April, May and June 2009 News on Nursing in the Media
June 30, 2009 -- Tonight's episode of TNT's HawthoRNe again presented the lead character as an authoritative chief nursing officer who fights for patients and families. Hawthorne tries to solve problems in creative ways, notably in using hospital systems to give a grieving man time to say goodbye to his brain-dead mother before her life support is disconnected. The new nurse Kelly, who is very meek, does manage to show some skills and to solve an important health care mystery, determining the surprising cause of an infant patient's ingestion of a toxic substance. And nurse Ray forcefully explains to a patient that he is a trained professional, though not until he has spent an entire shift letting her treat him like a servant. And his speech about nursing does show that he is still a wannabe physician. Indeed, the show seems to focus on nursing weakness, and what nurses lack the authority to do. Perhaps the most striking problem is that the episode finally makes clear that Hawthorne reports to the chief of surgery. This plays out in a horrific scene in which the hospital CEO criticizes the chief surgeon for failing to control "this nurse," i.e., Hawthorne, who stands by, essentially silent. This wrongly suggests that nurses, no matter how senior, automatically report to physicians, and by extension, that nursing is merely a subset of medicine. The episode, "Yielding," was written by Sarah Thorp. more...and please speak to the producers.
Always remember to help ladies on with their coats!
June 29, 2009 -- Tonight's episode of Showtime's Nurse Jackie highlights the expert psychosocial care Jackie Peyton and her nurse colleague Mohammed (Mo-Mo) de la Cruz give to ED patients and families. No one could mistake these nurses' thoughtful, sensitive care for unskilled hand-holding. The episode also suggests that physicians are often less adept at these tasks, even though they may receive all the credit from those the nurses have helped. Once again, the show's nurses play a central role in patient care, and Jackie ably trains more junior health team members. At the same time, the episode features a remarkable scene in which a school nurse goes head to head with Jackie about whether Jackie's daughter has a potentially serious anxiety disorder that may require medication; both of them seem to have valid points. One less impressive aspect of the episode involves Jackie ordering the removal of a patient's non-disruptive mother and twin brother from a trauma room without asking if they want to stay, just like the physician characters in other hospital shows do, with no hint of the potential benefits of family presence. This fourth episode, "School Nurse," was written by Christine Zander. more...
The good, the bad, and Zoey's stethoscope
June 22, 2009 -- Tonight's episode of Showtime's Nurse Jackie continues to present Jackie as a clinical leader with a vast skill set, and to show that nursing can be as compelling as medicine--if you actually let nurse characters do the nursing, as no other major show has done on a regular basis. Here, Jackie provides skilled care to a dying heart patient and a young woman who has become addicted to Vicodin. She also joins her best friend, physician Eleanor, in an amusing but deceptively important effort to teach nursing student Zoey not to be intimidated by physicians. One of the most impressive aspects of Nurse Jackie is that it goes out of its way to show not only that Jackie is clinically expert and a strong patient advocate, but also how patients and their families benefit from her advanced psychosocial skills. These are all the more amazing given her somewhat raw approach to colleagues and the addiction to painkillers that seems to haunt her. Small parts of the episode do reflect what may be the show's most significant ongoing problem, its iffy portrayal of nursing autonomy and authority. Jackie's interactions with physician Coop suggest she has little idea about what the hospital's upper management structure is--it seems to consist of the physicians. And the episode's depiction of Jackie's boss Gloria Akalitus tells viewers that nurse managers are not really nurses. On the whole, though, the episode offers another engaging look at what a strong, skilled nurse can do for patients. The episode, "Chicken Soup," was written by Mark Hudis. more...
