Comment on: Stanley D. (2012) Celluloid devils: a research study of male nurses in feature films. Journal of Advanced Nursing 68(11), 2526–2537

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Celluloid devils: a research study of male nurses in feature films

I found the article by Stanley (2012) interesting, but troubling in its overall premise. The evidence was just 13 films from over 36,000 films during the period 1900–2007. This amounts to approximately 0·0361% of the total films reviewed; yet, from this identified group, the research findings make some impressive assumptions. The key component is the hypothesis that male nurses are frequently portrayed negatively or stereotypically in films, and that this potentially will have a negative impact on male nurse recruitment and the public perception of male nurses.

My first concern is the fact that this hypothesis is based on only 13 films. The criteria, although robust, identified these films of which I had only heard of two from a database containing some 36,000 films. These films may portray male nurses in a poor light in terms of being effeminate, homosexual, homicidal, corrupt, or incompetent. However, to suggest that this could affect recruitment or public perception of male nurses is an extrapolation. This research is based on the same principle that is used in advertising such as ‘9 out of 10 cats prefer our cat food’ when the numbers of cat owners used are small. The science may be theoretically sound, but that does not mean that it is telling the entire story or explaining the results. There is no question that the media can have an impact on health care and that is why we have public health campaigns, for example, for breast, prostate and colon cancers. The media can also have a negative impact on people's perceptions as well such as the Measles, Mumps and Rubella (MMR) vaccination or with the care of the dying pathway controversy. But to equate the two is quite wrong; public perception is not just about what they read or see in the films or on the television. Public perception comes from several sources including their own and friends’ experiences and interactions with health professionals. To assume that because these 13 films portray male nursing in a poor light, it has or it will have an impact on public perception and recruitment is not supported by the facts. This research appears to make some assumptions, the most important one being that members of the general public are not only unable to differentiate between fantasy and reality, but are also incapable of making their own conclusions. This, I think, is not only a serious flaw in the research, by excluding other factors, but there is clear evidence to the contrary to prove that the basic premise of this research is wrong.

To illustrate my point with regard to how ineffective the media can be with regard to public perceptions, consider the following five infamous healthcare professionals:

Beverly Allitt (a nurse convicted of murdering four children, attempting to murder three others and causing grievous bodily harm of six other children); Genene Jones (a nurse who killed somewhere between 11–46 infants and children in her care); Kristen Gilbert (who worked at a veteran's affairs medical centre – convicted of four murders and two attempted murders); Doctor John Adams (convicted fraudster and suspected serial killer 1946–1956) who some believe was the role model for Doctor Harold Shipman (branded by the media as Doctor Death convicted of killing 15 of his patients; a subsequent government inquiry concluded that he may have been responsible for over 250 deaths).

These cases have not made the general public look at female nurses or medical staff as cold-blooded killers. As far as I understand, recruitment for both professions has not been affected. This seems to contradict the main thrust of this research that negative media publicity affects health professional recruitment.

Why would these 13 films (which may not have been widely seen) make the public view male nurses any differently? Given the worldwide attention the cases such as Allitt, Jones, Gilbert and Shipman had in the media and wider general public, I would propose that more people would be aware of these killers than these fictitious characters depicted in the chosen research material. Therefore, why no ‘backlash’ in female nurse recruitment, and why none in the medical profession?

The argument is further weakened if we take a more general view of films and television, which have at times portrayed health professionals in a very poor light. Despite this portrayal, the public perceptions of health professionals remain very positive. To illustrate my point, I have chosen at random the following films:

Carry on Nurse (1959)Night call nurses (1972)
Nurse on Wheels (1963)One flew over the Cuckoo's Nest (1975)
Carry on Doctor (1967)Night Nurse (1931)
Carry on Again Doctor (1969)Rosie Dixon- Night Nurse (1978)
Carry on Matron (1972)Sick Nurses (2007)

Female nurses in these films are portrayed as either sex symbols, cruel and sadistic, or killers. Are we to assume then, given the hypothesis of this research, that because these films portray female nurses in a particular light, the public will have a negative view of female nurses? Or is this negativity only directed at male nurses? Could these films actually be portraying the film makers’ bias and not the public's? In which case, should we really be that concerned? These 13 films appeal to a view that nursing should not be considered a proper job for a man or that for a man to train as a nurse should be seen as a consolation prize for not getting into medical school. This is as outdated as the view that women should not be doctors.

Male nurses have enriched and improved the nursing profession; numerous studies have shown the value of male nurses and the contribution men have undertaken to enhance the role. If we are still being stigmatized by a minority view, nursing research should not give credence to such outdated views. When a patient enters hospital, he/she does not expect to be greeted by a ‘Carry On’ character; why should we assume that negative perceptions of male nurses in the media can affect recruitment? Surely, a better argument for the likely reasons for low levels of men entering the profession would be levels of salary and status, rather than issues of gender. Perhaps the real message from this research is not that the media affect male nurse recruitment, but that we must improve the current levels of male recruitment.

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