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News on Nursing in the Media
Possible success--jury's still out!
American Family Care clinics--You get to see a physician, not a nurse!
May 31, 2013 -- Truth About Nursing supporters recently told us about a television commercial being aired in the southern United States by American Family Care, an aggressively expanding chain of urgent care clinics that plans to have more than 140 locations in 26 states by the end of this year. The ad featured two people texting back and forth about where to seek health care. At the end, one texter recommended that the other go to American Family Care because there you get to see "a doctor, not a nurse." We could not locate the commercial (we created the image above based on what people told us the ad was like), but American Family Care itself was not hard to find. We placed about 7 calls, 1 per day, to Felicia Fortune, the corporation's director of marketing. She never returned any calls. Then we placed a call to company CEO Bruce Irwin and left a detailed message. American Family Care's chief medical officer Glenn Harnett returned our call and had a long discussion with Truth executive director Sandy Summers--you can listen to a recap of that phone call here in an mp3 (9 min). Harnett insisted that the care provided by physicians was better than that provided by APRNs based on the length of physicians' formal education. However, APRNS typically get as much formal health science education--4 years--as physicians do, and in any case a mountain of research in recent decades has shown that if either of the two professions has better patient outcomes, it's nurses. Harnett was not interested in the research, despite the strong and increasing emphasis on evidence-based practice in modern health care. He did, however, tell Sandy that American Family Care would pull the ad. We thanked him. Harnett said the company would replace it with an ad that went something like this: "At American Family Care, we care about you. That's why when you come to our clinics, you get to see a physician." We told him that isn't much better, since it implies that the people you're not seeing--which in the quick clinic context would only be APRNs--are inferior to the ones you are seeing. Sadly, Harnett did not see our point. And he refused to let us help the company create an ad that was not offensive or to send us a link to the new ad once it was done. By the way, we see that the company's "staff openings" section currently lists four (4) Family Nurse Practitioner positions in Alabama--we certainly hope the company "cares about" its Alabama customers as much as the others! Anyway, if you see a new version of the company's ad or related marketing efforts, please send us a copy or write to us at info@truthaboutnursing.org. Thanks very much!!
December 21, 2012 -- Recent obituaries for two extraordinary nursing leaders show how far nursing has come in the last half-century and, to some extent, how far it has yet to go. On June 9, the Baltimore Sun published Frederick Rasmussen's long, generally good obituary for Elizabeth Scanlan Trump, the co-founder and longtime nursing director of the University of Maryland's Shock Trauma Center, arguably the finest trauma center in the world. The piece portrays Scanlan Trump as "the first trauma nurse" and as the driven "full partner" of the pioneering trauma surgeon R Adams Cowley. Cowley is generally given sole credit for founding the Trauma Center. The piece has good quotes from the Trauma Center's current heads of nursing and medicine, as well as from Cowley's widow. They make clear that Scanlan Trump was a remarkable nurse who fought to establish the Trauma Center and to improve nursing education, though we could have used more detail on that and Trump's role as a nurse manager. The obituary also has a couple bits of handmaiden imagery that are especially unfortunate for a piece about someone so fierce. We noticed that the Trauma Center bears Cowley's name alone, though the obituary suggests that Scanlan Trump effectively co-founded it. We reached out to the chief nursing officer of the University of Maryland Medical Center and the Vice President of Nursing of the Shock Trauma Center and suggested that the hospital consider adding Scanlan-Trump's name. In a cordial meeting, CNO Lisa Rowen, RN, DNSc, and Shock Trauma VP of Nursing and Operations Karen Doyle, RN, MS, MBA, persuaded us that Scanlan-Trump's contributions, though great, did not merit that recognition in terms of trauma care innovation. However, the nursing leaders did agree to take other permanent steps to highlight Scanlan Trump's contributions to nursing, including naming one of the conference rooms in Shock Trauma's new trauma tower after her. And today, the New York Times ran a shorter but very good obituary by Daniel Slotnick for Vernice Ferguson. She "fought for greater opportunities, higher wages and more respect for nurses as a longtime chief nursing officer" of what became the U.S. Department of Veteran Affairs (VA), supervising more than 60,000 nurses. When Ferguson left in 1992, after 12 years, the number of VA nurses with at least a bachelor's degree had more than doubled. Ferguson's nursing career required a bit of drive as well. When the African-American graduated from the nursing program at New York University in 1950 with an academic prize, the director of nursing reportedly refused to shake her hand. The piece has several telling quotes from Ferguson, and it effectively conveys the male-physician-dominated environment that Ferguson worked hard to change. The item also notes that Ferguson conducted and supervised nursing research, including at the National Institutes of Health; we could have used more detail on those aspects of her career. But on the whole, both obituaries are powerful reminders that nurses can better their profession--and the world. more...
September 1, 2012 -- Today the Los Angeles Times ran a good tribute by prominent columnist Steve Lopez to the nurses who recently cared for him after his heart stopped following knee-replacement surgery at the University of Southern California's Keck Hospital. The piece has its share of generic help 'n' comfort imagery, referring to the nurses with phrases like "dedication and compassion," "noble profession," and "uncelebrated soldiers." Those tend to reinforce the angel image of nursing, masking the fact that nurses are college-educated professionals who save lives and arguably undermining nurses' claims to the tangible resources they need. Fortunately, the column does a lot to counter that impression, not least of which is the sub-head's statement that "an alert nurse's quick action save[d] the columnist's life." In addition to explaining how that happened--CPR by a post-op nurse--Lopez discusses the professional and personal histories of three nurses who cared for him, in the process giving readers a sense of nurses' professional training and skills (e.g., counseling patients and "translating doctor-speak") as well as their gender and cultural diversity. Lopez even notes that one of the nurses is about to start a master's degree program to become an "acute care nurse practitioner." So on the whole, despite some lingering sense that nurses are lofty spiritual beings, Lopez's "note of gratitude to nurses" really is a fitting tribute to the profession. We thank him and the Los Angeles Times.
