A Letter to Hollywood: Nurses Are Not Handmaidens

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Published Mar 25, 2010

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General E. Speaking, RN

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A Letter to Hollywood: Nurses Are Not Handmaidens

Laura A. Stokowski, RN, MS

Authors and Disclosures

Posted: 03/12/2010

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A Letter to Hollywood: Nurses Are Not Handmaidens

Myths About Nurses Perpetuated by Hollywood and Other Uninformed Media

Spotlight on the Best and Worst Media Portrayals of Nurses

References

Information from Industry

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Explore a hypothetical case in insomnia A Letter to Hollywood: Nurses Are Not Handmaidens

Dear Hollywood,

We, the nurses of the world, have something to say to you. Nurses are not what you think. Nurses are independent, highly educated, and skilled healthcare experts who save lives every single day. We work hard and are dedicated to making differences in people's lives.

And we are really sick of going home after a 12-hour shift, turning on the television, and seeing ourselves depicted as brainless bimbos. This has been going on far too long, and it has to stop.

The Clown Took a Job as a Nurse

I remember a time when I was in nursing school, watching TV with my roommate, Liz. A skit came on, in which a famous comedienne of the day was dressed up like a clown. For some reason the clown had to leave the circus. "So," said the narrator, "the clown took a job as a nurse." We laughed at the absurdity of this, but I never forgot it. We were in the middle of a demanding 4-year nursing program, and the suggestion that anyone, even a clown, could be a nurse, just like that, was wounding. I think it was then that I began to take notice of how Hollywood represents nurses.

The answer is...badly. But it isn't just disrespect that comes through in Hollywood portrayals -- it's contempt, and it's not at all subtle. You scorn us in the way you pigeonhole nurses on the small screen -- it seems that we're either half-wits, nymphomaniacs, or latter-day Nurse Ratcheds. Obviously, you have no concept of nurses as autonomous, knowledgeable professionals. We work alongside physicians, but we are their colleagues, not their subordinates. Yet in every hospital drama, physician characters are ordering nurses around, treating them like uneducated servants, or performing nursing care themselves and getting the credit for it, while the nurse characters just fade from view.

I can almost hear your reaction to my complaints. There, there, dear, don't take it personally, it's harmless, it's funny. Is it, really? Will it still be harmless or funny one day in the future when you are in the hospital and you press your nurse-call button and no one responds? Or it is answered -- eventually -- by a minimally trained hospital "technician"? The nursing shortage will have reduced our ranks considerably, and driven many of us into early retirement. It doesn't help the situation when schoolchildren and teens already discount the notion of becoming nurses because of the way nurses are portrayed on Grey's Anatomy. Becoming a nurse, they believe, is a waste of their talents.[1]

Maybe You're Misinformed

I'm going to give those in Hollywood the benefit of the doubt, and assume that they just have the wrong impression of nurses, and have no idea what nurses really do. But for the non-nurse readers, we'll pretend that you are in the hospital, and you've just had emergency heart surgery.

*Who do you suppose will be at your side, watching your blood pressure, making sure you don't go into shock?

*Who will be alert for the slightest hint of life-threatening hemorrhage?

*Who will respond in mere seconds if your heart begins to beat irregularly?

*Who will make sure that your chest tube doesn't get blocked and cause you to go into cardiac arrest?

*Who will keep the circulation moving in your lower legs so you a clot doesn't develop and you don't die from a pulmonary embolism?

*Who will be constantly watching to make sure that you don't stop breathing, that you are getting enough oxygen, that postoperative pneumonia is not developing?

*Who will relieve your pain before you even have to ask?

*Who will explain everything that is happening to you and teach you how to take care of yourself after you go home?

I'll give you a hint -- it's not your physician. It is your nurses. They will see you safely through one of the most dangerous times of your life, doing all these things and more.

