UCLA
CSW Update Newsletter
Title
Media Images and Screen Representations of Nurses: Conference Review
Permalink
https://escholarship.org/uc/item/4c831776
Author
Sher, Ben
Publication Date
2011-06-01
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MEDIA IMAGES AND SCREEN
REPRESENTATIONS OF NURSES
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contents
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T
HE THING about stories is, theyre sort of
the intellectual diet of society. We learn
about the world through the stories we
tell, said Joseph Turow, Robert Lewis Shayon
Professor of Communication at University of
Pennsylvanias Annenberg School. “We re-en-
force our ideas about society through the stories
we tell. People learn about occupations through
stories, about what’s good and bad, about
romance. Over time systematic presentations
of certain people, certain ideas, certain worlds,
bring people behind the scenes. And whether
they know it or not, [audiences] learn about how
certain occupations act, how theyre supposed
to do things…When it comes to health care, and
specically the representations of doctors and
nurses, it is inuential on how we perceive the
elds.
Thus began Turow’s presentation, “Playing
Nurse, Playing Doctor, in which he insisted that
media representations must be studied in order
to assess their impact on audiences’ perceptions
of the world in which they live. This idea was
at the core and foundation of the conference
“Media Images and Screen Representations of
Nurses. Taking place on May 12, the event was
organized by MarySue Heillemann, Associate
Professor in The UCLA School of Nursing, with
assistance from Ph.D. student Heather Collette-
VanDeraa and Professor John Caldwell in the
Department of Cinema and Media Studies. It
was cosponsored by The Center for the Study of
Women and The UCLA Chapter for the American
Assembly of Men in Nursing.
Impressive in scope, the conference incor-
porated presentations by nurses, journalists,
academic scholars, activists, and major play-
ers in the entertainment industry. Their topics
ranged from representations of nurses smok-
ing in advertising throughout the 20
th
century
to methods by which nurses can inuence and
improve upon their often oensive depictions
on contemporary television. The rst half of the
day-long conference, which will be covered in
this article, began with presentations by Turow
and Sandy Summers, who presented a multi-
faceted portrait of the ways in which nurses have
been represented in media since the 1950s, and
the historical, cultural, and industrial events that
have informed these depictions.
Turow discussed the development of medi-
cal shows on television, which were inspired Dr.
Kildare, MGM’s B-movie series of the 1930s. Stu-
dio head Louis B. Mayer dictated that lmmakers
idealize Dr. Kildare and his mentor, Dr. Gillespie,
making them perfect in terms of societal norms.
This developed a formula dictating what made
successful programs about physicians: [They
had to be] hospital based, doctor centered, and
usually involving a younger and an older doctor,
said Turow. Unfortunately, this idealization and
emphasis of physicians relegated nurse char-
acters to the sidelines. For example, in the lm
series, Dr. Kildares girlfriend was a nurse. Howev-
er, little attention was paid to the character until
she was run over by a car in its nal entry. Turow
argued that these plot structures gave birth to
the medias inaccurate
notions that nurses are
peripheral, unimportant,
and exist only as lovers
to physicians, which have
endured throughout the
decades.
One of the rst
shows to make an ef-
fort to break this pattern
was The Nurses, which
Impressive in scope, the conference incorporated presentations by
nurses, journalists, academic scholars, activists, and major players
in the entertainment industry.
contents
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ran from 1962 to 1965 on CBS. It starred Shirl
Conway as the older, wiser nurse (a Dr. Kildare
equivalent), and ballet dancer Zena Bethune as
her young protégé. The American Medical As-
sociation strongly inuenced medical shows that
preceded The Nurses (forbidding studios to shoot
in their hospitals without their script approval of
each episode). Herbert Brodkin, the head pro-
ducer of The Nurses, resisted the inuence of The
American Nurses Association and instead hired
an acquaintance, a professional nurse, to be an
advisor on the show. The series’ representation
of nurses, like many socially concerned television
series, contained both progressive and reaction-
ary elements. Turow described an exemplary
episode in which a juvenile delinquent comes to
the hospital suering from low self-esteem that
has manifested itself as terrible headaches. In a
move that was highly unusual in popular culture
at the time, the hospital sta brings in an African
American social worker to help them to nd a
cure for the boys ailments.
