Chapter 2 The Contemporary Image of Professional Nursing Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Images of Nursing Magazines Television Movies Statues Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

The Nursing Shortage Employment rate projected to increase by 22%; projected to grow faster than all occupations until 2010 By 2025 the U.S. is projected to need 260,000 more RNs than will be available Number of foreign graduates is small Strategies to entice retired nurses back into practice will produce little, because 84.8% of licensed nurses are in practice Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

The Nursing Shortage (cont'd) Nurse Reinvestment Act funded at $20 million was signed into law August 2002 Nursing scholarships Public service announcements Faculty loan cancellation programs Geriatric training grants Nurse retention and enhancement grants Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Patient Protection and Affordable Care Act (2010) Increased student loan amounts Provided $50 million/year to fund nurse managed health centers Funded gerontology nursing fellowship programs Provided up to $40,000 in educational loan repayment for nurse faculty and $80,000 for doctorally prepared nurse faculty Strengthened Title VIII advanced nursing education grants Graduate nursing demonstration grants to hospitals providing clinical training for Advanced Practiced Nurses Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature Antiquity’s image of nursing Literature Earliest references to nursing are in the Bible and chronicle the action of two nurse midwives in approximately 1900 bc Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) Victorian image of nursing Literature Charles Dickens’ portrayal of Sairey Gamp, the drunken, physically unkempt, and uncaring nurse who used nursing to profit from the sick and dying Henry Longfellow’s portrayal of Florence Nightingale as heroine Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) Florence Nightingale Created a positive image for nursing Her success in improving the health of British soldiers against overwhelming medical obstacles was the beginning of modern nursing One of the early users of statistics; developed the pie chart Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) Early 20th century nursing Art: opportunities offered to nurses by war captured the attention of artists and portrayed nurses as dedicated, heroic, and caring Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) The 1930s: the nurse as angel of mercy Media images and art: radio programs, movies, and sculpture portrayed nurses as dedicated, intelligent, brave, and compassionate, and portrayed nursing as a holy vocation In 1936, Warner Brothers’ movie The White Angel chronicled the professional life of Nightingale; it was endorsed by ANA in 1992 In 1938 a tall, white, imposing statue, the Spirit of Nursing was placed in Arlington National cemetery to honor military nurses Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

1. While one is visiting Arlington National Cemetery, a large limestone statue, the Spirit of Nursing, can be seen. This statue honors: A. Florence Nightingale’s accomplishments in public health. B. Nurse Rivers, who advocated for victims of the Tuskegee experiment. C. Clara Maass, who found the cure for yellow fever during World War II. D. All military nurses for their bravery and compassion. ANS: D Rationale: D is correct because the Spirit of Nursing statue was placed in Arlington National Cemetery to honor all military nurses. A is incorrect because the Spirit of Nursing statue pays tribute to all nurses who have served in the military, and although Florence Nightingale provided care to the soldiers in the Crimean War, she did not actually serve in the military. B is incorrect because although Nurse Rivers advocated in the end for participants in the study, she followed orders, and it is questioned whether she thought an unethical situation had occurred. C is incorrect because Clara Maas did indeed die of yellow fever, and she has been honored with a postal stamp. Level of Difficulty: Comprehension Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) The 1940s: nurse as heroine Nurses were commemorated as war heroes through movies, stamps, and the naming of a U.S. Navy destroyer for a Navy nurse, the USS Higbee After significant contributions during WW II, nurses found low salaries and poor working conditions at home Glamorized in romance novels such as Cherry Ames and Sue Barton series Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) Nursing in the antiestablishment era of the 1960s Media images and art Television shows: nurse as a background figure to physicians Movies: nurse as a power figure who cruelly punished patients Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) In reality, nurses were making significant contributions to health care Served at the forefront of public health initiatives Central figures in the development of coronary care units and the performance of hemodialysis First nurse practitioner programs began A U.S. Bureau of Labor study indicated that salaries of nurses were woefully inadequate in comparison with other, far less trained American workers Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) Nursing in the sexual revolution of the 1970s Media portrayed nurses negatively—uncaring nurse in M*A*S*H One positive image was the commemorative stamp of Clara Maass, who died after deliberately obtaining two carrier mosquito bites so she could continue providing care to soldiers with yellow fever during the Spanish-American War Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) Nursing in the 1980s and 1990s Media images Movies portrayed nurses as nonjudgmental, caring, knowledgeable, and heroic—Miss Evers’ Boys, The English Patient, Love and War, Paradise Road Artistic portrayals of nursing focused on caring Advertisements portrayed nurses as sex objects Vietnam War Women’s Memorial Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing in Art and Literature (cont'd) Millennial media The image of men in nursing Usually absent in the media Movies and television: Meet the Parents, ER, Grey’s Anatomy, Scrubs, House, HawthoRNe Media campaigns for nursing Sigma Theta Tau International (STTI) study of 20,000 articles published in newspapers, magazines, and other health care publications (1998) indicated that nurses were cited only 4% Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing’s Response NSNA Image of Nursing Program Center for Nursing Advocacy Nurses for a Healthier Tomorrow Campaign for Nursing’s Future—Johnson and Johnson; $30 million Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