June 16, 2009 -- Tonight's series premiere of TNT's hospital drama HawthoRNe makes a serious effort to tell stories from a nursing perspective and to focus on nursing care, particularly the exploits of the dedicated, expert, and strong chief nursing officer Christina Hawthorne (Jada Pinkett Smith). Remarkably, the show has four diverse major nurse characters--including the black female lead and a man--with just one major physician character. This is an unheard-of TV ratio, though a good approximation of hospital reality. Indeed, the very fact that HawthoRNe shows that chief nursing officers exist is helpful. Nurses are not interchangeable widgets, and some here are clearly more skilled than others; to some extent they provide autonomous care. In several cases the pilot gives viewers a sense of the lack of respect nurses often receive from patients and physicians. And it suggests that nurses have the skill and perhaps even some obligation to resist physician "orders" in order to protect patients. One nurse questions but still gives an erroneous physician insulin prescription, then gets in trouble when the patient crashes. But sadly, the overall portrayal does not convey enough of nurses' real skill or autonomy, and elements of the episode reinforce harmful stereotypes. The nurse-physician conflicts do not really make clear that nurses are legally and ethically obligated to resist dangerous physician care plans. Many scenes suggest that the direct care nurses are, well, weak, and very much in need of rescuing by Hawthorne. As on other shows, the blistering contempt of some physician characters is not adequately refuted, except to some extent by Hawthorne herself. And surely nursing does not need an image of a frustrated nurse who really, really wants to be a physician but was unable to get into medical school, and so harbors a huge inferiority complex. Surely we don't need an image of a beautiful young nurse named Candy who thinks it's part of her job to grant sexual favors to Iraq War veterans as a "thank you" for their service, and who we see cheerfully provide manual sex to a soldier in the pilot. And at times, the show suggests that staff nurses tend to be frivolous physician helpers--physicians still do both defibrillations we see. HawthoRNe may not inspire a lot of critical respect, but its main character and basic structure could help nursing a great deal, so we hope future episodes will avoid stereotypes, and do more to convey what nurses do to save lives. The pilot was written by series creator John Masius. The first episode was seen by 3.8 million viewers. more...
Ms. Goldberg needs some helpers
June 16, 2009 -- Today the Examiner web sites posted a transcript of a recent interview in which The View co-host Whoopi Goldberg explained the professional aspirations of Brenda, the lead character in the "Sugar Plum Ballerinas" children's books she has written. Goldberg assures us that Brenda's desire to be a physician is not unusual today, because girls now have not "been told what they couldn't do," unlike girls of her generation, who "all heard, 'You have to be a nurse first. You have to be a helper. You can't be a doctor. Be a helper.'" Goldberg says nothing to cause us to doubt that she shares the contempt for nursing that is inherent in these statements. She is plainly thrilled that girls today are not forced into what she sees as the assistive work of nursing. And although Goldberg rightly suggests that this shift in attitudes is due partly to mass media like NBC's popular ER, the Lifetime drama Strong Medicine that Goldberg herself helped to create and lead from 2000-2006 pushed the idea even more strongly. That show focused on two female physician characters, but it never presented female nurses as anything more than anonymous physician subordinates. That is not feminism. In fact, nursing is a distinct health science whose autonomous practitioners use their years of college education to save lives. Of course it's great that girls now have diverse career choices. But uninformed comments like those of Goldberg and some other celebrity opinion-makers reinforce harmful stereotypes. They push able career seekers of both genders away from nursing and undermine the profession's standing among those who allocate scarce health care resources, contributing to the global nursing shortage. We urge everyone to "help" Ms. Goldberg understand nursing better. more...and please join our letter-writing campaign!
June 2009 -- A recent article in the Colorado Springs Gazette highlighted the continuing problem of physician abuse of nurses in some care settings. John Ensslin's June 26 piece was "Nurse sues Memorial, claims surgeon threw human tissue at her." The story reports that in mid-2008, Bryan Mahan, the chairman of cardiac and thoracic surgery at Memorial Hospital, allegedly threw and hit operating room nurse Sonja Morris with a 4-by-6-inch piece of bloody tissue (the pericardium), and committed other physical assaults on her. Morris says she complained to the hospital with no result, then filed a gender discrimination claim with the U.S. Equal Employment Opportunity Commission. Morris says hospital administrators soon transferred her from the heart surgery team to the main operating room, which is considered less prestigious. She finally filed suit in federal court against the hospital--but not Mahan--on the grounds that she was demoted for complaining about the abuse. Commentary from local nurses posted on the Gazette's web site in response to the story suggests that physician abuse of nurses has been tolerated at the hospital, and that one reason for such tolerance is money. Since physicians are viewed as vital revenue generators, there is a strong incentive to ignore or excuse their misconduct. Of course, patients could not survive surgeries without nurses, and physician abuse of nurses is a major threat to that survival as well, since it is difficult for abused nurses to perform their work as effectively. In addition to economics, the historic power imbalance between the two professions, and between the two genders, would seem to play a role in the cycle of abuse and impunity as well. The Gazette might have provided more context and detail, but we thank the paper and the nurses who responded for drawing attention to these important issues. more...