Turow showed a clip from the episode, in
which a physician, the head nurse, and the social
worker argue about the best treatment for their
patient. The physician emphasizes the patients
physical problems, the social worker insists upon
the sociological reasons for his illness, and the
head nurse argues that the boy needs maternal
nurturing and loving kindness, and that she
should bring him milk and cookies. In the end,
the social worker is proved to be correct, and the
nurse acknowledges it. While the nurses agency
in this episode is relegated to the feminine
sphere and eventually overturned by her patriar-
chal co-workers, the majority of the teleplay rep-
resented the characters as equals, reecting the
beginning stages of the Civil Rights movement
and second wave feminism. Similarly striking is
the episodes representation of women and Afri-
can Americans ghting together for each others
causes: in the episode, a nurse aggressively takes
the juvenile delinquent to task for referring to his
social worker using a common pejorative term
used to describe African Americans.
While The Nurses showed promise on an artis-
tic and sociological level, CBS’ programmers said
that the show was problematic because it was
too dicult to nd ways in which to make nurses
central. In the middle of the series run the head
of CBS programming forced the show to become
a soap opera, and changed its title to The Doctors
and the Nurses. “Shirl Conway said at least they
should have called it The Nurses and the Doctors,”
noted Turow.
Julia (1968-1971), starring Diahann Carroll,
emerged at the height of second wave feminism
and in the wake of the Civil Rights movement.
“In those days, the designation of ‘nurses indi-
cated professional non-second banana status,
said Turow. Therefore, it was a good place to
have an African American actress. The show, a
substantial hit, was considered by many to be
progressive for its depiction of a professional
African American single mother successfully (if
sometimes rockily) balancing a career, parenting,
friendships, and dating. However, even though
Julia worked as a nurse in the health oce of
Diahann Carroll starred in Julia
from 1968 to 1971, as nurse and a
single mother balancing a career,
parenting, friendships, and dating.
contents
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an aerospace rm, Turow pointed out that the
shows focus was not on the details of her career
as a nurse, but on her balancing of the personal
and the professional. Once again, Julia was, in
fact, made “second banana to her boss at work:
a gru, paternalistic Lou Grant-type who asked
questions like “Have you always been a negro
or were you just trying to be fashionable?, and
made casual, laugh-track inducing statements
like “I’m tired of seeing ugly nurses. Although
there is much documentation to suggest that
Julia had a profound inuence on many viewers,
the show was met with contradictory responses
from its black audiences, with some arguing that
the show propagated the “Uncle Tom stereo-
type. According to Turow, these accusations
nally led Carroll to leave the show in 1971.
Turow broadly outlined structural changes
that took place on medical shows from 1970
until 2000: the gender and race of physicians be-
came increasingly diverse, there was a shift from
the idealization of hospitals to a focus on non-
ideal hospital conditions, and, nally, doctors
and doctors’ personal issues moved to the fore-
front again. These changes were exemplied by
series like St. Elsewhere (1982-1988, NBC), Private
Practice (2007-present, ABC), and Grey’s Anatomy
(2005-present, ABC). As importantly, the shift
from network domination to cable programming
inspired television producers’ growing interest
in “niche audiences”: perhaps most prominently,
women. Nurse Jackie (2009-present, Showtime)
and Hawthorne (2009-present, TNT) have made
eorts to portray nurses who are fully realized
Hawthorne
characters. They have also strived to accurately
depict the requirements of the job (Summers
elaborated on the depictions of nursing in these
series, as will be discussed below). While Turow
argued that these shows are a step in the right
direction, he concluded by stating that the most
mainstream depictions of physicians and nurs-
es—those on the major networks—continue to
focus on physicians, and relegate nurses to the
margins. “Since ER there seems to have been a
drop in the number of nurses apart from these
shows, said Turow. “On Greys and Private Prac-
tice, the nurses are faceless people. They simply
aren’t there. Turow pointed out that television
has yet to adopt the concept of the medical
team (on which physicians and nurses work
together, each serving dierent, fundamental
roles), even though it is a hallmark of contempo-
rary hospitals. Furthermore, Hollywood’s histori-
cally problematic appropriation of second wave
feminisms inuence on the workplace may have
ironically contributed to nurses’ increasing invis-
contents
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ibility. When you have women who are physi-
cians you don’t need to have women who are
nurses to add some romantic ardor, said Turow.
