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Private Practice episode analyses

Nursing rating

Rating guide:
excellent = 4 stars; good = 3 stars;
fair = 2 stars, poor = 1 star

Artistic rating 2 1/2 stars

The beck and call girlsnurse mouse

January 22, 2013 -- Several recent episodes of ABC's Private Practice, including tonight's series finale, had a few scenes with strong, smart, articulate labor and delivery nurse Stephanie Kemp. And actress Justina Machado, who seems to have made nurse TV characters a career specialty, brought her usual dignity and likability to the role. We appreciate this rare effort by show creator Shonda Rhimes and the other producers to suggest that nurses are not necessarily idiots and that they can be skilled members of the health care team. However, it could also be argued that the Stephanie character was a last-minute Band-Aid on the gaping wound caused by the show's overall portrayal of nursing during its six-year run. Stephanie's skills appeared to consist almost entirely of anticipating physician needs and acting as an assistant to physicians; she displayed little autonomy and rarely interacted with patients. In this sense, she was not unlike the show's now-deceased Dell Parker character, a nurse midwife who often functioned more as an office manager or receptionist than a health professional. At the same time, the other nurses in these recent episodes were even more extreme versions of the show's usual handmaidens, coming off as clueless and/or terrified mice, meekly obeying physician commands and performing the kind of "wallpaper nurse" tasks seen on Hollywood shows like Grey's Anatomy, House, and ER for decades. By contrast, Stephanie was even worthy of a relationship with hunky heart surgeon Sam Bennett. But that romance followed the same trajectory as nurse-physician relationships on show creator Shonda Rhimes's earlier show Grey's Anatomy. For example, in 2008, Grey's surgeon Derek Shepherd's relationship with nurse Rose ended when he returned to surgeon Meredith Grey, and in 2011, Grey's nurse Eli's relationship with surgeon Miranda Bailey ended with her returning to an ex-flame anesthesiologist (who has since become a surgeon; on Grey's, even non-surgeon physicians are unworthy!). Here, Sam ultimately left Stephanie to return to his ex-wife Naomi, a physician fertility specialist. It seems that a few unusually skilled and feisty nurses deserve some basic respect. But let's not get carried away. On Private Practice, it's a physician's world, and the nurses just live in it. see the full review and film clips from relevant episodes...


"A midwife in a world of doctors"

Medical school in the skyAugust 2010 -- In the last episodes of the third season of ABC's Private Practice, the show killed off its one nurse character, midwife Dell Parker. That was no great loss to nursing, but the plotline that played out in the May 6 and 13, 2010 episodes included attacks on the profession, most notably through Dell's elation at having just been admitted to medical school. That was a powerful reinforcement of the enduring Hollywood fantasy that the most able nurses achieve by going to medical school, when in fact they are perhaps 100 times more likely to attend graduate school in nursing. The wannabe-physician stereotype is one with which real advanced practice nurses and of the wannabe-physician stereotype with which real advanced practice nurses and men in nursing must still contend. In an amusing twist, the key May 6 episode was written by physician Fred Einesman, a former advisor to NBC's ER, which also pushed the wannabe-physician theme. Private Practice did, rarely, include minor plotlines in which Dell actually showed some aptitude for patient care and some limited autonomy. For instance, although the March 25, 2010 episode was mostly about how amazing the show's physician characters are, Dell did get to deliver a baby by himself in the field. And because he successfully executed a risky maneuver to free the baby, who was stuck in the birth canal, physician Cooper credited Dell with saving two lives! But Dell's exit reminded us of what the show really thought of midwifery and nursing. Don't take our word for it. In the May 24-June 6 issue of TV Guide, show creator Shonda Rhimes explained that Dell was "a midwife in a world of doctors. Babies can only be delivered in so many episodes. Dell got lots of coffee, answered lots of phones." She lauded actor Chris Lowell by noting that "an actor of his caliber should be doing Shakespeare, not handing people charts." In other words, nurses and midwives don't do much of interest, which is why Dell spent so much time doing receptionist work, and why he eventually had to go. But at least he has now gone on to that great medical school in the sky! more...and see video clips from the relevant shows.


It hurts

Dell ParkerJanuary 21, 2010 -- In a minor plotline in tonight's Private Practice (ABC), nurse midwife Dell Parker actually shows some autonomy and knowledge in coaching an expectant single mother who is determined to stick to her "natural" birth plan, despite spending three days in labor. The mother ultimately succeeds in her plan and the show displays real sympathy for her. But the plotline also spends time mocking the holistic birth model that she wants and that real midwives follow. And the show gives no real indication of why that birth model might make sense--why, for example, a mother might want to avoid drugs, C-sections, or physicians--offering only the mother's vague statements that she wants to "experience" the birth and to give her baby the "best chance that he can have." The episode also presents Dell less as an expert in natural birth than as someone trying to cope with the mother's odd ideas. And at one point, Dell brings in superstar OB/GYN Addison Montgomery for a consult about the mother's status and options that a real nurse midwife would need no help with, partly undermining the sense that Dell is an autonomous professional. Still, Dell does show psychosocial skill in helping the patient through labor, and he does finally deliver the baby solo with no problems. The plotline ends with the mother looking ecstatic. So we give the show credit for a mildly positive, though deeply flawed, portrayal of a nurse midwife. This episode, "Best Laid Plans," was written by Patti Carr & Lara Olsen. more...and please join our letter-writing campaign!


