1. Beauregard, Mary A. BSN, RNC
  2. Deck, Dinah S. BSN, RN, CNOR, RNFA
  3. Kay, Kathleen Coughlin BSN, RN, CNOR
  4. Haynes, Jodi BSN, RN
  5. Inman, Ruth BSN, RN
  6. Perry, Martha BSN, RN
  7. Richardson, Sharon BSN, RN
  8. Rose, Beverly A. BSN, RN
  9. Silver, Kimberly N. BSN, RN
  10. White, Cathy BSN, RN, BC
  11. George, Eda PhD, RN

Article Content

The nursing community is making a concerted effort to create a positive public image of the profession. The $20-million Johnson & Johnson video advertisements so prominent on prime-time television depict ethnic and gender diversity among actors who simply say, one by one, "I am a nurse." However, the multiple roles in nursing careers reflect more diversity than culture and gender alone.


Webster's dictionary defines "image" as "character projected by someone or something to the public. 1 This definition implies that one image is formed by the public given certain inputs. On one hand, the public has fun with the stereotypical image of the nurse as the ministering angel, the battleaxe, the naughty nurse, or the doctor's handmaiden. On the other hand, the 2002 Gallup opinion poll on honesty and ethics placed nurses at the top of the list and a poll by Vanderbilt University showed that 95% of Americans trust, respect, and admire nurses. 2,3


What are the multiple visions that we want to come to mind when we think of a nurse? Ideally, these visions should be around professional attributes such as critical thinking, therapeutic interventions, and communication.


After a review of the literature on the image of nursing and much discussion, we conclude no clear image of nursing that encompasses our diversity exists. As nurses transitioning into administrative roles, we know there is so much more to "us" than any of the images held by the public. In our graduate class of 10, our areas of expertise include hospice, acute care, pediatrics, quality improvement, informatics, risk management, peri-operative, education, and supervisory nursing. Our one commonality as nurses is our commitment to quality patient care. We know, both individually and collectively, that nurses are regarded as honest and valued by our patients. How can anyone develop a single, all-encompassing image that can adequately convey to the public who and what a nurse is?


Much of the work nurses perform is invisible to all but the patients and organizations that we serve. In the Woodhull Study on Nursing and the Media, a review of more than 20,000 articles related to healthcare were found and nurses were mentioned in only 4% of the articles. 4 Additionally, the Woodhull Study states that "nurses are practically invisible."4 Nursing does not have a strong relationship with the media. When the media approaches nurses, it focuses on human-interest stories rather than on our professional abilities. By publicly sharing aspects of our work, nurses will gain more recognition and thus help to enhance the public image of nursing.


Barker emphasizes that to be appropriately valued in healthcare and by the public, it is critically important for nurses to be more visible "in every role and place of employment."5 Promoting our accomplishments, becoming actively involved in professional organizations and community issues, participating on committees, and writing articles for professional journals are ways to achieve visibility. Collaboration between nursing administrators, educators, and researchers will provide opportunities for nurses to be recognized for their professional contributions.


Unfortunately, we can't ignore the disconnect that exists throughout the nursing profession that affects our image. Parker and Gadbios explore the dynamic of fragmentation and contention between administration and staff in the healthcare community and loss of belonging and commitment in the workplace. 6 Working together to acknowledge achievements will promote unity throughout the nursing profession. We must celebrate one another's contributions. Providing conflict resolution skills, improving communication, and promoting team building are ways nurses can enhance the image of nursing.


From an educational perspective, a unified entry academic level into the nursing profession will help our image. Physical therapy, psychology, and pharmacology professions all require the same educational entry requirements and have moved towards post-baccalaureate entry for professional practice. We want to encourage the same educational advancement in our profession and provide opportunities for educational development. However, we recognize the different levels of entry into nursing contribute to our diversity and allow more people to enter the profession at different stages in their lives.


As nurses transition into different practice areas, providing orientation, mentors, and qualified preceptors fosters the development of all nurses. The image of nursing will be enhanced because we will be seen as professionals who care for each other and support one another's professional growth. Continuing education is essential and must be encouraged to develop professional nursing practice.


Public opinion shapes political agendas. Because public opinion is often based on inaccurate images, nurses must participate in the political arena to shape our image. Archer, Goehner, Diers, and Kalisch were early proponents of the view that nurses had to become politically active if the profession were to advance. If not, we run the risk of being excluded from important political decisions that would affect the practice of nursing. More nurses at the policy-making tables would result in increased visibility and representation for nursing and healthcare issues.


In addition, although the nursing profession has some strong organizations, political activism is a weakness of the profession as a whole. 7 Of the approximately 2.6 million registered nurses in the United States, fewer than 7% are members of national nursing organizations. These low numbers influence our nursing image and ability to become politically effective.


Clarks's 5 Cs model of political action (communication, collectivity, collegiality, commitment, and challenge) provides a framework for nurses to become actively involved. Clark notes that nurses need to be active members in coalitions supporting critical policy issues. 8 Nurses working together and becoming actively involved in social policy issues will successfully challenge and overcome opposition in the political and policy making arenas.


Nurse executives are creating practice environments that encourage the best attributes of each nurse. The image of nursing will continue to evolve with the influence of skillful nursing leaders who help shape the direction of our image. We invite you to join us in celebrating the diversity of our nursing image. We look to you, the readers of our article, to guide the way, to foster our growth, to be our mentors, and most of all, with the hope that we will support one another, to advance the nursing profession.




1. Merriam-Webster Inc. Webster's New Explorer Dictionary and Thesaurus. Springfield, Mass: Federal Street Press; 1999. [Context Link]


2. Jones JM. Effects of Year's Scandals Evident in Honesty and Ethics. The Gallup News Service. December 4, 2002. Available at: Accessed March, 29, 2003. [Context Link]


3. Domrose C. Mending Our Image. [serial online]. June 2002. Available at: Accessed March 29, 2003. [Context Link]


4. Sigma Theta Tau International. The Woodhull Study on Nursing and the Media. Available at: Accessed January 21, 2003. [Context Link]


5. Barker E. Increase your visibility! RN. 2001; 64( 2):41-42. [Context Link]


6. Parker M, Gadbois S. The fragmentation of community, part 1: the loss of belonging and community at work. J Nurs Adm. 2000; 30( 7/8):386-390. [Context Link]


7. Rains JW, Barton-Kriese P. Developing political competence: a comparative study across disciplines. Public Health Nurs. 2000; 18( 4):219-224. [Context Link]


8. Clark S. Five C's of political action. Chicago: Illinois Nurses Association; 1995. [Context Link]