Editorial: Nursing on television: are we being served?

Few would argue that television has hada profound affect on modern life. As asource of popular information, it isunparalleled. In the Western world atleast, there are few homes withouttelevision, and not many with only asingle television. The modern (Western)home often has televisions in multipleliving areas and bedrooms, and somemodels of refrigerator even feature anin-built television in the door, so that,even while foraging for sustenance, nota moment of television viewing needs tobe missed. With the development oftelevision reception capacity in mobilephones, today’s television viewer canpotentially tune in wherever they are –on the train, at the beach, or at the mall.

Given concerns about the recruitmentof new people into nursing, one wondersabout the effects of television. Discus-sion about nurse recruitment tends tohighlight the increased options foryoung people today, particularly youngwomen, compared with options avail-able up until the 1960s and 1970s. It hasalso been said that nursing has an imageproblem, in that old and entrenchedstereotypes about nurses prevail. Earlyliterature suggested that television hasexerted an enormous influence on thedevelopment and proliferation of thesestrongly gendered stereotypes, such asthe nurse as doctors’ obedient andcompliant handmaiden, the authoritar-ian old battle-axe nurse, the nurse asministering angel and the naughty nightnurse (Kalisch et al. 1982, Bridges1990).

Currently, nursing and nurses remainwell represented on the television, insoap operas/serials, dramas, reality tele-vision and in advertising. Because muchpopular information about nursing isgleaned from the television, accuracyabout what nurses actually do is one of

the concerns that have been raised bynurses over the years, and this is still thecase when considering current televisionportrayals of nurses (Bauer 2007).

While nurses have long been depictedin advertisements for everything frombreakfast cereals to health insurance, insome parts of the world, nursing hasitself become an advertising focus. Dif-ficulties in recruitment and nursing’sperceived image problems have resultedin the involvement of the advertisingindustry. After all, where else does onego to resolve marketing and imagedifficulties? Thus, we see the presen-tation of slick televised advertisingcampaigns, where nursing is presented(in ultra-quick bytes) as a rewarding,challenging and thoroughly moderncareer. In these ads, we see patient(s)who are generally youngish, good-look-ing (nearly always male) and desperatelyill. These advertisements depict verypretty (or impossibly handsome), young‘nurse’ characters scanning the complexarray of equipment, upon which thisattractive patient’s life depends. Otheradvertisements in this genre show beau-tiful young people in nursing uniforms,often accessorised with stethoscopes andfacemasks, standing over humidicribscontaining tiny, calm and very cuteinfants, or alongside attractive, sereneand smiling new mothers, holding per-fect healthy infants.

Obviously, a 30-second commercialcannot show every aspect or nuance ofany profession; therefore, the advertise-ments tend to focus on the perceiveddramatic and exciting aspects of nurs-ing. Judging by those advertisements Ihave seen, these seem to be the intensivecare environment, emergency, maternityand children’s nursing. Advertisementsdepicting nursing in the mental health,aged care, or community environments,

or the other diverse settings wherenurses practice, are less common. Ofcourse, in these settings, the patients/clients are often not particularly cute orphotogenic. Furthermore, in these typesof settings, high-tech gadgetry can bequite thin on the ground, with the realtherapeutic expertise embodied in theform of skilled and experienced nurses –something that would be infinitelyharder to capture in a short televisionad byte.

In the interests of balance, it shouldbe noted that some of the longer info-mercial-type productions shown on thespecialist health or education televisionchannels, capture more accurate andvaried images of both nurses andpatients. A notable example of this isthe USA produced Dare to Care recruit-ment video, which features age, genderand cultural diversity among nurses, andsome realistic looking patients. Dareto Care also acknowledges nursing’sunique contribution to healthcare, anddepicts some of the non-hospital settingsthat nurses practice in. However, atapproximately four minutes duration,this would be unlikely to be shown oncommercial television (the costs wouldbe enormous).

