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Scrubs (2001-2010) Archive 2004-2005 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

See our single episode reviews

Summary

"Scrubs" remains one of the better sitcoms to debut in recent years, though it has clearly lost some steam in recent seasons. An irreverent, at times hilarious show with gifted actors, it poses the question: what if a hospital was staffed by insult comics? "Scrubs" has trained its lacerating wit mainly on the professional and personal lives of several young 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 J.D.. 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 has been 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 on the whole the show continues to reflect the prevailing Hollywood vision of nurses as peripheral health workers with limited skills who report to physicians. 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 young physicians at Sacred Heart Hospital. They are 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 surgeon; and the insecure, odd 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. However, they have become close friends. 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 regularly does battle with Cox. Neil Flynn plays a hospital janitor (known only as "The Janitor") who often takes offense at J.D.'s insensitivity and exacerbates his neuroses. The Janitor has increasingly spent time playing juvenile power games with the male physicians. Minor recurring characters include Nurse Roberts (Aloma Wright), whose work consists mostly of sitting around and fulfilling stereotypes, and the crude, comically arrogant surgeon Todd (Robert Maschio).

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.

Over the course of "Scrubs"' first four 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. then 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 then-boyfriend, J.D. realized that she wasn't the one after all. His mishandling of this poisoned his relations with Elliott for some time. 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. At the end of the fourth season, the main characters finished their residencies. Turk and Carla's marriage seemed to have survived serious early difficulties, including adjustments to Turk's recently diagnosed diabetes, and uncertainty as to whether their romance was really strong enough. One result of these marital struggles was that J.D. finally moved out of the apartment they had all still shared. Elliott, having gained some professional confidence, appeared to be accepting a position at another hospital.

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, especially in its earlier years, "Scrubs" seemed a little better for nurses than most current serial television. It featured a major, positive nurse character in Carla Espinosa, and it 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. One early episode was called "My Nightingale" (most of the episodes are entitled "My _____", with the pronoun referring to J.D.). In this episode, the young residents relied on Carla's health care knowledge on a night when there was no attending on duty. 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.

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 flawed but still dominant heroes is underlined by its theme song, whose lyrics are: "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 still need some help. This is the same message often addressed to preschool children, as in, for example, recent "Rescue Heroes" products. But "Scrubs" viewers are unlikely to see it as a subtle dig at physicians. Instead, most will likely see the key issue as the extent to which physicians are "supermen," which reinforces the notion of physician primacy in health care. Moreover, based on the show's content, the help the song envisions would probably come mainly from other physicians. And suggesting that nurses exist to help physicians is not a good thing in any case.

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 often manage to treat and discuss patients despite the constant hijinks. Likewise, while 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.

Early 2005 episodes offered somewhat more nuanced visions of physicians directing nursing care. One featured code scenes in which omniscient physicians issued flurries of commands to expectant nurses, who then leapt to carry them out, displaying little autonomy or expertise. The scenes suggested that nurses have some technical knowledge, but that they are heavily reliant on physician direction--they report vitals and await orders. J.D. at first struggled with this superman role, but there was no indication that experienced nurses would be able to help him make decisions in codes, as is actually the case. Another troubling 2005 episode actually had Cox assign nursing tasks to Turk as a result of short-staffing caused by a SARS quarantine. In doing so, Cox impugned Turk's masculinity, and joked that he should give his "special sponge baths" and a "happy ending" if the patient so desired. Beyond the harmful association of nursing with submissive female sexuality, this wrongly suggests that physicians can and do manage nursing care. In that same episode, Carla tries to get Turk to help her. When Turk says he doesn't "have the expertise" to redress bedsores, Carla says that "any idiot can be a nurse." When he agrees, she shoves him, and he sees that she has trapped him. We get that she disagrees with his view, but not why, and the episode does nothing to disprove what he has said, leaving viewers to conclude that Turk is not very tactful, but he may be essentially right about his wife's job.

Carla has been central to a number of plot lines, but in accord with prevailing Hollywood practice, the focus is generally on her personal life and not her nursing. And as with other television nurses, a major theme has often been Carla's romance with a physician. One episode did involve 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.

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.

That is not to say that the Flowers character's understated reaction to the slurs is one we would recommend for nursing as a whole. In this one isolated case, the character had a writer, director, and actors all working to send the message to the viewer that he was a formidable guy and the physicians were idiots to give him a hard time. Real nurses do not enjoy those advantages, and in the real world, failing to counter ignorance and bigotry can breed or at least allow more of it. The average week of US network television includes hours of persuasive programming telling tens of millions of viewers that nurses don't matter, and there is no viable chance for nurses to counter that. No one spends an equal number of hours each week immersing those viewers in compelling depictions of how vital and complex nurses' work really is. Indeed, nursing has generally taken the "just say nothing and rise above it" approach, and we can see the results in the staffing crisis, the lack of adequate resources for nursing research and education, and the fact that even today, less than 6% of US nurses are men.

On the whole, "Scrubs" is not the worst show on television for nursing. But it's far from being superman.

Reviewed by Harry Jacobs Summers
Nursing Editor: Sandy Summers, MSN, MPH, RN
Review last updated December 22, 2005

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

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For archive purposes, you can click here to see the current Scrubs review, 2003-2004 or the 2002-2003 editions of the "Scrubs" reviews.

 

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