Nurse Jackie Revival: A Nurse’s Insightful Perspective – Part 3: The System
You can’t make a TV show about a nurse without tackling the healthcare system. The system is nurses, and nurses are the system. They are one. Like tragically conjoined twins fused at a most unfortunate spot, it is impossible to separate the two without catastrophic consequences.
Talking about healthcare systems issues, though, can be…a bummer, man. And at the end of the day, a TV show is about entertainment. It’s about escape. So, how do you delight the audience while encouraging them to think about real-world problems?
If you’re the Nurse Jackie creators, you write a character embodying much of what plagues our current system, and you sprinkle her throughout the seasons to give Jackie something to work against professionally. You make her funny compared to Jackie’s sometimes grim palette of storylines. You make her likable. You create Gloria Akalitis.
Akalitis represents everything we love to hate about American healthcare: the labyrinthine bureaucracy, the maddening redundancy, the cutthroat bottom line. With her helmet-like hair, imposing stature, and militant demeanor, she is the Vader to healthcare’s imperial fleet of faceless administrators. She thwarts Jackie at every opportunity and drops in from time to time to remind us that healthcare is, in fact, a business.
Just when we might start being lulled into the warm, comforting thought that compassion and care are infinitely abundant, Akalitis pulls us back to reality. Behind every marketing slogan of “Compassion for All” or “Care Is Our Mission,” there’s an Akalitis stuffed away in an office, crunching the numbers and calculating just how much compassion and care the organization can afford.
We catch glimpses of our system’s corporate, contradictory, and all-around clown-town aspects through her. She chastises Jackie for working too much, yet in the same breath, asks her to pick up more shifts. She ruthlessly delegates bed space in the ER and casts her constant, watchful eyes on the staff. She calculates incidents of gun violence not by potential for human harm but by property damage. She threatens a Monseigneur with his life.
She also has incredible moments of tenderness, loyalty, and grace. So, we end up loving her. She tries to adopt a baby left behind in the hospital, crushes on a patient, and rallies alongside her staff when the hospital’s literal existence is on the line. Like Jackie, she is human; through this humanity, the writers can tackle more significant issues without preaching or clubbing us over the head. They can explore big systemic stuff like understaffing, insurance reimbursement, workplace violence, budgetary restraints, and hospital foreclosure—stuff that might otherwise knock us out faster than a Jackie-sized line of Xanax. We need a human guide. That’s Akalitis.
Who knows what the reboot will bring regarding how our healthcare system is depicted on screen? Early press reports said Jackie had lost her nursing license. And ‘All Saints’ was shuddered at the end of the last season, so it’s hard to imagine how a significant portion of the show could occur in any hospital. Maybe the creators are taking a hard left and pivoting away from any medical theme. I hope they don’t.
Ten years have seen a lot of changes in our discussion around nursing and healthcare and how they are delivered. The moment is ripe for cultural commentary, missing from other medical shows. I hope the reboot takes a stab at it. Also, I just can’t imagine the show without Gloria Akalitis. I don’t know if I even want to. What could I imagine? Jackie and Gloria are putting aside old differences and taking off on a whacky cross-country road trip. Vacationing in Mykonos. Retired, getting tanked together at Sip and Paints. Just spitballing here. Showrunners, call me. Plenty more where that came from.