After the Angels: In Search of A ‘Knowledge-Based’ Professional Identity

If you’re looking for angels, you’ve come to the wrong place. So says GuitarGirlRN in her latest blog post.

One stereotype of nursing (and it’s perpetuated by nurses as well as by those not in the medical or nursing fields) that bothers me is that of nurses as “angels of mercy.”

We’re expected to smile while up to our elbows in bloody shit and vomit, be pleasant to rude and sometimes violent people, put up with crap from doctors, managers, patients, their families, nurse techs, and janitors yet keep our cool, never cry, never sweat, never lose our tempers with each other, always be prepared and be right there when we are needed.

by shioshvili/via Flickr

Her point is that nurses are human; they do the best they can with scant resources, but they aren’t superhuman. They aren’t saints, they have lives of their own, and they can’t always be all things to all people. Back in 2005, noted author Suzanne Gordon wrote, with Sioban Nelson, an article for us called “An End to Angels.” In it, they presented the idea that nursing is a profession with a serious image problem, one that undercuts recruitment efforts and ill prepares new nurses for the reality of their work. The arguments in the article are subtle and thought provoking, and impossible to summarize. Here, anyway, is the introduction:

Nurses often disagree on the causes of and possible solutions to the current nursing shortage. Mandatory staffing ratios versus Magnet hospitals? Sign-on bonuses for nurses versus more unionization of RNs? The aging of the nursing workforce versus working conditions? Still, most nurses agree that the profession needs a contemporary image to attract new recruits and reinforce the idea that nursing is a profession grounded in science, technology, and knowledge. To present a modern image and solve the crisis, dozens of different groups have produced advertising campaigns and promotional messages to attract new recruits to the profession.

A close analysis of the words and images used in these campaigns reveals that, instead of creating a modern, accurate version of today’s nurse, many simply repackage nursing’s traditional stereotype of women born to be good, kind, and self-sacrificing-not educated to provide care based on science and practical skill. Although many studies-conducted by nursing, medical, and public health researchers-have documented the links between nursing care and lower rates of nosocomial infections, falls, pressure ulcers, deep-vein thrombosis, pulmonary embolism, and death, most promotional campaigns are conspicuous for their failure to promote these data. Even when ads feature a mix of men, women, and minorities, what is often communicated is a sexist, archaic message: nursing is virtuous work.

The subtitle of Gordon and Nelson’s article is “moving away from the ‘virtue script’ toward a knowledge-based identity for nurses.” So, five years on, how is the nursing profession doing with this? Do you feel you have a “knowledge-based” professional identity? Is that how patients, physicians, nursing instructors, administrators, your friends and family, and the general public see you?—JM, senior editor

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2016-11-21T13:15:44+00:00 September 14th, 2010|career, nursing perspective|4 Comments
Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


  1. Kaitlin September 16, 2010 at 6:53 pm

    As a student with the career goal of becoming a nurse (and eventually a nurse practitioner), I hope that, by the time I enter the workforce as such, nurses are respected for their knowledge and valued as thinking individuals rather than just people who “care”.

  2. Kathleen Burke, RN-BC September 14, 2010 at 10:17 pm

    ‎”Caring” is not exclusive to the nursing profession. When I go to “Starbucks” and order my grande latte, extra shot, double Soy, with extra foam (I don’t really order that…but the point is) that Barista cares about my order. Most times… they get it right..and with a smile, I hand over my money. My number one asset as a registered nurse is my BRAIN…my ability to THINK. We are replaceable and undervalued if we only are deemed important because of our ability to care. Of course I care about my patients — but that is not what keeps my patients alive. We have to have experienced, SMART nurses at the bedside…with an ability to monitor, record, decipher, integrate, and communicate information and then ACT on it. This is my value as a bedside nurse — this is what keeps my patients alive and protects them from harm.

  3. MaleNurse, NE September 14, 2010 at 11:57 am

    We are not even close. Nursing remains stuck in the past. The reasons are very complex. Simply put, We agree that our knowledge and evidenced based care can improve outcomes yet we continue to allow multiple entry points dumbing down the workforce, we refuse to self police poor performers, and we encourage apathy toward continuing education. We are sending mixed messages at best.

  4. JParadisiRN September 14, 2010 at 11:53 am

    I had this very conversation with a colleague last night. I call the assignment of virtue to nurses “the burden of the color white.”

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