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Practice comment

TV dramas must tune in to the truth to prevent misconceptions


With a growing focus on health issues on television, nurses can help programme makers to ensure the public receive accurate health education, says soap adviser Victoria Harmer

The increasing focus on health related issues in television dramas makes it vital for programme makers to ensure their storylines are clinically accurate. Nurses can help them do this. Inaccurate portrayal of medical issues can lead to public misconceptions or false expectations about services.

HIV, SARS, BSE and nvCJD, anaphylaxis, dementia, blood clots, miscarriage and mental health problems have all featured in various TV dramas in recent years. In 2009 Coronation Street saw 22 medical storylines involving ambulance crews, medical emergencies and consultations. The question is, does this have any impact on public perception or behaviour regarding health and illness?

Although conflicting, the evidence does suggest a link between illness plots and public behaviour. For example, while it seems there is no increase in the number of suicides if a television character attempts suicide, there may be a link with the choice of drug that people choose to overdose with.

However, when cancer gets the leading role the repercussions are significant. The media plays an important role in information provision about prevention, diagnosis and treatment of cancer, as well as informing health policy and personal experience.   

The knock-on effects of a 2002 storyline on cervical cancer in Coronation Street resulted in a 21% increase in those attending cervical screening in the north west of England in the 19 weeks after the storyline. Whether this was due to increased awareness or subsequent public anxiety, it still resulted in a higher screening attendance rate, which can only be good.

So can these programmes endorse health promotion activities? Health education involves communicating information on underlying conditions that impact on health, as well as creating opportunities for learning, improving and disseminating knowledge; perhaps what some may say results from a well researched storyline. 

Actions have consequences and when discussing potential scare mongering, the ramifications of storylines focusing on illness can be far reaching. The programmes I have advised (BBC Radio 4’s The Archers, Channel 5’s Family Affairs and ITV’s Coronation Street) all had researchers who seemed dedicated to getting the facts correct. However, all three characters who had treatment for breast cancer were young (pre-menopausal) - a minority (20%) of those who actually develop this disease. Perhaps breast cancer in younger women is thought to be more sensational. 

Furthermore, some programmes do get their facts wrong. An EastEnders character was diagnosed with a benign breast lump and it took two weeks for her to get her results, when it would normally take a day or two. This could lead to patients being unnecessarily worried about lengthy delays in diagnosis.

There seems to be a cycle; that is, the more articles on a condition in medical journals, the more likely it is to feature on television, in magazines and newspapers. This media coverage promotes charity fundraising, and prominent celebrities will acknowledge their condition and champion it, which in turn sparks more media interest. 

Nursing has traditionally had a distant relationship with the media when trying to use it to communicate with the public, with few nurses willing to speak to the media. Often even when they are key experts on a subject, nurses are reluctant to engage in dialogue, possibly due to lack of confidence or understanding of the way the media works. The media can be used as a tool and nurses should recognise their expert knowledge and expertise to share their rich experiences with the public, to help programme makers ensure people receive the correct facts. 

VICTORIA HARMER is clinical nurse specialist in breast care, Imperial College Healthcare Trust, London. 


Readers' comments (10)

  • I actually agree with this and have said this before.

    Personally I am not a fan of the majority of programmes where Nurses are portrayed, (soaps, no angels, casualty, that type of thing). But I know many, many people out there are, and unfortunately the vast majority of sheep in this country DO have perceptions and opinions formed by these programmes, as pathetic as that is.

    So whilst they do, then I believe these programme makers have a bit of a responsibility to ensure a more accurate portrayal of what Nurses face. I understand that they have to add drama etc, but we are not all sex straved Doctors assistants who drop into Nursing with no qualifications!

    Nursing has a huge, huge problem with public perception at the moment, and whilst this does affect moral, it also more importantly affects our relationships with our patients, who may not ask for advice, or come to us for help or realise exactly what help we can give them, because they believe we are nothing more than handmaidens!

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  • bob cat

    not my experience mike. my experience is that people do ask me as a nurse, things that they haven't said to or asked their GP because they didn't want to bother the GP but weren't aware nurses could help. All the nurse practitioners I know are now considered invaluable by patients who are more than happy to see them for clinical care and advice. In our area we, as nurses, have made it part of our contact with people to include education about our service and the team skills. What you describe has become a rarity.

