Who’s Flying the Plane?

We've Gotten Off Track photo: JParadisi 2009

       Perhaps a change of nomenclature is needed in health care.  Physicians should be called Pilots, and nurses renamed First Officers, like in the airline industry, which the health care industry often compares itself to. The term doctor’s orders would change to instructions. Instead of a nurse requesting orders from a doctor, the First Officer would ask for further instructions from The Pilot. The name changes promote the team approach that more accurately describes patient care. 

     Gallup Poll: Power Elite Believes Nurses Should Have More Say in Policy, Management  posted by Shawn Kennedy on the American Journal of Nursing blog, Off The Charts  quotes that “69% of ‘people who run things in this country’ see nurses as having little influence on health reform.”  The poll ranks nurses at the very bottom of the list of groups influencing health reform, under patients, who lag behind physicians. Listed as the most influential  are  government, insurance and pharmaceutical executives. In other words, the people flying the plane do not control the plane. Decisions about health care policy are made by people who are not on the plane. Sometimes the decision makers aren’t even at the airport. 

         That’s not to say that physicians and nurses should dictate health care policy without thought or consideration of cost for treatment or alternative options. In the short story Voyagers, I write about recognizing the need for administrators, whose jobs keep hospitals solvent and regulated. However, demoting nurses, doctors, and the patients themselves to the bottom of the list of influential voices in health care policy, while allowing corporate administrators to have the most influence, seems a crippling case of the tail wagging the dog.

Mandatory Flu shots for Healthcare Workers Criticized in New York

     Today’s New York Times has an article supporting the right of that city’s health care workers to refuse both the seasonal  and H1N1 vaccinations. It brings up some very good points, like the question, why is it ethical to violate one group of peoples’ rights over another’s, and do states have the right to enact it?

     Presenting mandatory vaccination of nurses (and other health care workers) as an ethical responsibility, is a tactic  utilizing the media’s representation of nurse- as-angel: ever- willing to sacrifice his or her own feelings of safety to save the world. I don’t worry about the Nurse Jackies, or Hawthornes, but when media-produced stereotypes  extend to manipulate a group of people into believing that self-sacrifice, without justification, is necessary, they are harmful. Nurses are just people, like everyone else. We have rights over our own bodies, and the choices we make about them.

     Read the article:


Nurses and TV: Why Do We Care?

     Doctors don’t get all pissy when they are portrayed as immature adults with adolescent behavior problems (Scrubs), drug dependence (Cider House Rules), or happily married, goofy fathers (remember Cliff Huxtable?). They appear to roll with it.  So why do nurses  take it so much to heart how we are portrayed in the media? Why do we care so much about it?

     When was the last time you heard a physician complain about Dr. Cox drinking scotch in his t-shirt and underwear on the living room couch?   

     When was the last time you saw a nurse portrayed on TV with a sense of humor?

     Get it?

      Why are there no flight nurses on TV?  Everyone knows, in any exciting story, something flies, and there are nurses who do that for a living.  If Gage and DeSoto on Emergency! riding around L.A. in a fire truck were exciting (did anyone know what a paramedic was before that series?), how much more so are  flight nurses, who land on freeways in helicopters, saving the lives of trauma victims of car accidents? Or military flight teams, providing extracorporeal membrane oxygenation (ECMO) inside of flying surgical suites and the stories of  how the patients got there? How about the life of a midwife, or a neonatal resuscitation nurse, as if the life of an emergency department nurse, or an oncology nurse, isn’t exciting enough?  Why not make a TV series that’s populated with staff from different departments of nursing?  Maybe we need nurses to become producers and screenplay writers. Any emerging filmakers out there?

   TV dramatizes the personalities of nurses (and doctors) because writers either don’t really know what we do, and/or what we do simply isn’t exciting enough as it plays out in real life.  TV is for entertainment, and to sell commercial air time. That’s all.

   For the record, I like Nurse Jackie, but I’ve only seen the first episode.

   Be the nurse you want to see portrayed.  The rest doesn’t matter.