Dirty Harry, Meet Nurse Jackie: AJN’s Editor-in-Chief Emeritus Takes Sneak Peak at First Six Episodes of Showtime Series

Today Showtime launches Nurse Jackie, its new series starting Edie Falco. (Click the video above to watch the first episode.) The publicity people at Showtime saw my initial post on the trailer, so they sent me the first six episodes to watch. (Don’t worry, nothing I write here should spoil any major plot point in the coming episodes.)

This is already a controversial series. Postings on a nurses’ listserv indicate that many nurses who have watched the trailer or first episode aren’t thrilled with nurse Jackie Peyton. She’s addicted to pain medication that she obtains from the hospital pharmacist with whom she is having an affair. Although she’s smart and a fierce advocate for patients, she often goes beyond the bounds of appropriate professional conduct, as when she forges the signature of a dead bicycle messenger to authorize donation of his organs. (The disregard for official procedures and rules shown by Clint Eastwood’s Dirty Harry character came to mind when Jackie flushed down the toilet an ear that a prostitute had cut off the john who’d stabbed her.)

For over a decade, nurses at the Center for Nursing Advocacy have decried the depiction of the nursing profession on the many television series with health care themes, such as ER, House, Grey’s Anatomy, and others. These programs have featured nurses as wallpaper, backdrops to the ever-present physicians who provide not only medical care but the care nurses typically provide. The nurses are often dim lights, leaving one to wonder why anyone would go into nursing after watching these popular series. Any strong nurse character inevitably decides to go to medical school.

Nurses across the blogosphere and at nursing advocacy centers have provided blistering critiques of these hit series and called for producers to develop a prime time series that features a nurse as the lead character. More recently, the Web site Truth About Nursing has posted an excellent critique of the pilot episode of Nurse Jackie.

I don’t know if my input made the least difference in the final product, but some months ago I was contacted by a writer for Nurse Jackie who wanted to talk with me about nursing and the series. I told her that I wasn’t looking for the perfect nurse character, since I know that perfection is not the stuff of great drama and comedy. But I did want to see a program that would show nurses who acted as smart advocates for patients, played the central health care roles that they assume in real life, provided nursing care that saved lives, supported patients through trying times, and were everyday heroes.

Nurse Jackie delivers on all of these points. Jackie is an expert nurse. She can look at a patient and get that intuitive and experience-based message that the patient is “going down the tubes,” even when the physician says everything is fine. She challenges physicians and others when she thinks she’s right (and the time she doesn’t go far enough, the patient dies). She tries to right the wrongs of health care, as when she supports an elderly woman in refusing treatments for her dying husband or helps a former nurse colleague to die when metastatic cancer has overwhelmed any hope of recovery. And it’s not unrealistic at all that her drug addiction arose from a back injury—an injury that is all too common among nurses.

Nurse Jackie is a complex character in a dark comedy. Edie Falco, Emmy-award winning actor for The Sopranos, is perfect for this role. She’s filled with contradictions (for example, her extramarital affair with drugs, despite seeming to be in love with her husband and committed to their children). She bounces between being dour, witty, in-charge, vulnerable, soft, and tough. Life isn’t simple or easy for Jackie—and it’s not for any of us. That’s one of the beauties of this series.

I understand the concern of those nurses who hate her addiction and on-duty sex. But it’s been a very long time since there’s been a great nurse lead character in a series that showcases her smarts and advocacy but allows her to be full of contradictions. The last one I recall is Hot Lips Houlihan on Mash. She was belligerent, bureaucratic, driven by her desire for love, but uncompromising in her expectations for the best of care for patients. She could have been Nurse Jackie’s teacher.

And besides Edie Falco, there’s Anna Deavere Smith, the brilliant author and actor many will know from her role in The West Wing. In Nurse Jackie, she plays the hardened nurse administrator who, on the surface, seems more worried about protecting the hospital bureaucracy than in serving staff and patients. Her performance in one episode left my husband and me laughing out loud.

