Grey’s Anatomy is a little bit sorry about that “skanky syph nurse” thing
In the ABC show’s 14th season, Nurse Olivia returned with some verbal payback for surgeon Alex Karev. But the hospital drama continued to focus on heroic physicians providing all the care that mattered, while nurses were low-skilled serfs who could, at most, alert the physicians to problems that the physicians alone could solve.
May 2018 – Season 14 of ABC’s Grey’s Anatomy carried on the hospital drama’s rarely-seen-or-heard approach to nursing portrayals. Once again, a slew of surgeons did everything important, and the show regularly glorified them, not least with its signature voice-overs from lead character Meredith Grey, like this one from episode 14: “For surgeons, every day is game day.” And for nurses, every day is peripheral subordinate day. The season’s only notable appearance by a nurse character came in episode 21, when Nurse Olivia returned from the show’s early seasons to haunt attending Alex Karev. Longtime fans will recall that in season 2 episodes 11 and 12, airing in 2005, then-intern Alex had sex with the wide-eyed Olivia and gave her syphilis. That led Alex’s furious girlfriend, intern Izzie, to label Olivia a “skanky syph nurse,” which was a minor landmark in the history of naughty nurse stereotyping. Before long Olivia went away, as the show’s few nurse characters always do. But now she is back, all grown up with a son who has an object stuck in his throat. And of course treatment for that falls to Alex, now an attending pediatric surgeon. Olivia accepts this care, but she also objects repeatedly to her past mistreatment, pointing out that no one back then was calling Alex “syph doc.” These remarks briefly unsettle Alex’s relationship with his fiancee, surgeon Jo. Olivia also displays some social skills and a little health knowledge. But she is still not presented as anything like a peer to the expert surgeons. And the minor plotline is not enough to redeem the show’s overall portrayal of her or, needless to say, of nursing as a whole. The Grey’s creator is Shonda Rhimes.
See the nurse Olivia plotline below:
You’re the surgeon
Every major Grey’s character is a physician, and nurse characters play no significant role in the vast majority of the show’s clinical scenes. When nurses appear at all, it is likely to be in the background, maybe pushing a gurney or fiddling with some device. Occasionally, they may be involved in a code or operating room sequence, or they may pass a message from one physician to another physician. But they rarely speak beyond what is needed to tell physicians they are complying with some direction (e.g., “right away!”). Nurse characters almost never speak to patients or other nurses. And they are almost never seen to provide any care without a physician present. Meanwhile, the physician care is not limited to the real-world physician roles, but also includes activities in which nurses would likely be far more involved in real life, such as bedside surveillance and monitoring, patient education, and psychosocial care.
During the course of this season, a couple nurse characters besides Olivia did get a few lines. In episode 11, senior attending Miranda Bailey has a heart attack while she is out and about, in a plotline that seems to be an infotainment vehicle about poor treatment of heart attacks suffered by black females. Bailey is forced to take herself to a different hospital. There, she bullies an uncooperative senior emergency department (ED) nurse into taking her condition seriously (in fairness, Bailey also bullies the hospital’s sub-par physicians). Later, we see that same ED nurse trying to keep Bailey’s physician friends from visiting her; they eventually figure out that they can get past the nurse if they claim they are Bailey’s family members. When they reach Bailey, she is actually doing CPR on a nearby ED patient, by herself. Naturally, none of the hospital’s nurses was able to detect the patient’s impending doom or doing anything about it. As for the senior nurse who did have a role, she was a rule-bound bureaucrat, the usual modern form of the classic battle-axe stereotype.
In episode 20, many of the physician characters unwittingly ingest marijuana by eating some cookies. At one point, an African-American nurse alerts physicians to a coding patient. A stoned physician resident rushes to help. But his altered state prevents him from functioning well.
Nurse: Patient is in septic shock. Systolic is 90 and falling. Heart rate 130. He had a bolus of L.R. (lactated ringers).
Resident: Oh man, he needs a central line.
Nurse: Then put one in.
Resident: You do it.
Nurse: I can’t! You’re the surgeon!
Resident: No, I can’t, I’ll get someone…
The resident backs away, falls down, and is injured.
Nurse: I need help in here! … My patient needs a central line!
Compared to the usual Grey’s portrayal, this nurse is knowledgeable, assertive, and high-functioning. She can also be seen as panicky, too aggressive, and unable to do much more than report symptoms and call for help. And of course, she is onscreen for no more than a minute.
You’re the doctor
Nurse Olivia, last seen in a 2009 episode, returns in episode 21 of this season. At this point, attending surgeon Alex Karev and resident Jo Wilson are planning their wedding after a long and somewhat rocky relationship. Alex, never very communicative, also seems to be preoccupied with something he won’t talk about. Enter Olivia, now with the surname Jankovic, who arrives in the ED with her young son Milo. She tells a couple physicians on duty, one of them Jo and the other an intern, that she thinks Milo has swallowed a toy. Milo wheezes and Jo suggests that sounds like a good diagnosis. Olivia adds that she thinks it may be lodged in the epiglottis and asks whether they should go to trauma 1. She explains that she used to be a nurse at the hospital, a long time ago. Later, Olivia relates that her family (including her husband) were just at her parents’ house when her father starting talking politics, so maybe her son was looking for an easy way out by swallowing the toy, ha ha. The intern doesn’t get the joke. Olivia tells Jo that she sees they are “still getting the interns straight from Mensa.” Jo wants X-rays. Olivia brings up some sexual harassment allegations that have recently hit the hospital. She is not surprised: “When I was here, you wouldn’t believe the [indistinct] we had to put up with.” They need a pediatrics consult for Milo, and of course that is Alex. It’s awkward. He and Olivia greet each other. Still very resentful, Olivia covers her son’s ears and addresses Jo: “Is he still giving nurses syphilis, or has he moved on to gonorrhea?” Obviously, Jo is not thrilled to hear that.
