The Defenders of San Fransokyo

The fall 2017 TV season offers a few bright spots for nursing

Call the Midwife can be expected to offer a consistently good portrayal of nursing. Chicago Med and even The Defenders may offer glimpses of nursing skill, advocacy, and autonomy. But the physician-focused vision of shows like Grey’s Anatomy and The Good Doctor, on which nurses tend to be handmaidens, will likely dominate another Hollywood season.

TV Preview 2017September 2017 – Most health-related shows in the new U.S. prime time season are physician-centric, but a few will likely convey helpful information about nursing. The only new major network show is ABC’s The Good Doctor (premiering Sept. 25), a series from House creator David Shore focusing on a brilliant physician (no, really!), in this case a very young one who is on the autistic spectrum. No apparent major nurse characters. Since late August the Acorn TV network has been offering the limited ITV series The Good Karma Hospital, about a young UK physician who travels to India and practices at a small hospital there, facing health care challenges and romantic intrigue. No apparent nurse characters. But one new series of potential interest for nursing is Disney XD’s animated Big Hero 6: The Series (November), which follows the 2014 Big Hero 6 film. A key character will again be the charming android “nurse” Baymax, who in the film displayed some of the important health skills of real nurses. Among returning shows, the BBC’s powerful Call the Midwife will be back in early 2018 with London nurse-midwives providing expert, autonomous community health care in the early 1960s. Under the heading of an old character on a quasi-new show, Netflix’s ever-expanding Marvel Universe now includes the multi-crossover show The Defenders (August), with familiar nurse-to-the-superheroes Claire Temple (right), who is skilled, tough, and savvy. Outlander (Starz) returns this month for more adventures by time-traveling nurse Claire Randall among the rebels of 18th-century Scotland. Unfortunately, this season shows 20th-Century Claire become a physician, striking a blow for women but sending a message that undermines nursing. In present-day health-focused programming, physician-focused shows still dominate. NBC’s Chicago Med (mid-season) is mainly about six physicians, although it has two competent emergency (ED) nurse characters who actually think and talk (sometimes to each other!); plus, a hospital executive who is a nurse heads up the trauma center. No such luck with ABC’s Grey’s Anatomy (Sept. 28), which returns for a 14th season of sexy, brilliant surgeons doing everything that matters, including nursing, with a few appearances by meek handmaiden nurses. CBS’s Code Black (mid-season) is set in a busy Los Angeles ED, where one senior nurse character serves as a skilled aide-de-camp to about eight major physician characters. And this month Hulu began airing the final season of The Mindy Project, which focuses on quirky but skilled OB-GYN physicians, but also has a few silly nurses—and one more sentient nurse who lead character Mindy actually married at the end of the last season, although indications are that marriage may not last long. Please join us in encouraging better portrayals of modern nursing!

The Good Doctor (ABC)

The Good Karma Hospital (Acorn / ITV)

Big Hero 6:  The Series (Disney XD)

Returning shows / characters

Call the Midwife (BBC/PBS)

The Defenders (Netflix)

Outlander (Starz)

Grey’s Anatomy (ABC)

Chicago Med (NBC)

Code Black (CBS)

The Mindy Project (Hulu)

Conclusion

Take Action!

 

New shows

The Good Doctor

The Good DoctorThis new show, created by David Shore and Daniel Dae Kim based on a South Korean series, follows the exploits of a very young pediatric surgeon who ABC says has “autism and savant syndrome.” Lead character Shaun Murphy leaves “a quiet country life” to join the staff at an elite hospital in San Jose, CA, where it looks like he will be joined by about five major physician characters and no nurses. Sadly, that is what we would expect from the creator of House, even though his mother was a nurse; that popular Fox show featured rampant physician nursing and, when nurses did appear, tended to suggest that they were disposable helpers, at best. ABC describes The Good Doctor this way: “Alone in the world and unable to personally connect with those around him, Shaun uses his extraordinary medical gifts to save lives and challenge the skepticism of his colleagues.” So, once again we would expect to see the physician role (particularly the surgical role) in hospital care magnified and glorified. And previews provide no reason to think the show will question the prevailing Hollywood model.