And just so we're clear, I'll tell you what your nurses won't be doing. They won't be clustered around the nurses' station as though at a cocktail party, flirting with physicians. They won't be in the broom closet or the stairwell or behind the patient's curtain giving sexual favors. They won't be trailing after the physician as he marches down the hall, in case he needs a cup of coffee or someone to dump on. Nor will they be in the receptionist's chair, moaning about not being able to get into medical school. If these scenes sound a little familiar -- I'm not surprised. This is how nurses are regularly portrayed on television dramas.

No Angels of Mercy, Please

Hollywood, we're not asking you to glorify nurses. Don't turn us into heroes or martyrs. We just want to be accorded the respect, the esteem that our education, status, and profession warrant. We want our dignity back. We don't want the entire world to think of us as sleazy, dim-witted underlings. We want to erase the image of the "naughty nurse" -- this is your bizarre fantasy, not ours.

We want young, impressionable children to view nursing as a viable, respected, and even admired profession, one they would be proud to call their own. But most of all, we want our patients to trust us and value our knowledge, so that when we teach them how to become healthier people and live longer, healthier lives, they will listen. This, our most treasured ability -- the core of nursing -- is what you threaten with your cheap attempts to increase ratings by ridiculing the nursing profession.

So my question to you is, is it worth it? Is the money you make from entertaining viewers with mentally unbalanced, sexually promiscuous, or idiotically subservient nurse characters worth influencing potentially hundreds of thousands of young men and women to shun a career in nursing? Will you feel content, even proud, the next time you encounter a nurse, in the thought that you regularly chip away at her self-respect and her ability to be effective in her job?

Or will you infuse some realism into your tired stereotypes? You can start by discarding the following myths -- their demise is long overdue.

Section 1 of 3 Next: Myths About Nurses Perpetuated by Hollywood and Other Uninformed Media »

A Letter to Hollywood: Nurses Are Not Handmaidens Myths About Nurses Perpetuated by Hollywood and Other Uninformed Media Spotlight on the Best and Worst Media Portrayals of Nurses

ReferencesInglis M. Put off nursing by TV portrayal. Evening Telegraph (UK), December 18, 2009.American Nurses Association.Definition of Nursing. Available at: http://www.nursingworld.org/FunctionalMenuCategories/FAQs.aspx#def Accessed February 3, 2010.Laurant M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B. Substitution of doctors by nurses in primary care. Cochrane Database Syst Rev. 2005;18:CD001271.Dierick-van Daele AT, Metsemakers JF, Derckx EW, Spreeuwenberg C, Vrijhoef HJ. Nurse practitioners substituting for general practitioners: randomized controlled trial. J Adv Nurs. 2009;65:391-401. Abstract Lenz ER, Mundinger MO, Kane RL, Hopkins SC, Lin SX. Primary care outcomes in patients treated by nurse practitioners or physicians: two-year follow-up. Med Care Res Rev. 2004;61:332-351. Abstract Aigner MJ, Drew S, Phipps J. A comparative study of nursing home resident outcomes between care provided by nurse practitioners/physicians versus physicians only. J Am Med Dir Assoc. 2004;5:16-23. Abstract The Truth About Nursing. The Truth About Nursing Decade Awards Rank Best and Worst Media Portrayals of Nursing, 2000-2009. January 1, 2020. Available at: http://www.truthaboutnursing.org/press/awards/2000-09_decade/rel.html Accessed January 15, 2010.The National Nurse. Available at: http://nationalnurse.org/ Accessed January 16, 2010.

