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Fall 2014 television overview

Fall overviewOctober 2014 — The fall U.S. prime time television schedule has several new shows with nurses among the regular characters, although there is a notable trend toward the distant past. Outlander, the Starz series which has now aired half its first season and will resume in April, is based on popular books about a British World War II combat nurse who is transported back in time to 18th-century Scotland. There, she falls in with local rebels, has romantic adventures, and occasionally displays impressive emergency health skills–which are mistaken for witchcraft! There’s not much health care, but nurse Claire is smart, tough, and ready for action. Cinemax’s The Knickwhich ended its first season on October 17, focuseson the exploits of early 20th-century surgeons at a New York hospital. The show’s tone is unusually harsh and corruption is everywhere, but it still embraces the traditional view of surgeons as the brash ‘n’ brilliant heroes of health care. The nurses are peripheral handmaidens; the only one who really seems to emerge from the background is also a sexual partner of the main surgeon character. Both shows will be back for second seasons. Perhaps capturing the Fault in Our Stars Zeitgeist, Fox’s new Red Band Society follows a group of seriously ill teens in the pediatric ward at an LA hospital. The show has two nurse characters and one physician, but early episodes are consistent with show ads, which label the characters using stereotypes:  the physician gets “the hot doc,” the junior nurse is “nurse cupcake,” and the senior nurse is “nurse tough love” (which is at least better than “Scary Bitch,” the label for her seen on some LA bus ads). The show’s nurses have some psychosocial skill, but otherwise seem to lack health care knowledge. Another unpromising new show is ABC’s sitcom Black-ish, which focuses on a successful black family struggling with its racial identity. Mom is an anesthesiologist who wants her gifted 6-year-old daughter Diane to become a physician too, so in an early episode she takes the adorable tyke to work, where Diane tells the useless emergency nurse who is babysitting her that he is a “man with a woman’s job.” Physician-centric returning shows include ABC’s endless Grey’s Anatomy (sexy, brilliant surgeons; handmaiden nurses); the Fox sitcom The Mindy Project (quirky but skilled OB-GYN physicians; stooge nurses) and the CW’s Hart of Dixie (returning mid-season) (smart, sexy small town physician; no nurses). Of course, some returning shows are better for nursing. In spring 2015, Showtime’s powerful Nurse Jackie will return for a seventh and final season of clinical expertise and creative patient advocacy. Returning for a fourth season on PBS in 2015 will be the BBC’s Call the Midwifewhich focuses on skilled, autonomous nurse midwives caring for poor women in 1950’s London (admittedly, that show is part of the distant past trend). Channel 4’s U.K. documentary 24 Hours in A&E will be back for a seventh season, moving from King’s College to St. George’s Hospital, but we hope skilled emergency nurses will remain key members of the cast. We’re not sure which category HBO’s patheticomic Getting On (returning Nov. 9) falls into; the engaging portrayal of modern geriatric care seems to view both nurses and physicians with sad-eyed contempt. On the whole, a few good shows for nursing are hanging on in the midst of the flood of physician-centric television, but we are hoping for more before those veterans have to be, like Jackie. . . getting on.

Summer Shows

Summer headlinesFrankie (BBC)
Breathless (ITV)
NY Med (ABC)
A Young Doctor’s Notebook (Ovation)
The Night Shift (NBC)
Rush (USA)
The Strain (FX)
Royal Pains (A&E)
Black Box (ABC)

 

Fall Shows

Red Band Society (Fox)

Black-ish (ABC)

Getting On (HBO)

Grey’s Anatomy (ABC)

The Mindy Project (Fox)


Spring Shows

Nurse Jackie (Showtime)

Call the Midwife (BBC)

Conclusion

Summer Shows

Frankie Maddox and othersA slew of shows airing this summer have included some portrayals of nursing, but physician characters have dominated. Perhaps the most promising was the BBC drama Frankiewhich focused on the work and personal life of Frankie Maddox (right) and other district nurses, a show whose 6-episode first season aired in the U.K. in 2013 and on PBS in 2014. Unfortunately, that show will not be back.
 
