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OPINION

The image of nursing: It's in your hands

In the latest in our series of blogs on the image of nursing, Sandy and Harry Summers explain what nurses should do to right the wrongs done to nursing’s image

Who should take the lead in improving public understanding of nursing?

You.

Nurses must play the leading role. Nurses have the power - and the responsibility - to foster change for their profession. That’s why we founded The Truth About Nursing.

The first hurdle in this advocacy is self-image. Some nurses will need to focus first on believing in the profession and in their own power to make a difference.

We urge nurses to project a professional image in all interactions. When you meet a patient, introduce yourself as a nurse. Include your surname, as professionals do. That doesn’t mean you have to be cold or formal. You can provide good psychosocial care and earn respect.

Consider telling patients what your role is, including your duty to advocate for them. And you might try “nursing out loud”. This means describing more of what you’re thinking while you’re providing care, consistent with patient confidentiality and sensitivity. If you do, then patients, families, physician colleagues and others will get a better sense of your education and skill.

Educate colleagues. Nurses already teach physicians a lot about healthcare in clinical settings, but they could tell them more about nursing. Nurses might also reach out to medical schools to start joint learning or shadowing programs like those we mentioned in our last piece.

The benefits of nursing care - which often involves preventing adverse events - can be hard for people to see. And some nurses have become expert at hiding their expertise. Please don’t do that quite so well! We’re not saying nurses should brag, but don’t let others get credit for nurses’ life-saving work. If not for yourself, do it for your colleagues. We have designed a bumper sticker that tries to help people understand the value of nursing. It says: “Save Lives. Be a Nurse.” Email us; we’ll send you some.

Even your clothes affect how others see you. Some nurses wear scrubs with cartoon characters on them. Do many physicians or other professionals do that? We commend the nurses of Wales, who last year adopted professional uniforms so that they can be more easily identified.

Advocate for progress on public health matters, as the Royal College of Nursing has recently done on issues ranging from the scope of nursing practice to the proper “drink drive” limits. When nurses speak out, the public sees that they are committed, engaged health professionals. And don’t be reluctant to let others know you are a nurse, as some nurses are once they gain positions of influence. Let people know that the articulate person they’re listening to is a nurse.

Nurses must also help the media create better depictions of nursing. Build media expertise, establish relations with your local media, and get coverage for nursing at your workplace. Praise the media when possible. The Truth About Nursing issues annual awards for the best (and worst) portrayals of nursing it has seen in the past year. Our 2010 awards just appeared.

Persuading the media to reconsider specific products is also important. It’s not easy, especially when it comes to television, but it can be done. Consider phone calls, emails, and letter-writing campaigns. In trying to influence ongoing media portrayals, it’s important to identify the key decision-makers, to collaborate with others when possible, and above all, to be persistent.

In 2007, Cadbury Schweppes Canada ran television commercials featuring female nurses hopping into bed with male patients who chewed Dentyne Ice gum. After extensive discussions with the company’s Canadian affiliate proved unproductive, we launched a letter-writing campaign. The Registered Nurses Association of Ontario joined us. More than 1,500 letters later, the company still would not budge. So Sandy began leaving detailed voicemail messages for the top Cadbury Schweppes executives in the world. After a week, the CEO of Cadbury Schweppes called Sandy from London to discuss her concerns and to tell her he was pulling the ad.

Of course, no one knows nursing as well as nurses do. So nurses should create their own media, to explain nursing to the world.

Are you a writer? Consider letters to the editor, op-eds, feature articles, and non-fiction to explain nursing to the world. In 2005, U.K. nurse Claire Bertschinger published Moving Mountains, a book about her work caring for children in the 1980s Ethiopian famine - work that reportedly inspired the 1985 Live Aid benefit.

And fiction can be very influential. J. K. Rowling’s Harry Potter books include the minor character Nurse Pomfrey, who is skilled at healing in a supernatural setting. But we need nurses to put nursing centre stage. Maybe Harry Potter could become a flight nurse; that broom would be pretty quick to accident scenes!

Even poetry can convey key elements of the nursing experience. The Los Angeles poetry magazine Rattle included a “Tribute to Nurses” in its Winter 2007 issue. The tribute featured nurses’ own work: insightful essays and well-crafted, irreverent poems that captured modern lives and deaths without sentiment.

The internet is a growing source of health information, and nurses must use it. Consider your institution’s website. These sites rarely highlight the work of nurses as much as they do the work of physicians. But hospitals exist mainly to provide nursing care, and nurses should work to make their websites reflect that.

Despite the damaging examples we have seen, television is not a lost cause in the battle to improve the nursing image. Recent shows like Nurse Jackie and BBC4’s Getting On have great potential to convey a more realistic vision of the nursing experience. And nurse-focused documentaries like the Channel 4 series now being filmed in Birmingham NHS hospitals can make valuable contributions.

When others do not understand the value of what nurses do, nursing cannot get the respect and resources it needs, and people suffer and die. But we can change that. As the philosopher Albert Camus once wrote: “Tasks are called superhuman when humans take a long time to complete them, that is all. The first thing is not to despair.” Together, we can create a world that allocates the resources nursing needs to save the lives of millions.

All we need is you.

Readers' comments (13)

  • Words fail me!

