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ADVANCE Perspective: Nurses

Hawthorne: Nursing Goes Hollywood

Published June 17, 2009 12:26 PM by Adrianne OBrien

I tuned in to TNT for the series premiere of Hawthorne last night and came away a little disappointed.

Christina Hawthorne, played by Jada Pinkett Smith, is the CNO of the fictional Richmond Trinity Hospital. She's smart, tenacious and compassionate. She's respectable.

Other characters, not so much. Stereotypes abound. Nurse Ray Stein questions Dr. Marshall's insulin order for a patient with diabetes -- and rightly so, it turns out. Stein finally tracks down Dr. Marshall via phone (naturally, the doctor is on the golf course), to question the order and gets a curt "I'm the doctor, you're the nurse" response. The patient has an adverse reaction, a lawsuit is threatened and the fingers start pointing. Dr. Marshall's orders are clearly written on the patient's record. Wouldn't that give clarity to the situation? And there was no mention whatsoever of nursing documentation throughout this process.

Another stereotype: this patient, until it's explicitly stated, repeatedly refers to Stein, a man, as "doctor." When he finally gets that Stein is a nurse, he chuckles derisively. Can't we evolve past this? On the up side, at least there's a male nurse in the cast. He's a frustrated former med student (he was on track to graduate from an institution in Paraguay), but at least he seems to have his act together.

Probably the worst stereotype is that of nurse Candy. A blonde cutie, she gives the patient with diabetes, a veteran, a little extra (ahem) TLC. "While the program attempts to depict nursing in a positive light, it also resorts to the offensive and demeaning stereotype of sexual interaction between a nurse and a patient," read a June 17 ANA press release, "and in doing so, insults the intelligence and professionalism of nurses and of women." Yes.

And I know this is a drama that focuses more on the staff's personal lives than medicine, but the show would have been more credible had it gone into some detail and used more medical terminology when discussing cases.

Let's face it, this is a fictional television show, not a documentary. I'm all for the dramatic arts and creative license. And the fact that there is this new hour-long drama about an executive-level nurse shows that nurses and nursing are creeping further into the public consciousness. But it seems to me that a number of stereotypes should have been avoided. Maybe this is Hollywood's view of what nursing is. Let’s hope this show evolves.

23 comments

I have enjoyed Hawthrone since the first episode.  This is entertainment not a documentary. The show has many positives and very few negatives.  I can feel what each nursing characters feels the new grad, the experience ER nurse etc. I like this hospital base show does not portray a nurse a some flirt or loin straved female. I think this show is off to a great start and like a fine wine will get better in time. That's my view and I sticking to it.

elaine, Nursing August 22, 2009 1:00 AM
Los Angeles CA

I AM A REGISTERED NURSE IN NY AND CAUGHT ABOUT 30 MINUTES OF NURSE HAWTHORNE. OF COURSE IT IS NOT ACCURATELY PORTRAYING THE NURSING PROFESSION. I WATCHED THE EPISODE WHERE IN ORDER TO SAVE A NURSES POSTION  THEY WOULD CUT THE COST OF LIVING RAISE..I AM A UNION MEMBER CURRENTLY WITHOUT A CONTRACT.,(NEW CONTRACT IN NEGOTIATION) .THANK GOD FOR UNIONS, AND THANK GOT FOR THE POWER OFF ON MY REMOTE CONTROL...REMEMBER NIGHTENGALES...THIS TOO SHALL PASS, MAYBE ONE DAY HOLLYWOOD WILL GET IT RIGHT..UNTIL THEN THE ONLY PEOPLE THAT CAN UNDERSTAND OUR JOBS, ARE NURSES AND THE PATIENTS WE CARE FOR. DON'T GET ME WRONG, THIS SHOW GETS  ME ANGRY, BUT I KNOW WHAT I DO EVERYDAY, AND ITS HOLLYWOOD..NOT REALITY..AND THANK GOD WE CAN TURN IT OFF.....          MAZ

MARYANN ZAMBRZYCKI, CARDIAC - RN, HOSPITAL August 16, 2009 11:47 AM
BRONX NY

This show makes me sick to my stomach! What a horrible misrepresentation of doctors and nurses. I've never seen nurses act like idiotic servants to doctors in real life. I have worked as a critical care RN and now I'm an oncology NP. This show is an embarrassment to nurses and doctors both. I have encouraged all of my medical professional friends to stop watching it.