During a question and answer period that
followed Turows presentation, several in atten-
dance asked what they could do to improve the
lm and television industries’ depictions of nurs-
es. Turow argued that in order to inuence the
media, proponents of change must make sug-
gestions that would both revise representations
and appeal to the media industries “rewards
system (in other words, activists must suggest
dierent kinds of representations that will sell).
When one audience member suggested that
television depictions of nurses would be highly
dierent if they were created from the perspec-
tive of patients, Turow responded: “If you tell
someone to do something on the patient’s per-
spective of a nurse, theyre going to yawn. When
I nished my book I asked writers ‘Why don’t you
do something about the politics of medicine?,
and they said the audience isn’t interested. The
trick is to gure out how you can propose [such
a series in a way that also strongly suggests] that
the lm will succeed. You’re dealing with people
who sometimes spend a couple of million on an
episode.
Sandy Summers, R.N., M.S.N., M.P.H., the next
keynote speaker, demonstrated that nurses can
and do strongly inuence their depictions in
television, lm, and advertising from the ground
up. Summers is the Founding and Executive
Director of The Truth About Nursing, a non-
prot organization that seeks to increase public
understanding of the central, front-line role that
nurses play in modern health care. In particular,
the organizations focus is to promote more ac-
curate, balanced, and frequent media portrayals
of nurses and increase the medias use of nurses
as expert sources. Summers’ recent book, Saving
Lives: Why the Medias Portrayal of Nurses Puts Us
All At Risk (co-written with Harry Jacobs Sum-
mers) argues that most media representations of
nurses are not merely oensive, annoying, and
in-accurate: they negatively inuence the health
care that patients receive in the real world.
Summers’ presentation began with a startling
list of data suggesting that the media has con-
tributed to some of the problems that nursing
as a profession faces today. She cited a poll in
which 24% of participants said that they trusted
comedian/Playboy bunny Jenny McCarthys
advice on the dangers of vaccinating children.
A study of 1800 private school students taken
in 2000 said that boys stopped paying attention
when conversations at school about possible
career paths turned to nursing because the
career didn’t pertain to them. The same survey
suggested that, because of the media, students
felt that they knew more about nurses love
lives than their careers. Another study stated
that television depictions of nurses discourage
young people from pursuing the profession.
Summers argued that these studies exemplify an
overall trend in which nurses and their work are
devalued and misunderstood, which creates an
array of serious problems for health care and its
constituents. “If our patients can’t respect us, we
Summers’ recent book argues that most
media representations of nurses are not
merely offensive, annoying, and in-accu-
rate: they negatively influence the health
care that patients receive.
contents
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can’t do our jobs, said Summers. “So we need
to build up the respect of the profession so we
can enhance nursing care. We are ignored by
our colleagues, physicians especially, because
they don’t respect us. Summers argued that
when adults without signicant understand-
ing of nursing receive a lifetime of inaccurate,
stereotypical messages about the profession,
the eects are far-reaching. Public ocials and
health care decision-makers with little under-
standing of nurses’ importance fail to allocate
sucient funds to nurse stang, education,
and research by, for example, understang
nurses, which leads to increased patient mor-
tality and promotes a general nursing shortage.
She pointed out that there is a dearth of federal
funding for nursing. Resident nurses earn one
dollar for every 375 dollars earned by resident
physicians, and only one dollar out of every 200
dollars in the NIH budget is allocated towards
nursing research.
Summers followed her description of this
worrisome state of aairs with a comprehen-
sive discussion of the ways in which media
(in particular, television shows and adver-
tisements) have repeatedly promoted and
naturalized the belief systems that lead to the
devaluation of nurses, and its ensuing ef-
fects. Clip after clip from hit series like Grey’s
Anatomy (2005-present, ABC) and House, M.D.
(2004- present, Fox) show physicians “doing
all the work” while nurses wander around on
the sidelines, mostly cleaning up after them. In
one potent example, (Dr.) House is seen caring
for a patient who falls to the oor, leading him
to proclaim “Now this is why I invented nurses.
