Nursing group ranks best and worst media portrayals of nursing for 2003

The Center for Nursing Advocacy has issued its list of the best and worst media portrayals of nursing during 2003. The list highlights a variety of depictions of nursing--from television to the print media, from fiction to news, and from Milwaukee to Malaysia--that the Center believes deserve recognition, for better or worse. "The Center offers congratulations to those responsible for items on the 'best of' list," said Truth executive director Sandy Summers, "and we encourage continued strong efforts from them. We are also reaching out to those responsible for items on the 'worst of' list, in the hope that we can help them improve their treatment of nursing issues in 2004."

Golden Lamp Awards

The Ten Best Portrayals of Nursing in the Media 2003

1. Angels in America, Directed by Mike Nichols, Screenplay by Tony Kushner, HBO, Dec. 2003-to date -- Mike Nichols' film version of Tony Kushner's epic play exploring faith, politics and sexuality in the AIDS era includes one of the best depictions of nurses in feature film history. Angels in America rightly places nursing at the center of AIDS care. The main nurse character is Jeffrey Wright's former drag queen Belize, who--despite a few questionable choices--balances skill and determination, cynical wit and tough love, as he fights to keep his friends alive and sane. Nursing the nasty, AIDS-afflicted power broker Roy Cohn (Al Pacino), Belize provides Cohn with a measure of comfort and dignity, even as they trade high grade invective across a chasm of mutual loathing. Belize is the moral center of the entire 6-hour work. In addition, Emma Thompson plays the autonomous, compassionate AIDS nurse Emily. see more...

2. Newspaper columns, Ronnie Polaneczky, Philadelphia Daily News, Nov.-Dec. 2003 -- In the closing months of 2003, this columnist mounted a seemingly relentless campaign to highlight the plight of nurses striking the Medical College of Pennsylvania over the practice of mandation (forced overtime), and in support of nurses generally. Polaneczky columns addressed the importance of nursing to the survival of patients, the extent to which the nursing "shortage" is really a shortage of nurses willing to work in current short-staffed conditions, and how nurse practitioners provide excellent, cost-effective primary care. Polaneczky's columns have shown an understanding of and regard for nursing issues that is rare in the mainstream media. see more...

3. "America's Biggest Health Care Crisis," John Pekkanen, and "One Day in Critical Care: A Nurse's Story," Anonymous, Reader's Digest, Sept. and Oct. 2003 -- In the fall of this year, the widely circulated magazine Reader's Digest ran two prominent, unusually well done pieces about the nursing crisis in the United States. One of the September cover stories was a lengthy piece by John Pekkanen explaining the causes and significance of the nursing shortage, including recent research showing how short-staffing harms patients and harrowing real-life anecdotes to help readers understand just how it can affect them. The magazine's October issue followed up with an anonymous ICU nurse's powerful account of one short-staffed shift in which the nurse does complex, life-saving work despite facing an array of improper demands and abuse caused by the short-staffing itself. see more...

4. "A critical shortage: With nurses' ranks thin, scramble to fill shifts intensifies," and "Looking for a shot in the arm: Programs aim to make nursing more fulfilling, efficient," Joel Dresang, Milwaukee Journal-Sentinel, Feb. 22 and 23, 2003 -- After spending three days following nurses, journalist Joel Dresang wrote two detailed, very well-done articles on nursing that appeared on consecutive days on the front page of the Milwaukee Journal-Sentinel. Dresang's first article addressed the nursing shortage and how nurses are coping with it, and the second depicted a day in the life of a nurse--an effective approach that was also followed in the Reader's Digest articles described above, which appeared many months later in the fall of 2003. see more...

