I just do

August 18, 2008 -- Tonight's episode of TNT's police drama Saving Grace featured an impressive portrayal of a burn ICU nurse who projects advanced clinical skills in treating a six-year-old boy who has been horribly burned by his father. Nurse Angela gives key information about the boy's care to the show's lead character, Oklahoma City detective Grace Hanadarko, conveying that she has holistic health expertise. Angela also displays interpersonal skills; she cares deeply about the boy, yet is tough enough to handle the suffering she witnesses. Angela plays the central role in the boy's care, just as she would in real life. A physician appears briefly to remove a breathing tube, but Angela is the main point of contact for the detectives. And unlike a 2004 episode of Law and Order: Special Victims Unit with a sexual assault nurse character, this episode resists the urge to have Grace herself take the lead in the care of the crime victim. A few elements of the portrayal could have been better, including Angela's decision to talk about the likelihood of the boy's dying right in front of him. But the actresses playing Angela (Camille Saviola) and Grace (Holly Hunter) both do a great job in their interactions to support the overall themes, beyond what the script requires. "Are You An Indian Princess?" was written by Mark Israel and Roger Wolfson, and directed by Gwyneth Horder-Payton.

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(If you want to skip over our recap of the episode and go straight to our analysis, click here.)

In the episode, six-year-old Jack has been badly burned in a car fire apparently set by his father, who had killed his mother and abducted Jack. Jack's father remains at large. Detective Grace Hanadarko rushes to see Jack in the burn ICU. Outside Jack's room, we see an unidentified care giver, perhaps a nursing assistant, help Grace put on a plastic isolation gown to reduce the chance of infection. Grace enters Jack's room, and nurse Angela stands at the boy's bedside. Angela greets Grace, though she does not introduce herself. Angela wears patterned scrubs, apparently images from the Disney show Charlie and Lola. The great majority of Jack's body is covered with bandages.

Angela:   Detective Hanadarko?

Grace:   Yes.

Angela (politely, motioning):   Gloves.

Grace puts on gloves. Angela is methodically wrapping Jack's terribly burned body in gauze.

Angela:   Meet Jack Fielding.

The very tough detective Grace seems shocked at the young boy's injuries, the breathing tube and other equipment.

Angela (smiling, trying to put Grace at ease):   A "good afternoon, Jack" will do just fine.

Grace (smiling back):   Good afternoon, Jack.

Angela (continuing to work on the bandages):   Thank you for calling, Detective. Until you did, he was just the boy in room 229 with third degree burns over 70% of his body. You can call a kid "sweetheart" for just so long, you know? Any idea how old he is?

Grace:   Turned six in October.

Angela:   Six years old, in October? Well, Jack, that means you're either a Libra or a Scorpio. (Turning to Grace.) My money's on Libra! More sociable and easygoing than secretive and obstinate.

Grace:   Will he regain consciousness soon?

Angela:   If he lives, he will. When 70% of your skin has been scorched off, that's a big if.

Grace:   And the chances of that?

Angela:   It's in someone else's much more capable hands than mine. If he lives, he'll be here a minimum of 70 days, one day for each percentage of body burned. (Noticing Grace looking uncomfortable.) Are you hot? You'll get used to it. (Glancing up.) The heat lamps. They keep the room at 85 degrees. Jack lost so much skin his body can't regulate its own temperature.

Grace:   Has he said anything?

Angela:   No--thank you, sweet Jesus. I know you want to talk to him. I just want him to miss as much of this pain as possible.

Grace:   Any visitors?

Angela:   Just you. (Grace helps her arrange Jack's bedding.) Thank you.

Grace:   How long you been doing this?

Angela:   Long enough to know that whoever did this is also burned. Come. (Showing Grace under Jack's head bandage.) Those are fingerprints. Someone held him down.

Grace decides to try to lure Jack's father to the hospital by having the media broadcast that Jack is in pain and asking for his father, and herself posing as "Dr. Hanadarko," complete with a white lab coat. However, the show never suggests that Grace is under the impression she can actually provide skilled health care. She is posing to catch a criminal.

At one point, we see Angela and Grace at the nurses' station, as Angela goes about her work.

Grace:   How do you do your job?

Angela:   I don't know, Grace, I just do.

Grace:   Patients are personal to you.

Angela:   Just to a point--same as with your cases I imagine. (Answering the phone.) Burn unit? OK, sir, one moment. (Handing the phone to Grace.) Says he's Jack's father.

Grace gets on and tells Jack's father that Jack has been asking for him. She says Jack needs to see him, but the father hangs up, and it's not clear whether he will come.

Angela:   If Jack does wake up, this is exactly what's going to happen. He's going to want to see his daddy. He's going to need to see his daddy.

