The Impact of the Image of Nursing on Nurses' Perception of Self and the Profession

Friday, 28 July 2017: 2:30 PM

Nancy Laplante, PhD
School of Nursing, Widener University, Chester, PA, USA
Wendy Ostendorf, EdD
Division of Nursing and Health Sciences, Neumann University, Aston, PA, USA


The purpose of this research study was to explore the impact of a professional presentation offered at a national nursing conference, on participants’ perceptions of the cinematic images of nursing. Image has been a focus of interest to nursing for over a decade; influenced by sentinel work by Kalisch and Kalisch (1986) that examined the portrayal of nurses compared to those of physicians in different media forms and nursing stereotypes.
A concept analysis of image by researchers in Iran provided validation that image is a multidimensional concept (Rezaei-Adaryani, Salsali, & Mohammadi, 2012), concepts that were explored in the current study. Rezaei-Adaryani et al. found that image encompasses four dimensions: public’s perception of nursing, nurses’ self-image/ professional identity, nurses’ perception of the public’s image, and image of nursing in the media.
For the current study, image was examined through the lens of cinematic images and in relation to several Core Values of Holistic Nursing. In particular, the American Holistic Nurses Association’s (AHNA, 2013) Core Value #5, which highlights the focus on nurses being self-reflective and instrumental in creating self-care programs. This study provided the opportunity for self-reflection which must come before self-care practices can be identified and created.


The researchers obtained approval from their Institutional Review Boards and from the Research Committee of the conference prior to the start of the study. At the presentation, all attendees were given a packet of information that included an informational letter with all study details, a response form, and plain white envelope. If an attendee chose to participate responses were written on the form during the presentation.
Positive and negative cinematic images were shown as part of the presentation. Four open ended questions informed by the presentation were individually embedded at various points in slides in the power point presentation. The first question was: Before attending this presentation, what was your perception of the image of nursing? (Slide 2 after introductory slide.) The next two questions were presented on slides 12 and 28 respectively: How does the public’s view of the image of nursing impact the way nurses view themselves? and How does nursing’s image impact recruitment and retention into the nursing profession? The fourth question was: After attending this presentation how did your attitudes or beliefs about the image of nursing change? (The last slide of the presentation.)
During the presentation the researchers paused at each question to allow time for participants to write their response. At the end of the presentation, participants placed their response forms in the envelope, and placed these in a designated container at the exit of the room. Attendees had the option to not participate and remain as a viewer only of the presentation. They also could write responses, and not submit their forms at the end of the presentation. Once forms were placed in the bag, participants could not withdraw from the study as all forms were anonymous. Content analysis was used for this study. The researchers first individually read through all responses for each question, coming together in person after this to discuss commonalities they found. An audit trail was kept, documenting four additional sessions of discussion, with the researchers further collapsing the data of each question, ultimately to four themes. An expert in qualitative research was contacted to provide validation to the researchers for the process.


Participants ranged in age from 24 to 84 years of age, and practice years of experience ranged from one to 63 years. Four themes were discovered: An Evolving Identity; In Defense of the Profession; Reality to Retain; and The Greater Voice.
Views of image were mixed prior to viewing the presentation. Participants felt they were caring, trusted and well-liked by the public, but at the same time had to defend that they were not “less” than a doctor. Public perception and recruitment/retention issues impact nurses worldwide, and there were many in the study who felt students needed a better understanding of the profession they chose early on to avoid a distorted sense of reality when they began practice.
Participants felt they possessed a positive image of nursing, but that there was a need for a stronger collective voice. Many felt they could do more to promote image; they expressed gratitude for the presentation as it encouraged them to dialogue and realized there is still work to be done to improve the image of the profession.


Nurse educators play an important role in the socialization of undergraduate students from their first year through graduation. They can assist students to develop a positive professional image and support students’ development throughout their education.
When nurses are viewed from a negative perspective, roles can become ineffective when collaborating with persons receiving care or partners in the health care community. These negative stereotypes have caused stress in practicing nurses, therefore the need for self-care is heightened. This study provided practicing nurses an opportunity to self-reflect on their perceptions of image, and participant responses support continuing this dialogue with students and practicing nurses alike to provide context and correct inaccurate stereotypes.