[ CLOSE WINDOW ]Table 1. Ten Best Media Portrayals of Nurses of the Decade, 2000-20091 Nurse Jackie New York ED nurse Jackie Peyton is tough but talented, and finds creative ways to help patients lead better lives or find lasting peace

2 Mercy Veronica Callahan is an Iraq war veteran with PTSD who leads a crew of smart and committed nurses.

3 Critical Care: The Making of an ICU Nurse Boston Globe article chronicled the 8-month training of a new ICU nurse showing the high level of skill required to care for these complex patients

4 The Rookies Episode 1 of Lifeline: the Nursing Diaries shows nurses engaged in routine nursing functions, such as life-saving interventions and patient education

5 Angels in America Nurses at the center of AIDS care, balancing skill, determination, humor, and caring

6 Media by Diana Mason Weekly radio show Healthstyles with nurse experts; garnered mainstream press for nursing research

7 HawthoRNe Chief nursing officer Christina Hawthorne is a strong and skilled expert nurse in Richmond, Virginia.

8 Media by Theresa Brown Blog for New York Times about nurses, giving nursing perspective on key policy issues

9 Media by Suzanne Gordon Wrote the book Nursing Against the Odds: How Health Care Cost-Cutting, Media Stereotypes, and Medical Hubris Undermine Nursing and Patient Care (2005)

10 California and Massachusetts Nursing Associations. Advocated for nursing through mass media campaigns explaining the value of nursing and presenting nurses as articulate, holistic advocates of public health

Adapted from The Truth About Nursing Decade Awards[7]

Table 2. Ten Worst Media Portrayals of Nurses of the Decade 2000-2009

1 Grey's Anatomy Nurses are insignificant, as physicians perform real-life nursing work. Nurses are portrayed as bitter or fawning losers.

2 House Ignores nurses completely or treats them as annoying fools who are there to clean up the mess.

3 Private Practice Mocks clueless nurse character who works as a receptionist.

4 The Naughty Nurse Many appearances throughout the decade, including ads by Virgin Mobile, Gzhelka Vodka, the Lung Cancer Alliance, the Heart Attack Grill; and in degrading comments made by Kelly Ripa and "Dr. Phil" McGraw on TV.

5 The Today Show For attacks on advanced practice nurses, including nurse midwives and nurse practitioners.

6 ER (2000-2005) Portrayed nurses as physician handmaidens whose highest aspirations are to go to medical school.

7 Passions An orangutan named Precious serves as a private-duty nurse, suggesting that apes can do nurses' jobs.

8 Hopkins 24/7 & Hopkins Repeatedly suggested that physicians perform all important care; virtually ignored the thousands of highly skilled nurses who work there.

9 Media by the American Medical Association Comments in major news media questioning the competence and qualifications of nurse practitioners, in spite of evidence of their effectiveness.

10 The robot nurse Doesn't exist, but makes appearances in the media as "robo-nurse," "virtual nurse," "nurse robot," electronic nurse," etc., reinforcing the view that a "nurse" is anyone or anything that acts as an assistive caregiver.

Adapted from The Truth About Nursing Decade Awards

Annual awards for the year 2009 are found in Table 3.

Table 3. Best and Worst Portrayals of Nurses in the Media, 2009Best Worst

1 Nurse Jackie 1 Grey's Anatomy

2 Mercy 2 House

3 HawthoRNe 3 Private Practice

4 Theresa Brown 4 The Today Show

5 Pauline Chen, New York Times 5 Minette Marrin, Sunday Times (UK)

6 Nurses advocating in the media 6 New York Times damaging portrayals

7 Reports on nurse innovators 7 "Naughty nurse" advertisements

8 Zara Nicholson, Cape Argus (S. Africa) 8 Three Rivers

9 Erin Thompson, USA Today 9 Mental

10 Reports on school nurses 10 The robot nurse

Adapted from The Truth About Nursing Annual Awards, 2009.

Available at: http://truthaboutnursing.org/press/awards/2009/awd.html.

Used with permission

Authors and DisclosuresAuthor(s)Laura A. Stokowski, RN, MSStaff Nurse, Inova Fairfax Hospital for Children, Falls Church, Virginia; Editor, Medscape Ask the Experts Advanced Practice Nurses

Disclosure: Laura A. Stokowski, RN, MS, has disclosed no relevant financial relationships.

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