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Making a difference from the inside outMarySue V. Heilemann, PhD, RNa,*, Theresa Brown, BSN, RN, PhDb,

Larry Deutchman, BA, MBAc

aAssociate Professor, UCLA School of Nursing, Los Angeles, CAbClinical Nurse and New York Times Opinion Columnist

c Executive Vice President of Marketing and Industry Relations, Entertainment Industries Council, Inc., Los Angeles, CA

a r t i c l e i n f o

Article history:Received 1 March 2012Revised 16 June 2012Accepted 21 June 2012

Keywords:Authorship - sociological aspectsNurses in mass mediaSocial changeStereotypes (social psychology)in mass media

Television authorship

* Corresponding author: Dr. MarySue V. HeilLos Angeles, CA 90095-6919.

E-mail address: mheilema@ucla.edu (M.V

0029-6554/$ - see front matter � 2012 Elsevihttp://dx.doi.org/10.1016/j.outlook.2012.06.01

a b s t r a c t

Nursing leaders, researchers, and activists have called for change in mass mediadepictions of nurses since the 1980s, but some nurses are not sure they shouldmake any effort. This article offers a focused look at the trajectories of 2 indi-viduals: Theresa Brown, a clinical nurse and author who writes for the New YorkTimes, and Larry Deutchman, the Executive Vice President of Marketing andIndustry Relations at Entertainment Industries Council, Inc. Both Brown andDeutchman were motivated to acquire skills and to take risks to think creatively,and/or to collaborate with other professionals in media to benefit nursing andhealth. Analysis of their paths offers ideas for action, growth, learning, andcollaboration for nurses in relation to the ways that nursing is represented inwritten and visual media.

Cite this article: Heilemann, M.V., Brown, T., & Deutchman, L. (2012, OCTOBER). Making a difference from

the inside out. Nursing Outlook, 60(5S), S47-S54. http://dx.doi.org/10.1016/j.outlook.2012.06.017.

Beginning in the 1980s (Kalisch & Kalisch, 1982, 1986,1987; Kalisch, Kalisch, & Clinton, 1981, 1982; Kalisch,Kalisch, & Petrescu, 1985; Porter, Porter, & Lower,1989), researchers, journalists, activists, scholars, andleaders have asked nurses to take action to influencethe ways that media depicts, portrays, or representsnurses (Berry, 2004; Buresh & Gordon, 2006; Diers, 2004;Donelan, Buerhaus, DesRoches, Dittus, & Dutwin, 2008;Strickland, 2006; Summers & Summers, 2009;Woodhull Study on Nursing and the Media, 1997).However, 30 years later in the 21st century, some havedescribed “a profound ambivalence” (Buresh & Gordon,2006, p. 5) among nurses about whether or not theyshould gain such skills or take a more active role tocommunicate to the public about the profession ofnursing.

While this ambivalence hovers, the costs of nurses’silence when their profession is misrepresented to the

emann, Associate Profess

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er Inc. All rights reserved7

public include the failure to attract talented recruits tothe nursing profession; diminished respect for nursesamong the public and other health professionalsincluding administrators; insufficient salaries that arenot commensurate with the expertise of nurses; andthe tendency for hospitals to treat nurses “as a cheap,disposable labor force” or merely “as inter-changeablecogs in an industrial machine” (Buresh & Gordon,2006, p. 12). In their expansive analysis of the effectof media on nursing, Saving Lives: Why the Media’sPortrayal of Nursing Puts Us All at Risk (2009),Summers and Summers explained that the public’smisunderstanding of nursing ultimately contributes tothe lack of funding related to practice, education, andresearch. In terms of nursing practice, this leads toproblems such as inadequate staffing in hospitals,which can set up unsafe conditions for nurses andpatients. Failure to understand the value of nursing

or, UCLA School of Nursing, Factor Bldg, Room 5252, Box 956919,

.