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  • Anonymous | 30-Jan-2011 6:04 pm, why? I actually agree with them wholeheartedly, with one exception. I am unsure what single individuals can do against such a system. I have been railing against the public perceptions of Nurses since my first day as a student, nothing changes. It takes a wholesale shift from the top down. For example, the expansion of Nurse led services such as expanded walk in centres and clinical care given by Nurses in this new NHS, with Nurses becoming independent practitioners in their own right able to demand the pay and conditions they deserve, would do a lot to force a perception change. However, now it looks as if Nurses will be ignored in the new NHS, (but still used as the most important part of the workforce) and we have to fight to even get fair pay (but then most of us won't fight because of the spineless apathy that infects Nursing). So how is that going to help public perception of us?

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  • I agree that all nurses have to individually contribute to enhancing the image of nursing. I believe that there is a lack of respect in some nurses for their own profession that leads them to behave in ways that give nursing a bad name. I am so proud of being a nurse and I endevour to behave professionally at all times in order that people feel they can trust me, confide in me and that I am good at what I do. I didn`t come into nursing for the pay either. I came into it because I believe I can make a difference to someones day. I want to look after others and bring alittle comfort and compassion. There may be some that are spineless as mentioned by others, but I definately am not, I fight for my patients rights first.

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  • Professionalism is something I take in myself totally for granted. I do not have to think how to behave professionally. I was brought up in a medical household where I think high standards and caring about and for others has been ingrained in my makeup. I am certainly very far from perfect like most of the rest of the human race but at least this is one aspect I don't need to worry about so that I can concentrate on areas which need my greater attention and improvement. All the recent articles on the image of nursing have been a great surprise to me. I believe it is attitudes, behaviour, authenticity, respect for others, a strong sense of responsibility, motivation, huge efforts to try and understand their suffering and their point of view even if it vastly different from our own, as well as too many other qualities to list here, that guide professionalism and not external masks, props and symbolism such as different uniforms for different people, different colours, etc. If you are professional you know instinctively how to comport yourself.
    I agree though that other nurses possess other admirable attributes which sadly I do not have but finding their own personal level of professionalism may be more elusive to them and it may have to be worked hard for or role-modelled by others as I obviously must have moulded myself on my role models who happened to be my parents and their professional medical and nursing colleagues in preparation to enter the nursing profession.

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  • As with above, my mother is a nurse ( still on the register at 65 years of age). She remains my main role model although I have collected many others over the years.
    The image of nurses in the real world is established by nurses 'on the floor'. The nurses who do the job well and make a longlasting difference and impression upon those they care for.
    Not everybody watches television on a regular basis but I defy anyone to say they have never been a patient or visited anyone in hospital.
    We should start to celebrate those who provide excellent patient care and publicise their success in the media rather than relying on images which make good television.

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  • To be perfectly frank - as a man within the nursing profession it's really motherhood and families that are responsible for the weakness of the profession.

    Rightly so nurses with children are mothers first and families always come first - but the price to be paid is the lack of fire, political power and strength that ultimate dedication brings.

    Most if not all nurses i speak to would rather put up with appalling conditions derisory and sub-par pay and god awful selfish, lazy and demanding patients than take a stand and demand more from a system that clearly and readily takes advantage of them.

    The ignorance of some makes them feel that if they protest, fuss or voice their concerns then their jobs will be at risk, despite the total opposite being true but this is the rpice the profession pays for having the majority of the profession place their careers behind their status as mothers.

    And of course, rightly so. My mother - a nurse of some 38 years experience put her career and ambitions on hold to be my parent.

    But just remember the image won't change if nurses want to pertain to some image that depends on their feminity then they must expect a certain amount of 'male' (but not by men) domination particularly as nursing is forced into submission and subservience.

    the bitches succeed in nursing but they bring no benefuts to anyone except themselves

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  • Well said, Jjjez

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  • I think there is truth in the fact that women, more than men work around child care, cost of child care and sometimes care of ageing parents. In trying to maintain the balance of all this, and some sanity they sacrifice career progression. Senior experienced nurses return to part time and lower grade posts to fit in. It's not surprising they don't always have the strength to fight the system too.

    As a country though - aren't we all a bit wimpy? Although there is nothing like a Tory government to get a few riots going - on the hole we don't complain or protest we accept and get on. Although it doesn't make it right, or always appropriate, perhaps the apathy in nursing is a reflection of out national psyche?

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  • That's a good point Sara, they certainly don't seem to have this crippling apathy in Australia for example!

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  • Your remarks probably refer to those who wish to be left in peace to get on with the work they chose to do and are paid for which is looking after patients!

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  • Yes well once the only patients you are looking after re the ones that can afford it and the ratio is 1 RN to 14 patients and all budgets have been cut ou certainly will be busy looking after the patients.

    Wake up and get real. You're apathy and reliance on some 'husband' somewhere to do the finances and look after our interests is dead in the water.

    Welcome to today, you've been asleep since the eighties!!!

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  • To jjjez:
    It seems to me that the beginnings of the profession is owed to 'motherhood' and familial concepts. It is the reason this profession justifies 'other ways of knowing' (intuition) as evidence (perhaps a worthwhile debate in its own right). The point is, the origins of the profession shouldn't be blamed for its present state.

    We are presently at a state where defining the practice of nursing and evolving the concept of 'nurse' from its matriarchal and religious past is essential. And I'm sorry but "I believe I can make a difference to someones day" simple does not cut it. Many other occupations from Psychology to fast-food work make the same claim. Interestingly, neither Psychologist or fast-food worker would say that making a difference to someone's day is an all-encompassing description of their roles.

    So my question:
    What special knowledge,skills and preparation are unique to registered nursing, and apply to the profession universally (throughout the world)? --Such an answer defines a profession, and would greatly help this nursing student out!

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  • ?whats the volume and issue number

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