Helpful and caring and the whole sponge bath thing
February 22, 2011 -- Although the physician handmaiden remains the main Hollywood stereotype of nursing, the unskilled female sex object is still there. This week she appeared in two popular prime time television dramas airing on successive nights. In tonight's NCIS: Los Angeles (CBS), a cheerful but apparently unskilled Nurse Debbie is the subject of two leering "ready for my sponge bath!"-type comments from a wounded detective. And last night’s House (Fox) presented a nameless female nurse as a physician sex object in a fantasy scene, and later, in a “real” code scene, as a panicked lay person who needed physician rescuing. In neither episode does the nurse dress provocatively. But neither nurse objects to the sexual comments either. Debbie is not even present for the remarks, and in the House fantasy scene--a fantasy constructed by House himself--the nurse actually looks a bit intrigued by two physicians' propositions. In both shows it is a different female who does object--on NCIS: LA a detective and on House a medical student. Maybe these strong, smart other women recognize that sexual abuse even of the least of their sisters--nurses--degrades all females. On the other hand, the heroic characters who are actually responsible for the imagery--Greg House and the NCIS detective--may be more interested in tweaking these female peers than anything else. In any case, the nurse characters display no real health care expertise. And the helpless House nurse responds to her crashing patient in classic House-nurse style, as the physicians rush in to save him: "I don't know what's wrong, he was stable for a while, and then all of a sudden--!." Joseph C. Wilson wrote the NCIS: LA episode ("Personal"), and Thomas L. Moran wrote the House episode ("Two Stories").
NCIS: LA: Debbie Does Los Angeles
NCIS: Los Angeles is a successful spin-off of the popular NCIS. Both shows focus on U.S. Navy officers who investigate crimes involving Navy or Marine Corps personnel. In tonight's episode of the Los Angeles show, one of the detectives, Marty Deeks, is shot trying to prevent a grocery store holdup while off duty. The team believes that this was no random encounter; someone seems to be targeting Deeks.
At the hospital, we see a post-surgery Deeks lying in a hospital bed, conscious. Kensi Blye, a female colleague, engages Meeks in some banter about whether he should be dead. Deeks briefly fakes memory loss; he's a kidder, and clearly a flirt as well. But he is also in pain. Off camera, a female voice says "Hi!" Blye moves to intercept an attractive young nurse who has appeared near the foot of Deeks's bed. Blye asks for her ID, and the nurse holds up her card. ID checked, the cheerful nurse moves to the patient's side, quickly examining his IV.
Nurse (brightly): You're awake. How do you feel?
Deeks (smiling, apparently flirting): Oh . . . better and better.
The nurse reaches across his body to show him buttons.
Nurse: Pain relief button . . . call button. OK, Mr. Deeks?
Deeks (still smiling): You can call me Marty.
Nurse (also smiling): If you need anything, I'm right outside.
Deeks: Thank you, Nurse . . .
Rather than simply replying, the nurse holds up her ID card for him to read. (Is this a clever test of his cognitive function? How many viewers will see it that way?) Deeks reads the ID aloud.
Deeks: Debbie. (Debbie leaves, and Deeks speaks to himself.) Nurse Debbie. (He sees Blye's look of disapproval.) What?
Blye: What? What is it with guys and nurses?
Deeks: What are you talkin' about? They're helpful and they're caring . . . they do the whole sponge bath thing.
Blye (a little exasperated, but smiling): Oh, come--. I should shoot you myself.
Deeks: Get in line [to shoot me].
A later ICU scene finds the show's two lead detective characters visiting Deeks. They confirm that it looks like someone is targeting him, but they say that because the hospital is "crawling with LAPD," he should be safe. Deeks asks who will protect him from Blye, who is again present. The two main detectives start to leave. Deeks calls after them.
Deeks: Hey, if you see Nurse Debbie out there, will you ask her when I get my sponge bath?
Blye: Definitely feeling better.
