This essay will discuss the role and stereotype of the nurse from a historical view as portrayed by the public up to the present day. It will then outline ways, which could extend the nurses role in working for health.
Nursing is and always has been a caring profession, although the role of the nurse changed dramatically over the centuries. Historically, the community saw the nurse as a nourishing and protecting person, who was willing to care for the ill, injured and elderly. A nurse was also simplified as a woman who suckled and took care of children. (Ellis and Hartlay, 2000: 165; Taylor and Field, 1997: 235) For the reason, that only a female can suckle children, it is clear, why the public associated nursing with women.
Through the decades, the role of the nurse moved from just motherhood, nourishing and fostering children, towards a role of a person with rising responsibilities, expanding tasks and no specific gender. Today, nursing is related with caring for an individual in a variety of health related situations. (Ellis and Hartlay, 2000: 165) However, caring and curing is not the only important task for the nurse. He or she also participates in health promotion, for example educating clients about health and the prevention of infirmity.
In today's society, nursing takes place in many different contexts including patients' homes, communities, hospitals, schools or rehabilitation facilities and is involved in a range of different health care activities. The work of a nurse can reach from primary health care to tertiary care and encompasses a central role in ensuring the highest standards of health care in different environments. Nurses today have an immense responsibility in association with working in a diversity of different health care settings. It is therefore important for the profession to have autonomy, authority and recognition.
Another essential fact is that nurses need critical thinking skills to perform all the different tasks expected from patients, physicians and other health professions. (Ellis and Hartlay, 2000; Greenwood, 1996)
Despite the multi tasks that a modern nurse can be involved in; there is still a clear disparity between nurse and physician. The nurse's main task remains to be caring for the patient and the physician's task is to diagnose and treat the ill and injured. This clearly states that physicians have the autonomy over decision making on the patient, how to treat the patient and to decide on further medical procedures. However, due to the great changes and impacts on the health care system, policies and Nurses' Acts alter and can give the nurse a new role, for example as a nurse practitioner, which will be discussed later in this essay. (Nolan and Hazelton, 1995)
The role and image of the nurse was not always shown so clearly and realistically to the public. Media has always had an immense influence on the Image of the nurse. Kalisch and Kalisch found that "nurses often had no substantive role in the television stories...when a nurse was the focus of a program; the story line involved the nurse's personal problems, rather than her role as a nurse" (Kalisch and Kalisch in Ellis and Hartlay, 2000: 176). In a diversity of television series, the nurse was often seen as the handmaiden of the physician and therefore believed to be obedient and conforming. According to Kalisch and Kalisch (in Ellis and Hartlay, 2000: 178), nurses were usually portrayed as women, which as a result accentuated long-established female roles, like mothers or mistresses. Some of the influencing media led the audience to the conclusion that nurses were not as important in the health care team and that they were sex symbols and easy to manipulate due to their obvious sexual interest in males (usually physicians).
The image of the nurse and so the stereotype has improved to some extent due to change of television programs and other media in the last decade.
Whereas television series in the 1970s, like "The young doctors", portrayed nurses as sex symbol, handmaiden or battle axe; programs like "All saints" or "Chicago hope" showed the more real nurse as highly skilled, autonomous and rational decision making member of the health care team (Ellis and Hartley, 2000: 176-177; Bloomfield, 1999). The change of the old image was very important to the public, as much as to the nurse itself. The old stereotypes have undermined the complexity of the nurse's role as well as they have distorted the images of the nurse. They were dangerous for both, nurse and patient, as they influenced the attitudes and beliefs of the patient, policy makers and politicians. It also was of great disadvantage in encouraging people to choose nursing as a career.
As stated above, nurses must have the ability of critical thinking; autonomous decision-making and they must be highly skilled to participate in today's health care system. Those abilities can broaden the role of the nurse in working for health in different sectors. The primary health care concept encourages nurses to actively work towards helping communities become self-dependent and self-reliant. Therefore, the nurse is the advocate, sharing resources and information, rather the decision maker (Ewles and Simnett, 1992). The nurse can also be involved in health promotion, which has the aim to empower people to have more control over their health aspects and to improve their health. Nurses can be involved in this concept in educating clients about their health, and how to prevent illness. This broadens the nurse's role out of the medical model towards the community health/ development model.
Many Australian rural and remote areas can only provide limited health care. Small rural communities may not have access to a physician, providing primary health care. Under these circumstances, nurses could make a difference in providing primary health care as a highly skilled nurse practitioner. The Nurse Amendment Act was released in 1998 in NSW. The act gives the advanced practitioner, called Nurse Practitioner, the right to examine, diagnose and treat the patient for minor complaints and under the approved clinical guidelines (Crisp and Taylor, 2001: 31).
The nurse could broaden her role in becoming a nurse practitioner and work for health especially in remote and rural areas. This would be of benefit in improving the primary health care service. The model of the nurse practitioner would further take the pressure of the physician in emergency departments of urban areas. This would enable sick people to be seen more quickly by the doctor and it would be more time for health promotion activities, not only treatment and curing of the patient. In return, the less acute patients could consult the Nurse practitioner, and a high focus on health promotion could be set. This innovation, which is at the moment only available in New South Wales, but under development in other states, may reduces the cost of health care over the time, because more people would have access to health promotion and take better care of themselves.
In the discussion of the role and stereotype of the nurse it is interesting to see that there was great change over the last decades from the nurse simple being a mother to a highly skilled person without specific gender. Because of those tremendous changes, the role of the nurse has been greatly extended and will continue to expand and change. The discussed images and stereotypes will continue to revolutionize to a more realistic portrait of the nurse.