Truth Hearts Midwife
Fall 2019 TV preview: All your favorites, plus the return of Ratched
Call the Midwife will still offer a strong portrayal of nursing. Chicago Med and The Resident will show some nursing skill and advocacy, although physician characters dominate them. And the all-physician narratives of shows like Grey’s Anatomy and The Good Doctor will remain. The new sitcom Bob Hearts Abishola features a nurse who seems competent, although she also hopes her son will become a physician. And oh yeah—OG battle-axe Nurse Ratched returns in a high-profile Netflix series that will likely be very damaging to nursing.
September 2019 – The new U.S. prime time season offers a range of health-related shows, most highly physician-centric, a few with some value for nursing. First among new shows, we have Netflix’s Ratched, an origin story for the prototypical nurse battle-axe that will apparently arrive in late 2019. There’s little chance Ryan Murphy’s show will avoid reinforcing the misogynous stereotype that powerful female nurses must be evil. Please click here to send a letter to the producers! On the new CBS sitcom Bob Hearts Abishola (premiering Sept. 23, 2019), a Detroit sock salesman falls for his cardiac nurse, an immigrant from Nigeria. Abishola seems tough and fairly knowledgeable, but sadly, she also tells her son she wants him to become a physician so he can take care of her when she is old. The show seems unlikely to focus on the clinical setting. On another new CBS sitcom, Carol’s Second Act (Sept. 26, 2019), a woman becomes a physician at 50 and is surrounded by much younger medical interns. Five of six main characters are physicians. There are no nurses. And among returning shows, physicians likewise still dominate. It’s true that the BBC’s powerful Call the Midwife (early 2020) will offer a ninth season of nurse-midwives providing expert, autonomous community health care in 1960s London. The show has roughly 10 major nurse characters, more than every other show discussed here combined. Tune in to Call the Midwife to see the best show for nursing! Also, the reboot of the family sitcom One Day at a Time will be back for a fourth season in 2020, although on CBS’s streaming service Pop TV, not Netflix. Lead character Penelope, now a nurse practitioner, has shown some health skills, although the show’s understanding of nursing is limited. ABC’s The Good Doctor (Sept. 23, 2019), back for a third season, focuses on a brilliant young surgeon who has autism. There are six major physician characters, but no nurses. ABC’s Grey’s Anatomy (Sept. 26, 2019) returns for a 16th season with a dozen brilliant surgeons doing everything that matters, and a few appearances by meek handmaiden nurses. NBC’s New Amsterdam (Sept. 24, 2019), back for a second season, focuses on the brilliant medical director at a fictional version of New York’s Bellevue Hospital. All six major characters are physicians. NBC’s Chicago Med (Sept. 25, 2019), starting its fifth season, is also mainly about six physicians. But it has two competent emergency nurse characters who actually think and talk, plus a strong hospital executive who is a nurse. Fox’s The Resident (Sept. 24, 2019) returns for a third season focusing on the exploits of a rebellious (and brilliant) Atlanta hospital resident. Five main characters are physicians, but the sixth is nurse practitioner Nic Nevin, who displays skill, advocacy, and some autonomy. Returning shows from overseas, like the U.K.’s The Good Karma Hospital (available in the U.S. on Acorn), also offer physician-centric visions. At least the final season of Canada’s Mary Kills People (not yet available in the U.S.) features a nurse as the wisecracking sidekick of the euthanizing physician lead character. Please join us in encouraging better portrayals of modern nursing!
