Factors contributing to nursing shortage

Image of art, media, literature, and architecture over time

Nursing actions that convey a negative image of nursing

Strategies to enhance the image of nursing

Magazines Television Movies

Average ages Nursing graduate = 33 years Community college graduate = 44

years By 2015 more than half of U.S. RNs are

predicted to retire New career opportunities for women Declining number of students Effect of media images of nurses

By 2006 the U.S. Bureau of Labor Statistics predicts that jobs for RNs will have increased by 21% in comparison to 14% for all other occupations

By 2020 the need for hospital RNs will have increased by 36%

Hospitals are competing with medical groups, insurers, and dot-com companies

Antiquity image of nursing Literature

Earliest references are in the Bible; two nurse midwives

Art 16th century BC; statuettes portrayed midwives 11th century AD; hospitalers portrayed as

soldiers 12th century AD; religious order or person of

wealth

Advocates and protectors

Untrained servants

Soldiers

Respected caregivers

Charles Dickens portrayed Sairy Gamp as drunken and uncaring

Henry Longfellow portrayed Florence Nightingale as a heroine

Created a positive image for nursing through her success in improving the health of British soldiers

Her work was the beginning of modern nursing

Early user of statistics; developed the pie chart

Art—Images of war portrayed nurses as dedicated, heroic, and caring

Architecture—Nursing school buildings symbolized nurses

Nurse portrayed as the angel of mercy Nurse portrayed as dedicated, heroic,

and caring 1936 movie The White Angel chronicled

the professional life of Florence Nightingale (endorsed by the American Nurses Association [ANA] in 1992)

Nurses commemorated as war heroes through movies and stamps

U.S. Navy destroyer named for a Navy nurse

After World War II, nurses had low salaries and poor working conditions

Media images and art Television — Nurse as background

figure to physicians Movies — Nurse as power figure, cruel Canvas — Nurse as worried, angry

Served in the forefront of public health

Central in development of CCUs and performing hemodialysis

First nurse practitioner programs began

Salaries inadequate compared with those of other less trained American workers

Negative media image—Uncaring nurse in Mash

Positive media image—African-American nurse in TV series Trapper John, M.D. (important because Louisiana was the last state to admit African-American nurses to the State Nurses Association in 1964)

Media—Movies portrayed nurses as nonjudgmental, caring, knowledgeable, and heroic

Advertisements portrayed nurses as sex objects

Art portrayed nurses as caring Architecture portrayed the

importance of nursing through impressive buildings for schools of nursing

Usually absent in the media Movies and television

Meet the Parents ER Trauma Life in the ER

Public roles Dr. Carolyn Davis, RN—

Appointed by President Reagan to head Health Care Financing Administration (HCFA)

Dr. Shirley Chater, RN—Appointed by President Clinton as Commissioner for Social Security Administration

Nurses of America Campaign conveyed to the public that nurses are expert practitioners

Goal of the campaign: Make nurses aware of invisibility in the media

Too few RNs Inappropriate use of unlicensed

assistive personnel (UAP) Honesty and ethics Feminine, nurturing characteristics Knowledgeable, essential Hears nurses’ negative messages Seeks nursing advice

Modern health care institutions exist to offer nursing care

Public highly values the profession Nursing’s heroic image is etched in

stone, glass, and canvas Surveys indicate one in four nurses

plans to leave 40% of nurses would not recommend

their practice setting

Nurses marketed as caring, individualistic, holistic, yet unable to meet patient expectations

Patient advocates who cannot fix the system

Unrealistic understanding of health care reform

20% to 50% of RNs being replaced with multiskilled, unlicensed workers

Nurses doing more with less Patients angry about early discharge Nurse practitioners battling for full

acceptance as primary care providers

Patients are indirectly buying nursing care

Buyers seek to purchase services at lower costs

Profession has failed to use power No control over enrollments Fewer than 8% belong to

professional organization

Communication Understand the mysteries of medicine Understand the effect of

communication patterns on image First name Positioning Allow interruptions

Inappropriate dress

Deferential positioning

Wearing nursing uniforms in public places

Wearing nonwhite

uniforms

Reserve term nurse for registered nurses

Understand the legal scope of practice

Avoid first names Increase comfort with proclaiming

name, practice, and contributions

Reclaiming the name Reclaiming personal identity Reclaiming the birthright Reclaiming the practice Changing the song

Nurses should tell everyone what nurses do well

Nurses should confine disagreements

and conserve energy for important issues

Consider the implications of the “entry into practice” issue

How long can nursing justify withholding the benefits of science from patients?

Take the role seriously and dress the part

Be highly visible to patients, families, and physicians

Avoid negative comments Be active in professional organizations Value caring, health promotion, and

health teaching Recognize the value of illness care Supervise UAP to ensure excellent care

Each nurse forms the image of nursing every day