To like this series, you don’t have to agree with everything that Nurse Jackie does. And who knows how the character will unfold? The promotional materials I was sent included the statement that “Perhaps there will be a time when Jackie can break free of her secrets and addictions . . . ”

I suggest that nurses rally around this series and stop wishing for perfection in any lead nurse character. Diahann Carroll’s docile nurse character in Julia in the 1960s wouldn’t attract viewers in today’s entertainment world. There’s not another program that shows nurses as smart, fierce advocates who actually provide nursing care. Sure, I’ll cringe when Jackie pops another painkiller or steals from a jerk of a patient and gives the money to the pregnant woman who can’t afford a taxi home. But Nurse Jackie isn’t perfect, and neither am I. I’m signing up for Nurse Jackie now.

–Diana J. Mason, PhD, RN, AJN editor-in-chief emeritus

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Senior editor/social media strategy, American Journal of Nursing, and editor of AJN Off the Charts.


  1. Deena July 4, 2009 at 1:11 am

    As someone who worked along side nurses in nursing homes for many years, I find this show just about perfect.
    Jackie is imperfect and I find it hard to believe that with such a hottie at home, she’s getting it on with someone at work, but, I love the imperfections.
    I find Hawthorne so totally “Julia”, that I stopped watching it this past week.
    Even though they are some similarities – student nurse, bumbling doctors, nasty patients – the responses are so different from each lead.
    Hawthorne is *perfect* – always right, knows exactly what to do, doesn’t break a sweat and is a widow so when she has the prerequisite love relationship we can all go, “awww”.
    It’s far more trite than “Jackie” and the story lines seem stretched even for the 42 minutes of actual story without commercials.
    Give me Jackie – warts and all

  2. Janice RN July 2, 2009 at 11:41 am

    Love this show. Imperfections are rampant in the medical profession. Why try to hide it? She is a great nurse, an advocate for patients on this show. Many of us “real” RN’s wish we could do and say what she does. We are simply too afraid.

    As for the drug addiction, in my 29 years as a nurse, I have seen it all. Many addicted nurses and MDs. As for the affair, have witnessed many of those as well. The hospital can often be viewed as Peyton Place. Many secrets linger there.

    I love this show and will continue watching it.

  3. AG July 1, 2009 at 8:13 pm

    While entertaining, we must realize that this show will affect the perception some have of nursing. The last thing needed is for the public to feel that any nurse that has a bad back or a crabby attitude is on drugs, and lets face it people do compare us to characters on shows…ie: Nurse Ratchett. While, yes, we do have drug diverting nurses…there are consequences to this such as losing licensure, rehab, and losing the trust of your colleagues. Also, does this send the message to people who may have a drug problem that its ever so easy to have access to drugs. The extramarital affair, while wrong morally, is an issue that is fluent in most shows and nurses are people too so that isn’t that big of a shocker for me. However, the flushing of the ear, sleeping with the pharm guy to get the drugs, stealing money and being so deceptive as to put crushed vicodin in sugar packets….its just a bit much. So, yeah…I’ll probably watch it every week to see where it goes….at least she speaks her mind.

  4. Jackie June 20, 2009 at 9:18 am

    As a 35+ year veteran ER nurse (and my name is Jackie) I find this show refreshing, darkly funny, and a welcome change from the usual medical shows. I have had three back surgeries through the years and I totally get her addiction…while I never worked under the influence of narcotics or anything stronger than Ibuprofen I know there are nurses (and MDs) out there who are addicted and I do understand how it can happen. I found the moment when she pulled herself up her front steps in the first episode very poignant and personal…I remember having to do that myself for months prior to my last surgery. Her flaws make her real and when she crosses the ethical line she does what I have wished many times I could do…if you didn’t cheer when the ear went down the toilet then you probably don’t get the ED RN mentality. Gallows humor is in part what allows a nurse to survive the busy ED environment long enough to become a veteran. Edie Falco is perfect and I hope the show has a long and successful run…if they ever need material they should call me ;)!

