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July, August and September 2010
News on Nursing in the Media



The sexual assault nurse

It is not beyond the capacity of skilled U.S. television producers to give a fair portrayal of a SAFE nurse, even in a segment that lasts only a few minutes and that involves a heroic detective character. But doing so would require that a show take forensic nursing seriously enough to make that a priority, and not permit the profession to be sacrificed on the altar of anti-crime fury.

September 29, 2010 -- Tonight NBC's long-running drama Law and Order: Special Victims Unit offered a portrayal of a sexual assault forensic nurse as part of an episode intended, commendably, to highlight the nationwide backlog in analyzing rape kits. But sadly, this was a highly damaging misportrayal of nursing, with the nameless nurse presented as an insensitive technician who carefully collects evidence but utters not one word to the distraught rape victim. The plotline is reminiscent of a November 2004 SVU episode in which a SAFE nurse did get a name and a few lines, but likewise came off as an awkward assistant to the lead female detective character Olivia Benson, who provides all emotional care to the victim. The new plotline does not so strongly imply that Benson is actually directing the exam, but here the nurse character is far more callous.She gets no name and no introduction, and Mariska Hargitayshe goes about her work saying nothing, even when she hurts the patient--no warning, no apology, no explanation. Of course, since the show never bothers to identify her to viewers as a nurse, maybe viewers will not see her as one. In real life, it's unlikely a police detective would be present at all for this exam, but it has always been very important to the show to present Benson as the 24/7 advocate and savior of rape victims, so it's no surprise that she again usurps much of the nurse's role. The show also remains eager to portray rape exams as awful ordeals in which the victim is re-traumatized by an insensitive evidence collector, arguably associating the SAFE nurse more with the rape itself than the prosecution. In the 2004 episode, a prosecutor actually described the exam as a "sexual humiliation" comparable to the rape itself. We assume SVU's longtime show runner Neal Baer--a physician who also wrote for ER--knows better than to portray nursing this way. But he and Jonathan Greene, who wrote this episode, seem to have other priorities. more...and see the film clip!


How do so many journalists miss it?

bulls-eye rashSeptember 27, 2010 --  Today The Washington Post published a lengthy entry in its "Medical Mysteries" series headlined "Nurse solves mysterious ailment that puzzled orthopedists, oncologist." Sandra G. Boodman's piece describes a local man who spent more than a year consulting various specialist physicians, enduring "two unnecessary knee surgeries and dozens of physical therapy sessions, as well as acupuncture and other useless and sometimes painful treatments that cost thousands of dollars," before "a nurse" at an infectious disease specialist's office suggested that he might have Lyme disease. He did. You might think, then, that the article would be a tribute to nursing expertise, but instead the central fact of the story is overwhelmed by disrespect for nursing. It's not just that the piece repeatedly dismisses what the nurse did by calling it "simple" and "obvious," "a basic query by a nurse, not the acumen of five specialists." No, the most striking thing is that in this 1,300 word story describing all the erroneous thinking of the "specialists," the nurse who actually solved the problem is never named, quoted, or further described. It's true that none of the specialists are named or quoted directly either, which certainly protects them from embarrassment. And it seems that the approach of these pieces is to rely mainly on the patient's account; perhaps this patient never actually met the nurse, though he says he "remains grateful" to the nurse. But the piece does name and quote an infectious-disease expert the patient consulted after the diagnosis, so it might have done more with the nurse, even if could not give the nurse's real name. The net effect of what we do have here is to suggest that the nurse solved the problem by being so simple and limited, with a mind uncluttered by real expertise. Needless to say, there is no suggestion that maybe the nurse solved the problem because of her own expertise, or the nature of nursing, including the profession's holistic and flexible approach, which is no less "expert" for being broad. The piece pokes fun at the specialist physicians, but it still reinforces the idea that they are the main source of health knowledge--the same idea that seems to have gotten this patient in so much trouble. more...


