PAGE 37 / APRIL 10, 2007 SCRIPTDOCTOR: MEDICINE IN THE MEDIA Media Portrayals of Nurses (Part 1 of a 3-Part Series) By Andrew Holtz, MPH hears and understands the criticisms Andrew Holtz, MPH, is a former CNN Medical Correspondent from nursing groups, but says she r. Gregory House injects and the author of “The Medical Science of House, M.D.” This works hard to help the writers be as a patient with edropho- column examines mass media programs, particularly realistic as possible. “ nium chloride. The drug entertainment TV, for insight into popular perceptions, so that “I’m trying to even out the fairness D blocks acetylcholinester- rather than merely wincing at distortions or of the portrayals in ways that I can, ase and can boost muscle strength in oversimplifications in the portrayals of medicine on these while still keeping the drama in the people with myasthenia gravis, so it is shows, health care professionals can learn something from show,” Bergstrom says. “It’s a show sometimes used to help confirm a that works. It’s really a fantastic show. media professionals about the way that medical and health diagnosis. The patient, who had been The writing is excellent and I love topics are presented. Send questions to him about how the too weak to even sit up, suddenly working on the show. I’m very proud media treat medical topics or suggestions for future columns stands. But the effect is temporary and of it.” to [email protected] after a moment, the patient crashes to Bergstrom concedes that the physi- the floor. Dr. House looks down at him. cians on House do a lot of nursing, as “This is exactly why I created nurs- they do in other shows. es. Clean up on aisle three!” Dr. House “The reason they do that on our bellows. shows set in hospitals, features a cast in Espinosa catches an intern’s error and show is that the way the show is writ- This scene from the Fox TV show which doctors far outnumber nurses; takes charge of handling a patient’s ten, the scenes are so intimate that to House is one reason the series is unlike- while of course in real hospitals the seizure. The lead writer of the episode, have an extra person in there, doing ly to win any awards from nurses. ratio is the other way around. But a Angela Nissel, says that even though what a nurse would actually do, would Indeed, when the Center for Nursing nurse, Carla Espinosa, is featured the show is a comedy, the scene echoes take away from the drama of the Advocacy announced its “Golden Lamp among the leads. She’s no mere bed- reality. scene.” She notes that the attending Awards” for media portrayals of nurses pan-changer—as one retort to the hos- “Over and over we do hear doctors physicians also invade the turf of all earlier this year, House was listed pital’s Chief of Medicine makes clear: say that when they start, they are sorts of specialties, such as radiology, among the worst shows. “You’re worried about what I can amazed that nurses know so much pathology, and every type of surgery. “Grey’s Anatomy and House are the handle? Vascular surgery wants an up- more than they do. You’ve just finished worst offenders,” Center Executive date every two hours on bed one. I’m all these years of medical school, and to Director Sandy Summers stated in the weaning Mrs. Jones’s dopamine from have a nurse step up and say, ‘No, awards announcement. “These globally 10 mics to 5. Mrs. Myers’ abdominal that’s not how you do it.’ Or to have a popular shows portray nurses as brain- wound is dehiscing. And Mr. Wilder’s nurse actually save someone’s life, it less servants, while heroic physicians about to be turfed to psych because he must really put you in your place really provide all important care—much of thinks he’s Flo from Alice,” Carla says. quickly and let you know how much of which nurses do in real life, like defib- One of the patients, Mr. Wilder, a newbie you really are,” says Nissel. rillation, triage, and patient education. chimes in, “Kiss my grits!” By the way, her mother is a nurse. With a nursing crisis stemming in large Carla responds, “Exactly, Flo, (See sidebar) part from undervaluation of the profes- exactly.” “I just wanted my Mom to look at sion, this is unacceptable.” In another episode noted by the an episode and smile for once and say, Other popular shows on the cen- Golden Lamp Award judges, Nurse ‘Thank you! After four years of writing ter’s “worst” list include episodes of on Scrubs, you actually showed