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"Scrubs" letter-writing campaign


We believe the show is off the air, so we have ended our campaign, but you can write to the show's producer here:

Bill Lawrence
Executive Producer, Scrubs
12629 Riverside Dr. 3rd Fl.
Valley Village, CA 91607-3489

The letter we and many others sent Scrubs over the years is below:

Dear Mr. Lawrence:

I am writing to urge you to improve the portrayal of nursing on "Scrubs." The handmaiden image of nursing that your show often presents is decreasing public understanding of what nurses do to save and improve lives. When all credit for patient outcomes on "Scrubs" goes to the physician characters, viewers are left with the (false) impression that physician care is all that matters. I know that some recent "Scrubs" episodes have made an effort to present better images of nursing. And I understand that much of what is depicted on the show is a fantasy. But even the fantasy images tend to convey damaging assumptions that reinforce nursing stereotypes.

The February 1, 2007 "His Story IV" told millions of viewers that nurses are handmaidens with low-skilled jobs, that physicians supervise nurses and can become nurse managers at will, that nursing is for women so men who do it should be mocked, and that physicians take the lead in skilled patient monitoring, though nurses actually do that. The episode does suggest vaguely that "head nurse" Carla Espinosa is needed. And nurse Laverne Roberts, who has often been presented as a lazy, disagreeable stereotype, takes a more active and realistic role here. But on the whole, Mike Schwartz's episode is one of the worst "Scrubs" episodes ever for nursing, and it is an unfortunate step backward from several the show ran last season that included relatively helpful visions of nursing.

One scene suggests that physicians, rather than nurses, are responsible for patient monitoring. In this scene, an intern is the only person monitoring Private Dancer, and it is apparently only the physicians who bear responsibility when he goes downhill. Of course, monitoring patients and detecting changes in their conditions is a nursing function. Perhaps the show thought it was doing nurses a favor by involving them in some care tasks, but apparently absolving them of responsibility for what happened here. It wasn't. The scene wrongly sends the message that physicians do important nursing work, and that nurses merely carry out physician commands.

The "Kelso becomes a nurse manager" plotline gives viewers the false idea that the chief of medicine supervises nursing management. It tells viewers that nurses are physician helpers, not members of an autonomous profession with its own vital scope of practice. Read more about nursing autonomy here: The scenes after Kelso announces that he will take over as "head nurse" until Carla returns present further problems. The idea that Kelso could step directly into any nurse's job, much less a nurse manager job, is more damaging than merely suggesting that nursing managers report to him in some vague administrative way. A physician who was not a nurse could not manage a nursing staff in this way, and to pretend otherwise sends the message that nursing is just a minor subset of medicine that any physician could handle, more or less.

Later scenes with nurse manager Kelso play on nurse stereotypes but do not challenge them. First, there's the physician handmaiden, underlined by Cox's remarks about Kelso getting him new scrubs from housekeeping. And the "girl talk" angle (e.g., the "handsy" remark) suggests that nurses hang around and gossip. The actual nursing here--scheduling and giving a patient "meds"--will strike most viewers as pretty trivial. The suggestion that Kelso is not doing well is linked more to his being out of touch generally than to a lack of nursing skill and knowledge. Then there are Cox's remarks about Kelso needing a bra because he's "distracting" the physicians, a variation of the "nurse as physician sex toy" idea.

Of course, the only male "nurse" in the episode--Kelso--is an object of relentless mockery. Viewers are unlikely to see the show as questioning the idea that male nurses should be mocked for doing something that society has traditionally regarded as feminine. They are likely to think how funny it would be if Kelso took a job meant for servile females.

There are a few bright spots in the episode. Nurse Roberts, previously presented mainly as a tired stereotype, actually participates in substantive discussions, calling vitals and complaining about the lack of a nurse manager. Since she seems to be the closest thing to a backup to Carla, the show could have made her acting nurse manager. Of course, the idea that the hospital needs Carla in some general way is also of some value. Unfortunately, this episode does not make very clear why she's needed.

In general, a key reason that nursing is in its current state--understaffed, underfunded and underempowered--is that the work of nurses is undervalued by the general public and health care decision makers, all of whom are consumers of media and advertising. The handmaiden images of nursing on "Scrubs" discourage self-respecting, talented men and women from entering the profession by suggesting that the profession is all about feminine servitude, instead of education and hard work.

I urge you to be part of the solution to the global nursing shortage and the improvement of public health by ending the use of nursing stereotypes and by consulting nursing media experts when you create your scripts and film your episodes. Help us improve public understanding of nursing at this critical time.