Goodbye to Parks & Rec and nurse Ann Perkins
February 24, 2015 -- Tonight's series finale of the NBC sitcom Parks & Recreation included a final appearance by nurse character Ann Perkins (Rashida Jones), the long-time best friend of the lead character, government manager Leslie Knope. Up until her January 2014 departure from the show, Ann was arguably the mockumentary's most normal character--smart, supportive, and relatively adult, although with enough quirks to be credible and entertaining. In a sense, Ann was like nurse Carla from NBC's earlier sitcom Scrubs. Carla was bright and competent, often playing adult / straight man to the immature kooks around her. But unlike Scrubs, Parks & Rec has not spent a lot of time suggesting that physicians are the directors or providers of all skilled health care. In addition, nurse Ann was capable of acting with real autonomy and skill, at least on the limited number of occasions when we saw health care on Parks & Rec. In a remarkable April 2013 episode, Ann casually maneuvered around an uncaring physician, Nurse Jackie-style, to provide the difficult city worker Ron Swanson with the holistic care he needed to improve his health. And when Ann also became the part-time public relations director of the Pawnee City health department, she showed leadership, at least within the show's comic context, by spearheading public health initiatives including a public service announcement about diabetes in a September 2011 episode. Not every element of the series was great for nursing. For example, the show did not seem to understand that Ann was still acting as a nurse in her health department work. But she was such a strong and persuasive character--Leslie often seemed in awe of her--that the series was a net gain for nursing. We thank those responsible, including show creators Greg Daniels and Michael Schur.
The greatest nurse in the world
The early seasons introduce Ann Perkins as a new hospital nurse, but one who is not afraid to advocate. She meets and befriends Leslie Knope, then the Pawnee City deputy parks director, at a parks and recreation meeting. Ann is there to argue that a large pit near her apartment be filled in, after Ann's then-boyfriend Andy Dwyer has fallen into the pit and badly hurt himself (below).
It is during the third season that Ann joins the city health department. In the May 12, 2011 episode ("The Fight"), Ann complains to Leslie that she's a little sick of the long hospital hours, night shifts, and so on. Because Pawnee is looking for new public relations director for its health department, Leslie submits Ann's name. Then Leslie dumps a stack of health initiatives on Ann to review by the next morning, when an interview has already been set up. Ann protests that she's been a nurse for 10 years, and that it's not something you just quit. Leslie says that with the new job she could "make real change happen," and they could work close by--Leslie has been seeing less of Ann and wants to fix that. Leslie also suggests that she fears Ann may waste away at her hospital, turn into a disgruntled older nurse (like someone they know) and have to pull strange things out of people's butts every night. Ann assures Leslie that only happened once. After some argument about the direction of Ann's life and Leslie's role in that, Ann does eventually interview for and get the city job. As Leslie describes it in voiceover, Ann did not want to totally leave nursing, so they made a deal, and "two days week, she still gets to be the greatest nurse in the world. Win win."
Overall, this plotline is helpful because it presents a nurse as a smart, able public health professional. There is not much detail about Ann's qualifications, but it does seem clear that they relate to her nursing background. On the other hand, it is unfortunate that the episode repeatedly suggests that Ann is not acting as a nurse in her public health work, which reinforces the false traditional conception of nursing as being only about physical care at the bedside. In fact, nurses have long worked in public health and policy, which is easily encompassed by the profession's holistic health focus. Nursing is about thinking and advocating, not just tending. And of course, it's not exactly a great vision of hospital nursing; it's fair enough for the show to note drawbacks, but Ann might have explained what about direct care nursing might make her hesitate to leave it.
The public health advocate
The fourth season includes a couple comic plotlines that also suggest Ann has real health care knowledge and the initiative to use it to promote public health. In the September 22, 2011 episode ("I'm Leslie Knope"), some unknown man circulates to city hall staff a digital image of his genitals. Ann tells her off-and-on boyfriend Chris Traeger, the town manager, that the testicles seem enlarged, which could indicate a hernia or a case of the mumps, which in turn would be a potentially significant public health issue. Impressed, Chris tells others that Ann has diagnosed a case of the mumps, and soon, many other male employees are sending the attractive nurse pictures of their genitals. Chris has to forbid this practice, and Ann indicates that she will arrange for a "male doctor" to come and do screenings. In the September 29, 2011 episode ("Ron and Tammys"), we see Ann actually making a public service announcement (PSA) with Chris. She explains that she wanted to make a PSA about diabetes with someone healthy and telegenic, and Chris is perfect. He is enthusiastic, but soon turns into an enthusiastic diva, wanting to do endless takes and so on.
