Getting it Right – Redefining the Image of Nursing

One of the first images of nurses most see is Florence Nightingale. Best known as the lady with the lamp, she is usually depicted standing over a wounded soldier’s bed with a lantern, her face showing care and concern.  But Florence Nightingale was so much more — she laid the foundation for professional nursing, established the first secular nursing school in the world, led social reforms and was a pioneer in the visual presentation of information and statistical graphics. But do we ever see pictures of her explaining her statistical analyses? No.

And 100 years later, we are still trying to get the image of nursing right.

Dr. MarySue Heilemann has taken issue with the media image of nursing. In her Director’s Lecture “From Silver Screen to the Web, Portrayals of Nursing in Media” given at the National Institute of Nursing Research (NINR) this past June, she raised important questions and offered some solutions to addressing the opportunity for change.

So why is the image of nurses so important to the profession? For the answer, Heilemann shared a quote by Joseph Turow, Robert Lewis Shayon Professor at the Annenberg School for Communication at the University of Pennsylvania and author of the book Playing Doctor. “Why are the images of nurses important? Some people say, ‘Well TV is just TV, it doesn’t really matter, it’s just storytelling.’ But the thing about stories is they are the intellectual diet of society. We learn about the world through the stories we tell. We reinforce our ideas about society through the stories we tell. Research has shown that people learn about occupations through stories.

And unfortunately, said Heilemann, the nursing story has not fared well. There are three difficulties in nurse portrayals on TV according to Kathleen McHugh, Professor of Film, Television and Digital Media at UCLA. “The first difficulty is that the gender is predominately female which puts the characters at risk for being stereotyped related to sexuality, maternity and femininity.  The second difficulty is that the work of nurses involves the care of people’s bodies. This puts nurses at risk of being stereotyped as angels of mercy for doing the work that others wouldn’t want to do or as battleaxes who are cold and uncaring towards the vulnerable. The third difficulty is about the requirement for compelling stories on television.” Heilemann elaborated that the hour by hour life-sustaining care given to patients by nurses offers many opportunities for compelling drama, but the stuff of nursing is usually given to physician characters, leaving no role for nurses.

Heilemann pointed out that the nurse image is of global concern – nurse scholars around the world have analyzed the image of nurses and found that incorrect images not only impact the general public, but nurses themselves in areas such as education, turnover, recruitment and work behavior. Nursing activists also believe the stereotypes reduce funding allocation for nursing.

How can the image of nurses be changed? Heilemann suggests that one way is for nurses to take the opportunity to articulate the actual work they do. For example Theresa Brown, New York Times Opinion Columnist and author, encourages nurses to look into taking classes such as the ones offered for nurses at the Center for Health Media Policy at Hunter College in New York City to learn how to communicate their profession through articles, interviews, and media.  Heilemann ended her presentation with a call to action. “We need to continue the work through activism, collaborations with partners outside of nursing, strategies to enhance the talents and skills of nurses related to media, and research so we can gain an understanding about what is effective in improving the public’s image of nursing.”


Taking My Own Advice

Heilemann’s research is focused on helping Latina women overcome the stigma of getting therapy for depression or anxiety. Inspired by a UCLA/USC conference on Transmedia

Storytelling, Heilemann realized that the use of videos, interactive digital media, and blogs to engage people in target audiences was ideally suited to nursing interventions and outcomes.

Drawing from her qualitative work with Latinas, she received an intramural grant from the

School of Nursing, and teamed up with a Latino director and a cast of Latino actors from

Hollywood to create her own series: Catalina: Confronting My Emotions. In the series,

Catalina works with a nurse therapist, Veronica Sanchez, RN, PMHNP. Veronica acts

just as nurse therapists do in real life — allowing Heilemann to tell the nurse story.

Heilemann also is collaborating with individuals in IT and Engineering to collect data

through interactive processes using smart phones, tablets and computers.