1. How does the public see the nursing profession and nurses?
In the public's eye, it seems as though nurses are invisible, seeing the job as a supplementary and unskilled profession that does more wrong than right. The authors detail a 'problem narrative' that takes place in the media, one wherein the problems of nurse shortage, staff rations and problems with patients are the norm rather than the exception when it comes to learning about nurses. "This 'problem' narrative is not balanced in the media by a 'practice' narrative that would help the public understand what it is that nurses do" (Buresh & Gordon, p. 5).
There is a significant underreporting of the lives of nurses, leading to a dramatic lack of knowledge regarding what their lives are like. As a result, it can be easy for the public to downplay the importance of nurses, not considering them as important as doctors, or even worth respect at all. This comes from a lack of communication from nurses and an unwillingness to talk about the job. Often, by personally devaluing the work that nurses do in order to humble themselves, they make it seem to the public that nursing is easy. This is a significant problem that needs to be addressed if nurses are to be taken seriously.
2. What does the "Silence of Nursing" mean?
The Silence of Nursing refers to the lack of communication that often occurs when nurses are reached by journalistic bodies (reporters, etc.) in order to learn more about the profession. "Journalists still complain that they are frustrated in their attempts to find nurses who will do even the basics of communication - return phone calls or answer simple questions about their work" (Buresh & Gordon, p. p. 4). This leads to an expectation that nurses simply do not want to be interviewed or tell people about their work, leading to an expectation that few nurses want to talk to the press. A lack of media training is often to blame for this phenomenon, as nursing practitioners simply are not equipped to handle journalistic interviews and questions.
Often, when a scandal or some other medical mishap occurs, nurses are far too afraid of losing their job to open up to the press. Other concerns include having their private lives intruded, as well as potential scrutiny by the public about how they do their job. All of this leads to a code of silence, wherein the need is not seen to speak out on issues that are even directly pertinent to their jobs, like the growing market of nursing research and exposing ethical problems within the healthcare system.
3. How can nurses advance the public understanding of health and healthcare issues?
There are many different things nurses can do to increase the public's understanding of issues related to healthcare. First, a credible professional image must be constructed of the nursing profession, in order to bring up the level of respect for nursing to appropriate levels. While nurses do provide palliative care, they must take steps to make sure the public knows that their job does not rely on intuition or 'something commonplace'; it is the result of incredible training and hard work. It is the job of nurses to start "explaining that caring is complex and skilled work that is essential to patient care" (Buresh & Gordon, p. 18).
Through an accurate depiction of the work of nurses, a better image of a nurse can be provided to the public, given their extensive training, certification and dedication to their task. Nurses must also be careful to shift the public image of nurses from an 'idealized image' of nursing to a more scientific approach (Buresh & Gordon, p. 18). The importance of nursing must be emphasized further; much like how doctors are directly associated with life and death, so must nurses if they are to be accurately represented.
4. How would you answer the following question: "Why did you become a nurse when someone as obviously intelligent as you could have been a doctor?"
I would answer by saying that there are many different factors to becoming a nurse; the most important thing to keep in mind is that a nurse is not a low-rent doctor. What's more, my choice to become a nurse is not indicative of a failure to become a doctor. They are two entirely different career paths, both of which are equally important to the field of medicine. The choice to become a nurse was not based on a perceived lack of intelligence, or a lack of effort on my part to pursue that career path - I found incredible personal and ethical rewards and satisfaction from my career as a nurse.
My abilities as a nurse are just as important, if not more so, than a doctor's. My skill set still requires an extensive knowledge of the human body and its component parts, as well as how they work. I work with many doctors on an equal footing in operations and patient care. With that in mind, it grants me a personal sense of satisfaction that I would not receive as a doctor, as that is not what I personally chose to do. I am not seeking a profession that could earn me more money, as helping people is the primary motivator of my career choice; I am personally satisfied by my nursing career.
5. How is the media reporting on healthcare issues, nursing care and nurses? Give examples. How do you see this process improving?
The media's reporting of healthcare issues, especially those involving nurses, tend to spin the reporting to favor doctors rather than nurses as the chief indicator of a patient's condition. There is an overall emphasis on doctors providing medical research, innovations in medicine, and specific details as to medical-related cases. In the instance of a nightclub explosion that occurred, there were two nurses on the scene, but one admittedly downplayed their actions as "common sense, really" (Buresh & Gordon, p. 105).
This attitude reflects a need for nurses to actually get rid of the humility-based reporting of their activities; by stating that these activities are 'common sense, really,' they are making the general public believe that nursing is easy. This process can be improved by discussing the problems out loud and to the media; nurses need to make the public aware of the changes in healthcare that nursing care cuts are creating, and the overall consequences of that change. Nurses must be more detailed in their assessments of what is done as a nurse, focusing on the specific medical accomplishments of nursing instead of touting nurses as merely virtuous, good people.
