April, May and June 2013 Archives
News on Nursing in the Media
June 2013 Archives
Vice President Joe Biden explains how nurses differ from physicians
June 3, 2013 -- Today, during a speech about mental health awareness, U.S. Vice President Joe Biden spent about a minute paying tribute to nurses. That short part of his speech implicated issues including nursing skills, nursing autonomy, the nurse as angel, the profession's gender mix, and even the naughty nurse. Biden mentioned psychiatric nurses, and then, apparently departing from his prepared text, said that "if there's any angels in heaven, by the way, they're all nurses," referring to his personal experience with neurosurgery. Of course, nurses are not angels, but real professionals who save lives with education and skill--and unlike angels, they need the resources to do so. Then, in the remark that's gotten the most attention, Biden said: "Doctors allow you to live, nurses make you want to live." Well, sort of. If he meant nurses focus on psychosocial care, motivating you to keep trying and showing you how, that's good, although he might have simply meant nurses are nice people who cheer you up. Unfortunately, the remark implies that physicians save lives and nurses don't save lives, which is false. And as titters from the audience alerted Biden, the statement can also be interpreted, though not fairly, as a clichéd reference to hot female nurses making sick men want to live for reasons that we can't specify here or our news alert will bounce back. Biden quickly noted that he was referring to "male nurses and female nurses." Finally, Biden said that during the two months he spent in the ICU, his neurosurgeon would enter his room and say (here Biden adopted a deep, somewhat pompous voice): "We gotta do this, this, this, and the other," and "my nurses would all go, 'yes, sir,' and then they'd do exactly what I needed." We appreciate Biden's suggestion that the nurses had the knowledge and skill to do "exactly what [he] needed." It's sad but plausible that the nurses felt they had to do it covertly, as Biden implies, presumably because they lacked the social power to simply discuss care with the surgeon as a professional colleague. We thank Vice President Biden for presenting some helpful information about nursing. more ... and see the video clip!
May 2013 Archives
Physicians are better than APRNs because they just are!
May 31, 2013 -- Truth About Nursing supporters recently told us about a television commercial being aired in the southern United States by American Family Care, an aggressively expanding chain of urgent care clinics that plans to have more than 140 locations in 26 states by the end of this year. The ad featured two people texting back and forth about where to seek health care. At the end, one texter recommended that the other go to American Family Care because there you get to see "a doctor, not a nurse." We could not locate the commercial (we created the image above based on what people told us the ad was like), but American Family Care itself was not hard to find. We placed about 7 calls, 1 per day, to Felicia Fortune, the corporation's director of marketing. She never returned any calls. Then we placed a call to company CEO Bruce Irwin and left a detailed message. American Family Care's chief medical officer Glenn Harnett returned our call and had a long discussion with Truth executive director Sandy Summers--you can listen to a recap of that phone call here in an mp3 (9 min). Harnett insisted that the care provided by physicians was better than that provided by APRNs based on the length of physicians' formal education. However, APRNS typically get as much formal health science education--4 years--as physicians do, and in any case a mountain of research in recent decades has shown that if either of the two professions has better patient outcomes, it's nurses. Harnett was not interested in the research, despite the strong and increasing emphasis on evidence-based practice in modern health care. He did, however, tell Sandy that American Family Care would pull the ad. We thanked him. Harnett said the company would replace it with an ad that went something like this: "At American Family Care, we care about you. That's why when you come to our clinics, you get to see a physician." We told him that isn't much better, since it implies that the people you're not seeing--which in the quick clinic context would only be APRNs--are inferior to the ones you are seeing. Sadly, Harnett did not see our point. And he refused to let us help the company create an ad that was not offensive or to send us a link to the new ad once it was done. By the way, we see that the company's "staff openings" section currently lists four (4) Family Nurse Practitioner positions in Alabama--we certainly hope the company "cares about" its Alabama customers as much as the others! Anyway, if you see a new version of the company's ad or related marketing efforts, please send us a copy or write to us at firstname.lastname@example.org. Thanks very much!!
