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Archived Scrubs Review (2003-2004 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 better sitcoms to debut in recent years. An irreverent, at times 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 far less impressive. It does have a major and positive nurse character in Carla Espinosa. And a few 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. But in other ways the show reflects the prevailing Hollywood vision of nurses as peripheral health workers who report to physicians and need to know their place. Indeed, the nurses' lives often seem to revolve around those of physicians, who are seen as the providers of most if not all 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. A good example of the show's not-for-everyone comic sense was J.D.'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.

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 three 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, and at the end of the third season they finally married. J.D. and Elliott, who had flirted from the beginning, spent some time as "sex buddies" until Elliott pulled back. J.D. became convinced that Elliott was the woman for him, but after finally working up the courage to tell her at the end of the third season, causing her to dump her current boyfriend, J.D. realized that she wasn't the one after all. Cox now appears to be back together for the long term with ex-wife Jordan (Christa Miller Lawrence), whose ultra-nastiness matches his own, and whose new baby turned out, unexpectedly, to be fathered by none other than Cox himself.

The show has made frequent use of guest stars, though they appear far more commonly as physicians than nurses. Rick Schroder appeared in several early 2003 episodes as confident, witty and sensitive nurse Paul Flowers (yes, a male nurse named Flowers), 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 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

At times, "Scrubs" seems a little better for nurses than most current serial television. It features a major, positive nurse character in Carla Espinosa. It has at least touched on some real nursing issues, including the decision to become a nurse practitioner, bigotry towards male nurses, and nurses' informal teaching of residents.

Unfortunately, the show suffers from "Marcus Welby Syndrome," in which physicians are shown directing if not providing all meaningful health care. The show's vision of physicians as comically flawed but still dominant heroes is underlined by the theme song ("I can't do this all on my own/No, I'm no superman"). This associates the young physicians with a teamwork message, as if their development involved learning that however wonderful they are, they at least need some help. This is the same message commonly addressed to preschool children, as in, for example, recent "Rescue Heroes" products. But "Scrubs" viewers are unlikely to see this as a subtle dig at physicians. Instead, most probably will get that the key issue is the extent to which physicians are "supermen." Even framing the issue that way reinforces the notion of physician primacy in health care. Moreover, based on what actually happens on the show, the help the song lyric envisions would probably come mainly from other physicians. And suggesting that nurses exist to help physicians would not be helpful in any case.

Moreover, the show seems to regard nursing as a fairly low-skilled and peripheral job. It does not give much sense of the range of nursing practice, or nurses' central place in hospital care. We do not often see Carla actually give or discuss nursing care, in contrast to the physicians, who do manage to treat and discuss patients despite the constant hijinks. Likewise, though the professional development of the physicians is often the show's main topic, the development of the nurses is almost never mentioned. And the show has on occasion indulged in the naughty nurse stereotype, in fantasy sequences based on the characters' overworked imaginations.

As on other television series, "Scrubs" physicians are shown supervising nurses, and nurse managers generally don't exist. One late 2003 episode, which purports to teach Carla that nursing is all about doing what physicians tell you, is one of the most virulently anti-nurse TV episodes we have ever seen. In the episode, after a patient has an adverse reaction to a medication Carla recommended to Elliott, Elliott and Turk persuade Carla that physicians are in charge of nurses, that it is the nursing role to follow physician "orders" without question, and that nurses should be happy to accept their subservient role as brainless physician helpmates. Another episode shows Kelso firing the nurse who had made Cox's favorite cup of coffee, which suggested not only that Kelso could actually do that at will, but that nursing involves making coffee for physicians.

In fairness, Carla is often portrayed as strong and competent, and she is probably the most prominent Latina nurse character in modern US television history. She is the only major character on the show 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. As with other television nurses, a major theme has often been Carla's romance with a physician. However, at times the focus is at least somewhat on her nursing. 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 then-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.

As if to balance Carla's fairly 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, as discussed above. 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
Review last updated August 25, 2004

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

Also see our "Scrubs" news page where we write up various episodes.

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!

See the current review or the 2004-2005, 2003-2004 (this one) or the 2002-2003 edition of the "Scrubs" review.

 

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