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contributes to a lack of educational resources fornursing students, which ultimately reduces thenumber of properly educated and available faculty forschools of nursing. Misunderstanding of the role andimportance of nursing in the greater healthcare arenacontributes to a staggering lack of funds for nursingresearch in comparison with other disciplines(Summer & Summers, 2009). Other researchers haveconcluded that inappropriate or inaccurate portrayalsof nurses can contribute to verbal or physicalmistreatment of nurses while on the job (Ferns &Chojnacka, 2005); disempowerment (Kaler, Levy, &Schall, 1989); lack of self confidence among nurses(Fletcher, 2007); and lowered self-image, which furthercompounds inequalities of power between nurses andphysicians and compromises patient care (Kalisch &Kalisch, 1986).

Despite these costly consequences, some nurses failto realize that, rather than being inherited or“instinctual,” most verbal and written skills for publiccommunication are learned through classes andrefined through practice over time (Buresh & Gordon,2006, p. 7). Because some nurses are motivated totake action and develop the necessary skills but othersare not, future research may help us understandnurses’ personal and professional priorities in relationto media representations of nursing, why they are orare not motivated to gain skills to correct misrepre-sentations, and how they might become motivated toengage in the learning process related to media inrelation to nursing. Meanwhile, literature is availablefor those who are motivated to learn how to becomemedia savvy, create their own media, write editorialsfor their community newspapers, reach out to thenews media about a compelling story (Summers &Summers, 2009), write a news release, assemble pressmaterials, develop media strategies, or promotenursing research (Buresh & Gordon, 2006; The TruthAbout Nursing, 2012).

Resources such as these are essential and can bea tremendous aid to nurses all over the world.However, deeper analysis of particular cases of mediainvolvement may shed additional light on thephenomenon of media engagement for nurses who arestill wondering how such efforts can make a tangibledifference for the profession. The purpose of this paperis to take a closer, more focused look at the trajectoriesof 2 individuals who made choices, not only to becomeequipped with skills, but to act with courage to takerisks, think creatively, and act collaboratively in rela-tion to media. Then, suggestions for possible actionwill be offered.

Theresa Brown and Larry Deutchman started withintentions to use their talents to benefit the health ofthose around them. They followed their interests andpassions, developed their talents and skills, and asa result, ended up on paths that led to meaningfulchange in relation to media. Brown, a writer whoearned a doctorate in English from the University ofChicago, taught in some of America’s finest liberal arts

colleges before she decided to become a registerednurse. While working at her first clinical position,she found herself confronted with a series of oppor-tunities to write about being a clinical staff nursein oncology. By welcoming these opportunities,Brown’s path led to a national audience eager to hearher insights on “death, life, and everything in between”(Brown, 2010). Deutchman started on a path to becomea filmmaker and, along the way, realized he had de-veloped an effective philosophy for collaboratingwith image-makers in Hollywood’s entertainmentindustry to effectively portray various health-relatedtopics on television and film. Turning first to Brown,we will consider how her decision to write abouther experiences as an RN ultimately her led to theNew York Times, where she currently writes an opinioncolumn.

Analysis by Theresa Brown

The first-ever piece of writing I did on nursing came outin the New York Times “Science Times” section onSeptember 9, 2008. Called “Perhaps Death is Proud,More Reason to Savor Life,” it described my reaction tothe sudden and gruesome death of a patient who wasscheduled for discharge later that afternoon. Thepatient died when I was still a new nurse, only 6months into my first year. I wrote the essay because Ithought that if I could contain the experience within 2or 3 sheets of paper I could also contain it in my mind.

Over time I discovered that painful memories arenot so easily tidied away; but nevertheless, the essaymanaged to capture the up-swell of feelings triggeredby my patient’s horrific death. When I finished it Ithought, “This is gooddI think I’ll send it somewhereand see if I can get it published. Aim high.” I had aneditor friend at the New York Times who thought it wasgood enough to pass onto Science Times, and a coupledays later I heard from an editor there that they wan-ted the piece.

