Angels and advocates

The nurses of Fox’s Red Band Society

February 2015 — Fox’s Red Band Society was a teen hospital drama that featured three recurring nurse characters, each somewhat stereotypical, yet each displaying some health care ability. The show lasted 13 episodes, until February 2015, with its silly core premise: that a group of teenagers with illnesses debilitating enough to make them long-term inpatients would also be healthy enough to spend much of their time running around a Los Angeles hospital pursuing romance and hijinks. But some of the nursing elements were better than in many Hollywood dramas. The most prominent nurse character was Dina Jackson, or as she was known in early ads for the show, “Scary Bitch.” Jackson could indeed reinforce the battle-axe stereotype, but overall she was more of a savvy tough love type. She watched over the wayward teens, reined them in when necessary, and veered toward the maternal variation on the angel stereotype. At times Jackson showed some health knowledge, and even authority, advocating strongly for patients with physicians and others. Occasionally she even acted like a peer of the lead physician, at least until he “suspended” her, indicating to viewers that nurses report to physicians, a damaging inaccuracy. Brittany Dobler was “Nurse Cupcake,” not just for her baked-goods-bearing approach, but also for her perky naiveté and inexperience. Brittany made comments glorifying physicians as a class. She also had a crush on the lead physician, and they had a drunken hookup, but the show made clear that he was out of her league. Brittany wasn’t really naughty, and her care did improve, but on the whole she reinforced the unskilled angel. The least prominent nurse character may have been the best. The Latin-American Kenji was a gay man in nursing (a stereotype), and the character did check off some diversity boxes for the show, a common function of minor nurse characters in Hollywood. But Kenji also seemed like the most credible nurse on the show, not really “a character,” but strong, wise, funny, and seemingly competent, although he did not get to display much technical knowledge. Kenji kept the other two nurses from going off the rails. And the nurses sometimes talked to each other–not always about physicians! In sum, the show had some good elements for nursing, and we thank creator Margaret Nagle for those.

Scary Bitch, don’t kill my vibe

“You’re suspended”

Nurse Cupcake

“Buying tacos isn’t really part of being a nurse”

Scary Bitch, don’t kill my vibe

Nurse Dina Jackson is an authoritative veteran whose work seems to involve managing the care, especially logistics and schedules, for the small group of teen inpatients whose social interactions are the show’s focus. The September 17, 2014 premiere establishes Nurse Jackson’s tough-love relations with the teens–her own coffee cup says “Scary Bitch”–and her generally collaborative relations with the main physician character, Jack McAndrew. A new patient, the disagreeably popular Kara, puts Jackson down by saying she is just a nurse who rides the bus. Jackson chastises Kara for getting attention by pushing her call button, but Jackson does not defend nursing, and later we see that she does in fact take the bus home. Still, Jackson seems to have some authority, at least over fellow nurses; the October 15 episode includes a flashback suggesting she was involved in hiring Brittany, although she is not identified as a manager.

The portrayal of Jackson’s actual skill is mixed. She generally offers good psychosocial care, giving the teens sage (if fairly basic) advice on managing their illnesses. In the episode aired on October 8, she dispenses significant technical knowledge about patient Jordi’s cancer, giving his newly arrived mother all kinds of technical material (and also judging her, for abandoning her son). On the other hand, in the episode aired on September 24, Jackson seems to little know more than a savvy layperson who’s been around awhile. At one point, she asks physician McAndrew to explain a decision not to operate on patient Jordi in a way that doesn’t exactly suggest advanced health knowledge: “So, getting to keep his leg was a bad thing?”

Nurse Jackson advocates for patients. In the October 15 episode, the show narrator Charlie (right), comatose following a car crash, is set to be transferred to a long-term care facility because he has been unresponsive so long. Jackson has a special bond with Charlie; she pushes for him to remain. And in the next episode, aired November 5, she essentially switches Charlie’s bloodwork so he will seem to have an infection and need to stay and have various tests. (Shades of Nurse Jackie here.) Jackson also goes to see the new chief of surgery Erin Grace, who is an old friend of Jackson’s as well as being McAndrew’s ex-girlfriend. Jackson brings charts along and proposes bringing in an innovative African surgeon, now working in Israel, to help Charlie: “Dr. Naday uses brain stimulation with MRI imaging to gauge consciousness, and he’s had positive results in 89% of the patients.” In this scene Jackson does display a certain command of the technical aspects of care. And Grace agrees to try to recruit Naday if McAndrew signs off, but of course, feeling threatened, McAndrew does not, and he is also unhappy that Jackson went over his head.

