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| The stereotypical and feminized historical imagery of nursing routinely subverts the complex modern challenges that nurses now face, often without adequate resources. Image Credit: Seattle Municipal Archives/Flickr |
When I first read NPR’s investigative reports about nursing injuries, I was shocked that this injustice had been festering so profusely, yet these deep wounds remained invisible to the public. How could this be?? Especially since nurses are such a beloved fixture in American culture. They are often visible figures of professional femininity within popular culture, and they grace the screens of both movies and television shows. In That 70s Show, the lovable Kitty was a devoted nurse. Even in The Notebook, the fiery love interest, Allie, briefly nursed injured soldiers in the Red Cross. Perhaps this is why nurses were used by NPR as figureheads for this issue, although data from the Department of Labor’s Bureau of Labor Statistics (BLS) shows that the more marginalized nursing assistants and orderlies “are injured more than any other occupation, followed by warehouse workers, truckers, stock clerks and registered nurses.” But then I realized that was the issue! These dominant and one-dimensional images of nursing feed society with cultural narratives about “feminine” professions, thus inducing a blind spot to the full realities of nursing and stifling society’s ability to respond to the suffering of nursing employees. Society is rendered unable to hold key institutions accountable. It’s difficult for reality to compete with and push against the flood of box office illusions.
I decided to google images for nurses and was inundated with a collection of smiling faces engaged in “safe” tasks like holding a stethoscope, calmly writing on a pad, holding the hand of a frail yet healthy elderly woman, holding a clean baby, and taking the temperature of “safe” patients. When I used the keyword “nursing,” the smile remained superimposed on faces while taking the heartbeat of a seemingly healthy girl holding a cuddly teddy bear, giving bedside comfort, and holding a needle. The smile dominated and was a static feature despite who was posing as a nurse. Other features or aspects of nursing were hidden, including distress, danger, or daunting tasks, and any pain associated with nursing. For example, there was no imagery depicting a nurse grasping her back after a particularly brutal lifting or appearing exhausted after a long shift. Only one type of expression was showcased, which gives the misleading perception that nurses only deal with one type of scenario. While the nursing profession is multifaceted, the one-dimensional dominant images of nursing crowd out and subvert the reality. Consequently, spines are crushed in silence beneath an omnipresent smile.
This one-dimensional conception of nurses and nursing has gender implications. According to the Department of Labor’s Bureau of Labor Statistics (BLS), 90 percent of nursing employees are women, while almost 70 percent of physicians are men. Historically based structures, attitudes about gender, and the logistical challenges of motherhood reproduce these gender divisions. Therefore, nursing is overlaid with themes about womanhood and nurturing. Since nursing is represented as a feminine profession, it is intertwined with harsh dichotomies between masculine and feminine. These dichotomies reinforce sharp divisions between nursing, safety, and femininity versus power, danger, and masculinity. However, in reality, nursing requires a delicate balance of feminine and masculine qualities. Yes, there is smiling, but the heavy lifting shouldn’t be a mere footnote in society’s narrative of this profession. There needs to be acknowledgment of both stories and the realization that nursing and nurturing are also dangerous.
Since these gendered views of nurses are implanted within cultural narratives, their workplaces and their hospitals are not structured to support the full realities of nursing. The policies within most hospitals do not demand recognition or support of these heavy realities, which contrasts with workplaces associated with masculinity, such as auto factory workplaces. James Collins, a research manager in the NIOSH Division of Safety Research, discovered that his subjects, who were “93 percent men, heavily tattooed, macho workforce, Harley-Davidson rider type guys, and they were prohibited from lifting over 35 pounds through the course of their work.”
Proper body mechanics, which were developed more than 100 years ago to “safely” move patients, were formulated under the context of these anarchic and one-dimensional gender views that normalized undermining women in the workplace. In 1898, the textbook Nursing: Its Principles and Practices made light of the fact that women “occasionally” complained about injuring their backs. The fact that hospitals refuse to invest in equipment to offer some support indicates they could be as equally far behind in their view of nurses. Thus, nursing employees suffer back and musculoskeletal injuries three times more than construction laborers, according to the BLS. The machines that could assist with moving patients, who could weigh up to 400 pounds, are viewed as an expensive luxury and not a necessity. Despite that, “The bottom line is, there’s no safe way to lift a patient manually,” says William Marras, director of The Ohio State University’s Spine Research Institute, which has conducted landmark studies on the issue. “The magnitude of these forces that are on your spine are so large that the best body mechanics in the world are not going to keep you from getting a back problem.”
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| Nursing imagery being used to sell Coca-Cola products is a testament to nurses’ elevated position in pop culture. |
Myth: Nursing and Nurturing are wholly safe and feminine endeavors.