They published it a fewmonths after the acceptanceand the reaction took me completely by surprise. Rightaway I got phone calls and e-mails from agents. Within3 days I had a book contract, and that book, Critical Care:A New Nurse Faces Death, Life, and Everything in Between,was published June, 2010 by HarperStudio. It’s a greatstory, but there’s more to the story than “formerLiterature Professor becomes a nurse and proves the 6years she spent getting a PhD in Englishweren’t wastedafter all.” The agents and editors I spoke with all saidthey were hearing a voice that was rarely, if ever,heard: the voice of a hospital nurse.

I began writing for the New York Times blog called“Well” a few months after I got the book contract.Readers often commented that they were surprisedand grateful that the Timeswas including the writing ofa staff nurse. Nurses themselvesdor ourselvesdwere

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not used to hearing the voice of a clinical nurse inmainstream media, and they liked it.

For me, combining my love of nursing and my loveof writing is an easy fit, but more important, there’ssocial value to having nurses who write about the job.People come to hospitals because they need nursingcare, so the story of hospital nursing is the story ofpatient success in the hospital. The attention ofphysicians will be crucial during any hospital stay, butit is nurses who, minute by minute, get patientsthrough. We’re all familiar with doctor narratives, butthe public needs to learn nurses’ stories, too.

Let me explain why by turning to my book, CriticalCare. One of many readers’ favorite chapters in CriticalCare is titled “Doctors Don’t Do Poop.” The chapterfollows one patient during 2 different hospital visitsthat were separated by several months. During the firstinpatient visit the patient, an older man with a veryattentive adult son, was severely incontinent of stooland an aide and I spent the day taking turns cleaninghim up. In the second hospital stay, the patientreached the end of the treatment road. His cancer hadreturned, and the physician told him there were nomore curative options. The son responded to this newsby asking me to find them a Bible. They had forgottento bring their own.

My account of these 2 widely divergent patientneedsdhelp with incontinence, and the desire fora Bibledspoke to readers as illustrating somethingessential about nursing. I would describe that essenceas being focused on and directed by what the patientneeds. Whether that need is incredibly mundanedincontinencedor consciously etherealdneedinga Biblednurses will go to that area of vulnerability andtry to help.

Unspoken in the continuum of nursing care pre-sented in “Doctors Don’t Do Poop” is that nurses meetall patient needs, not just those involving humanwasteand fear of death. When I began writing about nursing,I felt I had a mission: to inform the public about whatnurses really do, because we’re nursesdwe do it all.We educate patients about how their medicationswork and we’re the final check on making sure all drugdoses are safe. When something goes wrong clinically,we’re the person responding at the bedside, and ifneeded, sounding the general alarm. We are the innermechanism of the healthcare machine and its humanface.

For my writer half, “Doctors Don’t Do Poop” let meuse a patient’s story to catalogue the breadth ofsensation and emotion that nurses encounter everyshift. A writer who wasn’t a nurse would not be able totell this story with the same level of detail. For a nursewho was not a writer, the story would never be told,and the importance and value of the continuum of careprovided by nurses would remain as hidden as before.

However, being the “nurse who writes” isn’t alwayseasy. A New York Times op-ed of mine published May2011, called “Physician Heel Thyself,” about doctorsbullying nurses, definitely created tension in the

hospital. After the column came out, I met with a fewmembers of the medical and nursing staff to talk itover. It was not an easy discussion.

The meeting ended late in the morning, and I had togo back to work just a few hours later for an eveningshift. I felt grumpy and preoccupied, and after havingbeen at work already, in civilian dressed-up clothes, Ididn’t want to return in scrubs and work as a clinicalnurse for 8 more hours. However, I have enoughexperience that routine can kick in. My patientassignment was straightforward, and the night prom-ised no surprises.

I ended up being quite surprised, though, andpleasantly at that. One of my patients, a middle-agedman with a big heart and a generous personality tomatch, was having a birthday. Before I could argue,he’d included me in his family’s celebration by loadingme up with pork chops and pasta and directing me tothe cake that he’d had delivered for all the nurses. Thefood was delicious, but my patient’s generosity is whatfelt truly nourishing that night.

