Inmate or nurse?

Boys & Girls Club billboards spark debate in Cleveland

November 2014 -- Since at least September, The Boys & Girls Clubs of Cleveland have been running a billboard ad campaign featuring photos of a young African-American nursing student. In one version, she wears blue scrubs and the tag line is: "Inmate? Nurse? Your donation makes the difference." Another version of the ad offers a split photo. In the right half, the woman wears the same blue scrubs, but on the left, she wears an orange prison smock. The tag line: "Inmate, or nurse? You decide." The idea is that viewers can, by supporting the Boys & Girls Clubs, help at-risk youth avoid trouble and ultimately find worthwhile careers. We know that because the Clubs' website makes clear that the ads feature Kinyatta, a real Cleveland youth who overcame a difficult background--with lots of support from the Clubs since early childhood--to become her high school salutatorian and enroll in the nursing program at Hiram College. Thus, it appears that the Clubs intend to present nursing as a career worthy of academically advanced students and a good indicator of a life transformed by effective social programs. However, some nurses have objected, arguing that the ads suggest nursing is one step up from prison, or perhaps that young people at immediate risk of prison--who presumably don't have a lot of good career options--could just become nurses as a last resort, since that work, in the minds of many, doesn't require much education or skill. And unfortunately, the view that nurses lack serious skills does remain widely held. Nursing has been suggested as a good career choice for those on public assistance, former prostitutes, and others deemed to have few options. So there is a risk that some who see the billboards will have the "last resort" interpretation, despite the Clubs' good intentions and the real backstory, which of course does not appear on the billboards. It appears that the Clubs removed at least some of the nurse billboards after pressure from outraged nurses, although we have been told that some of the billboards have recently reappeared. In any case, we and others have urged the Clubs to consider adding billboards with some other non-inmate success stories. Or, if they wish to keep the prison-or-health-care scrubs overlap, they might craft ads with other health professions, like physicians and pharmacists, that do not suffer from an unskilled stereotype. That would clarify that the ads' goal was not to suggest that nursing is one step removed from prison, but instead that it is a world away.

We understand that Kinyatta has appeared on billboards around the Cleveland area. And she still appears on the Clubs' local website, in a section called "Save Our Kids" that offers seven "real stories from real kids whose lives were saved by the Club." Another tag line: "Become a Statistic: Beat the Odds." Kinyatta's story indicates that she has been attending the Club regularly since age six and that she lost her father at age 11. It says that the Club was "the only place she felt safe and, sometimes, the only place she ate a hot meal." The staff "supported her in school and encouraged her to excel," even taking her on college tours and helping her find scholarships. The site says that Kinyatta graduated as salutatorian from John Adams High School in 2011 and is enrolled at the nursing program at Ohio's Hiram College, which is a BSN program. Other profiles on the site reveal young people who have overcome very difficult family lives, as well as environments plagued with violence and drugs--where prison is not an unlikely destination--and who now hope to pursue careers in health care, teaching, law, and the arts.

Given all this, there is little doubt that the Clubs' intention in the Kinyatta ads was to present nursing as a shining example of how a life can be changed--saved--and how an at-risk youth can achieve great things. It seems clear that the Clubs view nursing as a fitting career for someone who graduates near the top of her high school class. In fact, good nurses do need a rigorous college-level science education, and research shows that nurses with more education achieve better patient outcomes, saving lives. Unfortunately, none of that is really clear from the billboards. And it is possible that some who see the billboards will in fact interpret them as suggesting that nursing is a good option for those with few options, a last resort that they might turn to so as to avoid prison. (Give the Clubs a donation, and they will find that unskilled youth an entry-level nursing job and get her off the streets!) It's not the Clubs' fault that nursing suffers from that kind of stereotyping, but their ads have to be assessed from the perspective of the public that is viewing them.

So we did urge the Clubs to consider modifications to make it clearer what the ads are saying--that Kinyatta is an academically advanced college student who turned her life around years ago with the Clubs' help--and also to consider additional ads that would either include other success stories from the Cleveland area, or present other health professions, including medicine, as possible end points for Club kids if the charity receives adequate support. A Cleveland-area nurse reported to us in October that the "ANA, local nursing schools and nurses in Northeast Ohio" had successfully pressured the Clubs to take the nurse billboards down, although this nurse told us more recently that at least some of the billboards had reappeared.

On the whole, we thank the Boys & Girls Clubs of Cleveland for using nursing as a marker for the salvation of at-risk youth and, by extension, our troubled society. But we urge them in future billboards and advertisements to take care in how they present that message, lest it reinforce the persistent stereotype that nursing is a low-skilled job that offers a last chance for those who really aren't qualified to do much else.

You can contact the Boys & Girls Clubs here.