Perceptions of Nursing PDF (BNUR 1001, November 2024)

Perceptions of Nursing BNUR 1001 November 5, 2024 Peter Kennedy RN, BScN, MBA Learning Objectives  Profession’s identity and image, overlapping concepts.  Describe the progression of the image of nursing over time.  Identify current issues related to the image of nursing.  Develop stra...

Perceptions of Nursing BNUR 1001 November 5, 2024 Peter Kennedy RN, BScN, MBA Learning Objectives  Profession’s identity and image, overlapping concepts.  Describe the progression of the image of nursing over time.  Identify current issues related to the image of nursing.  Develop strategies to address current issues related to the image of nursing.  Profession’s Identity Competency framework 1. Clinician There is a total of 101 2. Professional competencies organized 3. Communicator thematically under nine 4. Collaborator roles: 5. Coordinator 6. Leader 7. Advocate 8. Educator 9. Scholar https://cno.org/Assets/CNO/Documents/Become-a-Nurse/41037-entry-to-practice- competencies-2020.pdfhttps://cno.org/Assets/CNO/Documents/Become-a- Nurse/41037-entry-to-practice-competencies-2020.pdf  Direct & Indirect POC Experiences Legacy Societal Attitudes Media Profession’s Profession’s Identity Image Direct & Indirect POC Experiences Evolving Societal Attitudes Media Our Profession’s Identity Versus Our Profession’s Image Kalisch and Kalisch Nurses need to define the scope of their own profession. Kalisch and Kalisch identify six images of nursing: 1. Angel of Mercy: Self-sacrificing, moral, noble 2. Girl Friday: Subservient, physician handmaiden 3. Heroine: Brave, dedicated 4. Wife/Mother: Maternal, passive, domestic 5. Sex Object: Sensual, romantic, promiscuous 6. Careerist: Knowledgeable, intelligent, respected professional Kalisch, P., & Kalisch, B., A comparative analysis of nurse and physician characters in the entertainment media. Journal of Advanced Nursing, 1986, vol. 11, pp. 179-195. [An analysis of 670 nurse and 466 physician characters portrayed in novels, motion pictures and prime-time television series, published or produced from 1920-1980.] Angel of Mercy  Self-sacrificing, moral, noble Girl Friday  Subservient, physician handmaiden Heroine  Brave, dedicated Wife/Mother  Maternal, passive, domestic Sex Object  Sensual, romantic, promiscuous Careerist  Knowledgeable, intelligent, respected professional   Bureaucratic: Does anything necessary, emphasis on structure.  Battle Axe: Bossy, scary, inflicts pain and More Stereotypes humiliates into compliance and another longstanding image that is not often acknowledged The Real Public Perception of Nurses “…Thus, there is little scope of the public staying updated on the professional developments in nursing practice. Hence, to the public, nursing is caring for someone in distress. They know that a caring nurse can give comfort and solace to someone in need. The public perceive a nurse as just someone who assists the doctor during and after treatment of the illness assisting the patient in keeping up his personal hygiene, giving the medications as prescribed by the doctor, dressing the wounds when there is a need ensuring the welfare of the patient. There are also people both male and female who are of the view that men have no business working in the field of nursing due to lack of capacity to care compared to a woman.” (The Journal of Nursing, 2007) https://www.asrn.org/journal-nursing/249-the-real-public-perception-of-nurses.html Fuller, W. (2021)  Crafting our image for success in advocacy:  Comportment  Freedom of expression – impact and cost to the profession?  Media examples  “Personal responsibility to represent the profession honorably in ways that do not compromise the support and respect of our stakeholders and the public” Fuller, W. (2021). Crafting our image for success in advocacy. Florida Nurse. 69 (2), p. 2-2. van der Cingel & Brouwer (2020)  Professionalism, autonomy, doer versus thinker  Historical: Female characteristics, hierarchical dualistic role  Identity today: United and special group of professionals  Moral values shape professional identity: Caring, compassion  Changing identities: Stereotypes, labelling Conclusions Differently as in a profession in which:  Thinking and the use of knowledge is necessary for good quality of care.  Using a professional’s potential would contribute to the prevention of burnout and compassion fatigue.  That would be a fulfilling job for men and women alike in which they can ‘do good’ and be of importance to others.  