The public and professional images of nursing and the portrayal of nurses in the media have a great impact on several work-related issues – how health care as a collaborative enterprise is provided to patients, the extent that nurses’ work is valued, the participation of the nurse in healthcare team decision-making, the visibility of nurses in shaping national health care and the effect of these images on nurses’ job performance (Fletcher, 2007.
Most researchers agree that although there have been improvements in the image of nursing, the portrayal today is still largely negative – an issue that has been raised by nurses for the past century. Gender issues seem to be at the core of this situation.
Other disciplines, specifically the medical profession, view nurses based on certain qualities. In a study by Weinberg, Miner and Rivlin (2009) on the perspectives of medical residents on working with nurses, nurses were trusted and regarded as colleagues depending on how competent, congenial and hardworking the residents perceived them to be (p.37).
This implies that the collaborative approach does not always permeate the nurse-medical resident relationship despite nursing practice being elevated into a profession that is equal to other health disciplines. To be respected as a colleague requires a condition – nurses must first have to prove that they possess the qualities expected of them.
Meanwhile, the media reinforces the image of nurses as a health worker that is lower in status than physicians or as other concepts other than being a professional. In a literature review conducted by Fletcher (2007) concerning the media portrayal of nurses, the author found that television shows, novels, films and advertisements then and now mainly portray nurses in four categories, namely “as ministering angel, battleaxe, physician handmaiden and naughty nurse” – negative images because these do not capture the reality of nursing (p.208).
As an acute nursing shortage looms ahead, the campaign to improve the image of nursing, in order to attract more students into the profession, yielded a positive outcome. A recent Gallup survey on professional ethics and honesty found that 84% of Americans agreed that nurses are the most trusted professionals (Singleton, 2009). The Gallup survey image of nurses represents a positive development because nurses were viewed as professionals who are bound by a code of ethics and who adhered to such a code.
Both the positive and negative images of nursing seem to reflect the unequal power relationship between men and women in society where women are viewed as either sex objects or as domestic partners. The end product is a stereotypical view of women’s roles as subservient to men.
Along with this role are the associated feminine traits ranging from obedience, hard work, compassion and congeniality to promiscuity. The physician-nurse relationship reflects these stereotypes as physicians are disproportionately male and while nurses are disproportionately female. As a male-dominated profession, the physician’s work is highly recognized and valued while the nurse’s work is undervalued and unrecognized.
Because of the stereotypes reinforced by media, the public largely identifies nurses only with bedside care and with carrying out physician’s orders. Most would think that since the work involved seems trivial, nurses do not need to obtain a 4-year BSN degree. They do not see the complex daily responsibilities of the nurse that requires education, training and autonomy or the current scope of nursing practice. As such, they fail to appreciate the significant impact of nurses’ work on patient health and outcomes.
Although men have enrolled in nursing, it is still mainly a women’s profession and as Lavinia Dock (cited in Fletcher) aptly put it, “the status of nursing in all countries and at all times depends on the status of women” (2007, p.210). Because the nurse is a woman in a caring profession, expectations of her relate to female gender roles as well. Hence, further improvements in the status of women will similarly uplift the status of nursing.
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