For more information, see The Good Doctor’s ABC website.

The Good Karma Hospital

Good KarmaThis ITV drama, available in the U.S. through Acorn TV, follows the path of the disillusioned young U.K. physician Ruby Walker, who moves to South India and practices at a small coastal hospital run by another expatriate physician. Described as a crossover between Grey’s Anatomy and The Best Exotic Marigold Hotel—it actually reminds us of the short-lived Shonda Rhimes show Off the Map—this visually attractive series appears to focus on four physician characters, their professional struggles in the face of limited resources, and their romantic interests. The first season had six episodes, and a second series has already been announced for 2018. There does not appear to be any significant nursing element, and it seems likely that the series will reinforce the common view that only physician care really matters.

For more information, see The Good Karma Hospital’s page on the Acorn TV website.

Big Hero 6: The Series

BaymaxIn November, Disney XD will launch a full season of animated half-hour episodes that follow the characters from the 2014 film Big Hero 6, which was itself based on a Marvel comic book series. Despite our usual reservations about “robot nurses,” we found the robotic Baymax “nurse” character from the film to be “cognitively advanced, with diverse skills, a vast knowledge of health care, and a persistent holistic focus.” Plus, he was cute. Yet he also used martial arts to save his friend Hiro and a band of young, tech-oriented human companions from an evil plot. Anyway, most of the film’s major voice cast has returned to reprise their roles, and the plot evidently picks up after the events of the film. Disney explains: “As the new prodigy at San Fransokyo Institute of Technology, Hiro faces daunting academic challenges, not to mention the social trials of being the little man on campus. The stakes are also raised for the high-tech heroes when they must protect their city from an array of scientifically enhanced villains.” Disney gave the show a second season order months ago. We could see the series forgetting the movie’s health care element; an available preview is pretty much martial action. And even if Baymax does continue to provide health care, the show would have to make it clear to viewers that he is in fact operating as a nurse, as Hiro once called him in the film, and not just as a “personal health care companion,” as Baymax referred to himself. So, we’ll see.

For more information, see Big Hero 6:  The Series’s page on the Disney XD website.

 

Returning shows / characters

Call the Midwife

Trixie and BarbaraThe BBC’s Call the Midwife returns for a Christmas special in December 2017 and a seventh season in early 2018. The drama follows the exploits of nurse-midwives caring for poor women and others in London in the early 1960s. We count roughly 10 major nurse characters (!), but the show does not pretend only nurses provide care; one of the nurses is married to a kind, expert community physician who plays a critical role in some plotlines. In its first six seasons, the show has generally presented the midwives as skilled and autonomous community health workers whose abilities vary in accord with their relevant experience, just as on physician-focused shows. The nurses visit pregnant women to monitor their progress, deliver babies under difficult conditions, and advise the new mothers, in an environment in which birth control is just now starting to become widely available. In fact, in the sixth season, one striking example of the midwives’ work was Trixie’s great technical and psychosocial care in the eighth episode for a mother who unwittingly combined the newly-available contraceptive pill with smoking, resulting in a pulmonary embolism that led to her hospitalization and eventual death. The season’s second episode included several great examples of nursing advocacy. Among them was Shelagh’s appearances at a coroner’s inquest following a deadly dockside warehouse fire, where she argued for better health supplies to be available at the warehouse.

See our webpage featuring analyses of the show, or see the show’s website, where you can find episodes.

Outlander

Claire from Outlanders caretakingOutlander (Starz) is based on a series of popular books about British World War II combat nurse Claire Randall, who time travels between the 20th century and 18th century Scotland, where she marries a handsome Scottish rebel and has adventures across Europe. In the first two seasons, Claire displayed some impressive health skills, proving herself to be smart and tough. In the long first season she healed wounds, treated asthma, mastered herbal remedies, comforted the dying, diagnosed and treated mysterious ailments using her advanced knowledge from the future. The ratio of health care to romance and intrigue dropped off as the show went on, but the second season also included some care. Claire diagnosed and acted to limit a smallpox outbreak and tried to manage battle wounds. She also had to contend with PTSD from her years in World War II. But not enough was made of her nursing background – she was seen more as a “healer”— for nursing to benefit too much from her health exploits. And the early episodes of the third season will show her become a physician back in the 20th Century. It’s not a shock; Claire’s skills seemed to be a mix of what is now done by nurses and physicians. But it appears that this transition, in the face of blatant mid-20th Century sexism, will convey the standard “feminist” message: that nursing is not enough for bright, ambitious modern women. And after this, it seems that Claire will be seen as a physician and medicine will get credit for her health skills.