June 9, 2009 -- Tonight's episode of Fox's summer drama Mental illustrates the peripheral subordinate role played by the show's one recurring nurse character. It also reminds us that, despite the two nurse-focused summer shows that have received recent attention, physician-centric shows like Mental and USA Network's hit Royal Pains continue to attract many more total viewers--especially if you count the summer re-runs of Fox's House and ABC's Grey's Anatomy, Private Practice, and Scrubs. Mental is essentially a variation of House. In both shows, a brilliant hospital physician uses unorthodox, at times outrageous methods to diagnose and treat challenging conditions, amazing his less gifted fellow physicians and earning the tolerance of a long-suffering female boss. The twists in Mental are that the patients all have psychiatric problems, so instead of inside views of patients' bodies, we explore the troubled patients' minds. Also, Mental's lead character Jack Gallagher is charming and social, rather than a witty but obnoxious loner. Jack and four other physician characters provide all important patient care, including psychosocial care. Nurse Malcolm Washington does care about the patients. In one scene here, he reports a basic symptom, one that anyone would notice. In another scene, he briefly advocates for the patient, making a point that is understandable but uninformed. In general, he seems to be on hand to perform basic physical tasks and keep patients company, as Jack puts it at one point. And Malcolm's manner is more that of a faithful assistant than a college-educated professional. The episode, "Book of Judges," was written by co-creator Dan Levine and drew 4.7 million viewers. more...
Dear Readers:
Below is our review of the first episode of Showtime's new television show Nurse Jackie. Please consider that what Nurse Jackie says about nursing is far different from what it is saying about its main character. We urge you to keep an open mind and watch the show in full. We know not all readers will agree with our review. Even so, we are hoping that nurses will use the show as a vehicle to teach friends, family and society what nursing is, what nursing is not and what nursing could and should be. A powerful, critically-acclaimed nurse-centered television show has been a long time coming. Let's use what we can from it to change how the world thinks about nursing. Thanks for tuning in.
Sandy Summers, Executive Director, The Truth About Nursing
Make me good, God. But not yet.
St. Augustine; Nurse Jackie
June 8, 2009 -- Tonight's series premiere of Showtime's "dark comedy" Nurse Jackie is a brutal subversion of the unskilled angel stereotype. The first significant nurse-focused show to emerge from Hollywood in more than 15 years, Nurse Jackie may be the strongest--though not most positive--fictional TV portrayal of a modern nurse that we have ever seen. Jackie Peyton is a New York City ED nurse. Like esteemed TV physicians Greg House (Fox's House) and John Carter (NBC's ER), Jackie is a high-functioning drug addict. But she is also a tough, life-saving nurse who works at the center of patient care, and the show is unusually alert to what nurses experience. Jackie displays formidable clinical expertise, advocates forcefully to save a patient from an arrogant young physician (though she does not save that patient), and provides adroit psychosocial care to patients and families, as well as tough love mentoring to an innocent nursing student--and the physician. Also, she is a major wit. Jackie is not a role model in some respects. To treat a bad back, she takes powerful painkillers that she gets illegally from her pharmacist boyfriend. She has sex with him in the hospital pharmacy. She forges an organ donor card after a young patient dies. She flushes a diplomat's severed ear down the toilet upon learning that he will not be prosecuted for a vicious assault on a prostitute. She steals a wad of the diplomat's money and gives it to the organ donor's impoverished, pregnant girlfriend. And viewers may not get that it was her job as a nurse (not just as Jackie) to protect her patient from the physician; they might wrongly assume that physicians are ultimately in charge of patient care, and Jackie is just unusually assertive. But nothing else here reinforces the stereotypes that have led the public to undervalue nursing. Jackie is deeply flawed, like real people, but she is not a brainless physician helper, a naughty nurse, or an angel, though the nursing student 
calls her a "saint." Since Jackie seems to leave few Commandments unbroken, "God's rogue henchman" might be closer to the mark. She is like a Jack Bauer (24) of the ED (Jackie Bauer!), an extraordinary operative doing things she has no real right to do so she can achieve her vision of social welfare. Still, there is more intelligent life in this pilot than in a whole season of some hospital shows, and Jackie may well end up as one of the most important fictional nurses in history. The episode was written by series creators Liz Brixius & Linda Wallem and Evan Dunsky. more...