-sarah, NP

sarah pakron August 14, 2009 2:56 PM

        First, let me say that I have been a registered nurse with national certification for 25 years, and a Family Nurse Practitioner with national certification for 15 of those years. I have experience in many areas of nursing including med-surg, pulmonology, ICU, geriatrics, and Nursing Administration. I am very disappointed with this show and have stopped watching it.

    There are soooo many things wrong with this show that I do not know where to begin. There are a ton of technical issues, such as a non-insulin needle used to administer insulin, recapping of a used needle, and gloves not worn appropriately.  But, in my opinion there is at least one much bigger issue.  

    First and foremost for me is the issue that the main character is not a bedside nurse but is being portrayed like one. The actress who portrays Hawthorne is also the producer of the show who chose to make the RN portrayed a Chief Nursing Officer (CNO) rather than a bedside nurse. A CNO is an ADMINISTRATOR; a pencil-pusher, who hopefully has a seat at the "big-boys" table as a representative during attempts at shared-governance. They do NOT give bedside care, make rounds to each hospital unit to receive in-person, verbal report about patients from the nursing staff, discuss treatment options and life-saving measures with patients, arrive miraculously in the middle of the night to be at the side of a suicidal patient,  etc., etc., etc., etc.

    The way in which Jada Pinkett Smith is portraying this character is fictitious and disturbing. This character is shown as being a "Wonder Nurse" who is all-things-to-all-people and always involved with everything that is of any importance in the hospital. A CNO does not have a job description that includes any of the things that are being depicted in this show. The fake persona that is being presented by Smith is just as harmful to the profession as the stereotypical sex-pot or fat old grouchy nurse that is commonly portrayed in the media.

    Smith had an opportunity here to portray the life of an everyday real bedside nurse, which comprise the majority of the nursing workforce. There are plenty of intriguing, exciting, scary, disturbing stories that she could have covered in each episode that involve these nurses. Instead she assumed a nursing position that is administrative, and in REAL LIFE, has little or no contact with patients or bedside nurses on a daily basis.

    What I take away from that decision is that Smith did not think enough of bedside nurses to focus her character on "just a nurse." She had to inflate the "importance" of her character by making her a nurse administrator who gets to associate with other hospital administrators while running around the hospital units "playing nurse" and being superwoman.

    I am very disappointed in this show and Smith's attempt to elevate her importance as a actress. As flawed as the Nurse Jackie show is I continue to watch it because it more closely represents the lives of the real nurses, who are real people with problems, whom I have known and worked with for 25 years, than anything on this fictitious program.

Michele July 21, 2009 7:53 PM

Too bad a "reality" show which would follow REAL hospital staff members, can not be done.  

Unfortunately it would be the ONLY way non-medical persons could truly see doctors, nurses, all auxillary personnel, and patients interacting, day after day after day after day.

Personally do not like made for TV shows that give the impression one nurse can be all things to all the people in all the areas of a hospital.  No one RN or MD is GOD !!!!  That position is already taken and has been for some time!!!!

Kate, RN July 21, 2009 7:00 PM

Initially, I enjoyed HawthoRNe.  It depicted some of the demands that we, as nurses, experience day after day, ie;  patient jumping off roof while security is "going by the book".  Homeless mother of newborn hemorrhaging while 5 other things are happening, some of them needing urgent attention, while visitors and others are at the desk wanting to know why it has taken someone 20 min to get their mother some ice.  

However, although I can truly appreciate the intelligence and hard work of the CNO, I find it unrealistic that the doctors would actually back off from a nurse who takes things into her own hands such as refusing to call a time of death and continuing resuscitation, stopping a surgical procedure based on a "hunch" she has, or refusing to turn a minor over to social services because "he can stay with me".

I do wish we had more respect for our intuition and our experience from the physician's, but that is an ongoing battle and has been since Florence Nightingale's time.  

It is entertaining, funny, and makes you want to sing, "for she's a jolly good fellow" to Christine, but highly unrealistic.   And, for God's sake....please put those side rails up, up, up!!!!!

Thanks.

