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In the last year or so I’ve written a bit about inappropriate images of nurses in the media and elsewhere.  Inappropriate in my view because they depict nurses unprofessionally, or as objectified or over sexualized, or grotesquely parodied.  Each time, I’ve been congratulated and berated in equal measure.  I’ve been called ‘brave’ and a ’stupid, stupid woman’ (and worse).  I’ve been thanked and also accused of having a ‘sense of humour failure’.  No matter.  What does matter to me is the profession of nursing and its future.  I’m a nurse, and I care very much about how my profession is presented to and viewed by the public.  Not least because that public image underpins society’s trust in nursing, it’s view and value of nursing, and because society’s view influences the view of decision makers and Government.  And there are some important points that need to be made to counter some of the negative views put forward.

*Firstly, there’s nothing wrong with being seen as attractive and sexy – as long as it doesn’t become one of the most common public images associated with your profession. ‘Sexy nurses’ are a persistent fantasy – a well-know high street and online lingerie shop sells a ‘Naughty Nurse’ outfit that is very popular.  It’s right next to the Naughty Maid outfit.  And the Naughty Air Hostess.  I couldn’t find a Naughty Doctor, Naughty Lawyer or Naughty Engineer outfit.  In fact, it seems that the Naughty costumes are largely associated with jobs that are traditionally female, as nursing is.  Does it matter?  Well, it matters to me to see the profession used as shorthand for unintelligent, submissive, or sexually dominating, available females, or pantomime-dame-parodied as if there was something intrinsically amusing about a profession that concerns itself with the health and well-being of the population.  And I know it bothers other nurses, many of whom won’t speak up because they don’t want to be seen as strident, or shrill or prudish, or any other of the tedious adjectives applied to women who say they don’t like their profession being seen in this way.

*Secondly, objecting to these portrayals isn’t about nurses ‘losing their sense of humour’ or their ability to have fun.  It’s about pointing out the danger of ‘disparagement humour’ – when prejudice/sexism/racism is delivered in a joke.  When disparaging remarks, or a demeaning image, is presented ‘in fun’ it discourages criticism of the discriminatory message, because it encourages the receiver to accept that message as the norm.  There is research from the USA that has found that repeated exposure to disparaging jokes creates a greater tolerance of future discriminatory events in those who are already prejudiced.  It’s called ‘prejudiced norm theory’.  So, if the jokes aren’t called out for what they are, they’re repeated, and they become more and more acceptable, and it becomes more and more difficult to challenge them.  Does this seem familiar?  There is a big difference between nurses knowing how to have fun, and nurses being made fun of.  I think many nursing leaders need to understand this.

Thirdly, the pressure on nurses to ‘just get over it’ has been around forever.  I don’t want to get over it, I want to change it.  If there is anyone reading this, who is not aware of nursing’s history, then please, go and find out about it.  Its route to professionalism has been nearly two hundred years of struggling for improvement and change.  For example; gaining acceptance as a job for women other than gin-soaked semi-criminals or religious orders (a nineteenth century cliché, but it will do for starters); for the most basic training in the care of the sick; for regulation and registration in order to protect the public from the untrained and incompetent; for recognition as something more than a doctor’s helper; for recognition as a profession in its own right; for formal education in line with other similar professions; for a career structure that rewards skill and knowledge; for better pay – all of these are linked to a battle for respect.  Every step hard-fought and hard-won in the face of political prejudice, societal norms about what women – and men, come to that – should and shouldn’t do, can and can’t do, and sexism and gender constraints.  And  in the twenty-first century there are still those who think nurses don’t need to be educated to the same level as other health care professionals, that a warm heart and a cool hand are all it takes, and that as long as they hand over a few quid they can patronise and make fun of nurses.  And if that sounds angry, then yes, I’m angry.

*If a profession is subject to decades of  low recognition, innuendo, and lack of respect, then should we be surprised if sections of society and government are dismissive about its worth or importance?  Or if that societal disrespect turns into an impact on its terms and conditions and how well it does when the government resources are divvied out?  Should we also be surprised that a profession so closely associated with females and constantly associated with female sexuality does not attract and retain many men? Or that the many bright, intelligent men and women who do go into nursing can become disillusioned to find themselves not worthy of more respect – in terms of recognition for the job, in terms of career, and, of course, in terms of pay – and so they leave?  To use the cliché, it isn’t rocket science to see that a century or more of this kind of broad societal disrespect will have an impact, and will be a factor in people avoiding nursing as a career – the number of men in nursing hasn’t increased above 10-12% for years – or discouraging their kids from going into nursing or leaving the profession itself.  It’s naïve to say that the public’s understanding of nursing fed by media stereotypes has nothing to do with the nursing crisis – that the shortages are only about poor pay and poor resourcing.  That may be the end point, but the low pay and poor resourcing have their roots way back in that insidious lack of respect for ‘women’s work’ and a continuing lack of understanding of what modern nursing is.

At the moment there is a big national campaign by the Royal College of Nursing – ‘Scrap the Cap’ – to lobby the Government to remove the 1% pay cap nurses (and others) are subject to and pay them what they are worth to society.  And there’s the rub.  When some elements of society see nurses as cheerful, hard-working young females happy to give their all for the love of it; others see them as something to make fun of, mock or denigrate; our own professional organisations and leaders don’t make a strong, consistent stand against disrespectful representations; and some nurses collude because they think it’s ‘affectionate’ or funny – don’t expect any Government to be falling over itself to treat nurses as the serious, highly educated, knowledge-based professionals that they are.

 

Bibliography

American nursing campaign website  ‘The Truth About Nursing.’ This is a fantastic website, full of resources and I’ve used their stuff in this blog, marked * because they make great arguments.   If you don’t know it, take a look.

Thomas E. Ford and Mark A. Ferguson (2004) Social Consequences of Disparagement Humor: A Prejudiced Norm Theory Personality and Social Psychology Review 8 (1) 79-94, http://tinyurl.com/9gwl48f.

Girvin J (2015a) Editorial: the public understanding of nursing – time for a step-change? Journal of Clinical Nursing 24 (23-24) 3341-3342

Girvin J (2015b) Guardian Health Network blog site. 14th September 2015

Girvin J, Jackson D, Hutchinson M (2016) Contemporary public perceptions of nursing – a systematic review and narrative. Journal of Nursing Management 24 (8) 994-1006

Twitter thread on low value of women’s work and caring.

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