SandySummers

Good, I'm glad that you are working on the issues that drag down your ability to provide quality patient care. More nurses need to do this. But none of us operates in a vacuum. There is no one solution to the nursing shortage and no one person who fixes it. We all must work in our own corners of the world to improve the situation. We have had success in removing many negative stereotypical depictions of nurses and convinced others to improve their portrayals. Had those in positions of power at your institution been bombarded with the negative images that we have gotten removed, perhaps they would have further undervalued your work and not given you the ability to participate in decision-making. I think it's impossible to know exactly how the Center has affected you and how it hasn't. I'm not sure why it's so important to you to dismiss the value of our work. Sandy

There is not just one way to solve the nursing shortage. Everyone needs to do his part to work on the causes. When nursing is so undervalued in the public consciousness, nurses can't get the resources they need to do their work. For instance, it sounds like you need a secretary to do a lot of your paperwork. If your work was valued in line with its worth, maybe you would be able to convince hospital executives to give you one. But instead, you mock the people who are trying to improve your status in the world. Talk about a self-loathing nurse. Nurses themselves need to work on issues they see before them. I hope you are working on the paperwork issue that plagues you. Because if nurses aren't going to try to solve the problems we face, they likely won't get solved. And our patients ultimately suffer.

The mass media is in the business of affecting how and what people think. To believe that people are able to disregard everything they perceive in the entertainment media because the scenarios presented aren't literally "true," or because they are loosely staged simulations of reality (as in "reality" shows), we would also have to believe that people disregard all messages in advertising, since ads commonly present actors and models in simulated situations. But that is simply not how the human mind works. In order for an entertainment show or commercial to be effective, the audience must identify in some way with the characters and what they are doing, even if some aspects of the situation are "unrealistic." Most people understand that what they are seeing in fictional media products is not a depiction of "real events." In a recent TV ad, when the brilliant female "brain surgeon" and mother expertly demands a certain surgical tool in the OR, then practically commands the deferential "nurse" to buy a certain brand of minivan, we know we are not seeing real health care professionals in a real OR. (see the Caravan ad in Quicktime) The scene, which also included a dopey male "patient" and a goofy male anesthesia professional, didn't show a real surgery. But that does not stop viewers from internalizing messages and signals at conscious and subconscious levels. Despite being "fiction," media products like this can still influence: our views of the vehicle in question (as the advertiser fervently hopes); the ability of women today to become authoritative, powerful professionals, yet to still have a family (presumably this ad was directed mainly at women who would identify with the surgeon); the basic set-up of OR's, the kinds of professionals who participate, how they dress, and what tools they use; and of course, the relative power, knowledge and professional roles of physicians and nurses. Some of this may be unintended, but all of it sells the minivan to the target demographic. All of the elements above contribute to the high credibility of the "surgeon," who is, after all, doing the selling. more...

