Nursing image is closely tied to the concepts of roles and identity - in this context, the image and identities of nurses online are being considered. Cyberculture theory is rich with references to identity formation in the cyberspace environment. In professional contexts, nursing tends to convey a professional image, one that motivates trust and expectations for accountability.

The word nursing is derived from the Latin word "nutrire" which means "to nourish." From its earliest beginnings, the nursing profession has evolved in response to human need. I believe that it is this responsiveness to the needs of others that has allowed the diversity within nursing to flourish. Among the nursing profession’s greatest strengths are the tremendous breadth and variation of opportunities it offers. Levels of nursing practice range from licensed practical nurses to advanced practice nurses such as nurse practitioners, nurse midwives and nurse anesthetists. Registered nurses can pursue degrees at the associates, baccalaureate, masters, and doctoral levels.

There have been many images of nurses purported in the media, in movies and books, and in the news. Common images include: "ministering angel," "physician's handmaiden," "oppressive battle ax a la Nurse Ratched," and sexually related stereotypes ranging from rigid prude to sex kitten. Even though these multiple misconcieved images abound, nurses continue to be quite invisible in the media, compared to other cultural groups."The 1997 Woodhull Study on Nursing and the Media, conducted by Sigma Theta Tau International, found that nurses were severely under-represented in print media, including in comprehensive coverage of health care. Of 1,153 health care stories in 16 major newspapers, only 11 carried references to nurses, the study found" (Sussman, 2000, p. 1). Nurses are in the background, seen only by the people who have first hand experiences with them - the patients they provide care for. Operating in the media shadow, nurses function as a very real but transparent infrastructure that keeps the health care system from literally falling apart. Rarely do people hear about their fine intellects, their on-the-spot critical, "life or death" thinking, or their heroic efforts to provide accountable, complex, quality health interventions in a time of chaos and crisis.

Scholars who have studied the historical context of nursing's image trace it back to the time of Florence Nightingale, often lauded as the "founder of nursing". In the United Kingdom, nurses have petitioned to have present day nursing disassociated with Nightingale. Her image and her writing have held back the image of nursing in the subserviant and invisible shadows of the health care system and the social eye at large. "Florence Nightingale believed nurses should be subordinate to doctors, was against registration of nurses, opposed the three-year formal training of nurses, did not see mental health as a field for nurses and had "questionable success" at her hospital in the Crimea. She added that Ms Nightingale was against lay women healers and opposed women speaking in public" (BBC Health, 1999, p. 1).

Around the world, from the Americas to India, nurses have struggled with a poor image in the general social context. Australian nurses have shared in this misconceived identity: "The public image of Australian nursing has been subject to a plethora of influencing factors since health-care services were first established in this country over two centuries ago, Since its colonial origins, when considered an occupation suitable only for the socially outcast, nursing has evolved through decades of changes and reform. From a position of significant oppression and medical subservience, generations of Australian nurses have fought for public recognition in terms of identity, respect and role acknowledgement" (Bloomfield, 1999, p. 1).



Foskett and Hemsley-Brown found that young people held vague and fragmented views of what nurses were and did in their practice. Misconceptions included:

• Could not visualize where nurses work
• Not aware of career advancement
• Viewed nurse as supportive role to MD
• Most knew at least one nurse
• Idea of "wearing a uniform" was unappealing
• Students of all ages felt nursing "is a girl's job" (1998, p. 1)

A personal survey of thousands of images of nurses on the internet showed that over 80 per cent of the images depicted nurses as white, middle class and often blonde. Most appeared to fall within the age range of 20 to about 35 years old. Images of these young nurses were almost all female and attractive. Many showed nurses with stethoscopes around their necks (not professionally sanctioned), with caps on (rarely worn by contemporary nurses) with a syringe poised in her hand, ready for administration (injections are being phased out in practice in favor of less invasive administration methods). Even the pictures that portrayed nurses as friendly, caring, professional included some of these visible "myths" associated with nursing. Almost any toy - whether a doll, a teddy bear, a wall hanging, what have you,...if it depicted nursing, there was a cap and a cross evident as identifiable icons. The dozen or so images shown on this page were all found on the internet with the key word "nurse" as identifier. Despite an obvious move to try to convey professionalism in images of nurses, we still have a long way to go to make these images realistic and grounded in true nursing practice. Nursing's identity is still being shaped and shifted - this process is fully visible on the internet if one looks for it.



