Because of her continued allure, much of Nightingale’s life has been reconstructed and, in the process, subject to various forms of poetic licence. An excellent example of this poetic licence is explored by Jones (1988) in her critical examination of The White Angel, a motion picture released in 1936, which purported to be a biographical representation of the life of Florence Nightingale. On its release, this film was widely acclaimed, both within and outside the nursing profession, with influential professional nursing journals promoting the movie as ‘a good educational picture’, and commending it to the nursing profession, ‘especially those concerned with information and education’ (Jones 1988:222). However, although the movie was widely accepted as factual, even by the nursing community, Jones (1988) proposes that the screenplay contained a series of key errors, which served to trivialise major events in the life of Nightingale, and reinforced the myth that her decision to become a nurse was made in the manner of a religious calling.

However, notwithstanding the influence of myth and legend, nursing does have a noble history, and there are many stories of the fortitude, bravery and courage shown by Australian nurses in wartime and other times of community hardship (e.g. Biedermann, 2004, Hallett, 2007 and Scannell-Desch, 2005). In Chapter 2 of this book, you will find an in-depth discussion of the history of modern nursing and, after reading it, you will have greater insights and understandings of the origins of some of the myths that surround nursing.

Nursing is endlessly fascinating to many people and this is reflected in the number of television shows, novels and movies that feature nursing and nurses as a major component. There is not the same level of interest in bank workers, or bus drivers or beauty therapists for example. Nursing is ripe with imagery. Many of the images associated with nursing are seemingly at odds with one another, yet all may be conjured up by the word ‘nurse’. Images of selflessness (Fealy 2004), kindness, compassion and dedication, hard work, long hours, submission and low pay are among the things that come to mind for some people when they think of nursing. But though nursing has current or historical elements of all these things, there is so much more to nursing than these portray.

Nursing and nurses are subject to various entrenched stereotypes (Fletcher 2007), and some of these are at least partly derived from the myth that surrounds nursing. In the early 1980s, Kalisch et al (1983) identified some major ways that nursing and nurses were stereotyped, and though this work was undertaken in the United States more than two decades ago, it remains relevant to nurses in Australia today, as well as nurses in other parts of the world (see also Muff 1988). The media and popular literature also tend to present nurses as having stereotyped personal characteristics such as youth, femaleness, purity and naivety, altruism and idealism, compliance, and diminutive stature and ‘good character’ (Fealy, 2004 and Fletcher, 2007).

Nurses are also credited with having certain qualities and virtues that are grounded in romanticism. De Vries et al (1995), in their study of images of nurses as portrayed in popular medical romances, found that nurses are almost always represented as youthful, pure, virginal, kind, petite, beautiful, subservient, sensitive, considerate, competent and able females. In addition to these personal characteristics, the heroines of these stories are typically presented as Caucasian, with blonde hair and green or blue eyes. They are also portrayed and represented as being emotional and hence not to be taken seriously (Ceci 2004).

Darbyshire (1995), in his exploration of the depiction of Nurse Ratched in the popular film One Flew Over the Cuckoo’s Nest, discusses a counter image of nursing—the battleaxe/torturer. Unlike the nurses found in the medical romance genre, Nurse Ratched is not petite or subservient, and nor is she acquiescent or particularly beautiful. Hunter (1988), in her discussion of the book upon which the film is based, proposes that the Nurse Ratched character is but one example of misogynistic literary tendencies which, she argues, frequently satirically portray the battleaxe/torturer/oppressor nurse as female, and the tender, gentle carer nurse figure as male. Hunter (1988) supports this notion by exploring the images evoked in Tolstoy’s description of the gentle hero, Gerasim (The Death of Ivan Ilyich, 1886), and Whitman’s poem ‘The wound dresser’ (Leaves of Grass, 1891), and comparing them with those evoked by Kesey’s Nurse Ratched (One Flew Over the Cuckoo’s Nest, 1962). In Chapter 4 of this book, Philip Darbyshire scrutinises some current and past nursing stereotypes in more detail.

Though we still see nurses portrayed in various stereotypical and sometimes highly sexualised ways, which is exemplified in the myth of ‘nurse as whore’, these stereotypes coexist with some of the noble and romantic images of nursing. Failure to challenge these stereotypes is dangerous for nurses and nursing (Fletcher 2007): various stereotypes give the nurse the status of a worker–handmaiden rather than a health professional (Fealy 2004). Stereotypes of this nature perpetuate an anti-intellectual bias against nursing, which is manifest in the view that good nurses are practical people, rather than highly educated professionals.