April 14, 2013 -- With the fifth season of Showtime's Nurse Jackie set to begin tonight, it's time to review the last season, which aired in spring 2012 and once again highlighted the central role nurses play in patient care. Most of the season focused on Jackie's recovery from her drug addiction and other personal issues. But when there were clinical scenes, the show continued to present Jackie, at least, as essentially a peer of the physicians. She was a clinical leader providing creative technical and psychosocial care. And in the last two episodes of the season, she actually took over the emergency department in the midst of a staffing crisis, running it expertly until the malevolent hospital CEO Mike Cruz fired her. The show also featured more credible, compelling interactions among nurses, and between nurses and physicians, showing that nurses are sentient three-dimensional beings. All of that is rare in Hollywood. Jackie's quirky mentee Zoey Barkow continued to show potential as a future version of Jackie--at several points Zoey showed the kind of clinical courage and initiative that Jackie does. There is still no really strong male nurse character, though nurses Thor and Sam do seem to have settled into their roles as competent, funny Jackie acolytes. On the downside, the show continued to struggle to portray nursing autonomy. There were several more suggestions that physicians control nurse staffing, and, after Cruz demoted nurse-manager Gloria Akalitus to staff nurse, the show proceeded without any apparent nurse managers at all. Still, on the whole, Nurse Jackie remains probably the best show for nursing in U.S. primetime television history. The executive producers of the show are Linda Wallem, Liz Brixius, Richie Jackson, and Caryn Mandabach. more...
October 14, 2012 -- Today the Indian Express (New Delhi) website ran a good story about a recent study by sociologist Sreelekha Nair (right) of the Centre for Women's Development Studies focusing on the troubling situation of India's nurses. The study reportedly found that nurses continue to confront appalling working conditions including understaffing, especially in the private sector; abuse from employers, colleagues, and patients' families; very low pay and workplace restrictions that seem to approach servitude; and widespread undervaluation, including low work and social status, even though, as the report itself notes, they save lives. The Indian Express story, headlined "Indian nurses still an exploited lot: Study," originated with the Thiruvananth-apuram press agency. The article quotes extensively from the study and relies on additional comment from the study author, as well as Indian Nursing Council member P. K. Thampi. The piece links the status of nursing to the fact that the profession remains predominantly female. The report notes briefly that some nurses do find opportunities and even "adventures" by taking their skills overseas, though it does not explore how that migration affects India. The piece might have sought more input from nurses themselves, particularly those working in the clinical setting, and it might have gotten some reaction to the study from government and hospital officials. But the article provides valuable information about the state of nursing in India today, and we thank those responsible. more...
January 27, 2013 -- The demise of Lady Sybil in the episode of Downtown Abbey broadcast on PBS tonight in the United States marked the sad end of one of the popular U.K. show's two nurse characters. It's true that the show's third season has really featured no nursing from the independent, idealistic young Sybil or from her senior nursing colleague Isobel Crawley, the crusading (and at times grating) mother of Downton heir Matthew. But in the first two seasons, which followed the Downton household through the First World War, creator Julian Fellowes and the other producers did offer a few notable glimpses of British nursing of the era. These ranged from portrayals of Isobel as a formidable health system organizer with clinical knowledge that in some ways rivaled that of the local physician, on the one hand, to some unfortunate suggestions that nursing amounted to unskilled tending that could be done by any of the Downton females. The show has at least managed to present nursing as an early outside-the-home career option for strong, idealistic women who sought to contribute more broadly to their war-torn societies--and as a harbinger of a more egalitarian world in which women would enjoy more control over their own destinies. It's too bad that, in popular media depictions about our own era, when women can become physicians, we are far less likely to see strong, able female characters choose nursing. more...
Join this Public Health Campaign!
"Just because she's drunk . . . doesn't mean she wants to . . ."
August 29, 2012 -- Today an article by Sarah Deeth in the Peterborough Examiner (Ontario) reported that nurses at the local Kawartha Sexual Assault Centre had launched the "Don't Be That Guy" campaign to raise awareness among men about what constitutes rape, primarily to convey the message that having sex with a woman who is too drunk to consent is rape. The campaign targets not only potential rapists but also bystanders who may be in a position to step in to prevent assaults. The campaign's posters have unusually direct tag lines, among them "Just because you help her home . . . doesn't mean you can help yourself"; "Just because she isn't saying no . . . doesn't mean she's saying yes"; and the priceless "Just because she's drunk, doesn't mean she wants to f**k." The piece briefly explains the campaign, relying on strong quotes by Centre "sexual assault examination nurses" Karen Giles and Mary Waters. The Peterborough area seems to include a large number of university students, and Waters points to recent research about the special risks to first-year female university students and the belief among many young men that sex with a woman who is too drunk to consent is not rape. The campaign coincides with the start of classes at the universities, and the nurses plan to speak to students about sexual assault and drugs. The report might have done a better job explaining what the nurses do for patients clinically; it merely notes that they have recently "helped" several sexual assault victims. But on the whole, the piece is a great example of nurses taking the lead in aggressive public health advocacy and education on behalf of their patients. At the same time, it presents the nurses as autonomous experts in an important health context. We thank Sarah Deeth and the Peterborough Examiner. more...