"To everyone we are just tools"
June 1, 2009 -- A number of recent press items from sub-Saharan African nations portray the nursing profession in positive terms. They stress how important and difficult the job is in those nations during the global nursing shortage, even though the articles sometimes fall prey to angel stereotyping or fail to convey much about the advanced skills nursing requires. A good example appeared on March 11 in the Kampala-based magazine The Independent: "Nurses -- Uganda's angels," by Mubatsi Asinja Habati. Then there are the stories about nursing in South Africa. A sadly typical example is Graeme Hosken's "Nurses 'drink tea while mom gives birth,'" which appeared today on page 1 of The Pretoria News. Another discouraging article with a drinking theme was Sipokazi Maposa's March 2 story in The Cape Argus, "Nurses drink on duty, say terrified patients." Pieces like this describe--as they should--the poor "care" that some patients report receiving from nurses in South Africa. Unfortunately, few of the pieces we've seen provide much context to explain why health care professionals might fail so miserably to discharge their duties to patients. One notable exception is Zara Nicholson's "Nurses also victims of poor health care," which ran on March 28 in The Cape Argus. Nicholson's article tells readers about the extreme challenges public sector South African nurses face, from critical shortages of staff and resources to widespread disrespect to the abuse by frustrated patients that is a natural result of the shortages. We commend those responsible for the above items--most of which focus on nurses working in obstetrics--for telling readers something of value about the troubled state of nursing. more...
May 2009 News on Nursing in the Media
Summer 2009 TV Preview
May 24, 2009 -- This summer Hollywood will unveil four new fictional health care television shows, an unusually high number. But what's even more striking is that two of the shows--Showtime's Nurse Jackie (premieres June 8) and TNT's HawthoRNe (June 16)--will be the first significant nurse-focused shows to emerge from Hollywood in more than 15 years. These two shows appear to feature strong central nurse characters: Jackie (right) is a New York City ED nurse played by Edie Falco, and Hawthorne is a chief nursing officer played by Jada Pinkett Smith. And although we can foresee some issues with the two shows, there is cause for hope that they--along with NBC's Mercy, a nurse-focused regular season drama that will reportedly air in mid-season (est. January 2010)--may do what we have been urging Hollywood to do since 2001: convey more of what nurses really do to save lives and improve outcomes. The pilot episode of Nurse Jackie is one of the best (though not most positive) fictional TV portrayals of a nurse that we have seen. The other two new summer shows, Fox's Mental (May 26) and USA's Royal Pains (June 4), are in the traditional physician-centric mold. Mental, about a maverick LA psychiatrist, has one recurring nurse character to support the five physicians who will likely dominate. And Royal Pains is about a brilliant, hunky, good-hearted "concierge doctor" in the Hamptons; it appears to include no nurse characters. Of course, even if the new nurse-focused shows do offer better portrayals of nursing, Nurse Jackie and HawthoRNe are summer cable shows, which reach a far more limited audience than regular season broadcast shows and run only half as many episodes. As with any new show, there is no guarantee they will last long. And it would take a lot to counter the hundreds of hours of persuasive disinformation about nursing conveyed to millions around the world by popular hospital shows like House and Grey's Anatomy, to say nothing of the many damaging portrayals in non-health care shows like Law and Order: SVU and Desperate Housewives. In fact, even with the perhaps unprecedented event of two "nurse shows" premiering within a week of each other, there are still more major physician characters than nurse characters in the four summer health shows. Still, there is always hope. Tune in and see what happens. more...