  5. […] of that “great lead nurse character” that Diana Mason, AJN editor-in-chief emeritus, has suggested we need. (Click the video above for a preview of episode […]

  6. […] already posted about Showtime’s controversial new drama, Nurse Jackie. When it rains it pours: Hawthorne, […]

  7. Tammy Allen June 15, 2009 at 1:11 pm

    I love this show “Nurse Jackie”. I am not a nurse but a frequent inpatient because of Sarcoidosis and Polyradiculopy. I hope nurses do not become offended at this show because it is fantasy. I respect nurses and the demands of the job. If you feel that this show gives the public a bad view of nurses, then those people who believe this show is factual, need to be committed.
    As a patient, I try my very best not to be obnoxious and find myself frequently wanting to defend the nurses who do get these types of bothersome patients.
    In my next inpatient admission, if I should witness another abusive patient towards a nurse, then I can recall “Nurse Jackie” and enjoy a little revenge from that.

  8. Valerie Barbalace June 13, 2009 at 8:31 am

    I loved the pilot episode of “Nurse Jackie”. My mother who is a retired nurse has not seen it and when I told her about it, she got upset and stated that’s what patients are going to think that all nurses act like this. Mom needs to get a reality check. I have worked with nurses who became addicted to pain medication and what happens is the hospital has them go through a program for addiction. They come back to nursing with restrictions on administering narcotics for a period of time. Back injuries are extremely common in nursing. I found the show to be entertaining and loved it!!! If they did another show on regular TV about a nurse like me, it would be cancelled because it would be boring. It’s entertainment. Kudos for Jackie for flushing the ear down the toilet. This episode is only going to make me want to watch the next one.

  9. Andrea Anderson June 12, 2009 at 2:07 pm

    I agree that Jackie is entertaining, but I think you can be a tough,witty,smart, and very strong of character to let physicians know they are not always right or even know how to take care of patients. I don’t think taking hard drugs and acting immorally is what most nurses I have known over my long nursing career have done and some were tough as nails!!!! In fact taking drugs impairs your judgement and decisions, drugs do not make you smart or alert to patient’s needs, just sleepy or mouthy.
    If Jacjie really wanted to help a starving pregnant girl she should have given her money of her own not steal it. What kind of logic is that? She helps someone who is down and out with some else’s money some Robin Hoodette that is………
    Yes, there are many nurses out there that stand up to docs, break stupid rules for patients and get in administartive trouble, but they do it with to help the patient not to be immoral. Just think what would result if while on drugs Jackie killed a patient, would that still make her cool or badass???
    It seems to me that those who are not nurses or those that probably never worked in a big city, very busy ER, with a 6-8 hours waiting time, gun shot wounds and stabs,with very poor and needy patients, should not be the ones to critique/praise a pack of lies. The bottom line of course is that all seen on television is OK. The real test is to put yourself in the place of the patient who is victimized, such as what if the messenger who was killed really did not want his organs donated and you were his mother, father, sister or brother and know that…….would it be upsetting???? It all depends on whose ox is being gored.

  10. […] I agree with Diana Mason that Jackie, the nurse played by Edie Falco on Showtime’s new series, has some admirable […]

  11. Teresa, RN,CNS,PhD June 11, 2009 at 12:43 pm

    Flawed, courageous, complex, independent and damn smart; Nurse Jackie is all of these. We so NEED these nurse characters in the media! She’s a breath of fresh air in a media environment polluted with nurses who are either utterly absent or witless and boring.

    I’m not saying I’d want to work with Jackie, but I will certainly enjoying watching her on television.

    Great essay, Diana.