Clean up on aisle three!” On a series titled O
the Map (2011-present, ABC), a female physician
expresses envy that her colleague has gotten to
work on challenging medical cases, despairingly
stating that “I handed out band-aids today, like a
school nurse. In an episode of Eight Simple Rules
(2002-2005, ABC), a nurse says Without me, pa-
tients could die. When her companion responds
“Really?, she says Well, no, but they could wet
their beds.
According to Summers, depictions like these
are based on huge misconceptions about what,
exactly, nurses do: often, the very jobs that TV
shows repeatedly attribute to physicians. “Do
physicians do all the healthcare work that mat-
ters? Thats what it looks like, said Summers.
Summers showed a clip from an episode of
Grey’s Anatomy that featured the very common
medical show image of a physician successfully
debrillating an unconscious patient.
Who debrillates at UCLA? Nurses, said
Summers. Can you imagine if nurses debril-
lated on television shows? There would be 16
year old boys lined up around the back to get
into nursing school. It’s such a high testosterone
maneuver. You have to have nerve to do that,
but it saves lives. And you have to be smart to
read those squiggly lines on the screen. We need
credit for the work that we do. Summers coun-
teracted the notion, articulated by Turow, that
nurses’ work is under-represented on TV shows
because it is less ashy and cinematic than that
Summers counteracted
the notion, articulated by
Turow, that nurses’ work
is under-represented on
TV shows because it is
less flashy and cinematic
than that of physicians.
“Hollywood doesn’t think
nursing is dramatic
enough?” she asked.
“They’re already showing
nursing care all the time.
It’s plenty dramatic, it’s
passed the litmus test.
But they put it in the
hands of physicians.”
contents
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of physicians. “Hollywood doesn’t think nursing
is dramatic enough?” she asked. They’re already
showing nursing care all the time. It’s plenty
dramatic, it’s passed the litmus test. But they put
it in the hands of physicians.
Summers emphasized that strengthening
representations of nurses in the media will
strengthen the nursing profession and, thus,
benet nurses and patients alike. “We’re autono-
mous professionals, said Summers. “People don’t
know that, they have no idea that we have inde-
pendent thoughts in the healthcare setting, we
intervene to save patients lives, we coordinate
the healthcare team, we’re educated researchers,
educators, and advocates. It is our job to teach
the wider public about the value of nursing, be-
cause if we don’t strengthen the nursing profes-
sion we can’t help our patients to survive…That
is why it is important to spread this information
through the media.
Like Turow, Summers praised recent TV series
like Nurse Jackie and Hawthorne which, she stat-
ed, are groundbreaking for their accurate depic-
tions of nurses’ work. She showed clips of Nurse
Jackie making vital decisions in the treatment
of patients, a clip in which Hawthorne kicks out
a physician who wants to interview a patient so
that she can administer treatment, and another
clip in which nurses collaborate in order to as-
sess the best ways in which to treat a critically ill
baby (these sequences pointedly counteracted
another series of clips in which nurses deferred
to physicians, or were presented as powerless
and wholly dependent on the instruction of phy-
sicians). Summers stated that her organization
doesn’t insist that the media portrays politically
correct, idealized nurses, the sorts of characters
that people who criticize the notion of positive
representations” are against. In fact, the angelic
nurse is another stereotype her organization
protests. First and foremost, her organization de-
mands accurate, multi-faceted representations.
“People don’t like Nurse Jackie because shes a
bad person, but shes an excellent clinician, said
Summers. The series shows that nurses save
lives, and though the message may be delivered
through a very awed human being, we still
learn through the show what nurses do for their
patients...This is great stu that we need the
public to learn.
Summers nally outlined some of the ways in
which her organization has helped to improve
representations of nurses, and decrease or revise
ones that are oensive and/or in-accurate. In
particular, she discussed the ways in which The
Truth About Nursing has organized successful
press and letter-writing campaigns to protest
and revise depictions of nurses on television
and in print media. In 2010 the organization
launched a campaign in the Associated Press
against the reality TV show Dr. Oz, which fea-
tured a weight-loss segment in which women
dressed in provocative nurse costumes (tting
the “naughty nurse stereotype) got sexy and
danced with Dr. Mehmet Oz. Eventually, the sta
of the show issued an apology to the Associated
Press, Oz added a nurse blogger to his website,
and nally featured an actual nurse on the se-
“People don’t like Nurse
Jackie because she’s a bad
person, but she’s an excellent
clinician,” said Summers.
