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Archived Scrubs Review (2002-2003 last included season)

Starring Zach Braff, Sarah Chalke, Donald Faison, John C. McGinley, Judy Reyes, Ken Jenkins, Neil Flynn

Executive Producer/Creator: Bill Lawrence

Produced by Touchstone Television

NBC

TV-14


Nursing rating

Rating guide:
excellent = 4 stars; good = 3 stars;
fair = 2 stars, poor = 1 star

Artistic rating

Summary

Synopsis

Portrayal of Nursing

Summary

"Scrubs" is one of the best sitcoms to debut in recent years. An irreverent, often hilarious show with gifted actors, it poses the question: what if a hospital was staffed by insult comics? "Scrubs" trains its lacerating wit mainly on the professional and personal lives of several young resident physicians. Perhaps as a counterpoint to the put-downs, the show relies heavily on fantasy sequences and sentimental musings on life by its goofy, insecure lead character JD. This may seem a little too much like "Ally McBeal," but somehow "Scrubs" usually manages not to be cloying. And despite the nasty and surreal elements, its characters are not above learning or growing, as they try to cope with the very real stresses of life and death at the hospital.

The show's portrayal of nursing is less impressive. It does have a major and positive nurse character in Carla Espinosa. And some plotlines have had surprisingly thoughtful takes on nursing issues, such as the decision to become a nurse practitioner, bigotry towards male nurses, nurses' informal teaching of residents, and nurse-physician tension. Unfortunately, in other ways the show reflects the prevailing Hollywood vision of nurses as caring but largely peripheral health workers who report to physicians. The nurses' lives often seem to revolve around those of physicians, who are seen as the providers of most meaningful health care.

Synopsis

"Scrubs" follows the work and personal lives of three resident physicians at Sacred Heart Hospital . They are medical resident John Dorian ("J.D.") (Zach Braff), the earnest but klutzy lead character who narrates most of the shows in voiceover; J.D.'s long-time best friend Chris Turk (Donald Faison), a competitive, self-assured surgical resident; and the insecure, odd resident Elliott Reid (Sarah Chalke). Another main character is experienced, relatively normal registered nurse Carla Espinosa (Judy Reyes), the subject of Turk's romantic attention from the start. Carla's testy relationship with Elliott, at least initially, seemed to reflect a female nurse-female physician tension. The final major character is the attending-cum-drill sergeant Perry Cox (John C. McGinley), a gruff mentor to J.D. whose vicious insults seem designed to hide his crumpled idealism--a tactic that the show itself seems to employ.

Other important regular characters include chief of medicine Bob Kelso (Ken Jenkins), a charmless despot who displays a redeeming quality about once per season, and who periodically does battle with Cox. Neil Flynn plays a hospital janitor (seemingly known only as "The Janitor") who regularly takes offense at J.D.'s insensitivity and exacerbates his neuroses. Minor recurring characters include Nurse Roberts (Aloma Wright), whose work consists mostly of sitting around and fulfilling stereotypes, and the crude, arrogant surgeon Todd (Robert Maschio).

Over the course of "Scrubs"' first two seasons, the lives of its characters have developed considerably, especially in view of the show's irreverent, surreal themes. In the second season, the main characters finished their internships and became residents. Carla belatedly accepted Turk's marriage proposal. J.D. and Elliott, who had flirted from the beginning, spent some time as "sex buddies" until Elliott pulled back. A good example of the show's not-for-everyone comic sense was JD's multi-episode romance with Jamie (Amy Smart). Jamie, the attractive wife of a patient who had been in a coma for years and ultimately died, was delicately known to the hospital staff as "TCW"--Tasty Coma Wife. Cox appeared to reach a kind of truce with his ex-wife Jordan (Christa Miller Lawrence), whose defensive ultra-nastiness matched his own, and whose new baby turned out, unexpectedly, to be fathered by none other than Cox himself.

The show has also made good use of guest stars. Rick Schroder appeared in several early 2003 episodes as Paul Flowers, a confident, witty and sensitive nurse with whom Elliott had an affair. Paul faced anti-male nurse bigotry from the show's emotional wrecking crew, including Kelso and Todd, who called him a "murse" who did "women's work." Elliott herself struggled with her self-esteem when she belatedly learned that Paul was a nurse, not a physician. Paul easily rose above the slurs, casually dismissing Kelso and upstaging the jealous J.D. by offering a vastly superior toast to the newly engaged Turk and Carla. The Paul-Elliott relationship ultimately did not work out, in part because Paul could not resist trying to "fix" Elliott.

Portrayal of Nursing

On balance, "Scrubs" is probably a little better for nurses than most current serial television. It features a major, positive nurse character in Carla. At times it has addressed real nursing issues, including the decision to become a nurse practitioner, bigotry towards male nurses, and nurses' informal teaching of residents.

Unfortunately, "Scrubs" often shows nursing as a caring but fairly low-skilled and peripheral profession. It doesn't give much sense of the range of nursing practice, nurses' autonomy or their front-line and central place in hospital care. And it suffers to a significant extent from "Marcus Welby Syndrome," in which physicians are shown providing most or all meaningful health care. As on other television series, physicians appear to supervise nurses. One episode included Kelso firing the nurse who had made Cox's favorite cup of coffee, which suggested not only Kelso could actually do that at will, but also that nursing involves making coffee for physicians. And the show has on occasion indulged in the naughty nurse stereotype, in fantasy sequences based on the characters' overworked imaginations.

