Review of Saving Lives: Why the Media's Portrayal of Nursing Puts Us All at Risk

by Carole Bergeron
Executive Director, Connecticut Nurses Association

This newly published book is very disturbing. It chronicles the many ways in which nurses have been objectified, trivialized, marginalized and ultimately dismissed by media of all sorts. It does that not as a form of denigration or derision, after all, Sandy Summers is a staunch nursing advocate; she is a registered nurse and the executive director of The Truth About Nursing. It does that to wake us up.

There is nothing subtle about media messages. Although nurses are consistently admired as the most trusted profession, we are also misunderstood--what we actually DO within the health care system is confusing and often not readily visible to those who find us so trustworthy. More often than not, nursing's contribution is invisible and other members of the health care team are credited with this achievement. When actors portray omniscient physicians in House, Grey's Anatomy, and ER, nurses are relegated to support roles (helpmate, gopher, emotional supporter), if they are present at all. These messages allow the public to unconsciously view nurses in stereotypical roles of angel, battleaxe (Nurse Ratched) or whore (Naughty Nurse). And even when that same public receives competent, educated, knowledgeable nursing care, the role of the nurse in this equation remains invisible.

This book identifies the multiple ways in which nurses continue to be portrayed as unimportant, insignificant, and foolish. A major flaw (and important advantage) of this book is the fact that it is punishingly persistent in its message--

"A number of media items, particularly in print news, have communicated some sense of the advanced scientific skills that nurses use to improve patient outcomes. Unfortunately, much of the most influential media, particularly television, regularly sends a message that nursing is low-skilled loser grunt work unworthy of serious consideration by anyone with a brain. In addition, countless media items portray important nursing work as being performed by others, particularly physicians, thus robbing nurses of credit they need to save the profession. Others ignore nursing work and expertise, even when nursing plays a central role in the relevant subject, such as patient education, managing health care errors, or mass casualty events. Still other items suggest that any helpful person or machine is a "nurse", consistent with the broad use of the term "nursing" to include unskilled tending" (p. 56).

After 250 pages of almost relentless examples of media portrayals that are decidedly less than flattering or accurate (including the new TV shows of Nurse Jackie and HawthoRNe), the authors devote much needed space to advising what can be done. As a profession, we may well need the wake up call that the hundreds of examples of confusion and disrespect for nurses/nursing that the first part of this book provides. But we need guidance regarding what to do about it even more. And these are some good suggestions:

• Understand the power of language--words can reinforce the damaging assumptions and stereotypes about nursing;
   
• Educate local media about the expert nature of nursing commentary and testimony;
   
• Take an assertive posture and create TV shows about nurses;
   
• When you see something unacceptable (a disrespectful characterization of nursing, for example) contact the source and register a complaint;
   
• Develop your own clear message of what nurses do;
   
• Identify yourself as an RN---wear a name tag that identifies you accurately;
   
• Project a professional image every day
   
• Take credit for the lifesaving work you do
   
• Introduce yourself as a nurse

This book is disturbing. It is also essential. Like From Silence to Voice (Buresh and Gordon), Ordered to Care: The Dilemma of American Nursing (Reverby), and From Novice to Expert (Benner, P), this book forces us to face the ways in which we may be unwittingly complicit in the media's less than favorable impression of nursing. Words and images are powerful and long-lasting.