37 TV physicians Fall 201037 to 0?

Fall 2010 TV Preview

September 2010 -- As the 2010-2011 U.S. television season starts, there appears to be no major nurse character on any regular prime time broadcast show for the first time in more than 40 years. In part that is because so many of the health-related shows from last year have left the air, including all of the shows that premiered in 2009, notably NBC's generally helpful nurse drama Mercy, but also CBS's physician-centric Three Rivers and Miami Medical, which did each have one recurring nurse character. Other departures had little effect on the portrayal of nursing, including the ends of the long-running Scrubs (ABC), which had shed its lone nurse character the prior season, and FX's nip-tuck, which never had a significant nurse character. The one returning show that did have a nurse character, ABC's Private Practice (premieres Sept. 23), killed him off at the end of last season, when nurse midwife Dell Parker died from a car crash, just after giddily announcing that he had been admitted to medical school. The dominant hospital shows, Fox's House (Sept. 20) and ABC's Grey Anatomy (Sept. 23), still have no nurse characters as they start their seventh seasons. There appear to be just two new shows with any real health care focus:  ABC's Body of Proof (October), which stars Dana Delany as an elite surgeon-turned-medical examiner, and ABC's Off the Map (mid-season), a new product from Grey's creator Shonda Rhimes about five young physicians who work to save the poor at a remote clinic in South America. We see no nurse characters anywhere, though there are conflicting signals about whether one minor character on Off the Map is a nurse or physician. Leaving aside that mid-season character, of the five health-related prime time broadcast shows that are slated to start seasons this year, regular physician characters appear to outnumber nurse characters by roughly 37 to 0. Of course, nurses will not be completely absent from the small screen, since non-regular season cable shows Nurse Jackie (Showtime) and HawthoRNe (TNT) will return for third seasons in 2011. And there is even a nurse character on A&E's new summer police drama The Glades, which will return next year (though she is carrying on Dell's Hollywood dream by attending medical school). But given the dominance of the broadcast shows, which attract millions more viewers to many more episodes, the television landscape will remain dominated by programs that reinforce the false notion that physicians provide all important health care. more...


August 2010 News on Nursing in the Media


"A midwife in a world of doctors"

Medical school in the skyAugust 2010 -- In the last episodes of the third season of ABC's Private Practice, the show killed off its one nurse character, midwife Dell Parker. That was no great loss to nursing, but the plotline that played out in the May 6 and 13, 2010 episodes included attacks on the profession, most notably through Dell's elation at having just been admitted to medical school. That was a powerful reinforcement of the enduring Hollywood fantasy that the most able nurses achieve by going to medical school, when in fact they are perhaps 100 times more likely to attend graduate school in nursing. The wannabe-physician stereotype is one with which real advanced practice nurses and of the wannabe-physician stereotype with which real advanced practice nurses and men in nursing must still contend. In an amusing twist, the key May 6 episode was written by physician Fred Einesman, a former advisor to NBC's ER, which also pushed the wannabe-physician theme. Private Practice did, rarely, include minor plotlines in which Dell actually showed some aptitude for patient care and some limited autonomy. For instance, although the March 25, 2010 episode was mostly about how amazing the show's physician characters are, Dell did get to deliver a baby by himself in the field. And because he successfully executed a risky maneuver to free the baby, who was stuck in the birth canal, physician Cooper credited Dell with saving two lives! But Dell's exit reminded us of what the show really thought of midwifery and nursing. Don't take our word for it. In the May 24-June 6 issue of TV Guide, show creator Shonda Rhimes explained that Dell was "a midwife in a world of doctors. Babies can only be delivered in so many episodes. Dell got lots of coffee, answered lots of phones." She lauded actor Chris Lowell by noting that "an actor of his caliber should be doing Shakespeare, not handing people charts." In other words, nurses and midwives don't do much of interest, which is why Dell spent so much time doing receptionist work, and why he eventually had to go. But at least he has now gone on to that great medical school in the sky! more...and see video clips from the relevant shows.


