In the last
few months I have been to two separate nursing meetings in different
parts of the country. At each of these meetings, a nurse in the
group asked the
question, "How can I encourage anyone to be a nurse when
working conditions are
so bad and the pay is so low?" Nurses who feel this way are
frustrated, possibly
overworked and underappreciated, and probably burned out. To say
that the
current health care climate is challenging is an understatement.
There are,
however, places that I visit where, despite less than optimal
circumstances, the
nurses seem happy and the work atmosphere is positive. The combination
of these
events generated thoughts about image-both the public's opinion
about nurses and
nurses' self-image.
PUBLIC
IMAGE
Nurses generally
are well thought of by the public, and their image is very
positive.1 In a Harris poll taken in July 1999, more than 1,000
people were
surveyed about their attitudes toward nursing. The poll showed
that
- 92% of those
polled trust information about health care provided by RNs and
- 85%
would be pleased if their son or daughter became an RN.2
While reading
the October 1999 AORN of Suburban Atlanta newsletter, the positive
image of the RN seemed to be reinforced. I was struck by the powerful
story that
student nurse Sherry Rygmyr wrote about nursing's image:
Today was
our first day of clinicals. It felt a little strange to wear a
nursing
uniform, even a student nursing uniform. I found myself emotionally
moving
between feeling a little proud and excited about the materialization
of my long
awaited plans, and a little embarrassed-as if I was representing
myself some-how
better, more qualified, than I really am. Somehow, just wearing
the uniform
seemed to elicit recognition and respect from strangers. I had
stopped at a
local gas station for a cup of coffee-something I never do, because
until now, I
have rarely drunk coffee. When I entered the busy station people
looked up and
smiled and treated me as if I was already an RN. People have always
been
pleasant and respectful to me, but what they were recognizing
was the role. They
commented about my stethoscope and treated me with a respect and
position I have
not yet earned. What I learned from this is how important the
role of a nurse
really is and how important it is to conduct yourself professionally
at all
times. We really do, even as student nurses, represent our profession.
And the
way we conduct ourselves has an important impact.3
The impressions
of our novice nurses are important because they can help us
touch what is, or was, at the heart of why we became nurses. Positive
stories
such as this can have a profound impact on how we feel about our
profession and
ourselves. The image and the impact are all too easy to forget
when we are faced
with the challenges of delivering quality care in today's health
care environment.
We must, however, strive to maintain a positive image of our profession
and
ourselves. A negative image can become a self-fulfilling prophecy.
FIGURE
Gary Zukav,
in The Seat of the Soul, explains that if you picture yourself
as
powerless and your image is negative, on a subconscious level
you will seek to
make it so. You will look for, and likely find, examples in your
life to support
and sustain your beliefs. You also will gravitate toward others
who will
reinforce what you believe. Zukav says that we must work continuously
to combat
negativity and maintain a positive mental attitude.4
POSITIVE
ATTITUDE
The March
2000 president's message, written by Pauline Robitaille, RN, MSN,
CNOR, for the AORN of Massachusetts Chapter I newsletter, perfectly
demonstrates
the importance of the impression we leave with others.
Do you realize
the impact you have on others? Are you aware of the influence
you
have on the people you come in contact with in the perioperative
setting? What
would those you have interacted with say about their experience
with you? We
sometimes take so many things for granted, including the positive
(or negative)
influence we are having on those we come in contact with.
In the past
year, I have had the pleasure of participating in two perioperative
nursing courses. I found my participation in these courses to
be both gratifying
and rewarding. As I listened to the students' stories or read
the journals of
registered nurses who were reporting on their experiences from
their clinical
experience in the operating room, I found most of their descriptions
to be very
positive. Unfortunately, there were some that were also very negative.
Most of the
students reported how their preceptors spoke positively about
perioperative nursing and their experiences in taking care of
patients having
surgical procedures. They also went on to describe how their preceptors
took the
time to teach and support them, as they were so eager to learn
everything they
could about perioperative nursing. The difference these preceptors
made in
stimulating their students and the learning that took place was
evident in the
journal entries written by these students.
There also
were entries that described preceptors' behavior that was negative,
punitive, and critical of the nurses who were trying to learn
our sometimes
over-whelming specialty. The students described how difficult
it was to work
with these individuals. They also went on to describe how, when
they were
assigned to work with them, their experience was not as beneficial
as when they
were assigned to more positive individuals.
I was struck
by the difference a preceptor's attitude made to these individuals
and how important this is to our future as perioperative nurses.
