Nursing Empowered Leaders:
A Study Describing Who We Are and
Who We Want To Be
Judi Godsey, PhD, MSN, RN, Assistant Professor of Nursing
Tom Hayes, PhD, Dean, College of Business
Xavier University
Sigma Theta Tau International
Creating Healthy Work Environments Conference
Indianapolis, IN
March, 2017
Purpose:
To explore nurse’s perceptions of the
current versus the most desired brand
image of the nursing profession.
Objectives:
1. Describe nurses’ perceptions of their brand image
2. Compare nurses’ current perceptions of their brand
image with their most desired brand image
3. Discuss implications of nursing’s brand perceptions to
the future of nursing leadership
NURSES
What is “Branding”?
• People Misunderstand Branding
– They think it is a logo
– They think it is based on promotion
DEFINITION OF BRAND
• The sum total of all existing
associations made with your
institution
• Including the good, the bad, and,
possibly, the ugly
DEFINITION OF BRANDING
• The process of influencing those
associations
DEFINITION OF POSITIONING
• Your researched and documented
desired brand associations
Your logo, visual identity,
and/or marks are simply
reflections of your brand.
Your brand is where you are
now. Your positioning is
where you want to be.
Branding takes you from
point A to B. You are
successful when your brand
equals your positioning.
Review of Literature
• Brands can be managed by the media , competing
professions, the public, or not managed at all
(Hayes, 2009)
• Nurses in the media have been typically portrayed as
subservient to physicians, angels of mercy, or sex
objects
(Cunningham, 1999; Mendez & Louis, 1991; Pierce, S., Grodal, K., Smith, L. S., Elia-Tybol, S., Miller, A. &
Tallman, C., 2002; Ward, Styles and Bosco, 2003).
• Nursing needs to initiate branding strategies which 1)
attract more people to the profession, 2) increase the
morale of nurses, and 3) elevate their public standing
(Baldwin K.A., Lyons, R.L. & Issel, M.; Cabiniss, 2011; Dominiak, 2004; Rees, 2005; RezaaieAdaryani et al., 2012; Ward, 2006)
Review of Literature
• Little has been communicated to the public
portraying the brand image of nursing as a
cohesive group of autonomous, professional,
healthcare providers (Cabiniss, 2011)
• A lack of cohesiveness exists among nurses,
along with a failure to communicate a consistent
positive brand image for the nursing profession
(Rezaei-Adaryani, Salsali & Mohammadi, 2012)
• Numbering more than 3.4 million,
Registered Nurses have been called to
be “leaders in transforming the U.S.
heath care system” as “full partners
with physicians”
(Institute of Medicine, 2010)
….But do nurses see themselves as leaders?
Question?
What do you believe is the
brand image of nursing?
Keys to Success
• Consistency of Message and Action
Over Time
• Promoting the Brand
• Living the Brand
How Do You Begin?
• Relevance
• Distinctiveness
• Research
A Study Describing The Gap Between Nurses’
Perceptions of Their Professional Brand Image
and Perceptions Held by the American Public©
Judi Godsey, PhD, RN and Tom Hayes, PhD
Xavier University
Significant Gaps
in the Literature
1. Lack of a consistent brand image for
the nursing profession
2. Lack of quantitative tools to
measure this critically important
concept.
Focus Groups
• Focus group meetings (n=27)
Population and Sample:
– nursing faculty (n=7), graduate nursing students
(n=11), and Nurse Advancement Professionals
(NAP) leaders from the AACN (n=9).
• Information from surveys informed the
development of items for brand image
surveys
– Registered Nurses and
– The Public
Population and Sample
Combined national nursing sample (n=286)
• 152 nursing alumni (XU)
• 134 nursing faculty (Jesuit Network)
– 28 states
– 97% female
– Age: 19%< 30; 33% 31-50; 27% 51-60;
20% > 60
– 70% held MS or doctoral degrees
Population and Sample
National public sample:
• n = 801
– 48 states
– 44% male; 55% female
– Age: 15% < 30; 35% 31- 50; 26% > 61
– Education: 1% <HS; 47% HS/some
college; 47% Bachelor/Master; 4%
Doctoral
Procedures
Focus Groups resulted in three scales
---Administered via Survey Monkey
1. Nursing Brand Image Scale (NBIS)©
• 42 words and phrases describing nursing
2. Nursing’s Current Brand Position Scale (NCBPS)©
• 10 statements “Most Accurately Describe” the nursing
profession
3. Nursing’s Desired Brand Position Scale (NDBPS)©
• 10 statements “Most Appealing” for the nursing profession
1. Nursing Brand Image Scale (NBIS):
• 42 words and phrases currently
describing nursing
• Rank (“pick 3”)
• Rate each descriptor (Likert 1-10)
What three words best describe the
profession of nursing currently (Top 5)?
