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OPINION

The image of nursing: The naughty nurse

In the fifth of our series of blogs on the image of nursing, Sandy and Harry Summers reflect on the ‘naughty nurse’ image and whether this undermines the profession.

About the author

This article was written by Sandy and Harry Summers authors of Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All At Risk

Nurses: when you’re at work, do you often find that you’re too busy having sex with physicians and patients to provide clinical care?

Don’t worry, it’s a common problem - in the media.

For decades, naughty nurse imagery has been a mass media staple around the world. It appears not just in sexually-oriented products and in advertising, but in Hollywood shows, popular music, and even the news media.

A 2006 poll by Budget Van Insurance found that 54 percent of British men had sexual fantasies about nurses—more than about any other profession. Nursing led a list of traditionally female, service-oriented jobs. By contrast, women’s fantasies focused on traditionally male workers associated with heroism and/or socioeconomic power, including physicians and “firemen,” who led that list at 47 percent. For men, it seems, to be the object of fantasies is a mark of power and prestige. For women, it is a mark of perceived submissiveness and low status.

The media both reflects and reinforces the naughty nurse stereotype. To some extent, the image may be a reaction to the apparently scary idea of females providing intimate care to vulnerable men. And as we often hear, those who use the naughty nurse are “just joking”! But the social contempt behind the image discourages practicing and potential nurses, undermines nurses’ claims to resources, and encourages workplace sexual abuse - a major problem for real nurses.

In a 2005 study, University of Missouri communications professor Debbie Dougherty found that more than 70 percent of the nurses she surveyed in four U.S. states had been sexually harassed by patients. In March 2006, Dougherty told the Monster website that “patients threatened to attack nurses sexually and called them prostitutes.” In fact, in August 2004 the Times reported that in “some Asian cultures, nursing is considered on a par with prostitution.”

The naughty nurse image persists at all levels of society. In December 2006, sometime Italian prime minister and media mogul Silvio Berlusconi found a novel way to thank his nurses at the Cleveland Clinic, where he had just had a pacemaker implanted: “Italian nurses are better-looking…These ones scare me a bit. Don’t even think about leaving me alone at night with one of them.”

Of course, there’s nothing wrong with being seen as sexy—as long as that’s not your dominant image in the workplace. An article published in Psychology of Women Quarterly in late 2005, based on research by Lawrence University professor Peter Glick, suggested that more sexualized work attire lessens respect for women in responsible jobs like management, causing others to see them as less competent and intelligent. Constantly associating nursing with sex has the same effect.

Major corporations use the naughty nurse to sell alcohol, razor blades, cosmetics, shoes, and even milk. For example, Virgin Mobile India’s 2008 “Think hatke” (Think differently) campaign included an ad in which a supposedly immobilized male hospital patient tricked a scantily dressed female “nurse” into reaching around in his pants pockets, searching for his ringing cell phone.

And in 2005, Virgin Mobile Canada introduced a multimedia campaign with naughty nurse models who would supposedly help customers avoid “The Catch,” a venereal disease associated with rival companies. Virgin tycoon Richard Branson frolicked in the snow with some of the “nurses” at the kickoff event in Toronto.

Hollywood still uses the naughty nurse, including the variation that presents nurses as desperately seeking romance with physicians. On Grey’s Anatomy, nurse characters have often been vehicles through which female physicians confront latent fears about female subservience and sexual virtue. The show’s male physicians sleep with the disposable nurses when there is trouble in their romances with female physicians, their real peers. In a May 2008 episode, the pathetic nurses actually boycotted one physician’s surgeries because he had loved and left too many of them.

But it’s not just hospital shows. In an October 2007 episode of Desperate Housewives, the character Gaby donned sexy nurse attire as an erotic excuse to rub lotion on her husband, to covertly heal a case of the crabs she had given him.

Of course, the naughty nurse has long been a major force in sexually-oriented products. But even the news media will exploit the image when it has an excuse. In September 2006, the Daily Mail broke some urgent news with its report, “Nurses Face Ban on Thongs and Cleavage.” The piece explained that an Essex hospital was considering requiring nurses not to expose too much. And in case anyone could not quite picture it, the Daily Mail helpfully included a photo of Christina Aguilera in a naughty nurse ad for Skechers shoes, with this caption: “Sorry guys: don’t expect to see the likes of Christina Aguilera in this nurses uniform at Southend Hospital.”

At the end of 2006 and 2007, the Sun (UK) ran promotional tie-in pieces for Babes and Boys’ annual naughty nurse calendars. The Sun pictorials featured the usual lingerie-nurse outfits, but a key theme was that the models supposedly really were nurses. One “student nurse” told the Sun she posed for “a bit of a laugh” and “a bit of extra money.” Plus, “People always joke about nurses looking saucy so it’s fun to be the real thing.”

