Nursing and the Media

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.