Beyond “brother” and “sister”: Reclaiming the professional identity of nurses in modern healthcare

R. John Ebnesar*

ER Supervisor, Kauvery Hospital, Tirunelveli, Tamil Nadu

*Correspondence

Abstract

Nursing has evolved dramatically over the past century. What was once viewed primarily as a caregiving vocation is now recognized as a highly skilled, evidence-based healthcare profession requiring clinical expertise, leadership, critical thinking, and continuous professional development. Despite this evolution, many nurses continue to be addressed by traditional gender-based titles such as “Sister” and “Brother.”

This article explores whether such forms of address continue to reflect the identity of modern nursing. It argues that nurses should be recognized by their professional title, designation, or name, rather than by gender-based terminology. Professional recognition, gender neutrality, and respect for individual identity are essential components of contemporary healthcare culture.

Introduction

Language influences perception.

The way healthcare professionals are addressed shapes how society perceives their role, authority, expertise, and professional value. In many hospitals, physicians are addressed as “Doctor,” reflecting their professional identity and qualification. However, nurses are frequently addressed as “Sister” or “Brother,” terms rooted in historical traditions rather than professional designation.

While these titles were originally intended to convey respect and compassion, it is worth asking whether they continue to represent the modern nursing profession.

In an era that promotes professional excellence, equality, and inclusiveness, should nurses continue to be identified through gender-based titles, or should they be addressed simply as Nurses and by their names, just as other professionals are?

Historical Perspective

The title “Sister” originated from religious nursing orders in Europe, where nuns and members of religious communities provided care to the sick and vulnerable. As organized nursing developed, the title became synonymous with caregiving and was later adopted by hospitals in many countries influenced by the British healthcare system.

Male nurses were subsequently addressed as “Brother,” creating a gender-based framework of professional identification.

While these titles have historical significance, they emerged during a period when nursing was viewed differently from how it is understood today.

Modern nursing has moved far beyond its historical roots.

Nursing in the Twenty-First Century

Today’s Nurses are clinicians, educators, researchers, administrators, leaders, patient advocates, and emergency responders.

A modern nurse:

  • Manages critically ill patients.
  • Operates advanced healthcare technology.
  • Leads quality improvement initiatives.
  • Participates in evidence-based practice.
  • Coordinates multidisciplinary care.
  • Educates patients and families.
  • Contributes to research and innovation.
  • Provides leadership at organizational levels.

The profession demands scientific knowledge, technical expertise, ethical accountability, and leadership capabilities.

Yet despite these advancements, the language used to address nurses often remains unchanged.

Why Are Doctors Called “Doctor” but Nurses Called “Sister”?

Healthcare professionals are generally recognized by their professional identity.

Doctors are called “Doctor.”

Pharmacists are called “Pharmacist.”

Physiotherapists are called “Physiotherapist.”

Administrators are addressed according to their position and title.

However, nurses are frequently addressed through titles associated with gender rather than profession.

This distinction may seem insignificant, but professional identity matters.

A title should reflect expertise, qualifications, and professional contribution-not gender.

If a physician’s title acknowledges professional achievement, should not the same principle apply to nurses?

The Need for Gender-Neutral Professional Recognition

Healthcare is moving toward inclusivity and equality. Many countries have already shifted toward professional designations such as:

  • Registered Nurse (RN)
  • Staff Nurse
  • Nursing Officer
  • Clinical Nurse Specialist
  • Nurse Practitioner
  • Charge Nurse
  • Department Supervisors
  • Nurse Managers

Research discussing professional identity in nursing highlights how historical stereotypes and gender-associated perceptions continue to influence public understanding of the profession.

Modern nursing increasingly emphasizes professional roles rather than gender-defined identities.

A survey published in Collegian found that 70% of nurses considered the title “Sister” outdated, while 65% believed it did not reflect the contemporary image of a registered nurse.

Why should nursing leaders not receive similar professional recognition?

A Nursing Superintendent, Deputy Nursing Superintendents, Assistant Nursing Superintendents, Nurse Managers has earned that title through education, experience, leadership, and service. Their designation should be visible and acknowledged.

Professional titles communicate accountability, responsibility, and expertise.

They deserve recognition.

Professional identity should not depend on gender

Modern healthcare is moving toward inclusivity and gender neutrality.

The nursing profession today includes individuals from diverse backgrounds, experiences, and identities. Continuing to define nurses through gender-based terminology may unintentionally reinforce outdated perceptions about the profession.

Respect should be attached to professional competence rather than gender.