Debbie does not dress provocatively or really do anything to encourage Deeks's sexual attention. She seems aware that he is flirting mildly while she is there, but simply smiles, which is probably an appropriate response since it is so mild. And she does not do or say anything notably stupid; actually, she at least seems to have something to do with the call buttons she shows him, and presumably the IV that she examines briefly. Blye does take Meeks to task for his two "sponge bath" comments (two!). It seems likely that at least part of the motivation for his comments is to get a rise out of Blye. And we suppose Blye's reaction could have been worse; if it were Grey's Anatomy, she might have found a way to attack the nurse for having the effrontery to attract a man that a modern female professional might herself be interested in.
But we don't see Debbie do anything a lay person could not do. The episode doesn't really offer much about what is going on in Debbie's head. And although many real nurses have trouble introducing themselves as professionals with a surname, Debbie's failure even to tell Deeks her given name is pretty sad. As Deeks notes, nurses really are just about being "helpful" and "caring"--neither of which requires any health care knowledge or training. If it is wrong for Deeks to treat nurses as sex objects, the show suggests that maybe it's not because they're health care experts who can save your life, but because some of Deeks's peers are working women too and it hits a little close to home. We have no reason to think Blye sees Debbie as a peer, but she may have some basic or historical sympathy with her. If not for progress women have made in the workplace in recent decades, Blye herself might have been consigned to nursing! Of course, it's not like Blye is really upset about the comments; she's smiling. And at some level, we're meant to kind of admire Deeks for being so randy and flirtatious, and for being an NCIS investigator. He may be kind of a knucklehead, but he's also attractive, heroic, macho--and you know, boys will be boys.
The "sponge bath" comments here were unnecessary, since many male patients do manage to resist treating nurses as sex objects. But if the producers could not live without some suggestion that one the show's detectives sees nurses as helpful eye candy, they could have had Debbie confront the comments directly, or display expertise that belied Deeks's tired assumptions. As it is, despite Blye's weak objections, the episode will subtly reinforce those assumptions.
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House: I don't know what's wrong
The February 21 House episode focuses on master diagnostician Greg House's efforts to reconcile with his dissatisfied girlfriend Lisa Cuddy, who is the "dean of medicine" at the New Jersey hospital where House holds court. Part of House's efforts to make amends involve speaking to a group of fifth graders as part of a career day at a nearby private school. The episode is built on two story-recounting frames--one in which House describes recent exploits to the class, and another in which he describes some of the same events later to two other fifth graders who, like House, are waiting to see the school principal because they are in big trouble. In a few clinical scenes, nurses appear at the margins to play their usual House roles--silent, submissive, handling paperwork or simple equipment while physicians do everything that matters.
But in a couple scenes, one nurse character really stands out. House is telling the fifth grade class about one of his patients, a Rutgers student. We see the scene as House is recounting it to the class, so remember that the show is not saying that everything we're about to see actually happened; as House himself informed us in the show's first episode in 2004 and has been saying ever since, everyone lies. In considering the scene, it's also helpful to know a few background facts about members of House's team: physician Chris Taub has a history of cheating on his wife, physician Robert Chase has previously expressed interest in threesomes, senior physician Eric Foreman has struggled to assert authority effectively, and the brilliant but pesky medical student Martha Masters has been something of a thorn in House's side.
We see the Rutgers student in bed, coughing pretty hard, while an attractive female nurse stands by silently fiddling with his IV. Apparently there is little she could do for a critically ill patient except to call for physicians, and here comes House's physician team, though not House himself. Masters asks the patient what the problem seems to be. The patient says that he's having trouble breathing and has pain in his chest. He continues with some serious coughing.
But Chase and Taub are more focused on the nurse.
Chase (to the nurse): You're new.
Nurse (somewhat surprised at his question): Uh, yeah . . . I just moved from Chicago.
Taub: Chicago's awesome! What part are you from?
The patient is now coughing up blood. Masters says they will need a chest CT.
Physician Eric Foreman says that because he is the senior team leader, they don't need anything unless he says they need it.
