Changing how the world thinks about nursing

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Q: Why are you so darn critical of everything the media says about nursing? Don't you know that you catch more flies with honey than vinegar, that if you can't say something nice you shouldn't say anything at all, and that sugar and spice and everything nice, that's what little nurses are made of?

A: The Truth About Nursing tries to present a balanced, rigorous analysis of the media's treatment of nursing. In fact, we devote significant time to media products that we find to be mostly positive for nursing, and to positive aspects of mixed portrayals. We want the media, the public, and nurses to see the good, the bad, and the ugly aspects of the nursing image. We want people to think and learn. We provide a great deal of positive reinforcement to media creators, for instance in our annual Golden Lamp Awards, which honor the best and worst nursing-related media products. Indeed, a January 2006 story about the 2005 Golden Lamp Awards in the influental newspaper industry publication Editor & Publisher ran under the headline "Print Press Receives Clean Bill of Health from Nursing Advocacy Groups." The headline was not an accurate statement of our views, of course, but an unduly "negative" advocacy group would hardly have been perceived that way. The Truth promotes nurse-created media and the use of nurse experts. And we have worked collaboratively with a range of media creators, from the U.S. Department of Health and Human Services to Wal-Mart to the television show Jeopardy!, to improve media treatment of nursing.

Having said all that, we have major problems with how nursing is often presented in the media, and it is our job to explain why that is and what we think should be done about it. If all we did was point out what the media does right, or offer criticism that was so gentle as to barely register, it would fail to adequately address the nursing crisis that is taking lives worldwide. Indeed, in our view, we can see the results of the "only-nice-things" approach nurses have traditionally followed in the current state of nursing.

Unlike some other groups, nurses as a class have traditionally failed to challenge inaccurate and harmful views of their profession in the media and society. Most have kept their heads down, and even shunned positive recognition for their work. This has helped them to avoid ruffling feathers, and to evade blame when things have gone wrong. It seems to us that these attitudes remain alive and well, despite notable exceptions and the pleas of advocates like Buresh and Gordon that nurses move "From Silence to Voice." Nursing's silence is understandable, given the profession's origins and its traditional lack of significant power, but we believe it must change.

Of course, historically, many who have urged significant change in the way people think and act have encountered similar criticism from those who dislike confrontation or like things the way they are. We make no great claims for our work, but simply for purposes of analysis, consider the results if people like Thomas Jefferson, Florence Nightingale, Elizabeth Cady Stanton, Mahatma Gandhi, Eleanor Roosevelt, and Nelson Mandela had limited themselves to saying nice things. It seems clear that major social change is not achieved solely by gentle suggestions.

Some do not stop at disagreeing with our approach to a given media product. They argue that we must cease all critical comment about everything, and that our approach is actually hurting nursing, since it can create resentment and lead people to think of nurses as a bunch of insecure whiners. Of course, these are the common refrains of anti-reform forces throughout history. Those who protest mistreatment are often told that things would go better for their kind if they would just shut up and go along. In our view, shutting up and going along has not worked particularly well for nursing to date. Perhaps professional groups that enjoy great power and respect (physicians and lawyers spring to mind) can shrug off disinformation. Nursing cannot.

We know that some prefer to try to effect change only in an all-positive "inside" way that does not allow for serious criticism. But we fail to see why there is no room for at least a few nursing advocates who try to tell the full, unvarnished truth about what they see, even if it may be unpleasant. Those who argue that we must stop what we are doing seem to believe that change is monocausal, and that nursing can advance only in one way (theirs). We have not suggested that such people must stop pursuing their deferential, uncritical approach because it legitimizes the continued marginalization of nursing, allowing media creators to claim that they have dealt fairly with nursing when the reverse is true. In fact, we generally have not objected to people trying to effect positive change from within, by (for instance) telling Hollywood producers that they're doing a great job for nursing and it might be even better if they had a nurse character on their show actually say a line other than "yes Doctor" once in a while. And we have no doubt that such approaches have made some positive contributions to the nursing image. But it seems obvious to us that such methods are inadequate by themselves to address social misunderstanding as widespread, deep-seated and pernicious as nursing confronts today.

It is not the Truth's goal to persuade people to like nurses because they are nice people. Instead, we are trying to help people understand and respect what nurses really do, even if doing so means that some in the media will not be our best friends. Like any responsible media critics, we'd rather make people think about what they're seeing and what it means. The resources nursing needs to resolve its global crisis will not flow from affection. If that were the case, nursing's opinion poll position as the "most trusted" profession would have ensured that the crisis never happened in the first place. It seems to us that the resources nurses and their patients need will come only from real respect, from a common understanding that what nurses do is important enough to patient outcomes that nurses deserve adequate training, staffing and compensation. It is that understanding that we seek to promote.

last updated: January 15, 2006