Nursing status &Image

Arfa Nadeem
Nursing instructor
Aligarh college of nursing
 Objectives
At the end of this lecture the learner will be able to
describe:
 Define Status & Image
 Define Nurse & Nursing
 Significance Of Status And Image In Any
Profession
 Dynamics Involved
 Concepts Of Nursing In Past
 Development Of Nursing
 Foundation Of Nursing
 Nursing Development With Passing Era
Cont..
Dimension Of Nursing
 Nursing Scope
 Nursing Knowledge And Education
 Nursing Practice And Skills
 Nursing Administration
 Nursing Research
 Maintenance of nursing image and status in
Pakistan
 Perspectives of nursing in future
 Status & Image

Status : Relative social or professional

position;(standing, rank, ranking, position,
social position, station, level

Image : The general impression that

a person, organization, or product
presents to the public (public
perception, public conception, public
impression, persona, profile, face,
identity
 Nurse & Nursing
Nurse: “A person trained to care for the
sick or infirm ,especially in a hospital.”

Nursing:“The unique function of the nurse

is to assist the individual, sick or well, in
performance of those activities contributing to
health or its recovery (or peaceful death) that
he/she would perform unaided if he/she had
the necessary strength, will or knowledge..”
Introduction To Nursing Image
 Nursing image is very important for nursing
profession ,it is the way the profession appears to
others including to general public.
 Image of the nursing profession impacts to the
recruitment of students, the view of the
public ,funding for nursing education and research,
relationships with healthcare administrators, other
health care professionals, government agencies and
ultimately, the profession self identity.
 Image is defined as a mental picture representing a
real object or a more or less accurate likeness of a
thing or person.
HISTORICAL DEVELOPMENT OF
NURSING IMAGE

Credit is given to Florence nightingale for the

written history and development of modern
nursing.
The image of nursing may also have its roots in
the Victorian Age during which she lived .
At the time nursing perceived as ‘’Women s’
Work ‘’.
The expectations of nurses were
altruism ,sacrifice, submission and its not just
encouraged but demanded
Periods Of Nursing Development
Period 1: Angels Of Mercy
Period 2: Girl Friday
Period 3: Heroine
Period 4: Mother
Period 5: Sex Object
Period 6: Careerist
PERIOD 1:ANGEL OF MERCY
(1854_1919)
 In the early 1900s nurses were
viewed as honorable ,moral,
spiritual ,self-sacrificing and
ritualistic.
 World war 1 media representations
continued the “angel of MERCY “
image.
 Nurses appeared in a substantial
literary Endeavour's ,nurses
heroines were characterized as
being involved in dual search:
 success and meaning through
nursing.
 happiness and fulfilment through
PERIOD 2:
GIRL FRIDAY(19201929)
 Women’s entered in new domains of
professional endeavors and activities .
 1918s influenza epidemic created a vast
need for nurses.
 As a results of all these factors ,efforts
toward increased regulation of nursing
education were hampered.
 Nursing students were exploited as a
cheap labor ,literally staffing entire
hospital.
 Nurses were described as
faithful ,dependent ,cooperative ,long-
suffering and subservient.

 In films of this era ,nurse were not cast

PERIOD 3:HEROINE(1930-1945)
 Nursing was acknowledged as worthy
and important profession that enabled
women to earn an honorable living.
 Nurses were identified as
educated ,courageous ,fearless,
reasonable ,clear-headed and
humanitarian.
 The only feature –length film ever
produced that focus entirely on the
nursing profession ,these film stressed
the education and work of professional
nurses.
 Film on nursing profession ,nominated
for the 1934 Academy Award for best
picture ,the heroin of the film reject a
millionaire offer of marriage to continue
PERIOD 4: MOTHER (1946-1965)
 Itmay have been natural
development after world war 2 that
a major goal for many American
women was to say home and care
for children.

 Nurses during this period were

chronicled as
maternal ,compassionate ,unasserti
ve ,submissive and domestic.