contents
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ries. In response to a commercial for Dentyne Ice
gum in which “naughty nurses were lured into
bed by male patients, the organization launched
a letter-writing campaign that resulted in 1500
letters of protest. When these letters went
ignored, Summers called the top executives at
Cadbury Schweppes (who produce the gum)
every day for a week, leaving ve minute voice-
mails explaining why the ad was highly prob-
lematic, and promoted sexual harassment in the
workplace. After a week, the CEO of Cadbury
Schweppes issued an apology and announced
that they would pull the ad. When the makers of
E.R. had the character Abby triumphantly leave
her nursing profession to attend medical school,
The Truth About Nursing protested “for years”
to E.R.s creators, pointing out that there is data
showing that nurses who go to graduate school
are much more likely to go to graduate school
for nursing, rather than medical school. Years
later, Sam, another nurse character on the series,
went to nursing school.
Summers concluded her speech with a call to
action, suggesting that nurses at UCLA should
start a chapter of The Truth About Nursing,
contribute to the organizations’ letter-writing
campaigns, and visit www.truthaboutnursing.
org, which features a section titled “100 Things
that We Can Do to Improve Images of Nursing in
the Media.
“You guys are right here, right where all of the
Hollywood damaging stu is produced, said
Summers. “Nurses in Bangladesh can’t even get
married because theyre equated with prosti-
contents
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tutes. That idea comes from here: our Hol-
lywood. I believe it is our civic duty to repair
the situation, to improve the world’s respect
for nursing, so we can do a better job not just
helping the lives of nurses, but improving
patient care.
After taking in two presentations that
powerfully demonstrated the ways in which
media representational strategies are both
highly problematic and dicult to change, it
was refreshing to watch CSW Director Kath-
leen McHughs interview with Richard Hard-
ing, a lm producer passionately dedicated to
social justice. Harding is the President and CEO
of Sixth Sense Productions and the founder
of Malaria Now, a not-for-prot dedicated to
protecting children in Kenya from malaria.
He played a key role in nancing the Golden
Globe and Oscar nominated lm Hotel Rwanda
(2004), about a hotel manager who saved
1,000 potential victims of the genocide of the
Hutus and the Tutsis in Rwanda in 1994. His
most recent project, The First Grader (2010),
is based on the true story of an 84 year old
former Mau Mau resistance ghter in Kenya
who takes his government’s education for all”
promise literally and insists on being admitted
into elementary school, so that he can learn to
read. The lm was runner up for the Peoples
Choice Award at The Toronto Film Festival,
second only to The King’s Speech (2010). The
main focus of the interview was Hardings next
project, a lm about a group called The Beng-
hazi Six in press headlines.
Sixth Sense Productions’s current project is a film about The Benghazi Six, five nurses
from Bulgaria and a Palestinian doctor, who were accused by the Libyan government, led
by Muammar al-Gaddafi, of infecting 450 babies with the AIDS virus. It was later proven
that the infections were the results of poor sanitary conditions in the Libyan hospital,
and began before the Benghazi Six arrived.
contents
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The Benghazi Six were ve nurses from
Bulgaria and a Palestinian doctor who moved
to Benghazi, Libya, to work in a hospital and
make extra money for their families at home.
The Libyan government, led by Muammar
al-Gadda, falsely accused the group of infect-
ing 450 babies with the AIDS virus. It was later
proven that the infections were the results of
poor sanitary conditions in the Libyan hospital,
and began before the Benghazi Six arrived.
What happened in the hospital was that
Libyan nurses, said Harding, don’t feel that little
babies have diseases that they can spread to
others. So nurses shared needles among babies,
and that’s what created the mess. There was no
sanitation. These Bulgarian nurses were so well-
trained that they could not practice in this way.
They brought their own sanitized needles, their
own soap, their own gloves, but whatever they
did they were threatened, and people said ‘If
you don’t like it, go home.
Indeed, it has been suggested that one of
the reasons that the nurses were singled out is
because they fought the dangerous conditions
in the hospital. Their identities as both clinical
and residential outsiders made them especially
vulnerable.
“Gadda needed a scapegoat, said Harding.