TAMMY HOLLAND, NEONATAL - RN-C, METHODIST July 12, 2009 4:05 AM
DALLAS TX

What do we expect from TV land, must admit I was alittle disappointed. I will not watch it again. Did you know that  the person playing Hawthorne real life mother is an RN. At least ER had technical advisors when it was on.

Marsha, PCU - RN, Harris Methodist July 9, 2009 8:54 PM
Bedford TX

I agree very disappointed in betrayal of nurses on this show.  /writers need a reality check.  watched two shows do not plan to watch again.

Bernice Beja, school nursing - RN July 9, 2009 6:09 PM
temecula CA

I agree very disappointed in betrayal of nurses on this show.  /writers need a reality check.  watched two shows do not plan to watch again.

Bernice Beja, school nursing - RN July 9, 2009 6:09 PM
temecula CA

Yes I saw the show twice, thinking that I should give it another chance, what the big turn off for me is Nurse Hawthorne's title. nurse executive REALLY for reals? When was the last time any of us real nurses saw our EXECUTIVES make round, address there nurses by name and greet patients. I agree with everyone this show needs a REALITY check. I had an argument with my fiancee regarding the show, he does not get why I don't like the show

Marie, RN July 7, 2009 9:21 PM
Chicago IL

I was thinking and putting something together as a nurse for the world to see and know the magnitude/relevance of our profession and what we do caring out our job as nurses, when  l was told about Hawthorne RN. Though l have not watched the show, but what l heard from my children and fellow RNs was appauling.

Hollywood should consider nurses as casts/actors and threatrical medical consultants as Linda said than giving the world a wrong opinium of our profession, thank you.

Niki , Med/Surg/tele - RN July 6, 2009 2:49 AM
Atlanta GA

I really had such high expectations for this show. I thought we (nurses) would be depicted as professional, ethical and compassionate nurses. When I've completed a shift and go home physically and mentally exhausted; it's not because I've spend the night engaging in inappropriate acts with my patients or unprofessional behavior with other staff members. It's shows like this that gives nurses the false sterotype that does not demand respect for the profession. In the eyes of hollywood, it's about the all mighty dollar.   I am very disappointed; I know it's suppose to be entertainment but I've worked very hard and sacrificed a lot to accomplish what I have and it's like a slap in the face. Wake up hollywood, who's gonna take care of you and your loved ones when the time comes if we are demoralized and made a mockery of. . . . .

Brenda, ms/tele/ortho - RN July 3, 2009 12:29 AM
richmond VA

Patrice, you're certainly not alone in your strong feelings about "Nurse Jackie!"  My blog was strictly about "HawthoRNe."  I was discussing one episode of one show.  As you've probably noticed, there's plenty of "Nurse Jackie" coverage elsewhere on our site!

Adrianne OBrien, , Editor ADVANCE for Nurses July 2, 2009 11:19 AM
King of Prussia PA

Adrianne O'Brien,

I am somewhat taken back by your dislike and sharp criticism for HawthoRNe on TNT, while making no comments about the absolute disgrace that Nurse Jackie, on showtime is.  On Nurse Jackie, nurses are viewed as drug addicted, amoral and dangerous..  

You're a nursing magazine editor, I would expect better from you.

Nurse, NP PA

Patrice edwards July 2, 2009 12:02 AM
Philadelphia PA

I tuned in th HawthoRNe last night for the first time and was hopeful, but , in the end, disappointed. The pt. scenarios would have been handled differently by a true RN.  Also, dear little Candy would have never been counting supplies in a stockroom (shortage of nurses? Hello!) but I guess she and the male nurse have to be there for the TV-expected suggestion of sex. However, the absolute killer was HawthoRNe's daughter wandering throughout the hospital taking cellphone pictures of pt interactions for her school project and, at the end, Mummy giving her a big hug for it!  No room for HIPPA in this show.

Diana, recently retired - RN, Phelps Hosp, NY July 1, 2009 1:13 PM
Mytic, CT

 I tuned in for about 10 minutes.  If I ever saw an RN wearing what Jada was wearing, I would say something.  It just supports the "sex and the nurse" idea.  I don't know about anyone else, when I was working in a hospital setting, there was a dress code... Also, not name tags... and I definitely would NOT wear a blazer at work.  What are they thinking.  Have any of the producers or directors ever been in a REAL hospital.  I don't think I will watch it again.

