Editorial

Invisible Nurses

Media neglect is one cause of the nursing shortage.

By Diana J. Mason, PhD, RN, FAAN, AJN Editor-in-Chief
E-mail: dmason@lww.com

On the morning of June 6, I was listening to Public Radio International's Marketplace, a daily business program broadcast to 351 radio stations nationwide. The newscaster announced the story coming up next, about a survey's findings that nurse-physician relationships affect nurse morale and retention. The program that followed was excellent, except for one thing: there was no mention that the study was published in the American Journal of Nursing. AJN had published the study in June and had conducted a media campaign to disseminate its findings.

I called Marketplace journalist Helen Palmer to express my dismay that listeners wouldn't know where to read the full report or how to judge the study's credibility. She told me that she had credited AJN as publisher of the study, and that the announcer was to have read it, but it had obviously been edited out. Later, I saw Modern Healthcare's June 17 report of the same study, and again, in an otherwise very good report of the research, there was no mention of AJN as the publisher.

This shouldn't have surprised me; I doubt the editors would have removed the name of the journal if it had been the Journal of the American Medical Association or the New England Journal of Medicine. In fact, two studies published in the 1990s showed that nurses were grossly underrepresented in media reports on health and health care. One of them, 'The Woodhull Study on Nursing and the Media: Health Care's Invisible Partner,' published by Sigma Theta Tau International in 1998, noted that nurses were included as sources in stories in the health care industry's trade publications only 1% of the time.

Nurses aren't invisible just to the media. In the late 1990s, Sally Cohen and I, along with graduate nursing students, conducted a series of studies on managed care plans' arrangements with nurse practitioners. In one study of NPs in New York and Connecticut, their invisibility emerged as a major theme; the NPs said managed care plans seldom credential them or list them in the plans' directories of providers. As a result, patients can't find them, and the data on NPs' patient outcomes cannot be separated from those of collaborating physicians.

And are you as tired as I am of all the brochures that list upcoming conferences' speakers, not one of whom is a nurse? I recently received a brochure for a New York City-area conference on palliative care that targeted nurses. There was not one nurse on the roster of speakers. I was furious, knowing that nurses have long been at the forefront of care of the dying and that New York has several national experts on the topic.

Our hiddenness is one cause of the nursing shortage. What to do?

Speak up. When journalists fail to source nurses or nursing journals in their news reports, tell them. For example, I e-mailed the producer of Marketplace, commending Helen Palmer's excellent story and pointing out that omitting the name of the nursing journal that published the study did not serve listeners well and slighted nursing. The producer replied that he would circulate the e-mail among his staff. Also, I wrote a letter to the editor of Modern Healthcare that was published in its July 1 issue. And I e-mailed the contact person listed on the brochure of the palliative care conference to say that I was appalled that the program was to have not one nurse as a speaker and that I would neither attend nor recommend that my colleagues attend.

Put your money where the nurses are. When the primary care practice that my husband and I used stopped using NPs, I stopped going to it and told the manager why. I also wrote to a managed care plan to say that I would no longer enroll in the plan if NPs weren't on the provider panel.

Boycott. Will someone please tell me why nurses watch ER, a television program that so poorly depicts what nurses actually do in the emergency department? I say let's all stop watching it and tell the producers and sponsors why we've stopped.

I can't act every time nurses are hidden by others in our society. But I must speak up when I see injustice; my passion for nursing demands it. Imagine, what would happen if all nurses acted on their passion and outrage?