The naughty nurse is also a bit of a pop music groupie. In 2005, electronic-alternative-pop duo Goldfrapp set a video for their single “Number 1” at a plastic surgery clinic where everyone but singer Alison Goldfrapp has a human body and a dog’s head. In the video, Goldfrapp acts like a dog, dances with the clinic staff, and tells the song’s tale of sexual obsession. The “nurses” are all females in short dresses who hand things to the all-male “physicians.” The camera dwells on the nurses’ bottoms—on which the physicians, at one point, playfully place their stethoscopes.

The naughty nurse image is a factor in the nursing crisis. So nurses should urge the media to reconsider its rampant use of the image. We just hope there’s some other way to sell people mobile phone service. Think hatke!

*Authors’ note

We use the term “physician” because using the more common “doctor” to refer only to those who practice medicine wrongly implies that they deserve more respect than others.

Nurses and others earn doctoral degrees and make contributions to health and society that are just as valuable as contributions made by physicians. So the honorific should be available to everyone with that degree or to no one.

We also note that “physician” has been used in this way in texts ranging from Shakespeare to recent issues of the British Medical Journal.

Readers' comments (32)

  • what happens in the media and in reality are two entriely different matters. concern about what others think is a waste of time and energy where it could be better spent in the knowledge that we do our jobs to the very best of our own abilities. don't take it so seriously!

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  • I agree, it is a joke in the media and I am not entirely convinced that we are 'sexually harassed' by patients because of the media. As we are caring people a lot of transference goes on due to patients admiration and being grateful. We are dealing with intimate things which can be misconstrued by vulnerable people as something more personal. We are also sometimes looking after people whose social and sexual boundaries may not within 'normal' limits. Yes, if we are professional and do a good job and keep our own boundaries, most of the time we should be respected and safe. Sadly, due to our working hours, caring skills and in A&E etc, we are exposed to a potentially more dangerous environment. I would say that the behaviour of the Dr's in medical soaps is usually disapproved of and the Carry on films lampooned almost every profession. However, let's face it, I know of some pretty unprofessional sexual behaviour that has gone on involving nurses, but it happens all over the world too. There are some great non-sexy nursing role models in the media too, thank goodness! I suspect that people who regard nurses as sex objects might just regard all women in the same light. Very , very sad.

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  • Anonymous | 20-Oct-2010 12:06 pm, you are wholly wrong. Go back and read the rest of these articles and the comments on them and you will understand why.

    Now on the whole, I don't think the image of the sexy Nurse in and of itself does any harm. I mean for just one example Ann Summers has a Naughty Nurse outfit, as well as a Firemans and a Policewomans outfit, etc (so I am reliably informed ... ahem!) And it doesn't do those professions any harm? It's just a bit of fun in itself.

    The problem is, those other professions have something that Nursing does not. A professional status and cohesive identity. Nursing in the eyes of many is SOLELY this image, or this image combined with the perception of us being nothing more than low paid/lowly educated assistants. THIS is when these images become a problem, because we are often seen as ONLY that. The general public, unless they have had direct contact with us (and even then some hold on to perceptions) do not realise that we are a highly educated, highly professional and to a large extent autonomous profession. They do not see the education that we all have as valuable or regard our medical opinions as important. They assume that we simply 'wipe arses and make beds' (as I have actually been asked if thats what I did!!!)

    That is why these images are so damaging to us, when they do not damage other professions.

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  • we are all of what you say above and we know it which is why it matters so little what others think unless you have a chip on your shoulder about being a nurse and it sounds as though you would prefer to be in another profession where you can create your own public image. it is what we do that matters and not what others think we are. its sad with all the serious worries at the moment nurses are still concerned with such trivialities.

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  • I completely agree with anonymous 20/10/10. Nurses have far more concerning issues to deal with like poor working environments, stress and the knowledge that patient care is declining despite valiant efforts of Nursing Staff to work harder and harder for less pay and less appreciation, not to mention the very real daily threat of more job losses etc.

    Also, I dont consider myself to be an ugly person but have never been sexually harrassed by a patient and feel that most patients both male and female treat me with the upmost of respect and appreciation and I have very rarely felt undervalued by patients, only by higher management and the government who continually find ways to undervalue nurses and belittle the importance of the contribution that we make on a daily basis to those within our care!

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  • Who the hell cares about how we are percieved by the media. If we are not grown up enough to cope with what they will write or how they portray nurses or nursing then perhaps we should go back to Florence Nightingale and start all over again.

    I am sure she would be having a little chuckle at this article and saying to herself, "if thats all they have to worry about, then they haven't lived".