Pregnancy Pact:  A movie reviewNurse Beth played by Camryn Manheim

2010 -- Lifetime's The Pregnancy Pact portrays several high school girls who intentionally get pregnant, apparently seduced by fantasies of loving, carefree motherhoods. The movie was "inspired by a true story" and it's a competent made-for-TV issue melodrama, engaging enough if somewhat schematic and bland. Some might also see in the movie a "ripped from the headlines" exploitation of a serious and complex problem, particularly since the film references some events that really happened in Gloucester, Massachusetts, in 2008, but it reportedly invents key story elements. The movie does make a fairly serious effort to explore some basic aspects of teen pregnancy, showing young females who see little future beyond child-rearing. It seems like almost everyone involved here--teens, parents, and community leaders--is lying to someone. The film presents the school nurse as a forceful advocate for better pregnancy prevention, a compassionate professional who takes on the school administration and a "family values" group to try to stem the school's teen pregnancy "epidemic." The nurse might have done some direct counseling of the pregnant students, as a real nurse would. And the character is limited. She never gets at the deeper issues involved in the pregnancies, and she resigns in protest roughly a quarter of the way through the movie, never to reappear. The main force for a more progressive approach to teen pregnancy in the film is actually a relentless young New York video blogger who bonds with the teens and does far more to get to the bottom of the epidemic. Still, the portrayal of the nurse as an articulate professional who is willing to make a big personal sacrifice to advance public health debunks the popular notion that school nurses are just about aspirin and band-aids. And that's especially helpful at a time when U.S. school districts face extraordinary pressure to cut costs. more...


The Truth receives 501(c)(3) status

501(c)(3) approvedAugust 4, 2010 -- Today The Truth About Nursing was notified that it qualifies as a charitable non-profit organization under section 501(c)(3) of the federal tax code. That means donations to the Truth made since its inception at the end of 2008 are tax-deductible as allowed by law. See our 501(c)(3) status letter here. Please make a tax-deductible donation to support our work to improve understanding of nursing today. Thank you!


Rizzoli & Isles: I kissed a male nurse girl!

Rizzoli & IslesAugust 16, 2010 -- Some Hollywood shows have been careful not to mock men in nursing, making clear that the usual gay and effeminate stereotypes are unfounded or marks of simple bigotry. Not TNT's new hit drama Rizzoli & Isles. The show is about an odd couple of Boston crime fighters:  the swaggering, deep-voiced homicide detective Jane Rizzoli and her super-smart, girly-girl medical examiner friend Maura Isles. In tonight's episode, Isles sets Rizzoli up with a handsome man named Jorge whom Isles says is in "medicine." To Rizzoli's chagrin, he turns out to be a nurse, and a man who is determined to play a stereotypically female role in the relationship and to be a "stay-at-home daddy"--all of which is the target of an episode's worth of jeering from Rizzoli, despite Isles's half-hearted pleas that maybe a nice, supportive guy is what the somewhat abrasive detective needs. The episode pauses to mock nursing as only "technically" a part of "medicine," but it's more concerned with exploring gender roles. The characters investigate the murder of a woman outside a lesbian bar. We are invited to compare same-sex relationships to the Rizzoli-Isles friendship, including its possible romantic overtones, and to Rizzoli's doomed relation with Jorge, which Isles finally ends by telling him that Rizzoli actually is a lesbian. But whatever nuance the episode has does not extend to its contempt for Jorge. He is a nasty caricature of a traditional woman -- submissive, touchy-feely, chirpy, picky, smothering. (Well, maybe we can only say that he's female; Rizzoli also compares him to her cute little dog and to a hamster.) The plotline thus suggests that male nurses are not real men. Rizzoli's traditionally male traits draw affectionate ribbing, but they are a source of power and a force for good. She is a flawed hero. By contrast, Jorge is foolish and annoying, and his work is dismissed. The episode, "I Kissed a Girl," was written by Alison Cross. The show was "developed" by Janet Tamaro, based on books by Tess Gerritsen. more...

