2008 Fall TV preview
September 2008 -- The fall U.S. television season seems to offer mostly more of the same--a prevailing vision of nurses as peripheral physician subordinates--with one intriguing exception. The popular prime time dramas "House" (Fox, premiering Sept. 16) and "Grey's Anatomy" (ABC, Sept. 25) will return with no major nurse characters to complement the smart, pretty physicians who provide all important hospital care. "Grey's" spinoff "Private Practice" (ABC, Oct. 1) will still include hot but blank midwifery student Dell Parker, a nurse who works as a health clinic receptionist. The venerable "ER" (NBC, Sept. 25) and "Scrubs" (ABC, mid-season) return with one actual major nurse character each. The plastic surgery drama "nip/tuck" (FX, January 2009) will be back for more sleazy fun, but no significant nurse characters. And the new daytime show "The Doctors" (syndicated, Sept. 8), created by the people behind "Dr. Phil," offers a "dream team" of four telegenic physicians giving advice on health issues. But wait--there's something else. Reports say that in early 2009, the premium cable network Showtime will offer a new dark comedy with the tentative title "Nurse Jackie." The show, starring Edie Falco (above) as a tough New York ED nurse, would appear to be the first prime time U.S. television drama since the early 1990's to have a nurse character play the central role.
On the five returning broadcast shows listed above, 39 of 43 significant regular characters are physicians. The remaining four characters include one janitor and three nurses, one each on "ER," "Scrubs" and "Private Practice"---if you count receptionist Dell as a nurse. On these five shows, the lack of nurses means that the physician characters will be shown providing virtually all important care, including a lot that nurses do in real life. "House," "Grey's," and "Private Practice" have repeatedly mocked nursing. And nurses have almost never played any significant role in the hospital care on which those three shows focus, even though real hospitals exist mainly to provide nursing care. Both "ER" and "Scrubs" have at least one major nurse character who makes some contribution to care. "ER," in particular, has repeatedly shown nurses like major character Sam Taggart to have valuable skills, despite the show's overall physician-centrism and related distortions. If this is the last year for "ER" and "Scrubs," as reports indicate, it will mean an especially bleak broadcast network landscape for nursing.
The syndicated daily show "The Doctors" features four attractive physicians dispensing health advice. The hunky ED physician Travis Stork (from "The Bachelor") acts as a kind of host, but there is also a pediatrician, an OB/GYN physician, and a Hollywood plastic surgeon, whose work seems to receive the most attention. The show does include some practical advice and discussion of current health issues, and it may make some contribution to public health. However, early episodes suggest that the physicians will not hesitate to opine authoritatively on issues they know little about, and that the show is too entwined in the heroic physician narrative to provide balanced accounts of subjects in which the physicians have a preset agenda. For instance, the September 10 show featured an uninformed attack on home birth led by "dream team" OB/GYN Lisa Masterson. Masterson was permitted to deliver distortions about the risks of midwife-assisted births outside of hospitals, with no real contradiction. Likeable host Stork chimed in to stress that it was controversial issue and some couples had good experiences. But the segment was heavily weighted toward Masterson's scare tactics, and it ignored the relevant science showing nurse-midwife births to be just as safe as physician births. (For more on Masterson's approach to obstetric care, click to see personal stories from her patients.) The show mentioned "midwives," but did not consult one--evidently they could add nothing to what an OB/GYN would have to say about home birth! The word "nurse" was not mentioned once. Other early segments, including one about an overweight smoker, suggested that the show will rely more on special infusions of "miracle" therapies than on careful explanations of basic preventative approaches that are likely to have a broader impact on the show's audience. Expert nurses would be able to provide that holistic perspective. But as the home birth segment suggests, there appears to be no significant nurse involvement in the show
Showtime has marketed "Nurse Jackie" as a "half-hour single camera dark comedy series." It stars "Sopranos" veteran Falco as a "brilliant," "strong-willed, iconoclastic New York City nurse juggling the frenzied grind of an urban hospital and an equally challenging personal life." The tentative list of major characters includes two other nurses, two physicians, and a pharmacy tech, who is Nurse Jackie's boyfriend. We hope that the nursing on the show is as real and unvarnished as the lead character's "occasional weakness for Vicodin and Adderall." Nurse Jackie will reportedly display an uncanny ability to determine what is wrong with patients before physicians do. We hope that is not presented as something that must be supernatural, or evidence that Jackie should really be a physician. We hope initial diagnosis is not presented as the only important aspect of health care "House"). And we hope Jackie is not a "strong-willed" nurse who may sometimes tell physicians what's what, but whose job really is to serve them, and who in the end must defer to them in important care decisions.
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