Nurses still the servants in Grey's Anatomy's 9th season
May 16, 2013 -- Tonight's season finale of ABC's Grey's Anatomy capped another season of the all-surgeons-all-the-time drama, which has become of one of the most popular hospital shows in U.S. television history. The show has also been one of the most damaging to nursing, and this ninth season was no exception. As usual, clinical plotlines wrongly told viewers that surgeons do virtually everything that matters in the hospital, including all the skilled monitoring, critical interventions, patient education, and patient advocacy--things that nurses do in real life. A December 2012 episode did briefly feature an apparently knowledgeable nurse cajoling a nervous surgical intern into managing an infant patient in crisis. The scene suggested the nurse was training the surgeon to assume command, like a drill sergeant, but that nurses cannot act without physician direction. In the end, the nurse came off as an anonymous testing device for the surgeon, whose experience dominated the scene. A March 2013 episode included a fleeting suggestion that nurses were actually required for the hospital to do surgeries! But the rest of the season included apparently nurse-free surgeries. And the show otherwise presented nurses as obsequious servants, doing mundane physical tasks and absorbing commands with a standard "yes, doctor!" or without comment. In tonight's season finale, a major storm threatened the hospital, in a plotline seemingly based on what happened at NYU Langone Medical Center during Hurricane Sandy in 2012. In real life, NYU nurses transported critical NICU patients to safety. But here, Grey's surgeons appeared to staff the NICU pretty much by themselves, ventilating the babies and providing emotional support to distressed parents. And late in the episode, the show offered a classic Grey's insult. Attending surgeon Miranda Bailey, too upset by a bad patient outcome to perform surgery, is seen ferrying blood to the OR. Surgeon Richard Webber, not recognizing Bailey at first, says "Thank you, nurse," then, seeing his mistake, apologizes. This underlines just how far Bailey has fallen, that she could be mistaken for a nurse. Soon Bailey is operating again, and the responsibility for carrying objects from point A to point B is back where it belongs. more...
PARADE covers The American Nurse
May 6, 2013 -- To mark International Nurses Day, the widely-read PARADE magazine today posted on its website 10 portraits drawn from Carolyn Jones's The American Nurse, a coffee table book of portraits published in 2012. On the whole, the portraits and related interview text give a sense of the important, wide-ranging work of nursing. A few even briefly suggest how nurses use their skills to help patients, including an excellent portrait of a New Orleans family nurse practitioner who cares for mothers and babies, and good one in which an Appalachian hospice nurse describes his dream of opening a clinic and addressing the obesity epidemic. The images are diverse; they include two African-Americans, three men, and two advanced practice nurses, as well as nurses who work in a school, a prison, and an aircraft. All interview text includes the professional credentials of the nurses, including graduate degrees. And there is no suggestion that nurses exist to serve physicians. On the other hand, a lot of the text and portraits are infected with emotional "angel" imagery, vague about nursing, or not about nursing at all. Likewise, the introductory statement from Jones--that nurses are a "special breed" combining "innate compassion and learned behavior"--doesn't exactly tell the public anything new or helpful. We also do not learn here that nurses do anything on the cutting edge, or that they are engaged in research or innovation. And although some of the photos are powerful, as past photo collections featuring nurses have shown it's hard for still images to convey the most important thing most people need to learn about nurses--that they are life-saving professionals with advanced skills. We realize that the imagery and text that appears here primarily reflects decisions by Jones, not the nurses. In any case, we thank those responsible for the imagery and text that does advance public understanding of nursing. more...
The Mindy Project's three stooges...uh, nurses
May 2013 -- By the end of its first season, Mindy Kaling's Fox sitcom The Mindy Project had three recurring nurse characters, giving it almost as many as Showtime's Nurse Jackie had at that time. But that's pretty much where the similarity in nursing portrayals ends. Nurse Jackie's lineup is led by Jackie Peyton, arguably the toughest, most expert major nurse character in U.S. television history, along with her quirky but impressive protégée Zoey Barkow. On Mindy, set at a New York ob-gyn practice, the main nurse character is Morgan Tookers, a good-hearted but demented ex-convict who drives some of the show's more ridiculous plotlines and delivers unintentionally self-mocking lines like "I am not paying $10 to check this $5 coat." There is also Beverly, an older nurse who was initially so hostile, inept, and unhinged that the practice fired her; she reacted by breaking lead character Mindy Lahiri's nose. Still, after Beverly threatened to sue for age discrimination, she was re-hired as an administrative assistant, a job at which she has proved equally incompetent. In one episode, she queries: "Is it offensive to say that I only trust an older white man to give me the news?" And late in the season the show introduced Tamra, a nurse with little evident motivation who initially functioned as an office insult comic reminiscent of Perry Cox from Scrubs, except without Cox's expertise or authority. It's true that the show is irreverent toward the physician characters in romantic and personal matters--they have their foibles and they can act foolishly. But the physicians also display health expertise, and the show does not question their medical competence. Meanwhile, the nurses are peripheral misfits who help advance plots and offer comic diversions but show little if any health knowledge. The Mindy Project feeds the stereotypes that nurses are unskilled dimwits and physician lackeys. The show's executive producers were Mindy Kaling, Michael Spiller, Howard Klein, Matt Warburton, B.J. Novak, and Charles McDougall. see the full analysis... or go straight to our petition!