The global media's relentless linking of sexual images to the profession of nursing reinforces long-standing stereotypes. Even though those images are often "jokes" or "fantasies," the stereotypes they promote discourage practicing and potential nurses, foster sexual abuse in the workplace, and contribute to a general atmosphere of disrespect. Even humor and fantasy images affect how people act. That's why advertisers spend billions on them. Desexualizing the nursing image is a key part of building the strength the profession needs to overcome the current shortage, which is taking lives worldwide, and to meet the challenges of modern health care. Most people probably don't think the average nurse goes to work in lingerie, looking for sex. But the fusing of lingerie with nurses' work uniforms in popular media images, and the exposure of sexy "nurses'" bodies in these images, still associates the profession with sex in the public mind. One recent U.K. study found nursing was the most sexually fantasized-about job. And suggesting that nurses are primarily sex objects in turn conveys the idea that nursing work consists of satisfying the sexual needs of patients and/or physicians, or at best, that nursing is so unimportant that nurses have the time and energy to focus on sex while supposedly caring for patients. Some people may just regard nurses as being more sexually available than average. We're not kidding. Other people may simply see nurses as looking to meet a physician--even an already married one--to take them away from the dead end job of nursing, a stereotype that was actually expressed in late 2004 by Dr. Phil McGraw on his popular television show. When a profession is associated with sex, there is no bright line between "sex" and "romance." This association may be subtly reinforced even in relatively sophisticated products like "ER," which would be unlikely to present a blatant "naughty nurse" image, but in which the lone major nurse character often spends most of her time managing romances with physicians. Thus, even members of the public who don't think nurses actually have sex at work may be influenced to believe that looking for romance is a big part, if not the biggest part, of why they are at work. That is not a feature that is generally associated with serious professionals. Naughty nurse and other stereotypical images add to the chronic underfunding of nursing research, education and clinical practice. This is because health care decision makers--many of whom are sadly uninformed about what nursing really is--are less likely to devote scarce resources to a profession that has become so degraded in the public consciousness. Such images discourage talented men and women from entering and remaining in the profession. When you combine this lack of respect, the intense college-level training nursing actually requires, and the difficulty and stress of nursing practice, it is no surprise that the profession remains in the midst of a global shortage driven by rampant short-staffing. Many who display stereotypical images of nurses doubt that such images can really harm the nursing profession. However, as public health professionals at the University of Southern California's Hollywood Health and Society project and elsewhere can attest, popular media items clearly do affect how people think and act with regard to health issues. For instance, a 2000 JWT Communications study found that US youngsters in primary and secondary school got their most striking impression of nursing from the fictional television show "ER," and consistent with that show's physician-centric messages, the youngsters found nursing to be a technical field "like shop," a job reserved for "girls" and one too lowly for private school students. Nursing is none of these things. In addition, a Kaiser Family Foundation study found that "ER"'s message is so influential that one-third of the show's viewers use information from the show to make health care decisions. So what's wrong with being perceived as sexy? Nothing--as long as that's not your dominant image in the workplace. Recent research suggests that more sexualized work attire actually lessens respect for female workers in responsible jobs like management, causing others to see them as less competent and intelligent. Of course, the naughty nurse image seems to have little to do with a belief that real nurses are sexy, and perhaps more to do with a desire to have anonymous sex with hotties dressed in lingerie-like "nurse" uniforms. It may be diverting for some to think that nursing is populated by disposable bimbos, which may also help them handle the idea that female nurses have some power over them in clinical settings. But the disposable bimbo image does not appeal to most career seekers. Nursing remains over 90% female. Of course this sexualized female image is not the only reason, but it is part of an overwhelming social understanding of nursing as "submissive" and "female." This is the difference between sexual images of female nurses and, say, female FBI agents. The FBI is not in crisis because it does intensely demanding mental and physical work that few people really respect, in large part because of the idea that its agents are brainless handmaidens and bimbos. Nursing is. Of course, it may be hard to see how one apparently minor "naughty nurse" depiction can affect the real world. But each such image is part of a wave of images from the global entertainment, advertising, hospitality, and apparel industries, from Fortune 500 companies to isolated sandwich shops, suggesting nursing is about hot females bestowing sexual favors. In the aggregate, it's just common sense that decades of this kind of broad societal disrespect will have an impact, and will be a factor in people avoiding and leaving that profession. Of course, it's not the only factor; the handmaiden stereotype is probably more damaging because it's more credible and widespread, and nursing would be a difficult, stressful job even if it was well understood. Some argue that nursing's poor public image has nothing to do with the nursing crisis, because it's really all about poor working conditions and inadequate faculty resources. But that's like arguing that cancer death has nothing to do with cigarettes, because it's really all about cancer. Many things cause cancer, but cigarettes are one of them. For nursing, the lack of resources was not handed down from some divine place. It was the result of human decisions. Those decisions were made on the basis of what the decision-makers (government, hospital executives, the public) thought about how important nursing was relative to other things they might do with the resources available. It's also common to see suggestions that objections to the constant association of nursing with sex indicate prudishness or a lack of humor. But the Center has never objected to sexual images generally--only to the use of nursing as a marker for dim, submissive, sexually available females. So this is not about whether sexual images degrade all women, but about their frequent application to a specific professional group. And the suggestion is not just that nurses are silly ***** (ha ha! just joking!), but that their job is about that. Research shows that nurses suffer an inordinate amount of sexual and other abuse at work (see AP and Monster articles). Although it's difficult to prove the extent to which that is caused by naughty nurse stereotyping, that doesn't require that we ignore what would be the obvious results--if a profession is an object of sexual mockery and contempt, it's going to encourage sexual abuse, and the profession is unlikely to receive the human or material resources it needs. If a profession is constantly associated with female sexuality, it's not going to attract and retain many men. We assume few skeptics would require extensive evidence of ill effects if the media stopped "jokingly" suggesting that nurses were giggling bimbos, and started in on the female family members of the skeptics themselves. Even if the media barrage was "silly" (ha ha! just joking!), would the women in that family be taken as seriously in doing high-stress, life-and-death jobs with extensive public contact? Would they get all the resources they needed? Wouldn't they get more than their share of sexual abuse? Wouldn't they sometimes wish they weren't part of the family? Sure, those close to them might know there was no truth to the media image. But it's not like most in society would know them to be serious professionals. Most would just know what they heard in the media--that the women in that family were kind of a bad sex joke. The Center takes no position on the prevalence of sexual imagery in modern society. But we do object to the close association of that imagery with a traditionally female profession that must now fight through a critical shortage to keep millions of patients alive and on the road to recovery. In many cases, stereotypes do not simply go away of their own accord--they must be confronted and rejected. And the "naughty nurse" has proven its staying power for decades. Of course, we realize that sexual fantasies do not go away simply because images become less prevalent, and that deep-seated sexual desires are presumably not subject to anyone's control. Some aspects of current human sexuality may be practically unchangeable, perhaps because they have a strong evolutionary basis, or for some other reason. But we doubt that something as culturally and temporally specific as the "naughty nurse" image of recent decades is biologically predetermined or immutable, at least on a society-wide basis. It seems to us that the image is largely the result of specific cultural information, though it may incorporate some broader elements, such as the eroticism of apparent innocence. What is seen as "sexy" may vary in different contemporary communities, and we're not sure all of them have a special thing for the naughty nurse. And some aspects of human attraction may evolve over time, perhaps in response to changes in the perceived needs of the species. For instance, common standards of human beauty do not appear to be the same today as in past centuries. We think it would be in humanity's long-term interest to start considering new ways to think about nurses. One could also argue that the work of nurses is so intimate that it will always be subject to some level of sexual fantasy. But the jobs of others that are now subject to this kind of stereotyping (such as flight attendants) do not involve intimate contact. Instead, the common theme seems to be that they are traditionally female jobs that are seen--we said seen--to involve simple personal service. On the other hand, traditionally male professions that may involve intimate contact and/or personal service do not seem to suffer in the same way. People may imagine physicians sexually, but they are not generally presented with revealing images of physicians as silly and available. On the contrary, physicians are often seen as perhaps the ultimate marital prize, and it is hard to imagine the profession suffering from this kind of image in terms of recruiting, retention, or resources. At ground level, the devaluation of nursing translates into an underpowered profession that may not be strong enough to save your life when you need it to do so. The "naughty nurse" isn't going to catch deadly medication errors, intervene when a patient is about to crash, or teach a patient to survive with a life-threatening condition. It's time for her to change into something a little more comfortable. best regards, Sandy

