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Allison is a registered nurse and senior health policy adviser with some 25 years experience. Prior to launching CPD Nurse Escapes, Allison worked as a private consultant for a diverse range of clients in the government and non-government, health, community and education sectors. Allison has an extensive background in regulation, governance and professional practice and applies this in education, policy development and project management. Allison was the Principal Advisor, Professional Practice at the Nursing & Midwifery Board of South Australia, for 10 years where she was responsible for developing nursing and midwifery policy and standards and advising and educating nurses and midwives on professional practice issues.

Tuesday, 13 December 2011

Nursing stereotypes...what do we do to change them?

All you have to do is type ‘nurse’ into Google images and you will see every stereotype of nurses from angel to devil. Are these stereotypes really ever dispersed? What do the public really think of nurses? We are no more angels of mercy than we are naughty nymphets. Nurses remain misrepresented in and the public remain ignorant of the important contribution nurses make to health care.

We have reality talk shows like Dr Oz (Nov 2011) showing a line-up of naughty nurses  dancing provocatively with him, wearing high heels, retro nurses' caps and white dresses with red lingerie showing.  We have popular TV dramas like Grey’s Anatomy representing nurses as largely absent from the provision of care (performed mainly by doctors) and portrayed as 'kind but dumb' nymphets. How can we even hope to change the perception of the public?

Nurses are as negatively stereotyped today as they ever were, even though the profession has become a highly educated and technologically expert field of health science, along side its healthcare colleagues, and there is innumerable evidence that where nurses provide care, morbidity and mortality rates decline.

I suppose we should ask ourselves, are these stereotypes deleterious to nursing? Do the public believe them or are they just a bit of fun? 

Not all stereotypes are negative in nature. The image of the Angel of Mercy is one of a self-sacrificing, morally superior, noble nurse, selfless, altruistic and a reliever of suffering - based on the origin of nursing in the religious orders. The Heroine is the depiction of a brave, tirelessly dedicated nurse with its origins of war time nurses, virtuous – the good nurse ideal.

The trouble with these stereotypes is that they are no more accurate of nursing today than the negative images. The problem for nursing is that the common stereotypes are unrelentingly negative and totally removed from the reality of nursing. 

If public does not understand the complexity of nursing practice, it can’t support nurses fight for the necessary resources and infrastructure that enable nurses to do their work.  If the role of nurses is discounted and demeaned by these images then the public will not recognise the importance nurses play in meeting their health needs nor cry out when nursing numbers decline with the ever declining health dollar.

Although the public continue to hold nurses in the highest regard in relation to qualities of honesty, kindness and caring, the public have more faith in the doctor's knowledge than the nurse's knowledge. Although the public hold nurses in such high regard, it is deeply concerning that they do not have equal belief in the nursing professions level of professional knowledge and expertise. This view appears to be supported by the Gallop Polls (refer Nursing Autonomy Part 3).

But do nurses work at changing this perception or do they passively accept the stereotypes?

Have a look at the first images below. When I show these two images to nurses I ask them to describe who they see in the pictures. In the image on the left nurses routinely describe these as - a female doctor with two males nurses behind.  Nurses routinely describe the image on the right as - three doctors. When I ask them to explain why -  they rationalise that the first image shows the women in different scrubs and standing in front of and taller than the two men, hence this position of seeming authority must mean she is a doctor! They're rationale therefore that the subordinate positions must therefore be nurses!

The second image shows the same three people but now dressed identically and at the same height. When I ask nurses who these people are the most common response is - three doctors. When I ask why they couldn’t  be three theatre nurses the usual rationale is they were three nurses, there would be no doctor present and therefore unlikely!   I am astounded that nurses identify with these images in this way and seem to accept (and foster) the subordinate stereotype of nurses. 

Have a look at the images in the next slide. These are all generic stock photographs found on the web. What do you see these images representing? Be honest with yourself. Do you automatically identify with the subordinate images? Do you see the male roles as more likely to be a doctor? Do you see the person giving information as the doctor and the person listening as the nurse (taking orders)?

The next image is a poignant example how nurses are portrayed in the media (to the public) and how detrimental this is to our profession.  

The two photographs are from the Minister for Foreign Affairs, Mr Kevin Rudd’s, official website. The caption for the first image identifies the medical officer by name and even summaries the nature of the conversation he has with the Minister “....he relays the typical medical conditions presenting at the Camp Cockatoo Health Centre."  Mr Rudd attentively listens to what the doctor has to say.

The second image is captioned “Mr Rudd meets two Australian nurses with the AusAID civilian team” and even included in brackets “(names not known)”  We see two nameless, faceless nurses, Mr Rudd shaking hands with as he walks past. Did the nurses have an audience with Mr Rudd as he did with the doctor? Did he ask or was given their names? Did they have the opportunity to discuss nursing issues in Camp Cockatoo? Did the photojournalist take the time to ask the nurses their names so he could reference this information with the photographs (as he did with the doctor)? I somehow doubt it.

So how do we want to be represented? What images do we want the public to see when they Google us? Aren't these images amazing?

Isn't this what we want the public to see..to know, about nurses?



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