Bad reputation: Al Bawaba on protest of Egyptian nurse television character

Ghada Abd Al RiziAugust 16, 2010 -- Today the Jordan-based news service Al Bawaba ran a brief, unsigned report of a protest by the Egyptian Nurses Union about a new television show in which a nurse character steals medicines to sell on the black market, "in addition to performing polygamy and going against all the teaching of Islam." The piece says that the head of the union, Fathi Al Bana, believes the writers should have consulted the union about the show, and she says the union's board will meet to decide what actions to take. The article also includes an insightful paragraph about the causes and effects of nursing's poor image, relying on Dr. Nihad Abd Al Salam, a professor at the International Nurses Academy. This professor explains that the media reinforces the widespread perception that nurses are "girls with bad reputations who try to seduce doctors and rich patients," and that this image in turn has caused many families to forbid their daughters to become nurses. We thank Al Bawaba for this helpful, if short, article. more...


Take Action!

Have fun playing nurse!

Lexie and AveryAugust 2010 -- Five episodes from the sixth season of ABC's Grey's Anatomy (2009-2010) illustrate the two main stereotypes that the hit show continues to reinforce:  that nurses are physician handmaidens, and that they are low-skilled workers worthy only of contempt. As always, the show's 12 main characters--all surgeons--provide all the health care that matters, including vital care that nurses do in real life. In one episode, after senior surgeon Derek Shepherd asks female surgical resident Lexie Grey to monitor his own health during a marathon surgery, a male resident mocks Lexie by telling her that it sounds like she will be Shepherd's "bitch" and urging her to "have fun playing nurse." Lexie will have her revenge on her Seattle Grace colleague, but the show makes no effort to defend nursing. Another episode flashes back to 1982 to show surgical pioneer Ellis Grey (Meredith Grey's mother) as a resident fighting off a male colleague's claim that she is just a "nurse" who has no business defibrillating, though even in 1982, nurses did plenty of defibrillation. Again, there is no defense of nursing. Two other episodes include brief but damaging appearances by nurse Tyler, a bitter lackey who could not care less about patients and views his role as doing as little as possible to help the physicians who actually provide expert care. And still another episode features a rare prime time mention of nurse practitioners. Not surprisingly, it is an insult, as Shepherd suggests that another surgeon is wasting her time doing after-care since a "nurse practitioner can do this." Grey's seems to have made little progress since the anti-nurse insults of its first episodes five long years ago (e.g., "Did you just call me a nurse?"; "You're the pig who called Meredith a nurse!"). As in the early days, the show wants us to feel the pain of brilliant female physicians who must fight to avoid being mistaken for nurses, members of the backwards servant class of health care. We urge the show to consider if it could pursue its apparent mission of deifying physicians without attacking nurses quite so directly. more, please join our letter-writing campaign ... and see the film clips from 5 notable episodes!


Can't waste a minute

Atul GawandeAugust 2, 2010 -- This week The New Yorker ran "Letting Go," a 12,000-word article about end-of-life care by surgeon and health writer Atul Gawande. This "Annals of Medicine" piece is physician-centric, quoting seven physicians and repeatedly implying that physicians are the only health providers whose views and actions really matter on this issue, and more broadly, that physicians direct health care. But the article also includes a surprisingly substantial look at the skilled work of Boston hospice nurse Sarah Creed, as Gawande accompanies her on patient visits and actually relies on some of her account of hospice care, providing a far more substantial look at the nursing role in palliative care than did a long December 2009 New York Times story about sedation of the dying. Gawande's New Yorker piece offers a fairly candid and progressive view of end-of-life care, arguing that people in the U.S. too often approach the final days of life with an expensive heroic treatment model that can needlessly increase suffering and even shorten life. He stresses that careful discussion of patients' end-of-life priorities, though very difficult, seems to be the key to improving this situation (though he notes that recent U.S. health reform efforts to provide funding for such discussions were doomed by claims that they were "death panels"). Gawande does not seem to be aware that nurses, who have a holistic practice model and who have long spent far more time with the dying than any other health professionals, have been pushing just this perspective on end-of-life care for decades. And he consults no nurse as a stand-alone expert on end-of-life care, as he does several physicians; we guess that would be asking too much. But by including Creed, the piece does give nursing serious, sustained attention that is unusual in an elite magazine like this. We commend Gawande and the New Yorker for that. more...