Taub (to the nurse): Do you want to have an affair?
Chase (to the nurse): Do you want to have a threesome?
The nurse actually looks somewhat intrigued, but she says nothing.
Masters: You can't talk to her like that! I'm telling Cuddy.
Foreman: We need a chest CT.
Taub and Chase (responding together, while still ogling the nurse): Get it yourself.
Back in the class, a female fifth grader reacts to what House has recounted.
Fifth Grader: Isn't that like sexual harassment?
House: Not if you're good looking.
A woman at the back of the class, who is evidently waiting to tell the kids about her career, reacts badly to this comment. And the precocious class soon works out that at least some of what House has just told them is not accurate. But how much? It appears that the basic elements of the patient's condition and the team's initial actions in response are probably accurate; as for the nurse-physicians interactions, who knows? Maybe none of that is supposed to be accurate, except, of course, for the nurse's lack of any meaningful role in patent care.
Later, after House and the class have engaged in more banter, the physician tells them more about the patient. We see the same nurse with the patient, catching his blood in tissues as he coughs it up. Once again, she says nothing to the patient. And once again, the physician team arrives all at once to provide the skilled health care. The nurse does at least give them a detailed report, which gives viewers an excellent sense of House nurses' health care expertise:
Nurse: I don't know what's wrong, he was stable for a while, and then all of a sudden--
This suggests that the nurse has about the same level of health care knowledge as the patient's computer science buddies might have. But it is a typical example of what House nurses say as physicians rush in to save their crashing patients. In one May 2007 episode, a nurse trying to manage an unruly patient greeted her physician saviors by saying, "I was just trying to get a urine sample, and he went crazy!"
In House's account, the physicians and Masters proceed to discuss what could be going on with the patient. Masters speculates that he must have a drug-resistant strain, while Chase notes that his O2 sats are plummeting. Taub wants a broncho-dilator. Foreman wants suction, and to have the patient started on blow-by oxygen. Throughout all of this, the nurse says nothing; she is just trying to manage the patient's coughing up of blood. After an especially awful bit of coughing, they see the distressed patient holding a hunk of bloody tissue--apparently he has coughed up part of his lung. We are given no reason to doubt the accuracy of anything in this scene.
House and his physician team proceed to argue about the diagnosis, suggesting possibilities and pursuing leads, displaying their knowledge, intellect, and boldness, until House finally solves the puzzle, as usual. We do not see the nurse again, and she is not discussed. There is no suggestion that nurses like her would in fact be playing the central role in providing skilled care to a critically ill patient like this one, deploying a range of technology to keep him alive. Nor is there any recognition that in real life, sexual abuse of nurses is widespread, and not all that much fun. Yes, Masters and the career day woman do register disapproval of House's imagery and approach, but really, they are just uptight, nagging females who are fuel for House's reactionary iconoclasm, which the show pretends to disapprove of so the audience has permission to enjoy it. It's so cool how House mocks disempowered groups! He's outrageous! I wish I could get away with that!
We were hoping that before House bids adieu to his elite private school audience--an audience mesmerized by his Sherlock Holmes-on-crack blend of wit, candor, reasoning, erudition, immaturity, and flat-out abuse--he would ask the students how many would like to become nurses when they grow up. Now, we know that a 2000 study by JWT Communications found that private school students saw nursing as a technical job that was beneath them. But we feel confident that after all the expertise the nurse in House's account displayed, not to mention the still-popular naughty nurse overtones, those leaders of tomorrow would be simply unable to tear themselves away from the nursing career path. Sure, some of them might want to be like House and his team, the ones with all the knowledge who call the shots, save the lives, and actually talk to the patients. But how many academic achievers could resist the nursing role, which seems to be all about following physician commands, messing with IV tubing, holding containers for patients to fill with bodily fluids, bleating helplessly as physicians rush past to save lives, and maybe--if the nurse is hot enough--getting propositioned by physicians? Sign us up!
We thank House for all it has done to give its millions of fans around the world an accurate picture of the nursing profession.
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