"How to help nurses practice at the top of their game"
August 5, 2012 -- Recent press items report that new research has revealed critical aspects of nurse understaffing in the United States and the United Kingdom. On July 31, the Philadelphia Inquirer ran a generally good piece by Don Sapatkin (with Meeri Kim) about a study by researchers at the University of Pennsylvania that used 2006 data from 161 Pennsylvania hospitals to analyze the link between worse staffing and higher rates of infection. The study focused on the burnout associated with poor staffing, which researchers found played a critical role in higher infection rates, taking lives and costing money. The Inquirer article quotes two of the nurses responsible for the study, as well as nurses from the American Nurses Association and elsewhere as outside experts. Although its account of the study findings is not totally clear, the report does give a sense of why having enough skilled, engaged nurses plays such an important role in patient outcomes, particular because of good input from a Pittsburgh union leader. And on July 31, the Telegraph (U.K.) published a good article by Laura Donnelly about a new study of staffing at 46 National Health Service (NHS) hospitals by nursing researchers at Kings College London. That study found that nurses had an average of eight patients during the day and 11 at night (in some places 15 patients at night). Not surprisingly, most of the nurses did not have enough time to do their work. The Telegraph piece is more about the government's responsibility for the poor staffing amid an ongoing public inquiry into the 2009 Stafford Hospital scandal, and the piece does not quote the researchers, though it does include key findings and quote two nursing leaders. The article stresses that understaffing is closely linked to the growing use of less-qualified support staff. The piece could have done more to explain what nurses do to save lives (like detecting infections) that other staff cannot; instead, we hear mostly about custodial care and "compassion." But both the Telegraph and the Inquirer convey the importance of nurse staffing and show that nurses can be academic and health policy leaders. more...
January 6, 2013 – Today the Richmond (VA) CBS television affiliate WTVR (Channel 6) ran a short segment in which CVS Minute Clinic nurse practitioner Anne Pohnert debunked common myths about the flu in a friendly exchange with one of the channel's news anchors. The channel conveyed respect for Pohnert as a health expert, identifying her as a nurse practitioner. And Pohnert came off as professional and articulate, explaining in a direct, clear way that you can't get the flu from the flu shot, that there are no serious side effects from the shot, that it's important to get the vaccine every year, and that it's not too late to get the shot this year, particularly since the early incidence of flu suggests it will be a bad year for the disease. The short text matching the online video adds a fifth myth, namely that "natural immunity or living a healthy lifestyle is better than getting immunity from the flu shot"; we assume there was no time to discuss that one on the air. (Speaking of living a healthy lifestyle, recall that the Heart Attack Grill's first spokesman died of the flu at age 29. He weighed 575 pounds.) Pohnert's appearance is remarkable not just because it represents an appearance by a nurse as a health expert on broadcast television--still a rarity even on local affiliates--but because the station makes a point of mentioning that Pohnert practices at CVS Minute Clinics. In the early days of quick clinics, the major players almost seemed to apologize for staffing their clinics with NPs. But the explicit references to CVS here suggest that the company may now actually be promoting its clinics through the expertise of their nurse practitioners, at least in this case. We commend WTVR for this segment. more...
August 5, 2012 -- Today a New York Daily News piece (based on one in the Dawn (Pakistan)) reported that research showed Pakistani hospitals had made little progress in reducing the violence and sexual abuse that nurses suffer, despite a 2010 law aimed at curbing sexual harassment of women in the workplace. The short article was based mostly on two recent studies conducted by instructors at Karachi nursing schools. A survey by Shanila Jalaluddin of the Liaquat College of Nursing reportedly found that more than 31 percent of nurses at three Karachi hospitals had experienced "physical violence, and verbal and sexual harassment" in the preceding year, but only three percent reported the incidents, because they "feared retaliation and lack of support." Similarly, a study of Karachi hospitals by Rozina Somani of the Aga Khan University School of Nursing and Midwifery found that nurses tended to suffer violence and bullying at public hospitals, while verbal abuse "dominated" at private hospitals. According to that study, the perpetrators of the violence were patients, families, and other staff. But the incidents were "under-reported due to fear, shame and guilt." The Daily News commendably names both lead researchers, although the report does not explore possible reasons for the abuse or the atmosphere of impunity, such as gender bias and the low level of respect for nurses in particular. Even so, we thank those responsible for this troubling piece, which suggests that abuse of hospital nurses is common and that the nurses reasonably believe reporting it would result only in retaliation against the nurses themselves. more...
August 14, 2012 -- Today the New Zealand Herald ran a fairly good report by Hayden Donnell about a new Massey University study that found high rates of serious "moral distress" among Kiwi nurses. The study of more than 400 nurses nationwide found that 48 percent had considered leaving a job, and 16 percent were considering leaving their current job, because of issues "beyond their control." These included delivering poor care because of management pressure to cut costs; doing things that "unnecessarily prolonged the dying process"; and carrying out "physician's orders" for what the nurses believed were unnecessary treatments and tests. The use of the word "orders" in this context is always unfortunate since it wrongly suggests that nurses report to physicians and must do whatever they want. In fact, nurses are ethically bound to decline to carry out physician prescriptions if the nurses believe they are not in a patient's interest. Of course physicians do (wrongly) have more power, so this is a factor in the distress under consideration. 
On the upside, the piece quotes lead researcher Martin Woods, identifying him as "a nursing ethics and education expert," though oddly not as the lead researcher. It does refer to him as "Dr. Woods," and we hope that readers will understand that refers to his PhD in nursing rather than a medical doctorate. In any case, Dr. Woods explains that some nurses consider leaving not just one job but the entire profession, and he does a good job of emphasizing the gravity of the findings, which can lead to "depression, burnout and stress." The piece rightly (if minimally) notes that "results were similar to overseas studies." The article might have benefited from a little more detail on that, as well as from some information about the causes of and potential solutions to the nurses' moral distress. On the whole, though, the piece provides a helpful look at serious issues in New Zealand nursing today. more...
