October, November and December 2012 Archives
News on Nursing in the Media
December 2012 Archives
The 2012 Truth About Nursing Awards for Best and Worst Media Depictions
December 2012 -- The Truth About Nursing announces our 10th annual list of the best and worst media portrayals of nurses! The year 2012 featured the popular BBC/PBS series Call the Midwife, which showed skilled and autonomous nurses caring for the poor in 1950's London, as well as valuable new seasons from Showtime's Nurse Jackie and Channel 4's documentary series 24 Hours in A&E in the U.K. Mainstream press sources published good items ranging from Tina Rosenberg's excellent New York Times piece about the value of APRN-run clinics, to Julian Guthrie's San Francisco Chronicle profile of UCSF nursing dean David Vlahov, to Ronan McGreevy's Irish Times report about the University College Dublin study of nursing imagery on YouTube, to an Indian Express piece about a recent study on the appalling working conditions that Indian nurses confront. And many nurses advocated strongly for better public health and for better media about nursing, including Massachusetts nurse Wendie Howland, who monitors the "Help a Reporter Out" website to educate journalists when they seem to assume that only physicians can provide health expertise for their stories. On the other hand, the year also included the usual onslaught of damaging distortions from the media. The U.S. prime time landscape remained dominated by shows with little respect for nursing, including ABC's Grey's Anatomy and Fox's House, each of which featured a slew of strong, expert physician characters providing all meaningful care, while nurses were handmaidens who did little more than fetch things. Fox's new sitcom The Mindy Project focused on quirky but skilled OB-GYN physicians, but also included nurse Morgan Tookers, a goofy ex-convict with little apparent health skill. On The Daily Show with Jon Stewart, in a segment about re-integrating military medics into the civilian workforce, the host insisted that the medics were vastly overqualified to be school nurses and mocked school nurses as being all about "kickball" and "tummy aches." And the "naughty nurse" remained a staple of the entertainment industry, appearing in everything from a Dallas Mavericks Dancers routine to an actual job ad from a Swedish hospital. Despite these problems, we thank those responsible for the best media and encourage others to keep trying. see the full awards...
Obituaries highlight work of nursing leaders Liz Scanlan Trump and Vernice Ferguson
December 21, 2012 -- Recent obituaries for two extraordinary nursing leaders show how far nursing has come in the last half-century and, to some extent, how far it has yet to go. On June 9, the Baltimore Sun published Frederick Rasmussen's long, generally good obituary for Elizabeth Scanlan Trump, the co-founder and longtime nursing director of the University of Maryland's Shock Trauma Center, arguably the finest trauma center in the world. The piece portrays Scanlan Trump as "the first trauma nurse" and as the driven "full partner" of the pioneering trauma surgeon R Adams Cowley. Cowley is generally given sole credit for founding the Trauma Center. The piece has good quotes from the Trauma Center's current heads of nursing and medicine, as well as from Cowley's widow. They make clear that Scanlan Trump was a remarkable nurse who fought to establish the Trauma Center and to improve nursing education, though we could have used more detail on that and Trump's role as a nurse manager. The obituary also has a couple bits of handmaiden imagery that are especially unfortunate for a piece about someone so fierce. We noticed that the Trauma Center bears Cowley's name alone, though the obituary suggests that Scanlan Trump effectively co-founded it. We reached out to the chief nursing officer of the University of Maryland Medical Center and the Vice President of Nursing of the Shock Trauma Center and suggested that the hospital consider adding Scanlan-Trump's name. In a cordial meeting, CNO Lisa Rowen, RN, DNSc, and Shock Trauma VP of Nursing and Operations Karen Doyle, RN, MS, MBA, persuaded us that Scanlan-Trump's contributions, though great, did not merit that recognition in terms of trauma care innovation. However, the nursing leaders did agree to take other permanent steps to highlight Scanlan Trump's contributions to nursing, including naming one of the conference rooms in Shock Trauma's new trauma tower after her. And today, the New York Times ran a shorter but very good obituary by Daniel Slotnick for Vernice Ferguson. She "fought for greater opportunities, higher wages and more respect for nurses as a longtime chief nursing officer" of what became the U.S. Department of Veteran Affairs (VA), supervising more than 60,000 nurses. When Ferguson left in 1992, after 12 years, the number of VA nurses with at least a bachelor's degree had more than doubled. Ferguson's nursing career required a bit of drive as well. When the African-American graduated from the nursing program at New York University in 1950 with an academic prize, the director of nursing reportedly refused to shake her hand. The piece has several telling quotes from Ferguson, and it effectively conveys the male-physician-dominated environment that Ferguson worked hard to change. The item also notes that Ferguson conducted and supervised nursing research, including at the National Institutes of Health; we could have used more detail on those aspects of her career. But on the whole, both obituaries are powerful reminders that nurses can better their profession--and the world. more...
