Your favorite movie or TV show may feature a spunky heroine who’s smart, capable, and great at her job, but chances are she’s not a nurse. Although TV shows and movies are known to take artistic liberties with many professions—such as homicide detectives, lawyers, and politicians—the importance of what nurses do has been consistently downplayed and marginalized in mainstream media.

Historically, nurses have played a secondary role in health care-focused TV shows, perhaps showing up as the attractive “naughty nurse” or not featured at all. There were few prominent portrayals of nurses until the 1970s TV show M*A*S*H, whichintroduced Major Margaret “Hot Lips” Houlihan, played by Loretta Swit, to the popular culture. In addition to being the only main female character in the ensemble cast, Houlihan was an army nurse who served as romantic fodder for a few of the male characters over the course of the show.

But the majority of the media focus has traditionally been on physicians, with nurses serving as their handmaidens. “The media portrays nursing as a career for yesterday’s women living in the dustbin of history—women who just never got the memo that if you want to do anything of meaning in the field of health care, then become a physician,” says Sandy Summers, RN, MSN, MPH, who is the founder and executive director of the non-profit organization The Truth About Nursing, which seeks to increase public understanding of the central role nurses play in modern health care. “If the media knew that nurses actually perform intensely interesting and dramatic work and portrayed nurses doing it, the public would come to better understand—and respect—nursing.”

Recent Portrayals of Nursing

In the past decade, nurses have started to appear more frequently in entertainment, but the portrayals aren’t often reflective of reality. Summers says that unfortunately, the most popular shows that reach the largest audiences, such as Grey’s Anatomy, Private Practice, and House, tend to show physicians doing all the work—including tasks that are in reality performed by nurses—with nurse characters simply fetching things for the physicians. In real life, of course, the work nurses do is far more involved.

Manisha Ati, RN, BSN, is an operating room nurse at New York University Langone Medical Center in Manhattan. “During nursing interventions, nurses are making critical decisions without involving a doctor—decisions such as giving pain meds or escalating a patient’s situation if they’ve taken a turn for the worse,” says Ati. “I don’t think people realize what a complex and dynamic job nursing really is, just from watching media.”

The long-running TV hit ER (1994-2009) featured a large cast, but the emphasis was still on physicians. “Among the non-nurse shows, ER had good diversity of the nurse characters. There were Asians, African Americans, and men. Sadly, all were minor characters existing at the edges of the plot,” says Summers.

In recent years, more nurse-focused TV shows have cropped up, including Nurse Jackie, Mercy, and HawthoRNe, although Nurse Jackie is the only one that’s still on the air. “All three shows had good ethnic and gender diversity of nurse characters,” says Summers. HawthorRNe featured Jada Pinkett Smith in the title role of Christina Hawthrone, and Mercy featured Jaime Lee Kirchner as Sonia Jimenez, both African American nurses. Nurse Jackie, which Summers says does show some depictions of strong, astute nurses, includes South Asian and Middle Eastern nurse characters. The hospital-set comedy Scrubs (2001-2010) also featured a Latina nurse, Carla Espinosa, played by Judy Reyes.

Similar to entertainment, news reporters tend to highlight physicians instead of nurses when covering medical stories. One notable exception was during the October 2012 coverage of Hurricane Sandy at NYU’s Langone Medical Center, where Ati works. When the hospital basement flooded and back-up power generators failed, nurses evacuated 260 patients, including babies from the neonatal intensive care unit, and the national news outlets picked up the story, citing the heroics of nurses who worked through the night to carry patients to safety. “Nurses are generally portrayed as being in the background. That’s what was unique about the news coverage of Hurricane Sandy—the media actually recognized nurses for doing the work of moving patients. Even President Obama acknowledged the nurses for what they did—and that’s the kind of work nurses really do,” says Ati.

Are Minority Nurses Stereotyped?

As a field, nursing is extremely diverse. “Different cultures and backgrounds are embraced in the nursing profession, and I think that’s good; it makes you a better nurse,” says Ati. Diversity in the nursing field also helps nurses deal with the myriad backgrounds and cultural differences of the patients they serve.

