I recently received an e-mail invitation to a free one-hour webinar entitled, “How the Media Portrays Nursing: Does it Really Matter?” The speaker was Sandy Summers, RN, MSN, MPH, the Executive Director of The Truth About Nursing blog and website. As her billing says, “Since 2001 she has led the effort to change how the world views nursing by challenging damaging media depictions of nurses.” I would have signed up to participate in this webinar, but I was working in clinic during the time it aired. Here is the promotional blurb for the webinar:
“Ever watch Grey’s Anatomy, Nurse Jackie, House, or other television shows that seem to portray an inaccurate depiction of a nurse? How often do you personally experience the misconception that nurses ‘do what doctors tell them to’? The nursing shortage is a public health crisis that is one of the biggest dangers for patients and the public at large. Media products have long shaped and reinforced inaccurate perceptions about the nature of nursing work. Public health research shows that even entertainment media products have a significant effect on how people think and act with regard to health care. By reconsidering how our society thinks and acts toward nursing, we can empower nurses to improve safety for patients, reduce turnover, and enhance public health. Explore some overlooked roots of the nursing crisis and its effects, and learn ways you and other nurses can help.”
A few things I find interesting about her description and that I disagree with. One is contained in the last sentence and that is that media’s (implicitly stated ‘bad’) depiction of nursing leads directly to the nursing crisis. The “nursing crisis” is, of course, that oft-quoted “the sky is falling” alarm statement about how we don’t have enough nurses in the US to take care of all the aging baby-boomers. People have been screaming “nursing crisis” since before I went to nursing school, and I believe it is a largely manufactured problem. If there is a real shortage, it is not for lack of nurses, but for lack of decent working conditions for nurses. They leave nursing. And I doubt it is the fault of the media. “The nursing shortage is a public health crisis that is one of the biggest dangers for patients and the public at large.” Also inaccurate. Yes, adequate nurse staffing levels in hospital settings are clearly related to good patient outcomes. No one who has ever spent time in hospitals, as patient, family or staff, would disagree with this conclusion. But at a population health level, the number of nurses, doctors and hospitals in a country is not well correlated with good population health outcomes. In fact, it can start to have an inverse relationship, with more health care workforce/hospitals seeming to lead to a decline in overall population health—the effects of iatrogenics at work. I know they cover this in the MPH program at Johns Hopkins where Ms. Summers received her public health degree.
So that leads me to consider the overall issue of the media portrayal of nursing. That, after all, is what Ms. Summer’s Truth About Nursing is about. TV is only one segment of media, but an important one on a national level. I have watched episodes of Grey’s Anatomy, ER, Nurse Jackie, and HawthoRNe, both to see if they had any entertainment value, and to see how nurses were portrayed. I haven’t owned a TV—well—ever, so I watched all of these on DVD or streaming video. They are all TV shows, so they have really bad scenes involving resuscitation of deer, ferry crashes, helicopter crashes, and the usual soap opera hospital romances. Nurse Jackie and HawthoRNe at least have flawed but strong, smart and almost believable main characters who are nurses. TV drama shows like these are not reality TV. I still have faith that most Americans know this difference and don’t form their opinions about nursing from these TV portrayals. They form their opinions more from interactions with nurses they know as family members or as health care providers.
Ms. Summers and other nurse media watchdogs need to lighten up. The sexy nurse and the angelic nurse motifs are never going away completely. Having more men in nursing will help change the public’s perception of nursing more than trying to battle the media. And having a sense of perspective—and of humor—is needed.
It reminds me of other negative stereotypes of female-dominated professions, such as librarians. The Nancy Pearl Librarian Action Figure sits here beside me at my desk. Nancy Pearle is a real-life Seattle librarian extraordinaire. Seattle, as one of the most literate cities in the country, would have a librarian as a local celebrity. Our Seattle-based crazy toy-maker and seller Archie McPhee made an action figure of her several years ago that was a big seller. The librarian is dressed in dowdy clothes, a mid-shin length skirt, a loose-fitting jacket, and flat puffy comfort shoes. She is holding an index finger to her pursed lips, permanently ‘shushing’ people. Many librarians around the country were outraged by this action figure, complaining that it reinforced a negative stereotype of the anti-fashion, stern, matronly librarian. Nancy Pearle’s response was that it separated librarians who had a sense of humor from those who needed to check one out of their local library (OK—this is not a direct quote, I added the last part). I checked today and Archie McPhee’s doesn’t have a nurse action figure. I plan to recommend they come up with one—and not of Florence Nightingale. That reminds me of the Halloween costume I wore one year to a party at Hopkins. I went as sexy Flo and it was a hit…. Luckily I wasn’t in the same class as Ms. Sommers.
In my next blog entry I will continue this discussion, but will focus on nursing’s attitudes towards and interactions with the media, especially the news media.