5. RN: The Past, Present and Future of the Nurses' Uniform, Mark Dion and J. Morgan Puett, The Fabric Workshop and Museum, The Center for the Study of the History of Nursing, School of Nursing of the University of Pennsylvania, at The Fabric Workshop and Museum, Philadelphia, PA, October 2003-February 2004 -- This admirable exhibition offers an historic overview, a glimpse of an ambitious project to design an "ideal" nurses’ uniform, and intriguing predictions of the future. By relating the uniforms to nurses’ evolving professional and social roles, it reveals something about the profession’s development and where it may be headed. The show offers four specific visions of future nursing uniforms (the "bioterrorism nurse" (ca. 2015), the "diagnostic nurse" (ca. 2027), the "post-apocalyptic nurse" (ca. 2130), and the "intergalactic nurse" (ca. 2206)), including a helpful description of the imaginary historic events to which each uniform responds, and some amusing technobabble about its features. see more...

6. "At Hong Kong Hospitals, SARS Takes a Heavy Toll on Nurses," Keith Bradsher, The New York Times, May 8, 2003 -- This excellent piece described the heroic nurses who care for SARS patients, including the hundreds in Asia and Canada who have been infected while doing so. Bradsher focused on a young Hong Kong nurse whose life had been turned upside down by her SARS work, but who nevertheless continued to provide critical care to SARS patients. Bradsher emphasized that nurses face far greater risks than other health care workers as the crisis moves past the initial stages because they work so much more closely with patients--a point that has not often been made, especially in the many pieces that have left the impression that only physicians are involved in SARS care. see more...

7. "Drawn to nursing care," Catherine Siow, The Star (Malaysia), Dec. 1, 2003 -- This lengthy, very good newspaper feature described the life of Willie Kwa Sue Tang, a footloose Malaysian "boy" who three decades ago set out to see the world with his friends, starting in London. Kwa had little money and didn't end up seeing much of the world--but he did become a nurse and a leader in geriatric mental health care in Britain. Kwa has worked to provide better access to care for dementia patients and better support for their caregivers, eventually founding and leading his own hospital in London. see more...

8. Doctors Without Borders: Life in the Field: Cool Hand Luc, Producers Diane Best and David Wald, National Geographic Channel, July 2, 2003 -- This effective one-hour episode of the cable series Doctors Without Borders: Life in the Field, about the well-known international health care organization, focused primarily on the work of nurses in several struggling nations. Narrated by Kiefer Sutherland, the episode profiled a tough veteran nurse running a health care system in an Ivory Coast prison, a young Belgian nurse in a race to get a child treatment for tuberculosis during a refugee crisis in Sierra Leone, and a Dutch nurse on a mission to contain tuberculosis in a depressed region of Uzbekistan. While the show could have better conveyed the nurses' expertise, those involved deserve credit for a rare prime time show highlighting the critical work of nurses in the international development context. see more...

9. Television health expert appearances, Pat Carroll, CNN, May 2003, and Donna Cardillo, Weekend Today, NBC, October 4, 2003 -- Talented nurses appeared on television this year as health experts, among them Pat Carroll, RN, MS, and Donna Cardillo, RN, MA. Ms. Carroll appeared in a health spot on CNN Headline News in late May, giving practical advice on antibiotic resistance in an engaging and effective way. The articulate Ms. Cardillo appeared on NBC's Weekend Today to discuss the nursing shortage and practical measures patients and their families can take to cope with it. Although patient education is an important part of nursing and nurses excel at it, it is still unusual for nurses to be featured in television health spots. When they are, it not only improves public health, but also shows the public that nurses are knowledgeable health professionals who can deliver complex information in an accurate and understandable way.

10. "Nurses brace for SARS," Kirsten Downey, The Washington Post, June 10, 2003 -- This very good article described nurses' place on the front lines of the global SARS battle, not only as primary care givers but as a critical part of the health system's efforts to track and control the disease. Downey put nurses' SARS work in the larger context of their responses to other crises, such as terrorism and AIDS, and described reports indicating that nurses are more likely to get SARS than physicians are, possibly because they work more closely with SARS patients. Unlike many articles, this one drew a portrait of nursing as an autonomous, if troubled, profession with authoritative leaders, and it did not suggest that nurses are secondary to physicians in confronting health care crises. see more...

