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Why don’t health journalists interview nurses? We asked them.

Why don’t health journalists interview nurses? We asked them.

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When was the last time that you interviewed a nurse for a story on something other than staffing or scope of practice?

Can’t recall? Most health journalists would say the same. We recently published a and found that they were cited as sources in only 2 percent of stories. And most of these were about scope of practice of nurse practitioners or another nursing workforce topic. Nurses were never cited as sources in stories focused on health policy and rarely on the business of health care, despite being in policy positions in government or responsible for overseeing of a health care organization’s budget.

Our study replicated a 1997 study on nurses and media commissioned by Nancy Woodhull, a founding editor of USA Today who was concerned about women’s representation in newsrooms and the news. Conducted at the University of Rochester, the study examined all health news stories published by leading national and regional newspapers, along with news weeklies and trade publications like Modern Healthcare. For our version of the study, we partnered with the Berkeley Media Studies Group to randomly sample the same publications and found that there had been no improvement in nurses’ representation in health news media over the last 20 years. While women have long been underrepresented in news stories, the numbers are ticking up — women were used as sources , up from 17 percent in 1997.

So we wanted to find out why the largest group of health professionals — — remained invisible in health news stories, despite growing numbers of nurses with masters and doctorates who are NIH-funded researchers, executive administrators and expert clinicians. We interviewed 10 health news journalists about their and found a consensus around the following themes:

1.  Journalists and newsrooms often have biased views of women, nursing and positions of authority in health care.

This includes having to justify using nurses as sources with supervising editors who want to quote “rock star docs.” Most newsrooms continue to use the AP Stylebook, which permits the use of M.D. after a physician’s name but not RN after a nurse’s name. If the CEO of a hospital is a physician, you will know that by the Dr. before or M.D. after their name; if the CEO is a nurse, you will likely not know that. Why is it important to know in one case but not the other?

2.  Journalists told us that they didn’t fully understand what nurses do.

They are not unique. Even many physicians don’t understand the breadth of knowledge and skill that nurses have, and we have not always been very good at explaining it. One journalist we interviewed had figured out that nurses who work with people with diabetes are excellent sources on what it takes for people to better manage their diabetes — but this was an exception.

3.  Public relations staff of health care organizations and universities never recommend a nurse for a reporter’s interview.

Sometimes the PR staff doesn’t provide a nurse even when a reporter asks for one. Clearly, there’s work to be done with educating PR staff, as well as CEOs and other leaders in health care, about the expertise that nurses have to offer. One journalist who covers cardiac issues told us that she s an expert nurse in a hospital cardiology department to get background and figure out the nuances of the story. But she can never quote the nurse because the cardiac service’s physician is one of those “rock star docs” who insists that only he speak to the media.

4.  Nursing isn’t media savvy.

Journalists said that they almost never receive press releases from nursing associations or nursing journals about something that is new or cutting edge. Individual nurses may not respond to a request for an interview in a timely fashion or may want to be anonymous. So there is a lot that nursing itself needs to address.

We like to remind health journalists: “If you’re not interviewing a nurse, you may be missing the best part of the story.” Nurses bring unique perspectives on patients’ and families’ experiences with health, illness and health care. Many know only too well the impact that health and social policy can have on people’s lives. And they know what is needed to transform a dysfunctional health care system.

Our advice? First, discuss these studies in your newsroom and reflect on your own reporting. Second, get to know nursing associations the same way you know medical associations. There general, specialty or ethnic nursing associations, and most can help you find the right nurse for your story. Third, insist that a PR staff for a university with a school of nursing or a health care organization find you a nurse to interview. Finally, know that when one nurse fails to respond to your request for an interview, many others stand ready to respond.

Diversity of sources is a hallmark of . How does your reporting stack up?

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Comments

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Another factor nurses are not interviewed about important healthcare issues is they are employed by a company that will fire them if they raise their voice and speak negatively about problems.

Just like doctors, they have student loans, mortgage and car payments, children in school wanting to go to college, retirement plans, and job tenure. Nowadays, if comments are perceived as going against their employer, they could be affected or threatened with termination.

I agree, we must have more nurses interviewed especially to learn and tweak our healthcare system, but fear and apprehension about their jobs will keep many of them silent.

Gene Uzawa Dorio, M.D.
Santa Clarita, CA

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I applaud diversity and find this to be very pro-female, not so much true diversity. Try connecting with the American Association of Men in Nursing. They accept everyone.

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Thank you for bringing up this topic!
Journalists, and policy makers as well, tend to have go-to sources for various topics. There's a seemingly reasonable assumption that if you want to know about what's going on with nurses, you would get reliable information from one of the established nursing organizations, such as the ANA (American Nurses Association) or a large nurses union, such as NNU (National Nurses United) But this approach continually fails to capture the issues that most front line caregivers are facing.

