"Italian nurses are better-looking...These [U.S.] ones scare me a bit."

"Italian nurses are better-looking...These [U.S.] ones scare me a bit. Don't even think about leaving me alone at night with one of them."

These are the reported comments of Silvio Berlusconi, Italian Opposition leader, former Prime Minister (2001-2006), and billionaire media tycoon, on December 22, 2006, analyzing the care he was receiving at the Cleveland Clinic while receiving a pacemaker.

We know what you're thinking: what a nice way for Mr. Berlusconi to say "thank you and Happy Holidays " to the skilled U.S. nurses who'd been keeping him alive, and to demonstrate his diplomatic skills. But our problem is not so much with the former Prime Minister's views on whether one group of nurses is more attractive than another.

We are troubled by a world in which those at the very pinnacle of the governmental, corporate, and media sectors--e.g., Mr. Berlusconi--believe that the measure of a nurse is her physical appearance. His comment about being left alone at night suggests that he may also believe that it is a nurse's job to provide sex to patients. Or maybe he just thinks U.S. nurses are such monsters that they might attack him, rather than simply making the expected nursing sex unpleasant.

Whichever it is, it's evident that Mr. Berlusconi does not understand that nurses are not models or sex workers. Instead, they are health professionals with years of college-level science training whose job it is to keep him alive 24/7. Had the esteemed Cleveland Clinic obliged Mr. Berlusconi by keeping all the nurses away from him at night, he could well have died. Of course, if his attitudes prevail, he and everyone else may soon find out what it's like to get no skilled nursing care.

Why don't nurses get the respect and resources they need to provide the care their patients need?

Understanding.

Resources don't flow to nursing when the profession is undervalued by the public and its leaders. The Center works to increase the value society places on nursing. That will bring more resources to nursing clinical practice (e.g. improving staffing levels), education, and research. That will help nurses care for patients.

But we cannot do this on our own. Our tiny staff has donated over ten thousand of hours of our time over the past five years to the Center's work. To build a stronger, more sustainable organization, we need your help.

So far in our year-end fundraiser, we have raised US$1400. That's not even 2% of our goal of US$75,000. We thank those who have donated. But to those who have not, can you help us come closer to meeting our goal by making a tax-deductible contribution today? Remember, it's just US$25 to join, and only US$9 for students and recent graduates.

Yes!!! No!

**YES! I want to tell Prime Minister Berlusconi that nurses are life-saving professionals, not eye candy, and help the Center continue its important work. [for the letter, you might for once just let them write it themselves. if you want a short form, I would just adapt the 2 grafs right about the Australian link above, maybe with a short intro sentence like: "I understand you recently said the following about the care you were receiving in connection with getting a pacemaker at the Cleveland Clinic: [the quote]. then the 2 grafs, and maybe close with a note that these attitudes are a big factor in the nursing shortage that is a global public health crisis, and that he should apologize and make amends to nurses everywhere]

**YES! I want to help the Center continue its important work. I realize that in order to build a strong profession, nurses need to support the Center, which works to fix the largest bedrock problem facing the profession--undervaluation. I know that undervaluation like that recently expressed by Mr. Berlusconi undermines all other progress we try to make for nursing, including in improving workplace problems like short staffing, and getting adequate resources for nursing faculty and research.

I also know that the result of the Center's work helping society understand that nurses are skilled professionals--not ugly stereotypes--is that my work and that of my nursing colleagues is more respected. Nurses need and deserve credit for their work. Part of advocating for patients is making sure that nurses have the resources they need.

And I know that for the Center to sustain its work, it needs the support of the nursing profession and the profession's friends. The Center's tiny staff cannot volunteer the vast majority of its work for the Center indefinitely. So I will support the Center, because I value the work it has done for nursing and the work it will do in the future.

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What has the Center done to improve understanding of nursing this year? Here are some examples:

Spreading new ideas about nursing

Just last week we succeeded in getting an op-ed piece published in The Baltimore Sun. The op-ed, by Columbia University nursing professor Kristine Gebbie and Center director Sandy Summers, argues that nurses deserve a Nobel Prize or some comparable annual award. Nurses have changed the world by reinventing health systems, pioneering new therapies, and improving community health, from AIDS treatment to neonatal care to pain management. We think establishing such a prize would shine a light on the profession's life-saving achievements, which would help solve the nursing shortage.

Asking the media and the public to think about nursing and its image

The Heart Attack Grill

News of our recent campaign to persuade Tempe's Heart Attack Grill to omit the "nurse" element of its "naughty nurse" wait staff uniforms has reached around the world. Through coverage on television, radio, print media and the Internet, from CNN to The Times of India, we have highlighted the problems with this image, which can harm nursing recruitment and clinical practice, and inhibit nurses' ability to get the resources they need. In many cases, we have fostered media discussion of problems in clinical practice and the shortage in general.

