The Truth About Nursing

On June 1, 2016, Fox News posted a video report headlined "Vets may have to settle for a visit with the nurse at the VA," which featured statements about a proposed rule change by the Department of Veterans Affairs (VA) that would "allow highly trained nurses to act as doctors, and even administer anesthesia without a doctor's supervision."  The video report was apparently sparked by a June 1 press conference at which physician anesthesiologist groups voiced their objections to the rule. The report gave these physicians free rein to espouse their unsupported views, with no nursing response beyond a limited segment featuring a nurse practitioner (NP) assuring viewers somewhat vaguely that NPs do have clinical experience. The piece failed to convey that advanced practice nurses like NPs are graduate-educated health professionals with independent licenses and an autonomous nursing practice model, which is broader and more holistic than the medical model. There was no response from any nursing group. Fox News ignored the powerful rebuttal of the physicians’ arguments by the American Association of Nurse Anesthetists (AANA) that was issued on the same day as the anesthesiologists' press conference. Fox failed to convey that certified registered nurse anesthetists (CRNAs) have years of education specifically aimed at this work, which they have been doing safely for decades--they are not suddenly being asked to give anesthesia after learning about it in an extra night class or two. The AANA referred to the latest study showing that physician "supervision" of nurse anesthetists makes no difference to patient safety and is therefore unnecessary. We urge Fox News to apologize for its unbalanced report, including the insulting suggestions that patients would be "settling" and that the nurses would be "act[ing] as doctors." We also expect Fox News to make amends for this report by running a followup video report with AANA president Juan Quintana, RN, DNP, CRNA, himself a military veteran, to allow nurses the opportunity to defend themselves from these attacks and let the public know about the research that shows they are safe, effective science professionals.

Memorial Heights Emergency Center in Houston posted a billboard portraying nurses as eye candy in its quest to lure patients to its outpatient facility--one owned by physician Akash Bhagat, who thinks so little of nurses as professionals that he boasted on a radio program that his facility refused to hire nurse practitioners because they are trained "at a different level." 

Dr. Ken's damaging October 9, 2015 episode suggested that nurses are low-skilled servants looking for a physician to possess them. The theme of the episode was that Ken the physician learned that "his nurse" Clark was also his "friend" and should be treated better. But the plotline also told viewers that: Clark, formerly a "nurse" or "doctor's assistant," had just become a registered nurse by taking his "boards," after studying in an RN program "since last summer"; this transition was like a "streetwalker" becoming an "escort"; nurses are subordinate work spouses of physicians who essentially belong to the physicians, rather than serving patients under their own practice model; physician abuse of nurses is unfortunate but also kinda funny; and men in nursing do not embody traditional notions of masculinity. The show has yet to suggest that nurses have any actual health skills. This adds up to toxic stew of nursing stereotypes: the unskilled handmaiden, the angel, the weak male, and even the naughty nurse. In fact, nurses receive at least three years of college-level science education, and they use their advanced skills to save lives, often with little or no involvement by physicians. All this matters because research shows that popular media portrayals have a real effect on how decision-makers and members of the public view nurses. And a profession that gets as little respect as nursing does in this episode will have a hard time competing for scarce health resources. The result is an under-empowered profession unable to save lives it otherwise could. (More details and the film clips on The Truth About Nursing's website at http://bit.ly/dr-ken-truth1.) We are asking the makers of Dr. Ken to make amends for this episode and in the future avoid nursing stereotypes, which harm real nurses--and their patients--and to show nurses as college-educated science professionals who save lives and improve patient outcomes.

In Cloud Atlas, the nurse character Noakes is a battle-axe, overseeing the fake nursing home that actually serves to confine elderly people whose relatives have tired of them. Noakes resembles Nurse Ratched from One Flew Over the Cuckoo's Nest in her desire to control and torment those under her "care." But Noakes is less subtle and more menacing than Ratched. As played by actor Hugo Weaving -- acting and dressing in a traditionally female way -- Noakes has no virtues, and she quickly resorts to violence against anyone who gets in her way. Noakes appears to be based on Ratched and her repressed sexuality, but she is even worse, in part because the film seems to link her malevolence to her gender ambiguity. We are calling on the creators of Cloud Atlas to apologize to the nursing profession for its depiction of nursing and to make amends by creating nurse characters in their future films that present nursing as a live-saving scientific endeavor worthy of the attention of all genders.

  In the episode of Disney's Lab Rats broadcast on August 5, 2013 (“Bionic Showdown”), inventor Donald Davenport mocks his brother Doug by noting that Doug has turned into “Dr. Evil,” “or should I say Nurse Practitioner Evil, since you flunked out of med school!” That is a baseless and damaging message about nurse practitioners because research shows that even jokes affect what people think and that advanced practice nurses provide care that is at least as good as physician care.

People have the right to show the public the kind of conduct we see on Scrubbing In. But when that conduct is so closely associated with nursing, it can be troubling, because of the profession's poor image. Nursing has endured decades of negative media images, including the enduring ideas that nurses are unskilled and sexually available. These stereotypes form the foundation of the disrespect and underfunding that has led to the global nursing shortage, which kills millions of people every year. And because of nursing's poor image, it matters which nurses are chosen to appear on a show like Scrubbing In and what they are seen to be doing on the show. We cannot assume that the public, particularly the impressionable young MTV demographic, will know that there are millions of highly qualified professional nurses out there regardless of what appears on this show. So the show is a public health problem.