Later, Jack is waking up. The health workers are getting ready to remove his breathing tube, for reasons that are not well explained, as the detectives don't seem to question him, and later we see the tube back in. A breathing tube is not something that you put in and take out on a regular basis. In any case, the show does seem to recognize that the procedure is unpleasant, and that Jack will benefit from distraction, so they have decided on a Western theme, maybe because the boy named his dog Geronimo. As we see them preparing, Grace is dressed as some kind of American Indian. A physician wears a cowboy hat. Angela is at Jack's head, gently steadying it for the procedure.

Grace (giving Jack a sheriff's badge):   Hear you're the new sheriff in town, mister.

Physician:   I'm going to remove the tube from your throat, Jack, while your friend here shows you a trick.

Grace (pulling the wrapper from a straw and leaving it scrunched up on Jack's dining tray):   You ever see a paper worm?

Physician:   You're going to be able to breathe better, you're even going to be able to tell me how much you hate this stupid tube. OK, Jack, cough on three. One, two, three.

Grace has drawn water into the straw and made the "worm" wrapper wriggle to distract Jack. Afterwards, Angela stands behind Grace. The boy asks if Grace is an Indian princess. She asks if he is a real sheriff. He wants to know where his dad is, and says he wants his mommy and daddy. Grace says everything will be all right, not sounding too convinced. Angela gently moves her away. Grace is very upset.

Soon Jack's father shows up and Grace and the other officers apprehend him, and it seems like Grace can barely restrain herself from attacking him. Back at the police station, she and another detective are interrogating the father aggressively when another detective arrives and takes Grace aside, speaking very quietly.

Detective:   Jack's awake and asking to see his dad. Angela's not sure how long he'll last. She said seeing his father right now may be the one thing that'll help keep Jack alive.

So the detectives take the father to see Jack, with the detectives staying very close. Angela is at the bedside. Jack's father tells Jack he loves him repeatedly. Jack closes his eyes. His father calls to him urgently, trying to keep him awake.

Angela:   He needs to rest now.

She nods to Grace. The detectives haul the father away. Grace throws him down a stairwell and tortures him some more until he finally confesses; apparently he wanted to kill both the boy and himself so the family could all be reunited in heaven.
     
Nurse Angela shows toughness as well as clinical and psychosocial expertise, doing a very hard job which the show explicitly compares to the challenging police work Grace does. Positive elements of the portrayal range from the information that Angela gives Grace about physical and emotional aspects of Jack's condition to the fact that Angela addresses Grace by her first name, indicating that they are peers. Angela advocates for the boy repeatedly, telling Grace what he needs. When Angela tells Grace he will need to see his father, Grace listens. Angela is not a servant, but an articulate professional in control of her own work. The reference to "more capable hands" is plainly a reference to God, not physicians. Camille Saviola, playing Angela, does a great job with the character's manner, which is friendly and joking, but focused on business, always thinking about what will and should happen next. And Holly Hunter projects respect and admiration for Angela, well beyond what the script alone might require.

The show also gets points for resisting the urge to have Grace actually do a lot of the nursing, as SVU did in the 2004 episode with a sexual assault nurse. It was good that SVU included the nurse character, but she came off as an awkward assistant to the detective who provided all the important care to a rape victim. By contrast, here Angela not only does the clinical nursing, but she also shows expertise in forensic nursing and actually helps Grace with her detective work, showing her that the perpetrator is also burned because the fingerprints indicate he held the boy down. Grace certainly does help Angela and the physician manage Jack's reaction to the extubation, but there is no sense that she is directing the process.

A few relatively minor elements might have been better. Angela does not introduce herself to Grace when they meet, as a professional should, and while her patterned scrubs may amuse kids, they do not send the message that she is a professional with serious responsibilities. Physicians and teachers play important roles with children, but they do not need to wear cartoon characters. Of course, we can't say that these aspects of the portrayal are entirely unrealistic. But Angela's decision to stress that Jack may die right in front of him--twice--is hard to understand, especially since she herself has just made a point of suggesting to Grace that she should act as if Jack can hear them, greeting him and discussing his Zodiac sign.

On the whole, though, we commend those responsible for this episode, which offers an unusually powerful portrayal of what a skilled, veteran nurse can do for patients.

Please send a message of thanks to Saving Grace

Please send your comments to TNT's Senior Publicist Heather Sautter at heather.sautter@turner.com and please copy us on your messages at letters@truthaboutnursing.org. Thank you!

A note to readers

We didn't learn about this depiction of nursing until nearly a year after its original airing when one of our readers saw the show on rerun. We need your help in alerting us to good or bad depictions of nursing in the media as you see them so we can follow them as they happen. Thank you!