Bob Hearts Abishola (CBS)
Carol’s Second Act (CBS)
Call the Midwife (BBC/PBS)
Chicago Med (NBC)
The Resident (Fox)
One Day at a Time (Pop/Netflix)
The Good Doctor (ABC)
Grey’s Anatomy (ABC)
New Amsterdam (NBC)
Castle Rock (Hulu)
Ever since media sources reported two years ago that Netflix had bought the new Ryan Murphy project Ratched, the Truth and others have tried to persuade those involved not to reinforce the damaging stereotypes of nursing that seem inherent in the archetypal battle-axe nurse character. Now the show appears to be due for release in late 2019. Creator Evan Romansky’s Ratched is reportedly an origin story that traces the title character’s “evolution from a low-level nurse into the severe, manipulative tyrant who terrorizes mental institution patients in Ken Kesey’s 1962 novel,” and of course Milos Forman’s 1975 film, One Flew Over the Cuckoo’s Nest. Nurse Ratched embodies the enduring battle-axe stereotype of nursing, the idea that any female nurse in authority must be a repressed maternal tyrant bent on torturing patients and emasculating innocent, freedom-loving men. Deeply misogynous in its linking of female power with insidious oppression, the portrayal has spawned countless copies and variations in ensuing decades, right up to characters in recent television shows like Grey’s Anatomy. It would take great skill and care to make a show about this character and not have it cause serious damage to nursing. Ryan Murphy’s track record on nursing does not inspire confidence; consider his damaging misportrayals on Glee (2). Of course, Murphy has shown some concern for women’s issues. His aesthetic seems to reflect an interest in powerful, gloriously damaged females, for example in American Horror Story and Feud. But even if viewers need another hilarious portrait of twisted female malevolence, nursing does not. Female-oriented media stereotypes like the battle-axe have played a key role in the global nursing shortage that takes countless lives, especially through under-staffing. In fact, nurses as a class are not sociopathic monsters, but college-educated science professionals of all genders who evaluate, educate, advocate for, and save patients. Research shows that popular media stereotypes play a role in undermining nurses’ claims to respect and resources. Please join us in urging all involved in Ratched to at least reduce the damage by introducing some nuance in the title character and featuring other nurse characters with some of the positive traits of real nurses, such as expertise, courage, and decency.
Bob Hearts Abishola
This new sitcom focuses on earnest Detroit compression sock salesman Bob, who has a heart attack and falls in love with Abishola, a no-nonsense nurse who cares for him at the hospital. She is originally from Nigeria, so culture clash etc. That may not sound like a show that is destined to last long, but it is the latest offering from producer Chuck Lorre—the “King of Sitcoms”—so it may do just that. Previews suggest that the show will aim to increase tolerance. Abishola projects confidence, and she seems competent and snarky in the limited clinical interactions we see. She tells Bob three stents is not really a lot, for a man his size. And the show gets points for featuring a nurse character who is an immigrant from a developing nation, as so many are, and who is making significant contributions to U.S. society, as so many are. But this is still a mainstream U.S. sitcom, with the cliches and assumptions that entails. And none of the major characters besides Abishola appears to be a hospital worker; the show is really about the strikingly different social groups of the two leads. So it is unlikely to question the prevailing Hollywood stereotypes of nursing in a significant way. On the contrary, it may reinforce them. When Abishola’s young son says he wants to accept an invitation to join the school track team, she responds: “You want fun? Study hard, become a doctor, and take care of me when I’m old.” Really? So, not just implied contempt for her own profession, but a nurse thinks the most important health provider to take care of an older person is a physician? Anyway, the show’s effect for nursing may depend on there being as few interactions like that as possible, and as many casual displays of clinical knowledge and competence as possible from Abishola.
For more information, see the Bob Hearts Abishola page on the CBS website.
Carol’s Second Act
Another new CBS sitcom that does seem to take place mainly in the clinical setting is Carol’s Second Act. That one focuses on a divorced empty nester who decides to become a physician and is surrounded by hospital interns half her age, so culture clash etc. Plenty of major health care characters here, but all five are physicians. And previews of the show suggest that they will be presented as the primary care givers at the hospital where they practice, or at least the only ones who matter. That is in itself a damaging message, since nurses are generally the most numerous health professionals in a hospital. Previews also suggest the snark content may be high, so nursing seems unlikely to avoid mockery—although in one scene, the chief resident says contemptuously that those who fail as medical interns may become dentists, so we guess nursing dodged a bullet there. Maybe from dental school they can go on to lead the National Institute of Nursing Research!
For more information, see the Carol’s Second Act page on the CBS website.
