Angel or hero: The value of a nurse

An interesting review about the value of nurses caught my eye in a recent edition of the Lancet. Titled “Patient safety: The value of the nurse,” the main point of the piece was that the importance of a competent, confident, and credentialled nurse has never been more crucial, yet in many settings the importance of a robust nursing workforce is undervalued, and as a consequence, a safe health system is elusive. 

The commentary was based on information taken from 10 referenced works ranging from a WHO report on the state of the world’s nursing in 2020, to an article authored by four nurses (three with PhDs) with a focus on the public’s mistaken view of nurses. “Angels and heroes: The unintended consequence of the hero narrative,” explores how the angel and hero narrative undermines the professionalism of the nursing workforce, and reinforces the public’s perception that nursing is an innately feminine nurturing role. 

Specifically, the angel idea creates a perception that skill, education, knowledge, and discipline are of low importance, and that the high level of skill and knowledge demonstrated by nurses in the current pandemic is somehow bestowed upon them. The requirement to be a hero suggests that a nurse must act outside of the norm and that the system does not support their safety. The portrayal of nursing as inherently feminine reinforces the female heroin presentation. The inaccurate images of nursing limit the public’s understanding of nurses as knowledgeable and skilled health care professionals. Apart from devaluing the required knowledge and skills to be a nurse, it also narrows the diversity of nursing by limiting recruiting potential of students, including men. 

Being described as angelic or heroic in their highly skilled professional roles may be romantic and noble, but the unintended implications may rob the value of the nurse in their role as practitioner, leader, manager, and compassionate patient advocate. Apart from correcting other health care issues, the public’s view of nurses and nursing must be reset. 

Nurses are not angels, not heroes, they are human beings who want to do the job they were trained to do, and be protected to do it. 

The authors of “Angels and heroes” recommend corrective steps. Nursing organizations must make efforts to realistically portray to the public the accomplishments of nurses of all genders from various cultural backgrounds working in a variety of professional roles. Recruitment campaigns need to emphasize opportunities for nurses of all genders in the various health care roles. Individual nurses could challenge the hero stereotype by highlighting their skill, knowledge, and compassion in the media.
—George Szasz, CM, MD

Suggested reading

Stokes-Parish J, Elliott R, Rolls K, Massey D. Angels and heroes: The unintended consequences of the hero narrative. J Nurs Scholarsh 2020;52:462-466.

Ullman AJ, Davidson PM. Patient safety: The value of the nurse. Lancet 2021;397(10288):1861-1863.

This post has not been peer reviewed by the BCMJ Editorial Board.

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