Improving representation of nurses in the media
2018; Elsevier BV; Volume: 67; Issue: 1 Linguagem: Inglês
10.1016/j.outlook.2018.12.015
ISSN1528-3968
AutoresSandy Summers, Marion E. Broome,
Tópico(s)Media Influence and Health
ResumoNursing scholars just delivered some unsettling news about the image of our profession. In “The Woodhull Study Revisited: Nurses’ Representation in Health News Media 2018,” Mason et al., 2018Mason D.J. Glickstein B. Nixon L. Westphaln K. Han S. Acquaviva K. The Woodhull study revisited: Nurses’ representation in health news media 2018.http://bit.ly/2O33jIQDate: 2018Google Scholar examined how nurses are treated in the print news media and compared their findings to the landmark 1997 Woodhull study on that same topic (Sigma Theta Tau International 1997Sigma Theta Tau International Sigma Theta Tau International Center Nursing Press, Indianapolis, IN1997http://hdl.handle.net/10755/624124Google Scholar). So one could wonder: What had changed after two decades? Nothing, actually. Now, as then, nurses are almost invisible in the news media (Mason et al., 2018Mason D.J. Glickstein B. Nixon L. Westphaln K. Han S. Acquaviva K. The Woodhull study revisited: Nurses’ representation in health news media 2018.http://bit.ly/2O33jIQDate: 2018Google Scholar). Woodhull Revisited found that nurses were used as expert sources in 2% of health articles in 2017. What is remarkable is that this was an actual decrease from the 4% found in 1997. Although that difference is not statistically significant, it certainly makes the point. The researchers wanted to know more, of course, and interviewed 10 health journalists (Mason et al., 2018Mason D. Glickstein B. Westphaln K. Original research: Journalists’ experiences with using nurses as sources in health news stories.The American Journal of Nursing. 2018; 118: 42-50Crossref PubMed Scopus (17) Google Scholar). They found that journalists generally don't understand how nurses are educated or what nurses do to improve health. When journalists do want to talk with nurses, they often don't know how to find them. Hospital public relations (PR) personnel often are unhelpful. In their study, one journalist described a typical interaction with hospital PR: “I ask for nurses, they give me physicians.” On the rare occasions when journalists do use nurses as sources, they often have to justify it to their editors. A journalist related the common editorial reaction: “What, am I unable anywhere in America to find a doctor?” Nursing itself is part of the problem. Nurses on Twitter talk primarily to each other—journalists rarely follow nurses or read nursing journals (Mason et al., 2018Mason D.J. Glickstein B. Nixon L. Westphaln K. Han S. Acquaviva K. The Woodhull study revisited: Nurses’ representation in health news media 2018.http://bit.ly/2O33jIQDate: 2018Google Scholar). Journalists say there is little nursing outreach to the media to promote nursing expertise, innovations, or perspectives. And many hospitals and health systems tell nurses not to talk to the media. When nurses and journalists do manage to connect, physicians may chafe and wrest away the media opportunity. These results might cause cognitive dissonance in some readers. Since 2002, nurses have ranked first in Gallup polls measuring ethics and honesty (Gallup 2017Gallup. (2017). Honesty/Ethics in Professions. Retrieved from http://bit.ly/2O2V2V9Google Scholar). One could logically ask: Doesn't that mean people respect nurses and their views? The simple answer is “no.” The public may value nurses’ integrity, generous nature, and ability to provide good care under difficult conditions. But that is not the same as respect for nurses’ expertise and central role in health care. If nurses were viewed that way, journalists would clamor for nursing comment on health care research, challenges, and policies. The undervaluation of nursing goes even further. It means that nursing receives inadequate resources for education, practice, research, and residencies. Nurses are often dissatisfied with their working conditions and experience burnout, potentially endangering patients (Holden et al., 2011Holden R. Scanlon M. Patel N. Kaushal R. Escoto K. Brown R. Karsh B. A human factors framework and study of the effect of nursing workload on patient safety and employee quality of working like.BMJ Quality & Safety. 2011; 20: 15-24Crossref PubMed Scopus (150) Google Scholar). Nurses face undue limits on their scope of practice in at least half of states in the United States. And they often struggle to be heard in critical debates about the future of health care. Why are nurses undervalued? Longstanding stereotypes remain prevalent in a variety of settings (legislative bodies, universities, industry… even health systems). And together these stereotypes paint a picture of nurses as uneducated, low-skilled, assistants to physicians. The media both reflects and reinforces these views. In fact, research shows that popular media, ranging from hard news to fictional products, affect health-related views and actions. One study found that nine in 10 regular viewers of a popular television drama learned health information from it (Centers for Disease Control and Prevention 1999Centers for Disease Control and Prevention. (1999). 