Honorable Mention

"Whistleblower nurses stood bravely for cause," The Australian, December 19, 2003 -- This strong editorial praised five nurses the newspaper's readers had nominated for its "Australian of the Year Award" because they "blew the whistle on the unnecessary deaths of 19 patients at two Sydney public hospitals," despite being "dumped from their jobs, ignored by their superiors and shunned by their minister." see more...

Overall coverage of nursing issues, National Public Radio, 2003 -- Over the past year, NPR has run generally fair, high quality stories involving nurses and nursing issues, including Joyce Russell's "Male candidates sought to offset nursing shortage" (August 12) , John Ydstie's "Scranton, Pt. II" (August 26) profiling a displaced factory employee who became a nurse, Patricia Neighmond's "California Hospitals Scramble to Find Nurses" (October 29) about the impact of the state's new safe staffing law, and Melissa Block's "Record Numbers of Children Suffering from Flu" (December 11), which featured an interview with a nurse expert about the impact of this year's flu epidemic.

"Nurse's gadget saves NHS millions," BBC News (UK), October 24, 2003 -- This uncredited story explained how veteran U.K. nurse John Edwards devised a plastic hook to hang hospital fluid drips from curtain rails, replacing conventional drip stands at about one twentieth of the cost. According to the piece, Mr. Edwards had just signed a deal with his hospital and two companies to make and distribute the invention, which could save the country's National Health Service millions. see more...

"Flexible hours ward off sickness," Raekha Prasad, The Guardian (UK), May 21, 2003 -- This article describes a British charity's naming of psychiatric nurse manager Emma Brandon, who manages a staff of 16, as the nation's "best boss." Brandon introduced flexible work schedules that boosted morale, cut staff turnover and sick time, and improved care--reportedly reducing abuse, shouting and violence among the patients. see more...

Paul Flowers episodes, Scrubs, Executive Producer Bill Lawrence, NBC, January and February 2003 -- Several episodes of this popular sitcom aired at the beginning of the year featured guest star Rick Schroder as hunky nurse Paul Flowers, who had a relationship with major physician character Elliot Reed (Sarah Chalke). Some nurses found the show's somewhat glib depiction of anti-male nurse bias by physicians to be damaging, but the Center felt the story arc clearly showed its contempt for the characters who held those views, while Flowers was portrayed as smart, witty, secure, and fearless. see more...

Ten Worst Portrayals of Nursing in the Media 2003

1. "My Fifteen Seconds," episode of Scrubs, written by Mark Stegemann, Executive Producer Bill Lawrence, NBC, November 20, 2003 -- This episode of the popular sitcom, which purports to teach nurse Carla Espinosa (Judy Reyes) that nursing is all about doing what physicians tell you, is one of the most virulently anti-nurse prime time television episodes we have ever seen. In the episode, physicians Elliott (Sarah Chalke) and Turk (Donald Faison) persuade Espinosa that physicians are in charge of nurses, that it is the nursing role to follow physician "orders" without question, and that nurses should be happy to accept their subservient role as brainless physician helpmates. This is grossly inaccurate and damaging to nursing, a skilled, autonomous profession built around patient advocacy--a role that often involves questioning physician plans and thereby saving lives. see more...

2. "Dear Abby" and "Freefall," episodes of ER, written by R. Scott Gemmill and Joe Sachs, respectively, Executive Producers John Wells, Michael Crichton and Christopher Chulack, NBC, October 9 and November 20, 2003 -- In these two episodes (and others), the massively popular drama continues its long run as the world's most influential and sophisticated propagator of the "nurse as handmaiden" myth. In "Dear Abby," a standard misfortune-pileup episode about a bad day for nurse Abby Lockhart sends a series of destructive, inaccurate messages about nursing, including that nurses report to physicians and serve at their will, that nurses can excel only by learning what the heroic physicians know, and that no one would want to be a nurse if he or she could be a physician. "Freefall" focuses on Lockhart's struggles in her new role as medical student--never mind that nurses are 50 times more likely to pursue graduate education in nursing than in medicine--and manages to give the wrong impression that nurses are no more than capable assistants to physicians: the Girl Fridays of health care.

