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Symposium to challenge nursing stereotypes on 'ER,' 'Grey's,' 'House'

An upcoming UCLA Nursing symposium examines misrepresentations of nurses in the media, and the dangers of the resulting misperceptions.
An upcoming UCLA Nursing symposium examines misrepresentations of nurses in the media, and the dangers of the resulting misperceptions.
In the first episode of ABC’s medical drama “Grey’s Anatomy,” a nurse-hating doctor decides to insult a fellow physician by addressing her as a nurse. And boy, does it work.

“Did you just call me a nurse?” replies the show’s main character, her voice dripping with contempt.

Moments like this make nurses around the country cringe. Movies and TV shows often portray nurses as doctors’ helpers, or too dumb to be physicians, or don’t show nurses at all, which discourages people from joining or funding the profession, explained MarySue Heilemann, a nurse and associate professor at the UCLA School of Nursing. To address the problem, she is staging a symposium on May 12 about misleading portrayals of nursing and the dangerous misconceptions that result.

MarySue Heilemann
MarySue Heilemann
“We’re facing a global nursing shortage because talented candidates who could become nurses will not choose nursing,” Heilemann said. “These stereotypes deter funding from going into nursing .”

Because nurses are largely absent in medical shows and movies, physicians get all the credit for doing nurses’ work, Heilemann said. “The physician characters are shown doing nursing care: spending time with the patient 24/7, fulfilling the treatment plan, getting to know the patient, talking to them in the wee hours of the night – that’s not the physician’s role. That’s the nurse’s.”

Next week’s symposium, Media Images and Screen Representations of Nursing, aims to deepen the conversation about images of nursing, and to inspire people – including Los Angeles screenwriters – to think differently about nurses, Heilemann said. Speaking at the symposium will be Sandy Summers, a nurse and executive director of the advocacy group, The Truth About Nursing, which creates an annual top-10 list of the best and worst nursing portrayals in the media.

Sandy Summers
Sandy Summers
“Oh, ‘Grey’s Anatomy’ is the worst,” said Summers, who is also co-author of the book “Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All at Risk.”

Medical dramas like NBC’s “ER,” Fox’s “House” and “Grey’s Anatomy” educate the public about much of what they know about how a hospital works, Summers said. Physicians get all the credit for nurses’ work, so federal funding goes to them instead, in part because nurses are so often shown as physicians’ servants if they’re even shown at all, she said. Nursing residency programs get $1 of federal funding for every $375 that goes to physicians’ residencies, Summers noted.

“There’s one ‘ER’ clip where a nurse walks behind a physician, and she drapes a stethoscope around his neck. Not a word [is] exchanged, driving home the handmaiden stereotype of nursing so powerfully, because it's the kind of thing that makes you just nod along subconsciously in agreement,” Summers said.

To fight the subconscious elevation of doctors, some nurses sensitive to this issue never use the word “doctor” – only “physician.” Hundreds of fields produce Ph.D.s who are doctors – in fact, many nurses are doctors, Summers noted. “People believe there’s something a little bit superhuman about a doctor,” she said. “Physicians have no right to own that word.”

When nurses do appear in scripted TV, many shows pay more attention to the nurses’ love lives than their skills, she noted. “A study of private-school kids found that they felt more was expected of them than to become lowly nurses. Another study found that bright kids are driven away from becoming nurses, in part because they think nurses are brainless, sex-mad bimbos,” Summers said.

The “naughty nurse” stereotype leads to nurses getting grabbed, groped and sexually harassed everyday, said Summers.

Linda Sarna
Linda Sarna
The stereotype also discredits them, said Linda Sarna, an oncology nurse and professor at the UCLA School of Nursing who will speak at the symposium about her studies and support for anti-smoking programs – including for nurses. Tobacco companies once used nurses heavily in advertisements, Sarna noted.

“Some images portray nurses who smoke as ‘naughty’ nurses, even in a sexualized context, not addressing the power of addiction,” Sarna said. “There are even images of ‘compassionate’ nurses lighting the cigarettes of their patients … and nurses ‘teaching’ women the correct way to smoke. … These images undermine the nurse’s role as a public health advocate.”

Most people would be surprised by how many health care tasks are actually performed by nurses, not physicians, Summers said. Among these are triage, titrating medication levels, calibrating pumps that regulate the heart and even shocking patients’ hearts back to life with defibrillation. “We were telling ‘ER’ that for years, and finally they had a nurse perform the defibrillation, but he still didn’t say anything,” Summers said. “In shows like ‘House,’ nurses exist from the elbow down or seem to morph out of the wallpaper. They never monitor the patients.”

Summers praised shows like Showtime’s “Nurse Jackie” for characterizing nurses as dedicated, well-educated medical professionals who stand up for their patients. “What people learn is that she is an expert clinician. She can diagnose, and she intervenes to save patients lives. She’s a fearsome patient advocate,” Summers said.

Many television watchers don’t realize how well-educated and medically trained nurses are, Heilemann said. Nurses must obtain a degree from an accredited school before they can take the nursing exam, which they must pass before receiving their R.N. license, she explained. While 50 percent of R.N.s get a nursing diploma or an associate’s degree before taking the test, half of all nurses have a bachelor’s or graduate degree, including 13 percent who earn doctoral degrees, she said.

“When I was studying to become a nurse, people would say, ‘You’re so bright — why would you ever choose nursing when you could be a physician?’ My students hear the same thing,” Heilemann said. “I chose nursing because I wanted to work with my patients and get to know these people. That’s what gives me satisfaction.”
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