January 2013 -- Much of the reporting about U.S. Secretary of State Hillary Clinton's recent hospitalization ignored the role nurses surely had in her care and suggested that physicians alone monitored and assessed her condition, tasks in which nursing is in fact critical. For example, an Associated Press report posted on December 31 on Businessweek's website and elsewhere didn't just note that physicians had "discovered" the clot, which is fair, but also said (relying on a statement by Clinton's spokesman) that "doctors" would "monitor" her medication, "continue to assess her condition," and "determine if any further action is required," evidently all by themselves. Nurses were not mentioned, even though they provide the majority of skilled care to hospitalized patients, particularly the skilled 24/7 monitoring and intervention that often means the difference between life and death (granted, providing good nursing care can be challenging in the case of celebrities, who tend to be swarmed by physicians). Many press accounts, when not directly crediting physicians for Clinton's care, adopted passive language in describing it, thereby further suggesting that physicians alone were responsible and further masking the role nurses actually played. Thus, the AP story stated that Clinton was "under observation" and "was being treated with anti-coagulants." This passive voice hides the fact that nurses would be the ones giving her those drugs and carefully monitoring their effects. And as far as we could see, the press consulted only physicians for expert comment--in the AP story that meant neurologists at Georgetown and Duke--when critical care nurses could also provide valuable input on the care and experiences of patients with blood clots. Of course, physicians play a critical role in caring for these patients and the news media should consult them. But the media's failure to tell the public about the critical roles that nurses also play reinforces the damaging misimpression that physicians provide all the health care that matters. The AP article was written by Matthew Lee with AP Chief Medical Writer Marilynn Marchione. more...
July 24, 2012 -- This month the global news media ran short reports about a new study from University College Dublin (Ireland) that found that the most popular nurse-related YouTube videos stereotype nurses as stupid sex objects. On July 16, an Agence France-Press item posted on The Telegraph (Australia) and other news sites described basic aspects of the study and included several quotes from the lead author, nursing professor Gerard Fealy. The study found that, of the 10 most popular nurse-related YouTube videos, four portrayed nurses as sex objects, two showed nurses as stupid or incompetent, and only four--all posted by nurses themselves--showed nursing as a skilled and caring profession. All six of the stereotypical depictions were from television products or ads. Today, The Irish Times ran a good longer report by Ronan McGreevy that included more details about the study and the videos, as well as more quotes from Professor Fealy and Geraldine Talty of the Irish Nurses and Midwives Organisation. Among the new details were that the most popular YouTube video was a naughty nurse depiction from the 1990s U.S. sitcom Frasier. Another popular video showed a nurse responding to a question about whether she could do anything without a physician's permission by declaring that she could "wipe dirty ass and change diapers." Although it might have been helpful to hear more about the four videos that did not stereotype the nurses as sex objects or idiots, these press reports are generally good. We thank those responsible, as well as the nursing scholars who conducted the study. And we look forward to the day when popular media creators realize that nurses are college-educated, life-saving science professionals of both genders. Nurses can help bring that day closer by heeding YouTube's advice to "broadcast yourself."
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April 22, 2012 -- Today the Zambian Watchdog website posted an opinion piece by Andrew Silumesli entitled "Why do Zambian nurses abuse patients?" The piece says that such abuse is a serious problem in Zambia, and it discusses possible causes and solutions. Silumesii relies in part on research about abuse by nurses in the South African obstetric context and in part, we assume, on his own experience in Zambian clinical settings. The piece includes a note that Silumesii is a "Master of Public Health (MPH) candidate at the Institute of Tropical Medicine, Belgium," but does not make clear that he is a physician. The South African research on which he relies was led by a physician and a nurse, though he does not say so. Nor does he note that the research was from 1998, before the current global nursing crisis really took hold. Silumesii does deserve credit for asking the "why" question, which is rarely asked, despite the many media accounts about this kind of abuse in the region. These articles typically focus on horrific examples, but then stop at highlighting the abuse, offering no comment from the nurses involved and no ideas about why the abuse occurs; a notable exception is a March 2009 piece by Zara Nicholson in The Cape Argus, which told readers about the extreme challenges South African nurses face. Silumesii's analysis of the problem is fairly persuasive as far as it goes. He points to a complex array of factors, including inferiority and superiority complexes that may develop after a new nurse has managed to find one of the few escape routes from the generally bleak job prospects for Zambian youth. Silumesii might have looked more closely at potential factors that can't be addressed simply through changes in nurses' values and attitudes, like understaffing, resource shortages, and relations with physicians, which research has shown to be a problem in South Africa and around the world. Most of his proposed solutions are pretty vague. And there is no indication that he has asked any Zambian nurses what they think. Even so, the piece is a positive step, and we thank Silumesii and the Zambian Watchdog site. more...
