BMJ  2004;328:51 (3 January), doi:10.1136/bmj.328.7430.51-a

Letter

Further nurses' notes on ER

EDITOR—Lenzer's article describes efforts to persuade ER to treat nursing more accurately and fairly.¹ Warner Brothers says its show goes to great lengths to portray medical situations accurately. To the extent ER is accurate about technical medical elements such as diagnosis and treatment, it leads viewers to believe that other healthcare elements on the show are equally true to life—including the portrayal of nursing. This is not accurate and does a grave disservice to an autonomous profession in crisis.

Awful working conditions are the most obvious current factor in the shortage. The economic decisions behind such working conditions reflect, at least in part, a misunderstanding of nursing heavily influenced by the mass media. If the persistent handmaiden image deters today's more empowered women, consider how it continues to hamper the recruitment of men. Even today, only about 6% of North American nurses are men.

We at the Center for Nursing Advocacy have never argued that ER is the sole cause of the shortage, but we believe that popular media products like it contribute to the shortage by influencing how people view health care. A recent Kaiser Family Foundation study concluded that it was worth the effort to make entertainment programmes such as ER as accurate as possible because of their potential influence on the public.² On the other hand, the authors emphasised that fictional depictions could lead to viewers obtaining inaccurate information or taking away critical misperceptions about health topics.

No nurses are involved in the preparation of ER scripts—a point not disputed by those responsible for the show. It means little therefore if real nurses are on the set showing the actors who play doctors how to defibrillate or if the show's technical directors (all doctors) respect nurses in some general sense, so long as the show that employs them misrepresents nursing to over 20 million households each week.

Center for Nursing Advocacy, 203 Churchwardens Road, Baltimore, MD 21212, USA ssummers{at}nursingadvocacy.org

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Competing interests: SS is the executive director of the Center for Nursing Advocacy.

References

1. Lenzer J. ER blamed for nursing shortage. BMJ 2003;327: 1294. (29 November.)[Free Full Text]
2. http://www.kff.org publication 3230

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