Private Practice: Not a doctor, but...

Archived 2008 Letter to Private Practice Producers

Dear "Private Practice" Producers:

I am writing to encourage you to improve the portrayal of nursing on "Private Practice." I thank you for at least including a nurse character along with the seven physicians who dominate the show. Unfortunately, early episodes of the show either ignore or grossly undervalue nursing care.

Nurse character Dell Parker, who studies midwifery, has good intentions and an obvious interest in the clinic's patients. But he seems to be the least knowledgeable major nurse character in the last decade of prime time US television. The show's early episodes suggest that Dell's clinical studies consist of whatever ad hoc assistance he can give to clinic physicians. The episodes also rely heavily on mockery of Dell's midwifery studies as lightweight New Age kookiness. Show anchor and superstar physician Addison repeatedly utters the word "midwif" as if she had never heard of such an outlandish pursuit. Alert viewers can also catch glimpses of wallpaper nurses in the background once in a while, but it's not clear if any of them will ever display the ability to speak, much less think.

In the midst of a deadly global nursing shortage that is based largely on a lack of understanding of the profession, this unrealistic portrayal of nursing is unacceptable. The undervaluation of nursing, including media depictions of nurses as peripheral physician subordinates, erodes financial support for nursing clinical practice, education and research, driving the global shortage. Underfunding nursing also increases patient mortality, increases errors and poor outcomes like infections, and adds millions of patient hospital days, all of which fuel rising health care costs.

For the nursing shortage to end, society must learn what nurses do to save lives and improve outcomes, which also means unlearning the common misconception that physicians do important work that nurses really do. Research shows that entertainment television shows, like "Private Practice," have a real effect on health care views and actions.

So I urge you to consult a nurse expert in creating your scripts, and to consider dramatic changes that would allow the show to provide a vision of modern health care that gives viewers at least some basic sense of the role of skilled nurses. There is a limit to what you can do while Dell is employed as the clinic's receptionist, a position that a recent BSN graduate is very unlikely to hold. And no one with a nursing degree would be as lacking in health care knowledge as Dell is.

A different receptionist could be hired so Dell could at least be shown actually fulfilling a nursing role in the practice--educating patients, helping them cope with a new health care challenge, advocating for them--as real nurses do every day. You might also consider adding one of Dell's professors as a partner in the practice. An advanced practice nurse would fit right in with your existing characters, since nursing is a holistic profession. This would also allow you to show Dell learning from one of the nurse experts who would actually be his main teachers.

Real nurses are skilled, autonomous professionals who play a central role in health care--if they can persuade decision-makers and the public to provide the resources needed. It is no exaggeration to say that the future of global health depends in significant part on better understanding of nursing. We hope that "Private Practice" will move toward being part of the solution.

Thank you for your consideration.

Sandy Summers, RN, MSN, MPH
Executive Director
The Truth About Nursing
203 Churchwardens Rd.
Baltimore, Maryland 21212-2937
ssummers@truthaboutnursing.org