April 2013 Archives
CNN and New York Times on care of Boston Marathon bombing victims
April 17, 2013 -- Two major media press reports on the tragic bombing at the Boston Marathon illustrate the range of nursing portrayals in coverage of mass casualty events. Yesterday CNN posted a short piece on its website by Elizabeth Cohen, along with related video, that relied mainly on commentary from two experienced trauma nurses who were on the scene as part of the regular marathon health care contingent. The report reveals something of the nurses' expertise and the key role they played in caring for the wounded. However, the piece is careful not to suggest that nurses acted alone, referring repeatedly to the "team" of "doctors and nurses" who cared for victims. Granted, the headline is "Nurses relied on trauma experience to help bombing wounded," but the report makes clear that it was not just the nurses, and on the same web page there is a link to a video interview with a physician from a local hospital ("Doctor: we were ready for this") who describes the care for the patients who arrived there in some detail. So there is a little risk that the CNN audience will miss that it was a team endeavor. Less impressive is today's longer New York Times report by Gina Kolata, Jeré Longman, and Mary Pilon, which matches its headline--"Doctors Saved Lives, If Not Legs, in Boston"--with a comprehensive account of the victims' care that suggests physicians did or directed everything important. The report does include two references to "nurses" being present at the care settings, but it does not name or quote any. Instead, there are multiple quotes from six physicians and suggestions that physicians did pretty much everything, including tasks in which nurses were surely key players, such as preparing for marathon-related issues like dehydration. At one point, the report notes that a "medical team" left a hospital at 2 a.m. and returned at 6 a.m., checking patients at each point, as if nothing happened in the interim. But the article does take time to describe a surgeon's nap. We are aware of no other Times report that corrects the imbalance in this one. We do thank CNN for its coverage of the work of nurses in the aftermath of the attack. more...
Flawed heroes on TNT's Monday Mornings
April 2013 -- From February to April 2013, TNT broadcast the first and only season of its drama Monday Mornings, which portrayed surgeons at a Portland (Oregon) hospital and in particular the tense "morbidity and mortality" conferences at which they examined their errors. The cable series was created by noted television producer David E. Kelley (responsible for the CBS surgeon show Chicago Hope (1994-2000)) and by surgeon and CNN medical correspondent Sanjay Gupta. The new series was based on Gupta's 2012 novel of the same name. All eight major characters on Monday Mornings were surgeons, and the series glorified their work, even with the focus on errors and the portrayal of a few characters as insensitive, arrogant, or even abusive. The show really cared only about what the surgeons were doing, and only they interacted with patients and families. Nurse characters were unusually scarce. In many scenes, they were not even vague shapes in the background, as you might see on Grey's Anatomy. When nurses did appear, they were anonymous helpers, and it was rare to see their faces, though there was the occasional sound of vital signs being reported. One of the few scenes in which a nurse did briefly assert herself came in the series finale, when a crusty ICU nurse tried to limit the number of the surgeons who could see a sick surgeon colleague. The chief of trauma surgery dismissed the nurse's concerns, reminding her to pick her "battles"--a well-chosen word because she was indeed a "battle"-axe, an unpleasant bureaucrat enforcing hospital rules the show presented as trivial. On the whole, Monday Mornings followed the traditional Hollywood hospital show model in which physicians are the heroes who do everything that matters and nurses are, at most, peripheral subordinates. more...
Nurse Jackie returns
April 14, 2013 -- With the fifth season of Showtime's Nurse Jackie set to begin tonight, it's time to review the last season, which aired in spring 2012 and once again highlighted the central role nurses play in patient care. Most of the season focused on Jackie's recovery from her drug addiction and other personal issues. But when there were clinical scenes, the show continued to present Jackie, at least, as essentially a peer of the physicians. She was a clinical leader providing creative technical and psychosocial care. And in the last two episodes of the season, she actually took over the emergency department in the midst of a staffing crisis, running it expertly until the malevolent hospital CEO Mike Cruz fired her. The show also featured more credible, compelling interactions among nurses, and between nurses and physicians, showing that nurses are sentient three-dimensional beings. All of that is rare in Hollywood. Jackie's quirky mentee Zoey Barkow continued to show potential as a future version of Jackie--at several points Zoey showed the kind of clinical courage and initiative that Jackie does. There is still no really strong male nurse character, though nurses Thor and Sam do seem to have settled into their roles as competent, funny Jackie acolytes. On the downside, the show continued to struggle to portray nursing autonomy. There were several more suggestions that physicians control nurse staffing, and, after Cruz demoted nurse-manager Gloria Akalitus to staff nurse, the show proceeded without any apparent nurse managers at all. Still, on the whole, Nurse Jackie remains probably the best show for nursing in U.S. primetime television history. The executive producers of the show are Linda Wallem, Liz Brixius, Richie Jackson, and Caryn Mandabach. more...