Anatomy of the image of the nurse: dissonant and ideal models.

All professions, including nursing, rest on a cultural base. Berger and Luckman argue that the sociology of knowledge concerns itself more with common sense than with theoretical abstractions. Everyone must exist within some kind of structure, some kind of ordered world, and so people create a "reality" for themselves about nurses and nursing which is based on things they "know," regardless of the ultimate validity or inaccurateness of their "knowledge." The cultural lag implicit in current public 'knowledge" about nursing will exist until, and unless, it is directly challenged by new "knowledge." For example, the generally accepted "knowledge" of male/ female interaction of the 1950s has become unacceptable to the culture of the 1980s; a new "knowledge" has replaced the old, perhaps only substituting one set of stereotypes for another, but definitely altering the tone. Socialization, the process of learning basic values and orientations that prepare individuals to fit into their cultural milieu, contributes to the cognitive system a collection of interrelated items of knowledge and beliefs about the profession of nursing. A predominant consistency between the knowledge, ideas, and beliefs about nurses and the actual role, work, and nature of nursing yield an ideal or consonant image. The absence of such consistency and the ensuing internal contradictions provide a cognitively dissonant image of nursing. When this theoretical model is applied to a perceived incongruity between a person's attitudes and his or her behavior, there is evidence that people tend to reduce such dissonance by making appropriate changes in their attitudes and beliefs. The mass media are instrumental in the image formation process. Originally, mass media research did not put much stress on the socialization function, because it was thought that this was primarily performed by parents and the schools. Studies conducted in the 1970s finally put the spotlight on the media as a primary factor in socialization, showing that a