Anyone who has spent time in a hospital might notice there is something missing from prime-time TV medical dramas: nurses.
Nurses may make up the overwhelming majority of health care providers in hospitals, but viewers wouldn’t guess that from watching shows such as "Grey’s Anatomy," "E.R.," "House" and "Scrubs."
The characters who primarily populate these shows and drive the action are medical doctors in various stages of training and experience.
"You barely see (nurses)," says Marilyn Rouette, a nurse at Cape Cod Hospital who heads the local chapter of the Massachusetts Nurses Association. "The only time you see a nurse is when she’s having an affair with a doctor. But when you actually come to a hospital, that’s who you see ‘nurses.’"
Carol Conley, a nurse executive with Southcoast Hospital Group, which includes St. Luke’s Hospital in New Bedford, has just about given up on TV’s ability to get nursing right.
"I don’t watch those shows," says Conley, vice president of patient services at Southcoast. "It just annoys me too much."
But nurse-author Sandy Summers can’t look away from media images that depict nurses as nonexistent, eye candy or subservient.
Not only are these images unrealistic, she says, they have the potential to harm patient care.
In her book, "Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All At Risk," the Baltimore-based author says if people don’t believe nurses are all that important, they won’t mind underfunding nurse training programs or short-staffing hospitals.
Lives are in the balance, Summers said in a phone interview. Properly functioning hospitals rely on nurses to run defibrillators, inject medications, monitor patient care, provide patient education, take care of the dying, assist laboring mothers and — sometimes — catch physician errors.
But on TV, all these dramatic events that are actually part of nursing are taken care of by doctors, Summers said.
The young interns on "Grey’s Anatomy" cared for quintuplets in a neonatal intensive care unit — an adorable but unrealistic scene, since nurses take care of preemies, she said.
On "House," a doctor walked a patient around after major surgery and even took him to the toilet.
"Perhaps a physician has done this, but we’ve never heard of it," Summers and her lawyer husband, Harry Jacobs Summers, wrote in their book.
And although "ER," which recently ended its 15-year run, featured nurse characters, it led viewers to believe that physicians supervise them, when nurse managers are actually in charge, Summers said. There’s also no hint of the many career paths nurses can take, including administration and teaching, Conley said.
Oddly enough in these post-feminist times, the TV image of women who nurse has in some ways declined since actress Diahann Carroll created the role of nurse "Julia" in 1968.
One reason is that with women entering medical school in record numbers, female nurses are no longer required to provide the romantic tension in doctor-driven hospital dramas, Summers said.
That leaves a female doctor character on "Grey’s Anatomy" free to refer to a "skanky syph" nurse and even for female physicians on "Private Practice" to patronize a male nurse who wants to be a midwife, she said.
But most of the time, nurses are just invisible, despite the inherent drama of their profession, Summers said.
Back in 2001, Summers, who with her husband runs a media advocacy group called The Truth About Nursing, took to calling and complaining about nurses’ images to producers of "ER."
"They said, ‘What are you talking about? Nurses literally wallpaper the background,’" Summers said. "That is exactly what television does — they treat nurses as wallpaper."
That’s no way to get public or private money to pay for the expensive laboratory and clinical training student nurses require, or to get the public to understand the connection between heavy nursing loads and patient mortality, she said. And if nurses are indeed invisible, they won’t be able to advocate for patients, she added.
TV producers seem to be getting the hint, if plans for several new shows featuring nurses are any indication.
"Nurse Jackie," featuring Edie Falco as a drug-dependent and cynical but excellent E.R. nurse, premiered Monday on Showtime, and "Hawthorne," starring Jada Pinkett Smith, is scheduled to roll out Tuesday on TNT. An ensemble nurse show, "Mercy," is in NBC’s midseason lineup next winter.
The drug and adultery plotlines in "Nurse Jackie" don’t thrill Summers, but she’s eager to see how the show will portray a nurse on the job. "What I care most about is her professional competence," she said.
Media images can influence nurse recruitment, says Conley, who likes the Johnson & Johnson campaign that talks about nurses helping to evacuate patients during Hurricane Katrina and performing other acts that change patient lives.
Rouette at Cape Cod Hospital says TV watchers who want to see what nursing is really like can watch reality shows such as "Trauma: Life in the E.R." on the TLC network.
It depicts nurses, doctors, technicians and EMTs working together to save lives, she says. "That’s the thing you’d like to get across — it’s a team."