Nurturing is often dangerous during emergencies because nurturers and caregivers are on the front lines to face sickness. In the chaos, their wellness can be dangerously neglected. Oftentimes the situation can overwhelm the resources that are available since emergencies are so unexpected. In fact, NPR reports that, “most patients staying in hospitals today are sicker than the patients of 20 years ago.” Tove Schuster, in March 2010, raced to lift a fallen patient who weighed more than 300 pounds at Crozer-Chester Medical Center near Philadelphia, and that’s when she felt something pop. Another nurse can attest to feeling this ominous pop after lifting a patient without adequate equipment. Sunny Vespico, a registered nurse, moved an overweight patient who was having trouble breathing during her night shift at the intensive care unit at Temple University Hospital in Philadelphia on March 31, 2012. “Immediately I felt a pop in my back and pain down my leg,” Vespico says. “As a nurse, and understanding the mechanics of the body, I knew that there was something very wrong.” Leesa Evans, a registered nurse, rushed to lift a 300-pound patient who was dying of congestive heart failure and couldn’t move to relieve himself. Her nurturing spirit intensified the rush, and days later she couldn’t walk.
Nurturing can be a major burden that slowly crushes caretakers and weighs them down. Professions deemed masculine are more prone to the one-time catastrophic injury and thus are perceived as more dangerous. For example, David Michaels, the assistant secretary of Labor who heads the U.S. Occupational Safety and Health Administration (OSHA), sends agency inspectors mainly to factories and construction sites where workers suffer amputations and can get killed. However, the wear and tear over time, which is described as the buildup of microscopic tears that block nutrients to discs and eventually cause the discs to collapse, is just as catastrophic and deadly. Nurturing can be dangerous, because just like the horrific one-time deaths of factory and construction workers, lives are lost. But unlike the construction or factory workers, they lost their lives due to their commitment to nurturing, which is supposed to be feminine and safe.
Many injured nursing employees become physically detached from their lives permanently. Terry Cawthorn couldn’t celebrate her own birthday, even though she helped in the birth of another patient. Her birthday flowers and pink cake sat dejected while she was “on the floor, in tears, in so much pain.” She was transformed from having an active life to one filled with grief and debilitating pain. Abigail Velez, a nurse who was repeatedly injured while performing routine tasks, such as moving patients, at Kaiser’s Walnut Creek hospital in California, told NPR, “The pain got so intense and her motion was so restricted that she couldn’t pick up a glass of water. ‘I could not lift my arm. I couldn’t even raise it up to brush my hair’.” Leeza Evans’ relationship with her husband has been negatively affected since they can no longer garden, ski, and hike together. David Michaels, chief of the Federal Occupational Safety and Health Administration, explained to NPR, “They go home and have real disabilities. They have trouble lifting up their kids. They have trouble doing a lot of the daily tasks of life because of back injuries, arm injuries, shoulder injuries.”
Since these gendered views of women and femininity in the media and within dominant culture overwhelmingly appear celebrated, many women overestimate how much they will be rewarded and genuinely appreciated for their efforts. Many don’t even understand the oppressive implications of this “celebration” until it is too late. In fact, in another twist of cruel irony, so many girls and young women have internalized these glamorized and one-dimensional gender expectations that nurses and nursing employees are treated as expendable or, as Suzanne Gordon, author of Nursing Against the Odds, explained to NPR, a “disposable labor force.” Even if a supervisor testifies under oath that a nurse like Cawthorn, with 20 years of service at the Mission Hospital at Asheville, North Carolina, was “one of my most reliable employees.” Cawthorn lamented to NPR, “I really thought that I was someone to Mission. I had
poured my life into nursing. And when I got hurt, I meant nothing. I was
absolutely nothing to the hospital.” This devaluation is unchallenged due to the expectation that every year will generate a guaranteed supply of eager young women who aspire to be nurses because social norms continue to reproduce these aspirations. This produces a harsh combination of institutional betrayal and, in a broader sense, cultural betrayal.
When Cawthorn was ruthlessly terminated, she was “so emotionally destroyed.” According to her, “Nursing was not just a job, it’s who you are.” The institutional and cultural betrayal creates a betrayal of one’s identity. Tragically, the same culture and structures that helped to create this gendered identity has now injured and discarded them. What is the first step that society can take to rectify this issue? I believe that Ashley Moore, a registered nurse in the intensive care unit at Kaiser’s hospital in Walnut Creek, California, sums up the situation the best: “It helps to know that they [nursing employees] do more than measure patients’ blood, hook them up to IV and assess how patients are faring. Their work is also physically grueling, and the surging rate of obesity is making it worse.”
Sourced from the NPR Special Series Injured Nurses:
Despite High Rates of Nursing Injuries, Government Regulators Take Little Action
Even ‘Proper’ Technique Exposes Nurses’ Spines to Dangerous Forces
Hospitals Fail to Protect Nursing Staff From Becoming Patients
Hospital to Nurses: Your Injuries Are Not Our Problem
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