A November 2008 Gallup poll showed that nurses topped America's list of most trusted professions for the seventh consecutive year. According to the poll, 84 percent of Americans ranked nurses' honesty and ethical standards as "high" or "very high."

Yet in popular entertainment, nurses are often portrayed in a frivolous or even negative manner. In fact, the nurses who are at the center of two new television series have serious character flaws.

These portrayals can undermine the public's confidence and misrepresent the true nature of the nursing profession to individuals considering nursing as a career, according to Diane Peyser, MS,RN,NE-BC, Director of Staff Development, and Donna Tanzi, MPS,RN,NE-BC, Staff Development Educator. At the annual conference of the National Nursing Staff Development Organization in July 2009, Ms. Peyser and Ms. Tanzi gave a podium presentation on the image of nursing over the past 20 years. Titled "We've Come a Long Way . or Have We?" the presentation centered on a review of current literature as well as a retrospective look at the way that nurses have been depicted in the media over the past two decades and the impact this image has on both public perception and choice of nursing as a career. While progress has been made, the two maintain that there is still a long way to go.

"There has never been a nursing character that accurately portrays what we do every day," said Ms. Tanzi. "On the other hand, movies and television have presented many positive portrayals of physicians and other professionals."

In reality, nursing is a serious profession that requires a high degree of commitment, dedication to lifelong learning, and an advanced level of scholarship and intellect.

"Nursing is not merely a job, it is a profession," emphasized Ms. Peyser. "It shouldn't be a career that someone chooses because they have heard that healthcare is recession-proof. It should be something that one aspires to."

Ms. Tanzi, who also teaches nursing students at Nassau Community College and the New York Institute of Technology, often encounters people who are transitioning to nursing as a second career. "Frankly, the job is too challenging for economic reasons to be the driving force for choosing a career in nursing," she stated.

Part of the challenge is that hospitalized patients are much sicker than they were 20 years ago.

"Patients who would have been cared for in the Intensive Care Unit in the 1980s are now on regular Med/Surg floors," Ms. Tanzi explained. "Patient needs have increased exponentially. The role of the registered nurse has become exceedingly complex as it has had to expand and strengthen to keep pace with patients' needs." "Nurses are dealing with people at their most vulnerable," Ms. Peyser added. "Nurses need to possess a full complement of skills - interpersonal, intellectual, and critical decision-making." Although it is possible to become a registered nurse after two years of college, both Ms. Tanzi and Ms. Peyser noted that hospitals with a higher percentage of nurses with baccalaureate degrees report better patient outcomes. Huntington Hospital offers a generous tuition reimbursement program that makes it possible for associate degree prepared nurses to earn their baccalaureate degrees. A four-year degree is a minimum requirement for nursing leadership positions at the hospital. The relatively high percentage of nurses with fouryear and graduate degrees was one of the factors that led to Huntington being named a Magnet® hospital by the American Nurses Credentialing Center, a prestigious award presented in recognition of overall nursing excellence. Fewer than 5% of American hospitals are Magnet designated.

Nursing professionals are drawn to Magnet® hospitals and the positive working environment that Magnet® status implies. For that reason, Huntington enjoys a low RN vacancy rate, even in the midst of a nationwide nursing shortage.

"Magnet® status and our overall commitment to nursing as a profession helps with our retention efforts as well," said Ms. Tanzi.

During orientation of newly hired registered nurses, Ms. Peyser emphasizes the importance of maintaining a professional image at all times.

"Our nurses are role models in the community," she said. "New nurses don't always perceive themselves in this way, but we discuss that they are registered nurses 24/7. They represent professional nursing whether on or off duty."

Not only is demeanor important, but appearance matters as well. Ms. Peyser noted that dress standards have become more lax across society in general over the past 20 years. However, surveys of patients and nurses themselves have shown that appearance plays an important role in helping patients and family members recognize and respect nursing professionals.

In the end, Ms. Peyser believes that nurses need to take pride in the major impact they have on high quality patient care.

"Things are changing for the better," she said. "Physicians truly see nurses as collaborators now. And nurses understand that our skills and abilities are linked to patient outcomes. Now it's time for us to stand up for our profession and advocate for the image of nursing in the media to be more closely aligned to reality." Ms. Peyser and Ms. Tanzi are committed to providing on-going education to all levels of nursing staff to ensure that Huntington Hospital's Magnet® Nurses continuously project each critical element of the true professional image of nursing.

September 2009