Sources say that while nurses aren’t shown enough in the media, minority nurses are being portrayed fairly, when they do appear. “It’s not so much that minorities are being stereotyped—nurses as a whole are being stereotyped,” notes Summers. Ati agrees: “It’s not that minority nurses are portrayed differently—it’s that nurses in the media are the minority!”

Male nurses in entertainment tend to fall into two categories, says Summers: the “boy toy” that promotes female power when women boss them around, or the medical school drop-out, as evidenced with male nurse Gaylord Focker in the Meet the Parents movies—who won the professional approval of his father-in-law only after his fiancée revealed that he had scored in the 97th percentile on the MCAT—and staff nurse Ray Stein on HawthoRNe, who failed the MCAT the first time and dreamed of going to medical school.

Taking the Reins of Media Perceptions

The landmark Woodhull Study on Nursing and the Media analyzed articles published in 16 US newspapers, magazines, and health trade publications from September 1997. Researchers found that less than 1% of magazine articles and less than 4% of newspaper articles referenced nurses—and such references were made mostly in passing, not mentioning a nurse more than once. The study concluded that it was up to nurses to take a more assertive role in the media, such as speaking at public events and writing more letters to the editor to correct misrepresentations of the nursing field in the media.

Diana Mason, PhD, RN, FAAN, Rudin Professor of Nursing at Hunter College, City University of New York, heartily agrees. Dr. Mason is the co-director of the Center for Health, Media & Policy (CHMP) at Hunter, along with her colleague Barbara Glickstein, MPH, MS, RN, a health journalist. They also host a long-running radio show called Healthstyles on WBAI in New York. Through CHMP, Glickstein is the lead on media training, running workshops that prepare nurses to speak to the media—or start media on their own, such as through a blog, Twitter, or Facebook. “As nurses, it’s our responsibility to show the media what nurses do. We focus on what patients need and want, and that’s an important perspective,” says Mason.

Mason cites the CHMP blog, HealthCetera, as a good nursing media source to follow. In addition, Mason is proud of the ongoing work from nurses who have been through the media training workshop of CHMP, such as Chelsea Savage, RN, and Nancy Rudner, DrPH, RN. Rudner, a nurse practitioner, writes a regular health column for the Winter Park/Maitland Observer in Florida. Savage, a nurse who is interested in health care reform, is active on Twitter and Facebook.

Among minority nurses who have been through the CHMP media training, Mason cites Angie Millan, MSN, RNP, CNS, FAAN, who is the immediate past president of the National Association of Hispanic Nurses, and Patricia Lane, RN, BSN, an African American nurse in Virginia, as star students. Lane, whose passions include health policy and continuing education, wrote an op-ed piece entitled “More patients now assured of help” for the Richmond Times-Dispatch in June 2012 to comment on the passing of the Affordable Care Act.

“Since nurses are the most trusted health care providers, we can relay important health information to patients in a way they can really understand,” says Lane in a phone interview. Furthering her media outreach, Lane was selected by the American Heart Association to be part of the Spotlight Speaker Series on Racial and Ethnic Disparities in Hypertension: Beginning the Conversation 2012-2014. “It’s a volunteer engagement and community outreach program that will run in 18 US cities from January to June 2013,” Lane says. “We’ll assign mentors to coach participants to decrease their high blood pressure numbers and work with them to achieve a healthy lifestyle.”

How Nurses Can Gain More Exposure

When it comes to the lack of nurses portrayed in the media, Mason says that the problem goes both ways. Although the media should feature more nurses, there are also some barriers from the nursing community. “We have to do a better job of preparing nurses and nurse researchers to speak to journalists,” she says. “Nurses need to be prepared to describe what we do.”

In addition, nurses may be reluctant to talk to the media. “Nurses don’t respond to journalists. Nurses may be afraid that they don’t have the right expertise or aren’t comfortable speaking to the media. The media need to recognize and value that expertise, but they need nurses to speak to, as well,” says Mason.