 During the 1950s television

programs usually portrayed nurses
as worthy of respect and
appreciated for their skills.
Period 5:Sex Object (1965-1983)
 After 1966,mother image change of the nurse
change into sex image
 Nurses were increasingly depicted as being
sexually, promiscuous,
 self indulgent, superficial and unreliable.
 Nurses became “ sexual mascots” for health care
team and were seen in X rated movies. Eventually
nurses were portrayed as cord, uncaring ,power
hungry and unmotivated person.
 In films of these years, nurses were undervalued
and poorly represented, their contribution to health
care were not addressed.
Period:6 Careerist(1983-present)
 The careerist has became the new
image for the mid 1980 and
1990s,portraying as
intelligent ,logical, progressive,
sophisticated, empathetic and
assertive.
 Men and women both are
dedicated to providing the highest
standards of healthcare
 Each one of us holds the
responsibility and the privilege of
making this image the common
place awareness in every
household.
Cont…
An international production of a
television series has helped nurses
connect with other nurse using the media
to assist in improving care.
Collaborative practice.
Men And The Image Of Nursing
The literature that the nursing profession
would benefit from a large influx a large
influx of men into the profession , but if a
man decides to enter the profession he is
plagued by social stereotypes.
Male nurse are often considered social
misfits , unable to fit into a “real
mans”job.
Cont…
Men who choose a traditional female
oriented career are perceived as socially
demoted.
Our understanding of the imageof nursing
has been mainly based on other
perspectives such as the public or media
rather than nurses themselves.
Foundation of Nursing
Ancient civilizations through the renaissance;
Illness had supernatural causes women
delivered custodial care to family
Medicine men treated disease
As civilization grew priests were seen as
physicians
Male nurses vanished from profession
Home major locality for nursing care
Only poor hospitalized ,cared for by prostitutes
and female criminals
Significance of Nursing Image
The image of nursing is important. Public
image creates a frame-work by which
others approach nursing as a profession,
as well as each nurse individually. ...
Presenting a balanced view of the nurse's
role and contribution to healthcare is
essential. The impact of nursing's images
comes to bear in several important ways.
Image Building
A Process Knowing Oneself Being
Positive About One’s Self Image, Leading
To A Better Chance Of Increasing One’s
Self-esteem & Enjoying A Meaningful,
Happy Life.
(Hugh Prather)
Image Building
Remember-

“… no one can make you feel

inferior without your consent…”

(Eleanor Roosevelt)
Two Views of Nursing
1. Internal Image

2. External Image
Two Views of Nursing
Internal Image External Image
 how nurses see
 Views Presented To
themselves as Impress Potential
individuals Students, Legislators, the
Public...
 how nurses
envision the
profession
Will nurses want to improve their self-
image
Changing the Image of Nurses & Nursing

To change a large group requires a

concrete plan that is effective over time
The basic image of the nursing profession
has already been established
Changing the self-image of the individual
nurse
Do you think that nurses ... nursing has
image problems?
Components important for building image
 Experience
 Heredity
 Environment
Thoughts,Beliefs,Image&
ActionPerformance
 Gender Socialization
 Reference Groups
We always act like the person we believe
ourselves to be

Everything we do is consistent with our

self-image/self-concept. if you think it,
you can attain it?
If Any Idea Enters Your Mind, You
Literally Have The Ability To Accomplish
It.
The Only Factors That Stand Between
You And Your Goals Are Perseverance,
Hard Work, And A Willingness To Take
Risks.
Current image of professional nursing

Nursing shortage
The average age of nursing graduate is 33
The average age of nursing Rn is 44
Average age of faculty is 50
By 2015, 50 % of the RNs are expected to
retire
By 2016 , job opportunities are increased
by 21%
Image markers of nurse
Nurses of America campaign
 Convey To The Public That The Nurses
Are The Expert Clinicians

 Raising Consciousness Of Invisibility

Of Nursing In The News Media
Public concern with nursing
What is the image of nursing being
created today?
Saints vs. Sinner Image
Can I trust my life this Rn nurse ?
Public want to believe that
knowledgeable, caring , committed and
dedicated RNs will always be available
for them.
What the public believe about nurses
Rn ranked highest among all professional
standard of ethics and honesty.
Public seek advice in 4 areas
a. Self-care or immediate post op care
b. OTC health care products
c. Admin and SE of prescription drugs
d. Interpreting physician provided –
information
Why do RNs Deride themselves in front
of public
Sloppy clothing

 Dirty,wrinkled

 childish symbol
Evolution of Nursing and Health
Care
Nursing is art and science by which
people are assisted in learning to care for
themselves whenever possbile and cared
for y others when thry are unable to meet
their own needs .
 nursing 's early histroy was heavily
influenced by religious organization and
the need for nurses to care for soldiers
during wartime.
Scope of Nursing Practice
The scope of nursing practice is the range
of roles, functions, responsibilities and
activities which a registered nurse is
educated, competent and has authority to
perform. Nursing practice is underpinned
by values that guide the way in
which nursing care is provided”.
Scope of Nursing Practice
Nursing provide three types of care:
Individual
Family
Community