Coexisting with the romantic myths and stereotypes surrounding nursing is the reality of nursing. This reality is that nurses become acquainted with the visceral and raw aspects of humanity that are usually hidden from the world, because of the illness, the incapacity, the frailty, the disability or other needs of those who are the recipients of nursing care. Nursing provides opportunities for human connectedness and growth that few other careers can offer.

But why is this significant? It is clear, as Fealy states, that it is:

It is for this reason that nurses need to be aware of the danger lurking in latent meaning and rhetoric, and recognise that a reality is being created on behalf of nursing—a reality that is not necessarily theirs. It is important to recognise that the concept of ‘nurse’ is socially constructed, and that nurses may want to believe in their power and control, but the broader societal context situates nurses in a much more fragile position. Nursing exists within a male-dominated healthcare system, bound by authority and power of that class. The sense of ‘self as nurse’ is thus subject to what David (2000) refers to as ‘received behaviours’, which can result in ‘horizontal violence’ or bullying—behaviours of aggression towards other nurses—in order to maintain fragile perceptions of self. These behaviours are self-defeating, as they destroy collegial relationships, and ‘limit freedom of thought and action, and preserves nurses’ borderline status’ (David 2000:84).

The urge to define nursing has attracted the attention of nurse scholars for a number of years. While defining a nurse is relatively simple, as you will see as you read further in this chapter, nursing itself has proved somewhat more challenging to define. Though you can probably describe what you think nursing is, the nature and breadth of activities that comprise nursing have contributed to the difficulties associated with defining nursing. Some definitions centre on the functions of a nurse, rather than offering an intrinsic definition of nursing. Henderson produced such a definition of nursing:

What needs to be noted in passing is the sexist language that continues to be used when referring to nursing. Language is ‘not a neutral information-carrying vehicle’, but creates meaning; this meaning changes over time, which makes language very powerful (Fealy 2004:650); its importance cannot be underestimated. David (2000) provides a useful analysis of how nurses collude with their oppressors by uncritically accepting outsiders’ social construction of nurses and nursing, suggesting that nurses need to socially construct themselves and their context in order to regain their identity and power.

The complexities and difficulties associated with defining nursing means that some definitions may seem cumbersome and quite ambiguous. But remember that this is more a reflection of the complex nature of nursing than any lack of clarity on behalf of those who have proffered a definition. The International Council of Nurses (ICN), a coalition of nurses’ associations that represents nurses in more than 120 countries, has captured some of the complexities in its definition:

In 2003, the Royal College of Nursing (RCN) published a definition of nursing that was the culmination of 18 months’ research, and included extensive consultation. The RCN proffered a definition and six key characteristics that capture the essence and varied activities of nursing. The six characteristics are quite detailed and cover issues such as values, relationships and interventions. The full statements can be seen at the RCN website at www.rcn.org.uk/downloads/definingnursing/definingnursing-a5.pdf. The RCN definition reads as follows:

So what is it that excited us about becoming nurses? And, more importantly, what has sustained us on our journeys?

Nursing was a gender choice given the societal and historical context of the time (early 1960s and 1970s). It was certainly viewed as an appropriate career choice for females, but also offered potential for achievement, growth and development. It was also a profession that attracted people motivated by altruism and the desire to make a difference to people suffering because of illness and disadvantage. Indeed, this is still a significant motivator of people who choose nursing today. Since the 1970s nursing has made stronger claims to a focus on health promotion, and this now has greater emphasis in construction of nursing knowledge and in conceptualisation of practice. But further to that, there was an overriding quest for understanding and caring for people. This was demonstrated in an egalitarian approach that proved to be unacceptable in nursing at the time (1963–77), when spending time with and caring about patients was viewed as naive and misguided. Such a view denied empathy and concern, and existed through the 1980s and 1990s (McVicar 2003). Currently, the concept of nurses distancing themselves from their patients has been superseded by recognition of the importance of the nurse–patient relationship or the ‘therapeutic alliance’ (Speedy 1999), which is now characterised as ‘emotional labour’ (McQueen 2004).

One of the most sustaining things about nursing and being a nurse is the opportunity to contribute a perspective that is informed by feminism. A feminist perspective is ‘concerned with gender, power relations, patriarchy and hegemony in society, emphasising gender as a key factor in determining the experiences of women in … nursing’ (Fealy 2004:650). Feminist theory can be used to examine power relationships in nursing and healthcare, resulting in the exposure of the ‘doctor–nurse game’, and more recently in the ‘health administrator–nurse game’ (Dendaas 2004), which elaborates on how nurses can be losers in the power stakes.