These plotlines are mainly comic, and they don't have a lot of detail or very clear resolutions. But both do show Ann as a bright, competent professional who is at least trying, in a workplace of misfits, to improve the city's health.
Eat a damn banana
In the fifth season, the plotlines involving Ann are mainly about her decision to have a baby using a sperm donor, a process Leslie describes (in a February 2013 episode) as "giving up on love and deciding to have a baby with herself." After some wrong turns, the in vitro fertilization process leads Ann back to Chris, and their relationship is rekindled, this time for good.
The season also has one pretty great plotline for nursing, in the April 11, 2013 episode "Animal Control," written by Megan Amram. In the plotline, Ann's macho city colleague Ron Swanson seems to have a cold. He is treating it with high heat and alcohol. Ann urges him to instead try hydrating and go see "the doctor." Ron doesn't listen and collapses. Next, we see him in the hospital, where Ann has apparently brought him against his will. Evidently on duty, she wears solid-colored scrubs. She says Ron has "redacted" much of the information from his health form--this is consistent with Ron's suspicious survivalist persona. Ann assures Ron that it's confidential, but they need real answers. She also questions him about issues like his alcohol use, exercise, and family and sexual history. Then she says: "OK. I'm gonna go get your doctor. He's a rude, brash jerk. You'll love him." Later, the physician examines Ron briefly and tells him he has strep throat, for which the physician prescribes penicillin. Ann explains that they will have the rest of Ron's test results soon, but Ron is not interested in those and he leaves. Physician: "I wish all patients were like that. It's really annoying when they ask questions."
Later, Ann sees Ron back at the city offices, and notes that he looks better: "I guess actual medicine can be effective. Who'd a thunk?!" Ron wants to be left alone, but Ann insists on going over his test results and blood work.
Ann: Blood pressure looks fine. Not sure how this is possible, but your cholesterol is 120, which is the lowest I've ever seen. And the only problem I see is that your potassium is low, so just eat a banana once in a while.
Ron: No thank you. I live the way I live. I eat the things I eat. And I'll die the way I'll die.
Ann: That's oddly beautiful. But also stupid. You're not alone in the world anymore, Ron. You're dating a woman who has two kids. So every three days think about Ivey and Zoey and Diane, and eat a damn banana.
She puts a banana on his desk and leaves. Ron seems to be pouting about this, but later, we see him get out a photo of his three loved ones and try to eat the banana while looking at the photo. He's struggling, but finally manages to get the banana down by stuffing it into a "Paunch Burger."
This plotline shows an impressive amount of nursing autonomy and skill, and it highlights Ann's holistic focus and actual concern for her patient. Her manner may not seem like great psychosocial care, but she takes a blunt approach because she knows Ron and how difficult he will be. Gentle advice or pleading would be unlikely to work with such a person. Ann's approach does. And while we are not celebrating the negative portrayal of the physician, we do endorse Ann's critical, irreverent attitude toward him, which stands in stark contrast to the obsequious Hollywood standard for nurse characters when it comes to physicians. Of course, we might have preferred that Ann refer Ron to a "physician" rather than "the doctor"--or perhaps a nurse practitioner, who in any case might have been more likely to take a holistic approach similar to the one Ann did. Though probably without using phrases like "stupid" and "damn banana."
In the remainder of Ann's time on the show, her plotlines have been mainly personal, focusing on her relations with Leslie and Chris, and she has not provided much health care. During the sixth season, Ann has Chris's baby, and the duo leave Pawnee (and the show) to raise their child in Ann Arbor, Michigan. Ann has remained the smart, strong, supportive, and sensible one in an ensemble of semi-lovable freaks. And although her main role has been as Leslie's best friend--the show has clearly wanted to present a substantial, enduring female friendship--over the years the character has also conveyed some helpful information about nursing skill and autonomy. For that we thank all involved.