It has been more than 20 years since a landmark study found nurses were severely underrepresented in news coverage, and a recent replication of the study found that not much has changed, Kerry Dooley Young writes in a Medscape perspective.

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The original Woodhull study

The original study, known as the Woodhull Study on Nursing and the Media, looked at a sample of health-related news stories published by national and regional newspapers on a particular day in 1997. The study showed just 4% of quotes in those stories were from nurses.

But the health care landscape has evolved in many ways since 1997, Dooley Young writes. That's why a group of researchers, led by Diana Mason, an RN who is principal investigator and a senior policy service professor at George Washington University School of Nursing, recently decided to replicate the study to determine whether nurse representation in the media had improved. 

The researchers examined 537 articles published in September 2017 in many of the same media sources used in the original study. They discovered that nurses were sources for only 2% of the quotes in the examined health news stories, and only 13% of the stories used the word "nurse" at all.

When the researchers followed up on their findings by interviewing health journalists, they found that journalists didn't understand nurses' roles and education, and many also struggled to find nurses to interview.

Why journalists shouldn't overlook nurses

Patricia Davidson, an RN and dean of the Johns Hopkins School of Nursing, likened health care journalists to "sports reporters who only want to interview star goalies," but added that "health care is a team sport" in which nurses play a huge role.

Mason said that by failing to include nurses' narrative in health care-related news, journalists are leaving out a key perspective on the health care system.

For example, Mason said, "who better than the chief nursing officer to be able to explain the impact of budget cuts on patient care and safety?"

How nurses—and employers—can help redirect the spotlight

According to Mason, nurses and health care systems bear some responsibility for the lack of nurse representation in the media. Mason said she tells other nurses, "It's your job to explain [to journalists] what you do every day."

Mason also emphasizes the need for health care employers to be more proactive about communicating nurses' perspectives to the media and connecting them to nurses for interviews—rather than reflexively directing media requests to physicians or executives, as many press and communications staff reflexively do today, Dooley Young writes.

Susan Hassmiller, and RN and senior advisor for nursing at the Robert Wood Johnson Foundation, said nurses can be more proactive in reaching out to journalists. She suggests nurses get to know local reporters who cover health care and engage in media training, so they can understand the reporters' deadlines and schedules.

"They can begin by contacting these reporters to share story ideas; tell them what's going on in their communities; or give constructive feedback, especially if a journalist's story missed an important angle," Dooley Young writes.

Nurses can also use social media to amplify their voices and "open the door to sharing their knowledge, expertise, and views on a larger stage," Dooley Young writes.

Positive 'signs' of change

According to Dooley Young, there are "signs" that nurses are making inroads in the media. For instance, Dooley Young notes, nurses "turned to Twitter in droves" to defend themselves when Sen. Maureen Walsh (R-Wash.) said nurses didn't need breaks because they "play cards for a considerable amount of the day."

Walsh ultimately apologized. "I was in the hospital last year and the nurses were the one element that made that hospital stay bearable," Walsh said.

Davidson said Walsh's apology reflects a common experience: that many people don't appreciate nurses' hard work, education, or expertise until they are under their care. "I've been a nurse for 40 years," Davidson said. "Many physician colleagues have really not understood the importance of nursing until they became a patient and were seriously ill themselves" (Dooley Young, Medscape, 6/12).