Nursing practice involves four areas:

Promotion of health and wellness
Prevention of illness
Restoration of health
Care of dying person
Nurses workplaces
Nurses work in:
 Hospitals
 Acute care units
 Home care, and long-term care facilities
 Care for patients with general medical
conditions, including
 Infectious diseases,
 Asthma and
 Pneumonia.
Nursing education
History of Nursing Development
The Theoretical Foundation Of
Nursing
 Nursing theories provide the theoretical
foundation of the professional .
Theory define what the nursing is ,what it
does and the goals or outcomes of the
nursing care.
Nursing is synthesis or many theories .
 Nursing education
The three traditional educational avenues that prepare
men and women for registered nursing are:
1.Hospital-based diploma programs,
2.Associate degree programs (primarily found at junior
and community colleges),
3 .Baccalaureate programs (offered at 4-year colleges
and universities). It is also possible for students to begin
their nursing education in programs that culminate in a
master’s degree, and several programs now exist in
which a student can earn a doctorate before being
eligible to write the state licensing examination for
registered nursing.
 Atleast two other groups
of caregivers are
identified with nursing:
the nursing assistant, who
may be certified, and the
practical (vocational)
nurse, who is licensed
through a separate and
different examination
from that taken by the
RN. We begin with a
discussion of those roles.
Nursing education
Diploma nursing
Associate degree nursing
Baccalaureate Education
 Master’s and Doctoral Pre-licensure
Programs
Doctoral Studies
Articulated Programs
Distance Education
 Diploma Education
The earliest type of nursing education in the United
States took place in diploma programs administered
by hospitals, also referred to as hospital-based
programs. The early development of these schools is
synonymous with development of nursing as a whole.
Development of Hospital-Based Diploma
Nursing Programs
The first hospital with a nurse training
school was the New England Hospital for Women,
which accepted five probationers on September 1,
1872.
CONTINUE…….
By the late 1940s and early 1950s, many hospital-based nursing
schools had affiliated with nearby colleges and universities;
these schools adopted general education requirements, such as:
 Anatomy
 Physiology
 Sociology
 Psychology