Because nurses have to be so adaptive to whatevercomes our way clinically, nursing as a profession canbe emotionally and intellectually draining. Importantas I think my writing is, and much as I enjoy doing it,that day it felt as though my writing was demandingtoo much of me. Having a patient share his birthdayfood reminded me how special it is to be a nursebecause we’re there with the patients 24/7, helpingthem through the bad and the ugly, but also, some-times, the unexpectedly good.

In Critical Care, I showed how getting a Bible was theresult of a day several weeks prior spent cleaninga patient who continually soiled himself. Only a floornurse could bring that level of detail to the story andhave it say something important not just about whatnurses do, but about professionally who we are.

We clean up patients, insert IVs, administer some-times dangerous drugs, talk to physicians, give comfortas needed, speak up when it matters, and through allthat, keep our eyes clinically, if not literally, glued tothe patient. The importance of nursing to patientsuccess in the hospital has been well documented,most thoroughly by Linda Aiken (Aiken, Clarke, Sloane,Sochalski, & Silber, 2002; Aiken et al., 2010) at theUniversity of Pennsylvania. When I write aboutnursing, I validate that data because I show that thenurse is the one staff member in the hospital chargedto take care of the whole patient.

So, there’s a reality piece tomywriting that makes itimportantly credible, but what I would most like is forother nurses to share their stories, too. You don’t haveto write a book or write for the New York Times to makea difference. Nurses who feel drawn to writing canblog, write letters to the editors, or perhaps geta column going in a local newspaper; and if writingseems daunting, nurses can still powerfully contributeto the national conversation about healthcare by talk-ing honestly about what we do. Nursing needs to havemore of a voice, and the public needs to hear the voice

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of nursing because nursing matters so very much towhether hospital patients receive good care. There aresomany great nursingmoments to put into words, andI feel privileged to do that work. I also invite othernurses to join me in the telling of our story.

Commentary on Brown’s Media Experiences

Drawing from within, Theresa Brown wrote an essayabout a real experience in her life as a nurse. From theessay came an article, from that article came a book,alongside that book came a blog, and an ongoing voicein theNew York Timese not just any voice, but the voiceof a clinical nurse.

One wonders if Brown’s success would have beenpossible if she had not studied English first and gainedsignificant expertise inwritingbeforebecominganurse-writer. As a public communicator with a national audi-ence, Brown must take on a special set of expectationsand deal with almost instant feedback from a largepublic that does not necessarily edit itself or hold back.Publishing is a public endeavor where ideas may notonly be analyzed, challenged, criticized or even rejectedbut also may be applauded or accepted (Diers, 2004).Surely Brown’s in-depth study and practice of writinghave given her important skills to use her voice to writewhat she wants to say and how she wants to say it. It islikely that this professional training also strengthenedher ability to continue to engagewith readers, includingher critics, over time.

However, what stands out in Brown’s story is herrespect for her own voice as a nurse, and that of othernurses. By writing about her life as a nurse, Brown linksher daily reality to the greater realities that connect onenurse tomanynurses, one patient tomanypatients. Herreaders can relate to the feelings Brown encounters, thedilemmas she faces, and the decisions shemakes whiledoing the clinical problem-solving involved in her dailywork as a clinician and patient advocate. Brown’swriting seems a worthy response to Donna Diers’admonition that “We won’t be much better understooduntil and unless we put some energy into communi-cating in public formwhat our work is like, how it looks,howit feels,howitworks,ordoesn’t” (Diers, 2004,p.272).

