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Open Letter #8 to Grey's Anatomy

Dear "Grey's Anatomy" Producers:

I am writing to protest the portrayal of the nursing profession on "Grey's Anatomy." I recognize that the episodes broadcast January 22 and 29, 2006 which included the minor nursing strike plotline, seemed to be an effort to show nurses some respect. They did manage to convey briefly that the nurses' complaints about short-staffing and forced overtime had merit, that nurse staffing had been sacrificed to short-sighted cost-cutting, and that the hospital needed the nurses in order to run efficiently. I give the show credit for this.

But the strike episodes continued the show's tradition of misinformation and unrebutted slurs about nursing, and their overall vision of the profession was still so negative and inaccurate that it outweighed any benefit from the above elements. Nurses were presented as focused on administration and care tasks that viewers are likely to find trivial, like changing bedpans, handing things to physicians, minor hand-holding, and tracking patient quirks. Physicians were depicted as saving lives, and handling exciting work that nurses do in real life, including all key patient relations, all monitoring, all significant clinical interventions--and managing the nurses, since the nurses reported to the chief of surgery, rather than nurse managers. Indeed, since physicians on the show do all the nursing that matters anyway, the strike made virtually no difference in the clinical scenes. In the midst of a global nursing shortage, this is irresponsible.

My concerns about the show's portrayal of nursing extend to every episode that has been broadcast. Ten of ten major show characters are physicians, despite the central role nurses play in hospitals, which exist primarily to provide nursing care. Physician characters often perform key tasks that are generally the province of nurses, including various treatments, patient monitoring and psycho-social support. With only a few limited exceptions, such as the episode with the character described as Ellis's scrub nurse, nurses have been presented as marginally skilled physician subordinates, usually faceless and mute--like wallpaper. And recent episodes have offered a vision of nurses as fawning or vindictive losers (or even sluts, e.g. "skanky syph nurse") whose lives revolve around the physician characters.

As you may know, research shows that entertainment television like "Grey's Anatomy" and other Hollywood dramas has a significant effect on health care views and actions. Public health groups, such as Hollywood, Health and Society, work hard to improve public understanding of key health information through shows and public service announcements. Unfortunately, the public's poor understanding of nursing, reinforced by regressive media depictions of nurses as sexbots and peripheral physician subordinates, is a major factor in the nursing shortage that threatens lives worldwide.

I urge you to minimize the damage done by "Grey's Anatomy" by consulting a nurse expert in creating your SCRIPTS. Having a nurse on the set to teach actors playing physicians how to convincingly do the work that real nurses do is not helping nursing--it is harming nursing. I also urge you to consider dramatic changes that would allow the show to provide a vision of modern health care that gives viewers at least some basic sense of the role of skilled nurses in modern care.

Even if there is no room for even one major nurse character, or a recurring one who does more than act as a pathetic foil to the physicians, more could be done in virtually every clinical scene to avoid the suggestion that nurses are silent handmaidens. For example, a nurse character might be shown actually having a meaningful care interaction with a patient, or doing defibrillation or other key tasks nurses do in real life. Of course, the most obvious thing the show could do is just stop having its central characters express contempt for nurses, or have nurse characters clearly show why that contempt is unjustified.

Real nurses are skilled, autonomous professionals who play a central role in health care--if they can persuade decision-makers and the public to provide the resources needed. It is no exaggeration to say that the future of global health depends in significant part on better understanding of nursing. We hope that "Grey's Anatomy" will move toward being part of the solution.

Thank you for your consideration.

Sandy Summers, RN, MSN, MPH
Executive Director
Center for Nursing Advocacy
203 Churchwardens Rd.
Baltimore MD 21212
410-323-1100
ssummers@nursingadvocacy.org