Nursing at the Love Ranch
June 14, 2010 -- Tonight the actress Helen Mirren appeared on CBS's Late Show with David Letterman to promote her new film Love Ranch, which is about a brothel in Reno. In describing a real brothel that she visited to do research, Mirren said that the prostitutes there were very sweet and welcoming. Letterman noted that some people argue that prostitutes are the victims of something that has led them to do this work. Mirren agreed that many of them are "damaged" and "come from dysfunctional backgrounds," but she also observed that "a lot of girls who work in that industry actually come from the nursing industry, which kind of makes sense, because they're used to naked bodies, it's not intimidating to them, you know, the body and the bodily functions, if you like." Letterman responded that that must mean a "guy like" him could visit the brothel for a "check-up." We assume that there is some basis in Mirren's personal experience for her comments, but we're not aware of any data showing that a disproportionate number of prostitutes first became nurses. Suggesting as much reinforces the naughty nurse stereotype that has undermined nursing for decades, not least because of the activities of the "film industry." And it's not helpful to have a celebrity compare nursing care directly to acts of prostitution. We'll resist analyzing whether prostitution has more in common with nursing or acting, and just note that our understanding is that what prostitutes do tend to have in common is a history of serious abuse and few other skills. It seems unlikely, to say the least, that many "girls" with valuable nursing skills would become prostitutes. Of course, nurses do use those advanced skills to help prostitutes cope with the consequences of their dangerous work. We urge the famously candid Dame Helen to think more carefully before making statements that damage nursing.
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See the film clip below and our analysis following it.
During the discussion of the brothel visit, Mirren told Letterman that the madam, Susan Austin, was great and really helpful. Mirren said she spent the evening following Austin around.
Mirren: It was a really great experience, the girls were fantastic, really sweet, really welcoming--of course they are, that's what they're good at!
Letterman: When you have this discussion, one side will say, but they are actually the victims of this, or victims of something in their lives that have led them to this. What sense did you get of them when you were there?
Mirren: I think that's true. You know, a lot of them are damaged. They come from dysfunctional backgrounds, and that's what's led them to this place. But also, you know, a lot of girls who work in that industry actually come from the nursing industry, which kind of makes sense, because they're used to naked bodies, it's not intimidating to them, you know, the body and the bodily functions, if you like. [Audience laughter. Mirren smiles and points at Letterman.] He's having a serious conversation, don't laugh. I think he's being serious.
Letterman: So, a guy like me could go there for a check-up, then. [Audience laughter.]
Mirren: Yeah, you could, absolutely.
We're not sure what brothel Mirren visited, but Susan Austin is the Madam of the Mustang Ranch and Wild Horse brothels. These brothels have significant Internet presences, and there is a good deal of information about the prostitutes' physical attributes and activities, but to our surprise we found nothing about their apparent nursing backgrounds.
More generally, we're not aware of any data showing that prostitutes come disproportionately from nursing or any other "industry." We do understand that prostitutes often come from backgrounds that include long-term abuse, and that they often have few other work skills. Because of this skills deficit, most prostitutes have few other work options--unlike registered nurses, who remain in demand in the midst of a global shortage. Maybe someone at the brothel told Mirren that some prostitutes were "nurses." Maybe she even met prostitutes who said they were once in "nursing." Of course, "nursing" can encompass workers with a wide range of skills and training, including nurses' aides with as little as a few weeks of training, so it's hard to say what "nursing industry" might mean in this context.
The notion that nurses might become prostitutes partly because they are used to naked bodies is an interesting one, but we know of no support for it. Nursing does not need another suggestion that acts of nursing are like acts of prostitution because both require comfort with naked bodies. Physicians are also familiar with bodies; are they also more likely to become prostitutes? Or is it just nurses, because we all know they're subservient, low-skilled females with few good options? It seems very unlikely that many people with significant nursing training would become prostitutes. At best, Mirren seems to be generalizing from a small and vaguely defined sample. At worst, her claim suggests that prostitution is actually a step up from nursing, since "a lot of girls" in nursing supposedly made that job change (of course, the comment could also mean the job changers could not handle nursing). It seems to us that the real relation of nurses to prostitutes is that nurses try to help prostitutes cope with the many hazards of their work, from emergency to community health settings. Kenyan nurse Elizabeth Ngugi has been a global leader in pioneering better ways to study and treat prostitutes with HIV.
Mirren's statements might not be such a big deal if not for the history of nursing, particularly the naughty nurse stereotype of the last few decades, which in some places includes an apparent belief that nurses are prostitutes. If Mirren had claimed that many prostitutes are accountants or pastry chefs, it seems unlikely that it would do much harm to those professions because there is no relevant stereotype. Nursing has always had to deal with society's discomfort with the idea that nurses provide intimate care to strangers. The naughty nurse image is one response to this, and to the fact that historically nurses have been mostly females who are perceived as subservient and low-skilled, yet may temporarily have some power over male patients. Clearly, such females need to be reduced to stereotypical feminine extremes, so that the natural order is restored. In view of all this, celebrities today cannot just assert to millions of television viewers that many prostitutes are from the "nursing industry," and that their nursing background prepares them to be prostitutes, without strongly reinforcing the naughty nurse stereotype, which in turn undermines real nurses' claims to adequate resources and respect.
Letterman's joke about getting the "check-up" was virtually a mandatory response for a comic (it's probably required in his contract). The talk show host has a mixed history with nursing. He paid tribute to nurses following his heart bypass surgery some years ago, yet his show has also relied on the naughty nurse image. And his response to Mirren here arguably cuts both ways too. On the one hand, it obviously underlines the actress' suggestion that nursing and prostitution blend together, and it does not directly question the basis for her comments. But his response does suggest that nurses have some skill, or else they would have no ability to provide a "check-up." And it's possible to read his remark as questioning the credibility of Mirren's comment; maybe he actually found it hard to believe and was poking fun at it, however ambiguously. In any case, we don't hold Letterman primarily responsible for this exchange.
We urge Dame Helen to apologize for suggesting that nursing is like prostitution, and to consider more carefully before making generalizations that reinforce the naughty nurse stereotype.
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Dame Helen Mirren
Ken McReddie Associates Ltd
11 Connaught Place
London, W2 2ET