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Nursing's anatomy

September 28, 2005 -- Today the San Jose Mercury News ran an op-ed by Suzanne Gordon, "America's shortage of nurses gets no help from Hollywood." The piece argues that popular entertainment products like ABC's "Grey's Anatomy" present a highly distorted vision in which physicians provide all meaningful health care and nurses are peripheral handmaidens. Gordon stresses that research shows these products are a major influence on how the public views nursing, and thus a big factor in the crisis that threatens to leave the U.S. short hundreds of thousands of nurses--just as the retiring baby boomers will depend on nurses to save and improve their lives.

Gordon's main point is that the nursing crisis is influenced not only by wages and conditions, but by "traditional stereotypes" that are persistently reinforced by Hollywood. In fact, the Truth argues that poor public understanding of the profession actually underlies most of the more immediate causes of the shortage, including short-staffing and the profession's continuing gender imbalance. Gordon wonders how many viewers of the popular ABC series "Grey's Anatomy"--which just had its second season premiere where nurses did nothing more than scurry in the background and deliver flowers to patients--see the link between such popular Hollywood "doctor shows and movies" and "one of the worst nursing shortages the country has ever experienced." Gordon points out that the U.S. shortage, now estimated to be almost 150,000 nurses, is projected to grow far worse if current trends continue, potentially growing to 600,000 at the time the baby boomers are retiring. If it does, she notes, "as recent studies have shown...even more hospitalized patients will suffer from preventable complication[s] like urinary-tract infections, pneumonias, blood clots, bedsores--to name a few."

Yet in Hollywood products, nurses rarely if ever appear in a way that "does justice to the life-saving roles they play in real hospitals." On the contrary, they tend to be "mere handmaidens" of physicians, lacking confidence, competence and professionalism. Gordon points to the dim-witted lead character in the movie "Nurse Betty," the maligned male nurse in "Meet the Parents," and the more assertive nurses of films like "Living Out Loud" and the TV show "ER" who prove themselves--by becoming physicians. Gordon discussed these products in more detail in her important book "Nursing Against the Odds" (2005).

Gordon argues that "Grey's Anatomy" may actually be "the worst offender"--a distressing thought not least because, though the piece does not mention it, the September 25 season premiere drew over 19 million U.S. viewers. Gordon notes, accurately, that the show "explicitly denigrates" nurses. She cites a scene near the start of last season in which a male surgical intern mocks a female nurse who has questioned his diagnosis for not having gone to medical school, then tells a nearby female intern that he "hates nurses." Actually, the male intern does turn out to be wrong about the diagnosis. But when the female intern herself suggests that he might have missing something, he effectively calls her a nurse; the female intern is deeply offended, and her intern friend later notes that she "hates" him for having called her friend a nurse. Welcome to feminism, Hollywood style. Gordon points to another scene in which an intern expresses shock that one of her colleagues has invited nurses to an upcoming party. And Gordon notes that when a "more sympathetic" nurse character does appear on the show, she is dying, "leaving us to conclude, apparently, that the only good nurse is a dead nurse." That's a bit of a stretch; the deeper problem with that crusty, dying scrub nurse is that she was defined entirely in terms of a physician, specifically the lead character's gonzo surgeon mother, and she seemed to exist mainly to comment on the development of the new physicians. Thus, she was not so much a skilled nurse as an experienced assistant to and observer of physicians.

But Gordon is right on the money in observing that the hospital on "Grey's Anatomy" "has almost no nurses in it, so the surgeons and interns provide most of the nursing care patients get. In real life, a hospital with so few RNs would have skyrocketing mortality rates." And Gordon is right that "Grey's Anatomy" may be the worst thing on TV for nursing, especially given its massive popularity, though Fox's "House," which shows even more physician nursing and even less nursing expertise, is at least as bad. The basic difference between "Grey's Anatomy" and "House" is the difference between nurses occasionally appearing at the bedside in a grossly inadequate and unfair way, and nurses rarely appearing at the bedside at all. Neither show has a single significant nurse character. Take your pick. And then there's NBC's still worse new drama "Inconceivable," which combines the shallow handmaiden with the vindictive naughty nurse. But that show, so far, has attracted only six million viewers. Yes, only six million.

Gordon addressed concerns about whether people really believe what they see on such shows by citing a 2002 Kaiser Family Foundation study showing that "a lot of TV viewers tend to confuse fact and fiction." Indeed they do, and in fact a number of studies in recent years have indicated that television products have a significant effect on the public's health care views and actions; the point appears to be beyond serious dispute in the public health community, and in fact, Hollywood itself is glad to claim credit for having a positive influence on public health and social progress. (See our FAQs on the media research). Gordon concludes that as long as Hollywood continues to "perpetuate these anti-nurse images" it will be hard to recruit the nurses we desperately need, and that with "role models" like those on TV and in film, "it's a miracle anyone wants to become a nurse."

We thank Suzanne Gordon and the San Jose Mercury News for this helpful piece "America's shortage of nurses gets no help from Hollywood: Nursing profession gets bruised by movies and shows celebrating doctors."

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