McAndrew: I’m Charlie’s doctor, not you. In fact you’re not even a doctor at all, you’re a nurse.

Jackson: And my job is to advocate for my patient.

McAndrew says this is really about Jackson’s fear that she will be unable to keep a promise she made to Charlie, at the beginning, that she would be there when he woke up. Jackson counters that McAndrew’s refusal to sign off on the plan is a result of his ego, and Grace’s willingness of listen to others is why she got the chief job instead of him. He says that nothing in Naday’s work suggests he can do more for Charlie. Jackson is not exactly advocating for her own care plan; she is going around one surgeon to a more powerful surgeon, who will help her get what seems to be an even more high-end surgeon for Charlie. This is similar to a July 2009 episode of the TNT drama HawthoRNe in which the CNO lead character went around one surgeon to get a patient the option of care from a different surgeon who was more experienced in the relevant procedure. Nursing advocacy means getting the best physicians! But the advocacy element is good.

“You’re suspended”

Another problem comes when McAndrew figures out that Jackson has switched the blood work to keep Charlie around. McAndrew tells Jackson that he signed off on bringing Naday in, and she is overjoyed, until he also notes that he reported Jackson for falsifying the lab work, and then delivers this line: “You’re suspended.” Of course, physicians can’t do that, but like most Hollywood hospital shows, this one never shows the nurse manager who might actually do such a thing. Obviously, this is a damaging misrepresentation of nursing autonomy.

Jackson’s absence does give everyone a chance to comment on her actual role at the hospital. And so the November 12 episode begins with Charlie describing in voiceover how all the pediatric patients count on Jackson to know everything, like when Dash gets his first oxygen treatment of day, or that McAndrew gets cranky without his “fix” from the taco truck, which the nurses evidently handle. Some of the teens even take a moment from their busy social lives to protest, notably Dash, who actually justifies one of their hospital hijinks to McAndrew by claiming that they managed to do it because Jackson wasn’t there to stop them, to give them a group purpose. Dash notes that Jackson’s transgression was an effort to save Charlie’s life–does McAndrew think he’s the only one saving people? Then Dash collapses and needs urgent care. At least he got in a suggestion that nurses save lives, albeit without a specific example that would mean more to an audience that may think it was just a figurative comment.

Then we get a window into Jackson’s personal life. We see her at her nice home, cooking French food for her niece, who is home from college, which Jackson evidently helps finance since her niece’s mother has died. Jackson complains about the “modern medical bureaucracy,” with its “paper work and pinheads.” Her niece thinks that Jackson might go back to her “gift,” which is that she used to be a professional backup singer. Then Brittany and Kenji actually come to see Jackson, and the sensible Kenji wants her to go apologize to McAndrew. She’s not ready for that. Upon learning of Jackson’s singing background, the crafty Kenji then says he doubts she can bring it anymore. So they go out to a piano bar, where Jackson impresses by singing “Midnight Train to Georgia.” Brittany agrees with Jackson’s niece that she could actually have a singing career. But Kenji argues passionately that nursing is Jackson’s calling, because she is “there for people when they need you most,” her family and the hospital teens.

When Jackson hears about Dash, she returns to the hospital. McAndrew tells her that Dash had an “event” but is back to his baseline. McAndrew says he understands why Jackson switched Charlie’s tests, but she should not take those risks. She admits that McAndrew may not have been completely wrong. He says that’s probably as close to an apology as he will get. Jackson agrees. McAndrew says he has lifted her suspension, noting that he did not realize how much she means to the kids–“they need you, but more importantly, I need you.” Jackson: “Then I guess I’m where I need to be.” Yes, but “more importantly?” Nurses work for patients, not physicians; too bad this is so poor on nursing autonomy. Jackson goes to see Charlie–and finds his eyes open!