The ITV series Breathless, which aired its first and only season on PBS this summer, focused on London gynecologists in the early 1960s, trying to capture a bit of Mad Men‘s swinging style. The surgeon characters tended to be brilliant if flawed, especially the lead one, and the nurses did fit the general description of handmaidens, as well as being way too thrilled at the idea of romance with physicians. On the other hand, the nurses were not two-dimensional “yes-doctor!” twits. They could actually form more complex thoughts and words, and one early scene saw an OR nurse subtly collaborating with an anesthesiologist to rescue an endangered patient from a flailing junior surgeon. And while the main nurse character was the lead surgeon character’s adulterous love interest, she was also fairly bright, knowledgeable about care, and willing to stand up for herself. 

Documentary maker Terence Wrong also returned with another season of ABC’s NY Med, the series that focuses on the exploits of physicians, mainly surgeons, at New York area hospitals.The 2014 version, like its 2012 predecessor, did include a few critical care nurses. But they displayed relatively little clinical skill in their brief appearances, and it was clear again that they were diversions, mostly there to show us their interactions with zany emergency department patients. (Perhaps the most notable aspect of the season for nursing was nurse Katie Duke’s firing for an Instagram post of an empty trauma room in which a patient hit by a subway train had been treated (right) that was deemed inappropriate.)

Ovation’s A Young Doctor’s Notebook just finished airing its second season in the US. The show was based on stories by playwright Mikhail Bulgakov about a troubled young physician at a rural hospital in early 20th Century Russia. Nurse characters did display some knowledge and authority in the first season, but the one who was most prominent in the second season was a sad, doomed romantic casualty of the caddish physician.

On other summer shows, nurses had even less of a presence. NBC’s The Night Shift focused on ED physicians at a struggling San Antonio hospital. For the most part it was the same old physician glorification, with a few peripheral nurse characters to report vitals, convey messages from one physician to another, and so on, but ratings were good enough and the show will be back next year. 

USA’s Rushwhich aired its first season and will not be back, followed a strand of failed recent shows about brilliant but troubled physicians who operate at or over the line of illegality. Here the main character was a “medical fixer” to the rich and famous, maybe somewhere between Ray Donovan and Hank Lawson of A&E’s Royal Pains. The “brilliant” physician William Rush had a logistics assistant, but she was not a nurse, which is just as well. There were no significant nurse characters.

In Guillermo Del Toro’s vampire infection thriller The Strain (FX), which will return for a second season next year, the lead character is a heroic CDC epidemiologist. There were no significant nurse characters.

Royal Pains recently completed its sixth season of tantalizing portrayals of concierge care in the Hamptons. There were still no significant nurse characters.

And ABC’s canceled Black Box, which aired the last half its first season episodes in the summer, was a show about a brilliant bipolar neurologist and her gifted physician cohorts. It had no significant nurse characters, and the nurses who did appear, briefly, were assistants who had to be shown what’s what by the star, even as to psychosocial care.