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  • I'm not saying that it doesn't happen bob, I too have had patients ask my advice on a variety of things, etc, and of course part of our duty is toward education and communication. And yes there are a lot of patients, especially those who have had a lot of contact with Nurses and the NHS, who will realise what we can do and ask appropriately.

    You say yourself however that a lot still were not aware Nurses could help. And there are a lot more people out there, especially those who do not regularly come into contact with the health service, who will not know this. Even elderly patients who do come into contact with the NHS a lot may value Nurses, but may not realise exactly what we do or what we can do for them.

    And these TV programmes do nothing to destroy the myth that Nurses can do nothing more than basic tasks.

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  • Having seen a couple of recent episodes of Casualty over the past few months, I'm concerned how they have portrayed the clinical research environment. The story-line involving the 'drug trial' portrays researchers and the research process as dodgy, underhand, covert, and ethically questionable. The latest episode has an investigator (hospital senior clinician) destroying evidence and deleting study files and data.

    This cannot be further from the reality of clinical research.

    Over the past few years an immense amount of work has been undertaken by DH + NHS+ NIHR + UKCRN to improve the research environment, bureaucracy, transparency, professionalism, ensuring patient safety. Nurses play a major role in delivering good quality research and ensuring patient safety. They are very knowledgeable and experienced practitioners, operating and performing high level and specialised procedures, that patients respect. Clinical Research is now incorporated into the NHS constitution as core business, and participation in clinical research is every patients' choice and right if they so wish.

    I feel that this show has sullied the reputation of the clinical research environment in the NHS. I'm concerned that viewers watching this may see this as 'normal' practice of NHS research and be dissuaded in consenting to 'drug trials' in the future.

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  • How about the way CPR is portrayed? Collapse, get a bit of resuscitation, be sitting up in bed having a cuppa within 10 minutes. Not very helpful to people who cannot understand that their frail elderly relative is simply not a suitable candidate for this to even be considered as a future treatment option.

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  • Anonymous | 21-Jul-2010 8:54 am exactly, and it certainly doesn't help when those relatives have completely unrealistic expectations and get angry and abusive either!

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  • I remember when I worked as a Transplant co-ordinator for a large Teaching Hospital, and our team was approached to give expert medical advice about a situation with a young man waiting for a heart transplant for the programme 'Doctor's'.
    We were consulted and they went away to write a script.
    When the script came back for us to review it bore no truth to the process we had carefully described, so we sent it back. We reviewed the script several times before we finally said that we were not happy to be mentioned in the credits and wanted to withdraw from the programme.
    I'm afraid I'm now very cynical of TV script writers and believe they are more interested in producing a good story line than trying to make it bare any resemblance to the truth.
    My husband has now banned me from watching most medical dramas (particularly Holby City!) as he gets fed up of me sat shouting at the TV

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  • To be fair I can understand a tiny bit of artistic licence when writing a script, most are drama's not documentaries after all, as long as things aren't portrayed in a completely unrealistic way that may undermine peoples health information or cause panic then it won't do that much harm to see every single person who gets admitted to hospital up on a drip, etc.

    What annoys me more than anything is the characterisation of Nurses, many programmes show us to be nothing more than subservient handmaidens. I think a lot more positive role models should be written in to programmes if they are going to include Nurses at all.

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  • Anonymous 22 July 9.32 am. I am not surprised at your comments. The depiction of organ transplants in soaps, especially 'Holby City' is horrifying. I know of several people who have torn up their donor cards because they fear the sort of shenanigans that they have seen on TV.
    I also object very strongly to the frequent breaches in patient confidentiality that are depicted. I'm surprised that patients still trust us with their confidences!
    Most of all I object to nurses STILL being shown as doctors handmaidens; and doctors go around threatening nurses with dismissal willy-nilly.
    As for all the sexual goings-on whilst on-duty...I WISH!!

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  • When i dropped into nursing i was definately sex starved...and definately had no qualifications. Unfortunately i am now highly qualified and highly sex starved.

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