Posts Tagged nurse stereotypes
A selection of “What I Actually Do” meme posters” related to nursing, which have been making the rounds on the Interwebs. Some of them, I guess, are funny and clever, and they’re meant (I suppose) to educate the public at large about the realities of nursing. But what I think is interesting is the way they reflect nurses’ perceptions of themselves, and how nurses perceive how others view them. Some common themes: nurse as lazy (by managers), nurse as bimbo, nurse as angel, nurse as waitress/bellhop, nurse as money-grubbing, nurse as menial. What do you guys think of them? Do they actually represent how nurses view themselves?
Posted by torontoemerg in Good Nursing Practice is Practising with the Heart and Mind on Saturday 21 April 2012
The world of nursing on a couple of dozen flash cards. From The Nursing Channel on YouTube. While I don’t agree necessarily with every card — some of them, I think, play into some old stereotypes on how nurses behave — it’s still a fresh perspective on nursing. What do you think?
Gob-smacklingly stupid or hip advertising? I’m leaning towards the former. Via CBC:
A Stockholm hospital that published an online ad looking to fill a summer position with a nurse who is “TV-series hot” says it was “written to catch people’s attention.”
“We want people to be curious and have a little imagination,” said Elisabeth Gauffin, head nurse at Stockholm South General Hospital (Södersjukhuset) to the Metro newspaper.
The ad read, in Swedish:
“You will be motivated, professional, and have a sense of humour. And of course, you will be TV-series hot or a Söder hipster. Throw in a nurse’s education and you are welcome to seek a summer job at Södersjukhuset’s emergency department.”
(“Söder” literally means “south,” but here refers to Södermalm, a fashionable district in Stockholm. Think “Soho.”)
The hospital’s nursing manager said the phrasing wasn’t meant to exclude anyone based on looks.
I (sort of) get what the hospital was trying to do. Readers may have noticed I’m not without a sense of humour. But I’m not sure the “And of course” phrasing of the ad effectively signals the intended irony. It’s a little pathetic the hospital needs to rely on a tired old cliché to recruit nurses. Ultimately, I think, the ad trivializes what nurses actually do in Emergency departments, and reinforces public perceptions and stereotypes. As a well-seasoned RN, I would be somewhat disinclined to work there. But maybe it’s all lost in translation, and the ad is deliciously funny in the original Swedish.
Incidentally, for the record, I am not “TV series hot.” On the other hand, I know to work the buttons on a defibrillator.
[Thanks to my friend Leigh for sending this along to me. Her comment: “Laugh or cry?? Mostly exasperation I think. Add more horror that the survey results show that people think this is appropriate!”]
By David F. Baehren, M.D.
[. . .]
We usually look afar for heroes and role models, and in doing so overlook a group of professionals who live and work in our midst: nurses.
And not just any kind of nurse: the emergency nurse. There are plenty of people involved in emergency care, and no emergency department could function without all of these people working as a team. But it is the emergency nurse who shoulders the weight of patient care. Without these modern-day heroes, individually and collectively we would be in quite a pinch.
It is the emergency nurse who cares for the critical heart failure patient until the intensive care unit is “ready” to accept the patient. The productivity of the emergency nurse expands gracefully to accommodate the endless flow of patients while the rest of the hospital “can’t take report.” Many of our patients arrive “unwashed.” It is the emergency nurse who delivers them “washed and folded.” To prepare for admission a patient with a hip fracture who lay in stool for a day requires an immense amount of care–and caring.
Few nurses outside of the emergency department deal with patients who are as cantankerous, uncooperative, and violent. These nurses must deal with patients who are in their worst physical and emotional state. We all know it is a stressful time for patients and family, and we all know who the wheelbarrow is that the shovel dumps into.
For the most part, the nurses expect some of this and carry on in good humor. There are times, however, when the patience of a saint is required.
[And so on and so forth. Read the rest here. I couldn’t find a link to original article. Sorry.]
Then I thought about it. The nurse-as-saint-and/or-angel meme is quite strong in this piece, and is something that needs to be retired quickly. And why do nurses look to other professionals for validation?
Or am I being churlish?
Posted by torontoemerg in Good Nursing Practice is Practising with the Heart and Mind, Nursing Naval Gazing, Random Thoughts on Tuesday 31 January 2012
Ian Miller, blogging over at ImpactedNurse.com, notes a disturbing trend in Australia, one, I’m afraid, is becoming more common in North America. “These days,” he writes, “being a nurse is tough. Really tough.”
I look around and see many struggling at the bedside. I see the increasing perception that this is menial or bottom-of-the-professional-foodchain work.
I see more and more of this sort of feeling online.
