Alison Jamison-Haggwood 31 Jan 07 9:04 PM MST Week 5 Discussion: Image of Nursing The magnetism force selected was image of nursing. The Magnet Program was developed to provide national recognition to facilities with the best nursing care (Mason, Leavitt & Chaffee, 2005). "The program seeks to promote the reputation and high standards of the nursing profession" (2005). The National Student Nurses Association (NSNA) has taken an active role in dispelling any misconceptions the public may have on nurses and the profession through the Image of Nursing program (NSNA, 2006-2007). The image of nurses is one of the 14 forces of magnetism as shown in this week video with Dr. Karlene Kerfoot. According to The Center for Nursing Advocacy, the image of nursing has been stereotyped from as being a female only profession to sexual images of the profession. I have not had the privilege of working in a Magnet program facility. The VP of Nursing at a hospital where I previously worked as a staff nurse, was interested in obtaining Magnet recognition. The force is evident in that the nurses maintain a professional attitude and appearance. In 2002, all nurses were required to wear white uniforms. The VP of Nursing implemented this change, rationalizing that this would help denote nurses from other staff members. There was an increase in patient satisfaction according to the Press Ganey scores. Many patients stated how professional the nurses were and the ability to distinguish the nurses from other staff by the white uniforms. This facility is in alignment with the image of nursing magnetism. Reference Bolton, L. B. & Bennett, C. (2002). The ANCC magnet recognition program and magnet hospitals. In D. J. Mason, J. K. Leavitt, & M. W. Chaffee, Policy & politics in nursing and health care (4th ed. p.324). St. Louis, MO: Saunders/Elsevier. Canter & Associates. (Executive Producer). (2004). The nurse leader: New perspectives on the profession. Los Angeles: Dr. Karlene Kerfoot. National Student Nurses Association. (2006-2007). Nursing: Not just a job, a profession. Image of nursing projects. NSNA Guidelines for Planning. Retrieved January 31, 2007, from http://www.nsna.org/pubs/guidelines/image_guidelines.pdf The Center for Nursing Advocacy. Increasing public understanding of nursing. Retrieved January 31, 2007, from http://www.nursingadvocacy.org/faq/naughty-nurse.html Alison SC Date Modified: 31 Jan 07 9:07 PM MST Betty Barrow 1 Feb 07 4:43 AM MST Hi Alison, According to the American Nurse Credentialing Center's web site (2007) the definition for Force 12: Image of Nursing is, "The services provided by nurses are characterized as essential by other members of the healthcare team. Nurses are viewed as integral to the healthcare organization’s ability to provide patient care. Nursing effectively influences system-wide processes." In light of this definition how well do you think the all white uniform edict affects the image of nursing as perceived by other health care team members? As I recall the history of uniforms during the past 30 years, when I first became a nursing assistant I wore all white uniforms. The only things that differentiated nursing assistants from nurses were school pins and caps. Nurses moved away from white uniforms and caps for a couple of reasons. One was to decrease the fear that some patients, especially children, had when they saw the white uniform. Another was to change the perception of other health care providers, especially doctors, of nurses as subservient care providers, since the uniform and cap hearkened back to the days of parlor maids and handmaidens. The hospital that went to a white uniform standard is in good company however, as Grady Health Systems in Atlanta did the same thing a couple of years ago. Grady is a well respected organization in the South, but is not yet a Magnet hospital. (Thrall, 2005). I'm not sure changing to white uniforms is going to help the image of nursing among other health care providers. The image of nursing is more about how the nursing department as a whole is viewed by others within the system. Thanks for bringing up the issue of uniforms, as we had a pretty lively discussion about this topic last semester. References: American Nurse Credentialing Center (2007). Forces of magnetism. Retrieved February 1, 2007, from http://www.nursecredentialing.org/magnet/forces.html Thrall, T. (2005). Back to basics. Hospital and Health Networks, 79-2, 27-28. Betty Barrow Tennessee Alison Jamison-Haggwood 1 Feb 07 7:45 PM MST Betty, I do not feel that nurses are perceived any differently by what they wear. I don't feel that doctors at least in this hospital setting viewed nurses as subservient. Many of the doctors seek the advice of nurses to better care for their patients. It does not matter what a nurse wears but how the nurse influence changes. As you have stated from the ANCC definition of the image of nursing, nursing is an integral part of any healthcare organization. This hospital is working on the 14 forces of magnetism. Thank you for your insights on this force of magnetism. Alison SC Mary Arnold 3 Feb 07 12:07 AM MST Alison & Betty: It is interesting that the white uniform issue is brought up. One of the local hospitals, the floor nurses where white, the ER nurses do not due to they have higher chance of getting blood or other body fluids on them. I had read in my nursing school news letter that I receive that they are changing from white uniforms to red uniforms, as the school colors are red and silver/grey (UNLV). I found that to be interesting as well. I personally can see both sides of the coin. I can see that the white is more professional looking, but in the case of the pediatric patient, I do feel that the white uniforms should not be used. Interesting post on both accounts. Mary Lynn, RN, BSN IL Linda Hinnant 1 Feb 07 9:08 PM MST Alison Great post on the 12th force of magnetism–image of nursing. According to Gaguski (2006) the 14 characteristics distinguishes hospital that draw and retain nurses from other hospitals. Research show that magnet-designate hospitals outperform non magnet hospitals, they have better patient outcomes, shorter