When considering serials, soap operasand dramas, it is doubtful that any othersetting has been as popular a backdropto these popular genres as the hospital.Hospitals seem to hold endless fascina-tion to the viewing public. Numeroussoap operas, dramas and serials arebased around hospitals, and build theirstorylines around the private workingsof the hospital, the patients and theprofessional groups in hospitals. Ofthose professional groups, nurses maybe the most visible, with nurses some-times being cast (alongside doctors) ascentral to the plot. However, and as was

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noted in the literature more than30 years ago (Kalisch et al. 1982), thenursing focus in this genre of entertain-ment is (still) frequently on the love livesand the personal vicissitudes of theindividual nurses themselves, ratherthan on the jobs that they do.

However, this is not always so, andepisodes of the UK show Casualty forexample, have depicted nurses as intel-ligent professionals, shown nursingcharacters as being engaged in skilledinteractive nursing work, and presentedstory lines that reveal the centrality ofexpert nursing care to the overall out-comes for patients. Other dramas oftenhave far less visibility for nursing roles,which may be barely in evidence. Inthese latter types of series, nursing andnurses may be depicted almost as props– presented as incidental and supportiveto medical roles. This particular depic-tion has changed little over time. In astudy of how nurses were representedon prime time television in the 1950sthrough to the 1980s, Kalisch et al.(1982) noted that nurses were consis-tently depicted as deferential and sub-servient to doctor characters, citing theMarcus Welby MD and Consuelo Lopez(the practice nurse character) dynamicas one example.

Then there is the hospital reality ordocu-drama; a genre where the camerais placed into busy hospital settings, andvarious aspects of ‘real’ hospital workare captured, edited and packaged as

entertainment/information for the view-ing public. In RPA, an Australian realityshow that focuses on the Royal PrinceAlfred Hospital in Sydney, selectedpatients are followed through the courseof their illness, from the time of presen-tation to the hospital or hospital spe-cialist rooms, through treatment andhospitalisation, to discharge, and then(sometimes) a post discharge follow-up.Although interactions between thesepatients and their treating health pro-fessionals are often shown, they areoverwhelmingly with medical staff, andvery few interactions with nurses appearin the series. In contrast, a seven partNew Zealand docu-drama, Nurses,filmed on site at the busy Auckland CityHospital, had more of a focus on whatnurses do. One of the reported explicitaims of this series was to ‘explore therelationships that nurses form with theirpatients and peers’ (Anon 2005:8).Although the series focussed on the highdrama areas of the emergency depart-ment and critical care, and so did notcapture some of the less dramaticaspects of nursing, nursing media re-ports suggest that nursing professional-ism and skill were highlighted, and thatthe series presented the profession in apleasing way (Anon 2005).

If we judge interest in a profession asbeing able to be in some way measuredby the amount of television time that isdevoted to it, it would seem that nursingfares better than many others. It is

undeniable that the public interest innursing and nurses continues. Notwith-standing that the televised images ofnurses and nursing are not alwaysexactly what we might want to portrayand may often not capture the full depthand breadth of nursing roles, otherprofessions would likely welcome theamount of television time that nursingmanages, with no apparent effort, toattract. Our challenge is to make themost of this interest – to take advantageof it, and harness it to raise awareness ofnursing, and to improve engagementwith and recruitment into the profes-sion.

Debra JacksonEditor, JCN.E-mail: debra.jackson@uws.edu.au

References

Anon (2005) Television series raises nurses’

profiles. Kai Tiaki Nursing New Zealand,

December/January 2004/2005, 8.Bauer J (2007) How could television improve

its portrayal of nurses? RN Magazine 70,

21–22.

Bridges JM (1990) Literature review on theimages of the nurse and nursing in the

media. Journal of Advanced Nursing 15,

850–854.

Kalisch P, Kalisch B & Clinton J (1982) Theworld of nursing on prime time television,

1950 to 1980. Nursing Research 31, 358–

363.

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Editorial