December 4, 2012 -- Mindy Kaling's new Fox sitcom The Mindy Project, which is set at a small obstetrics practice in New York City, is bad for nursing. Kaling's lookin'-for-love OB-GYN character and the other physicians alone provide skilled care -- by coincidence, Kaling's late mother was an OB-GYN -- while the one minor nurse character Morgan Tookers is a goofy ex-convict. Well-intentioned but ignorant, very odd, and a little scary, Morgan doesn't show much health expertise, and he seems to be based mostly on The Janitor from Scrubs. But wait -- tonight's episode, written by Kaling, also includes a grossly inaccurate attack on midwives! In the main plotline, a holistic midwifery practice led by two New Agey men is "stealing" patients from the traditional OB-GYN practice that Mindy and her two male physician colleagues run. Mindy gets the patients back by telling them that midwives have no significant health training or skill and that only physicians can provide real health care to pregnant women, lies the show presents as hard but inescapable truths. The show's physician characters also caricature the midwives as seductive "charlatans" and "quacks" who are hostile to all "Western medicine," including drugs and vaccines. These seem to be lay midwives, but viewers are likely to apply the show's powerful messages to all midwives (it's not clear if Kaling actually knows that many midwives are nurses with graduate degrees). In fairness, the lead midwife in the episode is a strong, clever character who notes that midwifery predates obstetrics. And we realize that the show mocks everyone for one thing or another; Mindy and her physician colleagues are a bit self-involved and socially maladroit. But the episode never offers any serious criticism of physicians as health providers. And this episode is consistent with the economic and territorial fear some physicians seem to have for advanced practice nurses. The episode may also reflect a reactionary sense that traditional professional and educational hierarchies are under threat. And it is telling that Kaling targets male midwives, even though the vast majority of real midwives are female. Of course, showing that reality might have complicated her gender goals, which involve getting her character the respect of her male physician colleagues. And speaking of reality, in the real world all midwives receive years of health care training. And research shows that the care of certified nurse midwives is at least as good as that of physicians overall. We urge the show to avoid further attacks on nursing and midwifery. more... see the film clips and please join our letter-writing campaign by clicking here!
One Day in the Life of the Uninsured
November 2012 –The new documentary The Waiting Room follows patients and staff in the overcrowded emergency room at Highland Hospital, which serves the poor and working class of Oakland, California. Working with footage shot over just 24 hours, director Peter Nicks takes a good look at how the United States cares for its underinsured residents. The result is a quiet but compelling indictment of our dysfunctional health financing system. We see Highland's staff try, with skill and patience, to help emergency patients with ailments from gunshot wounds to chronic back pain, although what many of them really need is good primary care. The patients are resilient, but most have to wait a long time, and they are often frustrated, even agitated. Some just seem lost. The film gives physicians more attention than other care givers. And there are only a few glimpses of direct care nurses, even though emergency departments typically have as many nurses as physicians. Five of the eight health workers identified on the film's website are physicians. There is also one social worker, one nursing assistant, and one registered nurse. She is a charge nurse who appears in several scenes, always at her computer, expertly managing a long list of patients, determining who can be moved and when, who can be discharged and when. Sadly, the film never identifies her as a nurse, so viewers may not realize she is one. Yet some may well see the nursing assistant as a nurse. She manages patients in the waiting room itself, taking vital signs, collecting and dispensing information, and displaying diverse interpersonal skills. Of course, these are just guesses about how viewers will see the providers; some theaters showing the film call this charismatic nurse's aide a "feisty head receptionist." In any case, she and one of the resident physicians form the moral core of the movie. For most viewers, the vision of nursing that emerges from this odd mix of likely misimpressions will probably be fairly good, but not great. The film's overall merit is clearer. As millions of people are still "waiting" for a more inclusive and effective health care system, everyone with a stake in that system--that is, everyone--should see this movie. see the full review ... The Waiting Room opens on Friday, November 30 in Washington DC, Boston, and Sacramento, and in many other places in the coming weeks. See a full list of venues here.
Take Action!
You will be required to deal with bruising
October 24, 2012 -- Tonight on The Daily Show with Jon Stewart, two former U.S. military medics appeared in a segment about re-integrating veterans into the civilian workforce. We honor the service of these veterans, who appear to have significant experience stabilizing wounded soldiers, following EMT Basic training. But Stewart's repeated insistence that the medics are vastly overqualified to be school nurses is a glaring example of the elite media's ignorance of nursing expertise. Stewart mocked school nurses as being all about "kickball" and "tummy aches," even though he explicitly noted that one school nurse position he found required a bachelor of science in nursing--we guess not all bachelor's degrees are created equal (Stewart's bachelor degree is in psychology). Sadly, the medics themselves seemed to agree that they were qualified to hold registered nurse jobs. But today's school nurses need years of university science training because they manage the health of many hundreds of students who attend with serious conditions including asthma, diabetes, and allergies. Students have died because no registered nurse was available. 
And school nurses play a key public health role, not only educating students about critical health issues like pregnancy and STDs, but also monitoring the student population for disease outbreaks. In 2009, school nurse Mary Pappas in New York City (where the Daily Show is recorded and Stewart's children attend school) set in motion the governmental response to the H1N1 flu outbreak, identifying and managing hundreds of her students' symptoms. She later gave compelling testimony at a federal government flu summit. Plus, she made a little girl's tummy feel all better!The segment's theme reminded us of a vague but troubling comment President Barack Obama made just two days earlier in the October 22 presidential debate that veteran medics who wanted to become nurses had to "start from scratch" so it would be good to "change those certifications." Of course, all students should have a chance to show they merit advanced placement in educational programs, but nursing requirements cannot be simply waved away for people with a few weeks of health training and some field experience, no matter how courageous and heroic. Please ask The Daily Show with Jon Stewart to make amends for the damage caused when it spread this disinformation to its 2.5 million viewers--maybe with a segment about the problems school nurses face caring for the kids of a nation whose elite sees their work as trivial. more . . . please join the letter-writing campaign and see the film clips!
