Thursday, June 18, 2009

HawthoRNe review

This is a bit self-serving, but it's worth noting that three of the new medical shows (Nurse Jackie, HawthoRNe, and starting in the Fall, Mercy) have nurses as main characters rather than doctors. As a nurse myself, it's about damn time. One main character and a handful of secondary ones on ER never cut it. Don't even get me started on the often nameless, ignorant, frequently dumped on nurses that populate the background of House, Grey's Anatomy, etc.

I was reading an online review (which inspired me to write my own) and it was telling that several commenters on the review didn't get that the main character isn't a doctor. We're so used to doc-focused shows that it's going to take some effort to get the necessary shift in the viewing public's mind. My biggest beef with the doctor-focused medical shows (aside from the frequently awful misrepresentation of actual medicine) is that they take away the work of nurses and give it to doctors. Why? Because non-trauma doctors mostly examine, diagnose, and write orders. Not exactly heartwarming or exciting. Doctors don't hold patients' hands, get social work consults, or stay at the bedside at the bedside continually monitoring and responding to changes in condition. All that shocking the patient and giving medications in a code? Never actually seen a doctor do it, always nurses. Sure the doctors there giving orders, but it's all mental work though which while absolutely important isn't terribly heartwarming or exciting to watch.

I'm going to write more about this phenomenon in the future, but I'll move on to the show at hand. HawthoRNe (and yes, that's a stupid name) features Jada Pinkett Smith as the Chief Nursing Officer of a mid-sized hospital. I don't watch The Closer or Saving Grace, but I get the impression that HawthoRNe is a continuation of the "strong woman taking on a male-dominated world in which she is underestimated" theme. Unfortunately, Hawthorne is portrayed as a superwoman capable of practically anything. Here she is starting an IV in a newborn's head vein! There she goes defending her staff against arrogant, deeply wrong doctors! Ad nauseum. She's too good. It's the pilot still, so hopefully she'll settle down and fail in future episodes.

I rather doubt the show will stick with a realistic portrayal of a Chief Nursing Officer, which is mostly meetings and paperwork. Why a CNO? It's an important job and gives an excuse to have her roam all over the hospital, but the position is not all that interesting. There was a much better opportunity for stories at the patients' bedsides and over hospital policy if the character was nurse manager of a unit. Oh well.

OK now I get into overcritical mode over specific plot points.

- If a knowledgeable nurse tells a doc that a patient has a Do Not Resuscitate order, the doc doesn't say, "Show it to me in the next five seconds or I don't believe you." The correct way to over-dramatize the scene is for the doc to note that attempted suicide is not covered by DNRs. Of course that route doesn't serve double-duty to show that the doctor is a jerk while Hawthorne is a fierce patient advocate and all-around superlady type.

- No surgeon would ever want to get this call in the middle of the night, "Uh, your patient is up on the roof threatening suicide. Do you want to hustle down here and talk him down?" Clearly Michael Vartan's character (portrayed as a surgeon, but the attending doctor for a cancer patient???) is supposed to be the shining white knight among the doctors, but this was a rather goofy way to try to get that across.

- A CNO would never not contact Child Protective Services as it professionally negligent and in this case would probably mean suspension of license and therefore loss of job. And making a social worker be the bureaucratic bad guy? Let's not exalt nurses and crap on social workers OK? We're all good guys.

- The "giving the patient a handjob" scene. Yes it seems gimmicky, except I can cite an actual occurrence of this shameless, really unprofessional activity. The nurse who did it giggled about it to two colleagues who didn't report it. Manager found out and fired all of them. So, believeable on this show.

Semi-accurate portrayals:

- Mention of verbal abuse from docs (a real, unacceptable issue) which was immediately undercut by stupid "paramedic is cute" comment.

- The "you're a guy, you must be a doctor" misunderstanding. Happens all the time to me and other guy nurses even when we're wearing the same scrubs as the women. Is it so hard to believe these days?

- Questioning doctor's orders when they don't seem reasonable, though 6 units of insulin (what kind of insulin? Though that may be a bit too picky) isn't crazy. And is definitely, definitely the nurses job. "Just following orders" isn't a defense against getting your license yanked for violating the Nurse Practice Act. The questioning the order scene was decent, but we really didn't need that nurses-are-just-failed-docs bit. I love being a nurse and would never want to be a doctor. Two quite distinct jobs not on a continuum (damn you ER's Abby Lockhart). Also, no recapping your needles! You're a suck-o nurse for that. Lastly, insulin overdose doesn't cause shockable heart arrhythmias. And if you were that worried, check his blood glucose as a follow-up, if you see it drop below normal levels, give the patient some orange juice. That's good nursing care. I'm not impressed with your work.

OK, that's enough. If this wasn't my profession, I wouldn't be watching the show. The feel-goodiness of the show is too saccharine, but I'm going to keep watching for a few eps to see if this mellows and to see how they handle the portrayal of nurses as main characters.

I don't have Showtime, so I haven't seen Nurse Jackie, which is a much more jaundiced view (in keeping with an ED nurse's job I'd say) apparently.


  1. Hawthorne is extremely unrealistic and degrades the nursing profession!! Stop watching!

  2. I'll give it one more ep at least because I'm reading a book that's partly about how media portrayal of nursing affects the profession, and I feel I'm almost doing sociological research by watching and thinking about it.

  3. You can see Nurse Jackie here.

    I wasn't blown away by it. Looks like too much attention was given to production values that aren't that realistic. Hospitals just aren't that clean. Where they keep their C-Dif?

  4. For what it's worth, I think the show is decent for what it is. Even in an interview with Jada's mom, she admits that no show like this will be perfect, but it can still be entertaining. I think it can be a good show.