Mason notes that nursing journals and organizations also need to become more media-friendly. She served for over ten years as editor-in-chief of the American Journal of Nursing (AJN), where Mason continues in an emeritus position. Under her leadership, AJN became the journal most frequently cited in the public media. It’s also important to frame nursing conferences to make them easy for journalists to cover, which hasn’t been done in the past, she says.

“What we can do is more outreach with public journalists,” says Mason. “The change will have to come from nurses and those who are educating nurses, not from the media.”

Summers points to the “Take Action” page on The Truth About Nursing website where nurses, the media, and members of the public can seek to improve the media’s understanding of nursing. She says it’s important for entertainment writers to start with an accurate idea of what nurses do before they begin creating TV shows and movies that feature them. “We encourage the media to consult nurses as experts on health care shows and news articles instead of assuming that physicians are masters of all health care,” Summers says. “So much relies upon the media to just stop buying into stereotypical assumptions and start asking nurses about nursing.”

What It Really Means to Be a Nurse

If media perceptions of nurses aren’t what they should be, there are different opinions on how to address the issue. “Although there aren’t many representations of nurses in the media, I just accept that that’s the way it is. I know what I do and the impact I have on my patients,” says Ati.

One nurse working to fill the media void is Kathy Douglas, RN, MHA, who is chief nursing officer for API Healthcare and the president of the non-profit organization On Nursing Excellence, which works to improve the efficiency, well-being, and recognition of the health care workforce. Douglas wants the public and policymakers to better understand who nurses are and what they really do. “The media is lacking true representations of nursing. The power of the role isn’t represented at all. You only hear about nurses when there’s a shortage or a strike,” she says. Douglas conceived and directed the documentary NURSES: If Florence Could See Us Now, which took about a year from its inception to its premiere in Los Angeles on October 11, 2012. The documentary seeks to paint a real picture of nurses today.

Douglas and her team spent about four months filming. They interviewed 120 nurses in nine different states, and of those, 73 nurses made it into the film. Douglas says there was no script she followed. “I would show up with a camera and interview nurses based on their specialty,” she says. “It was spontaneous, authentic, from-the-heart speaking.”

The NURSES documentary focuses on a wide variety within the field, including pediatric nurses, nurse educators, nurse practitioners, geriatric nurses, military nurses, critical care and trauma nurses, and nurse researchers, all sharing their stories of triumph and heartbreak. The goal of the documentary, says Douglas, is twofold: First, to educate the public, including the voting population and policymakers, to understand the role of nursing better. “People need to think of nurses not just when we need them, such as when we’re sick,” she says. Second, the documentary is for nurses themselves, to inspire and recognize them.

“I’m happy to share my story with others, to let people take from it what they will, which is hopefully a piece of hope or inspiration,” says Jonathan Van Nuys, RN, a nurse at Mission Neighborhood Health Center in San Francisco, who was featured in the film. Van Nuys was so moved by the support he got from a nurse named Laurie Mathers (also featured in the film) while he was a cancer patient undergoing chemotherapy that he was inspired to become a nurse himself. As an RN now, he works and volunteers to support people with HIV and is continuing his education to become a nurse practitioner.

During the filming, Douglas says her appreciation of nurses only increased. “I already had a deep respect for what nurses do, but it went to a whole other level.” Douglas was struck by how humble her interview subjects were: “I’m not sure they even know how amazing they are. It’s important for nurses to pause and recognize what they do.”

Douglas says that the reaction the filmmakers often got from nurses they interviewed was, “Who, me? I was just doing my job.”

“But that’s not the reality for those they touch,” she notes. Douglas adds that it shouldn’t take a crisis, such as Hurricane Sandy, to celebrate the work of nurses. “All the bad stuff in the news sells, but let’s talk about all the good nurses are doing.”

Nurses touch many lives, and this informs a unique perspective. “One of the deepest privileges of being a nurse provider is to sit as witness to people’s stories, their struggles, their vulnerability, their hopes and dreams,” says Van Nuys. Hopefully with more media created by nurses themselves and more media that seeks to have a true understanding of the profession, nurses will be able to do something they haven’t in the past— share their own stories with a larger audience.

 

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