Is Our name not enough?

An important question deserves reflection:

Perhaps the most respectful and inclusive form of recognition is simply a person’s name.

Our names represent our individuality.

Our professional designation represents our responsibility.

Together, they define our identity.

Addressing someone as:

  • Nurse. Merlin
  • Nurse. Jerold
  • Mr. Rajesh
  • Ms. Meena

Acknowledges both the individual and the profession.

Gender becomes secondary.

Professional identity becomes primary.

A Call for Change

Healthcare has continuously evolved by challenging practices that no longer serve contemporary needs.

The shift from “Brother” and “Sister” to professional forms of address is not an attempt to reject nursing traditions. Rather, it is an effort to strengthen the professional identity of nurses and align healthcare language with modern values.

Such a change would:

  • Promote professional recognition.
  • Support gender neutrality.
  • Strengthen nursing leadership visibility.
  • Reduce outdated stereotypes.
  • Encourage equality within healthcare teams.
  • Enhance the public image of nursing.

Every significant transformation begins with a conversation.

Perhaps this is one conversation the Nursing profession should be willing to have.

Respect Begins Within the Profession

Nursing often seeks greater recognition, professional visibility, and respect from society, patients, healthcare organizations, and other disciplines. These aspirations are valid and necessary.

However, an important question must also be asked:

How can we expect others to recognize our professional identity if we do not consistently recognize it ourselves?

Professional respect should begin within the nursing profession.

Many nurses continue to address their colleagues primarily as “Brother” and “Sister,” regardless of qualification, designation, leadership role, or professional achievement. In doing so, we may unintentionally continue a culture where gender-based identity takes precedence over professional identity.

If we wish society to recognize nurses as healthcare professionals, then we must first create that culture among ourselves.

Another perception that deserves reflection is the belief that titles such as “Sir” and “Madam” are reserved only for doctors or certain administrative positions. Such thinking may unintentionally place nursing in a subordinate position rather than recognizing it as an independent profession.

Respectful forms of address are not the exclusive property of any profession.

Professional courtesy should be based on Position, Experience, Leadership, and Mutual respect-not on professional hierarchy alone.

More importantly, no title is greater than one’s professional identity.

Whether we choose to use “Sir,” “Madam,” a professional designation, or simply a person’s name, the underlying principle should remain the same: respect must be equitable and inclusive.

The journey toward professional recognition begins with self-recognition.

Before asking the world to change how it sees nurses, we must first examine how we see ourselves.

Respect starts within us.

Professional identity starts within us.

And meaningful change starts within us.

Conclusion

The titles “Brother” and “Sister” have served nursing for generations and remain part of the profession’s history.

However, history should not prevent progress.

The modern nurse is a highly trained healthcare professional whose identity extends beyond traditional gender-based terminology.

If we address doctors by their professional title, we should extend the same principle to nurses.

  • If we do not address Nursing Leaders as “Sir” or “Madam,” then we should at least move beyond gender-based labels.
  • Our profession is Nursing.
  • Our designation reflects our expertise.
  • Our name reflects our identity.

That should be enough.

“I do not need to be called Brother. My colleague does not need to be called Sister.

We are healthcare professionals. Our names, our qualifications, and our work are sufficient to define who we are.”

We are Nurses.

“Let us be respected not because of our gender, but because of our profession”

“Before asking society to respect nurses as professionals, we must first learn to recognize and address one another as professionals.”

“If Nursing wants to be recognized as a profession, professional respect must begin at home.

Let us stop defining ourselves by gender and start defining ourselves by our knowledge, leadership, designation, and contribution to patient care.”

References

  • Evans JA. The ‘Sister’ title: past the use-by date? Collegian. 2004;11(1):35-39.
  • Jayapal SK, Arulappan J. Historical trajectory of men in nursing in India. SAGE Open Nursing. 2020; 6:1-9.
  • Zamanzadeh V, Valizadeh L, Negarandeh R, et al. Current stereotypes associated with nursing and nursing professionals: An integrative review. Open Nursing Journal. 2022.
  • Harding T, North N, Perkins R. Sexualizing men’s touch: Male nurses and the use of intimate touch in clinical practice. International Journal of Nursing Studies. 2014.
  • International Council of Nurses (ICN). Code of Ethics for Nurses. Geneva: ICN.
  • World Health Organization (WHO). State of the World’s Nursing Report. Geneva: WHO.
  • American Nurses Association (ANA). Nursing: Scope and Standards of Practice. Silver Spring, MD: ANA.

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