Why won't Hollywood fix its portrayal of nursing?

Q: Well, if all that research shows how influential Hollywood is on health care--and Hollywood itself claims credit for improving the world through "medical accuracy"--why won't it admit that its portrayal of nursing is equally influential, and take steps to fix it? Especially since the nursing shortage is now a global public health crisis.

A: Of course, there is no simple or definitive answer to this, and it's tempting to simply direct you to the major networks, studios, producers and writers and say: ask them. We can give you a few of the sadly inadequate responses some in Hollywood have given us over the years. These responses present a stark contrast to the industry's eager embrace of credit for the positive effects of its "medical accuracy" and its health messages, to say nothing of the views of public health professionals and the relevant research showing the powerful effects of entertainment programming.

Some in Hollywood have told us that their shows are not documentaries but fictional dramas; that they must be allowed some "dramatic license;" that there was a nursing shortage before their show came on the air; that it's actually better that people not see the reality of nursing today because it's so awful; that entertainment media have to focus on physicians because that's what viewers want; that the shows work hard to present a really accurate portrayal of all health professionals; and (perhaps most often) that so-and-so will get back to us about our concerns as soon as he or she can.

In our view, a full list of the factors in Hollywood's nursing problem would probably include:

(1) entrenched biases and stereotypes about nursing that persist even among the educated media elite, despite the increasing scope and complexity of modern nursing care;

(2) Hollywood's reliance on well-understood conventions and its relatively light focus on the complex realities of modern society compared to the hard news media, which is generally trained to at least try to report what it actually sees, rather than merely what its target audience expects to see;

(3) that nursing remains overwhelmingly female, but men still control most Hollywood programming; moreover, nursing has not generally enjoyed the respect or understanding of media "feminists," some of whom do hold positions of power and would be in a position to help if they cared to;

(4) a lack of support from most physicians, who are often the beneficiaries of the misportrayal of nursing, and who wield enormous power in the media, providing virtually all meaningful health care advice in Hollywood;

(5) nursing's own overall failure to adequately represent itself to the media and the public at large, as explained in Buresh and Gordon's From Silence to Voice;

(6) nurses' concerns, even when assertively presented, are not taken as seriously as the concerns of other groups, probably largely owing to the fact that nurses are still reflexively viewed as noble but unskilled handmaidens;

(7) that progress on the nursing image may be hampered by "PC-fatigue" in Hollywood, which faces scrutiny from many different quarters, and by the likelihood that nurses' concerns run counter to deeply held beliefs among some there that their work has a positive social impact; this is likely the case with some serious shows like "ER," which work hard to promote understanding of issues, diversity and tolerance as to race, gender and sexual orientation.

Taken together, these factors add up to a kind of "perfect storm" for the entertainment media image of nursing. And to be honest, we fear that some in the media could actually agree at some level that nursing's media image is causing real harm to the profession but still do little to address it, because deep down it may be so difficult for them to accept that the profession matters, having spent their lifetimes absorbing misinformation about it.

But unlike the weather, the nursing image is something that individuals can do something about, and an increasing number of nurses have, with some encouraging results. Visit our "Take Action" and Campaigns" pages to learn more.

Also see the following related FAQ's:

Come on. Even if the mass media does ignore nursing, or present it inaccurately, how can that possibly affect nursing in real life?

OK, fine. I can see that some media probably affects how people think about and act toward nursing, like maybe a respected newspaper or current affairs show on TV. But how can some TV drama, sitcom or commercial affect people that way? People know enough not to take that stuff seriously!

I get that the public health community and even Hollywood itself believes that the entertainment media has a big effect on real world health. But is there any actual research showing it affects what people think and do about health issues like nursing?

last updated October 1, 2004