If we are to
attract and retain these bright young minds, we must be willing
to portray our
profession and specialty in a positive manner. We must be willing
to take the
time to help them learn and do our very best to make their experience
a positive
one. Yes, I believe we all would agree that it is a very difficult
time to be
practicing as a health care provider, but will things be better
if we do not all
work together to make [them] better?
I still remember
when I was learning about our specialty and how much I
appreciated all the individuals who cheered and coached me as
I learned (and
yes, made mistakes). It is with their help and support that I
was able to grow
to be able to practice independently as a perioperative nurse.
Since that time,
I have been committed to assisting nurses, students, and other
individuals
interested in learning more about the perioperative specialty.
For those
of you who have benefited from the experience of a preceptor or
mentor, I encourage you to share your positive experience with
those who have
contributed to your learning. Let them know what a difference
they made, and
remember to thank them for their time and efforts.
With the current
critical shortage of perioperative nurses, I believe it is the
responsibility of all of us practicing in the perioperative setting
to make a
commitment to contribute to the learning of others and serve as
positive role
models. I think we should ask ourselves the following question,
"Am I committed
to being part of the solution and not being part of the problem?"5
POSITIVE MEDIA
PORTRAYAL
It is important
to maintain positive images within the profession because we
want to continuously let the public know that their positive view
of us is
accurate and deserved. We also need to come out from behind the
mask and
actively seek opportunities to let the public know what perioperative
nursing is
all about and the contributions we make to positive patient outcomes.
It is
crucial that we are not, as one article described "Missing
in action: nurses in
the media." The authors stated in this article,
As nurses
become increasingly integral to health care delivery, we must
be
represented accordingly in the media-not as accessories to a story
but as the
story.6
Think how
powerful we could be if we all looked for opportunities to positively
reflect our contributions to the health care system. Looking for
positive
portrayals in the media also could give us a stronger link to
the public we
serve. Little things we take for granted within the profession
could be vitally
important to the public, such as the practices we maintain to
prevent errors in
sharps, instrument, sponge, and needle counts.
A recent national
television show focused on the devastating effects that
incorrect counts can have on the lives of patients, and there
is no denying that
this is true.7 The other side of the story is that a majority
of the millions of
surgical procedures performed yearly do not result in foreign
objects being left
in patients. Madge Kaplan, Boston bureau chief and health desk
editor for Public
Radio International's "Marketplace" gave her ideas about
what might lead to more
positive visibility for nurses in the media:
The nursing
profession needs to announce its involvement in patient care and
consumer health issues. This could help shift the perception that
the only time
the news media need to talk to nurses is if they're threatening
to go on strike
over working conditions.... the nursing profession needs a new
narrative that
better reflects how much the profession has changed, how critical
nursing skills
have become to today's patient care, how much the profession has
stayed abreast
of medical and technological innovation, and what nursing is going
to look like
in the future.... the profession needs to better focus the public's
attention on
the key policy or congressional battles nursing is waging-especially
at the
national level.8
True, these
are only one person's suggestions, but if we seriously entertain
the
views of people outside the field of nursing, we can decide collectively
on an
agenda that will put the best possible public face on nursing.
It is important
that we do this because nurses are the health care providers involved
with the
patient throughout the care continuum-we manage the journey of
patients under
our care on a daily basis. As Margretta M. Styles, RN, EdD, FAAN,
has said, we
do this because we are,
Professionalists,
all. Together, we work for values, policies, standards, and
conditions that free nurses to practice to the full extent of
their education
and ability. Our highest reward is the certain knowledge that
our work is
shaping a future of healthy people in a healthy world.9
BRENDA
C. ULMER RN, MN, CNOR
President
NOTES
1. M Woody,
"Future practice," Reflections on Nursing Leadership
(First Quarter
2000) 34.
2. "Americans
believe nursing shortage affects quality of care," (Filler)
AORN
Journal 70 (September 1999) 488.
3. D Wagner,
"Professionalism," Suburban Alert 4 no 2 (1999) 5.
4. G Zukav,
Seat of the Soul (New York: Simon & Schuster, 1989).
5. P Robitaille,
"President's message," AORN of Massachusetts Chapter
I
Newsletter (March 2000).
6. J R Sieber
et al, "Missing in action: Nurses in the media," American
Journal
of Nursing 98 (December 1998) 55-56.
7. "What
the doctor left behind," 20/20 (New York: American Broadcasting
Co, 5
April 2000).
8. M Kaplan,
"Speech-why isn't nursing more newsworthy?" Medscape
Nursing
(online database). Available from http://www.medscape.com . Accessed
April 2000.
9. M M Styles,
"Professionalists, all," The Journal of Continuing Education
in
Nursing 31 (March 2000) 88-89.
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