"The Mindy Project" attacks nursing and midwifery
December 4, 2012 -- Mindy Kaling's new Fox sitcom The Mindy Project, which is set at a small obstetrics practice in New York City, is bad for nursing. Kaling's lookin'-for-love OB-GYN character and the other physicians alone provide skilled care -- by coincidence, Kaling's late mother was an OB-GYN -- while the one minor nurse character Morgan Tookers is a goofy ex-convict. Well-intentioned but ignorant, very odd, and a little scary, Morgan doesn't show much health expertise, and he seems to be based mostly on The Janitor from Scrubs. But wait -- tonight's episode, written by Kaling, also includes a grossly inaccurate attack on midwives! In the main plotline, a holistic midwifery practice led by two New Agey men is "stealing" patients from the traditional OB-GYN practice that Mindy and her two male physician colleagues run. Mindy gets the patients back by telling them that midwives have no significant health training or skill and that only physicians can provide real health care to pregnant women, lies the show presents as hard but inescapable truths. The show's physician characters also caricature the midwives as seductive "charlatans" and "quacks" who are hostile to all "Western medicine," including drugs and vaccines. These seem to be lay midwives, but viewers are likely to apply the show's powerful messages to all midwives (it's not clear if Kaling actually knows that many midwives are nurses with graduate degrees). In fairness, the lead midwife in the episode is a strong, clever character who notes that midwifery predates obstetrics. And we realize that the show mocks everyone for one thing or another; Mindy and her physician colleagues are a bit self-involved and socially maladroit. But the episode never offers any serious criticism of physicians as health providers. And this episode is consistent with the economic and territorial fear some physicians seem to have for advanced practice nurses. The episode may also reflect a reactionary sense that traditional professional and educational hierarchies are under threat. And it is telling that Kaling targets male midwives, even though the vast majority of real midwives are female. Of course, showing that reality might have complicated her gender goals, which involve getting her character the respect of her male physician colleagues. And speaking of reality, in the real world all midwives receive years of health care training. And research shows that the care of certified nurse midwives is at least as good as that of physicians overall. We urge the show to avoid further attacks on nursing and midwifery. more... see the film clips and please join our letter-writing campaign by clicking here!
November 2012 Archives
PBS's "Need to Know" and ABC's "20/20" highlight nurses' autonomous care for patients in crisis
November 3, 2012 -- Two recent U.S. television news pieces highlight nurses' skilled and autonomous care for patients in crisis. On June 22, PBS aired a 13-minute segment as part of its "Need to Know" series called "Nursing the Wounded." William Brangham's piece profiles three nurses at the large Veteran Administration hospital in San Diego. Each profile highlights a different facet of nurses' expert care for veterans who have returned with post-traumatic stress disorder (PTSD) and other problems. Each nurse comes off as articulate and authoritative; the profile of nurse scientist Jill Bormann, who is investigating the use of mantra therapy to manage PTSD, is especially impressive. And two of the three nurses are men, underlining the gender diversity of the profession. Unfortunately, the piece's suggestion that Bormann and the other nurses who are providing holistic, self-directed care to outpatients are playing "new roles" seems to reflect the erroneous view that nursing has traditionally just been about custodial bedside care until just yesterday. And tonight, the ABC current affairs show 20/20 included an 8-minute segment about New York University neonatal intensive care nurses who transported their fragile patients to safety after power failed at their flooded hospital during Hurricane Sandy. The segment, part of a feature about dramatic rescues during the storm entitled "The Heroes Among Us," appears to be the work of producers Gail Deutsch, Marc Dorian, and Adam Sechrist. The report consists mainly of co-host Elizabeth Vargas interviewing seven of the NICU nurses. The piece does include some references to the nurses' knowledge and skill, and it never suggests that physicians were directing their work or their actions to save the babies. On the other hand, the nurses are arguably treated more like bystanders who stepped up in a tragedy rather than highly trained health professionals, and there is a strong focus on the emotional state of the all-female group, an approach the show is unlikely to have taken with physicians. So the ABC segment is not nearly as helpful in conveying the nature and value of what nurses do in their everyday work as the PBS piece is. Still, both segments give prime time television audiences an unusual look at nurses acting autonomously to save and improve lives. more...
