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Article summary of "A comparative analysis of nurse and physician characters in the entertainment media," by Kalisch and Kalisch

A detailed summary of "A comparative analysis of nurse and physician characters in the entertainment media." From the Journal of Advanced Nursing, 1986, vol. 11, pp. 179-195 by Philip Kalisch and Beatrice Kalisch. [An analysis of 670 nurse and 466 physician characters portrayed in novels, motion pictures and prime-time television series, published or produced from 1920-1980.]

Results from the study

"An analysis of these data over time points to a steady and unmistakable decline in the mass media entertainment image of nurses while physician characters have remained consistently high or shown improvement."

Compared to physicians, nurses in novels, movies and television were:
  • less central to the plot ("nurses are not as essential or important in health care")
  • less intelligent
  • less rational
  • less individualistic
  • less driven
  • less nurturing (in television)
  • less empathic (in television)
  • less helpful to patients (in television)
  • less likely to exercise clinical judgment
  • less likely to value service
  • less likely to value their careers
  • less likely to value scholarliness and achievement
  • less likely to receive praise for their professional behavior
  • more submissive
  • Media nurses were female (99%), under 35 years old (63%), single (71%) and childless (89%).
  • Media physicians were male (93%) and were significantly older, wealthier and more likely to be parents than nurse characters.

"[The] nurse momentarily in the background carrying a tray, pushing a wheelchair or holding a chart has become a media staple, while significant leading roles for nurses have experienced a steady and alarming decline. Female physicians take on more and more of the female roles in the health care genre."

"The evidence is substantial" that "the contribution of the nurse to health care...has been distinctly underplayed and conversely the role of the physician has been presented in an exaggerated, idealistic, and heroic light."

Upon analyzing this data, Kalisch and Kalisch coined the phrase--"The Marcus Welby syndrome" to describe a set of characteristics common on television which was amplified in the 1970's. Fictional Marcus Welby provided "outstanding medical care and nursing care" including medical diagnosis and treatment, surgery, and also the nursing tasks of preparing patients for surgery, providing 24-hour surveillance, home visiting, emotional support, health teaching, and supervising the hospital nursing staff.

Plot lines were written to portray a medical story rather than a nursing or combined health care story. Only one aspect of the nursing role--meeting the needs of "fundamentally medical problems"--is consistently portrayed, which represents a biased and systematic exclusion of all other nursing roles. "The flattering frequency with which nurses appear in the entertainment media is ultimately deluding: they appear not as they are, certainly not as they would define themselves, but as conveniences to the resolution of physician' dilemmas." "[This leads people] to believe that no special body of nursing knowledge and skill exists and that physicians can step in at any point in time and provide excellent nursing care. This also reinforces the damaging stereotype that nursing is the lower part of the medical profession."

"Stereotypes influence how consumers view nurses...[and] also impact the images nurses hold of themselves." "When society gives its sanction, even praise, to stereotyped images of nurses, the nurses who work in that culture form their own self-images accordingly. Stereotypes may become, by a sort of perversity, an image of reality that even nurses seek to perpetuate." "Related to this fact is that authors, producers, directors and scriptwriters may actually avoid the notion that the current nurse image may be stereotyping and demeaning, and that other approaches could work as well or better, because the current approach is ultimately a reinforcement of their own prejudices. To change the method would need a counter-change, a reformation of their own attitudes which would be cognitively discomforting." When the mass media embodies these values and sustains these ideologies, this favors "the interests of physicians rather than nurses" and maintains "inequalities between medicine and nursing."

"Current depictions of nurses in the mass media are serving to seriously undermine the potential contribution nurses can make in health care." "It is essential for the future of health care in this nation that the mass media begin to light the way for nurses and nursing even if this does require a diminishment of the intensity of the halo that the media physician has worn in recent decades."

Evidence that the portrayal of nurses in the mass media affects the image of nursing

"The mass media have an enormous impact on the formation of images, largely on the unconscious level." "Adults who view a large amount of health care dramas on television...have been found to have more faith in physicians' abilities to help them than those who view no or very few of these dramatizations (Volgy & Schwartz 1980, Gerbner et al. 1982). Young children who are heavy viewers have also been found to have attitudes about the health care world similar to television depictions. (Arenstein 1974, McLaughlin 1975a, 1975b)." "The mass media have also been found to promote stereotypic thinking about such groups as women, the elderly and minorities...and influences attitudes about occupational roles [such as] teachers... [journalists]... and physicians."

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