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Letter to "ER" from Diana Mason

Mr. Parsons,

I am writing to share with you a longstanding concern that I have had about how nurses are represented on ER. I have been compelled to write now because of reports from colleagues about a worsening of the situation in this year's episodes. I find that I cannot tolerate viewing an entire episode of ER anymore because of the inaccurate portrayals of what nurses do as professional care providers. I turn the program off and usually cannot last 5 minutes before feeling so disgusted that I turn the channel. We are in the midst of a severe public health crisis due, in part, to continuous media portrayals of nurses as low-level handmaidens to physicians. It makes me sick to see ER perpetuate this situation.

I wrote an editorial in the American Journal of Nursing (circulation of 350,000; estimated pass-along reach to 1.5 million nurses) last year that addressed the relative invisibility of nurses in the media and the inaccuracies surrounding the few times that nurses are included in storylines. I ended that editorial asking readers why we are all not boycotting your program. I have since heard from many other nurses expressing their concern about these issues. I know that Sandy Summers and the Center for Nursing Advocacy have contacted the producers of ER in the past, without any noticeable, meaningful commitment to correct this situation. I hope you will consider the impact of your program on this nation's nurses and the people they care for, and direct your producers to do the following:

1. Hire at least one expert ER nurse to consult with you, not just about whether the IV is being inserted correctly, but how to more accurately represent the important work that nurses do in the ED. You might even explore hiring a nurse writer. I know of several who have published best selling books, as well as plays. I know script writing is different, but these are talented people and could at least provide some assistance to develop compelling story lines that better represent what nurses do.

2. Develop several lead characters who are expert ER nurses. I'm not expecting you to represent nurses as unidimensional saints but would hope that they would be able to demonstrate the drama and complexities of real life nursing practice in the interdisciplinary setting of the ED. Nurses loved Hot Lips Houlihan in MASH, not because she was mad for love, but because she accurately portrayed a nurse who advocated for her patients, had high standards, ran a very tight ship, and was an expert clinician. While nursing doesn't need every nurse character to be a sexpot (the longstanding media portrayals of nurses as someone's sexual fantasies is old and equally offensive to those of us who take our work seriously), I would actually support a thoughtful storyline that deals with how nurses respond to the sexual advances of patients--there are many dimensions to even this issue including psychological, sociological, and historic.

3. Quit suggesting that every nurse secretly wants to be a physician or are their charges. Neither is true. Your continued misrepresentation of these facts undermines our efforts to promote nursing as a career to young people.

4. Ask nurses for real stories that you might draw upon and that would illustrate other difficult, humorous, compelling issues that would make for great drama or comedic moments.

Nurses used to love your program and I believe were largely responsible for the program's early success. They watched it religiously, as did their friends and families. There are 2.7 million of us. I hope you will consider the social responsibility of your program and find ways to partner with expert ER nurses to develop story lines that would strengthen what you are currently offering.

Diana J. Mason, RN, PhD, FAAN
American Journal of Nursing
Lippincott Williams & Wilkins
333 7th Avenue, 20th Fl.
New York, NY 10001



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