Go see "The Waiting Room!"
November 2012 –The new documentary The Waiting Room follows patients and staff in the overcrowded emergency room at Highland Hospital, which serves the poor and working class of Oakland, California. Working with footage shot over just 24 hours, director Peter Nicks takes a good look at how the United States cares for its underinsured residents. The result is a quiet but compelling indictment of our dysfunctional health financing system. We see Highland's staff try, with skill and patience, to help emergency patients with ailments from gunshot wounds to chronic back pain, although what many of them really need is good primary care. The patients are resilient, but most have to wait a long time, and they are often frustrated, even agitated. Some just seem lost. The film gives physicians more attention than other care givers. And there are only a few glimpses of direct care nurses, even though emergency departments typically have as many nurses as physicians. Five of the eight health workers identified on the film's website are physicians. There is also one social worker, one nursing assistant, and one registered nurse. She is a charge nurse who appears in several scenes, always at her computer, expertly managing a long list of patients, determining who can be moved and when, who can be discharged and when. Sadly, the film never identifies her as a nurse, so viewers may not realize she is one. Yet some may well see the nursing assistant as a nurse. She manages patients in the waiting room itself, taking vital signs, collecting and dispensing information, and displaying diverse interpersonal skills. Of course, these are just guesses about how viewers will see the providers; some theaters showing the film call this charismatic nurse's aide a "feisty head receptionist." In any case, she and one of the resident physicians form the moral core of the movie. For most viewers, the vision of nursing that emerges from this odd mix of likely misimpressions will probably be fairly good, but not great. The film's overall merit is clearer. As millions of people are still "waiting" for a more inclusive and effective health care system, everyone with a stake in that system--that is, everyone--should see this movie. see the full review ... The Waiting Room opens on Friday, November 30 in Washington DC, Boston, and Sacramento, and in many other places in the coming weeks. See a full list of venues here.
October 2012 Archives
"New York Times" and the "Atlantic" on APRN skill and autonomy
October 24, 2012 -- In recent months a number of commentators have issued pleas for the United States to expand the authority and scope of practice of advanced practice registered nurses (APRNs), which studies show would improve health care and rein in costs, contrary to the claims of some opposing physician groups. Two of these pieces are Tina Rosenberg's excellent article "The Family Doctor, Minus the M.D.", posted today on The New York Times website as part of the paper's "Fixes" series, and physician John Rowe's generally good May 7 post on The Atlantic website, "Why Nurses Need More Authority." Rosenberg's Times piece makes clear that clinics run by nurse practitioners (NPs) provide primary care that is at least as good as physician-run clinics. She cites NP credentials and the research showing how good their care is, and she explains why the nursing practice model is so effective. Rowe's item still betrays some condescension and a mistaken belief that APRNs are suited only for "routine" care and unqualified for more difficult diagnostic and care management tasks. But both items argue forcefully that expanding APRN practice would improve access to care and likely reduce health care costs. Both note that organized medicine opposes these measures, claiming wrongly that APRN care is inferior. And both pieces suggest that the physician groups' opposition appears to be driven more by concerns about lost income and authority than by any well-founded concern for patients. We thank those responsible for these pieces and all who wish to base important health policy decisions on facts rather than fear or bias. more...
