In most countries, nurses are the largest group of health-care professionals that provide direct and indirect care to patients in a variety of health settings. The quality of care is strongly linked to their performance, and shortages of nursing staff cause suffering and diminished patient care. In 2008, it was estimated that there were 90 026 nurses in Iran, but health-care facilities need approximately 220 000 nurses in order to deliver optimal nursing care. This review article provides a detailed description of the nursing shortage and related factors in Iran. It is hoped that this will inform both Iranian and international policy-makers and administrators about the current situation in this country.

A long-term challenge to the nursing profession is the concept of image. In this study, we used the Rodgers' evolutionary concept analysis approach to analyze the concept of nursing image (NI). The aim of this concept analysis was to clarify the attributes, antecedents, consequences, and implications associated with the concept. We performed an integrative internet-based literature review to retrieve English literature published from 1980-2011. Findings showed that NI is a multidimensional, all-inclusive, paradoxical, dynamic, and complex concept. The media, invisibility, clothing style, nurses' behaviors, gender issues, and professional organizations are the most important antecedents of the concept. We found that NI is pivotal in staff recruitment and nursing shortage, resource allocation to nursing, nurses' job performance, workload, burnout and job dissatisfaction, violence against nurses, public trust, and salaries available to nurses. An in-depth understanding of the NI concept would assist nurses to eliminate negative stereotypes and build a more professional image for the nurse and the profession.

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