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Rating the fictional nurses
Tuesday, November 25, 2003

The Center for Nursing Advocacy was founded by a group of graduates students at Johns Hopkins University School of Nursing in April 2001 to address the growing nursing shortage. Recognizing the power of the media in how nurses are portrayed to the public, the center has developed a 4-star rating system (4 for the best, 1 for the worst) for TV shows, movies, books and other media that depict the profession.

Here are some movies and TV shows that the center has rated, including excerpts of its reviews. You can find a longer list at www.nursingadvocacy.org

In the movies

WIT (2001)

Emma Thompson and Mike Nichols' adaptation of Margaret Edson's intellectual anti-intellectual play "Wit" movingly explores an emotionally homeless scholar's confrontation with a life-threatening illness. At the same time, it ruthlessly deconstructs the modern medical research establishment. The one health care professional who actually cares for the patient is her primary care nurse. The nurse, while not an intellectual, simply wants to provide the patient with health care that is consistent with her professional obligations and with basic human decency.

Meet the Parents, (2000)

Is a nursing career fit for a real man? Why would anyone with a high medical school entrance exam score become a nurse? Will the phrase "male nurse" ever die?

Though nursing is not a major part of the movie, the script reveals an understanding of basic nursing issues that is unusual for a mainstream Hollywood film. Since part of the prospective father-in-law's skepticism about the lead character Greg relates to his career choice, common perceptions of nursing, particularly as compared to medicine, are a recurring theme.

Rear Window (1954)

Nursing is a subplot in this Hitchcock thriller, in which the lead character L.B. Jeffries played by Jimmy Stewart is homebound with a broken leg with nothing to do but look out the window and let his imagination run wild. Insurance company nurse Stella visits Jeffries' apartment daily, monitoring his condition, doing massage and preparing food. The care shown might not meet current standards; Stella never encourages Jeffries to walk with crutches, and he spends all his time in a wheelchair. But Stella is clearly helping him heal. Stella also displays her knowledge of medications when she and the other voyeurs see what may be an impending suicide.

John Q (2002)

This movie about an underinsured father (Denzel Washington) taking over a hospital to force authorities to give his son a lifesaving heart transplant pays little attention to accuracy or balance in depicting health-care activities. Even so, the character who is most identifiable as a nurse is a kind, knowledgeable ICU nurse who explains to the boy's parents some aspects of their son's condition and care.

One Flew Over the Cuckoo's Nest (1975)

Milos Forman's 1975 adaptation of Ken Kesey's 'One Flew Over the Cuckoo's Nest,' which won five major Oscars, shows just how much subversive brilliance and serious misogyny can inhabit the same film. Actress Louise Fletcher's portrayal of the insidious Nurse Ratched stands as a nursing image whose negative power may never be surpassed.

Nurse Ratched has become an American archetype, a soul killer who masterfully abuses her professional and institutional power over her patients. Even her name evokes words like "rat" and "wretched."

In television shows

ER (1994- ) 1.5 stars

The show's physician-centric world view has led to a continuing failure to give viewers an accurate or complete picture of the vital role the nursing profession actually plays in modern health care. The few nurses who emerge from the "ER" wallpaper are skilled but essentially fungible, serving mainly as subordinates and romantic foils for the heroic physicians.

Scrubs (2001- )

This show has a major and positive nurse character in Carla Espinosa. And some plot lines have had surprisingly thoughtful takes on nursing issues, such as the decision to become a nurse practitioner, bigotry toward male nurses, nurses' informal teaching of residents, and nurse-physician tension. Unfortunately, in other ways the show reflects the prevailing Hollywood vision of nurses as caring but largely peripheral health workers who report to physicians."

Presidio Med (2002-03)

Set in a private San Francisco hospital, this show focused on upscale, attractive female physicians. It lasted half a season. In one hospital scene, a veteran nurse brought an OB/GYN physician a cup of coffee because the physician had been working so hard. We must have missed the scene where a physician brought coffee to a nurse who'd been driven to the edge of breakdown by the nation's pandemic nurse understaffing.

M*A*S*H (1972-83, in reruns)

The series' depiction of nursing was somewhat better than that in the 1970 film on which it was based. Chief Nurse Major Margaret Houlihan (Loretta Swit) is probably the most important nurse character in television history. There was little doubt about Margaret's authority, nursing skills and commitment to the patients' well being, and as the show went on she grew increasingly sympathetic. However, especially in the early years, Margaret was still a fairly pathetic martinet, desperately seeking to enforce petty discipline -- and a man to fill the void in her career-dominated life.

First published on November 25, 2003 at 12:00 am