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Strategies needed to tackle negative image of nursing


Directors of nursing must develop strategies to address negative perceptions of the nursing profession at a local level before launching any national campaign to improve nurses’ image.

Pilot work on improving the public’s perception of nursing, carried out by senior nurses at two strategic health authorities, has found that the needs of the current workforce must be addressed “at ground level” as a priority.

Nurse leaders have told Nursing Times that serious failings in care, such as that experienced by patients at Mid Staffordshire Foundation Trust, have “tarnished” the public image of nursing and damaged nurses’ morale.

In its final report published earlier this year, the Prime Minister’s Commission on the Future of Nursing and Midwifery called for a national campaign to challenge the public perception of nurses and raise awareness of nursing as a graduate calibre profession.

Unison head of nursing and commission member Gail Adams said a national media campaign, such as the one used to recruit social workers, could be “very beneficial” in addressing the negative stereotypes that surround the nursing profession.

But the pilots have indicated the need to improve nurses’ sense of their own work first.

Robert Jones and Agnes Hunt Orthopaedic and District Hospital Trust director of nursing Vicky Morris, who is leading the pilot for NHS West Midlands, told Nursing Times:

“Unless we convince frontline nurses that we can support them in a better way, and that we can address issues of staffing and morale, then nurses themselves may actually shoot the recruitment drive or national campaign in the foot.”

Ms Morris said senior nurses must show “strong leadership” in making nurses aware of the range of opportunities within the profession, and where they can access support and raise concerns.

They should also highlight the levels of education and training undertaken by nurses to give them a “higher profile” with the public.

As part of the regional strategies, NHS London and NHS West Midlands are developing an interactive website for nurses who may want to pursue different career pathways and members of the public interested in nursing as a career.

The strategic health authorities are also working with The Patients Association to restore public confidence in the profession and explode some of the myths around nursing.

Project lead for NHS London and deputy chief nurse Janet Shepherd said: “The public view is that nurses earn between £11,000 and £15,000 a year and they don’t need to have qualifications because they are born with the ability to nurse. We need to give the public a better understanding of what nursing really is.”


Readers' comments (18)

  • Since our public profile is deserving of an upgrade (which I believe it is), what about our pay too?

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  • When I started nursing in 1989 the public perception of nurses was that we were " angels ". Now they mostly have the opinion that we are lazy and uncaring. Why is that? Well, I think that part of the problem is that due to reduction in staffing levels we now do not have the time to treat our patients "holistically". Infact I have been told that the days of sitting chatting to our patients are over. Patients now feel that nurses have no time for them and are only interested in getting them out of hospital ASAP, whether they are ready for discharge or not. This is not because nurses are lazy and uncaring but because we have managers who are obsessed with targets breathing down our necks for empty beds. Again, due to staffing levels I feel that patients are not having their hygiene and nutritional needs met. This is why the public all have stories of seeing someone in hospital unshaven, with food stained pyjamas, or food left at the bottom of the bed out of reach, and being unable to " find a nurse". This all leaves the public with a poor perception of nurses and makes us feel we are not doing a proper job. So to Robert Jones and Agnes Hunt Orthopaedic and District Hospital Trust director of nursing Vicky Morris I would say that if you address issues of staffing then morale will sort itself. Give us the staff, and therefore the time to nurse and the public will once again see us for the "angels" we really are. This is the only way you will change the public perception. It cannot be changed truly with some bullsh!t propaganda campaign.

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  • I could'nt agree more with Mr Anderson's comments. I too am sick of not having enough time to treat patients holistically, if only this was do-able! And it would be if we had enough staff. I would go home at night (probably on time and not 45 mins to an hour late-unpaid) without feeling the guilt of not taken more time with the patient hygiene and or nutritional needs, or even not getting the time to hunt for suitable perfume/aftershave make up etc. I only wish I could do all this and not feel terrible at the thought of being in hospital and getting enough attention just to make me feel me...

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  • Identity Crisis?
    Oh my Dear, you need to present your own image by concerning yourself with looking after patients which is what nursing is or used to be all about, you can't expect others to help you raise your self-esteem or find some image for you! One would hope others are busy looking after patients and not wasting time on such trivialities - whatever has happened to professionalism - youngsters still have a lot to learn! If nurses were doing the job they are trained to do they wouldn't be so preoccupied by their own image.

