Changing how the world thinks about nursing

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Nursing Vision
203 Churchwardens Rd.
Baltimore, MD 21212-2937

September 10, 2002

Ms. Dee Johnson, Co-Executive Producer
Warner Brothers Studios
4000 Warner Blvd., Building 133, Rm. 107
Burbank, CA 91522

Dear Dee:

As the new fall season begins, we are writing to thank you for the improvement in the portrayal of nurses on "ER." In the last few episodes of the past season, we were heartened to see that the nurse characters began to have a few lines per show depicting their critical thinking skills, they spent less time commenting on the lives of physicians, and Kerry acted less like a nursing manager. In a John Wells episode, we liked Abby's powerful lines about her passion for nursing.

We appreciated your final episode, which seemed to reflect the concerns we voiced in our December 6, 2001 letter that a bioterror event coupled with the nursing shortage would cause a breakdown in health care delivery. We were disappointed that the nursing shortage depicted was merely a temporary, scheduling-created shortage, while in actuality it is ongoing. As we have mentioned, we think portraying the very serious effects of the real nursing shortage on the delivery of health care would be dramatic and of enormous interest to your viewers. A great example of this was your scene in the final episode where Susan Lewis and another physician barked out orders--and instead of the usual instant care delivery, the physicians were shouting into the void. The vacuum of care depicted in that scene was notably well done, and we thank you for showing the public what happens when nurses are not there.

We still believe that "ER" would benefit by having its scripts reviewed by graduate degree-prepared nurses with relevant clinical experience to assure that nursing is portrayed accurately in each show. We would also encourage you to put more main characters into nursing roles or pump up the roles of the existing nurses to more fully portray their work. We also continue to urge you to ask the Warner Bros. webmaster to change the two web sites that portray nursing in a denigrating light. We will be happy to re-supply the suggested changes for the webmaster's consideration.

We also wanted to let you know about something that may help "ER"'s writers quickly generate new script ideas, or at least learn more about what nurses do. The Code of Ethics for Nurses is now available online. It is a comprehensive document outlining nursing roles and responsibilities and is available at:

We are attaching an article written by Drs. Beatrice and Philip Kalisch, professors at the University of Michigan and the foremost scholars on the portrayal of nurses in the media. In their comprehensive review of 670 nurse and 466 physician characters in novels, movies and television series from 1920-1980, they have identified recurring themes that are particularly damaging to the image of nursing. Especially interesting is the harmful effect of the "Marcus Welby syndrome." This syndrome, which involves the depiction of physicians as providing all health care including nursing care, unfortunately continues to afflict Hollywood programming even today.

Thank you considering our concerns and good luck with this coming season.

Sandy Summers, MSN, MPH, RN, Director, Nursing Vision

Jacquelyn Campbell, Ph.D., RN, FAAN, Associate Dean for Ph.D. Programs and Research, Professor of Nursing, Johns Hopkins University School of Nursing (JHUSON)

Linda C. Pugh, Ph.D., R.N.C., Associate Professor of Nursing,
Acting Director of the DNSc Program, JHUSON

Ruth Malone, Ph.D., RN, Acting Associate Professor of Nursing and Health Policy, University of California at San Francisco

Dan Sheridan, Ph.D., RN, Assistant Professor, Forensic Clinical Nurse Specialist, JHUSON

Rich Kimball, MSN, MPH, RN, Associate Director, Center for Nursing Advocacy, Clinical Instructor, JHUSON, Clinical Research Program Coordinator JHU School of Medicine

Gina Pistulka, MSN, MPH, RN, Ph.D. student, JHUSON, Member, Advisory Committee, Nursing Vision

Kelly Bower, MSN, MPH, RN, Clinical Instructor, JHUSON, Member, Advisory Committee, Nursing Vision

Bridget Roughneen, MSN, MPH, RN, Member, Advisory Committee, Nursing Vision

Christine Stainton, MSN, RN, Member, Advisory Committee, Nursing Vision

Pat Woods, BScN, RN, Instructor, Emergency Nursing Specialty, British Columbia Institute of Technology, MScN student University of British Columbia, Member, Advisory Committee, Nursing Vision

cc: John Wells, Jack Orman, Mark Morocco