For more information, see Outlander‘s website on Starz.

The Defenders

Nurse Claire Temple, The DefendersThis is actually a new show, but it seems like a returning one because all the major characters have already appeared in their own Netflix superhero shows, as the Marvel Universe continues to expand. The ostensibly new series was released last month. It features heroes Jessica Jones, Luke Cage, Daredevil, and Iron Fist battling evil in New York, but most episodes also include at least an appearance by nurse Claire Temple, who has already been on the main characters’ individual shows. Claire is a composite of the Claire Temple of the original Luke Cage comic book series (that character was a physician) and the Marvel character Night Nurse, another comic book figure with a complex backstory that appears to include some striking patient advocacy. In any case, Netflix Claire does not spend too much time dispensing health care, but she is a problem-solver who operates with autonomy, toughness, and no apparent fear. And she is often the voice of reason in a band of strong-willed, damaged superheroes.

For more information, see Netflix’s The Defenders page.

Grey’s Anatomy

Grey's AnatomyThis month ABC’s Grey’s Anatomy begins airing its 14th season, and it now features about 15 regular characters, every one a surgeon. Consistent with that lineup, the show persistently reinforces the idea that only physicians matter in health care. Over the years, nurse characters have appeared on Grey’s, usually embodying stereotypes, particularly the helpless handmaiden and the bureaucratic battleaxe, imagery that contrasts sharply with the cool professional paths of the show’s female stars. The thirteenth season featured almost constant physician nursing, with physicians often providing all bedside care, not just exciting procedures like defibrillation but also patient monitoring, psychosocial care, and even wound care. Anonymous nurses did at times appear in the background to provide color or absorb physician commands, perhaps with an obsequious “right away, doctor!” Once in a great while they displayed knowledge, but almost always in an assistive role, as in a March 2017 episode in which a nurse told the physician Karev that she had “noticed a systolic murmur” so that he could check it out. The most notable nurse appearance of the season came in October 2016 episodes in which Karev had been temporarily banished to a free clinic after assaulting another surgeon. The clinic was run by a weasely quasi-battle-axe nurse who, obviously insecure, made sure Karev felt as miserable as possible about his lowly role in that boring non-surgical care (like stocking supplies!). The coming season promises more of the same, as there is still no indication of any major character who is not a surgeon.

For more information see our Grey’s Anatomy page with analyses over the years or the show’s website on ABC.

Chicago Med

3 nurses Chicago MedNBC’s Chicago Med, returning in mid-season, is another Dick Wolf show about dedicated everyman public servants confronting the challenges of modern urban life–there isn’t much Grey’s or Code Black style “we’re the best!” boasting on Wolf’s shows. And perhaps not coincidentally, Chicago Med is the best of the current U.S. network hospital shows for nursing. The show is dominated by about six physician characters, and many scenes do suggest that nurses are mainly there to assist them. But three nurse characters, all African-American women, do actually get some screen time. April Sexton, a young ED nurse, appears solid in the clinical setting, not just reporting vital signs but displaying some knowledge and interacting with patients, although the show probably spends more time on her romantic life and other personal issues. The show seems to portray the more senior Maggie Lockwood as a permanent charge nurse. Both of these characters are serious, skilled assistants to the physicians, in the ER mode. The third nurse is hospital executive Sharon Goodwin, who has overall responsibility for the trauma center; she is wise and tough but not a battle-axe. A September 2016 episode had Lockwood telling Goodwin that since it was early July, she was keeping the new physician residents from killing patients. All three nurses seem to be personal friends with the physicians, something that would be unthinkable on a show like Grey’s Anatomy, where nurses are third class citizens who don’t mingle with their social superiors, except for the occasional temporary romance. Of course, the physician-dominated structure and assumptions about care do still leave the impression that physicians are the ones whose health skills and actions really matter.

