Portal de Periódicos da CAPES

Editorial: Nursing on television: are we being served?

2009; Wiley; Volume: 18; Issue: 16 Linguagem: Inglês

10.1111/j.1365-2702.2009.02866.x

1365-2702

Debra Jackson,

Media Influence and Health

Few would argue that television has had a profound affect on modern life. As a source of popular information, it is unparalleled. In the Western world at least, there are few homes without television, and not many with only a single television. The modern (Western) home often has televisions in multiple living areas and bedrooms, and some models of refrigerator even feature an in-built television in the door, so that, even while foraging for sustenance, not a moment of television viewing needs to be missed. With the development of television reception capacity in mobile phones, today’s television viewer can potentially tune in wherever they are – on the train, at the beach, or at the mall. Given concerns about the recruitment of new people into nursing, one wonders about the effects of television. Discussion about nurse recruitment tends to highlight the increased options for young people today, particularly young women, compared with options available up until the 1960s and 1970s. It has also been said that nursing has an image problem, in that old and entrenched stereotypes about nurses prevail. Early literature suggested that television has exerted an enormous influence on the development and proliferation of these strongly gendered stereotypes, such as the nurse as doctors’ obedient and compliant handmaiden, the authoritarian old battle-axe nurse, the nurse as ministering angel and the naughty night nurse (Kalisch et al. 1982, Bridges 1990). Currently, nursing and nurses remain well represented on the television, in soap operas/serials, dramas, reality television and in advertising. Because much popular information about nursing is gleaned from the television, accuracy about what nurses actually do is one of the concerns that have been raised by nurses over the years, and this is still the case when considering current television portrayals of nurses (Bauer 2007). While nurses have long been depicted in advertisements for everything from breakfast cereals to health insurance, in some parts of the world, nursing has itself become an advertising focus. Difficulties in recruitment and nursing’s perceived image problems have resulted in the involvement of the advertising industry. After all, where else does one go to resolve marketing and image difficulties? Thus, we see the presentation of slick televised advertising campaigns, where nursing is presented (in ultra-quick bytes) as a rewarding, challenging and thoroughly modern career. In these ads, we see patient(s) who are generally youngish, good-looking (nearly always male) and desperately ill. These advertisements depict very pretty (or impossibly handsome), young ‘nurse’ characters scanning the complex array of equipment, upon which this attractive patient’s life depends. Other advertisements in this genre show beautiful young people in nursing uniforms, often accessorised with stethoscopes and facemasks, standing over humidicribs containing tiny, calm and very cute infants, or alongside attractive, serene and smiling new mothers, holding perfect healthy infants. Obviously, a 30-second commercial cannot show every aspect or nuance of any profession; therefore, the advertisements tend to focus on the perceived dramatic and exciting aspects of nursing. Judging by those advertisements I have seen, these seem to be the intensive care environment, emergency, maternity and children’s nursing. Advertisements depicting nursing in the mental health, aged care, or community environments, or the other diverse settings where nurses practice, are less common. Of course, in these settings, the patients/clients are often not particularly cute or photogenic. Furthermore, in these types of settings, high-tech gadgetry can be quite thin on the ground, with the real therapeutic expertise embodied in the form of skilled and experienced nurses – something that would be infinitely harder to capture in a short television ad byte. In the interests of balance, it should be noted that some of the longer infomercial-type productions shown on the specialist health or education television channels, capture more accurate and varied images of both nurses and patients. A notable example of this is the USA produced Dare to Care recruitment video, which features age, gender and cultural diversity among nurses, and some realistic looking patients. Dare to Care also acknowledges nursing's unique contribution to healthcare, and depicts some of the non-hospital settings that nurses practice in. However, at approximately four minutes duration, this would be unlikely to be shown on commercial television (the costs would be enormous). When considering serials, soap operas and dramas, it is doubtful that any other setting has been as popular a backdrop to these popular genres as the hospital. Hospitals seem to hold endless fascination to the viewing public. Numerous soap operas, dramas and serials are based around hospitals, and build their storylines around the private workings of the hospital, the patients and the professional groups in hospitals. Of those professional groups, nurses may be the most visible, with nurses sometimes being cast (alongside doctors) as central to the plot. However, and as was noted in the literature more than 30 years ago (Kalisch et al. 1982), the nursing focus in this genre of entertainment is (still) frequently on the love lives and the personal vicissitudes of the individual nurses themselves, rather than on the jobs that they do. However, this is not always so, and episodes of the UK show Casualty for example, have depicted nurses as intelligent professionals, shown nursing characters as being engaged in skilled interactive nursing work, and presented story lines that reveal the centrality of expert nursing care to the overall outcomes for patients. Other dramas often have far less visibility for nursing roles, which may be barely in evidence. In these latter types of series, nursing and nurses may be depicted almost as props – presented as incidental and supportive to medical roles. This particular depiction has changed little over time. In a study of how nurses were represented on prime time television in the 1950s through to the 1980s, Kalisch et al. (1982) noted that nurses were consistently depicted as deferential and subservient to doctor characters, citing the Marcus Welby MD and Consuelo Lopez (the practice nurse character) dynamic as one example. Then there is the hospital reality or docu-drama; a genre where the camera is placed into busy hospital settings, and various aspects of ‘real’ hospital work are captured, edited and packaged as entertainment/information for the viewing public. In RPA, an Australian reality show that focuses on the Royal Prince Alfred Hospital in Sydney, selected patients are followed through the course of their illness, from the time of presentation to the hospital or hospital specialist rooms, through treatment and hospitalisation, to discharge, and then (sometimes) a post discharge follow-up. Although interactions between these patients and their treating health professionals are often shown, they are overwhelmingly with medical staff, and very few interactions with nurses appear in the series. In contrast, a seven part New Zealand docu-drama, Nurses, filmed on site at the busy Auckland City Hospital, had more of a focus on what nurses do. One of the reported explicit aims of this series was to ‘explore the relationships that nurses form with their patients and peers’ (Anon 2005:8). Although the series focussed on the high drama areas of the emergency department and critical care, and so did not capture some of the less dramatic aspects of nursing, nursing media reports suggest that nursing professionalism and skill were highlighted, and that the series presented the profession in a pleasing way (Anon 2005). If we judge interest in a profession as being able to be in some way measured by the amount of television time that is devoted to it, it would seem that nursing fares better than many others. It is undeniable that the public interest in nursing and nurses continues. Notwithstanding that the televised images of nurses and nursing are not always exactly what we might want to portray and may often not capture the full depth and breadth of nursing roles, other professions would likely welcome the amount of television time that nursing manages, with no apparent effort, to attract. Our challenge is to make the most of this interest – to take advantage of it, and harness it to raise awareness of nursing, and to improve engagement with and recruitment into the profession.