Call the Midwife
The BBC’s Call the Midwife (airing on PBS in the U.S.) returns for a Christmas special in December 2019, a ninth season in early 2020, and later for seasons 10 and 11. The drama follows the exploits of community-based nurse-midwives caring for poor women and others in London in the 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, skilled community physician who plays a critical role in some plotlines. In its first eight seasons, the show has generally presented the midwives as expert and autonomous health professionals. Their 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, often confronting the effects of larger social problems. In episode 5 of the seventh season, the fairly new nurse Lucy Anderson gave excellent psychosocial care to a pregnant woman who, it turned out, had been badly traumatized by the forceps delivery of her first child. The woman responded to labor by locking herself in a bathroom, putting the baby at risk, but Lucy talked her out and gave her adept support through a safe delivery. The midwives also provide critical community-based care well beyond midwifery. In that same episode, a Nigerian sailor was shunned and driven underground for having what most thought was smallpox. But veteran nurse Phyllis Crane managed to locate the sailor and then determined that he had not smallpox but leprosy, which could be treated. A key reason this show is so strong for nursing is the central role played by two real nurses: Jennifer Worth, whose memoir is the basis for the series, and the expert midwife Terri Coates, whose 1998 article “Impressions of the Midwife in Literature” inspired Worth to write, who served as midwifery editor for Worth, and who has been deeply involved in the television series from the creation of scripts to filming. We thank show creator Heidi Thomas and all who are responsible for Call the Midwife.
NBC’s Chicago Med, which returns for a fifth season, is probably 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 the nurses regularly display skill and knowledge, with limited obsequiousness. Three major nurse characters, all women of color, get significant screen time. Two more recurring staff nurse characters get lines and names (Doris and Monique), and they are generally competent, if assistive. Perhaps the most visible nurse character is April Sexton (above), a young ED nurse, who is very solid in the clinical setting. She does not just report vital signs but also displays knowledge and interacts with patients, although the show probably spends more time on her romantic life and other personal issues. In episode 16 of the fourth season, April worked closely with her sometime boyfriend, ED physician Ethan Choi, to provide good psychosocial care to a family in which the parents were pressuring one child to donate bone marrow to another child who was dying of leukemia. The show seems to portray the more senior Maggie Lockwood as a permanent charge nurse, and she runs the ED, logistically. In that same episode, Maggie worked closely with ED physician Will Halstead to determine how a patient with hypothermia ended up in the ED. Both of these nurse characters are serious, skilled assistants to the physicians, in the ER mode. The third nurse is executive Sharon Goodwin, who has overall responsibility for the trauma center and is often called upon to resolve disputes. She is wise and tough, but not a battle-axe. In that 16thepisode, in typical Goodwin plotlines, she had to determine if the potential bone marrow donor child had really consented to the procedure, and also to mediate a clinical dispute between two hotshot surgeons (and ex-lovers). All three nurses seem to be personal friends with the physicians, something that would be unthinkable on a stratified show like Grey’s Anatomy. Of course, Chicago Med’s structure still indicates that physician skills and actions matter most.
For more information see the Chicago Med page on the NBC website.
