Media: Where are the Nurses?

Nurses have a very complicated job that requires intense critical thinking. We are the first line of defense as the patient advocate. So why are we so often left out of the story?

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Media: Where are the Nurses?

Most medical shows on television are full of inaccuracies.  Surely they could afford to hire someone to provide current and correct information, (such as a nurse). Who hasn't watched a 'Grey's Anatomy' or' House' episode and exclaimed, "What! That isn't the way it is!”, which often ruins the viewing pleasure of anyone else in the room. The show 'House' portrayed doctors as doing absolutely everything. There isn't a nurse to be found, and the doctors magically can do everything from brain surgery to an EGD. Not only that, all of the doctors gathered around to watch or help - no ancillary staff needed.

Public View

The public views nurses as trustworthy, but not autonomous or having any influence1. However, we know that nurses make decisions that will impact their patients all shift long.  Nurses institute changes to patient care that are grounded in evidence-based research, we are involved from the ground up.

Education

Nursing is a multifaceted, multidimensional profession that is not widely understood by the general public. Because of this, there is confusion regarding the exact role of a nurse. There are several reasons why our role is confusing to the public. We have many different levels of education: Diploma, Associate's degree, Bachelor's, and on up to doctoral level. We also have a multitude of roles, in just as many places. Add to that the fact that we are misrepresented and severely underrepresented in the news, on television, and in the legislature, and it's no wonder our professionalism is questioned1.

Years ago there began talk of streamlining nursing education requirements to require a  Bachelor's for entry-level in to nursing. Having an educational baseline would help define nursing, however, there are many issues surrounding it that have kept the requirement at bay. Even so, some hospitals are beginning to hire only nurses that have their Bachelor's degrees. 

Professional Organizations

Being more involved in Nursing professional organizations such as the ANA, or specialized nursing organizations help to keep nurses informed and involved in relevant issues. There is power in professional organizations to influence laws and help develop the future of nursing, but membership remains low. 

In order to change the public's perception of nursing, it must be seen as valuable, with defined skills that only a nurse performs. A large faction of the public's awareness about nursing is the media's depiction of what a nurse is. We are painted as being "less" intelligent or "less" competent than other healthcare providers2.

Hierarchy of Medicine 

Unfortunately, this hierarchy of medicine leads to the mistaken perception that nurses are not as valuable as a physician. According to the article, "Professional Identity and hospital-based registered nurses: A Phenomenological Study", the work of a nurse in the hospital is "invisible", while the work of the doctor is "visible"2. Because the patient sees us performing basic care needs, they don't understand the critical thinking that goes on all day regarding their care. Patients see a fraction of what nurses actually do.

FACT: Patients don't see the nurse double-checking a questionable medication order and calling the pharmacy or physician to make sure everything is safe; they only know that the nurse brings them their meds. 

Conclusion

Nurses are on the front line of medical care; we have the most patient contact.  Many have been attacked by patients or yelled at. Sexual advances or inappropriate behavior is not uncommon from a patient to their nurse.  Many have been exposed to deadly diseases and some have lost their lives from that exposure. So why are nurses continuing to be largely ignored in all forms of media? The news, television shows, and articles rarely offer a story based on reality when characterizing nurses. If the story is sensational, it will make headlines, but an in-depth nursing perspective is rarely offered.

What are your thoughts on how nurses are defined?

References

1 Registered Nurse Perceptions of Factors Contributing to the Inconsistent Brand Image of the Nursing Profession

2 Professional Identity and Hospital-Based Registered Nurses: A Phenomenological Study

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Brenda F. Johnson

About Brenda F. Johnson, MSN

Gastrointestinal Columnist

Brenda F. Johnson has 30 years experience as a MSN and specializes in Gastrointestinal Nursing.

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Specializes in Mother Baby & pre-hospital EMS.

Thank you for this!!

I can't wait for a day (IF there is such a day) when there is a medical tv show where nurses are accurately portrayed. I'm thankful for my husband who listens to me rant while we're watching them. I would be happy to be a nurse consultant for a medical show to ensure they're portraying us accurately.

The general public definitely doesn't know the depth of what we do. They underestimate it and may not understand why we're so exhausted after a 12-hour shift. I wish they could shadow us for a day.

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Specializes in Med-Surg, ICU.

The new show Nurses was pretty inaccurate. I was so disappointed. Have you seen Chicago Med though? I love how they portray the nurses. I would love to see a show about a float pool nurse. Let the public see what med-surg is really like and why we have been going on strike. Plus the nurse would float through different specialties within med-surg, so that would give some variety and creativity to the show. 

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Sometimes nurses are portrayed as frantic and panicking, pushing people out of the way. It's so ridiculous when that's not the case. 

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Specializes in Case Manager, Solid Organ Transplant Coordinator.

It took a pandemic to make the world see our presence and appreciate our work. But our moment of glory was short lived. Unfortunately, the entertainment business continues to see us as second to MDs even with the rise in the number of nurses with a doctoral degrees.
I saw a post on LinkedIn written by an APRN with a doctorate degree asking who’s ready for a hospital founded by nurses? Some of the comments from non-nurses was insulting. Until we are able to make an impact that will move us beyond our history then the entertainment industry will continue the status quo. 

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Specializes in Mother Baby & pre-hospital EMS.
20 hours ago, LaZarca said:

The new show Nurses was pretty inaccurate. I was so disappointed. Have you seen Chicago Med though? I love how they portray the nurses. I would love to see a show about a float pool nurse. Let the public see what med-surg is really like and why we have been going on strike. Plus the nurse would float through different specialties within med-surg, so that would give some variety and creativity to the show. 

