NNPBC Blog

Nursing Stereotypes: The Good, The Bad and The Ugly, by Lori Campbell RN

There has been a lot of discussion about the image of nursing in the media lately – why all the buzz?  Well, on Thursday, October 24, MTV aired its new reality show Scrubbing In, which follows a group of 20-something travel nurses in Southern California. Based on the trailer, in which these nurses are shown with a heavy focus on looking attractive, partying, and being “hell raisers”, many nursing organizations launched campaigns to convince MTV Executives that the show should be cancelled for its unfair portrayal of nurses (most of these petitions occurred before the show had aired even one episode). But this is the network that brought us Jersey Shore, Teen Mom and the Real World series - did we really think they’d produce a high-level documentary or drama series on the nursing profession?

The issue is bigger than this one show.  Every profession is dissatisfied with its portrayal in the media – because it’s difficult to show the intricacies of a multifaceted and complex profession in a cursory manner such as television.  Nurses are no different.  A quick Wikipedia search produces a list of more than 160 fictional nurses - from the battle-axe Nurse Ratched to the invisible (read: non-existent) nurses of House, to those who are portrayed as mere aides to the godlike specialists of Grey’s Anatomy and ER.

And then there’s Nurse Jackie, the lead in a TV drama series, condemned for her drug abuse and relationship issues by many nursing organizations, long before any episodes ran.  However, as the Truth About Nursing notes, “Jackie turned out to be arguably the strongest and the most skilled nurse ever depicted on serial U.S. television.”  The series portrays her courage in standing up to the powerful professional groups and organizations that threaten safe and equitable care. As the Truth About Nursing concludes, “these are vital messages to increase public understanding of nursing and funding for nursing practice, education, research and residencies.”

Although I didn’t live here at the time, I’m familiar with the campaign that occurred here in B.C. in September 2004, when Radio Station Z95.3 broadcast a TV ad depicting a group of nurses wearing skimpy outfits, dancing and singing in a Britney-Spears style music video around a hospital nursing station, until an elderly patient calls out: "It's time for my sponge bath."  The station agreed to remove the ad after the BCNU had its members write in and complain. The Union deserves a lot of credit for spearheading and pursuing that campaign until the images were off the air.

This brings up a lot of questions: What do these portrayals mean for nurses?  How has pop culture influenced the way the public perceives what we do?  How has it influenced how we view our own work and our profession?  Are negative images of nurses on TV more than just entertainment?  Do these portrayals affect real nurses and their patients?

We are in an era of nursing shortages, healthcare cutbacks, and regulatory changes.  How scary it is to think that the real skills that nurses possess as clinicians, teachers, researchers and administrators could be overshadowed by these inaccurate and incomplete depictions of who we are and what we do.

Television shows and ads like this should cause us to pause as professionals.  They should cause us to question how our profession is portrayed, and whether the ‘naughty nurse’ imagery is damaging public perception about our work.  Truth About Nursing notes that those who have actually studied the effects of media products, including the public health community, believe these portrayals do shape public attitudes and actions.

Rather than hand-wringing, let’s start an honest, open discussion about the deep-rooted stereotypes of nurses that are so prevalent in our society.  We need to think about whether these portrayals are damaging the relationships we as a profession build with the public, clients, and other professionals.  If they are, what can we do to change the perception? Are we reacting to the right things?  What do we need to change about how we present our profession to the world?

One of the barriers I perceive in helping to change this is our strict standard of privacy and anonymity.  Yes, you read that right.  We as nurses are some of the staunchest defenders of confidentiality - and we can’t easily brag about the details of our daily examples of nursing interventions that make a difference to patients and families across the breadth of the continuum of care.  Our challenge is to convey the essence of our complex professional roles through composite stories and scenarios, while abiding by our Code of Ethics.

Stereotypes and inaccurate perceptions often arise out of mystery. They fill in knowledge gaps where they exist. For many people, it is still a mystery what nurses do in our modern health care settings. If we were more intentional and less anonymous about our contributions to patient care and safety (while still protecting patient confidentiality), we might remove some of the mystery and prompt more accurate appraisals of nursing’s value and the key roles we play as part of the health care team/system

I think, though, that there are many things that nurses can do to balance and counteract the stereotypes and portrayals.  We can enhance the public’s trust in us by standing together for safe client care in all situations, advocate for responsible stewardship of our publicly funded healthcare resources, use our knowledge to educate clients at every suitable opportunity and ensure that the profession stays strong long into the future by developing and fostering leaders.

Be proud that the care you give is exemplary, ethical and safe – and share that with others.