The Golden Lamp Awards

In January, we released our third annual Golden Lamp Awards, in collaboration with the American Journal of Nursing. The Awards recognize some of the best and worst media depictions of nursing from the prior year. Early this year, the Awards got coverage in US Weekly, The New York Post, All Headline News, Editor & Publisher, and an Internet Broadcasting Systems story that ran on many U.S. television network affiliate websites.

Jack White

In our 2005 Golden Lamp Awards, we recognized a stereotype-laden song by the popular and influential White Stripes as one of the worst portrayals of nursing. We sent group leader Jack White an "award." White responded with a counter-award. Press coverage of this exchange appeared in the Los Angeles Times, Salon, and the Detroit Metro Times.

Asking the corporate world to think about nursing and its image

The Four-Hour Nurse Training Course

Early this year, one of our members alerted us to a new CVS television commercial in which a pharmacist said he had spent four hours of his own time explaining a medication regimen to a patient's husband, which the pharmacist referred to as teaching him how to be "a nurse." We discussed the ad with CVS. The commercial was edited to explain the pharmacist's commendable actions without suggesting nurses get four hours of training.

The "Electronic Nurse"

Recently, ALR Technologies launched a disease management compliance product using the informal name "Electronic Nurse." We contacted ALR about this. A few weeks later, a company representative told us ALR was changing the name. The device is now called the "ALRT500 Compliance Reminder."

More Intensive Care

A couple months ago, Schick launched print ads for its Quattro Titanium razor that featured "naughty nurses" tending to a young man in a hospital bed. The "nurses" were said to be providing "more intensive care." We discussed the ads with Schick representatives. The ads were discontinued.

Spurring Grassroots Action

Recently, the Center launched its new chapters. We now have six U.S. chapters and three in Canada, with more on the way. These chapters will extend our reach into the global community. With more funding, we hope to hire staff to better support and coordinate the chapters.

Why Does It Matter Whether People Understand Nursing?

Nurses are the critical front-line caregivers in health care today. They often make the difference between life and death, self-sufficiency and dependency, hope and despair. You know this! But too many people don't. And that is a factor in the global nursing shortage that has claimed countless lives and threatens to overwhelm our health systems.

Nurses around the world now struggle with short-staffing that kills patients and drives colleagues from the profession. Nursing education is severely underfunded. In the U.S., 150,000 reportedly qualified applicants could not get into nursing school last year. Nursing researchers struggle to find funding for their vital work.

Why is this? One key reason is that few non-nurses, including many of our health care colleagues, really understand what nurses do. This vacuum of knowledge is filled by long-standing social assumptions that are fostered and reinforced by the media.

Research shows that the media has a real effect on the public's health care views and actions. But the media commonly misrepresents nursing, often relying on stereotypes instead of reality. Countless influential health pieces in the news media continue to ignore nursing, or suggest that it consists of menial assistance to physicians.

Meanwhile, entertainment media products tell millions around the world that nurses don't matter. In Hollywood, 28 out of 30 major characters in the top four hospital shows are physicians. Only two characters are nurses. The physician characters spend a great deal of their time doing--and getting credit for--important work that nurses do in real life.

The bottom line: if nursing is seen as lowly "women's work" that's all about getting equipment for physicians and bestowing favors, there is little reason to provide it with many resources, especially in today's severely stressed health financing systems.

The Center's Vision

To help us move toward a world where society really respects nursing--and allocates its resources accordingly--the Center must be able to shape media portrayals in a more proactive and broad-based way. We must do more to:

train and work with those who create media portrayals;
educate the public in more direct and innovative ways;
encourage the media to use nurses as expert sources and advisors;
encourage nurses to create media and speak up about their work.

Help Us

Because of the lack of overall understanding worldwide, nurses must sustain a collective effort to shape media portrayals of their work. We must educate society in order to obtain more social, political and financial support. As Florence Nightingale once said:

In our imperfect state of conscience and enlightenment, publicity and the collision resulting from publicity are the best guardians of the interest of the sick.

The Center's global media monitoring, analysis and advocacy is a huge challenge. It takes extensive research, writing, communication, and Internet efforts. We must pay for office equipment, supplies, transportation, Internet products, insurance, postage and telephone costs. Our office is donated by our staff. And our staff can undertake only a small part of the work that needs to be done to improve nursing's image.

So we urge you to make a year-end donation to help us continue and expand our work. Just click here to learn about the great gifts you can receive for joining or renewing your Center membership, including our cool t-shirts and the Archie McPhee nurse action figure! It's quick and easy! And because the Center is a 501(c)(3) charity, your gift is tax-deductible as allowed by law.

Thank you for all of your support over the past year. You are the reason we've had a real impact on public understanding of nursing worldwide. Together, we can strengthen nursing, and give patients the kind of health care they deserve in 2007 and beyond!

Sandy Summers, RN, MSN, MPH
Executive Director
The Center for Nursing Advocacy
203 Churchwardens Rd.
Baltimore, MD USA 21212-2937
office 1-410-323-1100
fax 1-410-510-1790
ssummers@truthaboutnursing.org