    I don't ever remember anyone ever sexually harrassing me or even seeing me as some form of sex object.

    In fairness we should not attack a media, that over the years has supported nurses and nursing, just because a small minority have attempted to denegrate Nurses.

    Unfortunately, l am one of those people who still finds Barbara Winsor in Carry on matron, an absolute hoot. But then what more would you expect from a guy.

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  • frankly all this talk about the narcissistic obsession with one's image is nauseating and has nothing to do with the serious job and profession of nursing. what an insult to Florence Nightingale.

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  • Of course what we do is important, but it is naive to think that we can continue doing good work and just allowing that to speak for itself.

    Look at it this way, if our image as a profession is not important, if it doesn't matter that we are not seen as professionals by our peers, if our medical knowledge and opinions are not taken seriously by our peers or the public, or that we are viewed wholly as poorly educated assistants, then perhaps the government and the GPs are right to exclude us from the new white paper, perhaps we do not need a voice or a say in how the NHS will be run or how services are made available for patients, perhaps we should actually just bow down to our lords and masters the GPs as it seems the white paper wants us to do, because after all they are the only ones whose opinions matter, right?

    One of the primary reasons that our pay is so crap, that our working conditions are so poor, that we are excluded (apart from a token 'yes man' or two) from policy decisions like the hwite paper IS our image!!! We are not a cohesive profession, we do not have a strong professional identity in the same way the medical profession does to be able to stand against all these things. I mean our opinion doesn't matter does it? We aren't important. It doesn't matter if we start shouting out against our conditions because we can just be sent on our way with a little ruffle of our hair can't we?

    BULLSHIT!!!!

    And I make no apologies for the strong language, because the attitudes of the profession make me so angry sometimes!

    Frankly Anonymous | 20-Oct-2010 6:14 pm, Florence Nightingale's day is long gone, and it is attitudes like yours and others here that has kept the profession in the state it is in now.

    It needs to change.

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  • Odd... I seem to agree with many of the above perspectives, even those that clash, because nursing is all those things, and in addition, perhaps from our own experience. Female nurses may have had different experiences from the public perception point of view.

    I do think at the end of the day we can only ignore the media and either laugh or dismiss it, though there is a slight, but realistic annoyance that perhaps it does perpetuate the dominance nursing has by the medical profession, and as an earlier person said, lack of respect by higher management.

    As a nurse from the early 70's I have observed lots of unprofessional nursing activities, including nurses chatting (cringingly) by the bedside of their antics the night before, and what really went on on the linen cupboard!
    I have been sexually harassed by a couple of sick and vulnerable patients, bottom squeezed etc whilst removing bedpan etc

    Overall, I do think the humour is a fact of life, and Barbera Winsor probably did a good job of counteracting the officiousness of Hattie Jaques and her less sexy demeanor.

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  • People are not basically in the least interested who you are. Their concern is your integrity and what you 'can' for them. In the outside world people look to those with status and influence to advance their own position in society. In healthcare professionals their prime need is contact with those who have the relevant skills to resolve their medical and psychological problems and provide them with treatment and care. No more, no less. Our focus needs to be on improving our skills and knowledge and services (life long learning) and not on polishing some hypothetical, delusional and superficial image which is only a matter of personal perception anyway and is unachievable and meaningless to all but ourselves.

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  • until nurses in britain get their act together, undergo standardised training and post-grad education and have a clear career structure they may never command the respect or salaries they need as there is so much confusion of their roles which nobody understands. National Heath Service means national health service and not a fragmented service across the land with so many different roles and varying and often questionable standards of care.
    perhaps there would then be better use of funds, equitable care for all and more trust by everybody in the country in the system.

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  • in addition to above which was sent before I finished, nurses who then attain qualification standard and registration should be autonomous practitioners in their own right who do not need controlling managers and the NMC breathing down their necks. Then they may command more respect for the role they play and the job they do.

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  • I totally agree with all the anonoymous 20/10/10 - most patients are in a vulnerable position to ever to see you as sexual. In most TV programmes doctors are also portrayed as sexual beings; there for all to swoon over. From my experience of talking to those outside the nursing profession, many people now see nurses as moaners and lazy - especially if you read the Daily Mail!

    The professional identity of nurses is relatively young compared to doctors. To reach the professional status that doctors now have has taken many years (in the middle ages doctors training took 10 years at university). In fact at one time, doctors were seen as evil and bringers of death. Nurses were seen mainly wet & dry nurses for children then as a religious order. Care not cure. Or in Dickens, as drunks! To expect nurses to achieve the same status as doctors in such a relatively short space of time is a big ask.

