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Nurse Jackie reviews
July 13, 2009 -- Tonight's episode of Showtime's Nurse Jackie focuses on the care Jackie and the other ED nurses provide to a dying nurse who used to practice with them. The plotline offers an unusual portrayal of how the nurses manage their patient's end-of-life care, and equally rare, a serious and revealing look at the clinical interactions among very different types of nurses. The dying nurse--who makes Jackie look easygoing--asks Jackie to help her end her life, because she does not want to lie in hospice for her last couple weeks. As in past episodes, Jackie works around the system. She and the other nurses provide their old friend with the ending she wants, even though it is apparently a crime to do so in New York State. The nurses' actions raise complex and difficult issues related to our flawed end-of-life care policies, and Jackie's own consistent willingness to break rules in order to further her vision of what is right for patients. Although the plotline is more about psychosocial care and advocacy, there is also a scene in which Jackie, after minimal assessment, accurately estimates that a patient will die in 10 minutes, underlining her expertise in physical care. The episode, "Tiny Bubbles," was written by Rick Cleveland. more...
July 6, 2009 -- Tonight's episode of Showtime's Nurse Jackie is yet another powerful showcase for Jackie's clinical virtuosity. The focus in several plotlines is not so much on Jackie's care for ED patients' immediate ailments as it is her holistic focus, how she expertly manages the larger family dynamics that have such a huge impact on health. Here she negotiates hospital rules to help a precocious 10-year-old continue to manage her mother's debilitating lupus. She also finds a creative way to advocate for a stroke victim, demonstrating to his obnoxious family that he's "still in there," even though he can't speak or move much of his body. At the same time, Jackie continues to mentor nursing student Zoey and new physician Coop, teaching the former about triage and the latter how to relate to the 10-year-old girl. The show even includes a quick but telling comment on patterned scrubs and the nursing image. The episode is slightly marred by its depiction of triage--it does involve assessing serious conditions, but it's not a "very simple" task that would ever be assigned to a student. And the portrayal of nurse manager Gloria Akalitus seems to reflect the battleaxe stereotype. Akalitus is a disagreeable killjoy, obsessed with enforcing rules regardless of whether they advance the wellbeing of those around her. The show punishes her constantly, her scenes are often funny, and of course some nurse managers are bureaucratic. But Akalitus is the show's Percocet, a quick way to feel better, but with potentially serious long term costs. This kind of image may suggest that female nurses can't handle authority, and that any strong woman who chooses to be a nurse must be twisted and bitter. Of course, Jackie herself belies that suggestion, and on the whole this episode offers a persuasive depiction of her advanced nursing skills. The episode, "Daffodil," was written by Taii K. Austin. more...
Always remember to help ladies on with their coats!
June 29, 2009 -- Tonight's episode of Showtime's Nurse Jackie highlights the expert psychosocial care Jackie Peyton and her nurse colleague Mohammed (Mo-Mo) de la Cruz give to ED patients and families. No one could mistake these nurses' thoughtful, sensitive care for unskilled hand-holding. The episode also suggests that physicians are often less adept at these tasks, even though they may receive all the credit from those the nurses have helped. Once again, the show's nurses play a central role in patient care, and Jackie ably trains more junior health team members. At the same time, the episode features a remarkable scene in which a school nurse goes head to head with Jackie about whether Jackie's daughter has a potentially serious anxiety disorder that may require medication; both of them seem to have valid points. One less impressive aspect of the episode involves Jackie ordering the removal of a patient's non-disruptive mother and twin brother from a trauma room without asking if they want to stay, just like the physician characters in other hospital shows do, with no hint of the potential benefits of family presence. This fourth episode, "School Nurse," was written by Christine Zander. more...