And the only nurses he chose were those who
came from a country that had no backing from
the USA. They chose these nurses because there
was nothing that they could do.
The group was tortured, beaten, forced to
confess to crimes that they did not commit, and
sentenced to death three times over a period
of nine years. “I’ll tell you how bad the torture
“Gaddafi needed a scapegoat,” said Harding. “And the only
nurses he chose were those who came from a country that
had no backing from the USA. They chose these nurses
because there was nothing that they could do.”
contents
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was, said Harding. “I wanted a woman to write
the screenplay so it could come from her point
of view, and I had two ladies read the treatment.
It was raw, nothing was edited, and we gave it
to the writers to adapt it so that American audi-
ences could go through it. One of the women
called her agent crying and said ‘I won’t write
this because I can’t read it, and another woman
said ‘I can’t write this, it’s too horrible. But these
nurses wanted to tell the stories of what they
went through—how nurses, who are here to
help people, went through this.
The Benghazi Six were nally freed in 2007,
after France intervened to liberate them. Hard-
ing became interested in making a feature lm
about the group after his creative partner, Sam
Feuer, read an article about them while they
were still on Death Row. The rst thing I asked
was, what can we do as human beings to free
these nurses?” said Harding. “Because these are
ladies that were brought to Libya to care for peo-
ple, to heal people, and for them to be treated in
this manner struck me as a great injustice. And
making a movie about this was one way to see
how we could avoid having something like this
happen in the future.
Harding also wanted to make a mainstream
lm about the Benghazi Six because he felt that
the lm, and its production, could be instrumen-
tal in helping them to get released. “I got the
rights while these nurses were on Death Row.
I called my lawyer and asked ‘How do we go
about getting the rights?, and he said ‘Richard,
if you were on Death Row, would you be con-
cerned about being in a movie?’, said Harding.
So we had to y to Libya with their sisters and
relatives to get the rights to tell the story, and
we said that we’d get behind these people and
use our power to support them.
The news of the lms production did, indeed,
interrupt the status quo in Libya surrounding
their case. There was an uproar, and I think a lot
of it had to do with the fact that these were nurs-
es, said Harding. “It brought a lot of attention to
the case. And eventually we were able to get the
nurses to give us the rights to make the lm. By
then the French had gotten on board to help the
situation. The headlines wrote ‘Hollywood pro-
ducers come to Bulgaria to help the nurses, and
Gadda has a heart attack. Some people said
it had to do with the fact that we were making
the movie…We got calls once a month from the
Libyan embassy asking how we were going to
portray them.
Harding stated that, like the Truth About Nurs-
ing organization, the makers of the Benghazi Six
lm are highly concerned with presenting an ac-
curate depiction of these nurses, their jobs, and
their story: These are very strong women, and I
give them great credit. 95% of the story is based
on what we got from them, and we couldn’t
write it any other way. For them it is very impor-
tant that nurses are portrayed very positively, like
Sandy was saying, and that is something that we
will stand by. We made a promise to the ladies
that we would do them right and show who
nurses are, and also show the injustices that were
done to them.
In the question and answer session with the
audience that followed Hardings interview,
Summers asked that the lm devote at least a
small amount of time to showing the nurses
saving the lives of children and to representing
them as autonomous, skilled, educated profes-
sionals. Thats one of the things that the nurses
requested, said Harding. That we show them
doing positive things, whether saving a life or
taking care of kids, and we plan on doing that. I
think its important [that I] be here today to em-
phasize in my mind how important this is. I don’t
do TV. But I would love to do a TV show from the
perspective of nurses.
The conferences presenters and curators did
an outstanding job of painting a portrait of the
ways in which nurses have been, and continue
to be, represented in multiple forms of media,
the cultural reasons for these representations,
and their cultural eects. The morning’s presen-
tations ended on an encouraging note. Hard-
ings statement that he would take the discourse
presented at the conference into consideration
while producing the next mainstream movie
about nurses demonstrated that events like the
conference, and the work of Turow, Summers,
Harding, and the institutions with which they
are aliated, are not only important because
they increase our awareness of media depictions
of nurses and their cultural impact. They are
important because they truly have the power to
inuence them.
“I like you, and I think that the work you are
doing is very important, Harding told Summers.
And I hope that I never receive a phone call
from you.
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