Later, we see Alex examining Milo conscientiously. Alex asks if Olivia is still living in Seattle. She says no, she moved to Sacramento, and met her husband, who is “intelligent, kind, faithful, not your crowd at all.” Alex just smiles, and prescribes X-rays. He talks briefly to Jo outside about their wedding, then leaves. Olivia overhears and asks Jo if she and Alex are engaged. Jo says yes.
Olivia: “Best of luck with that.”
Later, Olivia returns to the theme.
Olivia: “Syph nurse, that’s what they called me, it was all over the hospital…lotta laughs. I got’em from Karev, but nobody was calling him syph doc.”
Jo agrees that is awful. Olivia guesses she should just shut up, but she thinks Jo seems pretty great, so she has to disclose more bad Alex behavior:
Olivia: “You know he cheated on his first wife, right? … He cheated with me. So, he kind of lost the moral high ground on that one, and to be fair, they weren’t married yet, so, slightly less horrible on his part.”
Jo takes this pretty well, noting evenly that that was a long time ago and people change. Olivia agrees, although she adds that it “couldn’t hurt to get tested” (for syphilis). Alex appears. X-rays show the object is lodged in Milo’s right main stem bronchus and Alex would like to get it out before it causes a broncho-spasm. He asks if Olivia is OK with that.
Olivia: “You’re the doctor.”
In Milo’s surgery, Alex tells the intern working under his supervision to do it right, because the kid’s mom hates Alex enough as it is. Jo, also present, notes that Alex did give Olivia syphilis.
“Olivia has a right to be pissed. I was an idiot back then. They used to call me evil spawn.”
Jo is troubled about Alex’s past cheating on his first wife. Alex asks if Jo really thinks he is still like that, a bad person. Jo says no, but she believes Alex is being weird about setting a wedding date, so she is troubled. With instructions from Alex, the intern successfully removes the toy from Milo. Later, Alex visits Milo and says he is well enough to leave the hospital. Alex good-naturedly tells Milo not to let Alex catch him back at the hospital next week with a skateboard or X-Box in his throat. Milo admits it was dumb for him to ingest the toy. Alex says we all do dumb things, then we outgrow them. Olivia understands this comment from Alex has a larger meaning. Olivia seems impressed with Alex’s overall performance and personal growth. She says, “Thanks, Dr. Karev.”
Alex: “You got a good kid, I’m happy for you.”
As Alex leaves, Olivia gives Alex her opinion of Jo:
Olivia: She’s too good for you.
Alex: You think I don’t know that?
Later, when Jo is still troubled about her relationship with Alex, Alex tries to assure her that his unfortunate deadlings with Olivia are well in the past:
Come on, you’re seriously gonna listen to some nurse I slept with when I was a stupid intern?
Jo says no, but she is concerned with Alex’s recent treatment of her, Jo. Alex confesses that the problem is that Alex has discovered that his mom, who lives far away and is not in close touch, has not been cashing the checks Alex has been sending her. So Alex is worried about his mom. Jo understands, and as far as Olivia goes, Jo assures Alex that he has changed, he is not the same person he was long ago.
This plotline does have some relatively positive features. Olivia displays a little health knowledge, some social skills, and some strength in advocating for herself, even if more than a decade too late. The show producers seem to understand, at least now, that the “skanky syph nurse” scenario it had fun with all those years ago was not great for women. And there may even be a hint here that it was not great for nurses, that it presented them as disposable physician groupies, although maybe that would be giving the show too much credit. Olivia does say that no one back then—meaning none of the surgeon characters the show has always glorified—was calling Karev “syph doc,” even though he was the one who gave Olivia syphilis. But now, Jo models a way to interact with nurses that is more respectful (note her comment that Olivia made a “good diagnosis” of Milo). And Olivia is clearly a stronger character here. However, she’s not really a peer of the physicians. Instead, she is still just “some nurse” and it’s the physicians who are “straight from Mensa,” even if some lack social skills. Olivia’s comment to Alex that “you’re the doctor” seems benign and a standard thing to say, but coming from a nurse character, it aptly sums up the show’s regressive views: Only physicians really have health expertise and even nurses should just defer to them in the clinical setting. And Olivia’s own recounting of the slur from years ago contains an odd cover-up, omitting the critical “skanky” part that gave the insult far more bite, especially for nurses, who continue to encounter the naughty nurse stereotype. So on the whole, the plotline doesn’t do much to address the contempt for nursing that Grey’s Anatomy continues to display.