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For as long as she could remember, Angie Silsby wanted
to be a pediatrician. Nurses would be her assistants,
she thought. They would help her carry out whatever
she needed to do for her patients. Then, the Boise,
Idaho, high school student had a chance to see health
care workers in action as part of a health occupations
program at her school.
"For the most part, it was the nurses doing the
patient care," Silsby said. "I observed doctors
and they were in and out. Nurses were there if the patient
was crying and needed help. The nursing aspect was more
my style. It was more social, more patient-oriented."
Silsby switched career plans and has been accepted
at the Boise State University department of nursing,
where she will enroll in the fall. At one time, some
people may have thought she had lowered her standards
because she decided to become a nurse instead of a physician.
"Nowadays, I don't think it's considered a step
down," Silsby said. "I think most people would
rather have a nurse take care of them. It's the gentle
spirit of nurses that I observed."
The "gentle spirit" that swayed Silsby to
nursing also has made a huge impression on the American
people, according to public opinion polls. Nurses are
seen as trustworthy, capable and conscientious caregivers,
critical to the health care system. Most people, including
nurses, would encourage a loved one to become a nurse.
But polls also show a gap in the awareness that people-especially
young people-have of what nurses do. Most do not know
that nursing offers career opportunities besides patient
care. Many do not understand the differences between
licensed practical nurses, registered nurses and nurse
practitioners.
And most Americans have little or no idea that starting
salaries in nursing compete with those of other professions.
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To close that gap, and to emphasize the qualities of
intelligence, competence and caring that many Americans
see in nurses, a number of groups, including health
care products giant Johnson & Johnson, national
and state coalitions of health care organizations, as
well as individual hospitals and universities, are creating
campaigns to improve the public's awareness of nursing
and to attract more people to the field.
Using videos, posters, Web sites, public service announcements,
television and movie advertisements and information
packets for guidance counselors, these groups strive
to transform nursing's image from the traditional picture
of a bedside caregiver into an exciting career for men
and women from any ethnic or socioeconomic background.
The campaigns highlight the profession's diversity,
salaries, opportunities for advancement and excitement.
Nurses travel. Nurses run companies. Nurses do research.
And, of course, nurses save lives.
"I think the lightbulb is beginning to go on all
over America," said Nancy Dickenson-Hazard, MSN,
RN, FAAN, chief executive officer of Sigma Theta Tau
International Honor Society of Nursing, based in Indianapolis.
"People are beginning to see the diversity in nursing."
Last year, nurses ranked second to firefighters in
a Gallup poll that asked respondents to rate the honesty
and ethical standards of people in various professional
fields. Nurses rated higher than the military, police,
pharmacists, physicians and clergy in a poll conducted
two months after the Sept. 11 tragedies.
In the two previous years, nurses ranked first in the
poll, with high ratings from 73 percent and 79 percent
of Americans.
A poll conducted in the spring by Vanderbilt University
Medical Center's School of Nursing and Center for Health
Services Research in Nashville, Tenn., had similar results.
It showed that 95 percent of Americans overwhelmingly
trust, respect and admire nurses, and that 83 percent
would encourage a loved one to enter the nursing profession.
A recent survey of nurses sponsored by NURSEWEEK and
the American Organization of Nurse Executives showed
that 83 percent of nurses said they were very, moderately
or a little satisfied with their jobs and that 60 percent
would definitely or probably advise a high school or
college student to become a nurse.
The Vanderbilt poll, commissioned by Johnson &
Johnson, also showed that almost all Americans recognize
that there is a nursing shortage and that it jeopardizes
the quality of health care in the United States.
"Certainly, nursing in this country is suffering
from a lack of interest," said Walt Baker, community
affairs director at Channel 2 KBCI-TV in Boise. Baker
said he eagerly agreed to air a public service announcement
promoting nursing. "We all will probably end up
needing a nurse one day. As a community, that's something
we should support," he said.
Baker himself gained new respect for nurses when he
saw how they cared for members of his family. "They
are surprisingly knowledgeable and capable," he
said. "My personal experience has been that nurses
are of more help than doctors. They seem to be more
committed."
Many Americans view nurses favorably, as Baker does,
because they have had positive experiences, according
to those who work on the image campaigns. But information
from the Vanderbilt study and others show that most
Americans see nurses primarily as bedside caregivers
and have little understanding about what else they do.
