I traveled to India recently on behalf of INS and got a wake-up call on a flight from Delhi to Bangalore. In mid-flight, the crew asked passengers if there was a doctor on board. When no one answered, I offered my services as a nurse. A young man was in distress, and when I stepped up to help I was told that, even though there was an emergency medical bag available, I was not authorized to open it (I wanted to check the man's blood pressure) because I wasn't a physician. Again, I stated that I was a nurse. Not good enough. This airline's policy maintained that nurses are not allowed to open a medical bag without physician supervision. (As it turned out, the young man was stressed about flying. His fear eased upon landing.)

Figure. Mary Alexander, MA, RN, CRNI(R), CAE, FAAN, INS Chief Executive Officer Editor,

This incident, as well as learning firsthand about the low level of esteem for nurses in South Asia, got me thinking again about the public's understanding of nurses' role in healthcare, our professional responsibilities, and the image of nurses created by the media.

Some of you may have seen or heard about the TV shows, "Nurse Jackie" and "HawthoRNe." These shows are worth highlighting because it is rare that nurses are the main characters in TV hospital dramas. Other shows, such as "Grey's Anatomy" and "House," revolve around physicians, with nurses either absent or portrayed as doctors' helpers or as sex objects. "Nurse Jackie," in particular, seems to have struck a chord with nurses because of its controversial depiction of a smart nurse who is a passionate advocate for her patients but is also addicted to pain medication (acknowledging the back pain endured by so many nurses). She skirts the boundaries of professional conduct and has contentious relationships with a number of colleagues. So love her or hate her, "Nurse Jackie" is sending a message about nurses to a large TV audience. What she projects to the public has the potential to shape how our patients see us, for better or for worse. The impression created by the media can affect the way nurses are viewed by patients and colleagues, and it is up to us, with our years of experience, to make our opinions known to the writers and sponsors of TV shows.

"The Truth About Nursing" is a useful Web site dedicated to improving the image of nurses and the nursing profession. Its focus is to "promote more accurate, balanced and frequent media portrayals of nurses and increase the media's use of nurses as expert sources."1 The site provides names and addresses of media contacts so viewers can express their opinions about the content of their programs.

In the media, nurses are nearly always portrayed by women. As we all know, there are many accomplished men in the field of nursing. Yet they continue to be ignored by the media or treated as oddities. The frequently used phrase "male nurse" fails to recognize the strides that men have made in the nursing field and draws attention to the person's gender, rather than his professional credentials. We are neither male nor female nurses-we are all nurses.

While in India, I was disturbed to hear that nurses there are held in low regard. This view was confirmed by my experience on the airline. Nurses in India are poorly paid by Western standards. They lack professional respect and autonomy and often have poor relationships with physicians.2 In addition, they are frequently denied opportunities for advancement and for the chance to influence health policy.3 For these and other reasons, Indian nurses often migrate to other countries, leaving India with an increasingly dire nursing shortage.

Our message to the media and to the world is that nurses are well-educated, autonomous professionals who are an integral part of the healthcare system. Our knowledge base includes disciplines such as biology, chemistry, anatomy, physiology, mathematics, pharmacology, information technology, and management. We are the primary caregivers for our patients, and we often work long hours on our feet to make sure those patients get the best care possible. We also teach, advocate, plan, evaluate, explain, manage, research, shape policy, and comfort. And we save lives every single day.

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