October 29, 2012 -- The remarkable new BBC series Call the Midwife, now airing in the United States on PBS, offers a dramatic look at the exploits of Anglican and lay nurse-midwives caring for poor women and babies in London's East End in the late 1950's. In the first three episodes, the series presents the midwives as skilled, autonomous health workers whose ability varies in accord with their relevant experience. Tough, expert senior midwives guide the nervous newer ones. In one early scene, after police try ineffectively to stop a raucous street fight between two women, one of the commanding senior midwives brings the altercation to a halt with one sharp question. The nurses visit pregnant women to monitor their progress, deliver the babies under awful conditions, and advise the new mothers, all in an environment without birth control where women seem to function as baby factories and one-person day care centers. One woman has 24 children. The midwives also provide community health services. Physicians do appear occasionally when their special skills are needed. But for the most part the focus is on the nurses who provide the vast majority of the care, and physicians are marginal, in what amounts to a reversal of the standard Hollywood model. Indeed, the show is remarkably free of stereotypes. It's not free of sentiment and generic uplift, some of the scenes are too pretty for the supposedly gritty setting, and central character Jenny Lee seems a bit unformed. The show is not quite on Nurse Jackie's level, and of course the setting differs greatly. But like Nurse Jackie, Call the Midwife is an often powerful, funny, and nuanced look at skilled nurses saving and improving lives in world whose concern for the health of the poor is open to question. Where Jackie offers regular critiques of the U.S. health care financing system, Call the Midwife includes advertisements for the U.K.'s National Health Service, which was new in the 1950's. Based on a memoir by midwife Jennifer Worth (nee Lee) and written by Heidi Thomas, the six-episode BBC series was a big ratings success in the U.K., and a second season is on order. In the United States, it seems to be doing well for a PBS show. We thank those responsible for Call the Midwife, and we urge all nurses to watch and support it. more...and see the film clips!
Fall 2012 TV Preview: Nursing in the Media
September 2012 -- More new health-related shows arrive in the fall U.S. television season, and there is actually one new nurse-focused show--the six-part BBC drama Call the Midwife, which focuses on Anglican and lay nurse midwives (apparently eight of them!) who care for poor women in 1950's London. The show, a big hit in the U.K. earlier this year, will air on PBS (premiering Sept. 30). Hollywood-wise, there do seem to be a couple sidekick nurse characters, but the primetime landscape will still be dominated by physician characters--we count 47 physicians to 2 nurses. This year, the four new network shows have different spins on Hollywood's health care portrayals, but none seems likely to question the prevailing view that only physicians really matter in health care. Fox's The Mob Doctor (Sept. 17) tells the story of one of the nation's "most promising young surgeons" who is "caught between two worlds as she juggles her promising medical career with her family's debt to Chicago's Southside mob." Right. And although the surgeon's "protective best friend" is nurse Rosa Quintero, the other three hospital characters are all physicians. In Fox's sitcom The Mindy Project (Sept. 25), created by and starring The Office veteran Mindy Kaling, the lead character is a romantically challenged OB-GYN; in addition to the four physician characters, there is a "male nurse" who is a "reformed ex-con." 
In the new NBC drama Do No Harm (mid-season), the lead neurosurgeon character has a "dangerous alternate personality," but aside from that unusual concept, the show seems to be dominated by its five physician characters. The CW's Emily Owens, MD (Oct. 16) sounds like the most conventional new show. It's not just the name; with all six major characters apparently pretty young surgeons struggling valiantly to grow up, it's Grey's-tastic! And speaking of which, among veteran shows, ABC's Grey's Anatomy (Sept. 27) still has about 14 surgeon characters and no nurses as it starts its ninth season. A few episodes last season did feature "Nurse Eli," the boyfriend of star surgeon Miranda Bailey and a nurse who displayed some health care skill and patient advocacy, but even that plotline ultimately confirmed that nurses are physician subordinates, with Bailey dumping Eli in a way that implied it was because he was just a nurse. The Grey's spinoff, ABC's Private Practice (Sept. 25), limps back for what may be its last year with plenty of heroic physicians but no significant nurse characters. ABC's Body of Proof (mid-season), about an elite surgeon-turned-medical examiner, returns for a third season having lost all its police characters, but none of its four physicians. The CW's romantic comedy-drama Hart of Dixie (Oct. 2) returns for a second season with the concept of a cute young New York physician who finds herself in a small Southern town. Lest we forget the one bright spot on premium cable, Showtime's powerful Nurse Jackie (spring 2013) will return early next year for a fifth season of Jackie's clinical expertise and creative patient advocacy, and if last season is any guide, some unfortunate suggestions that nurses report to physicians. On the whole, Hollywood looks set to continue telling viewers that health care is all about smart, commanding physicians, and nurses are their low-skilled helpers. See more details on the shows below!