LINKS TO EXPLORE

Nurses in Hollywood … Loretta Swit from M*A*S*H - Loretta Swit played nurse Margaret "Hot Lips" Houlihan for 11 seasons on M*A*S*H, one of the most popular shows in television history. During the course of the series, Margaret evolved from a sexy, one-dimensional comic foil for Hawkeye and Trapper John to a fully developed character with one overriding passion: to be the best damn nurse in Korea.



Nurses in the Comics - Nurses have appeared in a number of comic books, mostly as romantic heroines. . Nellie the Nurse began in the mid-forties, and The Romances of Nurse Helen Grant appeared in the late fifties. A flurry of comics were devoted to nurses in the early sixties, including Nurse Betsy Crane; Linda Carter, Student Nurse; Linda Lark; Cynthia Doyle, Nurse in Love; Sue and Sally Smith, Flying Nurses; The Nurses; and Three Nurses. In the seventies, the dramatic Night Nurse appeared briefly on the comic book racks. And, though she gained fame as a reporter for the Daily Planet, the intrepid Lois Lane took time out from chasing Superman to work as a volunteer nurse at Metropolis Hospital.

Thoughts to Consider when Promoting Nursing - The following are research and national survey findings for your consideration as you design nursing and/or health care promotional materials.To promote Nursing Image and Recruitment Among Youth Focus on: a) The intellectual challenge and high level of knowledge nursing involves b) Variety of work at all levels c) Career progression d) Wide range of career opportunities within nursing e) Nurses as autonomous practitioners f) Idea of "helping people" and ability to "make a difference"



Image of the Nurse - In order to clarify issues relating to the history of nursing it is useful to spend some time considering the image of the nurse. Done thoughtfully this exercise can reveal some of the issues embedded in the cultural stereotypes which are imposed on nursing.



Nursing Identity and Image - Nursing is seeking its Identity and Image because we are on a change of models, we are giving up a exhausted and obsolete one that has served till now, but that is going to evolve to other more human (and less expensive) through a general mentality change, for it nursing science needs people with ability and initiative, ready to think and investigate from this especific point of view.

Current Image of Professional Nursing - Dr. L. Andrews presents an insightful Powerpoint synoposis on the current trends and deconstruction of harmful images of nursing. Strategies for moving beyond stereotypical images to a realistic one where nurses are seen as the intelligent, motivated professionals they are offered. Likewise, Nurseresource.org provides campaign and media advise and examples of print, web, television, movie theatre and radio information and images to help raise the social consciousness of the realities of nursing.

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References

BBC Health. (1999). Nurses ditch Florence Nightingale image , BBC Online Network. http://news.bbc.co.uk/1/hi/health/329381.stm

Bell, D. (2001). An introduction to cybercultures. New York: Routledge.

Bloomfield, J. (1999). The changing image of Australian nursing. http://www.clininfo.health.nsw.gov.au/hospolic/stvincents/stvin99/Jacqui.htm

Foskett, N. H. & Hemsley-Brown, J. V. (1998) Perceptions of Nursing as a Career among Young People in Schools and Colleges. Centre for Research in Education Marketing: University of Southampton. Southampton, England.

NurseResource.org (2003). Nurses for a healthier tomorrow. http://www.nursesource.org/Career#PSA

Sussman, D. (2000). Image Overhaul: Media still are off target portraying nurses. Nurse Week, October 23. http://www.nurseweek.com/news/features/00-10/tv.asp