2. What company invested 30 million dollars in a campaign to reduce the nursing shortage? A. Pfizer B. Merck C. Johnson and Johnson D. Kellogg ANS: C Rationale: Answer C is correct because the Johnson and Johnson company invested 30 million dollars in a media campaign to increase awareness of nursing as a desirable rewarding career choice. Answer B is incorrect because Merck is a pharmaceutical company that has not been involved in a campaign to promote nursing as a career. Answer D is incorrect because Kellogg is a cereal company that has not been involved in a campaign to promote nursing as a career. Level of Difficulty: Knowledge Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Nursing’s Response (cont'd) Nurses of America Campaign: A 1990 campaign implemented by the Tri-Council with funding from the Pew Foundation, which was designed to: Convey to the public that nurses are expert practitioners who are able to interpret technical data and coordinate and negotiate health care Make nurses aware of the invisibility of nursing in the news media Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

The Enduring Public Concern with Nursing What the public believes about nursing: Gallup Polls ranked nurses first for having honesty and ethics 2001 World Trade Center attacks resulted in the public viewing firemen and nurses as heroes Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

The Reality of the Contemporary Staff Nurse Modern health care institutions exist to deliver nursing care The public highly values the profession Nursing’s heroic and noble public image is etched in stone, glass, and canvas Nurses have a high sense of satisfaction with their profession Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

The Reality of the Contemporary Staff Nurse (cont'd) Graduates are entering the profession at younger ages More than half of nurses practice in a hospital 40% of all health care professionals are RNs American Assembly of Men in Nursing is dedicated to positively influencing factors that affect men in nursing In a female-dominated profession, 41.1% of CRNAs are male Ethnic nurses are most likely to attain graduate degrees Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Creating the Image of the 21st Century Nursing is knowledge work Failure to rescue data documents human and financial loss when nursing judgment is not available Improving the RN/LPN skill mix and increasing RN hours decreases adverse outcomes Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Changing Nurse-Physician Interactions Understanding the mysteries of medicine In exchange for hospital privileges, physicians agree to abide by a set of medical staff bylaws that include a disciplinary process Nurses who work with a physician whose practice is substandard may wrongly believe that the problem is a nursing problem; in reality, the problem must be addressed through medical staff bylaws Communication is an ongoing problem for nurses and physicians; both disciplines need to be respectful of these issues Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Why Is This Happening? The look of nursing Nurses engage in numerous self-sabotage activities Inappropriate dress Inking and tattoos Deferential positioning in meetings and during collaborative activities Wearing nursing uniforms in public places Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Creating a New Image On a positive note: Nurses should tell everyone what nurses do well and should keep disagreements in-house Nurses should think carefully before disagreeing with each other and should conserve energy for important issues Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Creating a New Image (cont'd) Value nursing; project it daily Nurses should take themselves seriously and dress the part Recognize the benefit of membership in the American Nurses Association, Sigma Theta Tau International, National League for Nursing, and specialty organizations Portray the profession positively Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Creating a New Image (cont'd) Be highly visible to patients, families, and physicians Make negative comments only to other colleagues Be active in professional organizations Recognize the value of nursing’s contributions Value caring, health promotion, and health teaching Copyright © 2014 by Mosby, an imprint of Elsevier Inc.