Nurses are among the most trusted professionals in Canada (fourth - a small step behind firefighters, EMT’s and pharmacists) for a reason.  We are trusted because we are professional, we are competent, we are skilled, and we are caring.  And despite decades of stupid stereotypes, we are still one of the most respected professions on the planet.

Beat that, MTV!

 

ABOUT LORI CAMPBELL, RN

After completing her BScN at McMaster University, Lori started her career at VCH in 2005. Experiences in surgical care, intensive care, harm reduction, and Vancouver's downtown east side have shaped her passion to promote nursing practice. Her diverse practice areas give her a broad view of the role of nursing in BC and of the health-care system. Currently working as clinical educator/resource nurse in the Vancouver  Professional Practice department with VCH gives her an excellent vantage point to promote best practice, innovation, integration of technology, and enhance the knowledge base of nurses in Vancouver. A strong team player, Lori is actively involved with interdisciplinary groups in both project and committee work at VCH.

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Shauna

I'll go first. I've been reading Re-Tweetst from @BCRNs about the show and even though I've been glad to see them, I admit I was waiting and hoping that my association would come out and say something more. I'm not sure I even cared if it was for or against I just wanted to know that ARNBC is paying attention to an issue that is current.

The best thing about this post is that I didn't expect it to be different from what CNA has said. I'm so glad you didn't just follow their lead. I think probably all the buzz and protests has only made more people watch it. I like that with this post ARNBC is saying that it's about more than one silly show and we need to figure out how to fix the stereotype.

Thank you ARNBC, for posting something so smart. Nurses are in danger of actually embarrassing ourselves because of our reaction and all the campaigining on facebook and twitter, and this is a way better approach to take. That show will be cancelled because it's stupid, but the problem of how nurses are stereotyped will go on if we can't figure out how to take control.

AmyR

This is SO GOOD!

Jenifer Honda

When MTV did Jersey Shore they enraged the entire state of New Jersey, and what happened? Snooki became super famous and the show stayed on for years and even spawned some other shows. Major hit.

All of these petitions and letter-writing campaigns are only serving to gain more interest in the show, more viewers, more money for MTV. We've totally played into their hands by reacting this way. MTV has a hit and we gave it to them. Maybe nurses get picked on in part because we don't think before we react. Big picture people, big picture.

So good on ya for this post Ms. Campbell. About time someone used those critical thinking skills we brag so much about.

Jessica O'Conner

Totally disagree. We have to stand up for ourselves as nurses and tell producers that this stereotyping is wrong. If they want to do a show and profess it to be about nursing then they should show nursing as we are and not a bunch of crazy young nurses who do not represent me.

Lori pointed out that a campaign like this worked in BC, so we should try. I'd like to see it off the air.

Jenifer Honda

My point being, it isn't going off the air, because all this attention is making it a hit. Besides no one would watch a show on MTV that didn't have that kind of behaviour.

I wish I knew the answers to the questions Lori has raised.

Carl Meadows, RN

I have been following this story and when I hear about the stereotypes in nursing I can't help but think about the part the nursing family plays in many stereotypes. As an RN who happens to be male I see my own profession continue to perpetuate launguage of "female pronouns" from the front lines all the way up to highest levels of our nursing organization. In the Nurses Bargaining Unit (NBA) Collective Agreement (CA) the term "she" is throughout the CA. As a gay man, I have learned that stereotypes can be a double edged sword; we can't act against one ( as in anti-homophobia training) without looking at them all. I find it distasteful to see women of any type sexually objectified as nurses or otherwise. RN's have an important role to play in modelling the way. I am proud of the CNA and ARNBC to take a stand and there is more work to do.

Helen

Wow, what a well-written article Lori. Thanks for discussing some of the complexity around recent portrayals of nursing on TV as well as raising the point that we are a bit self-silenced by our Code of Ethics. I think that this is an important point to think about.

Michelle Devia

Well written Lori. You are absolutely right that there is an individual responsibility to educate our clients and the public about the real contributions of professional nurses to health care and I do appreciate your suggestion to develop and foster leadership to ensure our profession remains strong and healthy into the future. Thank you for this well written article.

Michelle Devia, LPN
President, Licensed Practical Nurses Association of BC
http://www.lpnabc.ca

Sarah Levis

So so so good. Never a truer word.

Thank you Lori and ARNBC for this. Like a previous poster said, I am just so glad to see my Association wading in on a current issue with something so considered and thought-provoking. I'm really proud of you ARNBC. More like this!