For more information see the Chicago Med page on the NBC website.

Code Black

Jesse: Code Black "Listen to your Mama"This CBS drama seems to be another in a long line of efforts to update ER, with some of Grey’s Anatomy‘s superficial egomania thrown in. There are eight major physician characters and one nurse. The added twist is that the show’s Los Angeles ED is supposedly the busiest (and of course the best) in the nation. That leads to some chest-thumping, much of which comes from the one nurse character, Latino “senior ER nurse” Jesse Sallander, who greets each new class of physician interns by announcing possessively that he is their “mama” and that they are not “smarter than your mama because you have an MD.” He also banters with the lead physician character Leanne Rorish, with whom he is close. Sallander manages ED logistics, calls out vitals, describes symptoms, provides psychosocial care, and at times even suggests courses of action and diagnoses. But his main job seems to be dispensing folk wisdom and half-jokingly burnishing his own legend. The show is alert to potential tensions between nurses and physicians, and it understands that a skilled nurse like Jesse might be protective of his dignity, yet it does not seem aware that nurses are autonomous. In one December 2016 episode, Jesse was fired (then rehired) by the chief surgeon for failing to disclose his suspicions that another attending physician had Alzhiemers. Anyway, the show’s physician-heavy structure and limited overall nursing role—nurses other than Jesse are faceless handmaidens—still leaves the impression that nurses are at best skilled assistants to the physicians whose actions matter most.

For more information see the Code Black page on the CBS website.

The Mindy Project

Nurse Ben and Mindy (The Mindy Project)Mindy Kaling’s sitcom The Mindy Project ends its run on Hulu after six total seasons, the first three on Fox. Set at a small obstetrics practice in New York City, the show has focused mainly on Kaling’s lookin’-for-love character and her baby daddy Danny, who are quirky but skilled OB-GYN physicians, until two seasons ago when they broke up. Meanwhile, the practice’s main nurse characters have been kooky in different ways, but united by their lack of significant health skills. The main one, Morgan Tookers, is a goofy ex-convict. Morgan specializes in inane comments, comical misunderstandings, and wild overreactions. His cohort is Tamra, a fierce but off-the-wall nurse with an off-and-on romantic interest in Morgan. Beverly, a dangerously inept nurse who works as an office assistant, exists to comment on the action in some unhinged way. And a more recent arrival, nurse Colette Kimball-Kinney, is generally unimpressive. Of course, all the show’s characters behave foolishly at times, and the nurses sometimes play roles in the plotlines that are similar to roles the physicians play. But the show rarely if ever suggests that the physicians are idiots in a professional context, while the nurses have tended to be potentially dangerous clinical subordinates. Except…last season the show did finally introduce a more respected minor nurse character:  pediatric nurse Ben, who is decent and intelligent. In fact, Mindy even married him at the end of last season! But in the first episode of this season, she seems pretty bored with married life, so the series may not end up that way.

For more information, see our page of analyses on The Mindy Project or the show’s pages on the Fox or Hulu sites.

 

Conclusion

Dreams, reality, actionThe ongoing physician-centric narrative of much U.S. prime time television is exemplified by shows like Grey’s Anatomy and The Good Doctor. Shows like Chicago Med, Code Black, The Defenders, and Big Hero 6: The Series may offer glimpses of nursing skill, advocacy, and (more rarely) autonomy. However, when most Hollywood shows focus on modern health care, handmaiden portrayals remain the norm, and only the amazing Call the Midwife can be expected to offer a consistently good portrayal of nursing–in the 1960s.

 

Take Action!

With all these shows, we need your help! Please watch one or more of the shows and let us know if you see a good or bad portrayal at info@truthaboutnursing.org. And please join our letter-writing campaigns to speak out to show creators, and consult our Take Action page for more ideas. If we all work on a piece of the puzzle, we can build a society that respects nursing in line with its true worth, helping to strengthen the profession so nurses can deliver better patient care. Thank you!

 

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