Bunny, Home Infusion - RN, Cape Cod Home Infusion Services July 1, 2009 12:28 PM
East Falmouth MA

I tuned into HawthoRNe a day late, due to a meeting that went long. However, was happy I was finally able to see it.

I agree with Adrianne OBrien, that there were too many stereotypes, in this show, and it sure isn't real life. But I was also  happy that this program didn't go the direction of Nurse Jackie, on Showtime.

Nurse Jackie, is a drug addict, that has sex, with the Pharmacist, in the hospital pharmacy (huh?), and spends most of her shift breaking the rules. While she doesn't follow protocol (checking patient ID before hanging a med?), seems to be trying to do what is best for the patient, she is not representing the bulk of dedicated nurses, and giving the wrong impression to the public about the respectable profession of nursing. What nurse has ever argued, about who is going to do the Heimlich, on a nearby fellow diner? ? ?

Nurse Hawthorne has many good qualities, such as mentoring Nurse Ray, and the student nurse.

However, I agree with other reviewers, that there are many areas where their nursing protocol stinks. For one thing, yes, nurse Ray appropriately questioned the doctor's order for incorrect sliding scale, and gave it according to orders, after "trying" to talk to the doctor about correcting it. However, what happened to his nursing judgment/intervention: i.e. monitoring the patient's blood sugar? And as mentioned, why wasn't documentation, which would have protected him, mentioned? What happened to gloves, and safety protocol, does not support capping needles anymore. Where are the safety needles nurses have been using for years?

I will continue to watch HawthoRNe, to see where it goes. But do not plan to watch Nurse Jackie, which is an insult to the nursing profession.

Claudia, Holistic/Integrative Health - RN June 19, 2009 5:00 PM
York PA

Well, did you really expect something totally realistic?  It's a TV show, made for ratings and to make money.  Is there much, if anything, that comes out of Hollywood that is unbiased, realistic, educational, and worthwhile?  I give you Michael Moore---

Connie Kupchunos, retired June 19, 2009 8:18 AM

I did not like the show because nurse Hawthorne is very high up in administration. Now where have you ever seen an executive work the floors or visit the ER and the nursery. Maybe walking through or on a tour,but not in uniform and really getting involved with the staff and direct patient care.

not realistic.

Joyce, Education - RN, SD College June 19, 2009 2:47 AM
Baltimore MD

Hawthorne is degrading and a disgrace to the nursing profession.  As a nursing instructor, the portrayal of nursing in this light makes my job very difficult! Do not watch!

Susan June 18, 2009 11:12 PM

Although I did not see the show, I read the excerpts. Part of the problem is that "we" as nurses are not asked to give input and our expertise to medical shows. It seems to be reserved for doctors except for one nurse from Cedar Sinai who worked with the character Sam in the show ER. We should be cast as extras and yes, actors also. Who better than to act in a drama or a comedy. I have been a theatrical medical consultant in Boston and have given pointers to an actor who protrayed a nurse in a off broadway show. The character was transferring bed to w/c all wrong and foley cath insertion was a problem so, I spoke to her after the show to guide her in what she should do for realism and make it more effective for the audience. That is what we need to do to make a difference. Are there any thespians out there that would like to work for Hollywood to teach them about "real" nurses? I know i would love to.

Linda, Nursing Instructor - BSN, RN June 18, 2009 7:44 PM
Boston MA

I watched too as we need to get some positive shows about nurses. Hawthorne is not one of them. I felt the portrayal of RN's was poorly done. If a younger person is watching this show, would they want to join the nursing workforce after seeing this?

Karen, Maternal Child Health/NICU - Nurse Educator, Hospital June 17, 2009 5:06 PM
Nashville TN

I watched the program last night and was disappointed too.

I have to agree with everything Adrianne commented on as well.

I have seen other programs that dealt with Nursing and find myself

frequently saying to myself, "we (Nurses) don't do that!"  "where are

the gloves for that procedure?" and "we don't recap needles!-among others.

I may watch the program again, but I'm not sure it is one that I will

watch regularly if the portrayal of Nurses doesn't change some.

Tina, Geriatric - Supervisor RN, Nursing Home June 17, 2009 4:58 PM
Frederick MD

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