PUBLIC
NURSES
Caring/Compassionate (36%)
1
Caring/Compassionate (44%)
1
Advocates (34%)
2
Health care providers (30%)
2
Essential members of healthcare
team (26%)
3
Essential members of healthcare
team (20%)
3
Patient centered/focused (25%)
4
Patient centered/focused (16%)
4
Critical thinkers (25%)
5
Skilled (15%)
5
Rank: Descriptors NOT Frequently
Selected by Nurses (% of Responses)
50
45
40
35
30
25
20
15
10
5
0
1.3%
1.3%
1.3%
0
0
Descriptors Frequently Rated Low
by Nurses
20.0
15.0
10.0
5.0
0.0
2.9
2.9
2.5
1.1
0.8
0.7
0.4
0.4
0.0
Current Descriptors of Nursing vs. Public
(Rating by largest differences) (p=0.00)
10.0
9.3
8.9
9.0
6.0
6.7
7.1
7.1
8.8
8.4
7.9
8.0
7.0
8.6
7.0
7.5
6.1
5.0
4.0
3.0
2.0
Nurses
Public
2. Nursing’s Current Brand Position Scale
(NCBPS)
• 10 statements which “Most Accurately
Describe” the nursing profession
• Rank (pick 1 statement)
• Rate each (Likert 1-10)
Top Five:
Statements Which Currently Describe Nursing
(Nurses vs Public)
NURSES
Nursing provides a patient centered
approach to health/wellness
Nursing is a caring profession
Nurses are influential patient
advocates
Nurses provide holistic healthcare to
patients and the public
Nurses base their practice on
evidence/research
PUBLIC
1
2
3
Nursing is a caring profession
Nursing provides a patient centered
approach to health/wellness
Nurses are influential patient advocates
1
2
3
4
Nurses base their practice on
evidence/research
5
Nurses are prepared to be leaders in an era
of healthcare reform
5
4
Most Accurately Describes:
Nursing provides a patient centered
approach to health/wellness (p = 0.00)
10.0
9.0
8.6 (#1)
8.0 (#2)
8.0
7.0
6.0
5.0
4.0
3.0
2.0
Nurses
Public
Most Accurately Describes:
Nursing is a caring profession
(NSS)
10.00
9.00
8.5 (#2)
8.4 (#1)
Nurses
Public
8.00
7.00
6.00
5.00
4.00
3.00
2.00
Most Accurately Describes:
10.00
Nurses are influential patient advocates
(p = 0.00)
9.00
8.2 (#3)
7.7 (#3)
8.00
7.00
6.00
5.00
4.00
3.00
2.00
Nurses
Public
Most Accurately Describes:
Nurses are Leaders in
Education, Research and Practice
(NSS)
10.0
9.0
8.0
7.0
6.97
6.72
6.0
5.0
4.0
3.0
2.0
Nurses
Public
Most Accurately Describes:
Lowest Scoring Statements (Nurses vs Public)
10.0
Nurses
9.0
Public
8.0
7.0
(p = 0.00)
7.1
6.7
6.5
6.5
6.0
6.0
5.6
5.0
4.0
3.0
2.0
Nurses are prepared to be
leaders in an era of
healthcare reform
Nurses are empowered
decicion makers
Nurses are autonomous
healthcare providers
3. Nursing’s Desired
Brand Position Scale (NDBPS)
• 10 brand statements “Most
Appealing” for the nursing profession
– Rank statements (pick one)
– Rate each (Likert 1-10)
Most Appealing Brand Statements
for the Nursing Profession:
TOP 5 APPEALING BRAND STATEMENTS (RANK)
5. Nurses base their practice on evidence/research
4. Nurses provide holistic healthcare to patients and the public
3. Nurses are prepared to be leaders in an era of healthcare
reform
2. Nursing provides a patient centered approach to health/
wellness
1. Nurses are leaders in education, research and practice
TOTAL: 76%
Nurses Describes –vs- Nurses Appeals
(largest differences) (p = 0.00)
10.0
8.7
9.0
8.8
8.5
8.2
8.7
8.0
7.0
7.0
6.0
7.2
6.5
5.6
6.0
Describes
Applies
5.0
Appeals
4.0
3.0
2.0
Nurses are
autonomous
healthcare
providers
Nurses are
empowered
decicion makers
Nurses are leaders Nurses base their
Nurses are
practice on
in educaction,
prepared to be
evidence/research
research and
leaders in an era of
practice
healthcare reform
• Nurses: Most Accurately Describes (top 4 summarized):
– Nursing is a caring profession comprised of
influential advocates who provide patient centered
and holistic care to patients and the public
• Nurses: Most Appealing (top 4 summarized):
– Nurses are influential advocates and leaders in
education, research and practice who provide
patient centered holistic healthcare to patients and
the public
The Most Appealing Brand Image for Nursing
Nurses are influential advocates and
leaders in education, research and
practice
who provide patient centered holistic
healthcare to patients and the public
Leaders in Education, Research and Practice???
