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24 Men in l October 2008 www.meninnursingjournal.com By Mary Hereford, RN, PhD, and Kathy Reavy, RN, PhD who want to pursue an engaging, challenging, and rewarding career that involves a high level of commit- The fictional nurses on TV and in the movies are just ment and service to others. Nursing needs to be correct- that—fictional. But they do influence how the public ly depicted in the media, so men and women discover perceives who nurses are and what nurses do. that it’s a well-paid, high-tech career offering a variety of The public gives nurses high ratings for being ethical employment choices seldom found in other professions. and trustworthy, but nursing is low on the list of profes- Part of the problem with the image of nursing—and Tsions that people find desirable or wish to pursue.1,2 thus, with recruitment into our largely female profes- The public has a widespread acceptance of nursing in sion—is the gender stereotype. Gender stereotypes may general, but a limited understanding of what nursing accurately reflect a certain individual’s or group’s behav- roles exist beyond the routine tasks.1-3 ior, but they may be so simplistic that they are inaccu- Both the fictional portrayal and the public perception rate.6 This inaccurate simplicity is apparent in the por- of nurses clearly affect whether young men and women trayals of men in the fictional realms of television and choose nursing as their profession. They also affect the movies. nursing students who believe the portrayal of nursing Nursing advocates want more men to enter the pro- on television and in the movies has led the public to see fession, but only about 5% of U.S. nurses are male.6 That it as a profession in crisis and as an unattractive career percentage hasn’t changed much in the last 10 years. in a physician-centric world, where nurses only follow Again, public perception plays a role. The public sees orders.4 men as not having the nature to become nurses. Most experts believe that the stereotype of nursing as a Image and the nursing shortage female-oriented profession is part of the problem, and Today, we face a nursing shortage that will affect every only recently have recruitment strategies been aimed at U.S. citizen in some way. The shortage may mean higher attracting men.7 medical costs, less care for a loved one in the healthcare system, or an inability to receive needed care. What male students say Nurses are leaving the profession in unprecedented In a 2005 study on the image of nursing, 14 male and numbers partly because of the aging workforce, but also female students were asked about the fictional image of because many other professions offer more pay, better nursing on television and in the movies.8 (See “What hours, and greater benefits. Today, nursing students say about the portrayals nursing is struggling to keep and perceptions of nursing.”) its most talented and Responses from male students ….I skilled nurses. don’t wan suggest that fictional nurs- t anybody The long-term effects to ever a ing is still steeped in the sk me again of the changes in the going if I’m female tradition. Here are to be a doc healthcare delivery sys- tor once I’m a few responses from done bei tem in the 1980s also con- ng a nurse. male nursing students: tribute to the shortage. Two “….I can tell you as a guy get- decades ago, nurses were seen as ting into nursing, I definitely want expendable. Hospitals replaced them with to see that anything with nursing represented people who lacked a higher and to the public involves male nurses. If all they do is keep were willing to work for less money doing nursing tasks showing women, it won’t help anything….” that hospital administrators thought were unimportant.5 “….I don’t want anybody to ever ask me again if I’m By the time administrators realized the importance of going to be a doctor once I’m done being a nurse. Or, if I nurses, a vacuum had been created in the profession. want to be a Physician’s Assistant (PA) after I’m done So what does this have to do with the perception of being a nurse. You know, it is just ridiculous to think that nursing? During a critical nursing shortage, perceptions way…” of the profession are extremely important. If nursing is “The public sees a man who is a nurse, and . . . thinks, portrayed accurately, the profession can draw people oh, he must be nurturing to a point. But they also think

www.meninnursingjournal.com October 2008 l Men in Nursing 25 What nursing students say about the portrayals and perceptions of nursing

In a 2005 study, nursing students gave their opinions on how fictional portrayals of nurses affect the public’s per- ception of nursing, their own career choices, and nursing recruitment.8 Here’s some of what they had to say.

