Who are nurse practitioners?

September 7, 2004 -- Tonight the popular television quiz show "Jeopardy!" implied that Nurse Practitioners treat only "minor ailments," rather than the critical illnesses and complex procedures that many handle every day. In fact, a growing body of research shows that NP care is at least good as that of physicians. The common media stereotype of Advanced Practice Registered Nurses (APRN's) as minimally trained sub-professionals must end if we are to improve nursing's image and strengthen the profession. We need your help.

On "Jeopardy," contestants receive the answer to a question, and they must provide the correct question to win points. In this episode, there was an "answer" stating: "Minor ailments can be treated by NPs (Nurse-practitioners) & PAs (these)." The contestant answered "correctly" by saying, "What are 'Physician's Assistants?".

This phrasing wrongly suggests that NPs treat only minor ailments, and that major ailments like cardiac disease, cancer, diabetes and asthma cannot be treated by them. But in addition to treating patients with conditions like those above, NP's care for patients in a wide variety of complex settings in which lives are on the line, from the certified nurse midwives who deliver babies to the nurse anesthetists who attend to patients during major surgery.

One of the most damaging anti-nurse stereotypes is that advanced practice nurses aren't real health care providers. The media often implies that patients see NP's for a sore throat or an ear ache and nothing more. This sends the message that NP's are minimally trained sub-professionals who deal with matters so simple that physicians can't be bothered, a message reinforced by the physician organizations that lobby hard to prevent APRN independent practice and reimbursement. (The ostensible reason for the intense physician campaigns is concern for patient well-being, but APRN organizations see a clear anti-competitive motive.) We very rarely see articles mention the increasing number of clinical studies finding that APRN care is equal to or better than that provided by physicians. Instead, as our recent write-ups of pieces in Vogue, MSNBC, the New York Times, and Good Housekeeping illustrate, the media routinely suggests that the care of APRNs is inferior to than that provided by physicians.

In our view, perpetuating the stereotype of NP's as sub-professionals is not unlike presenting the view that AIDS is not caused by the HIV virus without mentioning the wealth of clinical research finding the opposite.

See our update on the Jeopardy campaign!

Prior action is below:

Nurses need to educate not only our legislative bodies about the quality of APRN work, but also the media, which affects how the public--and public officials--view health issues. We urge you to begin with the writers of "Jeopardy!" specifically by writing to them.

A copy of our executive director's letter to "Jeopardy!" is below. Feel free to modify it and use it as your own.

Sandy Summers, RN, MSN, MPH
Executive Director
The Center for Nursing Advocacy
203 Churchwardens Rd.
Baltimore, MD 21212-2937
office 410-323-1100
fax 443-705-0260
ssummers@nursingadvocacy.org
www.nursingadvocacy.org

September 18, 2004

Jeopardy!
Mr. Harry Friedman, Executive Producer
Mr. Gary Johnson, Head writer
10202 W. Washington Blvd.
Culver City, CA 90232

Dear Messrs. Friedman and Johnson:

A: These graduate-prepared health professionals provide patient care that studies have found to be at least as good as that of physicians.

Q: Who are nurse practitioners?

I am writing to express my concern about an inaccurate and harmful statement about nurse practitioners made during the episode of "Jeopardy!" broadcast on September 7, 2004. In this episode, there was an "answer" which read "Minor ailments can be treated by NPs (Nurse-practitioners) & PAs (these)." The contestant answered "correctly" by stating: "What are Physician's Assistants?".

Contrary to the implications of this exchange, NP's regularly treat major ailments like cardiac disease, cancer, diabetes and asthma. NP's and other Advanced Practice Registered Nurses (APRNs) care for patients in a wide variety of complex settings in which lives are on the line, from the certified nurse midwives who deliver babies to the nurse anesthetists who autonomously attend to patients during major surgery.

In formulating a question defining for millions of viewers the work of over 100,000 graduate-prepared health care professionals, "Jeopardy!" should have done a little more research. The show should have consulted a nurse practitioner, the American College of Nurse Practitioners www.nurse.org/acnp or the American Academy of Nurse Practitioners www.aanp.org for the facts about the real scope of nurse practitioner care.

One of the most damaging anti-nurse stereotypes is that APRNs aren't real health care providers. The media often implies that patients see NPs for a sore throat or an ear ache and nothing more. This sends the message that NPs are minimally trained sub-professionals who deal with matters so simple that physicians can't be bothered, a message reinforced by the physician organizations that lobby hard to prevent APRN independent practice and reimbursement. (The ostensible reason for the intense physician campaigns is concern for patient well-being, but NP organizations see a clear anti-competitive motive.) We very rarely see articles mention the increasing number of clinical studies finding that APRN care is equal to or better than that provided by physicians. www.nursingadvocacy.org/faq/apn_md_relative_merits.html.

Many who create negative media about nurses doubt that such media can really harm the nursing profession. However, as public health professionals at USC's Hollywood, Health and Society project and elsewhere can tell you, the media does affect how people think and act with regard to health issues. Inaccurate and unfounded comments such as the one aired by "Jeopardy!" contribute to an unattractive media image, which in turn affects how people think and act with regard to nursing. We are in the midst of an unprecedented global nursing shortage that is only expected to worsen over the next two decades. The nursing shortage is one of our most urgent public health crises, and attaining accurate media coverage of nursing is an important factor in resolving the shortage. Indeed, a key reason that nursing is in its current state--understaffed, underfunded and underempowered--is that the work of nurses is undervalued by the general public and health care decision makers, all of whom are affected by the media. Such disrespect also directly discourages nurses and potential nurses.

We urge "Jeopardy!" to publicly apologize to nurse practitioners in the next edition of "Jeopardy!" We also urge you to consult nurse experts on any future health-related programs, to help prevent problems such as this one. The Center for Nursing Advocacy is in the process of developing a database of nurse experts and we would be happy to help you answer any questions and refer you to our database of experts for the development of any questions or answers involving nurses or their work.

I look forward to hearing from you.

Best regards,

Sandy Summers, RN, MSN, MPH
Executive Director