One bright spot for nursing on the show is the strong, competent Carla, who is probably the most prominent Latina nurse character in modern television history. She is the only major character who could really be described as normal and caring. Of course, in the "Scrubs" universe this could actually be a mark of disrespect, in the sense that maybe the show feels nurses aren't interesting enough to be truly screwed up.

Carla has been central to a number of plot lines. Of course, as with other television nurses, a major theme has been her romance with a physician (in this case Turk). However, in several episodes, the focus was at least somewhat on her skills as a nurse.

One episode involved Turk signing Carla up for a nurse practitioner program as a surprise gift--one of the few times serial television has acknowledged that the nation's 200,000 advanced practice nurses even exist. Though the show made clear that Carla was well qualified for the program, she chose not to pursue it so she could spend more time with Turk. No one should be quick to judge someone else's decision on such a difficult matter. But Carla did not say that she had no desire to be a nurse practitioner. And no one on the show really argued that perhaps her career was as important as her boyfriend. It seems doubtful that the show would have had a physician making that kind of sacrifice for a nurse (or a man for a woman) without further comment.

Another episode was "My Nightingale" (most of the episodes are entitled "My _____", with the pronoun referring to JD). In this episode, the young residents relied on Carla's health care knowledge on a night when there was no attending on duty.

On the other hand, we do not often see Carla actually provide nursing care, in contrast to the physicians, who do manage to treat patients despite the constant hijinks. Certainly we get little sense that she is an autonomous professional who reports to nurse managers. And there is some but not nearly enough discussion between Carla and the physicians about patient care.

As if to balance Carla's relatively positive persona, the show's other recurring nurse character, the obese African-American Nurse Roberts, seems to be a mix of stereotypes designed to advance comic plot lines. Lazy, disagreeable, and evidently skilled only at gossip, Nurse Roberts is one of the most consistently negative nursing characters on television, though she is a very minor one.

A notable guest role on "Scrubs" was Rick Schroder's nurse Paul Flowers (yes, a male nurse named Flowers). Paul had an extended romance with Elliott in early 2003. The abuse directed at Paul and Elliott by the physician characters caught the attention of many real life nurses. Some were offended at the comic mileage the show got out of these slurs, noting that men were unlikely to want to become nurses in the face of such manhood-threatening abuse.

But not every depiction of nurses can be a recruiting ad, and the series clearly showed its contempt for those who made the negative comments. The anti-male nurse bigots were portrayed as childish idiots, while Paul was witty, secure, and fearless. He calmly dismissed the slurs and continued with his work and his romance with Elliott, easily outclassing the physicians around him. Even the inevitable breakup with Elliott did not seem to stem from any questionable factor, such as some stereotypical aspect of Paul, but from his too aggressive efforts to improve Elliott. If anything, that made him seem more like a real person, rather than Mr. Perfect. On the whole, the Flowers character seemed to be an admirable effort to explode stereotypes about male nurses.


Reviewed by Harry Jacobs Summers
Nursing Editor: Sandy Summers, MSN, MPH, RN
Reviewed October 2, 2003

The views expressed herein do not necessarily reflect those of the Board Members or Advisory Panel of The Truth About Nursing.

Also see the Center's write-ups of the January 30 and February 21, 2003 episode of "Scrubs" with Rick Schroeder guest starring as Nurse Paul Flowers.

Please send your comments on "Scrubs" to Executive Producer Bill Lawrence at Scrubs@NBC.com. When you do write, please blind carbon copy the Center at letters@truthaboutnursing.org. Thank you!

If you need help on how to write an effective letter, click here.

In your letter, consider using some of these discussion points (re-written in your own words):

  1. The nursing shortage is severe and getting worse. We need "Scrubs" and other popular shows to help us get the word out about why nursing is compelling work in which nurses work autonomously to save lives. Such messages should aid nursing recruitment, help the public understand nursing better, and lead to more resources being directed to nursing research, clinical practice and education.

  2. Whether the makers of "Scrubs" intend it or not, the show carries messages about who nurses are and what they do to many millions of viewers each week. A JWT Communications focus groups study from 2000 found that the 1800 elementary and high school students studied got their most striking visualizations of nursing from television. Unfortunately, the students knew more about television nurse characters' love lives than their professional lives.

  3. The show should consider creating more major nurse characters, such as Rick Schroder's Paul Flowers character. We need smart, cool, confident role models like him to help recruit more men into nursing.

  4. The show should consider portraying nurses at different points in the career track, such as nursing students, nursing managers, clinical nurse specialists and a director of nursing, as is already done with physicians. These different characters would help show how much knowledge and skill nursing requires, and how nurses save and improve lives.

  5. The show should consider showing nurses as supervising other nurses, instead of the inaccurate depiction of physicians supervising, hiring and firing nurses.

  6. The show should consider having Carla pursue a graduate education part-time, a possibility that the show itself raised last season. She might consider, or discuss with other characters, which of the many graduate nursing program options she might choose, such as nurse practitioner, clinical nurse specialist, nurse researcher, nursing faculty, nurse anesthetist, or nurse-midwife, and whether she should go for an MSN or a Ph.D.

  7. Be sure to let Mr. Lawrence and the other producers know what you like about the show's portrayal of nursing at the beginning (and end) of the letter, and thank them for their efforts.

 

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