Fall Shows

Red Band Society

Scary Bitch Red Band SocietyThis new Fox drama focuses on a group of teenagers with serious illnesses who appear to live at a Los Angeles hospital. Apart from a coma patient who narrates the show from his coma, the teens seem remarkably healthy and highly functional, traveling around the hospital and having little escapades, attending class in what seems to be a hospital school, and so on. The show is mainly about their peer relations, and there is not much actual health care, despite the setting. Based on the first two episodes, it certainly does not seem that the public is going to get a much better understanding that hospitals exist to provide skilled nursing care. The main physician character, in addition to being “hot,” appears to be expert and authoritative in clinical matters; one teen seeks him out for an operation because he is supposedly among the best at it. The senior Nurse Jackson does seem to be all about “tough love,” as the show ads promise, and that kind of portrayal can easily amount to a mix of the battle-axe and maternal stereotypes of nursing, as it does here. Jackson certainly conveys authority, being wise to all the teens’ tricks and evasions, but the show seems obsessed with the idea that she can be unnecessarily harsh–show posters on LA buses gave her the alternative label “Scary Bitch,” although the ads were evidently taken down after complaints that they were offensive. Nurse CupcakeWe haven’t seen Jackson display much health care expertise. Indeed, in the second episode, after the physician elects not to amputate a patient’s leg upon finding that his cancer has spread, Jackson says: “So, getting to keep his leg was a bad thing.” A bratty patient insults Jackson by saying she is just a nurse who takes the bus, and later we see her do just that, suggesting to viewers that nurses are minimum wage workers who can’t afford cars and must take the bus–in LA. And junior nurse Britney seems as naïve and useless as her “cupcake” label suggests. At one point, after Jackson chastises her for being easily fooled by a non-adherent anorexic patient, the despondent Britney asks what might happen if she made a mistake and someone died. The physician consoles her this way: “It would be very difficult for you to kill anyone, Britney.” Because, of course, nursing does not involve anything consequential. Another unfortunate scene has the attractive Britney giving a sponge bath to a young con artist patient who plays on her sympathies in an effort to get sexual favors. Britney recoils and leaves, but the show treats it as a quick joke, trivializing the high levels of sexual abuse that real nurses do suffer, in part because of the common idea that it’s part of their job to provide sex to patients and physicians. Based on early ratings, the show seems unlikely to survive.

Black-ish

This new ABC sitcom is about a successful African-American family that struggles with its racial identity in its mostly white neighborhood and social environment. The father is an ad executive, and the mother, Rainbow Johnson, is an anesthesiologist. The show is mainly a family sitcom that revolves around the father, so we were hoping that there would be very few clinical interactions, because the chance of them not harming nursing would be close to nil. It is extremely unlikely that any Hollywood product that is seriously concerned with African-American professional success will question the standard assumptions that physicians are the brilliant masters of health care and nurses are low-skilled subordinates (see, e.g., Akeelah and the BeeGrey’s AnatomyDoc McStuffins). Sadly, we didn’t have to wait long to see that borne out in Black-ish. In the October 8, 2014 episode, Rainbow tries to inspire her precocious six-year-old daughter Diane to be a physician by showing her around the hospital where Rainbow practices. Diane is bored at first, and when her mother is paged to the emergency department (ED), it gets worse: Rainbow directs “Nurse Larry” to babysit Diane. As we all know, nurses have nothing better to do. Larry tries to amuse Diane by making a “turkey” from a blown-up medical glove. As his reward for these efforts, Diane calls him a “man with a woman’s job.” There is no indication the show finds that comment problematic; instead, we are invited to laugh at the joke delivered by the savvy young truth-teller. Unfortunately, it reinforces the damaging stereotype that nursing is just for women. Diane finally escapes that silly Larry and encounters the real life-and-death work of the ED, which involves a patient with a hatchet in his head. Even though her mom can’t save the patient, Diane decides she really does want to be a physician. Mom rejoices. And we can expect more of the same, since the show has a full-season order.

