By the early nineteenth century, the only model for paid nursing in the United States was one characterized by low wages and low status. While republican ideology held that nursing should ideally be performed for free by women within their own households, those who worked as hired nurses faced renewed moral suspicion. Popular culture reinforced these negative perceptions through literary and print caricatures that portrayed hired nurses as lazy, drunk, promiscuous, and unskilled. These depictions, often originating from Britain, shaped attitudes toward nurses on both sides of the Atlantic. These representations both reflected and reinforced societal prejudices, creating a cycle where only women with few other options turned to nursing, which in turn only fueled these stereotypes of nursing.