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"Nurses: Kick out sex-mad Makosi"

July 8, 2005 -- Today The Sun (U.K.) ran a short, unsigned piece reporting that a group of nurses is calling for a young cardiac nurse to be "struck off" the list of licensed nurses by the Nurses and Midwifery Council because she appeared to have had "unsafe sex" during a "boozy orgy" on the U.K. reality show "Big Brother." This situation raises interesting issues about nurses' professional obligations away from their main work settings, including any duties to model responsible public health conduct or conform to a particular moral code.

The Sun reports that Makosi, a 24-year-old cardiac nurse, "was seen apparently bonking Anthony in the Big Brother pool during a boozy orgy" on the popular television show. The piece notes that Makosi later told others on the show that she might be pregnant, as the two lovebirds had not used a condom. The piece says that Collette Wolford, a nurse from South Wales, is leading a petition drive to have Makosi struck off. According to the Sun, the petition will cite Makosi's "unprofessional" conduct, noting that the Council's "code of conduct" requires nurses to "act in a way that justifies the trust and confidence the public have" in them and "uphold the good reputation of the profession." A spokesman for the Council is quoted as saying that he doubts Makosi will return to nursing after "Big Brother," but "if she does she must stick to the code of conduct." Wolford is quoted as saying: "It’s disgusting. She’s a disgrace and she’s just playing a game. Millions of teenagers out there now think it’s OK to have unprotected sex. She should be struck off for being a bad influence on them and for behaving in an improper way.”

Obviously, a nurse having actual unprotected sex on a reality show that's popular with young people sends an abysmal public health message, and nurses are right to object. (It might be different if it was part of a scripted show, depending on the context.) It seems fair to expect nurses and other health care professionals to meet a higher standard of conduct in the area of their professional responsibility even outside the workplace, much as there may be a special expectation that lawyers follow the law and that government employees pay their taxes. But should nurses' license to practice depend on modeling responsible health conduct even while clearly away from their main work settings? If so, where should that line be drawn? What if Makosi had appeared smoking a cigarette--would that have been sufficient to have her struck off? What if she had had unprotected sex at a private party, rather than on television? Would such rules also apply to health workers who recklessly transmit incorrect health information to a large audience? Is it a sliding scale, depending on the severity of the bad health practice, how widely seen it is, and the level of recklessness? Is there any precedent for such discipline? In these respects, The Sun has not satisfied our inquiring minds.

We can't help but wonder to what extent the calls for Makosi to be struck off have to do with nursing's traditional virtue script. Clearly, Makosi's apparent conduct on the show will do little to dispel the "naughty nurse" image, though at least there is no report that she associated her conduct with her profession, such as by displaying any stereotypically "naughty nurse" attire. But we note that some of the language quoted in the article suggests the application of a moral standard as much as it does a professional health standard. For instance, the code of conduct speaks of the profession's "good reputation" and the public's "trust and confidence," and Ms. Wolford, while rightly upset about the terrible health message sent to young people, appears to cite "behaving in an improper way" as an independent reason that Makosi should be struck off. This language is uncomfortably close to the virtue script, under which nurses are seen mainly as spiritually pure females, rather than highly skilled professionals. Consider what standards society might apply if some of the professional and gender roles were different. The article does not state the profession of Makosi's partner Anthony, but what if he was a physician--would the same standards be applied to him? What if Makosi was a physician? And what if Anthony was a nurse?

As a side note, the Center notes that a Las Vegas ED nurse, Maggie, is currently appearing on CBS's U.S. version of "Big Brother." So far, we have had no reports of unsafe sex or boozy orgies.

See The Sun's article "Nurses: Kick out sex-mad Makosi" from July 8, 2005.

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