Why?

Only about 5% of nurses belong to the ANA, and that number has been slowly but steadily dwindling for many years. The ANA leadership is made up of primarily of managerial and academic nurses, with the bulk of the members coming from affiliate collective bargaining units, whereby membership is a compulsory part of an employment contract. The ANA likes to advertise that they "speak for America's nurses," but only a very small fraction of America's nurses have actually authorized them to do so.
Likewise, the largest labor union of RNs (NNU) claims around 6% of nurses. While their members re mostly direct caregivers, most of there members re are concentrated in California, Minnesota and Washington D.C.

The vast majority of nurses - estimated 85+% - are not affiliated with any professional organization. When reporters turn to ANA or NNU to interview "nurses," they invariably get the party line narrative that reflects the interests of small, specific subsets of the profession; management /academia and labor unions respectively.

There is one other big group of nurses - the upstart online nurses organization called "Show Me Your Stethoscope" (SMYS) - with a membership much larger larger than ANA & NNU combined. This group coalesced on Facebook in 2005, and operates primarily online. () SMYS nurses tend to be young and working at the bedside in hospitals and nursing homes. As digital natives, their approach to organizing and advocacy is more inclusive, ad-hoc, and collaborative that the legacy organizations, but neither the ANA or NNU has been willing to recognize the 650,000 member SMYS community as legitimate, and continue to snub SMYS entreaties to work and rally together.

As far as interviewing individual nurses independently, that's problematic as well. Employees with legitimate complaints are routinely ostracized, disciplined and sometimes fired. Hospitals will uniformly declare that they have processes in place to welcome constructive criticism and protect employees who identify dangerous or illegal activities, but corporate culture is adept at expelling "troublemakers," and often make it difficult for nurses to find comparable employment elsewhere. As employees, nurses are not permitted to speak to the press without PR permission and supervision, and even then, they may risk retaliation. As vital breadwinners in many households, nurses who would love to tell the whole truth about what their patients are facing simply cannot afford to risk the loss of their livelihoods.

I don't know what the answer to this is on the national level, other that that journalists need to be keenly aware that the nurses designated as spokespeople by legacy organizations like the ANA and NNU are unlikely to be speaking with an authentic voice of the workaday RN caring for patients in a hospital or nursing home.

On a local level, I suggest a more bottom-up approach to finding sources for nursing stories. Reporters probably already know a few nurses, some of whom work in the local hospitals and nursing facilities. Ask them about problems, and if they indicate there are issues, but aren't comfortable talking with you about them, ask them who the troublemakers are at work. There is always a troublemaker or two. If they will pass your info to the troublemaker, you may be able to develop a relationship with a valuable source, and maybe even get an interview.

Thanks again for this article. Direct care nurses are uniquely privy to critical knowledge about the many systemic failures at the front lines of patient care. If their collective voices can be effectively amplified, bringing their honest knowledge into our debates, the country will be far better informed for making more meaningful, effective health care policies going forward.

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Thanks for acknowledging this issue. As registered nurses, we are the clinical experts when it comes to promoting health, preventing disease, and alleviating suffering. There are several of us who are changing the perception and role of nurses whether through our own YouTube channels or personal blogs in teaching people how to promote their health and prevent disease through non-traditional, yet evidence-based ways. Not to toot my own horn, but as The Nurse Farmer, I teach how gardening activities can help us all live healthier lives. My esteemed colleague, Susan Allison is The Nature Nurse who also has her own blog and YouTube channel. Her mission is teaching people about the healing powers of nature. It is frustrating that our voices are sometimes not heard and we are overlooked. Thanks for writing about this!

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This was an excellent article. Being an RN, I've worked in many areas of nursing from the hospital and nursing home setting to working in the government and this topic needs and should be addressed but for another reason. Nurses working on the front line do have plenty to offer. However, my history when applying for positions, has been facility driven policy that nurses are not to speak with the media and the facility will choose who will be the interviewed representative. It's taboo and most nurses would agree that our voice is silenced even if we were asked to be interviewed due to facility policy.

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In my 50 + years of nursing, the large organizations I worked FOR did not allow nurses to speak to reporters. The PR staff gave the “facts”.
Suggestion to journalists: find recently retired nurses. Be sure they are truthful by verifying with another source also. Go behind the story. Organizations will block the story or try to discredit you. Patients need to have confidence in their healthcare provider. Some health care providers should not be providing healthcare. A personal situation was almost a disaster for me. I hope to never need immediate care from that institution again.
I wish you success in being able to report on the fantastic care being given by nurses in many settings. From horseback riding nurses in Kentucky to flight nurses in medical helicopters, great stories are out there.

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