As part of the curriculum. During this time, the

national league of nursing education—later to become two
organizations, the national league for nursing (NLN) and the
national league for nursing accrediting commission (nlnac)—
assumed an active role in curriculum guidance and accreditation
Cont…
Hospital-Based Programs Today
These programs vary in length from 27 to 36 months. Many
diploma schools are affiliated with a college or university so that
college credit can be awarded formally.
Graduates are provided with a foundation in the biologic and
social sciences and may have taken some courses in the
humanities.
There is a strong emphasis in diploma programs on client
experiences.
The course of study includes experience in nursing management
(e.g., being in charge of a nursing unit). Graduates work in acute,
long-term, and ambulatory healthcare facilities, fulfilling the
responsibilities established by the scope of practice for RNs as
defined by the state in which they are licensed.
CONTINUE…..
The elimination of hospital-based
programs has occurred because hospitals
could not sustain the costs of supporting
the programs and because students
became more attracted to programs
located in colleges and universities.
Associate Degree Nursing Education
The movement toward associate degree
education began in 1952. Today, associate
degree nursing programs prepare more
graduates for licensure as RNs than do
any of the other programs and comprise
over one half of all students enrolled in
prelicensure RN programs (NLN, 2009).
Associate degree programs have helped to
solve the nursing shortages of the 1960s,
1980s, and today.
Cont..
Characteristics of Associate Degree Education
In a typical program, approximately 40% of the credits
needed for the associate degree must be fulfilled by general
education courses such as English, anatomy, physiology,
speech, psychology, and sociology; the rest are to be fulfilled
by nursing courses. Clinical learning experiences are
carefully selected to correspond with the content delivered in
classroom lectures; the preconferences and postconferences
help to reinforce the relationship between the two. Some
modifications in this structure are occurring, as associate
degree educators strive to meet the expectations of
employers and the community while remaining true to the
concept of associate degree education
 Baccalaureate Education
 Baccalaureate degree nursing education occurs in a 4-year
college or university and is championed by many to provide the
minimum educational preparation for professional practice.
Development of Baccalaureate Education in Nursing
The first school of nursing to be established in a university setting
was started at the University of Minnesota in 1909 as a quasi-
autonomous branch of the university’s school of medicine. The
program was not very different from the 3-year hospital-based
program operating at that time; nothing was required in the way of
higher general education, and graduates were prepared for the RN
certificate only. Education took place predominantly through
apprenticeship, and students provided service to hospitals in
exchange for education. However, nursing education did become a
part of an academic organization, with 16 colleges and universities
developing programs by 1916.
CONTINUE…….
Characteristics of Baccalaureate Education
A baccalaureate nursing program is termed a basic or generic
program when it is a prelicensure program leading to eligibility
to take the NCLEX-RN. It includes an upper division (junior and
senior years) nursing major that is built upon 2 years of liberal
arts and science courses taken during the freshman and
sophomore years.
Changes in Baccalaureate Education
In recent years, the nature of baccalaureate education has
changed. Many baccalaureate nursing programs have taken steps
to respond to the need for more RNs prepared for licensure at the
baccalaureate level. Innovative methods include the development
of accelerated programs and external degree programs.
Master’s and Doctoral Prelicensure
Programs
Most of the graduates of these programs are
engaged in teaching and research.
Such programs reflect the thinking of some
nursing leaders that the minimum
preparation for professional nursing should
be the master’s degree. The programs also
provide a higher degree to those people who
possess basic baccalaureate preparation in
another area of study.
CONTINUE….
Master’s Preparation
Master’s preparation is recommended for
leadership positions in nursing, for clinical
specialization, and is generally the minimum
preparation required to teach nursing. The
AACN has outlined roles for graduates at the
various educational levels. Their vision is for
a generalist at the baccalaureate level and an
advanced generalist at the master’s level that
includes the clinical nurse leader.
 Doctoral Studies
Before doctorates in nursing were offered, doctoral study in
other fields allowed nurses to benefit from post-master’s
preparation. A doctorate outside the area of nursing was
often the only doctorate available to persons seeking further
education; doctorates in nursing are relatively new to the
educational milieu.
Doctoral programs in nursing offer various degrees, such as:
 The doctor of nursing science DNS),
 The doctor of science in nursing (DSN),
 The doctor of nursing education (DEd),
 The more traditional doctor of philosophy in nursing
(PhD)
Cont…
Non-nursing doctorates are available to nurses, such as:
 The doctor of education (ED)
 The doctor of public health (DPH).

 In 2004, the AACN proposed a doctor of nursing practice degree

(DNP).
 The DNP is designed for nurses seeking a terminal degree in
advanced nursing practice, as opposed to working in research
(AACN, 2006a).
 The DNP was developed with the premise that the challenges of
today’s healthcare demanded a higher level of preparation for
advanced practice nurses (APNs) who could design and assess care
and provide leadership. Some universities are changing their nurse
practitioner programs from master’s degree programs to this type of
clinical practice doctorates.
Nursing Responsibilities
Recognize that an image problem does not
exist and that each individual nurses has a
responsibility to improve the profession
image
Become politically active and politically
knowledgeable ,nurses should run for office.
Document activities.
Write and submit features stories on nurses
for local media.
Cont…
Demand that nurses authors to considered
for editing health columns.
Provide technical assistances to media.
Provide ongoing public services
announcement.
Create a public forums, "spend a day with
a nurses”.
Cont..
Share the positive aspects of the nursing
profession with other.
Learn to describe alternative nursing
education programs.
Continue to develop alternative nursing
education programs.
 crtically asses the action you take , that
might impact the image of nursing.
Cont..
Remember nursing image is you.
Be self-confident, self-confident behavior
respect.
Increase staff involvement in scholarly
activities .
Be positive.
Strategies For Improving The Image Of
Nursing
The nursing profession faces some
difficult issues and challenges as it related
to image building.
Collective bargaining.
Computer technology .
Elimination of internal sexism .
Development of internal media.
External media committees
Education
Nurses Image of Itself
Our greatest advocate is the cilent ,as we
reach out to care for them heart to heart, they
will reach out to work with us hand in hand.
Collectively, these individuals nurses attitude
,behavior and interaction constitute nursing
self image.
Nurses who verbalize comments such as “I
am only a staff nurse”I was just following
the physician order ,are not improving the
image of nursing
Cont…
Itis the challenge for each nurses to
extend the best image possible and offer
the utmost by substantiating the value of
that service.