Current descriptors of the nursing profession
that nurses did NOT frequently select:
•
•
•
•
•
•
•
Leaders (2.9%)
Powerful Decision Makers (2.9%)
Health Experts (2.5%)
Interprofessional (0.8%)
Influential (0.7%)
Researchers (0.4%)
Technological (0)
Gaps Identified by This Research
Incongruences were found between:
1) how nurses perceive their profession
currently versus how they would like it to
be perceived
Gaps Identified by This Research
2) how nurses perceive their profession
versus how members of the general
public perceive it.
Nurses: Who is most responsible for promoting
a consistent, positive image of the nursing
profession?
100.0
92.1
90.0
80.0
70.0
61.9
60.0
59.4
50.0
39.9
40.0
30.0
20.0
10.0
0.0
Nurses Themselves
Professional Nursing
Organizations
Universities/Schools
of Nursing
Medical
Facilities/Hospitals
Nurses: Do you believe there is a
consistent image for the profession?
90.0
77.3%
80.0
70.0
60.0
50.0
40.0
30.0
22.8%
20.0
10.0
0.0
YES
NO
Is it realistic for the largest group
of healthcare professionals in the
nation to be primarily responsible
for managing their brand image?
• Not Likely!
• Why do you think there is not a
consistent image of the nursing
profession?
“Because nursing has not yet defined
one”
(Anonymous Nursing Brand Study Participant, 2014)
Why Should We Care?
• Estimate of Patient Harm Associated with Hospital
Care
– To Err is Human (IOM, 1998)
– 98,000 deaths due to medical harm
(Kohn, Corrigan, Donaldson, eds., 2000)
• New Evidence Based Estimate of Patient Harms
Associated with Medical Care (James, 2013)
– Between 210,000-400,000 deaths associated with
medical harm
– Third leading cause of death in U.S.
Why should we care?
• Nurses called to be leaders in
transforming the U.S. heath care
system (IOM, 2010)
– Need to increase the morale of nurses
– Need to elevate nurses’ public standing
– Need to attract more highly qualified
people to the profession
(Baldwin K.A., Lyons, R.L. & Issel, M.; Cabiniss, 2011; Dominiak, 2004; Rees,
2005; Rezaaie-Adaryani et al., 2012; Somers et al., 2010; Ward, 2006).
Opinion Leaders’ Gallup Poll:
Who Will Influence Health Reform in the United States in the
Next 5-10 Years? (n=1,504)
47
Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions
January 20, 2010
Who Will Influence Health Reform in the
United States in the Next 5-10 Years?
Barriers to nurses’ influence and leadership:
• Not being perceived as important decision makers
• Having a focus on acute care rather than preventive
care
• Not having a single voice on national issues.
Opinion leaders’ suggestions for nurses:
• Take on leadership roles from bedside to boardroom
• Make their voices heard
• Have higher expectations of their profession
48
Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions
January 20, 2010
Why We Should Care:
• Numbering more than 3.4 million,
Registered Nurses have been called to
be “leaders in transforming the U.S.
heath care system” as “full partners
with physicians”
(Institute of Medicine, 2010)
Maybe it is time for us to see
ourselves differently….
References
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Baldwin, K. A., Lyons, R. L., & Issel, L. M. (2011). Creating a brand image for public health nursing. Public Health
Nursing, 28(1), p. 57-67.
Cabaniss, R. (2011). Educating nurses to impact change in nursing image. Teaching and Learning in Nursing .
Cunningham A. (1999). Nursing stereotypes. Nursing Standard, 13(45), p. 46-47.
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Hayes, T. J. (2009). Marketing Colleges and Universities. Council for the Advancement of Education (CASE): Washington,
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Institute of Medicine (2010). The future of nursing: Leading change, advancing health. Academies Press. Retrieved
from: https://www.nap.edu/catalog/12956/the-future-of nursing-leading-change-advancing-health
James, J. (2013). A new, evidence-based estimate of patient harms associated with hospital care. J of Patient Safety,
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Thank You!