Despite Brown’s published work, however, nurseshave been described as reluctant to pick up the pen.Award-winning author Lee Gutkind has edited 18creative nonfiction anthologies, including a collectionof essays by physicians entitled, Becoming a Doctor(Gutkind, 2010). As the leader and the founder of theliterary journal, Creative NonFiction, Gutkind (2008) isfrequently interviewed for magazines, television, andradio about his teaching andwriting.WhenGutkind setout to collect creative nonfiction essays for a newanthology by nurses, he was interviewed and said,

To be perfectly honest, the submissions for thenursing anthology are very low compared to other

anthologies. In my experience, we don’t get nearlyas many submissions as we would like from nurses.I don’t quite know why. It’s been very frustrating,and frankly we don’t get a lot of cooperation fromnursing programs. No one seems to be incrediblyinterested. Nurses in many respects have a lot moreto say that physicians could never say, because theyspend so much more time with patients. They havefrustrations with the medical system that arecompletely different from those physicians have.They have so much to say and the stories they tellwould help bring others in the field (Gutkind inFiore, 2011, para 7).

Although Gutkind (in Fiore, 2011) went on to explainthat perhaps nurses’ reluctance was due to the relativediscrepancy in power between nurses and physiciansin the modern healthcare arena, it is also possible thatnurses are less comfortable writing because they havereceived far less education, training, and feedbackfrom writing or literature professors. Nursing doesacknowledge the importance of narrative reflectionwithin the profession (e.g., Crawford, Nolan, & Brown,1995; Harden, 2000; Heliker, 1999; Paley & Eva, 2005).Alsomany instructorsmake use of reflection exercises,journaling, or narratives to increase nursing students’learning (e.g., Asselin, 2011; Ewing & Hayden-Miles,2011; Hunter, 2008; Hudacek, 2008; Koskinen,Mikkonen, & Jokinen, 2011: Levett-Jones, 2007).However, rigorous courses for nurses taught by expertwriting faculty are rare. Such courses could beuniquely fashioned to develop the writing ability ofnurses and to reduce their reluctance to share theirexperiences publicly.

The lack of courses for nurses is in contrast with thegrowing popularity of narrative medicine coursesoffered at various medical schools including Yale,University of Florida, and Penn StateeHershey. Inaddition, Columbia University Medical School hasa narrative medicine master’s program that hasattracted media attention from the New York Times(Kolata, 2009) and US News & World Report (Gordon,2012). Courses in narrative medicine have been inten-tionally designed not only to deepen the narrativecompetence of physicians to listen, interpret, andcommunicate, but also to better prepare physicians to“inaugurate consequential discourse with the publicabout health care” (Charon, 2001, p. 1897).

Intentional, goal-oriented planning of this sort isneeded to significantly enhance the public communi-cation abilities of nurses. Again, although nurses of allages and educational backgrounds could benefit fromtargeted, rigorous writing education and althoughnurseswould havemuch to offer the public in dialogue,such courses are not plentiful. However, one narrativewriting course has beendesigned specifically for nursesbased on Columbia’s narrative medicine program andis taught by writing professors; it is offered through theCenter for Health Media and Policy at Hunter College(Stubenrauch, 2011; 2012). Efforts to create courses

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specifically tailored to meet the unique learning needsof nurses are crucial because they increase the writingability and the confidence of nurses to take risks toengage in public discourse. Ultimately, these coursesmay increase the ability of nurses to effectivelycollaborate with media creators, including the writersof television. Compared to nurses, physicians havetaken the role of screenwriter more often with moresuccess. For example, the screenwriters for populartelevision shows such as House and ER have beenphysicians (Summers & Summers, 2009).

On the topic of film and television more broadly, wewill now focus on Larry Deutchman, the Executive VicePresident of Marketing and Industry Relations atEntertainment Industries Council, Inc., (EIC) in LosAngeles, California. Deutchman is committed toenhancing the accuracy of portrayals of various healthtopics in visual media. At the 2011 UCLA Symposium,hewas challenged to connect his ideas to theways thatnurses are portrayed in media. To understand hisviews, it is valuable to trace his professional trajectory.

Analysis by Larry Deutchman

It never occurred to me when I was in college that theprofession I ultimately made my life’s work in evenexisted as a career track. After graduating from Rutgerswith a double major in English and communicationsand a specialization in film, I planned to use publicrelations (PR) in entertainment as a way to transitioninto writing, directing and producing movies. My firstjobwas in PR at the Los Angeles Chapter of the NationalSafety Council.