Getting On

Nurses backing into each otherHBO’s Getting On, which aired its 6-episode first season in late 2013, follows the exploits, if we can call them that, of the staff at a geriatric care facility in southern California. An adaptation of a U.K. series, the show is a slightly less nihilistic version of Veep–almost every regular character is a pathetic loser, and much of the drama comes from just how much each is also venal. The show has three characters in nursing, along with one physician, so it certainly does show that nurses play the central role in this care. The main character seems to be nurse Dawn, a meek, odd person who allows the self-centered, stool-study-obsessed physician Jenna to bully her. Dawn does have some health knowledge and at times seems committed to the patients, although the benefits of those features are generally outweighed by the overall impression of her as a sad, sad mouse, a standard modern single-camera character whose main purpose seems to be giving viewers something to rubberneck and squirm about. Didi Ortley appears to be an LVN, although she has called herself an orderly and her health knowledge seems consistent with that description. Didi she seems to be the most normal character and best with the patients; she is the only major character who is not deeply self-centered. Naturally, the least powerful, least educated person is the best and wisest. And did we mention the woefully inadequate nursing supervisor Patsy, a man who is full of absurd modern workplace jargon but seems unsure how to deal with actual patients? Grossly insensitive to Dawn and others, he is hypersensitive himself. Patsy is apparently unsure whether he is gay or not, but he does seem to be using Dawn for sex. Every major nurse character is substantially overweight. The show is a persuasive and oddly compelling vision of what’s wrong with U.S. health care and those who provide it. But whatever its dramatic and social virtues, it’s hard to see that presenting most of the nurses as self-absorbed twits is all that helpful, even if physicians are seen that way as well.

Grey’s Anatomy

Tyler on Grey's AnatomyABC’s Grey’s Anatomy remains popular heading into its eleventh season, and it now features more than a dozen regular physician characters, every single one a surgeon. Over the years, nurse characters have occasionally appeared on Grey’s, usually embodying stereotypes, particularly the helpless handmaiden and the bureaucratic battleaxe, which contrasts sharply with the professional path that the show’s modern female stars have chosen. The tenth season was especially notable for physician nursing, with physicians often providing all bedside care, including handling all patient monitoring and psychosocial care. In one remarkable March 2014 episode, the perennially disagreeable Nurse Tyler returned, now apparently a CCU nurse manager who actually stood up to one of the hotshot baby surgeons on which the show has always doted. That sounds OK, but Tyler was still there to obstruct the surgeons and make their lives more dramatic, in this case grudgingly allowing the baby surgeon to move three fragile heart patients into the CCU but noting that he, Tyler, could not spare any nurses so the surgeon was on his own. So baby surgeons did the nursing, resentfully, and once again the show suggested that nursing consists of low-skilled scut work imposed on junior physicians as a punishment, keeping them from surgeries, which actually matter. Elsewhere in the season, nurses did, rarely, pop up to display some technical knowledge or act as an ineffective speed bump on baby surgeon rashness. But in general they simply served in deferential silence punctuated by the occasional “right away, doctor!” Looking forward to the new season, Geena Davis has joined the cast in a “major guest arc.” Davis has been active in recent years with the Geena Davis Institute on Gender in Media, which aims to improve entertainment media portrayals of women and girls. Even though Davis’s Grey’scharacter is a surgeon, and her initial scenes suggest that the character will further the show’s godly-surgeon narrative, we hope she will find some way to advance–or at least not further degrade–the media portrayals of the numerous female nurses who could certainly use her help. See the show’s website on ABC, or see our page featuring many analyses over the years.

The Mindy Project

Mindy ProjectMindy Kaling’s Fox sitcom The Mindy Project, which is set at a small obstetrics practice in New York City, returns for a third season. Kaling’s lookin’-for-love OB-GYN character and the other physicians are quirky, but they do seem to provide skilled care. Meanwhile, the practice’s three main nurse characters are demented and/or nasty punchlines with no evident health skills–three stooges, essentially. The main one, Morgan Tookers, is a goofy ex-convict. Well-intentioned but ignorant, very odd, and a little scary, Morgan seems to be based mostly on The Janitor from Scrubs. He specializes in inane comments; in an April 2014 episode, one of the OB/GYNs told him: “No, Morgan, I told you before, I cannot promote you to doctor.” An occasional foil for Morgan is nurse Tamra, an off-the-wall nurse who at first seemed like she would play an insult-comic role, but in recent times has been more of a variation on Morgan–and a romantic interest for him. In that same April episode, Tamra at one point complained that the physicians wouldn’t let her take off the high holy days. One physician pointed out that she is not Jewish. She asked how she would know if they wouldn’t let her try! The last nurse character is Beverly, in early episodes a dangerously inept and hostile nurse the practice fired, then re-hired as an office assistant, work at which she has proved just as inept, if less dangerous. Beverly generally appears so she can comment on the action in some unhinged way. Of course, all the characters behave foolishly at times, but Kaling takes care never to suggest that the physicians are idiots in a professional context. That is not true of the nurses, who are plainly inferior subordinates. See the show’s website on Fox, or see our page featuring further analysis.