That would take some serious cash. Cash and nursing aren't exactly synonymous. We're going to float the idea to a couple foundations. But don't hold your breath.

First of all, the article wrongly quoted me as saying "Move these sexual fantasies to other professions". I did not, and would not say that and I have written to the journalist to ask her to fix it. But there's only so much I can do to make that happen. What I did say to her was: "There are an unlimited number of sexual fantasies you can have, and we urge people to fantasize about someone else."

Of course, all nurses deserve more public credit for our work than we currently get, which is why we are working to improve public understanding of nursing through improving the accuracy of nursing's media portrayals. If our leaders get credit through Nobel Prizes, then that will bring more credit to the entire profession. Sandy

Timothy, the lamp is a strong symbol of 24/7 care. I worked for 3 years in Cambodia, and the hospitals there are essentially staffed from 8am-11am and then patients are pretty much on their own during the other hours. Round the clock surveillance saves countless lives. We should be proud of the standards of care Nightingale worked to establish. There's such a thing as clinical research, which our practice should be based upon. Reading nursing journals and doing literature research is a good way to stay current and making sure you're giving your patients the best care. Timothy, do you think nursing leaders don't have clinical practices? Does leadership and clinical practice not overlap? I think that you are wrongly equating petty bureaucrat managers with serious nursing leaders. If you don't know the difference, then you're not reading enough nursing literature.