| Call the Midwife | Do No Harm | The Mob Doctor |
| The Mindy Project | Emily Owens, MD | Grey's Anatomy |
| Private Practice | Body of Proof | Hart of Dixie |
| Nurse Jackie | Conclusion |
Nursing at the Olympics: Florence and the machines
July 27, 2012 – The opening ceremony of the summer Olympic Games in London illustrated the sweep of recent centuries, from Britain’s early agrarian history to the Industrial Revolution to the digital era, with a series of joyous, inventive, and amusing spectacles. Director Danny Boyle simultaneously emphasized the National Health Service and the nation’s contributions to children’s literature, which he linked with an 11-minute segment built around references to the work of Peter Pan author J.M. Barrie, who had donated the royalties from his books to a local children’s hospital. The segment included a group of real nurses and physicians who dressed in traditional uniforms and danced energetically. The nurses ministered to pediatric patients by pushing them around in big rolling beds, reading to them, and tucking them in. The kids bounced on their trampoline-beds and the nurses danced, while occasionally miming what may have been care tasks, such as giving medications and hand-washing. Finally, the children fell asleep and began dreaming. Cue the entry of huge literary villain puppets, including the Queen of Hearts, Captain Hook, and of course, Voldemort. But then a skyful of umbrella-toting Mary Poppins’s dropped in to the rescue! We were pleased that the nurses were presented as workers of value, right alongside physicians, with at least a suggestion of actual health care, but no obvious indication of subservience, the angel stereotype, or the naughty nurse. There seemed to be a lot more nurses than physicians—just as in real life! We saw no reference to Florence Nightingale, the British founder of modern nursing, who might have been mentioned in a long ceremony that found room for a lot of pop musicians. But we did appreciate the celebration of a national health care system that, despite its flaws, helps nurses care for everyone. The segment did underline the historic association of “nurses” with paid child care, and Poppins, the peerless nanny, actually seemed to be a more effective healer than the nurses. The nurses’ tucking and reading, while certainly good psychosocial care, probably did not enhance the public’s sense of them as skilled health professionals. But at least they knew how to read! Of course, there is only so much a brief historical depiction can say about nursing today. We were pleased that the ceremony presented nurses as vital health workers to a billion worldwide viewers, and we thank those responsible. more... and see the film clips!
July 5, 2012 -- Today The New York Times ran a very good "Doctor and Patient" piece by physician and regular columnist Pauline W. Chen about threats to hospital nurses' physical and mental health that can affect patient care and, of course, the nurses themselves. Chen uses the story of a back injury suffered by "one of the most respected nurses" in her hospital as a lead-in to discuss the causes and effects of nurses' health problems. Chen cites recent research in nursing journals and repeatedly quotes University of North Carolina professor Susan Letvak--a scholar Chen identifies as a nurse and then commendably refers to as "Dr. Letvak." At a few points the piece is too cautious, notably in suggesting that nurse staffing ratios "are not always standardized" and so "nurses can find themselves in the potentially devastating situation of caring for more patients than is comfortable." "Non-standardized" staffing can make nurses less than "comfortable"? Does Chen mean research shows under-staffing kills patients because nursing is a high-skilled scientific profession that is vital to patient survival? Chen might also have mentioned the add-on effects of compassion fatigue, which has received attention recently, for instance in January 2012 pieces in The Wall Street Journal. Chen does make clear that illness-related nursing errors cost the U.S. health system billions of dollars annually, and as usual, she goes out of her way to avoid stereotypes and convey respect for nursing. We thank Chen for another very helpful report about the challenges that nurses and their patients face. more...
Nurse Jackie on Nurse's Week: "THANK YOU NURSES!"
May 2012 -- As we reach Nurses Week in the United States and the fourth season of Showtime's Nurse Jackie gets underway, it's worth reviewing last year's third season, in which the show's tough, expert central character bluntly dismissed the annual appreciation week as "patronizing." The third season continued the show's run as the best dramatic U.S. television portrait of nurses in decades, perhaps ever. Sure, most of the season was not about clinical work, the show faltered badly on nursing autonomy (repeatedly suggesting that nurses report to physicians), and Jackie's ongoing drug problem remains a bit hard to reconcile with her clinical prowess. But when there were clinical scenes, Jackie remained essentially a clinical peer of the physicians, and in general, the nurse characters actually performed their own work, including triage and patient education. Jackie provided expert holistic care to emergency patients including a distraught cab driver with a pneumothorax, a gunshot victim who cared more about her dog than her wounds, and a nice man who was falling apart because of chronic hypertension. The show featured credible interactions among nurses and physicians, in clinical and social contexts, showing that nurses are sentient three-dimensional beings. The season also included nurse Kelly, a skilled, flawed younger nurse who resembled Jackie in some ways and was the strong male nurse that the show was missing in the second season. And we got periodic looks at the contempt that many people have for nursing, as well as wry commentary on the nursing image, from a patient's mockery of nurse Zoey's patterned scrubs to a more nuanced critique of Nurses Week, which went well beyond Jackie's "patronizing" comment. Yet the show repeatedly suggested that nurses "assist" physicians and that physicians control nurses' patient assignments, with emergency physician Eleanor O'Hara removing nurses from one case and putting them on another. Charge nurses or nurse managers do that in real life. Here, the closest thing to a nurse manager is Gloria Akalitus, a composite administrator who is a nurse but whose ill-defined authority seems to extend to the pharmacy and even medicine, to some extent. Despite its problems, though, Nurse Jackie shows us a world in which nurses are life-saving professionals, in stark contrast to the "yes, doctor!" model that prevails on U.S. television. more...and see the film clips!
Are your knuckles white? NPR on nurse understaffing
May 25, 2012 -- Today National Public Radio's Morning Edition ran a generally helpful 5-minute report by Patti Neighmond about widespread nurse understaffing in U.S. hospitals, as part of the radio network's "Sick in America" series. Following a poll showing that one third of U.S. hospital patients reported that nurses were "unavailable" when needed, NPR placed a "call out" on Facebook for nurses themselves to explain what was going on. Nurses responded with stories of being compelled to care for patients non-stop for their 12-hour shifts, with few or no breaks, and worrying that understaffing made it impossible to provide safe care. The Morning Edition piece consults University of Pennsylvania nursing scholar Linda Aiken, who argues that the U.S. now faces not so much a shortage of nurses as a shortage of nursing care at the bedside, which matters because nurses are the "surveillance system" in health care. And commendably, the piece explains, partly through an audio clip from a direct care nurse, how under-staffing can endanger patients, for example if a nurse is too busy to note subtle condition changes or respond to an alarm. An American Hospital Association representative stresses that hospitals today face financial constraints as well as sicker patients and a proliferation of care technologies. 
