The Image of a Nurse — Myth vs. Reality

Nursing Economics, Sept, 1999 by Eileen Meier

When the public conjures up the image of a nurse, what is it? The TV nurses of "General Hospital" have spent most of their "careers" standing around the telephone, chatting at the nurse's station and saying, "Yes doctor" when a doctor breezed through the scene. Most television or magazine interviews regarding health care in America are from a physician's perspective. Many individuals still see nurses as nice women who empty bedpans and straighten bed sheets. Nursing's image is many times outdated and incorrect.

We do not seem to be going in the right direction either with our image. More individuals hospitalized today are writing into newspapers or the hospital CEO about their experiences and complaining that: they could not figure out who the nurse was that cared for them because everyone looked the same and never identified themselves; they were never cared for by the same nurse; the nurses rushed in and out of the room too hurried to talk; they went days without baths or linen changes; and they had to wait in clothes and sheets soaked in urine because no one ever answered the call bell to help them get to the bathroom in time.

Nurses have had very little decision-making power in the re-engineering of hospital units which causes many of the complaints listed above, yet nurses and the image of nursing are ultimately harmed. More experienced nurses are leaving the profession every day, stating that they are "burned out." Younger nurses complain of being "eaten alive" by more experienced nurses and leave work confused, in tears, and disillusioned with the profession. We seem unable to control our profession and its image.

In a recent conversation with a senator's aide regarding the Patients' Bill of Rights and how to assure that nurses' concerns are heard for legislative provisions, the aide said it was crucial to get nurses' voices about this legislation into the media. Nurses must define and elaborate what is needed in the legislation and state, unequivocally, what they see as important. Nurses must exemplify to the public what would be lost in the delivery of health care if certain provisions are not included in the legislation. In other words, nurses must learn how to be media savvy and be very concise as to their own importance in the health care delivery system.

The Reality of Nursing and the Media

In a recent editorial, Eleanor J. Sullivan (1999) stated that the "image of nursing in the media isn't poor; it just isn't." She voiced her valid concern that nurses and the field of nursing are rarely in the media. Nursing research is also ignored.

The Woodhull Study, commissioned by Sigma Theta Tau International (1998) and performed by the Rochester School of Nursing, surveyed and analyzed the portrayal of health care and nursing in U.S. newspapers, newsmagazines, and health care industry trade publications. It found that nurses were invisible in media coverage for health care in the United States.

Health care issues were covered, but nurses were absent. Health care coverage composed 10% of total articles of the seven newspapers surveyed; yet nurses and nursing were referenced or directly quoted only 4% of the time in over 2,000 articles. Even in these few references, nurses were only mentioned in passing. In four newsmagazines surveyed, health care composed 14% of the coverage; but in 142 health care articles, nurses were mentioned only three times. In health care industry publications, where the total health care industry is focused upon, nurses were referenced only 1% of the time.

Specific Examples

In an AIDS article in Healthplan (Simmons, 1997) that discussed the search for expertise to keep health plans flexible and best education strategies, nurses, who currently provide the majority of HIV/AIDS patient care and education in the community, were completely left out of the story.

The general sources usually quoted in health-related stories are heads of associations, CEOs, directors of institutions, but not those "on the front line," such as nurses. Even in articles focusing on nursing issues, nurses were not consulted. In a Chicago Tribune article examining the issue of lay midwives who are barred from practice in Illinois by a law requiring all midwives to have a nursing degree, a physician and lay midwives were contacted. No practicing midwife with a nursing degree was contacted or referenced in the article. Nursing research is also ignored. A New York Times article examining teenage sexual activity referenced a University of Pennsylvania Education Department study, rather than a University of Pennsylvania School of Nursing study that had been selected as a model for HIV risk reduction curriculum by the Centers for Disease Control.

Continued Invisibility Despite Strength and Needs

Nurses have not gained any ground over the last 10 years. A study done in the first quarter of 1990 found that in 423 articles written on health care and of 908 sources, nurses were quoted and referred to only 1% of the time.

There are more than 2.5 million registered nurses in the United States who provide more hands-on care daily to individuals than any other health care profession, yet nurses are left out of the public picture and the image of nurses remains that of inaccurate stereotypes. Several nursing organizations were so alarmed about the lack of media coverage evidenced by the Woodhull Study that a 1-day conference was held on the subject, as well as how to increase nursing's presence in the media.