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ADVANCE Perspective: Nurses

Nurse Jackie: Ethical or Criminal?

Published April 14, 2010 2:31 PM by Gail Guterl
In the latest episode of Nurse Jackie (played by Edie Falco in this Showtime series), Jackie is quintessential Jackie. In past shows, we saw Jackie acting as a medical Robin Hood, never hesitating to rob from the rich (those who bestow health insurance) to help the poor (those who don't have it or aren't served well by their health insurance).

But in the April 12 show, Jackie truly breaks the law, making me so conflicted about this episode.

Here's what unfolds: In the emergency department, Jackie and Dr. Fitch "Coop" Cooper (played by Peter Facinelli) treat an emaciated, weakened cancer patient who is constantly nauseous as a result of chemotherapy. The patient says he has tried every anti-nausea medication known to medical science. To Coop's great shock, Jackie asks the patient if he's tried marijuana.

Hearing Coop's strong objections, Jackie later approaches the patient in private and sets him up with a "toke" of marijuana hidden in a hollowed-out apple, creating an apple pipe. And at her home, Jackie bakes "Alice B. Toklas" brownies for the patient and delivers them to him personally. There the man tells her he can actually enjoy watching TV and is feeling so much better for the first time in ages, thanks to her "prescription."

Of course, one can say, why would it be wrong to prescribe marijuana medicinally for nausea on one side of the Hudson River (the hospital where Jackie works is in New York) when right on the other side, in New Jersey, it recently became legal?

But if it's against the law, why suggest it to a patient (causing me to immediately recoil, thinking I might actually agree with anything Dr. Cooper said!)?

A dear friend who underwent the most grueling chemotherapy and radiation for cervical cancer saw Nurse Jackie's actions as the only right thing to do.

"The nausea from the treatments is so awful, you can't escape it," she told me. "You can't read, watch TV, or do any of the things you enjoy because the weakness and the urge to vomit is always there. It's terrible. It's all encompassing."

If nurses are a patient's strongest advocate, then what is the right thing to do? 

   

 

4 comments

Bobbye is that to say you would like nurses and doctors traipsing in front of a camera instead of actually doing what they went to college for? That's not to say I disagree with you, but you really have to look at the situation in perspective. Many actors go to college and special schools merely to train themselves for portrayal of characters who have knowledge of things they themselves do not. Not all nurses are "bimbos" and I am sure most people viewing television shows which have actors/actresses portraying them do not think that about health care professionals.

It's understandable that you would not want an actor doing your job in reality but given what they go through just to be in front of that camera, can you say you'd take their spot in a heartbeat, as a real nurse and a real care-giver. Not everyone goes to college for nursing just as not every person goes to college for acting.

On to the topic.

The legal implications of a health care professional "prescribing" marijuana in an illegal area is still illegal no matter the intent to help a patient. That being said there are still good qualities which come from using this plant in patients undergoing cancer treatment. It is not the morality or ethics that are questioned really for me. It's the legality. No one is above the law in any sense. Even the most competent nurse can still fall to their own morality and break the law. It doesn't make them a bad person. A nurse is a patients rock, their support, more often than a physician, as they tend to have patient autonomy given their close personal care of that person. I would want a nurse that could take care of me over a doctor that only sees me once or twice a visit to the hospital. Even a nurse who would break the law to have me feel better if she felt that it was the only way. Competent nursing is so much more about legality. Would anyone argue otherwise?

David July 22, 2012 7:20 AM

The Nurse Jackie episode, "Apple Bong" is a powerful argument for the legal use of medical marijuana. The depiction of medical marijuana in the episode was true and entirely favorable.  The patient's symptoms were resolved quickly and dramatically, with just a few inhalations, after the failure of many pharmaceuticals.  Just showing what marijuana can do is arguably more important than scientific studies in the public debate.  Also, the opposition to medical marijuana on the show came from its least attractive character--a pompous young physician.  The episode takes place in New York, where the relief obtained with marijuana by this patient is against the law.  There is no legal access to medical marijuana for about 75% of the U.S. population.  The episode shows what happens to patients and what patients must resort to throughout most of America--health care professionals making "secret" recommendations (i.e., not written on the patient's medical record), and clandestine delivery and use of medical marijuana, leaving the patient at great legal risk, despite marijuana's safety and efficacy from a pharmacological point of view.  

Generally, I think the Nurse Jackie series encourages mixed feelings about many of the issues it deals with, including the hero (anti-hero?) of the show, Jackie herself.  Jackie is a flawed character, with very human strengths and weaknesses.  On the other hand, she is an extremely competent RN, and there is an authenticity about Jackie that would be missing with a more one-dimensional character.  

Ken Wolski, education - RN, MPA, www.cmmnj.org April 19, 2010 12:32 AM
Trenton NJ

I tend to  have a problem with nurses portrayed on TV. Either they are 'bimbos' or 'super intelegent" nurses who tend to lead the entire medical staff who respond to every blink of an eye.

As a Registered Nurse, I would like to see 'realistic persons' portraying 'realistic' nurses.

we are not all perfect size 8s with perfect bodies and hair and makeup that just walked out of a 5th Avenue salon who wear uniforms that are so short and tight you can see every hair folicle.

Bobbye Kuhlman, RN, MAC, LLPC April 18, 2010 4:21 PM
traverse city MI

The legal system is not the medical system. It will always be lagging behind the most up-to-date scientific and medical knowledge, and a medical professionals' job is to make patient care the top priority. However, as an EMT, I've also learned that my personal safety is actually even higher than that of my patients. If something happens to me, I can't help anybody, i.e. if a car is on fire we are not allowed near the car until the fire can be put out. However, this is not the way the world works. I she should follow the spirit of the law, rather than the letter of the law. Mistakes will be made regardless, but ultimately putting the patient's best interest as your goal will not steer you wrong.

Girl InPain, EMT-B April 15, 2010 8:10 PM
Boulder

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