Public’s view “My initial avoidance of nursing as a career [was influ- “The public still sees us as order followers.” enced by] television.” “I don’t see enough on the shows where nurses are re- “I do not feel the media has affected where I want to ally out in the community and doing nursing.” work.” “They [the public] think of nurses as just doing dirty “It has made me defensive about where I want to work.” work in a hospital.” “I don’t feel that television or the movies have influ- “I think the public’s perception of nursing comes from enced where I want to work once I graduate from nurs- its motherly role, taking care of people and that sort of ing school.” thing.” “They show a very narrow view of what nurses can do.” “I think the public probably thinks that TV has drama- tized nursing a little bit.” Nursing recruitment “I am sure there has been a boost of nursing appli- “Some people might see it as a whole bunch of work cants and people trying to get into be- and not a lot of recognition.” cause of the images on television.” “The general perception of nurses is that they give you “I think the media makes the job look exciting and fun.” a pill and fluff your pillow.” “I think men might like that there are a lot of women Career choices in nursing.” “The media has impacted where I want to work.” “I feel the images of nursing do not help recruit people “They [television and movies] target the areas where I into the field because nursing is portrayed as a degrad- want to work, like the emergency department or inten- ing field.” sive care unit.” “The most positive things you see about nursing are “I like trauma and feel television has influenced where commercials.” I want to work.” “I feel the media shows nursing school as easy and “I think the media has really influenced me. I like that something you can do overnight. I think movies like kind of on-the-edge, different, unique specialty.” Meet the Parents don’t help people think of nursing.”

“I know from watching ER that I never want to work in “I really don’t see a lot that would encourage a man to that area.” become a nurse from the media portrayals.”

he is a sissy or . . . he doesn’t have what it takes to regarding the public’s perception of nursing weren’t so become a doctor. And I think society says one thing, but different from those of male students. Here are a few at the same time you are being judged in another way.” statements from female nursing students: “…I think the public gets its perception of nursing What female students say from where nursing started. We have always been tradi- Nursing has been viewed as a woman’s profession since tionally female. Nurses still hang on to tradition…the Florence Nightingale’s time, though men were the first media sees that and so does the public. And that is why nurses dating back to the Crusades and Knights I think the public still sees us as just following orders…” Templar. In historical literature, men are favored as nurs- “I think the images of nursing that the media portrays es because they are considered better suited to leader- are really negative. I don’t think that people realize the ship and administrative positions.9 Female nurses may specialties . . . They think of a nurse as just doing dirty be marginalized because they are seen as better pre- work in a hospital. They don’t realize there are so many pared to be the caring patient advocates who remain at aspects to it.” the bedside, delivering care that is traditionally consid- “I think the public’s perception of nursing comes from ered women’s work. its motherly role, taking care of people and that sort of Female nursing students’ responses to questions thing.”