The good, the bad, and Zoey's stethoscope
June 22, 2009 -- Tonight's episode of Showtime's Nurse Jackie continues to present Jackie as a clinical leader with a vast skill set, and to show that nursing can be as compelling as medicine--if you actually let nurse characters do the nursing, as no other major show has done on a regular basis. Here, Jackie provides skilled care to a dying heart patient and a young woman who has become addicted to Vicodin. She also joins her best friend, physician Eleanor, in an amusing but deceptively important effort to teach nursing student Zoey not to be intimidated by physicians. One of the most impressive aspects of Nurse Jackie is that it goes out of its way to show not only that Jackie is clinically expert and a strong patient advocate, but also how patients and their families benefit from her advanced psychosocial skills. These are all the more amazing given her somewhat raw approach to colleagues and the addiction to painkillers that seems to haunt her. Small parts of the episode do reflect what may be the show's most significant ongoing problem, its iffy portrayal of nursing autonomy and authority. Jackie's interactions with physician Coop suggest she has little idea about what the hospital's upper management structure is--it seems to consist of the physicians. And the episode's depiction of Jackie's boss Gloria Akalitus tells viewers that nurse managers are not really nurses. On the whole, though, the episode offers another engaging look at what a strong, skilled nurse can do for patients. The episode, "Chicken Soup," was written by Mark Hudis. more...
Dear Readers:
Below is our review of the first episode of Showtime's new television show Nurse Jackie. Please consider that what Nurse Jackie says about nursing is far different from what it is saying about its main character. We urge you to keep an open mind and watch the show in full. We know not all readers will agree with our review. Even so, we are hoping that nurses will use the show as a vehicle to teach friends, family and society what nursing is, what nursing is not and what nursing could and should be. A powerful, critically-acclaimed nurse-centered television show has been a long time coming. Let's use what we can from it to change how the world thinks about nursing. Thanks for tuning in.
Sandy Summers, Executive Director, The Truth About Nursing
Make me good, God. But not yet.
St. Augustine; Nurse Jackie
June 8, 2009 -- Tonight's series premiere of Showtime's "dark comedy" Nurse Jackie is a brutal subversion of the unskilled angel stereotype. The first significant nurse-focused show to emerge from Hollywood in more than 15 years, Nurse Jackie may be the strongest--though not most positive--fictional TV portrayal of a modern nurse that we have ever seen. Jackie Peyton is a New York City ED nurse. Like esteemed TV physicians Greg House (Fox's House) and John Carter (NBC's ER), Jackie is a high-functioning drug addict. But she is also a tough, life-saving nurse who works at the center of patient care, and the show is unusually alert to what nurses experience. Jackie displays formidable clinical expertise, advocates forcefully to save a patient from an arrogant young physician (though she does not save that patient), and provides adroit psychosocial care to patients and families, as well as tough love mentoring to an innocent nursing student--and the physician. Also, she is a major wit. Jackie is not a role model in some respects. To treat a bad back, she takes powerful painkillers that she gets illegally from her pharmacist boyfriend. She has sex with him in the hospital pharmacy. She forges an organ donor card after a young patient dies. She flushes a diplomat's severed ear down the toilet upon learning that he will not be prosecuted for a vicious assault on a prostitute. She steals a wad of the diplomat's money and gives it to the organ donor's impoverished, pregnant girlfriend. And viewers may not get that it was her job as a nurse (not just as Jackie) to protect her patient from the physician; they might wrongly assume that physicians are ultimately in charge of patient care, and Jackie is just unusually assertive. But nothing else here reinforces the stereotypes that have led the public to undervalue nursing. Jackie is deeply flawed, like real people, but she is not a brainless physician helper, a naughty nurse, or an angel, though the nursing student 
calls her a "saint." Since Jackie seems to leave few Commandments unbroken, "God's rogue henchman" might be closer to the mark. She is like a Jack Bauer (24) of the ED (Jackie Bauer!), an extraordinary operative doing things she has no real right to do so she can achieve her vision of social welfare. Still, there is more intelligent life in this pilot than in a whole season of some hospital shows, and Jackie may well end up as one of the most important fictional nurses in history. The episode was written by series creators Liz Brixius & Linda Wallem and Evan Dunsky. more...
May 24, 2009 -- From our summer 2009 TV preview...