1999 Porter Novelli Healthstyles Survey. Retrieved from Gateway to Health Communication & Social Marketing Practice: http://bit.ly/2qUmgiUGoogle Scholar). Another determined that half of viewers trust primetime television to deliver accurate health information (Centers for Disease Control and Prevention 2000Centers for Disease Control and Prevention. (2000). 2000 Porter Novelli Healthstyles Survey. Retrieved from http://bit.ly/2Tqzd0QGoogle Scholar). Indeed, a 2014 study found the reality show 16 and Pregnant and its sequels accounted for a 5.7% reduction in teen births—a third of the decline in the United States during the ensuing 18 months (Kearney and Levine, 2015Kearney M.S. Levine P.B. Media influences on social outcomes: The impact of MTV's 16 and pregnant on teen childbearing.American Economic Review. 2015; 105: 3597-3632https://www.nber.org/papers/w19795.pdfCrossref PubMed Scopus (117) Google Scholar). For nursing, recent research is less hopeful. Our extensive observations over the last two decades are consistent with Woodhull Revisited—nurses are mostly ignored in the media. For example, an October 2018 New York Times article explained how a “team of [30] surgeons” repaired fetal spina bifida in the womb. Surely many nurses played important roles during and after the surgery, but they got no mention (Yeginas, 2018Yeginas C. Spinal cord repaired in the womb, in first surgery of its kind in U.K.New York Times. 2018; (Retrieved from)https://nyti.ms/2QVQa1iGoogle Scholar). This type of messaging starts early. A 2015 study found that children's books with nurses relied heavily on the unskilled handmaiden and angel stereotypes. Physicians did almost everything that mattered (Carroll and Rosa, 2016Carroll S. Rosa K. Role and image of nursing in children's literature: A qualitative media analysis.Journal of Pediatric Nursing. 2016; 31: 141-151Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar). A study at the University of Dundee (Scotland) found that popular media discouraged elite primary school students from nursing careers by showing nurses as “brainless, sex-mad bimbos” pursuing “romance” with physicians (Neilson and Lauder, 2008Neilson G. Lauder W. 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. 2008; 28: 680-690Crossref PubMed Scopus (33) Google Scholar). So, how can we make more progress with the news media in the future than we did in the 20 years after the Woodhull 1997 study? Let's all take the Woodhull Revisited results as a call to action. We must ensure that any “Woodhull 2027” and subsequent studies show real improvement. First of all, it's critical to understand that the media can be changed. The Truth About Nursing www.truthaboutnursing.org has generated substantial media coverage for its issues and gotten many high-profile ads improved or removed over the last two decades. But affecting broader and deeper change in how the news media treats nursing will require a sustained effort from the whole profession, like the Healthy People 2030 initiative or any other major health challenge. We urge individual nurses to engage with the news media and offer expert commentary on health topics. We must build a culture in which qualified nurses put themselves in front of reporters and respond immediately when called. Consider media training to increase your confidence. Many universities and health systems have a media or PR office and can provide such training. Make sure that office knows who you are, what you know, and how you can help them. Practice advocating in your social media community. Nursing scholars and researchers have a special responsibility to do all they can to get their work covered in the mainstream media (Heilemann, 2012Heilemann M. Media images and screen representations of nurses.Nursing Outlook. 2012; 60: S1-S3Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar). We also urge formal nursing groups to target the news media with conferences, roundtables, and advocacy campaigns that promote nursing expertise. They might create databases of nurse experts who can be quickly identified. Can journalists find a nurse expert on dementia, tropical health, or sexual assault in a few seconds on your organization's website? Universities, hospitals, foundations, and journals should promote their nursing research to the news media, ideally with a PR person dedicated exclusively to nursing. Hospital websites still suggest that only physicians really matter; Magnet and nursing pages are aimed only at nurses. These sites would do well to highlight the institution's nurses, their expertise, and innovative approaches to care, instead of ignoring the heart of the services that hospitals provide. Finally, it is critical for nurses, their organizations, schools, hospitals, and foundations to support advocacy groups and their efforts to improve public understanding of nursing, including those by Diana Mason and her colleagues at the Center for Health Policy & Media. And a bold new initiative called the Coalition for Better Understanding of Nursing, a project of The Truth About Nursing, has detailed plans www.nursing-coalition.org to bring everyone together to create lasting change. Please read these plans and join the effort to transform the media. All nurses will benefit from a better media image. Let's all be a part of making “Woodhull 2027” a success story. Download .zip (.0 MB) Help with zip files
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