  12. rhonda June 10, 2009 at 9:19 pm

    I loved the show. I knew there would be nurses speaking out about her drug addiction though. Wasnt sure how I felt about that. But its entertainment, not a documentary. Ive trained under nurses similar and had nothing but respect. Ive seen nurses have words with doctors when there is a conflict regarding patient care. So I think we could lighten up a bit and just enjoy the show. I *do* believe its gutsy outspoken nurses that can very well save your life. Not the silent abiding nurse who believes she/he is powerless and only follows doctors orders, right or wrong.

  13. cathy d June 10, 2009 at 6:55 pm

    I watched the first episode and was highly offended.
    I won’t be watching again and have discouraged others from watching. She is working under the influence, disrespectful to MD’s, coworkers and students nurses. Yes nurses work hard and their back’s hurts, we dislike patients, coworkers and MD’s ,but to care for patients we need to work as a team. In this time of worsening nursing shortages I would like to see an image of a strong nurse leading character that does not bring down the image of nursing. The public repeatedly has voted nurses as the most trusted profession (above clergy). Shouldn’t we worry about how “Jackie” might effect this? I won’t be watching this and I encourage nurses to get the word out that Jackie is not the nurse that will save you.

  14. Ana M. June 10, 2009 at 5:22 am

    I watched the first episode of Nurse Jackie and absolutely loved it! I applaud all involved and Edie Falco especially, you are brilliant!

    I always wondered why no one came up with a series that has a nurse as the main character… It’s about time! I only wish the episodes were 1h not 30m. I was so sucked into the episode time flew by! I can’t wait ’till the next episode.

    And I’m really happy she’s not some “perfect nurse” because no one’s perfect! She a bit of a badass, so what? It’ll make the story fun and fresh 🙂 She’s cynical, sarcastic, dry, smart and competent 🙂 just the way I like ’em!:) I’ll be a Pre-Nursing student come September, and I know I won’t be such a badass, but it’s fun to watch Nurse Jackie 🙂 And OMG I wish for a mentor like her, ’cause if mine s some sort of “perfect nurse” I’ll feel like I can never measure up and never be good enough. I’m like that Zoey student, I even kinda look like her, not totally, but there are similarities, so it makes it even funnier to watch.

    As for the ear, I saw a clip from episode 2, and I think they’re going to blame the flushing on the student nurse. That guy totally deserves it to!

    And about the drugs, well her back hurts, so what? She needs drugs… And the cheating, well ya, I kinda have a problem with it but that’s just me… Hey, I know it’ll add to the drama eventually, so it’s cool.

    I love Nurse Jackie! Can’t wait for all the upcoming episodes! Dark comedy… I LOOOOVE dark comedy!!!!!!!!!!!!!

  15. Luz Huntington-Moskos June 9, 2009 at 9:20 pm

    As a child of the 80’s, I was inspired by the character of McMurphy on the show China Beach. The show left a lasting impression.

  16. Barbara Glickstein June 9, 2009 at 10:11 am

    Edie Falco is a brilliant actor and does a fantastic job in this role. Ms. Falco is also 45 years old, so a shout out to Hollywood for casting her and getting it right – that’s the age of the majority of nurses practicing today. I was sucked in from the opening scene through the closing credits. The writers crafted a great script introducing us to Nurse Jackie and a cast of supporting characters who will surely provide us with further insights weekly into what makes Jackie tick (in addition to those little red-orange balls she snorts that look like a sugary breakfast cereal currently banned in most healthy households). I was engaged trying to get inside the head of Nurse Jackie – her edgy, bold, radical, risky and illegal behaviors. I won’t touch on her infidelity with the chief pharmacist. Then flushing the ear down the toilet scene happened and I wondered– did the writer plant this as a fantasy or did she really do that? Let’s agree for a minute that it was a fantasy because then we can all relate to Jackie. Haven’t we all had thoughts of committing a revengeful act against evil? That guy committed a reprehensible violent act against that woman and we are told he will get away with it. For a moment, I secretly wondered what it must have felt like to be so bold to flush that ear down the toilet myself. Anybody else out there wonder about that too? It’s TV and all make believe.

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