Changing how the world thinks about nursing

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Falling without style

October 9, 2006 -- One of the main characters in NBC's new primetime hit "Heroes" is New York City hospice nurse Peter Petrelli. Peter is one of the "ordinary" people who reveal special powers that will help them save the world from an impending crisis. Peter is starting to realize that he can absorb the powers of others; initially, his brother's ability to fly. Sadly, the September 25 series premiere presents hospice nursing as a dead-end job for dreamy, unduly self-sacrificing losers. The episode, "Genesis," was written by show creator Tim Kring and seen by more than 14 million U.S. viewers. It has a couple generic references to Peter's skill as a nurse. But the rest of the show emphasizes the outright contempt Peter's successful family has for hospice nursing, which they say consists of just sitting with the dying. And far from defending his profession, Peter seems to agree. He ultimately vows that he is going to stop living for other people, and now it's his turn to "be somebody." Then he launches himself off a building. So nurses can be heroes...if they can fly! So it is no surprise that in tonight's third episode, Peter--determined to focus full time on his power--quits nursing as if it was a minimum wage temp job, rather than a professional career that requires years of college-level education.

The basic idea of "Heroes" is that a seemingly random group of individuals emerges with diverse "special" abilities, generally one per hero, that herald the coming of a new era in human development. Their talents include teleportation, seeing the future, mindreading, and physical indestructibility. Predictably, they pretty much come from the United States, though one is a Japanese office worker, and the paranormal-obsessed academic figuring it all out is Indian. The teleportation plotline includes many "Star Trek" references, but the show seems to owe much more to "X-Men" and "The X-Files."

In the premiere, we see Peter standing at the edge of the rooftop of a 15-story building, with flying on his mind. But it turns out this is a dream. He has just dozed off while working at the home of an older patient, who is now unconscious. (Peter also dozes off in a cab and has a similar dream; in case we missed the point, Peter's brother later suggests he's "dreamy.") Peter's hospice patient has an adult daughter, Simone, and it is she who wakes Peter up. Simone asks how her father is doing. Peter, putting aside a newspaper, says her father likes Peter to read him the "stock page." Peter estimates that her father may have a couple more days to live. Simone says that she doesn't know what her father would do without Peter: "You've got a real gift." Peter says he's just doing his job, but she insists he's "like a son" to her father. Peter: "That would make us like brother and sister. It'd be a little awkward if I ever wanted to ask you out." Simone smiles, but Peter apologizes for the "inappropriate" comment. She disagrees, saying it's "sweet" (sweet?), but she's seeing someone else. Peter starts to change the patient's IV.

Later, Peter's interactions with his brother Nathan and his mother reveal how the show really feels about his work. Nathan is near the end of a campaign for Congress. The brothers are distressed to learn that Mom has been arrested for shoplifting, even though their recently deceased father left her "a fortune." It turns out that she wanted some attention. At the police station, Nathan is mostly afraid of what it could mean to his campaign. Peter assures him that Peter will handle their mother's problem.

Peter and Mom proceed to have a heart-to-heart. When Peter remarks that Nathan cares only for himself, Mom says his father was the same kind of "alpha dog," but as for Peter, "for all your selflessness and sitting with dying people...what? You gonna retire on what you make?" Peter says maybe he'll shoplift. That's not a bad line, but Mom is relentless: "When you put everyone else first, you end up last. You always put Nathan first, he took advantage." Peter feels she's being "cruel," but Mom says she's "sorry if the truth hurts. I'm just saying you hero-worshipped him. And those feelings were never returned."

Later, we see this fraternal dynamic at Nathan's campaign headquarters. Nathan wants to give Peter a job coordinating volunteers in the final days of the campaign. Peter's "nice guy" persona will reflect well on Nathan. Nathan admits that "sounds self-serving, but this is for you too, right? You gotta think of your future." Peter notes mildly that he "already [has] a job." (Way to sell it, Peter! "Hospice nursing--a career that's a job!") But Nathan is ready for Peter's spirited defense of the value of end-of-life care. Nathan sets Peter straight:

Yeah, watching old people die, now there's a career. It's not cute anymore, man--the dreamy kid, sitting in the back of the classroom, staring out the window. It's time for you to grow up.

Peter looks hurt, but has no response. Nathan admits he "cast[s] a big shadow," but, well, life isn't fair, and now he's trying to "do the right thing" by poor little brother Peter. But Peter says he doesn't want Nathan's pity, and he leaves. So there.

Near the end of the episode, Peter gets a call from Simone. He finds her at her father's place, frantically searching for morphine. Peter is a little bit curious why, but he's more interested in getting something off his chest:

I need to tell you about this. I need to stop living for other people. My whole life--I have no idea what I'm supposed to do, what I'm supposed to be. I don't have a destiny of my own!

Simone says they'll talk later about that, but for now, she needs him to come help her artist boyfriend, because "[y]ou're a nurse, you can give out a shot, you can help him."

When they arrive at her boyfriend's apartment, Simone calls out that she has brought "a nurse" to help. But the boyfriend seems to be unconscious on the floor, presumably from a heroin overdose. Peter takes a few seconds to feel the boyfriend's neck pulse and listen to his chest. Peter says, "he's alive, call 911," then immediately becomes distracted by one of the artist's paintings--one that seems to show someone very much like Peter flying/falling. Peter gets up and wanders over to the painting, totally abandoning the freaked Simone and her semi-conscious boyfriend. Simone can barely keep it together as she talks to the 911 operator. Peter just stares at the painting. That dreamy nurse!