I haven't watched Chicago Med yet, but it's on my list to watch because Doctor Mike (on Youtube) ranked it pretty high on his most accurate medical dramas video. ? Nice to hear another recommendation for it!

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Specializes in Advanced Practice, Critical Care.

Most of the time, I'm like the rest of you talking back to the TV, "Oh so you're an ER doctor AND a neurosurgeon, AND a cardiothoracic surgeon?" Also yelling, "Where are the nurses Greys Anatomy, when was the last time an MD pushed a med in a code or at any time?" Seriously!

I only liked the show The Resident because at least they showed an NP who seemed somewhat realistic in her role...then of course they killed her off. Chicago Med is OK in that at least nurses are visible and are not complete doormats. For the most part I have given up hope for a realistic portrayal of a nurse or nursing on TV dramas, rom-coms etc.

Some of the shows on the Discovery channel have somewhat realistic portrayals of nurses, but they are heavily edited and of course, focus on the most dramatic cases and personalities.

What is really frustrating is that there are plenty of nurses qualified to speak on news shows and to give information to the public. However, news outlets usually seek out an MD spokesperson. There are some fairly well known media savvy nurses such as Nurse Alice Benjamin, but there needs to be more visibility and respect given to nurses' knowledge and expertise. We ARE the most trusted profession and we (and the media) should really capitalize on that fact.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

I can't watch most medical shows with my sons as I start yelling at the TV " that's a RN's job....that  oxygen/ventilator not hooked up properly.....  WRONG med,  etc."   

Sandy Summers RN, MSN  Truth About Nursing.org has been strong advocate for changing Nursing's media portrayals for over 15 yrs..  Great organization to support. See their MEDIA section along with blog for latest petitions and actions to reverse companies/media inaccurate nursing image and portrayal.

How does the media affect how people think? - Truth About Nursing

ANA: American Nurse Today

The nurse's growing role in media - American Nurse Today

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Specializes in Geriatrics, Dialysis.

The only shows that I can think of where nurses were portrayed reasonably well aren't on the air anymore. Scrubs, ER, Code Black and Night shift did it pretty well.  The couple that were centered on nurses? Laughably bad. Nurses is a Canadian show, the US got one season last year and for me one season was enough. Did anybody see that short lived show HawthoRNe? That was SO bad, LOL!

I still like some of the medical shows, no matter how ridiculous they are. I get a kick out of the MD bringing the emergency case into the ER from the ambulance because of course that happens where the doctors meet the  ambulance outside, LOL! Then the same  doc is  saving their life....but wait, this patient needs a heart/lung transplant to survive so the same ER doc is magically performing complicated transplant surgery the very next scene! Plus there's not a nurse in sight, anywhere in the hospital. I guess those doctors do everything.

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For some interesting reading about in nurse media representation and why things are the way they are, I suggest reading Playing Doctor: Television, Storytelling and Medical Power by Joseph Turow and Saving Lives: Why the Media's Portrayal Puts Us All at Risk by Jacob Summers and Sandy Summers. 

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Specializes in Psych, Addictions, SOL (Student of Life).

I am both a nurse and writer of fiction. While I agree that nurses could and should be better portrayed It's not likely to happen. Why because the shows referenced in the artical and comments are all fiction! Fiction is a from of fantasy that people engage in for entertainment. Most of the general public would quickly tune out If they had to watch a story where nurses worked 3 hours overtime just charting, or going all day without a bathroom break or sitting for hours in a preceptorship program. The public does not want to be bored. They want gritty portrayals that transport them to a place in a sort of voyeristic  attempt to live if even in their minds the life of another.  

One commenter mentioned the show ER (currently available on the Hulu platform for streaming) and it is a pretty fair representation of what nurses do if you discount the episode where Abby (Nurse turned Medical student) performs an emergency Crike on a patient who loses their airway. For the most part the nurses are depicted working in close colaboration with doctors who mostly appriciate their efforts.

The public does not want to see a show about Med/surg nurses. Or shows about how nurses are bullied by other nurses etc... They wouldn't understand and would be bored to tears. They want fast paced gritty escapism.

One of the very best shows IMHO was Nurse Jackie. Yes, she was an addict but she was also a pretty rocking nurse. Now the whole sub-plot of sex in the pharmacy was over the top but it gave a pretty good portrayal of how nurses are just flawed humans who make mistakes, have issues and struggle with balancing the obligations of work and family. Even the idea of the nurse addict was well played and fairly accurate. We may not want to believe our co-workers struggle in this way but A review released by New Drections for Women suggest that 10% of working nurses struggle with substance abuse issues that may substantially effect their practice and the ANA indicates that "Up to 10% of working RNs may be dependent on drugs or alcohol. However, the most worrisome statistic suggests that: between 14% and 20% of all RNs in the U.S. may have a problem with drug or alcohol dependence or abuse. This speaks to the suspected prevalence of unreported cases. Think about this now—1 out of every 5 to 7 RNs may be affected by an addictive disorder.

So in order to accurately to portray nurses we would have to show the good, the bad and the ugly.  

   

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The truth is if we really want to see more Nurse's in the media then we have to do something we do not want to do. Spend money. We will have to guarantee that there will be a return on Nurse themed projects. Which means helping writers and books get on best seller lists and buying, owning and gifting seasons of Nurse shows and movies we personally like. 

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