At the time, a researcher in Virginia began a petitioncampaign to get actors to wear their seat belts whendriving in movies and TV shows. It was standard backin themid-80s to see spectacular on-screen car crasheswith unbelted vehicle occupants walking awayunscathed (rather unrealistically). So the petitionswere designed to shame entertainment gatekeepersinto doing the “responsible thing” through negativereinforcement from the outside. I watched this fail (notsurprisingly) for about a year before recognizing, asa creator myself, that the only way someone could getme to change my own behavior would be throughpositive reinforcement and being asked to do so by mypeers.

So I proceeded to recruit about 75 name actors tolend their names to a letter that would begin a peer-to-peer movement. This letter stated that if there was noreason for a character to NOT buckle up, why not DO it?The actors said that they would try whenever appro-priate to buckle up for their own driving scenes andthat they were calling upon their peers in the per-forming community to do likewise. Using the collectivein-the-industry clout of the co-signors, I convinced theScreen Actors Guild, American Federation of Televisionand Radio Artists (AFTRA), Directors Guild of America,

Writers Guild of America and Producers Guild ofAmerica to mail the letter to all their members.

From this a movement was started. On-screen beltuse which had been nearly nonexistent became nearlyuniversal on television and quite frequent in movies.Major movie stars were role modeling seat-belt use,which in the public had been in the 25% range, creatinga perceived normalcy for the audience that morepeople wore seat belts in everyday life than actuallydid. Actors would buckle up in a movie role and theirco-stars would pick up the habit and bring it with themto their next project. Writers began including lines ofdialogue with characters reminding each other tobuckle up.

Soon after this successful collaborative venture, Idiscovered EIC, a nonprofit organization founded bymembers of the entertainment industry to bring theindustry’s power and influence to bear on preventingsubstance abuse during the “Just Say No” era. I realizedthat their philosophy was the same as my owndworkfrom within the industry, use only positive reinforce-ment, and support creative freedom that acknowl-edges the rights of the creator to choose whether topromote “responsible” behaviors or not. So I Joined EIC,and over time, the mission of EIC expanded as did thescope of my role there. The bulk of our efforts havebeen directed toward what we like to refer to as“Encouraging the Art of Making a Difference.” We helpTV shows andmovies accurately portray a vast array ofhealth and social issues, linking creators to experts,developing resource publications and depictionsuggestions for use in storylines. In addition to seatbelts and traffic safety, topics we have addressed at EIChave included drug, alcohol and tobacco use andaddiction; mental health and mental illness; obesity,eating disorders and diabetes; organ donation andtransplantation; foster care; women’s health issues;and sun safety and skin-cancer prevention.

EIC has become a valued resource for the creativecommunity by adhering to several core organizationaloperating principles. First of all, we utilize a nonjudg-mental process when working with the entertainmentindustry; we respect creative integrity and creativefreedom. Thus, there are no “bad” or “wrong” depic-tions. We are not a watchdog group. Rather, we aresolely a resource for information.We acknowledge thatmembers of the entertainment industry already makea variety of positive contributions addressing healthand social issues and we are here to help that process.We promote voluntary involvement by the entertain-ment industry to address health and social issues. Youcan’t impose on creators which issues are importantand which ones aren’t. We can merely bring issues totheir attention. It’s up to them to decide if they want totake action. Finally, we recognize the entertainmentindustry is only one piece of the larger societal puzzleas it relates to responsibility and solutions to pressinghealth and social issues. The industry is neither theultimate cause of society’s problems nor its silverbullet. EIC’s credibility and success at working with the

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creative community is due to our consistent adherenceto these principles.

At EIC, we know that themore accurate a productionis, themoreauthentic.Themoreauthentic it is, themorethree-dimensional. The more three-dimensional it is,the more engaging. The more engaging it is, the moreentertaining. When it comes down to it, entertainmentexists for two primary reasonsdto be entertaining andto be financially lucrative. To believe that individuals orcompanies invest millions (or at times hundreds ofmillions) of dollars in producing, marketing, and dis-tributing entertainment productions for altruistic pu-rposes is naı̈ve at best and censorship at worst. Weadvocate neither.

