 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 ethicsFeminine, nurturing characteristicsKnowledgeable, essentialHears nurses’ negative messagesSeeks 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

 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