This Fox hospital drama will offer a third season of exploits from renegade senior resident Conrad Hawkins and his Atlanta hospital cohorts, as well as, if prior seasons are any guide, an unusually heavy focus on the need to reform certain aspects of U.S. health care. All major characters are physicians, except for nurse practitioner Nicolette Nevin (above), arguably the best single nurse character now on U.S. television. Nic is a sometime love interest of Conrad’s. But she is also his chief clinical ally, and she regularly displays intellect, skill, patient advocacy, and some autonomy. Season 2 saw Nic establish a hospital-affiliated community clinic, along with an itinerant physician who was even more renegade than Conrad, although as that physician noted when he finally moved on in episode 22, Nic never really needed him. Nic also spent the season advocating in the clinical setting; in many episodes, she had to do so for her unfortunate sister, who struggled to overcome addiction and then the life-threatening effects of an experimental drug trial gone wrong. Nic feared no one. In episode 17, for example, she went head to head with the show’s House figure, the uber-arrogant surgeon Austin, who wanted to give the hospital’s one available ECMO machine to his 60-year-old surgical mentor rather than Nic’s patient, a 22-year-old student. With support from a couple other physicians, Nic prevailed. Also on the upside, although Nic’s ID said “BSN, NP” in the first season, in the second season we noted that it was “MSN, NP.” On the other hand, Nic often functions as a skilled aide-de-camp to Conrad. And nurses other than Nic mostly seem like little more than peripheral subordinates. There were limited exceptions. OR nurse character Jessica Moore is generally competent enough, although she tends to be meek in clinical settings and socially maladroit. A recurring nurse character in the ED, Ellen Hundley, is respected and competent, although she is assistive and rarely shows much technical skill or autonomy. On the whole, for all the merits of the Nic character, many depictions of nursing on the show are no better than those on shows like The Good Doctor.
For more information see The Resident’s page on the Fox website.
One Day at a Time
This reboot of the 1970s Norman Lear sitcom was canceled by Netflix in 2019 after three seasons, but soon picked up by the CBS streaming service Pop TV for a fourth season in 2020. It features nurse lead character Penelope Alvarez, a Cuban-American veteran who served as a nurse with the U.S. Army in Afghanistan. Now living in East Los Angeles, she practices with a goofy older primary care physician, and as the third season ended she had just become a nurse practitioner. Penelope struggles as a single mother with two school-aged kids and depression linked to her wartime experience. The show is mainly a traditional home-based sitcom exploring social issues, not health care. Still, Penelope has engaged in patient education and advocacy. In the third season, though, the nursing element was focused mainly on the final stages of Penelope’s preparation to become an NP, a plotline that was inaccurate and damaging. Penelope repeatedly freaked out about how challenging her studies were, having nightmares about missing diagnoses, which was helpful to an extent in showing that becoming an NP is challenging. But the show also presented NP education as largely a process of independent study for an “NP test” (which it half-jokingly compared to Penelope’s daughter’s SAT exam in episode 9), with occasional mentoring from Penelope’s physician colleague, rather than a university degree program run by nursing professors. In episode 13, Penelope graduated from “Our City of Angels Nursing School.” Her family cheered and waved a Cuban flag. But the ceremony was in a small room with few academic trappings; it could have been a non-university certificate program. She was thrilled to arrive at work later to see her name plate below the physician’s, reading “Penelope Alvarez F.N.P.” (no degree). Penelope has been portrayed as a committed and knowledgeable nurse. But so far those benefits have been undermined by the limits of her practice at the outpatient office and, especially, by the show’s undervaluation of nursing education.
The Netflix site for One Day at a Time still has episodes and information about the show.
The Good Doctor
ABC’s drama The Good Doctor, back for a third season, showcases the physician-centric vision of hospital care we would expect from House creator David Shore. The show focuses on Shaun Murphy, a young surgeon with autism and savant syndrome. That status seems to enable him to perform amazing medical feats, but it also presents daunting social challenges. Eight of the show’s ten main characters are physicians, none are nurses, and in the great majority of clinical scenes, nurses do not even appear. When they do, it is typically as meek assistants. The nurses receive commands from the physicians or silently complete basic tasks, like handing the physicians things during codes. In the second season, physician nursing remained frequent, as in episode 2 where we saw a physician manage a ketamine drip. There was one extraordinary plotline about gender bias in episode 3 that included an OR nurse actually challenging the conduct of a senior male surgeon toward a junior female surgeon, and then refusing to back down or leave even when he ordered her from the OR. The episode did leave viewers with the impression that the surgeon was supposed to be in charge, and there never was a suggestion that nurse managers existed. But the nurse played a key role in pushing the surgeon back and she never did appear to suffer for it, making the plotline a sort of isolated landmark for this show. Much more typical was a nurse’s panicky-layperson reaction in episode 11, during a high-stress quarantine plotline, upon seeing the surgeon Murphy curled up on the floor: “I think there’s something wrong with him.” In any case, the vast majority of the second season, like the first season, showed physician characters delivering all the care that mattered, including patient interactions, while nurses appeared, occasionally, as low-skilled helpers. We anticipate more of the same.