Nada Dhaliwal

Thank you. Also there are stereotypes for those of us who have immigrated to British Columbia from other countries. I appreciate this post, and the comments of Carl who spoke of the troubles being a man nurse and gay. This is a good discussion.

Anne Marie

Lori - this is such a smart response to the Scrubbing In issue. I'm going to share this with some of my colleagues who watched and were embarrassed by the show but didn't want to join the bandwagon which seems sort of futile. I really appreciate this sort of balanced approach. Leadership. Responsibility. Ownership. Really good stuff.

ColMobly

Cancelled would be good but, I didn't about the imprtance of thinking about the bigger picture. This blog was re-tweeted on the Cancel Scrubbing In forum on Facebook by a nurse in Southern Ontario, and is being shared by nurses all over North America. Kudos for that.

LaurieKD

BEST BLOG EVER!

Thanks Lori. I'm going to share this with my students. 🙂

Ali Snyder

This is amazing! I'm a new grad from Pittsburgh and saw this link on the 'Cancel Scrubbing In' Facebook page. I've been following the story closely, and even though I understand that people are upset, I agree we've missed the bigger picture here. It's about more than this show and we need to stand up for nursing in all pop and media culture. Good on you nurses in BC. I feel like I've finally found people who are making some actual good sense on this issue, and not just making futile attempts to get this cancelled. Cheers to you Lori!

Ali, Proud RN from Pittsburgh

Sean Alcombe

Truth in Nursing has finally posted their thoughts. Like you, they think Truth in Nursing should be cancelled, but they also note that it's probably less damaging than ER or Grey's, which portray nurses as sexually available or non-existent.

They also note that only 700,000 people watched the premier - not exactly a raging success by any standards, and usually more people watch the first one than subsequent ones. I wonder what that number would have been if pissed off nurses hadn't watched? A lot less. We should be kicking ourselves.

Here's the link: http://www.truthaboutnursing.org/news/2013/oct/24_scrubbing_in.html

Carl Meadows, RN

This is an amazing discussion and really taps into our own assumptions and beliefs about being a nurse and the power stereotypes have in holding us from our maximum potential. Nadia Dhaliwal makes another important point around how nursing can marginalize, based on ethnic stereotypes. I recently did a planning technique where you attempt to create barriers to success through identification of gaps or weak areas. Imagine if all nursing institutions (unions, colleges, association, and educations institutions) had to perform an exercise where they were required to identify ways to keep nursing from its full potential power. It would probably include marginalization and the effeminite portrayal of male nurses as gay, female nurses as passive caregivers, immigrant nurses as only good for residential care, etc. If these stereotypes didn't exist, then most of our institutions would possibly be ethnically and gender balanced. I agree with Ali and so proud that nurses are speaking out and also believe we also need to do some serious soul searching.

Lori C

Thanks everyone for such great thoughts and positive feedback!
I'm always glad when we can take part in a passionate discussion that leaves us all enthused to spread the energy in a constructive way!

JB

Another thing I wonder, with the constant protests and complaints from some nursing organizations that are constantly trying to be in the news - isn't this another way nurses allow ourselves to be stereotyped? I know myself and my colleagues are probably just as frustrated with seeing another angry protest featured on the news as we are with the 'sexy nurse' stereotype.

As nurses, we don't seem to know how to present ourselves as smart, well-educated, sophisticated professionals. We're either wearing sexy outfits and talking trash like the Scrubbing In nurses, or we're angry, uncompromising protestors. It's no wonder the public is confused. How often do they see, in the news or on tv shows, nurses behaving in a likeable way?

Mel

The ratings are slowly dwindling. I believe these are from the first episode. Scrubbing In (10:00) - MTV 0.521 million viewers, #43; 0.382 million adults 18-49 (0.30 rating), #36 #ScrubbingIn. The second and third episode are even lower.

Rebecca

This is an interesting article http://www.thegypsynurse.com/scrubbing-in-not-1813/#comment-10870

I sort of agree with this, and I think it kind of is related to what Lori was saying. The perception of nursing is off, and it's not just about this one TV show, it's about every portrayal in the media. But on the other hand, it's also true that you don't get the big physician organizations complaining about House, or the Nip and Tuck doctors, because at the end of the day, they know that it's a TV show.

Why do nurses have to behave like Florence Nightingale to be trusted and respected? What a ridiculous double standard!

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[…] blogposts in particular stood out for us this year.  Lori Campbell’s submission, Nursing Stereotypes:  The Good, The Bad and The Ugly focused on the controversy stirred up by the MTV reality show Scrubbing In, which caught the […]