But NPR presents no advocate on the other side, like a union leader, to respond with the argument that it is conscious policy choices, not something totally beyond the control of hospitals or government, that result in nursing being severely underfunded. No direct care nurse featured on the segment is identified, because almost all who responded were "worried about retaliation" from employers. And sadly, it seems that whoever wrote the piece could not resist having Morning Edition host Renee Montaigne lead off with the inane cliché that nurses are the "backbone" of the health care system, which suggests that nurses are tough but unthinking pieces of hardware, like beds. Still, we appreciate the report's basic points that the current understaffing means nurses are working on the edge and that this can threaten patient health. We thank NPR and Patti Neighmond. more...
Amanda Trujillo: Fired for educating a patient?
May 2012 -- On February 1, the Phoenix CBS affiliate KPHO-TV ran a short but good item by Peter Busch about veteran local nurse Amanda Trujillo, who said she had been fired by Banner Del Webb Hospital and had a complaint filed against her with the state board of nursing because she had educated a patient about the risks of an upcoming surgery and scheduled a consult about hospice. A hospital spokesman reportedly said that "the doctor, ultimately, is the focal point that directs care for patients" and that "company policy" forbids nurses to order a case management consult. The report does not mention other accounts suggesting that these events were set in motion because the patient's surgeon was displeased that the patient had decided against the surgery. Trujillo's case has itself become a "focal point" for nurses concerned about policies that discourage them from doing what they are trained to do, namely educate and advocate for patients and help them make informed decisions about their care--and about the failure of some in authority to support nurses who stand up for patients. As of this writing, more than a year after Trujillo spoke to her patient in April 2011, it appears that the Arizona Board of Nursing has yet to decide on her case. A "Notice of Charges" with a curiously wide-ranging list of apparent allegations against Trujillo, going back to 2009 and including her work with other employers, appeared online in March. The Notice purports to be signed by the Board's director but it is undated, and it is unclear if the document is genuine or represents the Board's position. At the same time, Trujillo's case has become a national rallying point for nurses concerned about nursing disempowerment, with some questioning the accuracy of the apparent allegations against her and the alleged relation of the Board to Banner Del Webb, and others questioning the accuracy of Trujillo's account or hesitating to prejudge the matter while the Board is apparently still considering it and many facts remain unclear. In any case, we thank KPHO and Peter Busch for this report. more...
Place FREE Truth About Nursing posters at your school or workplace -- it's good fun and good for you!
Tell colleagues and patients the truth! Our "I Am Your Registered Nurse" poster presents nurses as autonomous professionals on whom patients can rely. The poster explains that nurses are modern science professionals who protect and advocate for patients and empowers nurses to meet those challenges. Designed for the bedside, the poster comforts patients by educating them about the care environment and assuring them that nurses are there to fend for them.
Or consider the Truth's "Can Short Dresses Cause Short Staffing?" poster. This one takes humorous aim at the naughty nurse image that continues to haunt advertisements and other media, especially those aimed at males. The poster connects the naughty nurse image with the broader undervaluation that leads to gross underfunding of nursing education, research, and practice, ultimately threatening patients.
We'll send you up to 20 posters free to hang at your school or workplace. Just email us at info@truthaboutnursing.org to tell us how many you'd like and where to send them. If you'd like more, they are just 50 cents each! Thank you!
Teach medical students about the value of nursing
June 2012 -- Megan LeClair, RN, BSN, of the University of Wisconsin's Trauma and Life Support Center, recently performed a study based on a program from Dartmouth University in which medical students follow nurses at work to learn about the life-saving skills that nurses have. Her study was effective and we urge you to design your own! See the original Dartmouth program designed and led by Ellen Ceppetelli, RN, PhD. See Megan's abstract and results.
Encourage nurses who speak publicly to identify themselves as nurses!
August 2012 -- Elizabeth Winslow, RN, PhD, FAAN, wrote a great opinion piece in the August issue of the American Journal of Nursing entitled "We Silence Our Profession When We Fail to Identify Ourselves as Nurses." Winslow encourages nurses who speak publicly to weave into the message that the speaker is a nurse. We are reminded of a similarly great piece, "Pick Up That RN Flag and Wave It" by Pam Meredith, RN, NP, which appeared in Nursing Spectrum in December 2002. Get up, stand up, nurses!
The new Truth movie has everything...
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Watch now!
Check out the Truth's movie "Nursing: Isn't That Sweet?!" It's all about what happens when nurse Wendy encounters her old high school classmate Jim at a restaurant, many years later--after the two have taken their lives in very different directions! Can Wendy and Jim make a new connection? Or will things get a little ugly? Made using xtranormal software for Halloween 2011, the short video explores some chilling stereotypes that still infect public understanding of nursing. And for a different take on nursing stereotypes, check out the Truth's classic 2005 report "Nursing: Who Knew?" about a groundbreaking study in which leading researchers discover nurses' real contributions for the first time! See the video! Or if you can't access YouTube at your workplace, click here to see the video on our site. Thank you!
New Truth About Nursing FAQ:
Just how undervalued and underfunded is nursing?
In our new FAQ, we explore a few dramatic comparisons that illustrate how poorly nursing is valued and funded relative to medicine and other professions. See the comparisons...
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VIdLit (Video Literature)
Script for a nurse-centered television drama
HealthStyles radio show with Diana Mason and Barbara Glickstein
Beatrice and Philip Kalisch archives on media images of nurses
Saving Lives: Why the Media's Portrayal of Nurses Puts Us All at Risk
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Saving Lives: Why the Media's Portrayal of Nurses Puts Us All at Risk
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-- Florence Nightingale
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