Timothy, How sad it is that you can't appreciate nursing's leaders. Our nursing researchers and innovators make it possible for bedside nurses to change and improve our care so our patients will have better outcomes. For instance, if we had no nurse leaders we would not have any sexual assault nurse forensic examiners. Don't you think that they have improved patient care? Without anyone to push the creation of these SAFE nurses, rape patients would still be getting the barbaric care they used to receive. Did you see the leaders that we chose as potential people to consider for the Nobel prize? We're not allowed to reprint the article until 30 days have passed, but please click here and read the whole thing. http://tinyurl.com/yzy4lb Remember that the ultimate example of the "Ivory Tower Hack" is Florence Nightingale.

This is hilarious. Thank you EmerNurse.

Infirmières Sans Frontières December 3, 2006 -- Recently, the Nobel Prize-winning Médecins Sans Frontières / Doctors Without Borders (MSF) launched a U.S. tour of an exhibit highlighting the global aid group's vital work in conflict zones. "A Refugee Camp in the Heart of the City" features MSF aid workers guiding visitors through a model of actual relief facilities. The exhibit explains the challenges MSF faces in providing care, nutrition, and decent living conditions. This is a perfect time to thank the group for its admirable work--and to note that its continuing use of the name "Doctors Without Borders" sends an inaccurate message about who is doing that work. We understand nurses are the most numerous health professionals among MSF workers, and they play a central role in the group's efforts. Yet when journalist Suzanne Gordon suggested to a physician MSF leader that the group consider adopting a name that did not slight its nurses, the leader said that she hoped MSF would never be so "stupid" as to do so. The Center for Nursing Advocacy has tried to discuss the matter with MSF for two months, but we have gotten no real response. The group's name seems to reflect the undervaluation of nursing that is undermining health worldwide, particularly in the developing nations MSF tries to help. We doubt that MSF would suffer by phasing in a similar name, like "Soins Sans Frontières" ("Health Care Without Borders"). We urge MSF to give its own nurses the credit they deserve--and that nurses everywhere need to help their patients. Read more http://www.nursingadvocacy.org/news/2006/dec/msf.html or go straight to our letter-writing campaign! http://www.nursingadvocacy.org/action/letters/2006/msf/m_form.html

The Nobel Prize in Nursing December 8, 2006 -- Today The Baltimore Sun published "Nurses' achievements merit international recognition," an op-ed by Columbia University nursing professor Kristine Gebbie and Center for Nursing Advocacy executive director Sandy Summers. The op-ed argues that nurses deserve a Nobel Prize or comparable annual award because their leaders have long been at the forefront of health research and clinical practice. They have changed the world by reinventing health systems, pioneering new therapies, and improving community health, from AIDS treatment to neonatal care to pain management. Establishing such a prize would shine a light on the profession's life-saving achievements. It would also help show how important it is that nursing get the clinical and educational resources it needs to overcome the global nursing shortage. The publication of this piece is the culmination of significant effort by the Center. We thank The Baltimore Sun for its openness to new ideas on nursing, and its commitment to publishing the op-ed. And we urge you to read it, think about it, and show it to others. Thank you! See the op-ed... http://tinyurl.com/yzy4lb

The reason the "most trusted" poll results don't do too much for me is that this public view often goes hand in hand with the prevailing vision of nurses as devoted, angelic handmaidens. Of course, it's possible that a particular member of the public might fully understand how highly skilled nurses are and still "trust" them greatly. But given that public understanding of the nursing profession appears to remain very poor, we fear that the poll results are essentially an expression of a vague, sentimental affection for nurses flowing from the above stereotypes. They trust us to hold their wallets while they're in surgery. But not to save their lives. I can't help noticing that some of the professions near the bottom of the "trusted" list-- such as lawyers, journalists, and ad writers--do not seem to be suffering from any crisis in terms of supply of willing workers, working conditions, job benefits or social status. I wonder how many of the people who "trust" nurses so much would react if their son, or bright, ambitious daughter, announced that he or she wanted to be a nurse. Polling can measure many things, and much depends on the wording of questions and the context in which they are asked. In this case, we believe it would be a mistake to imagine that the word '"trust" implied genuine respect for professional skill. In this sense, putting too much stock in these poll results may actually be a dangerous illusion.