Strategies to accomplish this? Van der Cingel, M. & Brouwer, J. (2020). What makes a nurse today? A debate on the nursing professional identity and its need for change. Nursing Philosophy, 2021;22:e12343. Daigle (2018)  Nightingale: Floor length dresses with long sleeves , an apron and bonnet, WW II – shortened for practicality reasons  Colour to signify rank  1990’s scrubs: Comfortable, functional, gender neutral  White uniforms more professional, cleanliness and neatness  Professionalism includes elements of dress, attitude, communication, knowledge, and personal behaviour  Study results: Overwhelming theme – uniform changes have affected how patients perceive professionalism in nursing  Future research: Millennials, male perspectives in the change in uniform  Wang et al. (2019) Conclusions: Nursing students' academic burnout level was close to the median on the Academic Burnout Scale, and improper behaviour was most severe. Positive professional self-concept can reduce the level of academic burnout. It is meaningful for nursing educators to take measures to decrease nursing students' academic burnout and enhance their professional self- concept. Wang, M., Guan, H., Li, Y., Xing, C., & Rui, B. (2019). Academic burnout and professional self- concept of nursing students: A cross-sectional study. Nurse Education Today, 77, 27-31 Article Themes?  Wang - positive professional self concept  Van der Cingel - influence of others on identity is important as well as what they believe? Need to acknowledge the need for knowledge and thinking is important for good care, fulfilling job for men and women – letting go of stereotypes  Fuller - effectiveness linked to our expertise and professionalism  Geller - media affects how people think about and act towards nursing, stereotypes of nurses – reflects Kalish and Kalish, idea to nurse outloud - articulate what you are doing and why  McGillis Hall – positive light on the profession, opportunity to educate Public Perceptions The pandemic inadvertently brought the public into the nurses’ professional struggles, where they face daily ethical dilemmas and the ongoing challenge of providing quality patient care, sometimes with limited resources. This insight has resulted in public awareness of what was previously somewhat of a private struggle by the nurses. A more positive image of the profession can improve the nurses’ perceptions of themselves as professionals, help to promote the nurses’ struggle for independence and leadership, and at the same time increase the demand to learn the profession. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10048593/#:~:text=The%20nursing%20 Int.J.Environ.Res.PublicHealth2023,20,4717.https://d profession%20has%20had,demand%20to%20learn%20the%20profession. oi.org/10.3390/ijerph20064717 Changing Stereotypes External Internal  Historical role of nurse as not  Role confusion independent (handmaiden)  Lack of professional confidence  Hierarchical structure of health  Timidity care organization often limited nursing in decision making  Fear  Perceived authority of physicians  Insecurity  Hospital policy – limits nursing  Sense of inferiority actions  Threat of disciplinary or legal action if nurse speaks out  CNO’s Code of Conduct  CNO’s Code of Conduct is a standard of practice describing the accountabilities all Ontario nurses have to the public. The Code of Conduct consists of six principles including: 1. Nurses respect the dignity of patients and treat  CNO’s Code of Conduct provides, in them as individuals; relation to the principle requiring nurses to maintain patients’ trust by 2. Nurses work together to promote patient well- providing safe and competent care, being; that nurses are accountable to, and 3. Nurses maintain patients’ trust by providing safe practice under, relevant laws and and competent care; CNO’s standards of practice. 4. Nurses work respectfully with colleagues to best  CNO’s Code of Conduct also meet patients’ needs; provides, in relation to the 5. Nurses act with integrity to maintain patients’ principle requiring nurses to maintain trust; and public confidence in the nursing 6. Nurses maintain public confidence in the nursing profession, that nurses are profession. accountable for their own actions and decisions.  ONA represents 68,000 nurses Ontario Nurses’ Association (ONA) and health-care professionals, as well as 18,000 nursing student Position Statement: affiliates — who provide care in hospitals, long-term care, public The Image Of Nurses (2020) health, the community, clinics, and industry.  “…But as the union representing Ontario nurses, ONA has an important part to play in enhancing the image and reputation of nurses to challenge and dispute misconceptions, to show nursing as an attractive career, to empower nurses and publicize what they do, to urge nurses to “sell” our profession to future generations, to encourage more respect for the profession, and to raise the public voice and profile of nurses.”  “Education is key. At every opportunity, ONA speaks, and will continue to speak, to the media and the public about the actual work that nurses perform, including our advocacy work on behalf of patients/residents/client. We encourage the media to cover the full range of nursing.”  “The realistic depiction of nurses, regardless of gender, age, race and body type, will remain in the forefront of all ONA publications, campaigns and advertising. In cases where a nurse is portrayed in a negative, inappropriate, inaccurate or insulting light in an external advertisement, ONA will contact the advertiser, broadcaster and the Canadian Broadcast Standards Council to explain why the ad is offensive to nurses and demand that it immediately be withdrawn…” ONA Position Paper Valuing Nursing  What are the current issues in the portrayal of nursing?  