Sunday, 4 July 2010

Dear Media (newspapers, TV, and movies):

Found this little gem on the web and thought it worth posting here.  Make no mistake about it; the media portrayal of nurses is killing people. 

A Letter to Hollywood:
Nurses Are Not Handmaidens
Laura A. Stokowski, RN, MS Posted: 03/12/2010

Dear Hollywood,

We, the nurses of the world, have something to say to you. Nurses are not what you think. Nurses are independent, highly educated, and skilled healthcare experts who save lives every single day. We work hard and are dedicated to making differences in people's lives. And we are really sick of going home after a 12-hour shift, turning on the television, and seeing ourselves depicted as brainless bimbos. This has been going on far too long, and it has to stop.

The Clown Took a Job as a Nurse

I remember a time when I was in nursing school, watching TV with my roommate, Liz. A skit came on, in which a famous comedienne of the day was dressed up like a clown. For some reason the clown had to leave the circus. "So," said the narrator, "the clown took a job as a nurse." We laughed at the absurdity of this, but I never forgot it.

We were in the middle of a demanding 4-year nursing program, and the suggestion that anyone, even a clown, could be a nurse, just like that, was wounding. I think it was then that I began to take notice of how Hollywood represents nurses. The answer is...badly. But it isn't just disrespect that comes through in Hollywood portrayals -- it's contempt, and it's not at all subtle. You scorn us in the way you pigeonhole nurses on the small screen -- it seems that we're either half-wits, nymphomaniacs, or latter-day Nurse Ratcheds. Obviously, you have no concept of nurses as autonomous, knowledgeable professionals.

We work alongside physicians, but we are their colleagues, not their subordinates. Yet in every hospital drama, physician characters are ordering nurses around, treating them like uneducated servants, or performing nursing care themselves and getting the credit for it, while the nurse characters just fade from view. I can almost hear your reaction to my complaints. There, there, dear, don't take it personally, it's harmless, it's funny. Is it, really? Will it still be harmless or funny one day in the future when you are in the hospital and you press your nurse-call button and no one responds? Or it is answered -- eventually -- by a minimally trained hospital "technician"? The nursing shortage will have reduced our ranks considerably, and driven many of us into early retirement.

It doesn't help the situation when schoolchildren and teens already discount the notion of becoming nurses because of the way nurses are portrayed on Grey's Anatomy. Becoming a nurse, they believe, is a waste of their talents.[1] Maybe You're Misinformed I'm going to give those in Hollywood the benefit of the doubt, and assume that they just have the wrong impression of nurses, and have no idea what nurses really do. But for the non-nurse readers, we'll pretend that you are in the hospital, and you've just had emergency heart surgery.

Who do you suppose will be at your side, watching your blood pressure, making sure you don't go into shock?

Who will be alert for the slightest hint of life-threatening hemorrhage?

Who will respond in mere seconds if your heart begins to beat irregularly?

Who will make sure that your chest tube doesn't get blocked and cause you to go into cardiac arrest?

Who will keep the circulation moving in your lower legs so you a clot doesn't develop and you don't die from a pulmonary embolism?

Who will be constantly watching to make sure that you don't stop breathing, that you are getting enough oxygen, that postoperative pneumonia is not developing?

Who will relieve your pain before you even have to ask?

Who will explain everything that is happening to you and teach you how to take care of yourself after you go home?

I'll give you a hint -- it's not your physician. It is your nurses. They will see you safely through one of the most dangerous times of your life, doing all these things and more. And just so we're clear, I'll tell you what your nurses won't be doing. They won't be clustered around the nurses' station as though at a cocktail party, flirting with physicians. They won't be in the broom closet or the stairwell or behind the patient's curtain giving sexual favors. They won't be trailing after the physician as he marches down the hall, in case he needs a cup of coffee or someone to dump on.

Nor will they be in the receptionist's chair, moaning about not being able to get into medical school. If these scenes sound a little familiar -- I'm not surprised. This is how nurses are regularly portrayed on television dramas. No Angels of Mercy, Please Hollywood, we're not asking you to glorify nurses. Don't turn us into heroes or martyrs. We just want to be accorded the respect, the esteem that our education, status, and profession warrant. We want our dignity back. We don't want the entire world to think of us as sleazy, dim-witted underlings. We want to erase the image of the "naughty nurse" -- this is your bizarre fantasy, not ours. We want young, impressionable children to view nursing as a viable, respected, and even admired profession, one they would be proud to call their own. But most of all, we want our patients to trust us and value our knowledge, so that when we teach them how to become healthier people and live longer, healthier lives, they will listen. This, our most treasured ability -- the core of nursing -- is what you threaten with your cheap attempts to increase ratings by ridiculing the nursing profession.

So my question to you is, is it worth it? Is the money you make from entertaining viewers with mentally unbalanced, sexually promiscuous, or idiotically subservient nurse characters worth influencing potentially hundreds of thousands of young men and women to shun a career in nursing? Will you feel content, even proud, the next time you encounter a nurse, in the thought that you regularly chip away at her self-respect and her ability to be effective in her job? Or will you infuse some realism into your tired stereotypes? You can start by discarding the following myths -- their demise is long overdue.