What our brightest and best nurses should be doing instead of creating a culture of escaping the bedside or doing time at the bedside is acknowledging that it is the nurse providing direct care to the patient or client that is the absolute most important domain of our increasingly diversifying profession.
Nurses do not really want to be business entrepreneurs, unless they have no other choice. They want to be nurses.
I would even argue that if you are not regularly within arms reach of your patient/client you are not nursing. And if you have not done this for a long time you are not really a nurse. You are something else. Strong stuff1 I know.
The bedside nurse should be re-valuing themselves not re-inventing themselves.
Miller’s solution is “8 in 8,” i.e. having non-bedside nurses work an 8 hour shift every 8 weeks at the bedside as a condition of their registration. This is an idea I like the more I think about it. However, it would be complicated to implement, not the least because of resistance from said non-bedside nurses — and can you see all those functionaries from nursing regulatory agencies or upper management pulling on scrubs and Crocs and tending to stool incontinence and urinary drainage bags?
Hmmm. Maybe not.
But Miller’s premise, that bedside nursing itself is demeaned and devalued to the point where many of us — including myself — are plotting our escape to greener pastures is sadly true. But why? The reasons for this are pretty simple. Despite years of education and rhetoric, nurses aren’t really permitted to practice to the full scope of our knowledge. We all have heard managers speak of their time at the bedside like it was a prison sentence. Television shows like Grey’s Anatomy tell us bedside nurses are stupid. We know that hospitals view nursing not as a valued added service, but as an expensive cost centre, and that Human Resources thinks of nurses as a “problem” to be managed, like the kitchen guys who make the salads, not as practising professionals.
To be clear, we menialize ourselves as well, when we view nursing as a job rather than a profession, or when we see nursing as a series of tasks to be completed before shift change, rather than a process requiring frequent periods of critical thinking.
It’s all pretty overwhelming, and though I will publicly stand up for the value of bedside nursing, and argue strenuously to its central importance in health care, there are times when even I have a little shadow of doubt.
So really I’m not very surprised if nurses of all ranks and positions view the bedside as menial and demeaning. If people around you all day tell you you’re worthless and menial, and if you view what you do as being more or less thankless and trivial, pretty soon you’re going to believe you are worthless and menial — and so is your professional practice.
I would like to tell you my own motives for escaping the bedside are pure, but when I seriously reflected about it, I realized some of my reasons for wanting to leave had much to do with decent hours and status. And something else: the ability to act autonomously and effect change in a real way.
In other words, it’s all about power, and this explains why bedside nurses are so demeaned and devalued and want to escape.
Because we have none. Or think we do.
(I would argue front line nurses have far more power to shape their practice and workplace culture than they realize, but we all have been indoctrinated since the first day of nursing school never to question their place in the food chain and to always ask permission. And I’m not speaking about “making a difference in patient’s lives” — a phrase which has always struck me as infantile and meaningless. But this is a subject of a whole other post.)
Posted by torontoemerg in Battered Nurse Syndrome, Before I Start Throwing Things, I'd Better Write This Down on Thursday 12 May 2011
Theresa Brown has taken some heat for the op-ed she wrote for the New York Times last Sunday. When she wrote about her experiences being bullied by a physician and the detrimental effect bullying has on patient care, the reaction from MDs was angry and defensive. I am beginning to think, after reading though all the posts and comments, that her real sin was being a nurse challenging physician authority. Ford Vox, writing at The Atlantic took particular umbrage at a physician being called out at Brown’s work place. “Drawing and quartering your coworkers in the Sunday New York Times,” he wrote, “might be run-of-the-mill for politicians. I’d like to see something better out of doctors and nurses.” While making a very slight nod to the issue of bullying behaviour among physicians, Vox’s principal objection to Brown’s article was the ethics of making an example of one particular physician; he went to an exceptional effort at demonstrating the physician could be identified — at least by his co-workers — by a Google search (and in the process outing Brown’s place of work, which at least one commenter construed as an act of bullying itself.)
Kevin Pho was somewhat more even-handed. But still, while acknowledging that bullying is a serious issue — which Vox trivializes as a “workplace spat” — he accuses Brown acting in bad faith, of pandering to an anti-physician audience and “metaphorically” acting as a bully herself; he also engages in a tu quoque argument that nurses in general are bullies themselves. “Shouldn’t they [i.e. nurses],” he asks rhetorically, “bear some responsibility as well?” (Except that we do. Endlessly. Do physicians in the same way?)