    As for our professional standing and doctors having more of a say - well I would say the only doctors who have been able to make a stand are GPs. The reason for this I feel is that they are self-employed with, for many GPs (not all), money and incentives being their major concern. Hospital doctors are as much against it as nurses with working conditions etc. They do not agree with GPs running the show either. Much of the running of the NHS and decision making is made by those outside of any medical or nursing profession. No real professional identity other than "managers".

    Mike, although I agree with that we need to work together to achieve a higher professional status, I do not feel that making derisive comments about a nursing colleague is a good example of how to promote professional cohesiveness between the nursing fraternity.

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  • why don't professionals just work together as an interdisciplinary team and focus on the goals of their work which are the needs of the patients. all this criticism of different groups of workers does nothing to enhance these goals or lead to productive work. if nurses think they are so hard done by and are the poor victims they are victimising themselves to the ridicule of everybody else and they should have enough to do by focussing on their jobs otherwise they don't merit more pay, higher status or whatever they are attempting to demand!

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  • the NT Net has some interesting and good articles and the idea of adding personal comment is, if used correctly, useful and constructive as it opens up debate from different perspectives which is an important driver of change. However, it is shameful that some nurses cheapen themselves and slight their more professional colleagues by using it as a platform to slate others, often on issues that are totally irrelevant to the preceeding article, instead of continuing the debate on the topics raised in the article. They are also time consuming to read for those of us that are so busy to find the points relevant to the present discussion. (there is an opportunity to blog on other burning issues). If some are so lacking in self-esteem that they feel the exasperated need to attempt to create an 'image' for themselves please remember that unfortunately the general public also have access to this journal and such slagging of colleagues and other professionals does nothing to help that image and does not help to portray the rest of those who work seriously in the profession in a good light. It seems that obtaining a diploma and registration leads some to assume that they have licence to wield and abuse their professional powers and in a very negative way which cannot be heeded or taken seriously.

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  • my vision of a nurse is someone who does not hold radical views, especially to the detriment of their colleagues and patients, does not offend colleagues with bad language or call them names, stands up for themself in their own professional right for what is best for the patient as well as the good of the team and to facilitate their work, supports colleagues when they make a genuine mistake or lack knowledge, which means questioning the mistake or lack of undersanding without making judgement of the person or criticising them (or worse discussing them behind their back) and helping them make ammends. After all one's own knowledge comes from questioning others and trying to understand their position. Only then can we learn. Obviously if there is a question of negligence endangering patients or staff then there is recourse to the higher authorities but nobody has the right to jump down the throat of another in an aggressive manner for a small mistake as I have seen so often and usually by those who cover their own mistakes in an attempt to preserve their own perception of their 'self-image'. I would also expect a nurse to play their role in a multidisciplinary team where it is up to everybody to get on together and create a professional but congenial working atmosphere and working in a collegial and educative manner with mutual respect and support. Communications between all interdisciplinary professionals must be open and transparent as with managers and others who come into contact with the ward team. Many managers are non-clinical and have to rely on our expertise, judgement, communication and collaboration in order to enable them to coordinate and enhance the work of all team members in caring for patients. It is only when we all work together in a consensual manner that patient care will be enhanced, wastage will be reduced, we will, as a professional body gain recognition and appropriate renummeration for the work we do.

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  • it must be highly turbulent working with nurses with such strong views as some of those mentioned above and with those who have so many preoccupations and are so critical of others including doctors, managers and maybe even of each other. it is hardly conducive to focussing on the patients and their care and treatment needs.

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  • "On a par with prostitution"

    Not too far off the mark actually. Nurses are certainly selling their physical selves in their line of work....

    A better analogy would be "flogged like and egyptian donkey"!

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  • I believe that there will always be stereotypes with Nursing. It's difficult to stop it before it happens but if we object to commercials and advertisements that objectify nurses as sex objects then we can get our point across that this is not who we are.
    The RCN needs to represent nurses to the public as educated professionals. Where I come from (Ontario, Canada) we are represented by RNAO (Registered Nurses Association of Ontario). I believe you have the RCN.
    When a commercial or advertisement depicts nurses in a bad way, then the RNAO works very hard to have these ads removed from the media that they are portrayed, such as Richard Branson's stunt in Toronto.
    The RNAO is successful most of the time and the ad is taken down.

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  • from John D. Lyons, French Literature, A Very Short Introduction, OUP 2010
    referring to The Misanthrope by Molière

    "Philante is a fine example of the 17th century honnête homme: he never advances any particular achievement of his own (La Rocohefoucauld said just this in his 1664 Maxims: 'The true honnête homme is the one who does not attach his pride to anything in particular'), he views human imperfections with tolerance and detachment, saying that 'there is no greater madness than to try to set the world straight'.

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