Myths About Nurses Perpetuated by Hollywood and Other Uninformed Media

1. Physicians are nurses' superiors in the hospital hierarchy- nurses "work for" physicians. Not true. Nursing is a separate, autonomous profession. We work with, not for physicians. We have our own leaders, and we regulate, license, and manage ourselves. Nurses decide what nurses do, not physicians.

2. Nursing doesn't require much education. Nursing education is highly specialized, intense, and rigorous, because nursing itself is a profession grounded in science. Many people, if they believe nurses go to college at all, think that most nurses attend a brief 1- or 2-year program. In fact, 58% of nurses presently have a bachelor's degree or higher, a number that is growing every year. The "2year" nursing program doesn't really exist - the associate's degree in nursing requires prerequisites even before entering the nursing program, making it essentially a 3-year program. And in many areas, new graduate nurses undergo extended fellowships in the clinical setting that greatly increase their education and skill in nursing as they enter the profession.

 3. Nurses mainly "fetch things" for physicians. Nursing is a practice that is unique and distinct from medicine. Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.[2] Nursing's focus, and what sets it apart from medicine, is the whole person, not just the specific, presenting health problem, and nursing encompasses both actual and potential health problems. Nursing's scope of practice has been shown in numerous studies to save lives and improve health outcomes.

4. Nurses are those who aren't smart enough to get into medical school.
This might be the most irritating myth of all. It presupposes that nursing is just a tiny subset of medicine, a fallback for people who can't quite make it up the ladder. However, nursing is a different profession, not the same profession watered or dumbed down.

Read more here:

And check this out if you can:  How the media portrayal of Nurses is killing thousands of people every year.  Not only is the public' s view of nursing completely warped, but the managers who run our hospitals are under the influence of these media stereotypes also.   This is why we don't ahve enough real nurses to care for the patient's on our wards.  And this is why the few real nurse's we have are forced to do everyone's elses job as a money saving exercise by the powers that be.



The Shrink said...

What is this, huh, huh? You'll soon be suggesting that instead of gazing adoringly into my eyes, mopping my fevered brow, bringing me tea and biscuits (the better, chocolate ones) whilst decked out in something skimpy with stilettoes, you should instead be in practical shoes, dashing to attend to patients' needs and delivering clinical care?

Lots of nurses helping patients, as valued, autonomous practitioners?

Within the NHS or media I fear this is still a work of fiction worthy of the Booker prize, sadly . . .

Nurse Anne said...

You are right and that is the reason 100% why nursing care on the wards is so terrible.

UCL Med Student said...

Do you reckon it depends on the hospital/ward, Anne?

I recently underwent an operation in central London, the care I received was great.

I felt awful, but was quickly attended to, given PRN meds whenever I asked for them.

And an amazing old school sister managed to stop some bleeding I had that just wouldn't stop before hand.

I never felt ignored, and didn't once have to use my bell (I don't like to impose).

Nurse Anne said...

UCL med student,

I do not believe that the women you are describing are nursing students.

I know the interview process to get into nursing school. It's rough, even for a lass with perfect english diction. There is no way that the women you describe (grunting at patients because they cannot speak english) would get into the nursing program.

Once again I think you are confusing nursing students with cadets/hca's.

Nurse Anne said...

Ah that response was to your other comment on another post.

You will never hear horror stories coming out of surgical wards for generally well people (as you were a patient on). That is because they are well staffed with real nurses.

I have made it clear on this blog that the problems we are describing are primarily on general medical wards, MAU's, elderly wards, and rehab wards. These are the areas they do not fund nor staff.

Even in my hellhole trust we have a nice little well staffed post op ward for people like you.

Dino-nurse said...

Very true Anne. Surgery is a money spinner, medicine and rehab are not (they are money pits). As for elderly care.....This is the true sadness of the situation. The elderly and vulnerable end up neglected on admissions units whilst the hospital tries to cheapen their care. Who needs an RN to care for elderly, frail people afterall...any old fool can feed a patient and keep them clean. Thats what our fearless leaders believe. Young people dying from mistakes on elective/post op wards make for badpress. Another old person dying is just that...another old person dying. No one gives a c***

Nurse Anne said...

"Who needs an RN to care for elderly, frail people afterall...any old fool can feed a patient and keep them clean. Thats what our fearless leaders believe."

Exactly. That is why the 12 bed short stay surgery ward (young healthy people/easy patients)across the hall has 3 staff nurses that never get floated.

And our 28 bed medical ward with highly dependent acute patients with multiple drugs, diseases, sudden changes in condition etc gets 2 RN's per shift.

Nurse Anne said...
This comment has been removed by the author.
Anonymous said...