That's the way to support your profession! Sure, one result of our campaign may have been that the grill owner has had an increase in business. But our intended goal of getting people to think and talk about negative nursing images has been achieved. We cannot change the way people think and behave unless we first tell them this negativity is damaging and we ask them to stop. And just because the grill owner hasn't stopped yet, that doesn't mean the campaign has had zero effect. We have managed to educate millions of people about these damaging images, and hopefully the ones in the middle will just stop a minute and think.

http://www.nursingadvocacy.org/faq/most_trusted.html Q: Why aren't you more excited that public opinion polls often put nurses at the top of the list of "most trusted" and "most ethical" professions? A: Of course, there's nothing inherently bad about being trusted! A desire to care for others (as opposed to money, power or status) has traditionally been a major factor in why people choose to become nurses. And the public has tended to recognize that such care givers generally have their patients' best interests at heart. The reason the "most trusted" poll results don't do too much for us is that this public view often goes hand in hand with the prevailing vision of nurses as devoted, angelic handmaidens. Of course, it's possible that a particular member of the public might fully understand how highly skilled nurses are and still "trust" them greatly. But given that public understanding of the nursing profession appears to remain very poor, we fear that the poll results are essentially an expression of a vague, sentimental affection for nurses flowing from the above stereotypes. As one experienced nurse lamented: "They trust us to hold their wallets while they're in surgery. But not to save their lives." We can't help noticing that some of the professions near the bottom of the "trusted" list-- such as lawyers, journalists, and ad writers--do not seem to be suffering from any crisis in terms of supply of willing workers, working conditions, job benefits or social status. We wonder how many of the people who "trust" nurses so much would react if their son, or bright, ambitious daughter, announced that he or she wanted to be a nurse. Polling can measure many things, and much depends on the wording of questions and the context in which they are asked. In this case, we believe it would be a mistake to imagine that the word '"trust" implied genuine respect for professional skill. In this sense, putting too much stock in these poll results may actually be a dangerous illusion. http://www.nursingadvocacy.org/faq/dramatic.html Q: Nurses are just wonderful, but you really can't expect Hollywood to focus on them, can you? After all, popular media products have to be dramatic and exciting. Why don't you just focus on getting a nursing documentary on PBS or basic cable? A: Because the work of nurses is at least as dramatic as that of physicians, and getting the wider public to understand that would be of great value in resolving the nursing shortage that is one of the world's most pressing public health problems. More than a few Hollywood insiders have expressed to us some version of the sentiments in the above FAQ. But contrary to the current popular and mass media image, nurses are expert professionals who save lives autonomously--that is, in pursuit of their unique nursing scope of practice, not physician commands. They confront some of the most exciting human, policy and technological challenges in modern health care. These range from the extreme high-tech of teaching hospital ICU's, to chaotic urban level one trauma centers, to major health policymaking and research centers, to small community health projects where lives are changed, to war zones and development and humanitarian relief projects around the world. Perhaps the most telling evidence of the drama of nursing is that the major hospital shows on U.S. television today--"ER," "House" and "Grey's Anatomy"--actually do spend a great deal of time showing work that in real life is done by nurses, including fighting for better care systems, catching and preventing deadly errors, educating patients and giving them skilled emotional support, monitoring patient conditions, and performing exciting procedures like defibrillation. It's just that they inaccurately show physician characters doing it. What do nurses do? Nurses, with their years of college-level training, are on the front lines of the health care delivery team. They assess and monitor patients, and taking a holistic approach, determine what patients need to attain and preserve their health. Nurses then provide care and, if needed, alert other health care professionals. Nurses thus coordinate care delivery by physicians, nurse practitioners, social workers, physical therapists and others. Nurses assess whether care is successful. If not, they create a different plan of action. Nurse are patient advocates, protecting the interests of patients when the patients themselves cannot. Nurses are educators, explaining procedures and treatments to patients, teaching them how to care for themselves and work toward full recovery. Hospital nurses are responsible for discharge planning, deciding together with other health professionals when patients can go home. Nurses work to prevent illness through education and community programs designed to decrease transmittable illnesses, violence, obesity and tobacco use, and provide maternal-child education--addressing some of the