Could we teach your loathsome friends to be all smooth and polite like us?

June 7, 2007 -- The Center understands that a new TV show called "Mind Your Manners," slated to air on The Learning Channel (TLC), has been seeking "rude," "crude," and "obnoxious" nurses for the show...by asking major nursing groups for help. The show seems to involve a "Queer Eye for the Straight Guy"-style makeover effort to help subjects improve their interpersonal skills. Not surprisingly, the nursing groups have been less than helpful, firing off outraged missives and promising to urge nurses to boycott the show. Actually, it's not clear how the show could offer expert social advice if it's clueless enough to think nursing groups are going to help out. Anyway, we are not among those who believe that all three million U.S. nurses are nice, polite, and professional. It's also pretty clear that the show's overall focus is not on nurses; we assume that the outreach to nurses was just one of many efforts to involve different parts of society. But the current nursing shortage is driven in significant part by a public image dominated by easy stereotypes. It's hard to imagine that the show could resist reinforcing the battleaxe image, or perhaps glibly noting that a given nurse is no angel. And in presenting socially challenged nurses, how likely is the show to explain that nursing--always a stressful job--now faces rampant short-staffing, mandation, and other working conditions that could make it hard for anyone to stay on an even keel? In any case, a concerned nursing organization (which requests anonymity) contacted an executive at Discovery Communications, which owns TLC as well as Discovery Health. Today we learned that this nursing group has received assurances that there will be no episode focused on nurses. We hope that will be the case. And we urge the show to mind its manners by sticking to individuals, rather than focusing on a profession in the midst of an image-related global health crisis.

The Internet "casting application page" for "Mind Your Manners" is open to all, and it makes no mention of any specific profession or other group:

We're casting all levels of ill-mannered people - from the rudest, crudest & most obnoxious to those who simply behave poorly in public. We're looking for immature friends, inconsiderate fiancés, disrespectful boyfriends, boorish brothers, unsophisticated sisters, wild-child teens, barbaric husbands, ornery uncles, etc!

Sounds basic cable-tastic, doesn't it? Of course, it may be that the show could actually help those who appear on it and many viewers at home to improve their social skills. And it doesn't sound like the nursing angle would likely be a major theme in the show overall. It may simply be that the producers figured they could get some easy comic mileage out of an obnoxious nurse, and they're probably right. For example, consider this hypothetical lead-in:

Nurse Brenda is no one's angel, as we learned when we had our mild-mannered production assistant stop by her unit and politely ask this testy Nightingale for directions to the cafeteria!

This kind of thing would seem to be subverting the angel image, but of course it would also reinforce it, suggesting that Brenda should be an angel, but instead she's more of a...battleaxe, which is actually another enduring nursing stereotype. In fact, one group felt the show might recall Nurse Ratched (from the book and film One Flew Over the Cuckoo's Nest). That character's real problem was less that she was rude or crude in an obvious sense, and more that she was a slick institutional sociopath. But we suppose a nurse could be presented on "Mind Your Manners" in a way that would recall Ratched.

It's not clear to what extent the show would focus on the nurse's profession, as opposed to his family or friends. But it seems likely that the job would be a factor, or the producers would not have been specifically seeking out nurses in the first place. It may be that the show would feature other nurses to let viewers know that the socially inept one is an anomaly. Perhaps it would even note that it is critical that a nurse have good interpersonal skills in order to achieve key objectives, including patient education, patient advocacy, and of course, simply working well with the diverse health care team under stressful conditions. Maybe.

But even if it did, that would not be enough. Many professions could probably endure jokes and distortions, but this is simply not a good time for those who likely know little about nursing's situation to blunder into the profession's troubled image. We doubt the show would highlight shortage issues that could lead nurses to behave in less than ideal ways at times, including short-staffing, forced overtime, difficult relations with colleagues, and increasingly dissatisfied patients. Such stressful working conditions might make it difficult for anyone to remain congenial, even off duty, and many nurses have fled the bedside in recent years rather than continue to face them. Indeed, recent research suggests that many nurses exhibit PTSD and burnout symptoms, and that for many, workplace stress has been linked to sexual difficulties.

We admit that a good deal of this is speculative, as the show has not even been created, much less aired. But it is not too soon to consider how this could go. Maybe there would be little stereotyping, and instead a real focus on the deeper issues a troubled nurse might have, which could actually make a positive contribution. At this stage, though, it's hard to be optimistic.

Today the Center learned that a representative of a certain nursing group had contacted an executive acquaintance at Discovery Communications. We understand the nursing organization was assured that the show was "not looking" for rude nurses, and that TLC had not asked the "production company" to seek out nurses. Of course, we would not expect that the "rude nurse" search was directed by Discovery executives, as we believe such specific decisions would generally be made by those who create the show, the producers. We hope it is correct that the show is no longer looking for rude nurses, but of course it was doing so recently, whether Discovery executives were aware of it or not. (See a copy of the show's casting call for nurses that the New York State Nurses Association recently received.)

In any case, we salute the anonymous nursing organization for taking the initiative to voice nurses' concerns with contacts at Discovery Communications. We applaud organizational leaders such as Tina Gerardi, CEO of the New York State Nurses Association, for writing a letter to the show. We also thank Discovery executives for being responsive to those concerns. And we hope the show will avoid a focus on nursing unless it is prepared to grapple with the complexity of the nursing image and the related nursing shortage, which is a public health crisis.

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