Fiction Versus Reality

Nursing Image as Portrayed by Nursing Career Novels

Maureen Anthony, PhD, RN; Jill A. Turner, BSN, MLIS; Megan Novell, MA


Online J Issues Nurs. 2019;24(2) 

In This Article

Abstract and Introduction


Nursing career novels, published in the 1930s and extending through the 1960s provided girls with nurse role models and encouraged young women to choose nursing as a career. In view of their popularity, we wondered how these books depicted nurses and the profession of nursing. We examined 18 nurse career novels by different authors published between 1932 and 1970 to determine how nurses and nursing were portrayed at various times. A literature review suggested a guiding framework, with four themes related to motivation to become a nurse; image of nursing; stereotypes; and nurse/physician relationships. This article discusses our endeavor by reviewing the study purpose and methods, and we discuss the results in the framework of the four themes. Our discussion notes that many of these novels described examples of nurses contributing in times of great social uncertainty, such as during wars. They contained characters who were independent thinkers and successful nurses, caring for patients and saving lives. We conclude that the novels could have easily inspired young women of the time to choose nursing as a profession, and discuss the challenge to motivate men and women of today who seek purposeful, intellectually fulfilling work in a changing, uncertain world.


Nursing career novels are a genre of books written for teens, starting with the Sue Barton and Penny Marsh series in the late 1930s, and extending through the 1960s with the popular Cherry Ames books. The goal of the books was to encourage young women to choose nursing as a career. As such, these young adult novels provided girls with role models who sought personal achievement through careers as nurses despite societal limitations, love interests, and competing family obligations. The novels aimed to cast nursing in an exciting and desirable light, motivating young women to consider the possibilities a career in nursing could offer. Many of the books were set in the uncertain times of the Great Depression and World War II. The nurse and student nurse characters in these novels were depicted as courageous and unrelentingly focused on the care of their patients. They would have been a stabilizing force for young women in those turbulent times.

The way in which nurses were depicted in these novels provides a glimpse into the public image of nursing during these timeframes. A positive public image of nursing can attract prospective students to the profession, while an unfavorable public image of nursing can have a negative impact on admissions to schools of nursing, as well as on the profession of nursing's collective self-concept and self-esteem (Takase, Kershaw, & Burt, 2002).

Year after year, nursing is rated as the most trusted profession in terms of honesty and ethical standards by the Gallup poll (2017). In view of this enduring vote of confidence on the part of the public, why does the nursing profession continue to struggle with professional image? Authors ten Hoeve, Jansen, & Roodbol (2014) published a discussion paper on the public image of nursing which suggested our professional invisibility is to blame. What we do is not what the public thinks we do. The authors concluded that an organized, concerted effort is needed to inform the public of what nursing actually entails. Nursing career novels of the past had the potential to tell society what it is that nurses do.

Unfortunately, nurses are burdened with a number of stereotypes (Huston, 2017). The angel of mercy stereotype most likely began with Florence Nightingale, who was widely revered by the people of England for providing care and comfort to the wounded soldiers in Crimea. Although a seemingly positive stereotype, it conceals the education and knowledge needed to be a nurse. Nurses are also depicted as the love interest of physicians or patients, or worse as the sexy "naughty nurse," with no meaningful contribution to patient care. When viewed as merely the handmaiden to the physician, nurses become the sidekick of the almighty physician, with no need for education or independent critical thinking. Finally, there is the battle-axe, such as Nurse Ratched of the movie One Flew over the Cuckoo's Nest, or the unhappy spinster nurse intent on making life miserable for everyone. Portraying nurses as any of these stereotypes could be detrimental to the collective self-concept and self-esteem of the profession.