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Since 2019, the nursing profession has been frequently represented in mainstream media in the UK through the lenses of the COVID-19 pandemic and more recently, industrial action. In 2020, during COVID, we saw the nursing profession praised, with weekly neighbourhood applause and thanks to the National Health Service (NHS) staff schemes. In 2023, when, for the first time in history nurses voted to strike (fair pay for nursing), nurses again received media attention. Conversely, the media chose to report how striking nurses (and other health professional staff) contributed to long waiting lists in the NHS and unhelpfully, demonstrated how 64% of poll voters (n=7955) did not think nurses should have a better pay deal.1 The reality is that nursing is central to the delivery of quality, evidence-based, and person-centred care in our health sector in the UK and represents the largest clinical professional group with approximately 334 690 nurses and midwives.2 However, the identity of the nursing profession is continually, unhelpfully misrepresented in the media.3
The professional identity of nursing warrants our further attention. In psychology, concepts of professional identity include the values, knowledge, skills, beliefs and attitudes commonly shared within a professional group.4 A strong professional identity in nursing has been associated with increased retention, job satisfaction and a reduction in stress.5 However, developing a strong professional identity is protracted when there is a mismatch between the personal insider experience (of being a nurse) contrasted with the public outsider perception of what a nurse is, perhaps suggesting that nurse identity is given to nurses, rather than developed from nurses within the profession. Additionally, nursing is a diverse discipline, spanning many areas of expertise, fields of practice and specialties. For example, emergency nursing, surgical nursing, palliative care nursing, practice nursing, learning disability and mental health, to name only a few. Arguably, nurses within these specialisms or areas of practice are likely to have a stronger homogenous identity, while nursing (as a heterogenetic whole) does not have a strong cohesive professional identity and perhaps it is this nebulous concept that is linked to media portrayal and public perception. However, undoubtedly, the recently published Royal College of Nursing (RCN) definition of nursing will go some way to shape the nurse identity, from an external (outsider) and internal (insider) perspective.6 But why does all this matter?
In July, the NHS published the NHS Long-term Workforce Plan (2023), a much-awaited plan proposing workforce planning for the NHS.7 The ambitious plan details intentions to increase numbers of nurses, midwives and nurse associates by 48% by 2031. However, the plan fails to acknowledge the decreasing interest of applicants applying to study nursing courses, with recent figures showing that Universities and Colleges Admissions Service (UCAS) applications dropped by 19% (February 2023).8 In addition, the disproportionately low numbers of UCAS applications from male applicants (12% in 2023) remains a demonstrable example of how the public image of nursing impacts detrimentally on the actual capacity, diversity and inclusivity of the nursing workforce. Data show that more women than men undertake nursing courses in the UK,9 whereby only 10.9% of registered nurses are men.10 Unfortunately, the literature cumulatively points to a range of barriers for men which include the perceived feminisation of the nursing profession, which is consistently reinforced in the media.11
There is further debate as to what extent nursing has developed as a profession and to what extent the status of nursing professionals has been promoted.12 Arguably, the role of nursing has developed over time, but is inadequately professionalised.13 The professionalisation of the nurse identity centres around the scientific and technical aspects of nursing being emphasised, including the requirement of degree-level nurse training and a regulated registration through the NMC. In reality, many nurses now have masters-level qualifications (or Doctorates) but are still perceived as a cheaper ancillary workforce supporting doctors, rather than specialists in their own right. Consequently, nursing is not perceived as a high-status profession,14 and many people (including men) do not consider pursuing nursing as a career.15
Taken together, this suggests that the dominant media portrayal of a feminised role with a lack of professional status is the current media identity portrayal of the nursing profession. As this continues to define the external public image of the nursing workforce, consequently deterring individuals from joining the profession, due to a poor understanding of the nurse’s identity (as an outsider). Moreover, until a nurse has joined an education programme and embarked on their nursing career, they will not have developed a strong professional identity as nurse, from an insider and personal perspective, which is contrasted to that of which is observed in the media. Therefore, addressing the public perception (and media portrayal) of nurses’ professional identity is essential to achieve the NHS Workforce Plan’s (2023) aspirational targets for increased numbers of nurses by 2031. Failure to reframe the nurse identity will contribute to an inability to meet the health and care needs of future patients with depleted nurses in the profession.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.