Don't be lazy

Baby trapped in carAugust 2, 2010 -- Recent news items illustrate the important contributions family nurse practitioners make in preventing and diagnosing deadly health problems. On June 13, the Houston Chronicle ran a "Sunday Q&A" feature by Cindy George in which University of Texas nursing professor Elda Ramirez gives advice on how to cope with the very hot days that region experiences. Ramirez clearly has knowledge, but she also displays an ability to convey practical health information to lay people in a direct, engaging way that is one of the hallmarks of NP practice. And today, the University of Central Florida's Today site posted an article by KJ Lewis about Arden Monroe-Obermeit, who appeared as a morgue technician on the Discovery Channel reality show Dr. G: Medical Examiner. Monroe-Obermeit was about to graduate from the university with a nursing degree, and to enter its Doctor of Nursing Practice program so she could help people avoid ending up in the morgue because of preventable conditions. The article reports that Monroe-Obermeit's new career path was inspired partly by an NP who diagnosed her Cushings disease when many physicians could not. We thank those responsible for these helpful pieces, which look past stereotypes and recognize nursing expertise. more...

July 2010 News on Nursing in the Media

Physicians are awesome

Amanda GrabowskiJuly 22, 2010 -- Tonight ABC will air the fifth episode of Boston Med, the eight-part documentary about the work and personal lives of health care workers at Massachusetts General, Brigham and Women's, and Children's hospitals. Overall, Boston Med is almost as physician-centric as producer Terence Wrong's previous "greatest hospitals" efforts Hopkins 24/7 (2000) and Hopkins (2008), focusing overwhelmingly on physicians and generally presenting them as the brilliant providers of all meaningful health care. But the new series has received an amazingly positive reaction from some reviewers and even some nurses because, along with the 16 physicians and surgeons profiled in the four episodes that have aired so far, there is one nurse! In a few scenes, this MGH nurse, Amanda Grabowski, displays technical knowledge and gives viewers some sense of nurses' roles as patient advocates and autonomous practitioners. But as the episodes go on, the show steadily forgets her clinical work, focusing instead on her social life. This approach undermines the sense of her as a serious professional, and even flirts with the stereotype that nurses are mainly about romance. The episodes do portray the personal lives of some of the physicians, but the show also continues to focus on their work as esteemed health experts. The ABC web site suggests that there will be another MGH ED nurse profiled in at least the fifth episode, Mike O'Donnell; perhaps his segment will convey something of what it is to be a man in nursing. But it's unlikely the nurse elements will have much impact alongside what will likely be profiles of some 25 physicians, especially since those profiles utterly ignore the nurses who actually provide most of the skilled care to the patients portrayed. The overall message is that physicians, especially surgeons, are the life-savers who do everything that matters. Boston Med is probably a small step forward for Terence Wrong, since the nurse profiles here may be more substantial than the fleeting nurse appearances in Hopkins two years ago. But the new series could not be compared to a documentary like Richard Khan's Nursing Diaries (2004), or even a drama like Mercy (2009-10), which feature strong, sustained portrayals of nursing skill and care. more...


UPDATE on Cali Nurse campaign!

July 9, 2010 -- We have just had a productive conversation with Eli Holzman, the Executive Vice President of Studio Lambert, the production company that is planning to produce Cali Nurse. Mr. Holzman and his show colleagues received 78 emails (33 original--thank you!) from nurses and others concerned about the show in the two days since we launched our letter-writing campaign. He expressed concern about the stereotypes that plague nurses and vowed to try to avoid them in the show. He said that Cali Nurse is at least a year away from production, but that as work on it proceeds in the coming months, he will keep in mind all of the input he has received from us. He is also interested in reading our book Saving Lives, which explains these stereotypes, and we will send copies to his production team. (Thanks to those who have donated copies of the book so that we can send them to the media!) We also offered to provide advice to the show as it goes forward. Of course it is too soon to say what the ultimate result of all this will be, but we thank you so much for taking the time and effort to speak out about the potential pitfalls of the show. Your voices made the difference!


