I cannot stomach television medical dramas. I cringe as gross misrepresentations of handsome doctors, submissive nurses, absent clerks, transporters and housekeepers spew forth rapid-fire from across my family room. I roll my eyes at physician omnipresence, omniscience and omnipotence, cackle knowingly at gross physiologic and pharmacologic errors and too frequently ask aloud, "Where are the nurses?"
I was not always such a fussbudget about hospital correctness in entertainment media. As a newbie nurse in 1982, I held to a smidgen of a dream that the mysterious world I had entered wide-eyed and feckless might be revealed in the halls of St. Eligius. I soon outgrew my crush on the handsome but dimensionless Dr. Caldwell (Mark Harmon), moved on to the troubled nice guy Dr. Morrison (David Morse), was disappointed by Nurse Helen Rosenthal's (Christina Pickles) addiction to prescription painkillers, and finally abandoned St. Elsewhere altogether. St. Elsewhere was a great t.v. series, doubtless, but did the only important nurse character have to be an addict? My one role model was more than flawed and human: she was toxic.
After St. Elsewhere closed its doors in a truly inspired final episode, Televisionland marched out Chicago Hope, starring Christina Lahti, a St. Elsewhere alumna. I assigned my first-year nursing students to watch the show and prepare to discuss the depiction of nurses on television the following day. They were speechless: there were zero nurses in Chicago Hope! Invisible. Exit Chicago Hope.
Many of us pinned our hopes on Michael Crichton's ER. Lauded as the most realistic television medical show ever, we were ingratiated by its technical accuracy and the authentic teamwork between physicians and nurses. Only occasionally, for dramatic convenience, did docs feed patients and perform discharge planning, jobs done by nurses in the real world. Every once in a while, a nurse would defibrillate during a code or correct an errant resident's dangerous drug dosage - like real nurses in action! ER did, to its credit, establish that the nurse-as-handmaiden role was not essential to the medical drama plot line.
However...ER was no stranger to nurse stereotyping. Nurse Julianna Marguilies, smart and assertive, left the ER, marrying her handsome physician colleague George Clooney. (Ho hum - heard that one before.) The capable Labor and Delivery Nurse Abby Lockhart advanced her career, and became a regular on the show, not through graduate study to obtain advanced practice credentials in nursing, but by going to medical school. (Note to television writers: nurses are not lesser versions of physicians. Nurses are not health care providers who would have gone to medical school if we had been smart enough.)
What am I complaining about? It's just television, right? Well, not quite. We humans are subject to subtle, sneaky influences on our thinking from sources that we know to be fictional. According to a 2002 study from the Kaiser Family Foundation, "some media scholars argue that entertainment TV’s impact can be even more powerful than news in subtly shaping the public’s impressions of key societal institutions." Consider advertising: the best ads are funny and entertaining, not factual. We know they're not journalism, but they influence our purchasing choices nonetheless.
Subtle messages about nurses as passive order-takers do alter our power and position in society and the health care environment. Even though there is a federal National Institute for Nursing Research, even though nurses have been getting graduate degrees for decades, even though there are hundreds of nursing research and policy journals, well-intended but ignorant people still asked me as a PhD student in nursing, "Why don't you go to medical school? You're smart."
So I hope I can be forgiven if I'm not enthralled by the current batch of nurse-free hospital shows: Grey's Anatomy (Pretty girl docs with perfect makeup!) or House (Genius curmudgeon saves lives without benefit of social skills!), as are some of my friends.
There is one hospital show, though....
(Continued in Part 2)