For more information, see The Good Doctor’s ABC website.
ABC’s Grey’s Anatomy returns for its 16th season, and as always, it will feature about a dozen major characters, every one a surgeon. Consistent with that lineup, the show continues to reinforce the idea that physicians provide all meaningful bedside care. That includes many things nurses would do in real life, not just exciting procedures like defibrillation but also patient monitoring, psychosocial care, and even wound care. In episode 19 of the 15th season, three female surgeons handled all the care of a sexual assault victim, including all psychosocial care and forensic procedures, which a SAFE nurse would likely do in a major urban hospital like this one. Over the years, nurse characters have appeared on Grey’s, usually embodying stereotypes, particularly the helpless handmaiden. And anonymous nurses occasionally hand physicians things or absorb physician commands, perhaps with an obsequious “right away, doctor!” The 15th season did feature a few appearances by feisty veteran OR nurse Frankie. In episode 7, the pregnant nurse got to banter with senior surgeon Richard Webber over their shared history at the hospital, before she ultimately died in childbirth, despite the support of an aggressively vigilant but mostly helpless group of quirky fellow nurses. Supposedly Webber had hired Frankie long ago because she was number one in her class at “nursing school” and knew her “way around a central line” better than anyone! That’s a nice vague compliment, but so much for nurse managers as the ones who hire nurses. The plotline reflected a pattern: When shows like Grey’s do feel the occasional impulse to portray nurses, they are more likely to feature them more as patients, presumably because of a view that what they actually do as nurses is of little interest. Here, an apparent effort to pay tribute to nurses as devoted hospital staff ended up reinforcing stereotypes, with indications that physicians hire and manage nurses, and that nurses’ clinical role is admirable but limited. This plotline also suggested that nurses are a motley crew of somewhat feisty but somewhat pathetic oddballs. We imagine the show sincerely hopes nurses liked this pat on the head.
NBC’s New Amsterdam, set at a fictional version of Bellevue, New York’s legendary public hospital, will return for a second season. The show has six major physician characters and no nurses. Lead physician character Max Goodwin is a maverick medical director who, as network promotion promised last year, was determined to “tear up the bureaucracy to create a hospital that cares.” In the first season, a lot of what Max pushed bore a striking resemblance to traditional holistic nursing care, especially psychosocial care, but of course on the show it was presented as his medical innovation. As you would expect from its structure and heroic-physician approach, the show consistently told viewers that only physicians matter in the clinical setting, and even the nurses who did appear tended to be peripheral subordinates with no important role in care. The show repeatedly told viewers that the nurses reported to Max and the other physicians, even though at times that message took the form of Max expressing concern for the nurses’ wellbeing. A minor exception to the nurse-free plotlines was recurring ED nurse Casey Acosta (above). He was kind of a bantering sidekick to the talented but troubled ED physician Lauren Bloom in the first half of the season, and he continued to appear occasionally in ED scenes after she went to rehab. Casey was clearly assistive, but he occasionally showed some skill and authority in clinical situations. Perhaps most notably, in episodes 8 and 9 he actually pushed the Adderol-abusing Bloom to seek help, after we saw him correct at least two of her egregious and dangerous medication errors. This was a good, if limited, example of nurses’ role in patient advocacy and error prevention. But overall, despite all the talk about re-inventing health care, New Amsterdam followed the standard physician-centric Hollywood model.
For more information on New Amsterdam, see the show’s website.
We added a review of Castle Rock after we initially published this 2019 Fall TV preview. Please click here to see our Castle Rock preview.
The physician-centric narrative of much U.S. prime time television is exemplified by shows like Grey’s Anatomy, The Good Doctor, and New Amsterdam. In fairness, shows like Chicago Med and The Resident do offer examples of nursing skill, advocacy, and even autonomy. But for most Hollywood shows, 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.
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