6. Write a letter to the Editor about a current issue in nursing today. Give a history of the issue, why it is an issue and possible solutions. Write the letter as if you were going to send it to the newspaper.
Dear Editor,
I am writing to you today in order to bring light to a very specific and troubling issue in the world of nursing - that of nursing silence in the world of media interactions. According to research, nearly 2.7. million nurses in the United States are practically invisible from a media standpoint, where they are either not consulted regarding a pertinent medical issue, or their own lack of candor leads them to be ignored as they have nothing to say. This tremendous issue brings to light many other concerns; namely, the silence of nurses can lead to a false public perception of nursing being unimportant and easy. This can lead to a lack of respect and communication between patients and nurses; this leads to poor practitioner-patient communication, which can translate into reduced quality of care.
In order to combat this issue, there are many things both nurses and the journalistic community can do. On the one hand, nurses must be more confident, detailed and assertive about their role in healthcare; by downplaying their accomplishments, they are diminishing their own confidence and the hard work that goes into nursing. At the same time, more effort must be placed in the journalistic community to emphasize the role of nurses in dealing with natural disasters, performing needed and important research and so on. By nurses being more communicative, and journalists being more engaged with nurses as a profession, the public image of nurses as hard-working, respectable healthcare professionals can be successfully found.
7. How would you go about improving the staffing ratio of nursing to patients in your facility? If you do not work in a facility with a staffing ratio issue, how would you visualize this improvement?
I work at St. Joseph Transitional and Rehab; the nurse to patient ratio is a significant issue there. Often, there are far too few nurses for the sheer number of patients that our facility brings in on a near-daily basis. There simply need to be a higher number of nurses at the facility, as it would be unethical to bottleneck the number of patients we have in order to fit who can be successfully treated. As a result, interventions must be made to increase the number of quality nurses that are entering the field.
I would seek out local journalists and have an open, candid interview with them about the importance of nursing as a field, as well as the dire shortage that is being experienced at St. Joseph. I would make sure to emphasize the hard work and tremendous respect that is earned by nurses, as well as the incredible moral good that would be accomplished by helping others and providing needed patient care. By appealing to the desire to help others, it is possible to create a situation where added interest in nursing would lead to a staffing increase.
8. Will you think differently about the current issues in nursing as a result of reading this book and why?
On a personal note, I will most certainly think more about my status as a role model for nursing as a result of this book. Before this time, I had no idea that nurses were being portrayed in such an unfairly negative light; I consider myself to be a very humble person, and I often see people in terms of good or bad, instead of 'skilled' or 'unskilled.' However, it is easy to see how making nursing look easy can make nursing look unprofessional or downplay the hard work that nurses put into their duties. As a result, I will definitely be more aware of how nursing is portrayed, and try to present a positive image. This way, more people may be inspired to become nurses and help people as well.
9. Search the web and look for 2 Journal articles, peer review discussing "nurses in the media" Give a synopsis of each article and how the articles portray the nursing profession and or nurses. Include authors, publication, and date.
In Neilson and Lauder's "What do high academic achieving school pupils really think about a career in nursing: Analysis of the narrative from paradigmatic case interviews" (2008), interviews with collect students were conducted in order to get their feelings on the nursing profession. In the case of these high-achieving students, they felt as though nursing did not take full advantage of their abilities. Also, doctors were more important as they cured patients, while nurses merely cared for them. This indicates a relatively low level of respect and deference for the nursing profession.
Donelan et al.'s "Public Perceptions of Nursing Careers: The Influence of the Media and Nursing Shortages" (2008), the authors examine the social demographics and media portrayals of nurses to determining how the nursing profession is perceived. Overall, they claim that people have a high regard for nurses, but less so to the point where they want to be one. Media depictions of nurses helping out after natural disasters tended to have incredible sway within the people surveyed, demonstrating that they saw a positive impact the work of nurses gave to the situation. Overall, they paint a very positive picture of how nurses are regarded and the somewhat high possibility for people joining the nursing workforce.
References
Buresh, B., & Gordon, S. (2006). From silence to voice: what nurses know and must communicate to the public. Cornell University Press.
Donelan, K., Buerhaus, P., DesRoches, C., Dittus, R., & Dutwin, D. (2008). Public perceptions of nursing careers: The influence of the media and nursing shortages. Nursing Economics 26(3), 143-165.
Neilson, G.R., & Lauder, W. (2008). What do high academic achieving school pupils really think about a career in nursing: Analysis of the narrative from paradigmatic case interviews.
Nurse Education Today 28, 680-590.