Aggravating: The nursing shortage in Korea and Israel

quoteJuly 6, 2010 -- Two recent press reports offer very different perspectives on the global nursing shortage, though they do have one thing in common:  the content of each piece is somewhat at odds with its own headline. On June 22, the Korea Times published Bae Ji-sook's "Shortage of nurses aggravating." From that headline, you might think that the piece would be about how the shortage means patients must sometimes put up with lukewarm tea. But in fact, the report powerfully describes the plight of under-staffed nurses asked to assume crushing workloads. The piece does not discuss potential solutions, and it might have made clear that under-staffing endangers patients. But it certainly shows how these conditions affect the nurses, portraying a workplace in which, according to the piece's main source, nurses "suffer from constant fatigue" and are "virtually isolated from the other part of the world because after work, all [they] can think about is getting enough sleep." And today, the Jerusalem Post ran a report by Judy Siegel-Itzkovich about the plans of the Israeli government to address that nation's shortages of health workers. The headline is "Panel decries nurse, doctor shortages," but even though about 75% of the profession-specific information here is about an alleged physician shortage, Israel appears to have a higher ratio of physicians to people than most countries, including the United States. The piece does mention a few government ideas intended to help nursing, including plans to introduce "nurse assistants" and to improve nurse recruiting and education, but there is no detail. In any case, we thank those responsible for these pieces, especially the Korea Times one, for drawing attention to a nursing shortage that has not gone away just because it has been discussed for more than a decade. more...


Going Back to Cali Nurse

Cali Nurse logoJuly 2010 -- Recently MysticArt Pictures issued a casting call for a new "sexy docu-series" called Cali Nurse, to be produced by the prominent production company Studio Lambert. The show is seeking real nurses and nursing students, but the casting material makes clear that it is going to focus on damaging stereotypes. The show wants "gorgeous" young females (ages 21-30 only) who will experience "comedy, romance, and fun" and are all about "big hearts" and "dates with McDreamy." We didn't notice anything in the casting call about being bright, articulate, tough, or skilled, qualities that real nurses need to improve patient outcomes, though the casting call did suggest that the show would "capture the lives of those learning to save lives." The producers seem to be aiming at a reality show version of Nightingales, the bimbotic show from the late 1980's. We could urge the show to pursue a more responsible vision of nursing, though it's pretty hard to imagine a project with this genesis doing no harm to nursing unless it stopped being about nurses completely. Maybe the producers could focus instead on one of the many categories of professionals who have not been plagued for decades by the idea that they are either sexy twits looking to seduce physicians, or else angels with big hearts and small brains. Cali Doc would be too easy; we're thinking Cali Judge, Cali Scientist, or even Cali TV Producer! More realistically, please join us in urging Studio Lambert to at least minimize how much it tells the public that nurses are brainless bimbos and/or angels. more...


Lystra Gretter: Public Health Advocate and Professional Reformer

By David Yates

Lystra Eggert GretterWhen Lystra Eggert Gretter was inducted into the Michigan Women's Hall of Fame in 2004, she was honored for her "tireless" efforts in promoting nursing as a respectable profession in the late 19th and early 20th centuries. Gretter made many contributions to nursing. She shifted the model of nursing education from a one-year apprenticeship to a three-year academic pursuit. She created nurse-run hospital wards instead of allowing nursing students to run them. Gretter cut the work day to 8-hour shifts, to afford nurses and students more time to study and recreate. She wrote what is believed to be the first standardized textbook for nursing education and created one of the first professional nursing libraries. And Gretter was a founding member, at the end of the 19th Century, of groups that later became the American Nurses Association and the National League for Nursing Noting that the public perception of nursing was that of "women's work," Gretter lobbied for more political power, including aligning nursing with suffragettes who sought the vote. She established an early visiting nurses association. And Gretter was "the moving spirit behind the creation of the "The Florence Nightingale Pledge," an oath of ethics that many graduating nursing students still make today. Gretter also worked to advance public health generally. She established tuberculosis hospitals, lobbied for in-home nursing care and became a vocal public health advocate for Detroit's burgeoning poor and immigrant population. She also successfully introduced the first state-wide health inspections of school children and a free maternity/infant care clinic in Detroit. more...


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