Social acceptance of nursing during the coronavirus pandemic: COVID‐19 an opportunity to reform the public image of nursing

Dear Editor Nursing professionalism has been an important issue in the history of nursing and in recent decades significant progress has been made in this direction. One of the most important effective features in nursing professionalism is the public image and social acceptance towards nursing. Since Florence Nightingale, the public image of nursing has always been one of the major challenges of the nursing profession (Moore et al., 2019). The image of nursing is closely related to the identity and role of nurses and their cultural background and affects their clinical performance, job satisfaction, quality of care, social status, economic value and career development (Kaur Pushpinder & Rawat, 2017). The image of nursing has changed over time; from angel and servant in 1919 to a weak and feminine image in the years 1920 to 1929 and the following decades to subordinate and receiver of doctors' orders, and it has finally, morphed into the image of a caregiver in recent decades (Girvin et al., 2016). Findings show that the public image of nursing is a multidimensional, allinclusive, paradoxical, dynamic and complex concept and it is influenced by nursing stereotypes. In previous studies, 34 different nursing stereotypes have been identified, some of which include angels of mercy, the doctor’s handmaiden, battle axe and sexy nurse. It should be noted that most of the identified stereotypes have negative connotations for the nursing profession and the media have played a key role in the lingering effects (Girvin et al., 2016). Furthermore, RezaeiAdaryani et al. (2012) summarized the undesirable social perception of nursing in terms such as gender stereotypes, being a physician subordinate, having lower academic standards, harsh working conditions, low income and limited job opportunities for career advancement. These negative stereotypes can lead to frustration, low selfesteem and disruption of nurses’ professional and social identities, creating a repressive environment for enhancing the nursing profession (Fontanini et al., 2021). There are many factors associated with the public image of nursing. Important factors include media, newspapers, magazines, poor communication, invisibility, nurses' selfimage, behaviours, clothing style, gender issues and professional organizations (Elmorshedy et al., 2020; RezaeiAdaryani et al., 2012). One of the factors that is less known but effective in creating and strengthening the public image of nursing is the occurrence of disasters such as earthquakes, tsunamis and emerging diseases such as severe acute respiratory syndrome (SARS), Middle East respiratory syndromerelated coronavirus (MERS), Ebola, coronavirus and the role of nurses in managing these crises. It should be noted that there are no validated treatments for many new emerging infectious diseases such as SARS, MERS and COVID19 (Wibawa, 2021). The main strategies are symptomatic and supportive care, such as keeping vital signs stable, maintaining oxygen saturation and treating complications, such as secondary infections or organ failure (McGillis Hall & Kashin, 2016; Wibawa, 2021; Wu et al., 2020). Although we are 2 years into the Covid19 pandemic, due to the evolving nature of the virus and the emergence of new variants such as Delta and Omicron, additional studies on standard drug treatments are still underway (Cascella et al., 2022). The many challenges and problems that COVID19 has created worldwide have received a great deal of media attention. The general public relies heavily on the media as well as government and global health organizations for accurate and comprehensive information in times of health crises. Consequently, the media have covered more news and images related to nurses in response to COVID19. The results show that despite a threefold increase in media coverage of nursing between 18 March and 18 April 2020 (coinciding with the outbreak of COVID19) compared to the same period last year, the stereotyped image of nursing, such as the Angels of Mercy with wounded faces, national heroes, selfsacrifices shown to the public and even the use of military terms such as war, the battle on the front lines and death on duty, has become commonplace in both media and political discourses (Bennett et al., 2020). However, the use of these military concepts has recently been questioned. Comparing pandemics to war is both dangerous and wrong, since pandemics require collective, focused and coordinated responses, while wars divide the population (Fontanini et al., 2021; Varma, 2020). Thus, the conflict between the nursing profession and stereotypical public images remains. In this regard, the results of the study of McGillis et al. showed that the media in the early stages of the Ebola outbreak compared nurses to Florence Nightingale

The image of nursing has changed over time; from angel and servant in 1919 to a weak and feminine image in the years 1920 to 1929 and the following decades to subordinate and receiver of doctors' orders, and it has finally, morphed into the image of a caregiver in recent decades (Girvin et al., 2016). Findings show that the public image of nursing is a multidimensional, all-inclusive, paradoxical, dynamic and complex concept and it is influenced by nursing stereotypes. In previous studies, 34 different nursing stereotypes have been identified, some of which include angels of mercy, the doctor's handmaiden, battle axe and sexy nurse. It should be noted that most of the identified stereotypes have negative connotations for the nursing profession and the media have played a key role in the lingering effects (Girvin et al., 2016). Furthermore, Rezaei-Adaryani et al. (2012) summarized the undesirable social perception of nursing in terms such as gender stereotypes, being a physician subordinate, having lower academic standards, harsh working conditions, low income and limited job opportunities for career advancement.
These negative stereotypes can lead to frustration, low self-esteem and disruption of nurses' professional and social identities, creating a repressive environment for enhancing the nursing profession (Fontanini et al., 2021).
There are many factors associated with the public image of nursing. Important factors include media, newspapers, magazines, poor communication, invisibility, nurses' self-image, behaviours, clothing style, gender issues and professional organizations (Elmorshedy et al., 2020;Rezaei-Adaryani et al., 2012). One of the factors that For this purpose, nurses themselves should try to use the platform created in new social media such as YouTube and social networking platforms to demonstrate the unseen aspects of their profession; and combine their lesser known professional roles with their traditional roles to create a more professional, more valuable, nobler image to enhance the quality of care. Results of a study show that nurses who suffer from severe stress and traumatic experiences caused by COVID-19 are more likely to use social media to report the problems, overworking and concerns over their own physical symptoms, rather than mentioning their professional issues and specialized roles in the COVID-19 pandemic on social media (Fontanini et al., 2021).
In general, if we aim to turn the positive attention and discourse created about nursing into action, we should make the leadership and impact of nursing more visible in the public eyes. Governments and nursing leaders should provide the necessary infrastructure to recognize the professional and specialized roles of nurses in promoting health and strengthening healthcare systems by investing and developing training and counselling programmes with the active participation of nurses at various levels of society (Bennett et al., 2020).

CON CLUS ION
Although nurses have suffered and experienced hardships during the COVID-19 pandemic, this crisis can be a suitable opportunity for their personal and professional development. This pandemic could provide a stronger voice for introducing the nursing profession, influencing healthcare policies and future nursing practices. It should be noted that the opportunity created, especially in the context of cyberspace and social media, should not be limited to narrating the problems, sufferings, shortages and workload of nurses, considering these issues will be forgotten after the pandemic subsides. Instead, this opportunity should be used by nursing managers and nurses themselves in order to reform misconceptions, provide a more professional voice for nurses in influencing future healthcare policies and practices and pave the way for reforming the public stereotypical image of nursing.

ACK N OWLED G EM ENT
We would like to express our gratitude to all the nurses who stood by their communities with compassion and kindness and with a spirit of sacrifice in the COVID-19 pandemic; and honour the memory of those who lost their lives in this horrific pandemic to save others.

K E Y WO R DS
COVID-19, nursing, public image, social media

CO N FLI C T O F I NTE R E S T
The authors report no conflict of interest.

DATA AVA I L A B I L I T Y S TAT E M E N T
The data that support the findings of this study are available from the corresponding author upon reasonable request. Features, evaluation, and treatment of coronavirus (COVID-19). StatPearls.