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"It made me realize...what heroes doctors are"
Fall 2009 TV Preview
September 2009 -- The fall 2009 U.S. television season includes an unusually high number of health-related shows, and although one new show actually focuses on nurses and another on paramedics, overall the landscape seems likely to remain dominated by programs that reinforce the notion that physicians provide all important health care. Of the nine health-related prime time shows (including four new dramas) that are slated to start seasons in the fall or mid-season, regular physician characters appear to outnumber nurse characters by roughly 50 to 7. And four of those seven nurses are on NBC's new Mercy (premiering Sept. 23), which follows several nurses at a New Jersey hospital. Mercy will be the first nurse-focused regular season show to appear in more than 15 years. Previews suggest that it may actually show some nursing expertise and nurse-physician conflict, as on this summer's new shows Nurse Jackie and HawthoRNe, though Mercy seems to be more about the romance. The other new shows are adrenaline-fueled dramas that seem to want to be the new ER, which ended its 15-year run on NBC earlier this year. The new shows are Three Rivers (CBS, Oct. 4), which follows elite Pittsburgh transplant surgeons; Trauma (NBC, Sept. 28), a show about San Francisco paramedics and EMTs that manages to limit itself to just one physician and a paramedic with an MD; and a Jerry Bruckheimer project about an elite team of trauma surgeons that was called Miami Trauma (CBS, mid-season), but is apparently being reworked. Both Three Rivers and Miami Trauma have one nurse, but neither character seems likely to play an important role. The returning shows are the surgeon soap Grey's Anatomy (ABC, Sept. 24), with its unmatched line-up of 12 physicians and no nurses; the diagnosis-is-everything House (Fox, Sept. 21), with eight physicians and no nurses; the Grey's spin-off Private Practice (ABC, Oct. 1), with seven physicians and the novice nurse-midwifery student Dell Parker; the nasty plastic surgery drama nip/tuck (FX, Oct. 14), returning for a final nurse-free season; and the Lazarus-like Scrubs (ABC, mid-season), which will move to a medical school setting, with only two of its previous physician characters remaining as professors and a new crop of medical student characters, but apparently no nurses.
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Mercy's central character is Veronica Callahan, a tough young nurse who has just returned from a tour in Iraq, which the NBC web site says means that she "knows more about medicine than all of the residents combined." One preview shows her saving a person injured in a car crash using found materials that might impress Royal Pains concierge physician Hank Lawson. And it certainly does impress bystanders; when one asks where she learned to do that, she says "Iraq." We like the suggestion that nurses have startling expertise, but nursing skill is mainly the result of the college-level education and experience that all nurses get, not the happenstance that they have spent some time in a war zone, however useful that would be. And nursing doesn't really need hyperbole that may invite mockery (All the residents combined? Like maybe 30 residents in all specialties with a combined 50 years of clinical experience?). The other major characters are nurses Sonia Jimenez and Chloe Payne, who wears patterned scrubs, apparently the new Hollywood signal for "I'm a new and totally clueless nurse! Help me!" The show also includes a fourth nurse character, Angel Garcia, and physicians Dan Harris and Chris Sands, who was the married Veronica's boyfriend back in Iraq. (Yes, we can hear the boos from those who hated Nurse Jackie because of the adultery.)
Previews give cause for hope that Mercy will convey that nurses are skilled professionals who save lives and improve patient outcomes. Indeed, the previews suggest that the nurses may even save lives as part of their regular work, rather than only in rare field situations where there are no physicians. In one scene, Veronica rescues a patient from a morphine overdose caused by the clueless Chloe. It also seems that Veronica will not hesitate to give it back to physicians who aren't doing what she thinks they should (she tells one apparent resident that she wants him to be "better," and informs a disdainful patient that the nurses "do try to keep the doctors from killing you"). Another preview scene shows a patient informing Veronica that she is the only one who has treated the patient with respect. On the other hand, it's also clear that the show will be very much about the nurses' love lives. We hope their workplace skills appear in more than these few scenes.
