Extreme Makeover
Nursing image campaigns employ advertising principles to play up the perks of the profession

By Phil McPeck
September 4, 2003

The people who ultimately will turn around the nursing shortage didn't spend a day in nursing school. They are the geniuses of marketing and advertising programs who are polishing nursing and selling it to teens, those considering second or third careers and nurses themselves.

Take Greta Sherman, managing partner at J. Walter Thompson, the public relations and marketing giant that all but invented product branding. Subsidiary JWT Specialized Communications has 600 hospital clients in the United States and is the not-so-public face behind Nurses for a Healthier Tomorrow, the flagship campaign of 41 nursing and health care organizations to promote nursing careers.

Then there is Nancy Lewin, Johnson & Johnson's executive director of corporate equity, nursing and new ventures. She holds a master's in business administration degree from the University of Pennsylvania's Wharton School of Business and oversees Johnson & Johnson's $20 million Campaign for Nursing's Future.

Sherman and Lewin tell the same story of a profession in need of a boost.

Two years ago, Sherman polled 1,800 school-aged children, 2,000 parents and 350 career coaches and high school counselors. "We look at employee branding like others look at Ford trucks or Kraft Macaroni & Cheese," she said. "What we came away with was not a bad image, but certainly not a good image."

She found a profession that was thought of as weak on men, minorities and opportunity. So Nurses for a Healthier Tomorrow was launched on a shoestring-a couple of dozen organizations with a couple of hundred thousand dollars-and built around an inordinately large number of men and minorities to portray the diversity and breadth of nursing.

"Whenever we would talk to young male students, they just checked out," Sherman said. "Their answer was, 'It's a girl's job.' " Furthermore, "people actually believed there wasn't a lot of ability to move forward in a career in nursing-that you went into nursing and stood at the bedside for 40 years."

Seven print advertisements of RNs explaining the rewards and reasons for their careers include three men and four women, one of them Hispanic and one African American. Their positions range from staff nurse to researcher, advanced practitioner and chief executive.

Plans are to repeat the research in 2004, Sherman said, and tweak the campaign based on the new findings.

Unanswered questions

But still of major concern to her is a confusion about nursing that she blames on the profession itself and which is not easily addressed with media campaigns.

"As a profession, nursing has not grappled with the overriding point that there needs to be one entryway to the profession," Sherman said. That was identified as a "must" in a 1960s position paper on the future of nursing, and "We're here in 2003 and you can go for a two-year, three-year, four-year, even a five-year program and come out sitting for the same exam for the same pay and the same licensure," she said.

So many avenues cloud the image of just who and what a registered nurse is. Consumers, parents, students and their career counselors want the clarity they have with MDs, where the American Medical Association recognizes one level of education that underlies any specialty, Sherman said. "Nursing needs that. There has to be a coming together of what entry level is."

Lewin's research found more admiration than confusion, but the same underlying problem contributing to the nursing shortage.

Before Sept. 11, 2001, when firefighters' and police officers' popularity soared with their heroics at the site of the World Trade Center terrorist attacks, public opinion polls consistently ranked used-car salesmen as least trusted and nurses as most trusted.

"Everyone thinks they're the most wonderful angels, that they really care and get you through the illness," Lewin said. "But nobody wants to be a nurse."

She said girls who are strong in math and science dismiss nursing with the attitude that "This is 2003, I can be a doctor," and boys who excel in science and technology reject nursing as a girl's career-and a Caucasian girl's profession to boot. "That's the gap we have to bridge," Lewin said.

Besides a Web site, www.DiscoverNursing.com, and television commercials, Johnson & Johnson's Campaign for Nursing's Future has blanketed schools and career counseling centers with 3 million pieces of literature and recruitment videos since February 2002. "They can call us tomorrow and say, 'I want a million pieces,' and it would go out free," said Kristin Smith, director of corporate communications.

The campaign treats the idea of a nursing career as a product, selling it to specific audiences in much the same way that Motrin IB or Tylenol is marketed, said Lewin, who worked on those campaigns. "That's why our materials have African-American people, Hispanic people, Asian people, Native Americans. And then men and women, people who are fat and thin, and have white hair and no hair."

She said the goal is for high schoolers, college students, second and third career-seekers, Internet users and television viewers to see the diversity of nurses and say, "You know what? That could be me."

"We know that's going to take a couple of years," Lewin said, but it's been done before. Today, people think nothing of male flight attendants, but in the 1960s they were called stewardesses and were exclusively female.

Usually, "packaging" an idea would be more difficult than promoting a tangible product, but not in the case of nurses, Smith said. "What nurses do is amazing. They've got a great career and they really, really just needed some assistance to make that known," she said.

On target

Drawing on the latest campaign progress report, she said that about 55 percent of teens aged 16 to 18 know or have known someone who has considered a career in nursing. About 75 percent of adults believe that it would be a great career.

And 84 percent of nursing schools with Campaign for Nursing's Future materials have reported increases in applications and enrollment in the last year.

Nursing is on the rise again, said Nancy Dickenson-Hazard, MSN, RN, executive director of Sigma Theta Tau International, the nursing honor society. She said RNs are best able to convey the positives of nursing through their performance as clinicians, researchers, educators, entrepreneurs and administrators.

What's crucial, she said, is that they understand that nursing is not the support occupation it once was, but instead has "an identified body of knowledge and an identified skill set."

On a personal note, Dickenson-Hazard said she found that counselors in her daughter's Indiana high school were grateful for promotional material from both campaigns. "They didn't have a lot of information and there were a lot of young women who were interested in going into nursing," she said.

Improved self-worth and retention of RNs are also crucial aspects of the Johnson & Johnson program. The New Jersey-based Fortune 500 conglomerate awards scholarships to advance individual careers and grants to underwrite nursing faculty, Lewin said.

Additionally, the campaign has reinvigorated careers of veteran nurses who love their career but not their jobs, and newer RNs struggling to reconcile nursing school idealism with a workplace reality of too little respect and too much work.

The campaign has featured fund-raisers and nurse appreciation functions from Boston to Northern California and Phoenix to Michigan, with more to come.

Thank-yous keep coming in, Lewin said. "We've gotten hundreds of letters: 'I was ready to quit. I hated my job. I was so burned out and your event reminded me of why I became a nurse,' " she said.

Contact Phil McPeck at getpjm@aol.com