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Should you keep politics out of your career?

Advocacy is a core function of many health professions, including nursing and medicine. So why are we socialized not to engage with politically touchy subjects at work?

Funding for much of our work in science, medicine, and education comes from the government. Sometimes it comes from corporations that make pharmaceuticals or devices. Even in democracies like the U.S., legally protected free speech does not prevent organizations from restricting their employee’s participation in political activities or certain kinds of speech while working.

The current global public health crisis is igniting fierce debates around hot-button issues of workforce safety, inequality, prejudice, disparities, and personal freedoms. As the world changes rapidly, I am hearing lots of early-career folks wondering how to balance the call to engagement on divisive topics with the need for career stability. My profession, nursing, has a long history of activism and political engagement. I also work for a large university, where political engagement can rock the boat and raise eyebrows. This is a precarious position.

Here’s the rub: public health issues are inherently political. Think of political advocacy around tobacco and vaping, and food. These are everyday public health concerns and they are steeped in politics, yet they rarely result in career-ending political feuds; this kind of politics is generally tolerated in academic institutions. However, as we are now seeing, the relationship between politics and public health is stronger with rare and catastrophic events like the COVID-19 pandemic. Those of us in science and health professions are facing the ramifications of political decisions daily, such as access to PPE supplies, access to ventilators and medications, guidance to the public about masks and distancing, and travel restrictions. We feel this impact acutely, and many of us feel compelled to voice our opinions.

Yet, we may find ourselves at risk if we speak up about an issue with political implications, either at work or in outside public forums. Voicing dissent to institutional policy, governmental policy, or anything in between can be professionally and personally damaging. In the U.S., hospitals have been ordering staff not to speak to the media and terminating those who do not comply. This behavior can have a chilling effect on others’ willingness to voice concerns about safety. As a result of these gag orders, high-level decision-making is often missing key voices and information. The case of Dr. Li Wenliang, the Chinese physician who sounded early warnings of the dangers of the novel coronavirus, was reprimanded by the Chinese government, and later died of the disease, is a tragic example of just how the stakes are. Navigating the boundaries of political and scientific speech in life-or-death situations is not something we learned in graduate school.

The relationships among scientific data, lived experience, and government messaging are complicated, but that doesn’t mean they are untouchable in a professional context. Medical journals do not universally shy away from political perspectives. The Lancet, for example, recently  published an opinion piece pulling no punches in its assessment of American political leadership: Michael Marmot writes, “Apart from the mendacity, incompetence, narcissism, and disdain for expertise of the man at the top, there may be strong messages about the nature of US society and the response to the pandemic.” Not all professionals and academics are willing to voice such forceful political opinions, but this example shows that even strongly worded opinions can be embraced.

Can mixing politics and work hurt your career? Definitely. Is it possible to practice your profession apolitically? Maybe. Is that something you want to do? You have to decide.

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

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Equal Gender Representation in the News Media: How You Can Help

Last month, I wrote about gender representation in the scientific literature. This time, I’m taking a look at the popular press. Rather than look just at gender, I’m looking how nurses are represented (or not represented) as expert sources. I’m choosing to do this for several reasons; First, the public’s perception of nursing as a profession matters both to the future of nursing (who will pursue the profession?) and to the care we provide now (how do patients and other members of the health care team respond to us?). Second, there is an inherent gender bias in the under-representation of nurses as experts, since 90% of RNs are female1. Finally, the practice and science of nursing are distinct from other fields and are valuable to health – including cardiovascular health. (If you aren’t familiar with nursing research, there’s a list of nursing journals at the end of this post – have a look at what’s getting published). Increased public visibility is a gateway to broader funding, adoption of nursing-generated evidence, and professional respect.  This isn’t just good for nurses, it’s good for the health of the population.

Photo by Sam McGhee on Unsplash

Photo by Sam McGhee on Unsplash

Nursing has matured enormously as a profession and an academic field, but the public’s perception of nursing has not kept up. A seminal 1997 report, known as the Woodhull Study of Nursing in the Media2, found that nurses were identified as sources in only 4% of health news stories in national and regional newspapers, and even fewer in industry publications. Over 20 years later, we see some increased awareness, but not enough. A team at George Washington University recently investigated the current state of women and nursing in the media. They found that many journalists don’t have a clear idea of the scope of nursing expertise, and that news organizations are infrequently reaching out to nurses. Additionally, the authors reported that journalists don’t know how to find nurses, healthcare organizations aren’t offering them as experts, and nursing professional organizations aren’t effectively engaging the media. Women remain underrepresented as expert sources in news stories at just 36%3. That’s a lot of barriers to effective representation. Yet the public trusts nurses more than any other profession, including physicians4. The valuable voices of nurses represent a huge opportunity for health and science communication, if we can learn how to effectively promote them. This will take dedicated work and attention from all sides.

Photo by Matt Botsford on Unsplash

Photo by Matt Botsford on Unsplash

 

Here are some ways to work on this problem:

  • Women, recognize that your contributions are needed. Women will never be treated with full fairness and equality unless our voices are audible– this is as true in science and academia as it is in politics. Cultivate expertise and believe in your own status as an expert. (Fellow early career blogger Alison Webel shared some strategies to combat self-doubt.)
  • Nurses, engage with the media. Write letters to the editor. Tweet. Promote your work, both clinical and research. Talk to journalists when the opportunity arises (see my tips here). Find out if your organization has a blog, and offer to write a post. Often, PR folks run these blogs and are delighted to have volunteer contributors.
  • Leaders in adjacent professions, seek out and recommend nurses as experts. If you’re asked to provide a quote, or background, consider whether the best person for the job might actually be a nurse– don’t assume the interviewer will know that.
  • Writers, aim for balance. Are you quoting and citing diverse sources? Think about profession, age, gender, race, rank, and nationality when you’re evaluating your sources.

 

Can you choose a strategy to focus on for your next project?

 

References:

  1. National Council of State Boards of Nursing (2017). National Nursing Workforce Study. https://www.ncsbn.org/workforce.htm
  2. University of Rochester (1997). The Woodhull Study of Nursing in the Media. Indianapolis, IN: Sigma Theta Tau.
  3. Mason, D., Glickstein, B., Nixon, L., Westphaln, K., Han, S., & Acquaviva, K. (2018). Research Brief: The Woodhull Study Revisited: Nurses’ Representation in Health News Media. George Washington University. https://nursing.gwu.edu/woodhull-study-revisited
  4. Brenan, M. (2018). Nurses again outpace other professions for honesty, ethics. Gallup News. https://news.gallup.com/poll/245597/nurses-again-outpace-professions-honesty-ethics.aspx?g_source=link_NEWSV9&g_medium=NEWSFEED&g_campaign=item_&g_content=Nurses%2520Again%2520Outpace%2520Other%2520Professions%2520for%2520Honesty,%2520Ethics

 

Resources for nursing research:

Journal of Cardiovascular Nursing: https://journals.lww.com/jcnjournal/pages/default.aspx

Nursing Research:  https://journals.lww.com/nursingresearchonline/pages/currenttoc.aspx

Journal of Nursing Scholarship: https://sigmapubs.onlinelibrary.wiley.com/journal/15475069