We recognize that any positive impact for thegreater societal good is merely a wonderful side effectof certain entertainment, and therefore, our expecta-tions for success remain reasonable. By helping crea-torsmake their productionsmore entertaining throughincreased accuracy, we are helping them do their jobs,and this increases the likelihood that their doorsremain open to us.

In 1997, EIC launched the PRISM Awards to honor theaccurate depiction of addiction and drug, alcohol, andtobaccouse in televisionandfilm.Subsequently,mentalhealth portrayals were added to the mix. The theorybehind the PRISM Awards is simple: By providing posi-tive recognition to productions that portray the PRISMissues with accuracy, we encourage the honorees to doit again, and we encourage those creators not honoredto covet said recognition. Now in its 16th year, the PRISMAwards have evolved into a successful and prestigiousaward franchise. We started with a mere 35 submis-sions the first year. Now we average about 400 submis-sions per year. In addition to an annual gala ceremony,the PRISMs have aired for 12 consecutive years asa nationally televised special called the PRISM AwardsShowcase which celebrates each year’s winners. PRISMalso has its own celebration on Capitol Hill annually.

The following example demonstrates the EIC modeland principles in action. After EIC held one of itsnational forums in Washington DC on Post TraumaticStress Disorder (PTSD), we brought together membersof 40 different national stakeholder groups to come toconsensus on the top 5 messaging priorities on PTSD.Then, EIC developed a publication on PTSD featuringthese priorities and depiction suggestions for creators.We distributed the publication to members of theentertainment industry and held a briefing thatfeatured a panel of PTSD experts to deepen creators’understanding of its impact on story and character.Afterward, the staff researcher for the TV series Grey’sAnatomy” contacted us and requested a copy of thePTSD publication for each member of its writing/producing staff, which we quickly provided. Then theGrey’s Anatomy series introduced a new character,a surgeon who was a veteran of the Iraq War. Thecharacter, in a lengthy story arc, began to suffer fromPTSD, impacting his job and his relationships. Theepisodes aired, accurately portraying the topic of PTSD.

Then ABC, the airing network, submitted the storylineand won a PRISM award. More episodes featuring thesurgeoncharacterwithPTSDwerewrittenandaired thenext year, which led to another PRISM award, this timefor the actor who portrayed the surgeon with PTSD.Both PRISM wins were featured in a television specialshowcasing the PRISM Awards, bringing more recogni-tion to the creators. To date, EIC continues to workwiththe Grey’s Anatomy staff researcher and writers.

Thus the principles and themodel pay off with proofof success. EIC welcomes the opportunity to partnerwith nurses to help reinforce authenticity in portrayalsof this vital profession by simultaneously demon-strating some of the health topics nurses have animpact on daily through their work.

Commentary on Deutchman’s MediaExperiences

Through his story, we can see that after obtainingcrucial knowledge in the humanities and media incollege, Deutchman found a way to team up witha variety of Hollywood professionals early in his careeron a topic that they all agreed upon. The planworked inpart because it did not threaten the entertainmentindustry’s businessmotives. Rather, it embraced them.Deutchman’s appreciation of the goals of creators inHollywood solidified his stance to honor, and notcontest, the motives of writers and producers to createcompelling stories that entertain while being finan-cially profitable. However, together with colleagues atEIC, Deutchman endorsed the motto that increasedaccuracy leads to increased entertainment value. Thisgave Deutchman a realistic appraisal of how tosuccessfully influence producers, writers, and actors toinclude accurate health-related messages in theirproductions. Together with EIC, this work has beendone primarily through collaboration based on mutualrespect, including incentives that creators value.Indeed, the positive response of the Hollywoodcommunity to the kind of affirmation that is offered bya high-profile, prestigious award franchise such as thePRISM Awards, stands as an example for nursing toconsider.