There is more Jackson advocacy in the episode burned off on January 31, 2015, after the show was canceled. In that one she joins 15-year-old Jordi at a judicial emancipation hearing, which he apparently needs to get a surgical procedure. When Jordi falters, Jackson speaks for him in court, arguing that he needs a break. Jackson does a decent job, but the judge observes that if Jordi can’t fend for himself at the hearing, he’s not ready for emancipation, so she denies the request.

The show’s later episodes chart the efforts of the neurologist Naday to revive Charlie, as he seems to evolve from an arrogant charlatan to an effective healer–and a love interest for Jackson, although she resists enough that she can’t really be seen as looking for romance with physicians. She could be more of a clinical peer. In the December 3 episode, Jackson just doesn’t know how Charlie’s eye-tracking device works! Naday suggests she is a Luddite. She responds that she has a smart phone (at least she knows what “Luddite” means). Later, Naday wants to ask Jackson to dinner! Jackson: “Well, you’re the doctor, whatever you think is best…for Charlie.” This may seem clever, but it reinforces the sense that physicians are the clinical masters.

In the February 2 series finale, Jackson and Naday have their first date: the funeral of one of the teens who has died. But by the end of the episode, they have wrapped up both Charlie’s care and their romance, and Naday appears to be leaving to take on a new patient challenge far away. Charlie has no need for a feeding tube anymore and he gets around in a motorized wheelchair, although he still can’t seem to talk. The show ends with a final flourish, as Charlie suddenly recovers enough to thank Nurse Jackson for keeping her promise to him! And we see Jackson the next morning, greeting a new hospital patient, a scene that more or less closes out the show.

Jackson is a strong patient advocate who displays authority and occasionally advanced knowledge, but she is also reports to the surgeon McAndrew and sometimes appears deferential and low-skilled. At times she is a bit of a battle-axe. As for the romance with Naday, there is no suggestion of the naughty nurse and Jackson does seem to be worthy of him, but the show never takes it very seriously. On balance, the character may be a net positive for nursing, but not by a lot.

Nurse Cupcake

Brittany Dobler is not a net positive for nursing. She mostly embodies the pretty but unskilled angel and handmaiden images, with a tendency to mindlessly glorify physicians as a class. She is a young and new nurse, but that’s no excuse for just how clueless she is for most of the show. To some extent, she is a throwback to the kind of angel stereotype modern Hollywood doesn’t bother with much anymore. Few in the target demographic for primetime will buy this kind of character anymore–except as an object of the kind of throwaway mockery that Brittany receives.

In the September 17 premiere, Brittany is called “Nurse Cupcake” after bringing in some baked goods for everyone. At the same time, she is very attractive, and so in this same episode she attracts the wrong kind of attention from teen patient Dash, a would-be player. He tries to leverage a sponge bath, playing on her sympathies and saying he is afraid to die a virgin, and then apparently directing her to his genitals. She leaves the room in obvious discomfort, and the show does not pursue it. Brittany is not really a naughty nurse, but the plotline does trivialize the sexual abuse real nurses suffer due in part to the idea that their work includes being sexually available–which is presumably why this teen character thought this ploy was worth trying.

Brittany’s naiveté and ignorance is a recurring, if minor, theme as the season proceeds. In the September 24 episode, Brittany is depressed because Nurse Jackson does not seem to trust her, and Brittany herself worries about killing someone. McAndrew consoles her: “It would be very difficult for you to kill anyone, Brittany.” Meaning, of course, that Brittany–and by extension all nurses–doesn’t make life or death decisions; she doesn’t have enough responsibility to kill anyone. That is incorrect and very damaging. In the November 19 episode, Charlie’s unresponsive state reminds Brittany of the main character in the 2007 film The Diving Bell and the Butterfly, which she describes as that “artsy movie [she] saw by accident” while looking to see an Ashton Kutcher movie.

