|For immediate release
August 23, 2006
Nurses "Tax" Emmy Swag--Backgrounder
All of the most influential hospital shows--"Grey's Anatomy," "House," "ER," and "Scrubs"--are up for awards at the 2006 Primetime Emmys. The Center believes that the overall nursing portrayals in these shows range from fairly poor to very poor. And shows that only occasionally feature poor nursing images, such as "The Sopranos" and "Six Feet Under," are also key nominees. Research indicates that Hollywood shows influence how viewers think and act in health matters, and in particular, that they create the most striking impression of nursing for our school children. Hollywood shows like those listed above are shown around the world, and so they affect how hundreds of millions of people see nurses. Because resources are allocated in accord with these flawed views, the undervaluation of nursing is a key factor in the shortage that is taking lives around the world. The Center hopes to see nurses portrayed as the serious professionals they are, not as silent handmaidens and losers. And while we appreciate all the nursing that appears on shows like "House" and "Grey's Anatomy," we would like to see it being performed by nurse characters, rather than physicians.
"Grey's Anatomy" does not just ignore nursing, depict nurses as fawning or bitter losers with no significant role in hospital care, or have its nine physician characters spend half their time doing key care tasks that nurses really do. Shonda Rhimes's show also makes a point of attacking the profession, relentlessly. The very embodiment of superficial, "dress for success" feminism, this huge prime time hit has perhaps shown more express contempt for nursing than any other show in U.S. television history.
The May 15, 2006 two-hour season finale of ABC's "Grey's Anatomy" featured a remarkable level of physician nursing, even by the no-nurse standard the show has maintained since its two January 2006 nursing strike episodes. Those episodes now seem like a token effort to get nurses off the show's back, so it could go on with its inaccurate and damaging portrayal, regardless of the central role nurses actually play in hospital care--a reality that seems to be no more than a minor inconvenience to the show. In the finale's main care-related subplots, physician characters do everything that matters, with no nurses in sight. And an enormous amount of what they do would have been done by nurses in real life. Physician characters do all patient monitoring, all patient emotional support, all family relations, all patient advocacy, and virtually all supportive and therapeutic care. When a nurse does briefly appear, she is presented as a timid physician lackey. more...
The hit show's six brilliant physician characters constantly do key care tasks that nurses do in real life. The rare nurse characters tend to be silent, barely visible clerks, like wallpaper that assumes human form to move or hold objects. Although the show has mostly pretended that nurses do not exist, recent episodes indicate that its physician heroes consider nurses to be unskilled clean-up staff, "nurse-maids" who are good for handling stool and patients who have fallen down.
The 2005-2006 season's final two episodes of Fox's popular "House" featured the usual high level of physician nursing. The show seems to care only about physician diagnosis, but that has never stopped its brilliant physician characters from providing all key bedside care. Here, one physician even helps a post-surgical patient walk around and use the toilet. On the rare occasions when nurses appear, they often seem to be summoned into existence literally out of nowhere by the physicians to silently do a simple physical task. Such "House" nurses are nothing new, and we've referred to them as "wallpaper nurses." But given the metaphysical musings of the season finale--and House's own reference in the prior episode to the number 613 as "Jewish," presumably because the Torah has 613 commandments--these nurses reminded us more of the golems of Jewish folklore. Golems are mute, brainless humanoids crafted from inanimate material for basic tasks by the wisest and holiest, notably early rabbis: assistive creations of the most godlike. Now, can we think of any characters on "House" who might be described as godlike? more...
"ER" is arguably the best major health care-related television series since "M*A*S*H," and it is one of the most medically realistic dramatic series ever. When "ER" leaves prime time after well over a decade on the air, it will also have been one of the most popular shows in history. And it will likely continue for years in syndication in the U.S. and around the world. Accordingly, it will continue to have a tremendous influence on how the global public views health care, including nursing. "ER" has generally portrayed nurses as competent, caring health workers and avoided the worst stereotypes. But the show's physician-centric approach has led to a continuing failure to give viewers an accurate or complete picture of the vital role nursing actually plays in modern health care. The few nurses who emerge from the "ER" wallpaper are skilled but essentially fungible, serving mainly as subordinates and romantic foils for the heroic physicians. See our full series review or individual analyses of episodes.
"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. See our full series review...
Two late episodes of HBO's acclaimed series about the funeral-directing Fisher family present nurses as handmaidens, silent or petty, assisting the physicians who provide all important care. Perhaps nursing's perceived marginal importance helps explain why one major character gleefully abandons her nursing career to work in her husband's funeral home with no more than a backward glance. These episodes suggest that when it comes to an understanding of nursing, dramatic sophistication doesn't count for much. See our analyses of "Ecotone," July 31, 2005, and "Everyone's Waiting," Aug. 16, 2005.
Episode 68 of HBO's "The Sopranos" portrays ICU nurses as nasty, rule-bound physician subordinates who actually impede the psychosocial care of the gravely wounded Tony Soprano and his distraught family. Unlike the battleaxe nurses, all the physicians are seen as expert lifesavers who direct the important care. See our full analysis of "Mayham" episode that aired March 26, 2006.
The Center for Nursing Advocacy, founded in 2001, is a Baltimore-based non-profit that seeks to increase public understanding of the central, front-line role nurses play in modern health care. The focus of the Center is to promote more accurate, balanced and frequent media portrayals of nurses and increase the media's use of nurses as expert sources.
For more information, please contact:
Sandy Summers, MSN, MPH, RN
The Truth About Nursing
203 Churchwardens Rd.
Baltimore, MD, USA 21212-2937