TV Health Careers vs. Reality

Freelance Writer

When Quincy, Massachusetts, ER nurse Jill Baker watches any medical themed television drama, one thought can’t help but run through her mind. “I usually think, ‘That would never happen,’” she says. And while the Quincy Medical Center nurse enjoys the shows for their entertainment, it’s frustrating when her profession is shown negatively or when she sees the wrong task assigned to certain characters’ jobs.

“They just don’t have an accurate portrayal of the teamwork,” Baker says of the programs. “Especially in the ER, we work completely as a team.”

You probably aren’t totally surprised that Grey’s Anatomy isn’t holding a mirror to a real-life medical career. We all know shows in hospital settings—everything from Marcus Welby to Grey’s Anatomy and Scrubs—are just dramatic interpretations and that a typical day’s work isn’t terribly interesting to viewers.

But the way medical professionals are portrayed on television does creep into the expectations of both medical professionals and of consumers, whether they realize it or not. And if you are considering a career in the medical field, it pays to know what a typical day in a real hospital or medical setting looks like. Physicians are not always in crisis mode, nurses have much greater responsibilities, and all forensic specialists are not tattooed, wild-haired basement dwellers (although they could be!).

In general, television shows get a lot of the language and some of the procedures correct. But the lifestyle doesn’t come close.

“They glorify it, and they party all the time,” says Baker with a laugh. “It’s usually not that exciting when you are working the daily grind. This is hard work and a backbreaking job.”

And let’s be clear: unfolding relationship drama is mostly only found on television. Jason Marker, M.D., who works in a private practice in Indiana and serves on the board of the American Academy of Family Physicians Foundation, says relationships are bound to happen in health care settings because those are the people you work with every day. But fooling around in the on-call room? Probably not. “In almost all hospitals that is grounds for expulsion,” he says.

But television shows are getting things right a little more than they used to, especially in patient representations, Marker says. Shows are portraying accurate depictions of patients making bad decisions about health care. With such a public focus on health and wellness, dramas reveal the complicated and not always pleasant outcomes that come from unhealthy lifestyles. They are also slowly showing that one physician isn’t usually the only deciding factor in any case.

And some professionals have different views of how they see their work represented on television. On-screen nurses don’t get much exposure when it comes to saving lives and performing complicated procedures, something that nurses routinely do in real life. And when the portrayal is repeated, the image seeps into the public perception of what they do.

“To some extent, we have all grown up with the same images and portrayal of nurses as having no autonomy and that physicians direct them,” says Sandy Summers, R.N., M.S.N., M.P.H., and founder and Executive Director of The Truth About Nursing, a nonprofit aimed at improving public understanding of the field. Nurses, she says, are actually more autonomous and independent of physicians. “It is very important that nurses embrace their autonomy and that physicians understand it.” And it would benefit everyone if television shows stopped showing nurses as being there to assist physicians. “Our primary purpose is to protect the patient,” she says.

But the very aspect of medicine that often drives most medical professionals to log the hours and become so close to their patients isn’t the high drama of a hit TV show. The relationships between a patient and a medical professional—physician, nurse, or phlebotomist—is at the heart of why people are so dedicated.

“Many victories in actual medical practices are profound and less photogenic,” says Cynthia Smith, M.D., senior medical associate for content and development of the American College of Physicians. And few viewers want to venture into the frightening territory that all medical professionals tread into every day—the pure and genuine uncertainty that comes with figuring out the puzzles of the human body. “Most days, there are a small number of cases that I finish and I think I am 100% certain I got that right,” says Marker. “There is a lot of unknown in health care, and that is boring to put on TV.”

On most shows, Marker says, you’re sure to see a certain pattern: health care professionals locate a problem, in a short time they have answers, they do something, and the problem is resolved. “That is the vast minority of situations across the whole spectrum,” he says.

Accepting the uncertainty and navigating complex human relationships are key traits for career success in medicine. “If you are considering a career in medicine, you would be well served to figure out how to get along with other people and how to deal with uncertainty in life,” says Marker.

Students who think they can have a career in medicine and punch out when they leave the hospital or office are misguided, he says. “I want every doctor to feel like they will be a great doctor because that is the spirit of care,” Marker says. Even if that means they have to spend hours on paperwork or other humdrum tasks that are never shown on television. “You never see doctors getting a prior authorization on TV,” says Smith.

Summers, who also coauthored Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All at Risk, agrees, saying the way nurses are portrayed on television, as wallpapering the background or acting as mindless receptacles for physician commands, increases the dramatic appeal of a show, but does a disservice. Noting that the images do leave lasting impressions, Summers refers to a 2009 survey in which kids reported thinking a nursing career was for “brainless bimbos.”

“It is sort of maddening how they get it so wrong,” says Diana Mason, Ph.D., C, F.A.A.N., R.N., and Co-Director of the Center for Health, Media, and Policy and Rudin professor of nursing at Hunter College, City University of New York. “Nurses have a surveillance capacity, and if you start going down the tubes, it is the nurses who pick up on that. People aren’t aware of the constant scanning we do.”

When you enter the field, don’t be surprised to find patients with expectations slightly skewed from years of absorbing Hollywood-style medicine. “You see doctors working all the time and never having much time off,” says Smith. “It seems like every doctor can do everything when medicine is actually very subspecialized.”

So are there any shows that really get it right? Many medical professionals pointed to Scrubs for an accurate representation of hospitals. But it is not for the health care aspect; it is mostly for the relationships between the providers and the patients. The pros don’t always get everything right, but they are always showing their dedication.

Many nurses say Nurse Jackie gets it somewhat right too by having a strong, smart (but hardly perfect) nurse character. Summers calls her a fierce patient advocate and appreciates how the show portrays her as an intelligent nurse who displays great assessment skills. Jackie is a flawed hero, with a complicated personal life, “but when it comes to nursing skill, she is fabulous,” she says.

The teamwork needed to keep a hospital running smoothly isn’t really shown on television shows, but “physicians focus on the disease and nurses focus on the patient as a person,” Mason says.

At the end of the day, it’s important to remember when watching your favorite hospital show, as Baker says: “It is all entertainment.”

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