Showtime's half-hour "dark comedy" Nurse Jackie is probably the most prominent of the new shows, not least because it stars highly respected Sopranos actress Falco as "veteran ED nurse Jackie Peyton," who, in the pilot, "bends the rules to create something good from a patient's senseless death, while concealing her addiction to a pain killer she gets from her secret boyfriend, hospital pharmacist Eddie." The Showtime site explains that Jackie "navigates the rough waters of a crumbling healthcare system," "lighting into a smug doctor for failing to heed her advice," "stealing a fat money clip from a man who stabbed a prostitute," and "forging the organ donor card of a man who just died." Uh-huh. We're guessing the show might have some trouble getting the endorsement of major nursing groups, and of some individual nurses, what with all the drug abuse, stealing, and forgery. But none of those things are nursing stereotypes--they are not reasons the public undervalues nursing--and we won't necessarily hold them against the show if it conveys that Jackie is a real professional who saves lives. Among other things, Nurse Jackie may cause those who are interested in the nursing image to consider which qualities they deem most important in a nurse, among them clinical skill, toughness, initiative, patient advocacy, social action, compliance with ethical and other rules, personal morality, interpersonal skill, and a sense of perspective. Jackie brings all of these into question, and Showtime's promotion of the show seems designed to provoke: one of the images shows Jackie holding a syringe and needle with the tag line: "Life is full of little pricks."
The other major characters appear to be Eleanor O'Hara, a snarky British physician who is apparently Jackie's best friend; Fitch Cooper, one of the "smug, Ivy League doctors who have trolled the hospital halls for decades on their way to the golf course, leaving the nurses to deal with the repercussions of their drive-by diagnoses"; Eddie Walzer, the pharmacist boyfriend who "showers Jackie with love and the painkiller Percocet," which she apparently uses to ease poorly treated back pain; Mohammed "Mo-mo" de la Cruz, another veteran nurse and close confidant of Jackie, with a "biting sense of 'gallows' humor"; and Zoey Barkow, who the Showtime site says is a first year nursing student, but who the pilot suggests may actually be a first year nurse, and in any case is an "impressionable, exuberant" neophyte who is not sure she has what it takes to be a nurse.
The pilot is a deliciously brutal subversion of the unskilled angel stereotype and possibly the strongest fictional TV portrayal of the experience of a modern nurse that we have ever seen, certainly in the same league as the character Belize (right) from Mike Nichols' 2003 film version of Tony Kushner's Angels in America. Over time we may have reservations about elements of the show's focus and certain things its stylized approach may not make clear enough, for instance some aspects of nurses' real working conditions like short-staffing (how can Jackie spend so much time away from her patients during her shift?). But it's too soon to say based only on a half-hour pilot. What we can say is that Jackie displays formidable clinical expertise, advocates fiercely for a patient with the arrogant young physician Fitch, provides adroit psychosocial care to patients and family and tough love mentoring to Barkow (and Fitch, though he may not know it). She is thoughtful, witty, and a good friend to Eleanor and Mo-mo. On the other hand, she seems to know that she did not do enough to protect one patient, with tragic results. The writing is incisive and funny, and Falco's portrayal is powerful and nuanced.
But the show almost seems like it's trying to push the buttons of those who have a strict definition of what it means to be a good nurse. We can't tell you everything that falls into this category without spoiling parts of the pilot before it airs. But suffice it to say that Jackie takes powerful painkillers at work that she gets from her pharmacist boyfriend (it does not seem to affect her competence); has sex with him in the hospital pharmacy (though her sexual indiscretions have nothing to do with the naughty nurse stereotype); engages in the stealing and forging mentioned on the Showtime site; works dangerously long hours; is relentlessly profane; and commits at least three serious ethical breaches in an effort to achieve substantial justice where otherwise there may be none. The innocent Barkow calls her a "saint," but since Jackie does not seem to leave many Commandments unbroken, some will likely question that view.
Perhaps because the show is so compelling, Showtime has done considerable promotion, including (in addition to making the pilot available online) scheduling advance screenings of the first two episodes in Landmark Theatres in 10 major cities on June 3. The Showtime site also includes, in addition to the standard downloads and other paraphernalia, a section for "nurse stories," though what little is there now is very much about colorful patients, rather than things that would illustrate nursing skill.
See the first episode of Nurse Jackie online now ("shift happens" is the password). Click here to see it now. The first episode airs on Showtime June 8 at 10:30 pm ET/PT.
To send your comments directly to the show, please send them to:
Stuart Zakim
Vice President, Corporate Public Relations
Showtime Networks Inc
1633 Broadway
New York, NY 10019-6708
And please copy us on your letters at letters@truthaboutnursing.org. Thank you!
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