Media Malpractice

THE MEDIATED NURSE

What is the nature of media representations of the nurse? What are the implications of these representations? And more importantly, what can be done to proffer a more accurate, if not more positive, image of nurses and nursing. In short, "when the public conjures up the image of the nurse," as Eileen Meier asks," what is it?" (1) Media representations of the nurse have, historically, reinforced a range of negative stereotypes. In this paper I will briefly analyze four stereotypes of the nurse, as depicted in print, television, and film: the sex-kitten/naughty nurse, the flighty bimbo, the bossy, emasculating harpy, and the nurturing handmaiden. These stereotypic representations are disseminated across a broad range of media. For the purposes of this paper, however, I will confine my analysis to their appearance in Playboy magazine, the hit television series, MASH, and the films, One Flew Over the Cuckoo's Nest and Nurse Betty. Additionally, I will assess the implications of an even greater problem regarding the media's representation of nurses: invisibility. Finally, I will proffer some solutions to this problem.

Stereotypic representations in print, television, and film pose problems for nurses and nursing, affecting everything from recruitment and retention, to patient-nurse relations, and health care legislation. What precisely are the negative stereotypes of nurses that are disseminated by the media? The first is the naughty nurse/sex-kitten. This caricature of the nurse is just another in a long line of stereotypes that objectify male fantasies, following in the footsteps of her uniformed predecessors: the cheer-leader, the stewardess, and the French maid. She has appeared not only on the pages of Playboy pictorials, but is ubiquitous in adult videos as well. Unbuttoned uniform. Pouty-lipped. Blonde hair askew. As ready to raise your pulse, as take it. The most recent incarnation of the naught nurse, however, is found in the forthcoming Christina Aguilera ad campaign, "Naughty and Nice." In this ad, which appeared in "markets worldwide," the sultry diva appears as "a nurse confronting a patient sitting on a hospital bed . . . there is a strong element of sado-masochism . . . all figures are dressed and posed in sexually suggestive ways, often with exposed bras and/or short shorts . . . "("News on Nurses and the Media" 4) The naughty nurse by no means the only negative stereotype in this nursing sisterhood.

Equally ubiquitous is her flighty counterpart, the nurse-as-flighty twit, as evidenced in such t.v. shows as MASH and traces of which can be found in Nurse Betty. She is the sister to a more benign, yet no less stereotypical manifestation: the nurse-as-nurturing-handmaiden, who spends most of her career "standing around the telephone chatting at the nurse's stations and saying 'Yes doctor' when a doctor breezes through the scene" (Meier 1). The "edgy U.K. nurse show, No Angels" is populated with these "gossiping party twits more interested in sexual contacts with physicians than in caring for their patients" ("News . . . Media" 1). As Jacqueline Bridges observes, she is a close kin to the nurturing handmaiden or "the ministering angel . . . compliant, willing, caring and dedicated" ("Literature Review . . . Media" 851). The hierarchical nature of the physician-nurse relationship is merely a contemporary counterpart of the old master-slave dialectic. One speaks, the other is spoken to; one orders; the other carries out those orders etc. It should come as no surprise then that popular t.v. shows like ER and Scrubs "typically present nurses as peripheral subordinates to the physicians who dominate them" (News . . . Media 1) Nor should it come as any surprise that with a weekly viewership in the millions, that these shows would "affect people's view of health care" and as such "are probably the most influential ongoing media depictions of nursing" (1).

These relatively benign personality-stereotypes (the naughty nurse, the twit, and the handmaiden) operate in sharp contrast to the stereotype of their evil sister: the nurse-as-bossy-emasculating-harpy. The definitive example of this negative stereotype is Nurse Ratched (One Flew Over the Cuckoo's Nest). As a lobotomizing sadist, this nurse is the incarnation of the worst male fears. The surgical removal of a male organ (a lobe of the brain) by this female nurse merely represents a transposition of an even more primal fear: emasculation. As Kalisch and Kalisch observe, this nurse has a "propensity toward malevolence and a sadistic personality" (qtd. in Bridges 852).

From the nurse as sex-object to the nurse as emasculating tyrant, from the nurse as air-head to the nurse as nurturing handmaiden, these stereotypes reinforce some aspect of the male gaze, by which and for which they are constructed. They either objectify male fantasies and fears or fulfill male needs for power and nurturing. Even the stereotype of the gay male nurse reinforces these rigid gender categories. Instead of subverting the gender stereotype (or even bending the gender-boundaries) the gay nurse, by virtue of his aberrant status, reinforces traditional stereotypic gender distinctions.

Fortunately, the "picture" is changing. Recently, two television shows filmed at Johns Hopkins presented a more accurate and positive image of nurses. As Smith observes, "late last summer, ABC aired a series Hopkins: 24/7 . . . . that left the viewer with decidedly different perceptions of nursing" (1). Smith continues:

The Discovery Health Channel filmed at Hopkins . . . a five part series . . . which captured the high level of technical skill, respect, caring, and the energy required to meet the daily challenges of patient care . . . . They alluded to the daily challenge of managing the monotony and bureaucracy of nursing routines. They emphasize[d] the challenge of pulling it all together as you walk into a patient's room . . . the nurse's role in caring for the emotional needs of patients and families . . . the skill to listen and understand and intervene appropriately . . . . In summary, the nurse was accurately portrayed as a keen observer of status, a careful driver of care, and an interpreter between physician and families . . . . The intellectual and emotional challenges were balanced by the touching rewards of physical healing . . . (2)

Nevertheless, this representation of nurses and nursing was not without its problematic lapses. For example, "no footage was included of the nurse manager," reinforcing the stereotype of the nurse-as-handmaiden, but not as decision-maker (2).