Get Out of the McDream World
On Grey’s Anatomy last week, Dr. Derek Shepherd (enough playing, McDreamy) is called in from home to soothe a young man unhinged with pain after a highly invasive surgery.
The attending physician has already tried morphine with no relief. Where heavy narcotics fail, McDreamy flourishes. After placating the patient he turns to the worried mother, gazes into her eyes, and says, “the pain is not a dying pain but a healing pain, a victory pain..”The mother cries. I would have too, the whole thing was very touching.
Of course the whole interaction wouldn’t happen the Grey’s way. In hospitals, doctors don’t generally do bedside care. Over the years I had heard my mother—who is a nurse—complain from time to time about the absence of her profession in medical dramas. I never did much more than nod my head and roll my eyes, “How awful.”
But after spending time in a hospital bed and seeing how little doctors are directly involved in patient care, I decided to look into it. Turns out many nurses feel the same.
Yet aside from hurt feelings does it really matter? Do TV portrayals impact our view of healthcare?
Yes, and it’s been known for awhile. Long before Grey’s Anatomy the Public Health sector was imploring dramas(and even sitcoms) to incorporate “Education Entertainment” into scripts to address issues like immunizations and HIV/AIDS. Efforts weren’t a waste of time either; a Kaiser Family Foundation report found 90 percent of regular viewers say they learn something about diseases or how to prevent them from television, and almost half cite prime time or daytime entertainment shows.
WHO, CARES?
My low points over the last 16 months—-the rigors and 104 F degree fevers and transfusions and chemotherapy and vomiting blood and lungs filling with fluid—were overcome mostly with the help of people who weren’t doctors. In the hospital setting doctors are scientists and decision makers, not caregivers. They don’t stand around your bed in groups of four (thanks House), they don’t dispense medication to help with the pain or nausea and—in my experience at least—they aren’t present at anytime during a bone marrow transplant. Despite how it reads, I’m not mad about any of those things but I do feel it’s important we understand how care is delivered.
If we expect the healthcare experience to be as physician-centric as it appears on television, questions should arise. Do patients comply as readily with the advice of nurses (and nurse practitioners and physician’s assistants) as they do doctors? What is the effect on outcomes if they don’t? And even more worrisome, if patients decide every voice outside the doctor’s is just peripheral static, how compelled are they to take part in the conversation?
October 5th, 2010 at 8:29 am
Matt, So true. Bedside care is a haphazard combination of RN,s Tech’s and Nurses Aides that have an up close and real knowledge of the patients condition needs, state of mind . The physician’s direct and order the meds and look at the patient on the computer screen (Chart) Bedside care consists of a two minute vist. Even in the ICU . Of course those directives are made based on facts ,experience and a total assessment, yet the hands on as you say that is depicted in the top TV shows is not or rarely ever demonstrated . Hospitalist’s are taking over for the most part for many local hospitals . Somehow it would be so much better if the caring from the Dr’s /staff on the TV shows was the real deal… But then again every week the ER would blow up, the helicopter with critically ill babies would crash and half the staff would perish in a gun battle in the parking lot….. !!! LOL. Hope all is going well for you.