A study of 1,800 American schoolchildren last year
found that most saw nursing as scary and stressful,
with little chance of advancement and terrible hours.
Nurse recruiters who talk to high school students and
young adults about nursing said they routinely hear
comments such as "I don't like blood," and
"I don't want to work nights."
According to a recent Johnson & Johnson study:
- Only half of Americans know that RNs must have
a bachelor's or an associate's degree.
- Fewer than one in five know that nurses must be
licensed.
- Less than 20 percent of Americans know that RNs
must have continual education.
- More than two in three Americans do not know that
nurse practitioners are allowed to prescribe drugs.
While most know that nurses are responsible for bedside
care, administering IVs, giving injections and drawing
blood, fewer than four in 10 people know that nurses
are involved in reducing health care costs, working
in laboratories or writing and revising hospital and
clinic policies.
Perhaps because of this gap in knowledge about nursing,
the Vanderbilt study found that only 21 percent said
they would consider nursing as a career. This is the
number the nursing image campaigns hope to change.
"We're loved," said Sarah Keating, Ed.D.,
RN, FAAN, chair of the California Strategic Planning
Committee for Nursing. "The problem is, we need
more people to come in and be loved."
In February, Johnson & Johnson launched its "Campaign
for Nursing's Future" in response to a prolonged,
projected nursing shortage. The company plans to spend
more than $20 million during the next two years to attract
more people to nursing.
Its campaign includes television advertisements celebrating
nurses' contributions and showing the diversity of the
profession; scholarships for students and faculty; a
Web site (discovernursing.com) with information about
careers in nursing; and recruitment brochures, posters
and videos for high schools, nursing schools and health
care organizations.
"We've received thousands of phone calls, letters
and e-mails" requesting materials and information,
said John McKeegan, a company spokesman.
Last year, Nurses for a Healthier Tomorrow, a coalition
of health care and nursing organizations, launched a
new recruitment campaign to bring people into nursing.
The group, which includes the American Hospital Association,
Sigma Theta Tau, the Department of Veterans Affairs
and more than 30 other health care organizations, produced
a 30-second public service announcement, printed posters
and recruitment materials and launched a Web site.
The public service announcement has reached more than
50 million viewers, according to the coalition.
Using the Nurses For a Healthier Tomorrow ad campaign,
Boise State University's department of nursing reported
a 300 percent increase this year in the number of applications
to its program.
Margaret Kemp, MA, RN, nurse recruiter and adviser
for the university's department of nursing, said the
campaign was the cornerstone of the recruiting effort.
"We were not expecting 767 applicants for the 250
openings," Kemp said. "This high-quality marketing
campaign was absolutely tailored to the audience we
are trying to attract to our nursing program."
Kemp also used the campaign's print ads in her presentations
to high school students and the community. "The
profiles of successful nurses send a strong message
about the changing image of nurses today," she
said. "Discussing each profile, students were amazed
to realize the variety of nursing positions there are.
I don't think they realized just how professionally
satisfying a career in nursing could be."
Other state and local groups, such as the Coalition
for Nursing Careers in California and the Greater Houston
Partnerships in Texas, are bringing together local businesses,
hospitals, nursing schools and nursing organizations
to create similar campaigns. Greater Houston Partnerships
recently sponsored a job fair to fill vacant nursing
faculty positions.
"The reach of these campaigns has been pretty
phenomenal," Dickenson-Hazard said. "Part
of the issue, obviously, is to keep up this promotion
and education of the public."
Peter T. Buerhaus, Ph.D., RN, FAAN, professor of nursing
and senior associate dean for research at Vanderbilt
University, said he was surprised by the number of people,
especially men, who looked favorably upon nursing as
a career. According to the Vanderbilt study, one in
10 men said they had thought about becoming nurses at
one time, and eight in 10 said they would consider it
a positive career for a loved one.
"I don't think you would have seen that 10 years
ago," Buerhaus said.
Nursing, like teaching, has long been considered a
woman's profession, Buerhaus said. It was one of few
options for women who wanted a career.
As career opportunities for women began to open up
in the 1970s and blossom in the 1980s, fewer chose nursing.
Public money and public opinion supported women choosing
professions that had been previously closed to them,
such as law, engineering or medicine, Buerhaus said.
Many considered nursing a second-class option.