The last scene finds Peter actually at the top of the building from his dreams. He has called Nathan, who arrives below. Peter says he's been up there all night thinking about his "destiny": "It's my turn to be somebody now, Nathan." Peter steps off and falls straight down, but Nathan himself flies up into the air and catches him. They struggle to hold onto each other, and Peter does seem to have some ability to stay up on his own, but Nathan can't hold him, and Peter seems to fall. (He'll be fine, though his action does invite psychiatric scrutiny in the second episode.)

If there are any small bright spots in this portrait of the hospice nurse as a young loser, they're in the scenes with Simone. She does seem to value what Peter does, crediting him for his "gift" in being able to help her father. And she also believes that he has skills that can help her boyfriend, though these seem to be limited to giving a shot of morphine. Peter can also predict how long her father might survive, hang an IV bag, and determine that her boyfriend is alive. He reads to her father, valuable care for a terminal patient, though few viewers will see it as anything more than a good "son" would do.

But these scenes don't begin to show the real skill and importance of a hospice nurse. With Simone's father, Peter falls asleep while supposedly working, suggesting that hospice nursing is pretty much dozing with the dying, as Peter's family says. Peter apparently leaves morphine lying around unattended at Simone's father house. Perhaps the worst part of the Simone scenes is what Peter does with her boyfriend--virtually nothing. This nurse's care for a heroin overdose consists essentially of telling the distraught girlfriend to call 911, then going to stare at a painting that might tell him something about his struggle to actually "be somebody."

The episode as a whole denigrates hospice nursing. Peter simply absorbs contempt from his family. They see his work as low-paying and excessively self-sacrificing, a job for hero-worshippers who haven't grown up. As Nathan suggests, it's like sitting in the back of a classroom and looking out the window. We get no sense that Peter has real technical skill, nor that his care requires initiative or critical thinking. He passively "sits" and "watches" people die. We do not see that hospice nurses deploy a wide range of skills to help their patients, including advanced pharmacological and psychosocial skills. We do not see that they are autonomous professionals whose work requires great strength, and there is no indication that nursing requires years of college-level education. And although no one raises Peter's gender directly, we note that the faults his family finds in hospice nursing are qualities that have traditionally been less accepted in the work of men.

Peter himself seems to share his family's views. At first, his response to them is merely to look hurt, or say that the comments are "cruel" and that he doesn't want "pity." In other words, the comments are not necessarily incorrect, just mean. Later it becomes clearer that Peter agrees. He tells Simone that he needs to stop "living for other people," that he has no "destiny" of his own. Before jumping off the building, he announces that now it's his "turn to be somebody." As a hospice nurse, clearly, he is nobody.

As it happens, some nurses have raised the idea that a significant number of them may have chosen the profession in part because of an excessive need to derive feelings of worth from serving others, perhaps stemming from troubled relationships early in life (see Save the First Dance for You). There has been discussion of what nurses might do to balance the interests of others with their own legitimate interests. It may be that being too devoted to the interests of others could, in the long run, make one a less effective health care professional, perhaps by inhibiting nurses from advocating for themselves, contributing to burnout, or placing undue stress on their personal relationships.

But it is a far cry from making such observations about the possible motives and issues of some nurses to condemning their entire profession as a dead-end job for people who have no lives of their own. Nurses have saved or improved hundreds of millions of lives, and those lives are no different because some of the nurses may have been driven by childhood traumas or deficiencies. To paraphrase David Letterman in the wake of 9/11, fake courage is pretty much as good as the real thing. Likewise, great nursing by flawed people is still great nursing.

Of course, it seems unlikely that the creators of "Heroes" have thought deeply about this. More likely, they just figured no one with any real ambition or initiative would waste his time sitting around and watching people die. Hospice nursing easily fit the bill for the job of an "ordinary" person. But anyone who wants to make something of his life--to say nothing of being a "hero"--will naturally steer clear of it.

And as if to confirm this, in the third episode of "Heroes," Peter tells Simone that he has quit his job caring for her father. She has concerns about her father's care, but he assures her that he just showed his replacement what's what, and that she will be fine. Peter tells Simone that he's been trying to save the world one person at a time--not the worst description of clinical nursing--but he now realizes he's destined for something bigger.

We can't object to someone quitting nursing to "save the world." But Peter does it in a way that confirms everything the premiere told viewers--that nursing is a low-skilled, low-paying job that people abandon with little more than a backward glance. No one in "Heroes" asks Peter whether he's sure he wants to quit after all the years he spent in college training to be a nurse. And although Simone values Peter's brief relationship with her father, it really seems to be more as a kind "son" than a skilled professional.

Like Peter, Hollywood seems able to absorb many aspects of the surrounding world. We wish the truth about nursing was among them.

You can contact the show at:

Tim Kring, creator
Heroes
NBC Universal Television
3000 W. Alameda Ave.
Burbank, CA 91523-0001 USA
Phone: 818-840-4444
http://www.nbcuni.com

 

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