leading health problems of our time. Some nurses are independent scholars whose work is at the forefront of health care research. Many nurses obtain Master's and Ph.D. degrees in nursing, then work as scholars, educators, health policy makers, managers, or advanced practitioners such as Clinical Nurse Specialists or Nurse Practitioners. Yeah, yeah, but what specifically do nurses do that a mass audience would care about? (links below are to specific examples) Nurses catch and prevent the medication error that would have killed you. http://www.nursingadvocacy.org/news/2004jul/07_boston_globe.html Nurses catch and stop the infection that would have killed you. http://www.nursingadvocacy.org/news/2003oct_rd.html Nurses diagnose an ICU patient's wide complex tachycardia, call a code, and defibrillate--saving the patient's life. http://www.nursingadvocacy.org/news/2005may/24_house.html Nurses triage ED patients based on their own expert evaluation of how sick the patients are--saving patients' lives. http://www.nursingadvocacy.org/news/2003oct09_er.html Nurses give powerful medications and vaccinations--saving patients' lives. Nurses are the care givers most likely to be there when patients are screaming, crying, laughing, or dying. Nurses manage that violent, intoxicated patient alone until security gets there--if security gets there. Nurses are the hospital caregivers most likely to be assaulted. http://www.nursingadvocacy.org/news/2004nov/27_bbc.html Nurses persuade that psychiatric patient to stick with the program. Nurses persuade a poor young mother to save her baby's life through prenatal visits and breastfeeding. http://www.nursezone.com/student_nurse_center/default.asp?articleID=10234 Nurses provide adequate pain medication for terminal patients and the opportunity to die at home. http://www.nursingadvocacy.org/news/2004mar/28_press_democrat.html Nurses provide expert support in your final hour. Nurses teach you how to avoid getting AIDS, and how to live with it if you do. http://www.nursingadvocacy.org/news/2004mar/21_parade.html Nurses subtly show the sickest patients that it's worth trying, perhaps by discussing Harry Potter with the young leukemia patient, or watching a few minutes of the news with that despondent, elderly post-op patient. http://www.nursingadvocacy.org/news/2004nov/rd.html Nursing students spend years in demanding science programs that test their sanity and cause some to quit or fail. http://www.nursingadvocacy.org/news/2005jun/12_nytimes.html Nursing scholars struggle to get grants, publish groundbreaking research and get tenure. http://www.nursingadvocacy.org/press/nursing_research.html Nurses serve as the chief executive officers of large hospitals. http://www.nursingadvocacy.org/news/2004jan/25_birmingham.html Nurses spearhead efforts to help your teenage son not start smoking. Nurses deliver babies in U.S. teaching hospitals and mountain villages in Bolivia. http://www.jhu.edu/%7Ejhumag/0605web/ruminate.html Nurses provide much, if not most, of the health care given by aid groups with names like Doctors Without Borders. Nurses explain what that physician was trying to communicate--saving countless lives. Nurses, as commissioned officers, manage complex military care operations around the world. Nurses found and run new health systems for underserved urban and rural communities--saving countless lives. http://www.nursingadvocacy.org/press/breckinridge.html Nurses confront disruptive physician behavior, life-threatening nurse short-staffing, and bitter class divisions and horizontal violence within their own profession. Nurses go on strike. http://www.nursingadvocacy.org/news/2003nov17_philly_daily.html Burned-out nurses explode and quit. http://www.nursingadvocacy.org/faq/short-staffed.html Nurses train and mentor nursing students and new nurses. Nurses kick intoxicated surgeons out of the OR and fight to have surgeons who are dangerous removed permanently. http://www.nursingadvocacy.org/news/2005jan/18_nyt.html#scrub Nurses refuse to give drugs that will hurt that fetus, or any other patient. Nurses risk their careers to blow the whistle on deadly incompetence. http://www.nursingadvocacy.org/news/2005jun/22_dr_death.html Nurses make mistakes and kill people, especially when they are understaffed. http://www.nursingadvocacy.org/news/2004jun/20_nyt.html Nurses regularly have intense interactions with physicians about patient care. For instance, nurses may identify symptoms physicians have overlooked, and they may struggle to convince physicians that those symptoms exist. Is that dramatic enough? We know it is, because we've seen physician characters doing much of the above for years. And the nursing tasks that physician characters are not shown doing would often make for equally compelling drama, if media creators knew that they occurred. Unfortunately, the incorrect traditional assumptions about nursing have led to the matrix of physician-centric programming that has dominated popular media for decades, forming a persuasive but dangerous simulation of reality. Today, virtually every major character in the top three hospital shows named above is a physician--24 out of 25, to be exact, with the sole nurse being "ER"'s Sam Taggart. The combined viewership of new episodes of these three shows at the end of the 2004-2005 season was well over 50 million in the U.S. alone. Clearly, the idea that nursing is not dramatic must be overcome if we are to transcend the matrix, and help nursing gain the power it needs to meet the health challenges that lie ahead.