Perhaps Brittany’s most notable role is mooning after the McDreamyish surgeon McAndrew — at least the show stopped short of actually making McDreamy his name, although not by much. The plotline also gives Brittany repeated chances to marvel about how awesome it is to simply be a physician. Kenji fills Brittany in on McAndrew’s romantic history with surgical chief Erin Grace in the November 5 episode, explaining that they seemed fated to end up together, but then Grace wanted to “do some good” so she went to Africa for an extended period. Brittany: “Wasn’t she already a doctor? How much more good can a person do?” In the November 26 episode, Brittany and McAndrew end up in a bar together, commiserating drunkenly about their romantic troubles. He confides that Grace thinks he is immature and “selfish.” Brittany: “Selfish? You are a doctor who helps sick children. You’re amazing.” They end up in bed. Brittany wants to plan how they’ll manage an ongoing relationship at work, but McAndrew is obviously not interested in an ongoing relationship. He asks if she’s ever had a one-night stand before. She punches him in the eye, which, along with her ongoing resentment, suggests that she’s not a total pushover. But she does seem to play the role of the nurse as temporary romantic stand-in for physicians while they are working out their relations with other physicians. We saw this theme in the 2007-2008 Grey’s Anatomy plotline in which McDreamy himself dallied with wide-eyed nurse Rose (right) before returning to Meredith Grey. And Red Band Society doesn’t just let it drop. Brittany clearly holds a grudge. Eventually McAndrew, while still apologetic, has to basically order her to get over it for the good of the patients. She eventually does, conceding that she needs to grow up.

Brittney does do some “good” herself, but mostly just by trying hard. In the September 24 episode, she plays a key role in bringing back a wayward teen patient from an escapade outside the hospital. And in the February 3 finale, she gives decent psychosocial care to the despairing mother of an anorexic patient, stressing that her daughter is a good person and the mother “made that person.” Mom is touched and she re-engages with her daughter’s therapy session.

Buying tacos isn’t really part of being a nurse

Nurse Kenji Gomez-Rejon is savvy, articulate, firm but not harsh with patients, and seemingly knowledgeable, although he does not get to display a lot of technical skills. Since he is male, Latino, and apparently gay, he promotes diversity in nursing, although he also allows the producers to show diversity without consuming much screen time–or through many characters, since he’s an all-in-one diversity vehicle.

In the November 12 episode, after McAndrew “suspends” Jackson for falsifying lab work to keep Charlie at the hospital, Kenji complains to Brittany about the extra shifts they have to work. But he also declines to do what appears to be a regular favor for McAndrew, getting him his taco, evidently as a mild form of protest. Kenji tells McAndrew that such a purchase “isn’t really part of being a nurse, it’s more of a thing that friends do; but you fired your friend.” Even so, when Kenji and Brittany visit Jackson, Kenji wants her to apologize to McAndrew and return. When the subject of her singing comes up, Kenji slyly goads her into performing, perhaps so she can recover her sense of worth or mission. But after Jackson has sung at the bar and there are suggestions that she return to professional singing, Kenji gives his speech, describing how she could have done many things in life but chose nursing; it’s her calling because she is “there for people when they need you most.” The content is fine for nursing as far as it goes–lay people can be there for others too–but Kenji is impressive for his strong interpersonal skills.

Kenji manages clinical situations with a casual competence. In the November 26 episode, he corrals an unruly pop star patient, prying her away from mocking Brittany so she can undergo some tests. In the January 31 episode, we glimpse him sensitively breaking some bad news to one of the teens. And in the February 3 finale, Kenji at least tries, with Brittany, to protect two fragile teen cystic fibrosis patients from endangering each other by hooking up.

Not all of Kenji’s scenes are great. In the September 24 episode, he tells one teen’s parents that he’ll have a “doctor” come in and discuss her heart condition, as if Kenji’s nursing responsibilities did not include patient education. And in the November 5 episode, he fills Brittany in, with enthusiasm, on the romantic history between McAndrew and the chief surgeon, which does reinforce the common role of nurses on some shows as gossipy commenters on the activities of the physicians who really matter.

On the whole, Red Band Society did at least feature three nurses who sometimes talked to patients and each other about topics other than physicians. And despite some stereotypical overtones, two of the nurses at times displayed autonomy, strength, and even some health knowledge. We thank the show producers for these positive elements. Please send your comments to Red Band Society‘s creator Margaret Nagle via her publicist Maria Herrera at Maria.Herrera@pmkbnc.com or +1-310-854-4803.

 

 

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