"To solve nursing shortage, change attitudes about nurses"
May 12, 2009 -- Today the Baltimore Sun published an op-ed by Truth About Nursing executive director Sandy Summers arguing that resolution of the nursing crisis will require us to change our preconceptions about the profession. In her "Viewpoint" essay, published to celebrate International Nurses Day, Summers noted some positive recent developments. These include U.S. President Barack Obama's efforts to honor nurses and include them in policymaking, such as by appointing nurse Mary Wakefield to head the Health Resources and Services Administration and increasing funding for programs aimed at addressing the faculty shortage. However, Summers explained, long-term improvement in the clinical and educational resources available to nursing will require a fundamental change in how people see the profession. She pointed out that much of the influential mass media, from popular Hollywood television shows to the news media and advertising, continues to portray nurses as vacuous losers, scut work saints, or disposable bimbos. Only a true appreciation for nurses' life-saving skills can guarantee nurses what they need to meet the health care challenges of the 21st century. As Summers concluded: "Let's celebrate nurses every day by making the only change that will ensure nurses are there when we need them: Let's reconsider the value of what nurses do." We thank the Baltimore Sun. see the full op-ed...
May 6, 2009 -- Tonight, ABC will broadcast what seems to be the series finale of the irreverent sitcom Scrubs; the show may return next season without some central characters. For eight years (the first seven on NBC), the show has imagined what it might look like if a hospital were staffed by gifted insult comics with soft hearts. Like ER, which ended its far longer run just last month, Scrubs has been a highly physician-centric show that has included one major nurse character. That has always been Carla Espinosa (played by Judy Reyes), a no-nonsense, relatively normal bedside nurse who has at times been said to have a management role. Espinosa has generally been presented as a smart, skilled nurse with some leadership qualities. And the show has at times underlined her knowledge and good judgment, even showing her teach junior physicians. She is married to the new chief of surgery Turk, and she has long been perhaps the closest friend of the ornery chief of medicine Perry Cox. Despite all those connections, however, the show has (contrary to fact) made very clear that as a nurse, Carla reports to physicians, and that physicians are ultimately in charge of all aspects of patient care. The show has also featured extensive physician nursing, in which physicians do important care tasks that nurses generally do in real life, like bedside monitoring and psychosocial care, an enormous theme on Scrubs. Even so, the show has clearly been better for nursing than popular newer dramas like ABC's Grey's Anatomy. So tune in Wednesday, compose a wishful J.D.-style daydream in which the best Scrubs nursing moments were representative of the show as a whole, and give the show a not-so-bad five! Read more about Scrubs...
April 2009 News on Nursing in the Media
Seeking some firebrand: Nursing Standard reviews Saving Lives
April 29, 2009 -- This week's issue of Nursing Standard, the U.K.'s best-selling nursing journal, included Dame Betty Kershaw's review of Saving Lives: Why the Media's Portrayal of Nurses Puts Us All At Risk. Dame Kershaw (right) is the education adviser of the Royal College of Nursing. She gave Saving Lives 4 out of 5 stars. In her review, Dame Kershaw emphasized that although the book is a U.S. text, "every nurse should recognise the damage that negative portrayals of nursing in the press, films, television and even books can do to our image." Indeed, she noted, the "[t]he popularity of transatlantic film and TV shows means many of the United States images referred to here are seen in the UK." Dame Kershaw explained that "this well-researched text explores the negative effects of adverse publicity and how it inhibits our professional growth," and that the "constant failure to credit nurses for the work they do is addressed." She concluded: "The book deserves wide reading. Hopefully some firebrand may even be driven to duplicate this study in the UK." We thank Dame Kershaw and Nursing Standard. see the full article...
April 29, 2009 -- ABC's Private Practice, whose season ends tomorrow, April 30, may be the only broadcast network show with a major nurse character to return next season. In the February 5 episode (Mike Ostrowski's "Acceptance," 13 million U.S. viewers), lone nurse character Dell Parker, who is studying to be a midwife, shows some tentative clinical aptitude and knowledge to go with his boyish eagerness. Under the close supervision of OB/GYN Addison Montgomery, Dell ably performs a vacuum-assisted delivery. Later he haltingly guides the baby's parents toward breastfeeding. Dell also performs an assured solo ultrasound of pregnant psychiatrist Violet Turner, calming her panic attack and eliciting her agreement to his own suggestion that, though he's "not a doctor," he will likely become a "pretty good midwife." The show still condescends to Dell, who is also the office manager/receptionist at the LA clinic where the show is set. In the March 26 episode (Craig Turk's "Do the Right Thing," 10.1 million U.S. viewers), Dell starts hooking up with young women by pretending to be a physician. This earns quietly amused derision from the elite physician characters. Of course, neither registered nurses nor physicians are qualified to do the job of the other group. But aspiring advanced practice nurses, who may be wrongly perceived as "wannabe" physicians, would be unlikely to reinforce that impression, which would suggest a lack of respect for nursing and themselves. Needless to say, Private Practice remains physician-centric, with its many physician characters often doing key care tasks that nurses generally do in real life. Still, on balance, the early 2009 episodes seem to represent a small step forward in the show's portrayal of nursing. more... see film clips of the show and please join our letter-writing campaign!
