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The Truth About Nursing's Amended Decade Awards and Statement on Diversity in the Awards

Press release

2010-2019 Updated Awards

Today we are sending an amended version of our Best and Worst Media of the Decade for Nursing lists. Due to a shuffle between three different software programs, as well as our very limited resources, we failed to include nine awards that we intended to, three on the "best" list and six on the "worst" list. We apologize for this oversight.

The three new "best" awards go to:

  • Alexandra Robbins for a masterful wave of op-eds to promote her book on nursing;
  • Nurse members of National Nurses United and the Service Employees International Union for advocating for the health of refugees and migrants near the southern border of the United States.
  • The six new "worst" awards go to:

  • Family Feud for worst game show for its ongoing use of nursing stereotypes;
  • National Public Radio and Lourdes Garcia-Navarro for a report that suggested only physicians were working to stem the Zika virus in Brazil;
  • Lionsgate for using naughty nurse posters to promote blood drives in connection with its release of the film Jigsaw;
  • Terence Wrong for his documentaries NY Med and Boston Med, which ignored or marginalized nursing;
  • Kaiser Permanente for the use of unskilled-angel imagery in Nurses Week ads; and
  • The Week and Matthew Walther for his column purporting to explain why nurses don't need college.
  • We have also had feedback about the composition of our initial lists. In particular, a few have expressed concern that persons of color are over-represented on the "worst" list, an impression that may be due in part to the arrangement of photos we used. However, that impression is actually not correct, as a matter of population distribution. We understand that U.S. society is at least 40% racial and ethnic minorities. Of the 18 original entries on the "worst" list, we believe that 6 could reasonably be perceived as being mainly the responsibility of people of color, or 33%. In the amended list, there are 24 entries, and 7 could be perceived as mainly the responsibility of people of color, or 29%. On the far longer best list, which has roughly 45 entries depending on how you count, we believe 11 items, or about 24%, could be considered mainly the work of persons of color.

    We will discuss what these figures may mean in a moment, but first we want to apologize for failing to consider the importance of this aspect of the composition of our lists before we sent them. We should have done so. Our resources are limited--our organization is staffed by a very small number of volunteers--and we struggle to handle even a small percentage of the work we believe needs doing. In addition, we are so close to all this media that we did not make the effort we should have to step back and consider this perspective when making these lists.

    The feedback we have received has caused us to re-examine how the lists are created. We evaluate media based on two main factors: how it treats nursing, and its likely influence on society. We believe every item identified on the "worst" list deserves to be there, and we have yet to receive any substantive argument from those alleging bias that we are wrong about our specific choices. But the lists do reflect the media that we have seen over the last decade, as we stated at the outset of our summary / press release for the original list. And the composition of that set of media is to some extent a subjective one that would of course be affected by any bias in our own choices and in society at large. We are privileged white people, and no doubt our approaches reflect that. Even so, we make an effort to identify media created by persons of color that is helpful to nursing, and also to evaluate the media we do see based on how well it promotes diversity in the nursing profession. We will re-double those efforts. We will also try to consider the extent to which social bias may be influencing our perceptions, including running any future lists of this kind by others to evaluate diversity issues.

    Of course, these issues are not simple. We do not believe it is helpful to dictate that lists measuring the "best" and "worst" in any specific endeavor conform to pre-determined demographic ratios, without regard to actual merit, barriers to entry into the relevant work, or other social, economic, and cultural factors. And in many cases it is difficult to assign a single demographic characteristic to a mass media product that is the result of the efforts of many different persons. It does seem clear that persons of color have not historically had the same access to opportunities to create the kind of media that appears on our lists, and this has certainly still been the case over the last decade. So it is not surprising that such persons are somewhat under-represented on both lists relative to their presence in U.S. society. We note that we also try to remain open to global media, despite our limited resources, so the lists also reflect some non-U.S. media products, like Call the Midwife.

    As for why persons of color appear to be slightly more represented on the "worst" than the "best" list, we do not think the full answer is an easy one. Perhaps our own bias is part of the answer. But the harmful nature of the media created by those identified on the "worst" list suggests that is not a complete explanation. We want to emphasize that persons of color have been responsible for a lot of media that has been most helpful to nursing, as our "best" list shows. At the same time, our two decades of analyzing nursing in the media has shown that being a member of a historically disempowered group does not provide immunity from damaging stereotypical attitudes about the nursing profession. Nor does being a member of any other group, including the nursing profession itself. It does not surprise us that some members of historically disempowered groups create media that seems to reflect little regard for a profession that has not traditionally been associated with empowerment. In fact, some female media creators have explicitly stated that their goal is to tell girls they can be physicians and don't have to be nurses anymore. Celebrating that freedom to choose is good, except when it comes with the incorrect and damaging message that nursing and other traditionally female work is less worthy simply because it has been the province of a disempowered group.

    And we would not be doing our jobs if we omitted media from the "worst" list solely on the basis of the demographic identities of the creator, for example in the case of the powerful Hollywood producer Shonda Rhimes. Her influential work includes 15 years of direct attacks on the nursing profession, whatever social good that work may have done in other respects. Leaving it off the list would not be the truth about nursing.

    Lastly, as always we would like to invite anyone who wishes to discuss these issues, including the merits of our specific choices, or to propose other media that might have been included on these lists, to contact us. We would also like to monitor more media and hire a diversity officer, and so we will be trying to get more resources, including by finding more funding, interns, and more support for the Coalition for Better Understanding of Nursing. Thank you.

    See the updated 2010-2019 awards!

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