When Dr. Preston came in, he reviewed the patient’s chart. “I wish you hadn’t run troponins on him. His EKG didn’t show any changes.”
Clark Preston was an efficient doctor. He didn’t order more tests than necessary. He decided quickly on a patient’s diagnosis, then focused his testing on that diagnosis rather than conducting a broad spectrum of tests to make sure. This was easier on the nurses, who knew that his diagnoses were likely to be correct. But the nurses, who looked out for him because he was fun to work with, still worried that sometimes he was too brazen, too quick to assess. So far, he had not been sued. In this case, he wanted to examine the patient before running cardiac labs. Based on the EKG and the patient description of the pain, the problem could have been GI-related.
Forty-five minutes later, the lab called Juliette. She found Dr. Preston in the doctors’ back office. “Troponins came back positive,” she told him. The patient likely was having a heart attack and required further cardiac evaluation.
Dr. Preston leaned back in his chair, palms up, content to give Juliette credit. “Well,” he said with a disarming grin, “I’d rather be proven wrong than have to explain a dead guy.”
Juliette laughed, and went to administer the patient’s cardiac medications and reassess his pain and vital signs.
Midshift, Erica switched Juliette to triage to help improve patient flow. Knowledgeable, experienced nurses were more efficient at getting patients the right care. Soon afterward, someone from the Employee Health Department wheeled in a young, red-haired woman who was weeping uncontrollably. Juliette recognized her right away; she was a secretary who worked in the ICU. When they were alone, Juliette asked her name, per protocol.
“Nancy. You know who I am.”
Juliette smiled compassionately. “What brings you to the ER today?”
Between sobs, Nancy said, “I’m stressed and I can’t work and it’s horrible up there and I just can’t take it anymore!”
Juliette handed her some tissues. “What’s going on?”
“I’m . . . having . . . boy problems,” she said through gasping breaths.
Gradually, Juliette coaxed out the story. Nancy’s boy problem was that for nearly a year she had been dating Dr. Fontaine, a sexy charmer who worked in the ICU. That morning, Nancy had learned that Dr. Fontaine was also dating three nurses at Pines, and one of them was pregnant with his child. The pregnant nurse had told Nancy in person. Nancy was heartbroken. She couldn’t eat.
As Juliette triaged her, diagnosing anxiety and a panic attack, she offered what consolation she could. “I am so sorry this happened,” Juliette said. “Try to relax and we will take care of you. We’ll get you a private room in the back so you don’t have to see anybody.” Juliette was glad that the ER doctor that day was sympathetic. The doctor gave Nancy antianxiety medication and discharged her.
Juliette would never be able to look at Dr. Fontaine the same way. Nurses liked him because he was friendly and didn’t order too many ER tests per patient. The ER nurses’ goal for ICU patients was to get them quickly upstairs, where they could be stabilized and receive proper care. Many specialty doctors asked the ER nurses to do the initial tests, or they ordered extra labs and tests for the sake of ordering them. Dr. Fontaine usually said, “We can do everything upstairs.” Oh, that’s why he didn’t order a lot of tests, Juliette thought. He wanted to get back upstairs to get busy with all of his girls.
The Sexy Nurse: From “Yes, Doctor” to “Ooh Yes, Doctor”
The outdated caricature of the sexy nurse—breasts straining buttons on a form-fitting white minidress, shapely legs slipped into fishnets and white heels—remains pervasive and global. Nurses say it also holds the profession back.
A small (and strange) 2012 study published in the Journal of Advanced Nursing found that of the top-ten media-generated nurse videos on YouTube, six presented nurses as either sexpots or stupid. In a similar vein, on a 2010 Dr. Oz show, several women wearing sexy nurse costumes and red lingerie danced with Dr. Mehmet Oz. This came a few years after nurses objected to Dr. Phil McGraw’s on-air pronouncement that “cute little nurses” are husband hunters. Nurses strongly protested both doctors’ portrayals of the profession.
Imagery that sexualizes nurses can depict hardworking women as frivolous playthings or present a difficult job that requires significant expertise as nothing more than a provocative cartoon. At times, this portrayal has slipped into the province of actual medical care. Near a Las Vegas diner, where waitresses dressed as sexy nurses push customers to their cars in wheelchairs, a real medical assistant at an actual medical IV therapy practice wears a sexy nurse costume with white fishnets as she ministers to patients. In England, a bus company advertised its route to a hospital by adorning buses with a giant picture of a sexy nurse in a skimpy, figure-clinging dress, captioned, “Ooooh, matron!” Not only was the ad disparaging, but it also implied that patients need only step on board to be transported to the healthcare provider of their fantasies; the ad seemed to beckon, “This way to hot, nursey sex.”
Some hospitals aren’t above spinning the stereotype, either. A Swedish hospital recruiting nurses to work during the summer of 2012 posted an Internet ad that instructed, “You will be motivated, professional, and have a sense of humour. And of course, you will be TV series-hot. . . . Throw in a nurse’s education and you are welcome to seek a summer job at SÖdersjukhuset’s emergency department.” The hospital, which has the largest Emergency Care Unit in the Nordic region, completely trivialized nurses’ qualifications, tossing in a nursing degree as if it were an afterthought.
Nurses laugh at the idea that their job is TV-series sexy. Instead of come-hither white dresses, today’s nurses wear scrubs that might be stained with blood, urine, or various other un-arousing substances. A male nurse in Virginia said, “We’re sweaty and smelly and covered in germs. Plus, we’ve all had patients die in horrible ways in pretty much every corner of the building. I would never be able to get it on in a hospital.” Similarly, former certified nursing assistant Erin Gloria Ryan, news editor of the popular women’s issues blog Jezebel, remarked on a nurse-related comment thread, “Nothing sexier than someone who is going to record the frequency and consistency of your bowel movements on a chart.”
As a Michigan nurse manager pointed out, “Some nurses do fit the naughty nurse persona.” And some nurses are often happy to engage in tongue-in-cheek innuendo (or worse; see Chapter 5). But sometimes the sexy nurse seeps into the public consciousness as more than just a joke. Nurses told me about doctors groping them. An Oregon nurse said, “Some of the docs are lecherous old perverts.” Gail Adams, head of one of the United Kingdom’s largest unions, has noted, “People are happy to sexualize the image of nursing but are then surprised when nurses are attacked or have lewd or indecent comments made towards them.”
In 2010, a Dutch nurse union received complaints that male patients were requesting sex and some nurses were complying. Reuters reported that a 24-year-old nursing student told the union that she had seen a 42-year-old disabled man’s home care nurses sexually gratifying him. The man, who had a muscle disorder that let him move only his mouth and eyes, told her that his previous seven nurses had done the same. When the student refused his request, the man tried to fire her, claiming that she was unfit for the job. The incident prompted one newscaster to remark, “I’ve got to get myself a nurse in Holland.”