Take action!
April 27, 2009 -- Today's New York Times Crossword puzzle sought the answer "nurse" with the clue "hospital attendant." But nurses are skilled, autonomous professionals who use their years of college-level education to save lives and improve patient outcomes. They are not "attendants," a word which is generally used to mean an assistant or service worker with relatively little formal education in the relevant field. The clue recalls the Times Crossword's even more inaccurate February 2007 nurse clue "ICU helper." Of course, some will note that it's "just a crossword puzzle." But all mass media has some effect on how people think and act. And the fact that the premiere crossword in the world repeatedly features such clues illustrates the range of media that contributes to the deadly undervaluation of nursing, and of course, also shows how difficult it is to correct such stereotyping. This puzzle was created by Joe Krozel, and the current Times puzzle editor, as in 2007, is Will Shortz. more... and please join our letter-writing campaign!
April 17, 2009 -- Today the Cape Cod Times ran a very good article by Cynthia McCormick about the challenges nurses face in discussing spiritual issues with patients. The report describes a recent incident in which a per diem nurse at Cape Cod Hospital upset a patient's family by discussing "repentance" with the dying patient in a way that allegedly distressed the patient. "Spiritual talk by nurses spurs soul-searching" explores the nature of that incident through quotes from the nurse and others involved, but it also sets the issues in context by consulting a local nurse expert: Kathleen Geagan Ryan, a hospice nurse and ordained interfaith minister. Ryan explains that nurses can provide spiritual counseling by listening and letting patients take the lead, and being sure not to do anything that could be interpreted as imposing their own beliefs, a sensitive thing given the unequal power between nurse and patient. We thank McCormick and the Cape Cod Times for a sensitive report about a difficult aspect of health practice--one that would seem to be even more complex than the report indicates--for nurses who often confront the challenge of helping patients face their own deaths. more...
April 6, 2009 -- Recent press articles have told the stories of people in different parts of the world who mix nursing and art in ways that may serve both fields. On March 10, the Yuma Sun (Arizona) posted Geovana Ruano's profile of the experienced Mexican nurse and poet Beda Laura Domínguez, "A poet in search of love." And today, the Philippine Daily Inquirer posted Tony Maghirang's "Double life: Rapper wants to be a nurse," a portrait of a popular rapper who, despite having a stage name based on a gun, is in his third year of nursing school. Although the Yuma Sun piece does not have much about nursing, both profiles say that their subjects have incorporated aspects of nursing into their art, potentially conveying information about the profession in an engaging way and suggesting to the public that nurses are articulate observers of the human condition. more...
Are you a "doctor doctor" or a "doctor nurse"? The confusion is killing me!
April 2009 -- Recent news items illustrate important aspects of the nurse practitioner experience today. A February 22 report on National Public Radio's All Things Considered provided a basic look at the doctorate of nursing practice degree, and even allowed articulate nurses to explain its value. However, parts of Sally Herships's piece appeared to accept unsupported physician claims that calling nurses "doctor" would cause confusion or harm patients, despite the absurdity of the supposed linguistic crisis. Meanwhile, veteran NP and DNP student Diane Caruso published a March 14 op-ed in the Winston-Salem Journal (NC) urging the public to support health care financing reform, in order to enable the 45 million uninsured U.S. residents to obtain care. Caruso refuted some basic arguments of those who oppose reform, but the most powerful element in her column was the story of a disabled patient who has fallen in the cracks of the current financing system. We commend Caruso and the "doctor nurses" included in the NPR piece for their advocacy. more...
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Educate the world that nurses save lives!