The image of nursing took another serious blow during
the recession and downsizing that began in the 1980s,
said Katie Bray, MBA, RN, nursing workforce management
consultant for Kaiser Permanente Oakland and co-director
of the Coalition for Nursing Careers in California.
Graduates had a difficult time finding jobs. Stories
of layoffs and cutbacks gave many the impression that
nursing was not a good field to work in, Bray said.
Some nurses have not forgotten that period, she said.
| When asked how they would
rate the honesty and ethical standards of people
in the fields below as "very high", "high,"
"average," "low" or "very
low," 84 percent of Americans reported nurses
have "very high" or "high" standards. |
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| Firefighters |
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| NURSES |
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| U.S. military |
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| Police Officers |
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| Pharmacists |
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| Medical doctors |
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| Clergy |
 |
| |
| by Sigma Theta Tau International,
the Honor Society of Nursing SOURCE: The Gallup
Organization |
"That memory is still with them, so they are not
good ambassadors for the profession. Fixing that and
fixing the image of nursing is really tough," Bray
said.
Hospitals now have a responsibility to show nurses
that they are places where creative, innovative people
will have support, said Pamela Triolo, Ph.D., RN, FAAN,
senior vice president and chief nursing officer at The
Methodist Hospital in Houston.
Methodist would like to become a nursing magnet hospital
this summer and features a program that offers grants
to nurses to research practices and patient outcomes.
Recently, a group of advanced practice nurses received
$300,000 from the hospital board for a telenursing project
the APNs designed in collaboration with a group of visiting
nurses.
"This is nursing," the group told Triolo.
Triolo had no difficulty finding nurses to participate
in an advertising campaign that featured staff members
talking about why they loved nursing and why they loved
working at Methodist. An earlier campaign to find the
"100 best" nurses allowed the hospital to
hire 85 nurses in two months, including some who had
left the hospital and the profession.
"If you want to hire to your culture, you've got
to project that image in the workplace," Triolo
said. "I want to attract innovators. I want anyone
who looks at the advertisements to say, 'I might want
to be a nurse.' "
Everyone involved in the image-improvement campaigns
says it's too soon to judge their effectiveness. The
proof, they say, will be in nursing school enrollments
in coming years.
Enrollments have increased slightly, according to the
American Association of the Colleges of Nursing. A number
of nursing schools report increased enrollment and interest
in accelerated nursing programs for students who have
a degree in another subject. Besides the marketing campaigns,
other reasons listed for rising enrollments include
a shaky economy and the events of Sept. 11, said Robert
Rosseter, director of public affairs for the association.
"Many second-career seekers are attracted to the
job security that nursing provides," Rosseter said.
"With the Department of Labor estimating the need
for 1 million new and replacement nurses by 2010, nursing
has become a very secure field with opportunities to
practice virtually anywhere, in many different roles."
Many applicants also have said they want to "give
back" and "make a difference" in light
of recent world events, he said.
Kemp attributed the enrollment increase at Boise State
to concerns about the economy and media attention to
the nursing shortage, as well as the school's marketing
campaign.
Recently, hospitals and nursing schools in Sacramento,
Calif., staged a "Nurse Image Day" at a mall.
They set up displays and booths promoting careers in
nursing and explaining how to enroll in nursing programs.
Teens in high school and people considering a second
career, including many men, stopped by, asked questions
and seemed genuinely interested in the displays, said
Kathy Green, RN, nurse manager of recruitment and retention
at the University of California, Davis Health System.
Nurse Image Day had been an annual event in the 1980s,
Green said, but was discontinued in the early 1990s
when nursing jobs disappeared and hospitals lost interest.
At the latest event, Green said, she did not notice
much of a difference in the way people viewed nursing
as a profession from the way they did 10 years ago.
"But I think we're on the brink of getting that
changed," she said. "The role of the nurse
has really changed and I think we've just got to get
that out there."
Although Silsby chose nursing because of its caring
spirit, the possibilities of the profession excite her
as well. She dreams of opening her own practice as a
nurse practitioner. She would like to be part of a medical
team and travel. She loves children and wants to work
with mothers and babies. She also was excited when she
saw an open-heart surgery.
"I'm keeping all areas open," she said. "With
nursing, there are so many opportunities. You can go
anywhere."
Contact
Cathryn Domrose at kaguilar@well.com.
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