Three Rivers seems to be a pretty standard heroic-surgeon show centered on a Pittsburgh transplant team at what the CBS site describes as "the top transplant hospital in the US." We say "team," and the show does include a character named Pam Acosta who seems to be a nurse. There is also an inexperienced transplant coordinator named Ryan Abbott, who has not been identified as a nurse, though these coordinators often are nurses in real life. But there is little doubt that the show is most interested in inspiring worship for renowned transplant surgeon Andy Yablonski and the remaining three major characters, all of whom are surgeons. The CBS site describes Acosta as Yablonski's "no-nonsense operating assistant and best friend," while TV Guide says she is "Yablonski's feisty nurse and confidant." So it appears that she is a nurse, although we guess she could turn out to be a physician's assistant. But either way, available promotional material pretty clearly paints her as Yablonksi's appendage, rather than as an autonomous professional. Previews, in which the Acosta character is hard to find, suggest that even the patient interactions outside of the OR will be overwhelmingly conducted by the surgeon characters. One preview includes a clip of the actress who plays one of the physician characters noting that working on the show made her "realize how fragile we are, but also what heroes doctors are." That likely sums up Three Rivers pretty well.
Trauma is an action-oriented NBC show about gonzo San Francisco EMTs that one executive producer says focuses on "the half hour leading up to the double doors of ER." There are no nurse characters, but one of the medics actually has an MD. According to the NBC site, character Nancy Carnahan got the degree "to make dad the doctor proud," but became a paramedic instead of doing an internship. Another major character is Dr. Joseph Saviano, "the godfather of San Francisco City Hospital," who treats Nancy "like a daughter," which appears to entail pushing her to step up to medicine. The site also informs us that Saviano treats the character who seems to be the lead paramedic like "his screw-up younger brother he knows could be a brilliant physician if he wasn't just this side of crazy." So it appears that one theme, a sadly familiar one for Hollywood paramedic characters, will be whether some of them have what it takes to ascend to the pantheon of physician gods. No indication yet whether any will aspire to nursing; previews suggest that the show views emergency care as basically about transferring patients from paramedic to physician. The previews also feature daring rescues, things blowing up, ER-style Big Vehicle Drama, and untreated adrenaline addiction.
Details about the CBS show that was to be named Miami Trauma are understandably a bit fuzzy, but it seems the show will focus on an elite trauma unit, particularly a former military surgeon and other surgeons who work to save patients in the "golden hour." According to the CBS web site, one character will be Tuck Brody, a "head nurse who keeps the doctors on track and the patients' families updated." But available previews, which obviously may not reflect what the show actually turns out to be, suggest that Brody will play no major role, and that the show will consist mainly of swaggering trauma surgeons saving lives pretty much by themselves.
Viewers can expect more of the same from the physician-centric returning shows, with the partial exception of the ABC sitcom Scrubs, which will undergo major cast changes and move to a medical school setting after eight years at Sacred Heart Hospital. Of that show's prior cast, only physicians Turk and Perry Cox will return as regular characters, playing professors. The rest of the regular characters will apparently be medical students. The show's former lead character, physician JD, and his girlfriend, physician Elliott, will appear in several early transitional episodes, but it seems that the show's one recurring nurse character, Carla Espinosa, will at most return for guest appearances. That is unfortunate, because although the show's portrayal of nursing was generally weak, Carla was a strong character who did occasionally convey something helpful about nursing, such as through her efforts to teach the show's resident characters. Without Carla, any depiction of nursing on the show is unlikely to move beyond the handmaiden image.
ABC's Grey's Anatomy remains popular heading into its sixth season, and it now features an astonishing 12 regular physician characters, all surgeons. In prior years of the show, nurse characters did occasionally appear, usually embodying stereotypes, particularly the helpless handmaiden and the bureaucratic battleaxe, which contrasted nicely with the awesome professional path that the show's smart, modern female stars had chosen. Perhaps as a response to nurses' objections to these portrayals, in late 2007 the show introduced a nurse character named Rose as a love interest for neurosurgeon Derek "McDreamy" Shepherd, as he struggled with his romance with the surgeon and central character Meredith Grey. Rose was not a total idiot, but she was still pretty weak compared to Meredith, and Rose crumbled and fled to a job in pediatrics when Derek returned to Meredith in 2008. Since then, the show has included virtually no nurse characters at all. We can't decide if this is a loss, since the physician characters always provided all the care that mattered anyway, including much of what nurses do in real life.