Not a doctor, but...

April 29, 2009 -- ABC's Private Practice, whose season ends tomorrow, April 30, may be the only broadcast network show with a major nurse character to return next season. In the February 5 episode (Mike Ostrowski's "Acceptance," 13 million U.S. viewers), lone nurse character Dell Parker, who is studying to be a midwife, shows some tentative clinical aptitude and knowledge to go with his boyish eagerness. Under the close supervision of OB/GYN Addison Montgomery, Dell ably performs a vacuum-assisted delivery. Later he haltingly guides the baby's parents toward breastfeeding. Dell also performs an assured solo ultrasound of pregnant psychiatrist Violet Turner, calming her panic attack and eliciting her agreement to his own suggestion that, though he's "not a doctor," he will likely become a "pretty good midwife." The show still condescends to Dell, who is also the office manager/receptionist at the LA clinic where the show is set. In the March 26 episode (Craig Turk's "Do the Right Thing," 10.1 million U.S. viewers), Dell starts hooking up with young women by pretending to be a physician. This earns quietly amused derision from the elite physician characters. Of course, neither registered nurses nor physicians are qualified to do the job of the other group. But aspiring advanced practice nurses, who may be wrongly perceived as "wannabe" physicians, would be unlikely to reinforce that impression, which would suggest a lack of respect for nursing and themselves. Needless to say, Private Practice remains physician-centric, with its many physician characters often doing key care tasks that nurses generally do in real life. Still, on balance, the early 2009 episodes seem to represent a small step forward in the show's portrayal of nursing. more... see film clips of the show and please join our letter-writing campaign!


"Is That Even a Word--Midwifery?"

ABC's "Private Practice," the only new health drama of the 2007-08 TV season, is another prime time soap about smart, pretty physicians from "Grey's Anatomy" creator Shonda Rhimes. But in addition to the seven physician characters who dominate here, the show's LA "wellness clinic" also has cute surfing receptionist Dell Parker. The earnest Dell just got his "nursing degree" and is studying to be a midwife. He seems to be a young, network version of "Strong Medicine"'s Peter Riggs--except Dell uses his nursing skills to be a receptionist. Despite good intentions and an intense interest in the clinic's patients, Dell seems to be the least knowledgeable major nurse character in the last decade of prime time US television. The show's early episodes suggest that his clinical studies consist of whatever ad hoc assistance he can give to clinic physicians. The episodes also rely heavily on juvenile mockery of Dell's midwifery studies as lightweight New Age kookiness. Show anchor and superstar physician Addison repeatedly utters the word "midwif" as if she had never heard of such an outlandish pursuit. Alert viewers can also catch glimpses of wallpaper nurses in the background once in a while, but it's not clear if any of them will ever display the ability to speak, much less think. On the whole, "Private Practice" either ignores or grossly undervalues nursing care, as the show pursues its tired "heroic physician" narrative. more, including our 5 new film clips...

"Is that even a word?"

September 26, 2007 -- The premiere features Addison mocking the very idea of midwifery. We're meant to assume that bemused contempt for midwives would probably be the attitude of any true childbirth expert. more...

"I love talking to midwifs"

October 3, 2007 -- Early in the episode we see Dell asking fertility specialist Naomi to speak to his midwife class. Naomi can't teach the class, so Addison tells Dell: "I'll do it. I love talking to midwifs." more...

"Commit to the cake, man"

October 10, 2007 -- The show manages to get through the entire episode, without mocking the word "midwifery." However, the episode does nothing to counter its overall presentation of Dell as an office assistant with little to no health care expertise. more...

"Vulva! Labia Majus!"

October 17, 2007 -- In the episode it's back to mockery of "midwif" school and of Dell's role as office naïf. more...

"Don't mock the midwife"

October 24, 2007 -- The episode is notable for a minor plotline built around Dell's first pap smears. But on the whole the episode presents Dell as a nurse without significant skill or experience with patients. more...


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Shonda Rhimes, Lauren Schmidt, Mark Tinker
Executive Producers, "Private Practice"
Raleigh Studios
5300 Melrose Avenue
East Office Building, 4th Fl.
Hollywood, CA 90038-5111

Channing Dungey, VP Drama Series
Touchstone Television
500 S. Buena Vista St.
Burbank, CA 91521

Charissa Gilmore, VP Media Relations
Touchstone Television
500 S. Buena Vista St.
Burbank, CA 91521