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  • Typical arrogant attitude of the 'older' Nurse in the last comment, Anonymous | 7-Apr-2010 4:41 pm.

    Of course all us youngsters are all work shy skivers aren't we? We all got into Nursing because it pays the rent, none of us care about our patients do we?

    Sorry, sarcasm over now.

    Let me say this, and I think I can safely speak for the majority here, those of us who have only been working as a Nurse for a relatively short time ARE extremely professional, we ARE doing the job we are trained to do, and we ARE certainly busy! The problem is as others have said, we are often prevented from doing the job we are trained to do because of management incompetence, government targets and lack of trained staff!

    Let me also say that the job we are trained to do is also vastly different than it was in your day.

    The holistic patient care aspect of the job is still there, it always has been and always will be.

    But we are also now trained to be 'managers and leaders', we have to contend with paperwork, reviews, audits etc from day one.

    We are also much more medically trained and skilled than Nurses once were, with increased autonomy, accountability and responsibility as a result! We also have vastly different job descriptions!

    It is this last aspect in particular that I would like to see more of a focus on for any 'image strategy'. I am a highly skilled and competent professional Nurse, I have worked bloody hard for this role and yes, I would like some recognition for that! Is pride in one's profession so wrong? Is it wrong that I am tired of people saying to me 'two degrees and I'm JUST a Nurse?'

    The public do need to get a clue about exactly what it is we do as Nurses. Not only for our own pride in our professional image, but also for the fact that our patients need to be secure in the knowledge that they are being treated by qualified and skilled professionals when they see a Nurse, especially with the proliferation of Nurse led clinics etc and the growth of primary care.

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  • Firstly using bad language doesn't help the image of nurses and their professionalism as the public also have access to this journal through the newsagents, libraries, internet, etc. and sometimes even contribute to the comments.
    Secondly we should all be working together towards providing excellence in patient centred care and not discriminating against older and highly experienced nurses. I have no doubt that most dedicated nurses do work very hard what ever age we are and keep up to date with all the latest technologies, guidelines and evidence based care. In fact 'older' nurses have to work very hard to learn and keep abreast with IT, digital equipement and all the latest technologies as we did not grow up with these and furthermore many of us have higher degrees such as an MSc or PhD and are able to inspire confidence in our patients and colleagues with our skills and competencies and not by worrying about whether we are presenting a positive or negative image. We are too busy thinking about and meeting the needs of the patients, their families our colleagues in the multidisciplinary team and fulfilling the contractual needs of our employers to worry about this. Then an image will be created automatically which will hopefully be positive.

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  • Anonymous | 7-Apr-2010 8:39 pm,

    First of all, since writing has no inflections, gestures or body emphasizers to punctuate and emphasise its points, swearing is a legitimate reinforcement of our vocal qualifiers when it is used to emphasize a point, as I did and not used as a simple insult, which I did not. You are welcome to argue the academic and professional merits of this in another forum.

    As for the primary point, of course you are right, many older Nurses do have higher degrees and experience that inspires confidence and is worthy of respect. However there are some that do not, those who dismiss students, newly qualified Nurses etc as poorly trained counterparts to their 'superior' training (because they never spent too much time in the classroom in their day!) And that is the attitude I was railing against (as I have on other posts immediately prior to my last one).

    Now my point is that whilst it may seem lower on the list of priorities as you suggest, and a large part of it does indeed come automatically from our skill levels and professionalism and patient experience, the image that we as Nurses have IS important.

    Yes we are all busy meeting the needs of our patients, that is a given. But that does not mean you can dismiss out of hand other considerations.

    First of all like I previously stated, our image allows our patients to understand exactly who to turn to for specific advice. This is even more important for elderly patients who may not be used to the increasing plethora of Nurse led services, NHS direct, walk in centres, etc etc and are simply used to their GP for minor things and hospitals for everything else. The NHS IS changing and not everyone can understand it. They may not be used to, or like, the fact that it is increasingly likely to be a Nurse who will complete the cycle of care for them, they are increasingly likely to diagnose, treat, prescribe and follow up a lot of ailments.

