The image of nursing continues to attract comments from the profession, public and media and at times, appears conflicting.
The story of Jessica Anderson, who was initially denied a Guinness World Record for her marathon run while wearing a nurse’s uniform because she wasn’t wearing a dress, hit the headlines recently. The story prompted a huge amount of support via social media with the hashtag #WhatNursesWear, as many nurses posted photos of themselves in their workwear, reflecting the diversity of uniforms and non-uniforms. The responses highlighted that the Guinness World Record rules reflected an out-of-date stereotype. The recent retraction and amendment of a Guardian career profile after it described nurses as assisting doctors, rather than recognised as regulated autonomous professionals, showed that collectively, nurses have a powerful reach, but also that there is much work still to be done.
In a blog in August 2017, Professor June Girvin outlined nursing’s long route to professionalism and change, and how each step towards a career structure and recognition of a profession in its own right has been in the face of political prejudice and societal norms about what women and men should and shouldn’t do.
Nurses were included in the IPSoS Mori Veracity index for the first time in 2016 and topped the poll of the most-trusted professions and those most likely to tell the truth, at 93%. They have continued in pole position since increasing their rating to 96% in 2018. Why then does this outstanding recognition not translate into recognition of image?
Perhaps part of the issue is that nursing inevitably means different things to different people. Nurses work across the breadth of society, so the majority of the population will have some experience of nursing in a particular sphere.
Rather than recognising that this is just one aspect of a wide-ranging nursing career, the media or public tend to relate to their own experience when describing the image of nursing, which as we know may vary widely. Perceptions are shaped by what they encounter and reinforced through media stereotypes and anecdotal stories. These perceptions then become held opinion unless challenged.
An example of the pervasiveness of this attitude happened during a conversation in June. A 20-something university graduate with no real experience of nursing other than their partner’s sibling, who is an undergraduate nursing student, questioned why nurses need degrees and why they need to learn about policy as ‘they can learn that later’. As ever, a conversation ensued outlining evidence-based research, competency, technical advances and how policy is formulated before their opinion altered. This is time-consuming and not everyone has time to pursue similar conversations.
Another example is from within the profession, a recent @WeNurses hosted tweet chat asked nurses to describe the stereotypical of nursing in three words, the participants then commonly used words such as ‘angels’, ‘handmaid’ and ‘female’ – representing that even within nursing there is still a perception around the older stereotypical images.
Language used matters and influences. I would counter the nurses could equally have described nursing stereotypes as most trusted, competent and professional, which have more positive connotations that would also be recognised by the public. The nurses continued to highlight that they felt people didn’t always know about the professional responsibility and accountability nurses hold, but little was articulated about these aspects alongside the tweet chat.
Nurses need to remain alert to stories that portray both a positive and less positive image of nursing and be ready challenge where a perception of the nursing image is either inaccurate, out of date or misleading. We are in effect guardians of our own profession.
A personal perception is that many nurses are good at speaking out in arenas where they feel comfortable. Fewer, however, write to national bodies, politicians and national papers, demanding the image of nursing be updated in reports and policy papers.
”Nursing has its best opportunity in years to refine its image and broadcast it to the wider world”
Another recent example is the NHS Long Term Plan – it was astounding that nursing, a crucial element to the plan’s success, was barely mentioned in the report. If nursing abdicates that responsibility to challenge our image and participation within the health service, how can we claim to be surprised when policymakers don’t hear our voice and defer to others on the issues that affect nursing?
Nursing has its best opportunity in years to refine its image and broadcast it to the wider world. 2020 has been designated the Year of the Nurse by the World Health Organization. Alongside the Royal College of Nursing, International Council of Nurses, Nursing Now and other organisations, nurses need to be strategically planning the message they intend to amplify while they have the spotlight. Will nurses highlight the autonomous, educated and trusted aspects of the profession and how they are imperative to population health and societal change?
All nurses have within their power the opportunity to hold conversations, challenge perceptions, quote facts and research and correct inaccuracies – although not everyone will be comfortable speaking up.
I would challenge everyone to consider how they might individually or collectively define and broadcast nursing to the wider population in 2020.
Let’s not waste the opportunity but embrace it by writing articles for the nursing and non-nursing press, speaking at local events or schools, making videos, and inviting ourselves onto radio and TV.
Be bold; challenge, educate and update nursing’s image – the 21st Century beckons.
Ellen Nicholson is course director/module lead for PG Dip/PG Cert/BSc general practice nursing, London South Bank University