Where Are the Nurses? Not in the News Media.

Journalists consistently overlook nurses as sources in health news stories. It's been that way for decades, even as nurses increasingly reach higher levels of education.

Dr. Oz. Sanjay Gupta. Atul Gawande. These physicians have gained national notoriety via various media outlets. But who is the nurse equivalent? There isn't one. In fact, a replication study of the 1997 "Woodhull Study on Nursing and the Media" finds journalists routinely overlook nurses as sources in health news stories.

The original study analyzed 20,000 articles published in 16 U.S. newspapers, magazines, and health trade publications in September 1997. The researchers found that less than 1% of the articles in U.S. News & World Report, Time, Newsweek, and Business Week referenced a nurse. And nurses were referenced in less than 4% of the 2,101 newspaper health articles from seven newspapers across the country.

Despite the increase in nurses' levels of education over the past 20 years, the replication research, led by the George Washington University School of Nursing's Center for Health Policy and Media Engagement and published in the Journal of Nursing Scholarship and the American Journal of Nursing, found nurses continue to be underrepresented as sources in health news stories.

The current research team used the same publications as the original study and examined a randomly selected sample of 365 health news stories published in September 2017 to determine:

• The type and subject of the article
   
• The profession and gender of speakers
   
• The number of times nurses were referenced without being quoted

They found:

• Nurses were identified as sources in 2% of health news coverage
   
• Nurses were mentioned in 13% health news coverage overall

"The lack of progress in nurses' representation in health news stories over the past 20 years was stunning, particularly since the 2010 Institute of Medicine report on 'The Future of Nursing' noted that we can't transform health care and promote the health of the public without recognizing and tapping into the special expertise of nurses," Diana J. Mason, PhD, RN, FAAN, principal investigator of the GW study and senior policy service professor for GW's Center for Health Policy and Media Engagement, says in a news release.

Researchers also conducted one-on-one telephone interviews with health journalists to better understand the barriers and facilitators to using nurses as sources in news stories. The interviews revealed themes of biases among journalists, editors, public relations staff, and healthcare organizations.

For example, participants said preconceptions exist in health news about positions of authority, placing "rock-star doctors" at the top of source lists. They also said newsroom cultures affect their selection of sources, and they have had to defend using a nurse as a source.

"Journalists and the media play an important role in educating the public about issues affecting health and healthcare, but their biases about who are credible experts is limiting the richness of their reporting," Jean Johnson, PhD, RN, FAAN, executive director of the Center for Health Policy and Media Engagement, says in a news release. "If journalists aren't interviewing nurses, they may be missing the best part of the story."

The interviews also uncovered additional themes, including:

• Health journalists not understanding the range of nurses' roles
   
• The nursing profession not routinely engaging journalists

The researchers note that journalists and nurses can both do more to ensure the public benefits from the knowledge and insight nurses can provide

Additionally, a companion study found that biases in newsrooms about women, nurses, and positions of authority in healthcare can impede a journalist's use of nurses as sources in health news stories, despite unique perspectives that could enrich a story.