length of stay, experience increase time spent at the bedside with the patient, lower mortality rates, lower occurrence of needle stick injuries, lower rate of burnout, and increase retention and recruitment, higher patient satisfaction scores, (American Nurses Credentialing Center, 2005). I too have not worked at a magnet designate hospital, however, through this assignment, the literature review, and class post I look forward in taking the journey. References: American Nurses Credentialing Center. (2005). Magnet recognition program. Retrieved January 30, 2007, from http://www.nursingworld.org/ancc/magnet/consumer/benefits.html Gaguski, M. (2006). Magnet status-what's the attraction? Oncology Nursing Society, 21(3), 3-5. Kim Zolnier 1 Feb 07 9:22 PM MST In my facility I don’t think that nurses are looked down on because of what they wear. There are a few doctors that look down on women in general as this is a cultural belief. As far as patients are concerned (children), most of them call everyone doctor no matter what we are wearing. I think colored or print uniforms or scrubs are necessary in pediatrics. The children seem to respond better with colorful clothing. If everyone from housekeeping to nursing wear the same type or color of scrubs, patients are less likely to notice that there are fewer RNs. Hospital administrators do not object to this practice as it can help hide the fact that there is a shortage of nurses (Tobin, 2006). We need to be able to distinguish ourselves from other caregivers. At my hospital we have bright tags for our badges that state what we are, for example RN or LPN. Tobin suggests that we take a look in the mirror after getting dressed and see if what we are wearing projects the image we wish to portray (2006). I think we can still look professional in scrubs but they need to fit properly and look neat and clean. Comfortable does not mean sloppy. Reference: Tobin, S. (2006, October).How do you look? American Nurse today. 1, 38-39. Betty Barrow 2 Feb 07 8:30 AM MST Hi Kim, I agree that it really doesn't matter what we wear as long as we appear and act in a professional manner. In our hospital nurses' name tags are blue, light blue for registered nurses and dark blue for advance practice nurses. Our physicians wear green name tags, light green for interns and residents, and dark green for attendings. While this is explained to the patients as part of their admission orientation, it wasn't started for the patient's benefit. It was started so that when there is an emergency situation, specifially a code situation, it is quick and easy to look and see what level of health care provider is doing what. There may be a care partner doing compressions so the name tags help the doctor's and others know not to give the care partner an order to complete, since they are not nurses. Another by-product of this is that you know who you are talking with, even if you are in the cafeteria. It's not a matter of being snobbish, but knowing what level of understanding the other person probably has. Betty Barrow Tennessee Christine Higbie 2 Feb 07 4:29 PM MST Response to Alison: I agree with your statement of nurses being stereotyped as a only female profession. As a nursing instructor I see the how patients react to the students white uniforms verses the staff nurses colored. I tend to see that the patients listen and ask more questions to the students because of the uniforms; the patients can identify them as a nurse. This probably is why the Press-Gany score went up, the patients know who were taking care of them. Unfortunately, I think that there are nurses who do not act as professionals and this has been a detriment to nursing. Chris Margaret Imbrock 2 Feb 07 10:55 PM MST Ladies, I address the whole group, there are some good ideas here. Chris hit on a key point. The old saying I grew up of "clothes don't make the man" is certainly true. I am also of the opinion that it is not the clothes that set us apart as much as our behaviors. We do need to be visible as professionals. If we want to be viewed as professionals we do need to dress and act like one. Dress codes for healthcare workers have been debated within my organization for years. We have certain colors for support departments like maintenance and housekeeping but healthcare providers, like lab, radiology and nursing all wear scrubs - no definitive colors. Patients and family members do need to be able to identify a nurse from other care providers who may not be able to answer their questions. What kind of an image do we get from the TV shows? How does the media portray us? That is the image that patients have when they come into the hospital, will they leave with that same image or can we change their perceptions? We do have brains with knowledge, we can provide independent interventions. Date Modified: 2 Feb 07 10:58 PM MST Betty Barrow 2 Feb 07 11:53 PM MST Hi Margaret I think if we do what the JCAHO standards say we should do, introduce ourselves each time we have a patient encounter, it won't matter what we wear. As far as the porfession's image, that is really not what the Magnet Force is about. It is really about how the nurses in a particular organization are viewed by other health care providers in that organization. It is not even about professionalism per se, but is about how the nurses interact with others in the organization. Are they viewed as participants and contributors or do they work in a vacuum, not really participating in decisions that affect more than nursing or not including others when nursing's decisions may affect those others. Thanks for reminding us that we are professionals. Betty Barrow Tennessee Kristin Fowler 3 Feb 07 2:29 AM MST I agree with most of the other above postings that the color of the uniform should not make a difference. The image of a nurse should be one of professionalism and caring. A clean and neat uniform is essential, as well as no excessive jewelry or make-up, hair kept out of the way, and no perfume helps portray a good image regardless of the color warm. Compassion, knowledge and confidence portrayed at the bedside complete the image of a good nurse. Kristin