Most nurses have not pursued a degree in commu-nications, the humanities, or film. However, effectivenurses are expert collaborators. Nursing can bothcollaborate with EIC and learn from EIC’s approach tocollaborate with media professionals to increase theaccuracy of portrayals of nursing. Rather than directlyinforming media creators about the value of nursing asa profession, EIC’s vision is to be a resource to Holly-wood related to specific areas of practice, such asnurses’ work in oncology or primary care that will addtexture and depth to the context for a compellingstoryline or the development of a realistic character. Byhighlighting these areas of nursing practice, EIC fore-sees that nurses hold the key to collaboration when

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they share how nurses make an impact through theireveryday work. Writers will be attracted to the storiesand descriptions from nurse experts because they arerealistic and compelling.

EIC has already begun collaborating with nursing inrelation to the area of women’s health. In March 2011,EIC and the National Association of Social Workersorganized an event at the Writers Guild of AmericaWest and invited one of UCLA’s nursing professors, Dr.Colleen Keenan, to participate on a panelmoderated bya writer from the television shows, Private Practice andGrey’s Anatomy. Through this, Keenan was able tospeak to screen writers and producers from the majorproduction houses in Los Angeles about her work asa nurse practitioner in women’s health. She wasimpressed that thewriters in the audiencewere carefullisteners, vitally interested in hearing ideas that mighthelp them develop a strong story (personal communi-cation, June 13, 2012). Collaborations of this type with“insider” groups such as EIC hold promise for creatingmeaningful bridges between expert nurses and Holly-wood creators.

However, nurses need to develop and refine theirknowledge about media to increase the sophisticationof their interactions and collaborations with profes-sionals in the media world. Once again, the Center forHealth Media and Policy at Hunter College offersa model for this. Two nurses who are both experiencedjournalists, educators, and bloggers founded and co-direct the center: Diana Mason, PhD, RN, FAAN andBarbara Glickstein, RN, MPH, MS. Their leadership styleis specifically informed by an understanding of nurses’concerns and fears about media. In addition, they usea feminist, empowerment model for training nurses atworkshops and seminars with the goal of providing“advanced, comprehensive training and tools to posi-tion nurses as media spokespeople so they can bringthe nursing expertise and commentary to local andnational conversations on health and health care”(Diana Mason, personal communication, June 7, 2012).Such tailored training holds unique promise forequipping nurses for media advocacy roles.

Conclusion

As is the case with many societal issues, a diversity ofapproaches is needed to address the complex layersrelated to how nursing is depicted in both the print andvisual media. By considering the specific paths andgoals of Theresa Brown and Larry Deutchman, we cansee that being able tomake change related to images ofnursing from the “inside” of media agencies involvesrefined communication skills, expanded awareness ofhow media organizations work, and careful insightinto what makes written or visual media compelling orentertaining. Equally important is the motivation andthe courage of individual nurses to take action to sharepublicly about their life and work as a nurse. Theresa

Brown uses her writing abilities to share her life andideas and invites other nurses to write or speak fromtheir own personal vantage points to help the publicunderstand the value of nursing. Larry Deutchman andEIC have an approach that involves collaboration fromthe “inside” of the entertainment industry, and theyinvite nursing as a profession to partner with them toengage media professionals in ways that are compat-ible with the entertainment industry’s motives.Although various other approaches to catalyzingchange in the scripts of television and film are alsoworthy and effective (see Summers & Summers, 2009),awareness of EIC’s success warrants nursing’s seriousattention. Collaboration is needed with professionalsfrom different disciplines with diverse perspectiveswho employ different strategies to analyze problems inorder to propose creative solutions. Through this,nurses, nurse leaders, and activists can gain insight onpossibilities for action and opportunities for collabo-ration in the media world. To make significant stridesin the accurate portrayal of nurses in media, a widevariety of dynamic collaborations will be needed. Suchpartnering depends, in part, on the ability of nurseleaders and educators to have the vision, inspiration,and wisdom to make effective media involvementa priority for nursing now and in the future.

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