Nursing's focus, and what sets it apart from medicine, is the whole person, not just the specific, presenting health problem

many specialites are very much involved in holistic care and I disagree with your assertion. Furthermore, do you believe that if two students both had AAA and could get into medical school that one would choose nursing? if this were so, grades needed to become a nurse would be much higher due to more intense pressure for places.

Nurse Anne said...

That's how it is in the USA anonymous.

Very high grades and standards needed to get into the nursing program over there. Nursing is less schooling than medicine and also can make lots of $$$$$$. I have heard of places where the nursing schools have higher entry standards simply because so many people want to do it. Who would want to do medicine? It's like 8 years of school and then a residency. I wanted babies not 16 hour days and then on call.

You have to be very academic and competitive to get into nursing school over there anymore. And we were held to higher standards than other university students.

I could have got into med school with the grades I had in high school but there is no way I wanted the hours or the responsibility that a physician has. A nice $90,000 a year job as a staff nurse in the new york area was fine for me.

Look at the years and years and years of school doctors have to put in and the hours they have to work during residency!!! No way. Not for a million dollars a year.

Nursing school over there was 4 years and medical school was at least 8. Not worth it. I'd rather care for the patient than diagnose and prescribe anyway. I was in the top 5% of my high school class. Not to brag or anything but I'm a nerd.

But in the UK it is a whole different kettle of fish. Blew me away when I came back here as an adult. I expected pay and respect for being an RN. LOL.

I realised that I wasn't in Kansas anymore when my brother in law in England told me he didn't realise that I went to university because he thought I was a nurse.

Nurse Anne said...

They have a 3 year wait to even get into the crappy associate degree nurse training programs over there. And that is if you are a good student who got your pre-req university chemistry and anatomy completed with good grades.

Nurse Anne said...

Getting into this place is hell:

Nurse Anne said...

And if you come out of there with a BSc or whatever in nursing you have been prepared to be a bedside nurse. And it is also one of the top graduate schools in the nation.

Most of their nursing students will have been straight A overachievers in high school and I don't think they would appreciate your attitude.

Nurse Anne said...

UCL Med Student said...

For my helping out, my cheese and onion got stolen.

GAH. :(

Nurse Anne said...

You poor thing!! My stuff gets stolen all the time. We don't have a staff room or lockers or anything. I blame the doctors. ;)

Anonymous said...

Oh petal! There's a box of Thorntons in the clinical room :) Hurry before the good ones go X

Nurse Anne said...

Thorton's (like most euro chocolate) is gross. Currently living on washington state red delicious apples when you can get them here.

Dino-nurse said...

Quite true Anne. The NMC could learn a lot by looking at why the US nursing schools are so highly respected. If you trained in the UK during the 70s and 80s the US hospitals would bend over backwards to get you to emigrate. Not so anymore. When the US went down the science route, the UK chose the soft option and a wishy washy style of training that fits in with our wishy washy schooling system. I have taught university level science to nursing and medical students both here and in the US and I can honestly say that something has gone very wrong with education in general in the UK. Even those who get A* grades seem unable to add up or demonstrate simple problem solving skills. Just last week I was asked to proof read an essay for an RN (UK born and bred, schooled during the 90s) who is doing a Masters. Red pen anyone? Basic English language was bad enough BEFORE I have even started with the actual content. Gah...

Dame Davina Pancake said...

Nurse Anne - I regularly read your blog, but as a "civvy" I rarely comment. You are clearly one of the professional, good RNs who work hard and give a damn about patient care.

I have to say however, that watching my Gran's treatment in a large Surrey hospital geriatric ward (she was 90 and had cancer) was ghastly. There were about 24 patients on the ward and unfortunately, the nurses and other ward staff just sat on their butts round the nurses' station chatting unless a Consultant came on the ward, when it was all action. There were two particular things that drove me mad - the fact that the only person who would provide my Gran with ice/water was the cleaner (that was the "family's responsibility" although we lived 200 miles away) and the old woman who was literally screaming for two hours with NO attention until I complained to the Matron (this patient was unknown to me). I also wasn't impressed with the rolling waste-bags full of blood and used dressings that sat around for hours either. FAR too much demarcation and lack of care for human suffering.

I think that the rosey picture you paint of nurses in the UK is patchy at best!

Davina x

uknurse said...

Dame Davina Pancake,

I've just read your account of your experience and i am equally horrified! If accurate, what you describe is unacceptable, (along the lines of Mid Staffs...?) This picture is certainly not one that I have ever witnessed in my career...

....although perceptions of what patients/relatives see can sometimes be quite decieving...

I've had patients and relatives describe 'Ward X's" care to pretty similar to your experience. Yet, having worked there, with the most amazing but downtrodden and under-staffed team, I know that Ward X is nothing like that in reality. The nurses there do their very best, against the odds.

I don't deny poor care exists, and I certainly don't doubt what you say..but i also see how appearances can be deceptive.


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Anonymous said...

A 2 year BN exists in Scotland. You dont do honours but it is only open to science and social science graduates. Its the path I have chosen to go into nursing.

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