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Public Perceptions of Nursing Careers: The Influence of the Media and Nursing Shortages, conclusion

A majority of the public (61%) perceived a nursing shortage in 2007. While nurses themselves have become less likely to attribute nursing shortages to salary and benefit issues, and point to working conditions and faculty shortages, the majority of the public who perceive shortages still sees the main obstacle as salary. Nurses are seen by a majority of the public (53%) as being underpaid, as compared with only 8% who think physicians are underpaid. Differences between the public's and nurses' understanding of the causes of nursing shortages are not surprising. Nurses are closer to the realities of the labor market and issues in nurse training and education. To the extent that public perceptions inform career interest decisions, it is important to address public perceptions, especially if they are incomplete or inaccurate.
Some nurses and nurse re searchers have challenged the role of the media in harming the image of nurses. News stories about nurses helping during disasters, about the importance of nurses to patient safety, and about nurse shortages are seen by the public to have a positive impact. People who watch television shows about nurses are more aware of nurse shortages and hold nurses in high esteem. Television advertisements about nursing careers are most likely to reach the young and minorities, and have stimulated discussions about careers. While personal experience is the largest factor stimulating discussions of nursing careers, media and advertising both play a role for a substantial share of those who consider the career.
The public is very enthusiastic about nursing careers, and many people have considered them, but many have also chosen other careers for a variety of reasons. Among those who have considered the career seriously, salary does not appear to play a major role in decision making, rather a variety of conflicts of time and commitment are cited. Not surprising, there is a persistent gender difference in who considers nursing as a career, and in perceptions of nursing careers and compensation. Women are significantly more likely to see the work as difficult and as underpaid. Men are less likely to see nursing as a career for them.
As we move to the future, we must consider strategies that engage the public to move beyond high regard for nursing and into careers. Efforts to expand the capacity of nursing education programs and continue efforts aimed at increasing public awareness of the career advancement and salary opportunities in nursing are all important.
Many Americans have some interaction with health care services in the course of the year. These interactions provide critical windows of opportunity for patients, family members, and friends to become aware of the professionalism and skill required of a registered nurse. For many Americans, however, interactions with hospital-based nurses may be infrequent. That is especially true for young, healthy people who are considering careers. For this group, print and broadcast media are major sources of information. News, television dramas, and advertising all play a role in reaching this audience. But we can see in these data that the media in which nurses are typically viewed are more likely to have a positive influence (or no influence) on perceptions of nurses than they are to have a negative influence on their respect for nurses. Thus, the media will continue to be an important tool in engaging the population to consider a nursing career. Print and broadcast news stories about the work of nurses in responding to crises and in enhancing patient safety have a positive impact on public perceptions. Advertisements and media stories also play an important role in starting conversations about nursing careers and draw an already interested audience of young people. Positive stories from nurses themselves about the rewards of the profession will have an important impact on patients and the public.
Some 15% of U.S. adults we surveyed indicated that they have seriously considered a nursing career and not pursued it, representing approximately 1.8 million potential workers, more than enough to fill the nation's labor needs for nurses in the next 20 years. A prolonged and persistent effort is needed to educate people about nursing careers, to stimulate the expanded production of nursing faculty, and to bring creative approaches to financing nursing education and workforce improvements to convert the large number of seriously interested candidates into the nursing profession.
Many improvements in the workplace environment have, and are continuing to occur, job and career satisfaction have grown markedly, interest in nursing has increased, the private sector has come forth with large amounts of funding to support the profession, evidence of the impact of nursing on patient care quality and safety has grown tremendously, projections of the future supply of RNs have improved (but remain very worrisome), and prominent organizations and individuals focusing on improving the quality of health care have not only grown in influence in recent years, but its leaders have come to realize that without a well-educated and adequately sized nursing workforce their agendas will not be accomplished. The nursing profession has many new supporters, in addition to the admiration, trust, and respect of the public, who want to see these improvements continue and strengthen.
Finally, as we ponder these successes and positive momentum now apparent in the nursing profession, we confess to harboring a concern that there is still no national commitment to ensure that the nursing workforce will be ready to meet the challenges that await the health care system in the next decade, particularly as Baby Boomers retire and consume more resources on health care. Today, there is still no national workforce strategy nor is there any assurance that data will be routinely gathered, analyzed, and interpreted to allow us to know whether and how the state of the nursing profession is getting better or falling behind. Implementing an overall workforce strategy, supported by timely and relevant data collection function, is essential to understand and hopefully maintain the public's support of the nursing profession, and provide for the continued strengthening of the nursing profession.

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