If nursing iconography has an enduring stereotypic image, it must surely be the nurse as ‘angel’. While much of the earliest artwork and imagery of nurses showed nurses ministering to the sick in various quasi-religious ways and settings, nurses in Australia, even in the late 1800s, were ‘redefining the image of nurses as motivated primarily by self-sacrifice’ (Bashford 1997). However, it was Florence Nightingale’s story that captured the public imagination and stimulated a swathe of hagiographic accounts (which critic Leslie Fiedler called ‘shameless schlock’ (Fiedler 1988:103)), and movies such as The White Angel and The Lady with the Lamp (Jones, 1988 and Kalisch, 2008). So powerful were these images of the angelic presence which lit up the wards of Scutari with her lamp, that Florence Nightingale has become easily identified as the soul or spirit of nursing and as the embodiment of selfless, devoted, compassionate care that borders on the saintly. Despite some of the more critical and balanced scholarship concerning the life and work of Florence Nightingale (e.g. Hektor 1994), the stereotype of the nurse as selfless angel is still prevalent, especially in the public imagination.

There are several difficulties here. At first glance it may seem no bad thing to think that society views nurses as ‘angels’. Who wouldn’t like to be thought of in such a ‘positive’ light? Which nurse would not like to think that she was capable of such profound caring, which could earn such adoration? Is this not just being held in high regard by society? Don’t we feel good when opinion polls put nurses near the top of the list for perceived honesty, trustworthiness and hard work?Salvage (1983) perceptively pointed out that nurses often collude in sustaining the ‘selfless angel’ stereotype while professing to scorn it. As she noted, ‘The trouble is we are secretly flattered by the myths, especially those emphasising dedication and high-minded self-sacrifice’ (Salvage 1983:14).

However, buying into the ‘angels’ stereotype may be a Faustian bargain, for there is a price to pay for this. ‘Angels’ may be saintly, but such perfection is impossible for mere mortal nurses to achieve or maintain; nurses are, after all, only human. Nor do angels seem to require any education or experience; their sanctity is more of a divine gift. For real nurses, however, becoming a skilled and competent nurse is hard work. We may be born with particular dispositions and talents (although some would dispute even this), but we cannot be ‘born nurses’. That will take more than an accident of birth. Such shafts of grace as we achieve are often hard won through our sustained engagement in the lives of those people who place their trust in us.

If the ‘angel’ myth is a remnant of nursing’s religious order origins, then the unquestioning obedience of the doctor’s handmaiden owes much to nursing’s military origins. This stereotype touts the image of the nurse as a kind of ‘lady in waiting’, or the doctor’s ‘right-hand woman’. For decades this has been a hugely influential media view of nursing. Essentially, the nurse is there to provide faithful and obedient service to the doctor and, like the ‘angel’ myth, this view has often been sustained by nurses themselves, who were flattered by the idea that ‘their’ doctors or ‘their’ consultant says that he or she could not manage without them. In her analysis of nurses’ image in post-war Britain, Hallam (1998) noted also that: ‘Within the broadcasting environment, nursing’s professional discourse of “service” was interpreted as service to medicine, nurses themselves did little to challenge the picture’ (Hallam 1998:37).

In this sense, the ‘handmaiden’ stereotype may be less mythical than nursing would like to acknowledge. While nationally and internationally, particular nurses and nursing projects/initiatives have led healthcare advances (often in collaboration with medical colleagues), there are still many nurses who work with doctors who seem to not recognise nurses’ ability and responsibility to make an equal contribution to care, and who assume that the nurse’s role is to make coffee, not decisions. Despite claims of teamwork and ‘multidisciplinary’ cooperation, some nurses continue to work in ‘teams’ where teamwork is lots of people doing what one person says, and that one person is usually a doctor.

For images to be powerful and long lasting they must be capable of being both sustained and subverted. The battleaxe figure is in many ways a magnificent subversion of other stereotypes of the nurse. It is what Hunter (1988) calls, in a slightly different context, the translocated ideal. Where the ‘angel’ is often portrayed as pretty, feminine, Caucasian, slim, caring, white-clad for purity, fun, deferential and loved by patients, the battleaxe or matron figure was almost the exact opposite—tyrannical, fearsome, asexual, cruel, monstrously large, dark-clad, and set on crushing all fun and individuality. On a BBC radio program that I compiled several years ago, I listened to a recording of a 1960s radio quiz show where one of the male panellists joked that the tragedy of nurses is that they were one day destined to become matrons. Matrons, like other nurses who refuse to fit the accepted stereotype of the pretty, kind, compliant nurse, are banished to the moral margins of societal acceptance where they become objects of fear or ridicule.

Think here of ‘bad’ nurses like Charles Dickens’ Sairey Gamp (Summers 1997), Ken Kesey’s ‘Big Nurse/Nurse Ratched’ from One Flew Over the Cuckoo’s Nest (Darbyshire 1995), Annie Wilkes from Stephen King’s Misery and the more comic figures of Hattie Jacques from the Carry On film series (Ferns & Chojnacka 2005) or Matron Dorothy from Australia’s 1990 television series, Let the Blood Run Free (Delacour 1991). The ‘battleaxe’ stereotype cries out for a feminist analysis that reveals the fate of any nurse who does not comply with the mythical norms of the ideal nurse and who challenges male power (usually patients and doctors). Worse than this, perhaps, is that the battleaxe figure is a powerful woman who is unattracted to them (Darbyshire 1995), thus proving that she cannot be a ‘real’ nurse, as one of the most prevalent and damaging stereotypes is the nurse as an easily available sex bomb.

When I was lecturing in Scotland, I would discuss the question of nurses’ image with the first year students who had just begun their course. I asked them what a common reaction would be at a party if they happened to mention that they were nurses. After the laughter and ribaldry had settled, it was clear that a common, if not thankfully universal, reaction from some men was a ‘knowing grin’ and some suggestion that a night of unbridled sexual abandon might lie ahead. For this reason, many of the students said that they would make up an occupation rather than ‘admit’ to being a nurse. Why is the ‘naughty nurse’ stereotype so prevalent? Why are there no ‘naughty lawyer’ sexual stereotypes? Why are there no pornographic films made about the adventures of a group of occupational therapy students? Why don’t sex shops sell physiotherapist uniforms? What is it about nurses that make them such a target?

This is a deep and complex issue, but consider the following points in relation to Hunter’s (1988) notion of a ‘translocated ideal’. Nursing is utterly implicated in social power relations, between nurses and doctors, nurses and other nurses, nurses and patients, nurses and relatives, and more. When patients enter hospital, the traditional power relations are reversed and they find themselves vulnerable and dependent, rather than strong and in control. At a societal level (for not every male patient will see his situation in this way), one way of redressing this balance is to metaphorically (or perhaps even practically) sexualise the encounters between nurses and patients.