what NBC’s ER and Heroes, and HBO’s The we do,’” Nissel says. “It was important Sopranos. There is one, just one, prime- to show a nurse as something other time show on US television that won “‘Grey’s Anatomy’ and than a background character. praise from the nursing group: NBC’s ‘House’ are the worst “Carla is supposed to be a head Scrubs. It’s a comedy. nurse. She’s a Registered Nurse. Scrubs, like all other entertainment offenders, portraying She’s been there a while. She obvi- ously went to college. She knows a The depiction of nurse Carla nurses as brainless lot of stuff; and to have one or two Espinosa on Scrubs, portrayed by Judy Reyes, has won praise servants, while heroic episodes out of a hundred where she Clinical Notes shows what she went to school for is from nursing groups. continued from page 36 physicians provide all important.” So why don’t other shows fea- important care—much ture similar nurse characters? Accurate, But Not Dull Dr. King said he believes the device can of which nurses do in “It’s like asking why the ratio of potentially capture mesenchymal stem female superheroes to male super- Bergstrom says the writers and others cells as well. These unspecialized cells, real life, like defibrillation, heroes is so low. We just have this thing working on House want to be accurate, which form tissue, bone, and cartilage, in our society about what the hero or but they dare not be dull. could be used in tissue engineering or triage, and patient the main character looks like, and it “A good example is that in order to bone marrow transplantation. education. With a takes a long time to get over that. And take a pulse accurately in the real “The main advantage of the also because the majority of nurses are world, you have a minimum of 20 sec- implantable nature of the device is that nursing crisis stemming women, but the overwhelming majority onds to check it. Twenty seconds of it filters the peripheral blood 24 hours a of writers are male. When it comes time checking a pulse on TV is death to the day,” Dr. King said. “Thus, if circulat- in large part from to write the main characters, most of drama. So if you are watching a televi- ing tumor cells are being filtered, it is undervaluation of the them tend to be male,” suggests Nissel. sion show and you say, ‘No one could hoped that metastasis can be prevented It’s not that writers and producers ever check a pulse that quickly,’ you or significantly reduced. In the case of profession, this is are unaware of the role of nurses, even are absolutely right, but nobody wants stem cell therapy, native cells can be at House. Bobbin Bergstrom, RN, has to watch somebody check a pulse for 20 manipulated without having to remove unacceptable.” been helping shape episodes of House seconds.” O them from the body.” T since its first season. (See sidebar) She (continued on page 38) PAGE 38 / APRIL 10, 2007 ScriptDoctor continued from page 37 Scrubs Writer/Producer Angela Nissel: ‘I’ve Grown Up ngela Nissel has been on the and doctors compared with what assistants. Most people get most of And while she’d like to see more “Scrubs” writing team since the most people I work with have. I’ve their ideas about what nursing is nurse characters doing more of the A show’s second season. Over those five grown up hearing that nurses are the from television, so they think that all nursing on medical shows, she says the years she’s grown up from being, as ones you should trust when you go in nurses do is stand by doctors, listen to dominance of physicians merely re- she puts it, a “baby writer” to a con- the hospital,” Nissel says. orders, and change bedpans or adult flects the attitudes of society in general. sulting producer. “My Mom always said the nurse diapers.” “I’m not sure why, but physicians She takes a personal interest in will spend hours with you, and the Nissel says she feels fortunate to are still revered as next to godliness, the character of Nurse Carla Espinosa. doctors will run in and out. And I’ve have that familiarity with nursing in and that makes them interesting to peo- “My Mom is an RN, so I grew up always known there were different her background, but it can also stir ple. Many people think, ‘I could never with the opposite ideas about nurses levels of nursing, LPNs and nursing conflict with her fellow Scrubs writers. be a doctor.’ It’s a mystery to them. And so doctors are more glamorous than nurses,” Bergstrom says.