Every nurse knows such a situation could not be farther from reality. The writers and directors of several medical series now in production, however, continue to perpetuate the idea that nurses are insignificant members of the medical care team by relegating them to the background, if they write them into the script at all.

The professional watchdog organization, the Center for Nursing Advocacy (CNA) has noticed a rare positive portrayal of nurses on ER. Other shows, namely House and Grey’s Anatomy, completely ignore the existence of nurses in most episodes.

Many of the programs show everything important being done by physicians, including patient care that is routinely the responsibility of nurses. Such portrayals give the public the idea that doctors can do anything nurses can do, which is not the case. While there is some overlapping of skills, according to Sandy Summers, RN, MSN, MPH, executive director of CNA, doctors cannot do all that nurses do, just as nurses cannot do all that doctors do.

Unofficial surveys of nurses who are viewers of these series find that, while nurses admit that they usually enjoy the programs, the inaccuracies and improbabilities of many situations irritate them. Some nurses also believe that patients and their families come to expect what they see in the shows—such as every patient having a doctor at the bedside around the clock—and that families mimic the demanding behavior they see family members exhibit on TV.

One might ask, “What is the harm? TV is fictional, so is accuracy really that important?” Television is a powerful medium and, according to Summers, immense harm is being done to the nursing profession by the inaccurate portrayals of both nurses and doctors.

“The programs show the physicians hiring, firing and supervising nurses,” Summers said. “That is what makes people think we're handmaidens. When physicians behave in this way, the public is prevented from knowing that nursing is an autonomous profession with its own scope of practice, its own code of ethics and its own licensing exams and boards of nursing. Nurses are often made to look like they can't and don't have the knowledge and skills to save lives.”

CNA is rankled by the fact that the shows give all thanks for saving lives and improving outcomes to the physicians—only once on ER has a nurse been thanked. Something as simple as a camera shot lingering on the face of the physician can show (erroneously) who really matters and that is almost always shown to be the physician, not the nurse. According to Summers, such misplaced importance has significant influence on funding for issues vital to nursing.

“While there are four times as many nurses as physicians, nurses receive less than one percent of the National Institutes of Health budget,” Summers said. “Nursing gets little funding because that's a measure of the value that decision makers place on nursing. They learn from the media that nurses have no value, so they fund nursing in accordance with its perceived value. This is a direct result of the negative images created by health care dramas. And that's why the profession is being starved to death—not just in terms of research, but also for nursing education and clinical practice.”

Nurses who watch medical dramas are often annoyed by situations such as the absence of side rails on beds and the case of a drowning victim on whom CPR was performed for an hour-and-a-half and, then, suddenly awakened in a perfectly lucid state. Those annoyances are minor in the face of the critical effects that result from the degradation of the nursing profession by medical dramas, according to Summers. The Center for Nursing Advocacy will continue to bombard the powers responsible for the erroneous and disrespectful portrayal of nursing by pointing out each infraction and letting them know how a scene should be written.

“TV medical dramas are more influential than news programs in forming the public's perception of nurses,” Summers explained. “Viewers get caught up in the drama of the storylines and are much more likely to remember what they see and hear from a fictional show than what they hear from a factual news program. That is all the more reason to have nurses portrayed accurately on television shows.”