Spring Shows

Nurse Jackie

Zoe smiling; JackieShowtime’s veteran nurse-focused “dark comedy” will return for a seventh and apparently final season in spring 2015. After a couple seasons that were infected with increasing suggestions that physicians direct nursing care and fewer depictions of nurses’ clinical skill, the show’s sixth season was better, with a number of plotlines showing New York emergency nurse Jackie Peyton or her gifted protégé Zoey Barkow providing the expert care and audacious patient advocacy they had in previous seasons. In one scene in the April 2014 season premiere, a concerned mother’s initial disrespect of Jackie quickly changed after a senior physician confirmed Jackie’s plan for a blood test on the patient, and Jackie expertly located a difficult vein, ending with Zoey referring to Jackie as “the Vein Whisperer.”Zoe smiling; JackieIn an episode later that month, a patient was having reactions to different medications different physicians had prescribed, but none of the physicians would respond to the ED’s inquiries. So Jackie started calling all of the physicians and saying their mothers were in the ED; Zoey followed suit. All arrived quickly and got a stern talking to from the chief ED physician. And in a June episode, Zoey announced that she was thinking of getting a masters degree and becoming a nurse practitioner! Jackie was very supportive, and being Jackie, soon told a patient that Zoey already was an NP and that she would be giving him a full exam, which she appeared to do successfully. Of course, the season also featured Jackie’s tenuous sobriety unraveling, and at times endangering patients, something the show has actually not done enough of in the past. On the whole, though, the show continued to feature credible, compelling displays of nursing expertise. See our Nurse Jackie page featuring analyses of many episodes, or see the show’s web site.

Call the Midwife

Call the MidwifeThe BBC’s Call the Midwife returns for a Christmas special in December and its fourth season in the spring. The show is a dramatic look at the exploits of Anglican and lay nurse-midwives caring for poor women and babies in London in the late 1950’s. The Sisters of St. Raymond Nonnatus and a group of young lay midwives–eight major nurse characters!– try to cope with a high number of births and other health issues in the community. The central character is lay nurse Jenny Lee, whose “mature” self provides the narration for the series. In its first three seasons, the show presented the midwives as skilled and autonomous health workers whose ability varies in accord with their relevant experience, although by this point all the midwives seem pretty expert. Call the MidwifeThe nurses visit pregnant women to monitor their progress, deliver the babies under awful conditions, and advise the new mothers, in an environment without birth control where women seemed to function as baby factories and one-person day care centers. All work under the watchful eye of the authoritative but kind mother superior Sister Julienne, whose exploits in the third season included finding a way against all odds for a pregnant prison inmate to keep her baby upon her release. Physicians do appear occasionally when their special skills are needed, but even then, the nurses’ views carry weight. In the third season premiere, broadcast in the U.S. in March 2014, everyone was stumped by a baby who seemed to be failing to thrive. But then Sister Monica Joan provided the main physician character Turner with an old book documenting a similar condition, and he determined that the baby had cystic fibrosis, thereby at least giving the distressed parents some understanding and hope. See our webpage featuring analyses from the show. Or see the show’s website, where you can watch episodes online.

Conclusion

It does not seem that there will be much in the fall shows that will really help nursing or counter the dominant awesome-physician narrative on U.S. prime time television. But like last year, if you count the spring shows, this could still be one of the better recent seasons for nursing. With Nurse Jackieapparently ending, though, it could also be one of the last of those better seasons. So please stay tuned and help us monitor the media. Let us know if you see a good or bad portrayal. And please join our letter-writing campaigns to speak out to show creators. Thank you!

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