Break the stereotype of the nursing profession

Introduction

The advent of modern nursing in colonial India was in the middle of the 19th century (1). This was linked with the arrival of nurses from the west, generally women with a deep rooted Christian cultural heritage, with most being religious nuns or Christian converts (1).

Not only in India, but all over the world, Christian doctrine has had a strong influence on the growth of the profession (2).This influence is revealed in the use of nurses’ caps which evolved from veils worn by religious nuns and deaconesses of the church (3). Another example is the title “Sister” used for nuns, and still used to address professional nurses (1). Other than these visible influences, the years of religious orientation of the profession have caused vocationalism, asceticism and obedience to percolate into the very essence of nursing (1).

Winds of change

Nursing in India has evolved a lot over the last century. From a vocation, it has grown into a profession with its own body of knowledge and unparalleled contribution to healthcare. The use of caps has almost disappeared from nurses’ uniforms. It is a potential carrier of pathogens (4) and has no purpose other than a symbolic association. The traditional white frock uniforms have also been replaced by culturally appropriate dress or unisex scrubs, which are both comfortable and dignified.

However, the title “Sister” for a nurse continues to be used in Indian hospitals, and evokes the image of a selfless religious nun dressed in a spotless white frock. The title has been drained of its meaning in the present context, so too, the title of “Brother” for the male nurse.

Stereotyping of the nursing profession

According to John Pearn “A stereotype results from an attributional metonymy” (5). The idea of a nurse has been imbued with the attributes seen in religious sisters and thus a stereotype has been created around it. Prolonged use of the term over all these decades has reinforced the stereotype to such an extent that it has nearly become impossible to address a nurse anything other than ‘Sister’ or ‘Brother’. It can be argued that this has influenced nurses to subconsciously change to fit the stereotype. This stereotyping of a profession can eventually become a potential reason for distortion of one’s self-image as well as of the public image of nursing. This should be viewed as an ethical issue.

Until recently, the nursing personnel including males were designated as ‘Sister Grade II/ Sister Grade I’/‘Nursing sister’, which was nothing less than sexism and breach of gender identity. The job title of ‘Nursing Officer’ was initiated by the Government of India vide an order (6), for nurses working in Central government hospitals. However this has not changed the way nurses are addressed. In the wake of secular and gender-neutral workplaces, it is professionally unethical to be addressed by a title that is simply a remnant of the past with no specific meaning, other than perpetuating a stereotype.

Professional ways of addressing a nurse

Authentic respect should be reflected in the title used for addressing nurses. Referring to a nurse as a “nursing officer” in conversations or over the telephone will dramatically improve the professional aura attached to it. Even general appellations like “madam” or “sir”, from patients and other healthcare team members are respectful. Peers should address each other using their names. This improves the specificity of the communication and the receiver has a greater motivation to act on the content of the message. In order to facilitate being addressed by name, nurses should wear their name badges.

Nursing is a career choice for a large number of Indian youngsters. The professional bodies of nurses in India like the Trained Nurses Association of India and the statutory bodies like the Indian Nursing Council have taken several steps towards the professional development of nursing. Nevertheless, the image of nursing in India needs to be revamped and a change in the way of addressing a nurse will help the profession leave the shackles of the past behind and break the stereotype