26 Men in Nursing l October 2008 www.meninnursingjournal.com Effects on career choices nurse” because you never see a male nurse. And the The study found that the fictional images of nursing on female nurses that are on television, half of them are television and in the movies played a part in career portrayed as idiots…” choices and job opportunities for both male and female students. Here are some responses regarding employ- Nursing’s voice ment: Where does the nursing profession go from here to “..Well, I like trauma. I like the fast pace and the adren- attract and retain the brightest men and women? Not a aline rush. That is what I see on television all the time, lot has changed since the early 1980s when Kalisch and the fast pace and the adrenaline. I know it isn’t always Kalisch completed their first research on nursing’s going to be like that, but the shows really hold my inter- image in the media.10 Nursing needs to be proactive in est and have influenced my career choices…” speaking about the work nurses do and the education “Television shows have influenced me not to work in required to be a nurse. Campaigns to recruit young the emergency department. I don’t know if that is people into the profession because they portray it as so chaotic, but it has kind need to reach the ia of scared me to work in a hospital because of the med youngest students in the fact that the television shows make it look like hink look the elementary I t e job the nurses are overworked and not respect- es th n. schools. Both male mak nd fu ed by the physicians. They make it look like ing a and female nursing stu- excit it is not very much fun...” dents voiced concern about “I think if I had been the public’s perception of nursing going into nursing depicted in the media. Students right at the time expressed alarm that the media portrays The when Meet the gene the nursing profession in an unflattering nurs ral p Parents came out es is ercep manner. p that tion and from some of ill an they of Nursing has been a silent profes- d flu give the images I have ff yo you a sion. It’s only beginning to find its ur pi seen on ER and SCRUBS, llow. voice. Nursing professionals have I don’t know if it would begun speaking out about what nurs- have necessarily gotten me to ing does and what effects it has on peo- say, no I don’t want to do this. ple, communities, and the nation. The impact nursing But...it would have made me think has on the nation’s healthcare system should be a con- twice about it…” cern for all citizens and must be discussed openly and honestly. Effect on recruitment Nurses can participate by taking opportunities to How does the media’s portrayal of nursing affect recruit- teach. Not just teaching patients or students in a nursing ment into nursing programs? Students had this to say: curriculum, but teaching the public. First, talk to people. “I am sure there has been a boost of nursing appli- Bringing nursing to the public is one way to get people cants and people trying to get into nursing school to understand the profession. Speak at meetings such as because of the images on television. It is portrayed like a Rotary Clubs, book clubs, community groups, church kind of high-profile career because of these shows…” groups, youth groups, school meetings, and school fairs “I feel the images of nursing in movies and television to let people know about nursing. hinder the recruitment of people into the field because I Bring your passion. Let people know why nursing is think that they portray nursing as a kind of degrading exciting, interesting, and challenging. Speak about the career. Also, they portray nurses that are usually starting salaries and the opportunities available to nurs- women, and they show a lot of lazy nurses on televi- es. Talk about the degrees in higher education available sion.” to nurses and the difference nurses make in people’s “I really don’t see a lot that would encourage a man to lives. Discuss the research that nurses deal with daily to become a nurse from the media portrayals. There is bring cutting-edge care to their patients and students. nothing on television that makes nursing look like it Finally, nursing should learn to advertise in ways that would be a neat field and make people think, “I’ll be a bring the profession the respect other professions have. www.meninnursingjournal.com October 2008 l Men in Nursing 27 Write articles for newspapers and journals that reach 4030014A5B1/$File/consum.pdf. Accessed August 28, 2008. wide audiences. Write letters to editor. Show that nurses 4. Weber, A. Social psychology. New York, NY: HarperCollins; 1992. are valued and needed in wide ranging articles about the 5. Williams, D. Recruiting men into nursing school. Minority 11 fragile health care system. When colleagues do some- Nurse.com. 2006. Available at: http://www.minoritynurse.com/ thing remarkable, share it with the public through radio, features/men/03-21-06e.html. Accessed August 26, 2008. television, and newspapers. Volunteer to be interviewed 6. Gordon, S. Nursing against the odds: How health care cost about healthcare and nursing issues. Nurses need to cutting, media stereotypes, and medical hubris undermine nurses and patient care. Ithaca, NY: Cornell University Press; start putting themselves in the public’s eye and stop 2005. being the silent professionals in health care. Don’t let 7. Weinberg, D. Code green: money-driven hospitals and the dis- television and movies mold the image of nursing. mantling of nursing. Ithaca, NY: Cornell University Press; 2003. 8. Hereford, M. Exploring the reel image of nursing: How References movies, television, and stereotypes portray the nursing profes- 1. USA/Today Gallup Poll. 2006. Available at: http://www. sion. Moscow, ID: University of Idaho Dissertation; 2005. usatoday.com/printedition/news/20061212/a_honest_chart12.art. htm. Accessed September 17, 2008. 9. Williams, C. Still a man’s world: Men who do women’s work. Berkeley, CA: University of California Press; 1995. 2. Nevidjon B, Erickson J. The nursing shortage: Solutions for the short and long term. The Online J of Issues in Nurs. 2001. 10. Kalisch, PA, Kalisch, BJ. Nurses on prime-time television. Am J Available at http://www.nursingworld.org/MainMenuCate- Nurs. 1982; 82(2):264-270. gories/ANAMarketplace/ANAPeriodicals/OJIN/TableofCon- 11. Gibbons, S. Nursing shortage: It’s also in press and other me- tents/Volume62001/Number1January2001/NursingShortageSo- dia. Womens Enews. 2005. Available at: http://www.womense- lutions.aspx/. Accessed August 26, 2008. news.org/article.cfm/dyn/aid/2237/context/archive. Accessed Au- 3. Centre for Research into Nursing and Health. Consumer per- gust 26, 2008. ceptions of nursing and nurses in general practice. University About the authors of South Australia; 2002. Available at http://www.health.gov.au/ Dr. Mary Hereford and Dr. Kathy Reavy are associate professors at Boise State internet/main/publishing.nsf/Content/209FEF74BBC7E31FCA257 University, Boise, Idaho.

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