The message, in any case, from our physician colleagues, is that nurses should shut up. We should not be airing our dirty linen in public. Any mention of physician bullying will only serve to exacerbate poor nurse-physician relations. It’s unfair to single out physicians. We aren’t bad actors ourselves, we treat nurses with the utmost respect, ergo, nurses should acknowledge the physician bully is a singular creature, as unique as a butterfly in a Toronto January. Et cetera.
I beg to differ.
I don’t think it’s quite true that physician bullying is rare and out of ordinary, even now, despite assertions to the contrary. When I thought about it, I realized without too much difficulty I could list dozens of examples of physician bullying, that I have been subjected to or witnessed, some dating from the dark ages of the late 1990s. These range from the utterly appalling — like the ED physician who unfairly and angrily blamed the primary RN for the death of a septic neonate, in front of the parents — to the half-humourous, some of which I have documented on this blog. I’m pretty sure nurses reading this could come up with a similar list.
Stating that some physicians bully, and that it is a more widespread problem than physicians themselves suppose, is not to take away from the respectful and collegial relationships I enjoy with the vast majority of the physicians I work with, but rather to address the reality of the complex power relationships in the hospital pecking order. It isn’t physician-bashing to point out the obvious. In any case both Vox and Pho ignore the central point in Brown’s piece: that when physicians bully, patient care suffers. It suffers because nurses are understandably reluctant to deal with a physician who will demean them. Who wants to call with a high blood sugar in the middle of the night, or question an inappropriate medication order, if you’re pretty sure you’re going to get reamed out in the process? It suffers because it’s a large factor in determining quality of nursing work life: poor nursing morale results in poor patient outcomes.
So there are some very good reasons to point out this behaviour out. Should have Brown been so specific, even if anonymously so? Both Vox and Pho complain vigorously about Brown’s lack of discretion in her account of the incident. My only thought is that their reaction is a bit over-dramatic, because the only people witnessing the inappropriate behaviour were the care team and the patient — and they don’t have to be told who the bully is. Further, I guess if Brown is as careful as most health care bloggers, she’s disguised the identity of the physician in question by changing details and artful misdirection so that it would be difficult for even employees of her institution to make identification. And I’ll add a small artistic quibble: a direct, concise, personal example is worth a thousand words of exposition. In the event, I’m not clear where the appropriate place would be to deal with it, except publicly and openly.
Bullying is an exceedingly frustrating issue for nurses, mostly because of the sense of powerlessness. When you’re subjected to the bullying, you feel like a target, and helpless to boot — and you can only respond with difficulty because the power relationships within the hospital hierarchy. In short, physician-bullies, like bullies everywhere, get away with it because they can. Nurses have been complaining about bad physician behaviour since Florence Nightingale disembarked at Scutari. You would think, that after 150-odd years of politely asking physicians to pull up their socks, they might take the issue to heart and engage in some real collective self-reflection on the issue.
It was encouraging to see this in a few of the comments to all the posts, amid all the palpable anger toward Brown. But she only put to words what every nurse knows. The physician reaction to complaints of inappropriate behaviour has always been to minimize, to scorn, to condescend, to trivialize, to redirect, or to deny. Kevin Pho points out, correctly, that hospitals are beginning to address the issue through workplace respect programs. But in all seriousness, how many physicians have actually been called to account in any meaningful way by these programs? Pho writes, in another post on the subject that, “My issue is Brown’s methods, by pitting a wronged nurse against arrogant doctors. It’s a narrative that physicians will lose 100% of the time, no matter how they respond.” True enough. But despite this, it’s also true that nearly 100% of the time bullying physician behaviour will go by without serious consequences. The question I would like to pose to both Vox and Pho — and all the angry physicians out there — is this: have you ever witnessed a physician bullying a nurse, and what did you do about it?
Their answer, I would guess, would be, “Yes, and nothing.” I would be gratified to hear otherwise.
So physicians, stop complaining. We’re merely pointing out bad behaviour. It’s up to you to fix it.
Excellent short video on the public image of nurses and nurse stereotypes produced by Digital Education Strategies at The G. Raymond Chang School of Continuing Education, Ryerson University here in Toronto. Best line at 9:35: “I think what doesn’t help is nurses who don’t take themselves seriously.”
A brochure for scrubs. Because every nurse wants to be like the nurses on Grey’s Anatomy, i.e stupid and/or bitchy
handmaidens props who exist to demonstrate physician superiority.
And into the trash it goes.
‘Tis the season, apparently. After Dr. Oz, we have our very own Canadian example, from a beer company based in Calgary, featuring scantily clad nurses attending a physician. Here’s the ad — it’s already been flagged on Youtube, so you’ll have to login to to see it.
The thought occurred to me, as I was writing this up: from the beer companies perspective, the old truism might be true after all: there’s no such thing as bad publicity, and here I am, enabling them!