Fox's House is another popular show that is starting its sixth season without ever having a significant regular nurse character to balance its 7-8 physicians. Every episode of this show is a diagnostic mystery solved by a team of physicians led by the irascible genius Greg House. His team also tends to provide all meaningful care, including work that is really done by nurses or other medical specialists. Overall House has had even less nursing that Grey's. Mostly nurses are noticeable only when receiving the occasional mocking comment from House himself. But in the last couple seasons the show has offered a few plotlines that actually seemed intended to show that nurses might not be quite the morons House sometimes says they are. The most remarkable of these was a March 2009 episode in which the main patient was a nurse who believed that a cat had predicted her death. That sounds tailor-made for mockery, but the character actually displayed some expertise and went back and forth with House on matters of faith and predestination almost like a peer would. Nevertheless, we're not expecting a slew of strong, expert nurse characters on the show any time soon.
The Grey's spin-off Private Practice, starting its third season on ABC, focuses on an LA "wellness clinic" and features about seven major physician characters, led by "world class" OB/GYN Addison Montgomery. Nurse-midwifery student Dell Parker gets less attention than any other character, and early episodes of the show mocked midwifery and presented Dell as a receptionist and almost a complete health care novice, rather than someone in a graduate nursing program. In the second season, Dell got more respect--and even his own office!--and he was seen performing some procedures and showing some promise. Of course, the show still seemed to be suggesting that his main clinical training consisted of whatever ad hoc assistance he could offer the clinic's physicians. And the show (like Lifetime's Strong Medicine before it) seems to enjoy the idea that the male nurse-midwifery character is a hunky subordinate to powerful, expert female physicians. Still, with ER gone and Scrubs revamped, Dell seems to be the only regular nurse character on an established prime time show, and that has to be worth something--doesn't it?
Lastly, there is the edgy plastic surgery drama nip/tuck, which has finished filming a sixth and final season. The season's 19 episodes will apparently air in two groups, finishing in early 2011. The show centers on elite surgeons Sean MacNamara and Christian Troy, formerly of Miami, now of LA, who begin patient appointments this way: "Tell me what you don't like about yourself." The show has also included Liz Cruz, the anesthesiologist who practices with its two lead physicians. The show has never included a significant nurse character, and the role of nurses on the show has generally consisted of meekly absorbing operating room commands from the prickly surgeon stars. Here again, we would not expect to see much attention to nurses as the show nears its end.
Summing up
Aside from Mercy, the fall season seems likely to continue the overwhelming physician-centrism of recent years. See our handy chart showing the number of major characters on each show who are nurses and physicians, based on information currently available:
TV Show |
physicians |
nurses |
|
| Grey's Anatomy | 12 |
0 |
|
| House | 8 |
0 |
|
| Private Practice | 7 |
1 |
|
| Scrubs | 7 |
0 |
|
| Miami Trauma | 4 |
1 |
|
| Three Rivers | 4 |
1 |
|
| nip / tuck | 3 |
0 |
|
| Trauma | 2 |
0 |
|
| Mercy | 2 |
4 |
|
TOTAL |
49 |
7 |
The overall nursing portrayal, to the extent there is one, will suffer from the loss of ER's Sam Taggart, probably the strongest major nurse character of at least the last decade on the broadcast networks, although ER's overall portrayal of nursing was still inadequate. But of course, Mercy is actually focused on nurses. In addition, Three Rivers and the show formerly known as Miami Trauma also seem to have one nurse character each. Of course, it's not clear what those shows will actually tell viewers about nursing, or if any of the shows will be around next year. And it would take many years and many shows to counter the hundreds of hours of powerful disinformation conveyed by shows like Grey's and House, which are popular around the world.
In the meantime, tell Hollywood what you don't like about your TV self.
Please help us monitor the media!
We have a tiny staff at our international headquarters and cannot monitor all the media before us. We plan to watch every episode of Mercy, Three Rivers, Miami Trauma and Private Practice, since it appears that each of these shows will have at least one significant nurse character. But we don't have the resources to watch every episode of the remaining shows. We are looking for dedicated monitors to watch any one (or more) of the other shows and report back to us if there is a notable depiction of nursing. We will record the shows, but will probably not watch unless you alert us that there is something of interest. Please help us build our cadre of media observers! Email us at info@truthaboutnursing.org if you can volunteer. Please send us your name, credentials, and contact information. If you wish, we will post your name as our monitor for the show; of course we will keep your contact information confidential. Thank you in advance for your help!
Grey's Anatomy volunteers:
awaiting volunteers
House volunteers:
Patricia Crews, nursing student
Scrubs volunteers:
awaiting volunteers
Trauma volunteers:
awaiting volunteers
nip/tuck volunteers:
awaiting volunteers
Please volunteer to be a media monitor!
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