3. Passions, Executive Producer Lisa de Cazotte, NBC, March 2003-to date -- This campy daytime soap opera has for months featured a fun-loving orangutan named Precious in the role of a private duty nurse--a bold step backwards in the already slow...evolution...of the media's treatment of nurses. The Center realizes that no one expects this show to offer an accurate depiction of anything, with the possible exception of witchcraft. But Nurse Precious still fits too conveniently with harmful stereotypes about nursing that have long held the profession back, and have contributed to the nursing shortage that is now one of the world's most urgent health crises. see more...

4. "Militant angels of mercy," Christie Blatchford, National Post (Canada), June 7, 2003 -- In this piece, a popular newspaper columnist mounts a bizarre attack on the modern nursing profession, as she yearns for the good old days when nurses were "kind" and "loved, if not always respected." In support of her main argument--that nurses have not received much public support for their heroic work battling SARS because "an unsettling number" have become "outright shiftless or worse, just plain mean"--Ms. Blatchford offers startlingly uninformed generalizations. She feels that one reason for the lack of support is that nursing has "come to be deemed a capital-P profession, as opposed to a calling," so that people become nurses as much for "opportunities or pay or perquisites" as they do to help the ill. Evidently, Ms. Blatchford would rather have a system where people die because their nurses are angelic but untrained volunteers who cannot detect a declining condition, properly give a medication, or intervene to correct a medical error. see more...

5. "His and Her Body Test," Executive Producer Barbara Walters, The View, ABC, June 16, 2003 -- This prime time episode of The View, which was designed to impart basic health information, not only undervalued nursing but also included a direct attack on the profession. Co-host Meredith Vieira appeared disguised as an "ugly nurse" for inane comic interactions with passersby in a New York mall, including one segment in which Vieira cared for a woman's "shin splints" by drawing a happy face on her leg. The episode was structured around a series of multiple choice questions on health issues, with physicians supplying the correct answers and accepting lavish praise. Of course, the lack of any real nurses on a show devoted to the patient education and preventative care at which they excel is hardly unusual. But in the midst of a nursing shortage that is one of the nation's gravest public health problems, it is sad that some seem to feel that female empowerment involves slavishly embracing medicine, to which women can now aspire, while blatantly disrespecting nurses, over 90% of whom are still women. see more...

6. Comments, Sara Edwards, entertainment reporter at WHDH (Boston NBC affiliate), as reported in "Smock-clad Sara Edwards nurses her role on 'ER,'" Boston Herald, February 12, 2003 -- This gossip column described the appearance of Boston entertainment reporter Sara Edwards as a nurse extra on the February 13 episode of NBC's ER. When the ER prop room gave Ms. Edwards a floral scrub top to wear for her role, she reportedly said: "Ugh, I look like I should be scrubbing floors in that smock." Ms. Edwards was also quoted as stating: "I was so jealous that some reporters got to be doctors, the one from L.A. got to be a victim with blood all over her face, and I look like I should be cleaning toilets.'' As it happens, many nurses feel that patterned scrubs do not promote the professional image nurses deserve. But Ms. Edwards' point was not that the uniform was unworthy of nurses, but that the uniform and playing the role of a nurse were unworthy of her. She showed disrespect for nurses--skilled professionals who save or improve lives every day--and the housekeepers who maintain the hygienic environment that helps hospital patients recover. see more...

