; d) nurses are "talented, competent" professionals that carry out their responsibilities "excellently"; and e) nurses combine "authority with power sharing in patient care" (de Araujo Sartorio, 687).
In their discussion section at the conclusion of the article the authors reported that it was difficult for some within the study group of 18 instructors to define "ethics"; so, they tended to define "what was not ethical" rather than what was ethical. The reason for that might be connected to a "professional practice concerned with the struggle against a past and a history" that was not zeroed in on creating "new patterns for the good nurse of today" (de Araujo Sartorio, 693).
Before developing a marketing campaign to recruit and retain nurses, the author of this article in Nursing Management, Vicky Morris suggests that research needs to be conducted into how the field of nursing is perceived. In this article the author tapped into the views of nurses, nursing students, senior nurses as well as new nurses, educators and managers, 198 respondents in all; the results of these focus groups and interviews and questionnaires shows that there is a definite distinction between how the public views nurses and how they view themselves.
The public believes nursing requires dedication and is an honorable, vital service provided to society; the reality for nurses is their work is "unpleasant, dirty, menial and difficult" (Morris, 2010, p. 17). The public view of what it takes to become a nurse was "incorrect and outdated" and the public view of a nurse is "passive and subservient to doctors" (17). The public (according to what nurses perceive) bases the personality and character of individual nurses on "media cliches"; and the viewpoint the nurses have about the public's perception is that nurses lack in "variety, freedom and progress" (17).
All these things were taken into consideration prior to the marketing campaign; but what also came out of the research is that nurses need to have "a higher profile," need to take pride in their profession, and should be more willing to promote their standards, values, and share their positive experiences with others (Morris, 18).
The National Student Nurses' Association has published a…