    Secondly it allows us to become better patient advocates within the MDT and gives us academic and professional respect amongst our peers. Our increasing education and training allows us to, not compete, with Doctors, but certainly be considered on par with them professionally and work together to secure better treatment. I personally have been spoken down to by one or two Doctors who still percieve Nurses to be inferior, only to argue my point academically using evidence based practice, and therefore have secured better treatment for my patients.

    Third, and I admit we are not even close to this yet, a single professional image is important for the profession to come together as a coherent whole, rather than the disparate and broken profession we seem to be at the moment. When we work together as a coherent whole, we will be able to come together and demand better working conditions for ourselves and better conditions for our patients, such as in the aforementioned strikes for example.

    Professional image IS important for so many reasons; and just because I believe that does not make me any less of a Nurse or imply that I care for my patients any less.

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  • 1) Nurses are the public's main perception of the NHS because they are the biggest clinical workforce. They don't like the NHS ergo they have a poor perception of nurses.

    2) Many more 'extended' 'advanced' 'practitioner' roles - if you've done your time working on a hell hole acute medical ward with the constant crisis management and lack of resources wouldn't you take the opportunity to side step all the daily horror into the lovely fluffy world of noctoring? Unfortunately too many skilled and knowledgeable staff disappearing off the wards which de skills the non noctor workforce. How many noctor practitioners have a real input into the education and mentoring of ward nurses?

    3) Look a the pool of people who your recruiting from. Really take a long hard look at it and ask yourself why nurses suffer from a poor image in the public.

    Not too hard now is it?

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  • In addition to the ability to put into practice skills and knowledge learned and developed, attitude and confidence in one's ability and that of others, belief in the work being carried out, and respect and unconditional positive regard for all those with whom one comes into contact is paramount to 'image' even when their ideas or beliefs may be different or come from a different year or school of training. An open mind and willingness to learn from everyone no matter what their level and from patients as well provides a far more motivating environment and higher standars of care from which an 'image' will follow automatically without the introspection that detracts from concentration on the tasks in hand.
    Rivalry between colleagues of the same and different professions and those junior in years or 'considered junior in rank or lower down in the organisational hierarchy' (an attitude which is hopefully dying out) engenders negative attitudes and consumes precious time and energy which should be used in caring for patients and fostering interpersonal working relationships. Whether patient, ward cleaner, nursing director, doctor, professor or visitor all are entitled to the same level of respect from everyone else.
    Minds which are open to learning from each other, and that includes everybody one encounters, as well as keeping up to date with new skills and technologies, evolving teaching techniques and methods of appraisal creates positive ttitudes 'images'.
    If all this really fails then perhaps their is a need for a team of life coaches to come and further drain the financial resources of the NHS. They have a wide range of skills and tools to create new individual, group and corporate 'images', if that is really what is required, from logos, to uniforms, to changes in the attitudes and behaviours of individuals and collectively in the nursing team and even the interdisciplinary team. However, if one is clever enough to qualifiy as a nurse there should be no difficulty in projecting an 'image' of confidence, flexibility, kindness, respectfulness and efficacy and all other qualities contingent to the provision of nursing care of the highest standards. Confident and capable indiviudals have no need to obsess about their image or the impact they have on others or feel any need to put others down to inflate their own self-image. Therefore their minds are free to concentrate fully on their chosen profession and the work they do, and this work involves not only caring for patients and clearing out cupboards but also taking personal responsibility along with everybody else to foster a collegial and efficient workplace and therapeutic environment for their patients.

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  • I am just I am just about to start out as a student nurse, starting in September all going well with exams. Because I am just about to start allot of my peers have feel a need to articulate their views on the modern day nursing profession to me which, for them, ranges from “All you’ll do is wipe bum’s, clean people and feed people” to “Ah you’re going to be a nurse... but you’re a man”. Allot of them are shocked to find out that most nurses starting out in their career today have degrees. Some times I feel like screaming at these people, I think the public fail to recognise just how much work is involved in everyday nursing. Don’t get wrong I am under no illusions, I will have to wipe the odd bum or two however it appears the public still hold some very out dated views on what a nurse actually dose.

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