I agree. We do need to have a sense of humor. Cop and lawyer friends of mine don’t exactly love the the way they are portrayed in the media either!
Archie McPhee’s actually had a murse (male nurse) action figure made a few years back. They modeled him after a real ICU murse at Harborview. He isn’t terribly realistic, either. His scrubs are tight fitting, he’s well groomed and clean shaven, and he has rock-hard abs and pecs. Ha!
Oh yes! A Ken nurse–how great! I have to be at Harborview’s ICU today so will ask the nurses how many own the action figure… Go Archie McPhee’s….Thanks for pointing this out.
Hi Josephine,
I hope you will be able to take some time out and read our book Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All at Risk. In it we address every single one of your attacks. Misimpressions are built on stereotypes, wrong assumptions about the media and the same old popular thought processes that millions of people have. I’ll try to address your concerns one by one.
1) I direct a blog and website.
I’m founder and executive director of a 501(c)(3) non-profit organization called The Truth About Nursing. It’s not just a blog. My bio http://www.truthaboutnursing.org/about_us/bios/ssummers.html
2) Lighten up and get a sense of humor.
We actually try hard to be humorous. Here’s an analysis you might want to check out if you need a source. http://www.truthaboutnursing.org/news/2005/apr/01_jama.html
3) People have been screaming “nursing crisis” since before I went to nursing school, and I believe it is a largely manufactured problem.
Yes, it is manufactured, but that the manufacturing of it comes from the undervaluation of nurses. Why are nurses undervalued? The media routinely portrays nurses as unskilled losers incapable of independent thought who exist to serve physician needs; battleaxes, angels and women who exist to provide sexual services to patients and physicians. No sane organization would pay anybody well for doing what these stereotypes do. The denursification of health care began in the 1990’s when health insurance companies decided nursing care was too expensive, too valueless to pay for. So they started cutting patient hospital stays (reducing nursing care), understaffing, and replacing nurses with non-nurses. All this leads to less nursing care–decision makers don’t know nursing has value so they don’t fund it. How much is nursing underfunded? For instance, nursing residencies get $1 for every $375 that physician residencies get. This abysmal funding happens because of what goes on inside people’s heads. They don’t think nursing is worth anything because of what they see on TV and read in the media, so they don’t fund it.
4) But at a population health level, the number of nurses, doctors and hospitals in a country is not well correlated with good population health outcomes.
I couldn’t agree more. We need to take a boatload of ICU nurses and put them in community health settings and prevent health problems instead of treating them after it’s too late. We have way too much emphasis on tertiary care. The global nursing shortage is also far, far worse than the U.S. shortage. Our work does not stop at the border’s edge. Media stereotypes of nursing are global and nearly the same everywhere.
5) I still have faith that most Americans know this difference and don’t form their opinions about nursing from these TV portrayals. They form their opinions more from interactions with nurses they know as family members or as health care providers.
Most people don’t have much interaction with nurses. Their health visits are often with physicians (though increasingly not, which is great for patient health). They get way more ideas about who nurses are and what they do from the media. I would give you a lot of research in this message, but it’d save me and hour if I could refer you to this FAQ we wrote on it which is here. http://www.truthaboutnursing.org/faq/hollywood_research.html
There are three other FAQs that are related that you also might be interested in that address many of the points in your blog entry:
Come on. Even if the mass media does ignore nursing, or present it inaccurately, how can that possibly affect nursing in real life? answer… http://www.truthaboutnursing.org/faq/media_affects_nursing.html
OK, fine. I can see that some media probably affects how people think about and act toward nursing, like maybe a respected newspaper or current affairs show on TV. But how can some TV drama, sitcom or commercial affect people that way? People know enough not to take that stuff seriously! answer… http://www.truthaboutnursing.org/faq/media_affects_thinking.html
Well, if all that research shows how influential Hollywood is on health care–and Hollywood itself claims credit for improving the world through “medical accuracy”–why won’t it admit that its portrayal of nursing is equally influential, and take steps to fix it? Especially since the nursing shortage is now a global public health crisis. answer… http://www.truthaboutnursing.org/faq/hollywood_behavior.html
6) The naughty nurse never hurt anyone.
Here’s another FAQ:
What is the problem with the naughty nurse stereotype? I mean, no one believes that nurses really dress like that! answer… http://www.truthaboutnursing.org/faq/naughty_nurse.html
Not sure if I covered everything, but I hope you sign up for our free news alerts and follow our coverage of nursing and the media. We’d love to have you involved in reaching out to them, telling them what’s what about nursing so they’ll start portraying us as autonomous professionals who save lives and improve outcomes. Once the public gets a better understanding of the value of nursing, it will be funded in line with its worth, which will allow us to reach out to more and more people and save the millions of lives we are capable of saving if only we were funded to do so. That begins with changing how people think about nursing.