Jon Stewart ridicules school nursing
October 24, 2012 -- Tonight on The Daily Show with Jon Stewart, two former U.S. military medics appeared in a segment about re-integrating veterans into the civilian workforce. We honor the service of these veterans, who appear to have significant experience stabilizing wounded soldiers, following EMT Basic training. But Stewart's repeated insistence that the medics are vastly overqualified to be school nurses is a glaring example of the elite media's ignorance of nursing expertise. Stewart mocked school nurses as being all about "kickball" and "tummy aches," even though he explicitly noted that one school nurse position he found required a bachelor of science in nursing--we guess not all bachelor's degrees are created equal (Stewart's bachelor degree is in psychology). Sadly, the medics themselves seemed to agree that they were qualified to hold registered nurse jobs. But today's school nurses need years of university science training because they manage the health of many hundreds of students who attend with serious conditions including asthma, diabetes, and allergies. Students have died because no registered nurse was available. And school nurses play a key public health role, not only educating students about critical health issues like pregnancy and STDs, but also monitoring the student population for disease outbreaks. In 2009, school nurse Mary Pappas in New York City (where the Daily Show is recorded and Stewart's children attend school) set in motion the governmental response to the H1N1 flu outbreak, identifying and managing hundreds of her students' symptoms. She later gave compelling testimony at a federal government flu summit. Plus, she made a little girl's tummy feel all better!The segment's theme reminded us of a vague but troubling comment President Barack Obama made just two days earlier in the October 22 presidential debate that veteran medics who wanted to become nurses had to "start from scratch" so it would be good to "change those certifications." Of course, all students should have a chance to show they merit advanced placement in educational programs, but nursing requirements cannot be simply waved away for people with a few weeks of health training and some field experience, no matter how courageous and heroic. Please ask The Daily Show with Jon Stewart to make amends for the damage caused when it spread this disinformation to its 2.5 million viewers--maybe with a segment about the problems school nurses face caring for the kids of a nation whose elite sees their work as trivial. more . . . please join the letter-writing campaign and see the film clips!
"Indian Express" on awful conditions for nurses
October 14, 2012 -- Today the Indian Express (New Delhi) website ran a good story about a recent study by sociologist Sreelekha Nair (right) of the Centre for Women's Development Studies focusing on the troubling situation of India's nurses. The study reportedly found that nurses continue to confront appalling working conditions including understaffing, especially in the private sector; abuse from employers, colleagues, and patients' families; very low pay and workplace restrictions that seem to approach servitude; and widespread undervaluation, including low work and social status, even though, as the report itself notes, they save lives. The Indian Express story, headlined "Indian nurses still an exploited lot: Study," originated with the Thiruvananth-apuram press agency. The article quotes extensively from the study and relies on additional comment from the study author, as well as Indian Nursing Council member P. K. Thampi. The piece links the status of nursing to the fact that the profession remains predominantly female. The report notes briefly that some nurses do find opportunities and even "adventures" by taking their skills overseas, though it does not explore how that migration affects India. The piece might have sought more input from nurses themselves, particularly those working in the clinical setting, and it might have gotten some reaction to the study from government and hospital officials. But the article provides valuable information about the state of nursing in India today, and we thank those responsible. more...
October 29, 2012 -- The remarkable new BBC series Call the Midwife, now airing in the United States on PBS, offers a dramatic look at the exploits of Anglican and lay nurse-midwives caring for poor women and babies in London's East End in the late 1950's. In the first three episodes, the series presents the midwives as skilled, autonomous health workers whose ability varies in accord with their relevant experience. Tough, expert senior midwives guide the nervous newer ones. In one early scene, after police try ineffectively to stop a raucous street fight between two women, one of the commanding senior midwives brings the altercation to a halt with one sharp question. The nurses visit pregnant women to monitor their progress, deliver the babies under awful conditions, and advise the new mothers, all in an environment without birth control where women seem to function as baby factories and one-person day care centers. One woman has 24 children. The midwives also provide community health services. Physicians do appear occasionally when their special skills are needed. But for the most part the focus is on the nurses who provide the vast majority of the care, and physicians are marginal, in what amounts to a reversal of the standard Hollywood model. Indeed, the show is remarkably free of stereotypes. It's not free of sentiment and generic uplift, some of the scenes are too pretty for the supposedly gritty setting, and central character Jenny Lee seems a bit unformed. The show is not quite on Nurse Jackie's level, and of course the setting differs greatly. But like Nurse Jackie, Call the Midwife is an often powerful, funny, and nuanced look at skilled nurses saving and improving lives in world whose concern for the health of the poor is open to question. Where Jackie offers regular critiques of the U.S. health care financing system, Call the Midwife includes advertisements for the U.K.'s National Health Service, which was new in the 1950's. Based on a memoir by midwife Jennifer Worth (nee Lee) and written by Heidi Thomas, the six-episode BBC series was a big ratings success in the U.K., and a second season is on order. In the United States, it seems to be doing well for a PBS show. We thank those responsible for Call the Midwife, and we urge all nurses to watch and support it. more...and see the film clips!