How will you portray yourself?  How will you protect the image of nursing?  Believe in Nursing  Speak up for nursing  Identify yourself – you have a name use it  Protect the name of “Nurse”  Insist on being addressed as a professional  Speak up if image is being degraded  Don’t participate in negative image activities Creating a New Image  Nurses value nursing and image daily  Nurses take themselves seriously and dress the part  Nurses recognize the value of caring, health promotion, health teaching, and illness care  Nurses believe in themselves and their colleagues  RNs ranked highest among all professions for Serving the Public the highest professional standards of honesty and ethics  Think of how the society portrays nursing... Images, Perceptions What are the first images that come and Portrayals to mind.... How does past and current media depictions of nurses differ from other professional groups, e.g., physicians, lawyers, teachers? "There are four ways and only four ways, in which we have contact with the world. We are evaluated and classified by these four contacts: What we do, how we look, what we say and how we say it." - Dale Carnegie ONA 2020 Sound the alarm Sound the alarm Fighting for my profession Fighting for my profession This disrespect has to stop This disrespect has to stop  Stereotypes Reinforced By Media  Let’s take a look and see what images we can find....How do the depictions differ from other professional groups, e.g., physicians, lawyers, teachers? …By Celebrities Martha Stewart 1318214-tn_thoughtbubble114  Social Media Hamm faces potential discipline for a series of social media posts, podcast appearances, videos and other writings dating from July 2018 to March 2021 in which she "made discriminatory and derogatory statements regarding transgender people" while identifying herself as a nurse, according to a citation from the college. Her online posts have mocked various transgender women as "a man in a dress" and referred to them using the pronouns "he" or "him." In 2020, she co-sponsored the erection of a billboard on Hastings Street in Vancouver reading "I [heart] J.K. Rowling" in support of the author, who has made public comments that have been criticized as anti-trans by LGBTQ groups and other advocates. In a typical post on her Twitter account on Sunday, Hamm referred to the college hearings as a "witch trial" and suggested she is being persecuted. Social Media  https://www.youtube.com/watch?v=bxVHh1GsZHQ  Elizabeth Wettlaufer Elizabeth Tracy Mae Wettlaufer is shown in this still image, taken from video provided by Citynews Toronto, in Woodstock, Ont., on Oct. 25, 2016. Police have charged Wettlaufer with murder alleging she killed eight nursing home residents. (Citynews Toronto/Canadian Press) Elizabeth Wettlaufer Serial killer nurse "heard God" laughing in her head after telling her to murder desperately ill patients. Church-going Elizabeth Wettlaufer was dubbed the 'Angel of Death' after murdering eight elderly patients by giving them overdoses of insulin. http://www.mirror.co.uk/news/uk-news/serial-killer-nurse-heard-god-11557183 Unregistered Practitioners (CNO) Ottawa Region Cleroux, Brigitte a.k.a. Brigitte Marier, Brigitte Cleroux, Brigitte Fournier, Melanie Cleroux, Melanie Gauthier, Melanie Thompson and Melanie Smith https://www.cbc.ca/news/canada/british-columbia/bc-fake-nurse-new-charges-1.6577641  Discipline Committee of The College Of Nurses Of Ontario Decision and Reasons Publicly Available  Pain meds thief gets two years in prison | Published Sep 12, 2016:  A 30-year-old registered nurse, who stole pain medications from dying patients and diluted stores of hydromorphone supplying the palliative care unit at St. Mary's of the Lake Hospital, has been sentenced to two years in a women's prison and probation for three years to follow.  Excerpts from Discipline Committee of The College Of Nurses Of Ontario Decision and Reasons:  The Member was employed as a full-time nurse at Cambridge Memorial Hospital located in Cambridge, Ontario (the “Facility”) from June 11, 2018 until her termination on August 16, 2021. The Facility ran a further audit of the Member’s patient records accesses from June 1, 2020 to August 10, 2021. This audit identified that the Member accessed approximately 166 EMRs, without the patients’ consent, proper authorization, or clinical purpose.  During the personal and romantic relationship, the Member and the Patient communicated via Facebook, text messages and phone. The Member sent the Patient text messages such as: […] The Member and Patient would communicate via Facebook, text message and phone. Messages included “my heart is so into this [Patient]”. […] With respect to Allegations # 3(a) and (b), the Panel finds that the Member’s conduct in breaching the boundaries of the therapeutic nurse-client relationship through exchanging messages via Facebook and text messages was unprofessional as it demonstrated a serious and persistent disregard for her professional obligations. […] Final images…. http://www.youtube.com/watch?v=VlJmRU8EqqY