That there is a shortage of nurses isn't news. But a nursing advocacy group in Baltimore has come up with a new reason for it: "ER," the prime-time television drama that attracts more than 20 million viewers per week.

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The Center for Nursing Advocacy, a two-year-old nonprofit group whose advisory board includes several of nursing's most prominent leaders, has unleashed a protest e-mail and letter-writing campaign against NBC and the producers of the Thursday night show.

Executive director Sandy Summers accused the show of perpetuating "long-standing misrepresentations that . . . are contributing to the nursing shortage."

The protest comes at a time of mounting concern among public health officials about the scarcity of nurses. Three weeks ago a panel from the Institute of Medicine warned that patients are being endangered by medical errors exacerbated by nurses' working conditions, especially the fatigue caused by shifts of 12 hours or more.

Summers, herself a nurse, said that "ER," now in its 10th season, routinely and inaccurately features doctors usurping nurses' jobs, such as wielding a defibrillator to shock a patient's heart. Her group was particularly incensed after the show's major nurse character, Abby Lockhart, played by Maura Tierney, recently decided to chuck her nursing to return to medical school. A few weeks earlier, an attending physician on the show summarily fired striking nurses, replacing them with inexperienced foreign-born practitioners willing to work for "minimum wage."

In reality, hospitals are paying large bonuses to attract registered nurses. And ER doctors don't have the authority to fire nurses, as the show depicted, who are supervised by nurse managers.

"Wasn't there a nursing shortage before 'ER'?" asked one executive affiliated with the show. "I mean, this is a television show, not a documentary. There needs to be dramatic license."

So far, Summers said, more than 100 nurses have peppered executives at NBC and "ER" with e-mails in an attempt to persuade producers to make changes that in Summers' view "would portray nurses and nursing in a more accurate light -- not as handmaidens to physicians."

"People think what they see on 'ER' is real," Summers said. "Viewers, especially kids, see our profession as less than it really is, a horrible job. They see the show and think, 'Who would want to be a nurse?' "

Phil Gonzales, a spokesman for Warner Brothers Television, the show's production company, disagreed. "ER," he said, "goes to great lengths to portray medical situations accurately," adding that there are nurses on the set as advisers. "The series will continue to do its best to entertain television audiences while bringing to light the important work of doctors and nurses," he said.

Diana J. Mason, editor-in-chief of the American Journal of Nursing and a member of the advocacy group's advisory board, said the organization has singled out the show because of its enormous popularity.

A study last year by the Kaiser Family Foundation found that regular "ER" viewers learn about health-related subjects from the show and some consult their doctors because of what they have seen. An earlier study found that children's strongest impressions of various medical professions were primarily derived from "ER" and other television dramas.

To Mason, who last year urged in an editorial in her journal that nurses boycott "ER" to protest its depiction of nurses, the show's fictional nature is no excuse for what she regards as demeaning inaccuracies.

"I'm so disgusted with the continued invisibility of nurses and their expertise," she said.

The group supports the development of characters like "Hot Lips" Houlihan of "M*A*S*H."

"She was a loony-tune but she knew her stuff, she ran a tight ship, she cared about patients and the doctors didn't mess with her," Mason said. "We wouldn't mind a mixed story line, as long as it's accurate."