7. "The Long Goodbye," episode of Judging Amy, written by Barry O'Brien, Executive Producers Joseph Stern, Amy Brenneman, Connie Tavel, Alex Taub and Karen Hall, CBS, November 11, 2003 -- This episode held nursing in contempt, in part by suggesting that physicians can fire nurses and that they provide job recommendations for them. In the episode, a senior emergency department physician ordered a junior physician to fire a nurse. When the young physician's attempt to do this went awry, he tried to mollify the nurse by saying that he would write her an excellent recommendation. In fact, nursing is an autonomous, highly skilled profession managed by nurses, not physicians. And the notion that nurses would seek or appreciate physician references would be comical if it was not so harmful. Only nurses are in a position to evaluate the work of other nurses. more...

8. "Secrets to a Happy (and Healthy!) Pregnancy," Leah Hennen; "Should I Call the Doctor?" Jessica Snyder Sachs; "Simple Truths All Moms Can Use," Barbara Rowley; Parenting, October 2003 -- This issue of a popular parenting magazine illustrated the difficulty nurses face in getting proper recognition from a physician-centric media that often seems convinced that nurses lack valuable health care expertise. Hennen's lengthy, positive article about midwives, despite quoting several midwives, never mentioned that most midwives are nurses, nor that Certified Nurse Midwives autonomously manage countless births. Sachs' piece, on what worried parents should do when their infant may need emergency care, assumes that only pediatricians provide pediatric primary care, despite the fact that thousands of pediatric nurse practitioners do so in an exemplary, cost effective way. In Rowley's article, which offers basic tips to help new parents cope, she notes that her "pediatrician's nurse" had once told her that "[b]abies aren't fragile," advice that became her "mantra." Yet while two different pediatrician experts are quoted by name in the piece, no pediatric nurses are--not even the nurse who gave her her mantra. see more...

9. "How medical errors took a little girl's life," "From tragedy, a quest for safer care," Erica Niedowski, The Baltimore Sun, Dec. 14-15, 2003 -- This was a massive feature about Baltimore's Sorrel King who, following the death of her daughter Josie at Johns Hopkins Hospital due to preventable dehydration, joined the hospital in a major effort to reduce the risk of such errors. The moving piece made valuable points, but its physician-centric focus resulted in a failure to recognize the importance of nurses in resolving these problems. Though nurses play a central role in avoiding hospital errors, particularly from causes like dehydration, the piece quoted or described the actions of no less than nine specific, named Hopkins physicians, some of them many times, but not one nurse was quoted--or even named--in the entire text of the article. Even if nurses involved in Josie's care refused to speak for attribution, that fact should have been noted, which would at least have indicated to readers that nurses' experiences and observations mattered. see more...

10. The Nurse, Bangkok, Thailand retail outlet of the Pacific Cigar Company, as described in various press pieces, July 2003 -- This is not a joke: several reports noted that Thailand's real nurses were "fuming" over this international cigar company's local outlet naming itself The Nurse and dressing its staff as nurses. The Nurses' Association of Thailand mounted a campaign objecting to the damage to the image of the nursing profession being caused by The Nurse, and pointing to the negative public health implications of having "nurses" promoting health-harming substances. This story was covered in July by Agence France-Presse, as well as Thailand's The Nation and Malaysia's The Star. In May, the Bangkok Post had run a flattering profile of Pacific Cigar (Thailand) general manager Joe Thawilvejjakul that featured a plug for The Nurse, but did not address the effects of its marketing strategy on nurses or public health. see more...

Best Attempts to Remedy Negative Media Portrayals of Nursing 2003

Clairol Herbal Essences television commercial, Procter & Gamble, early 2003 -- As a result of strong protests from nurses, on June 9 Procter & Gamble apologized and promised to stop running a commercial that showed a carefree, underworked female nurse leave her patient unmonitored to wash her hair in his bathroom, then dance around his room, waving her hair in ecstasy. see more...

Lion Red advertising campaign, Lion Brewery (New Zealand), February 2003 -- After New Zealand's largest brewer began an advertising campaign involving female "nurses" in short dresses entertaining spectators at rugby matches, Kiwi nurses mounted a campaign arguing that the advertising harmed nurses and public health, and Lion canceled the advertising within days. see more...

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