Nurse Jackie is one of Showtime’s most popular shows this season. With Edie Falco, an HBO veteran of the hit The Sopranos, as an amoral emergency room nurse dedicated to saving lives, as she cheats on her husband and indulges in powerful pain relievers to combat her back pain, the show transcends the typical popular medicine dramas on primetime television. focusing on those who heal, not those who diagnose.
This Showtime drama also features The West Wing’s Anna Deavere Smith as Gloria Akalitus, a nurse-turned-hospital administrator. Akalitus is the butt of many jokes on the show, getting dizzy over coffee with Jackie’s Percocet, accidentally hitting himself in an elevator, and questioning a gay nurse about getting adoption papers for a child left at a nursing station.
Where is the dividing line between fact and fiction in the characterization of this hospital administrator? Frankly, the line zigzags. Hospital administrators play an important role in the internal workings of the hospital and help everything to run smoothly. But in a dark comedy like Nurse Jackie, Akalitus is a walking joke, providing a much-needed dose of laughter in the midst of so much darkness. However, if your employees were well behaved, Akalitus would most likely look like your average nursing supervisor.
In a notable episode, Akalitus urges Jackie Peyton to make a dying man vacate a bed due to overcrowding. Jackie asks you to look at the man again, not as a healthcare manager, but as a nurse. Akalitus allows Jackie until the end of the day to find him another place to stay, because he realizes that he will die soon.
This aspect of Akalitus’ character may be legitimate. It would make sense for a nurse to become a supervisor. Many hospital administrators started out as healthcare workers. However, it is not a simple jump from nurse to administrator. Most have at least a master’s degree in health services administration, although some have degrees in public or business administration. Hospital administrators with a financial background can become CFOs or CEOs.
The education includes a year of internship at a healthcare facility, and most administrators start out as administrative assistants for large hospitals, before seeking higher positions at smaller institutions. Therefore, it is unlikely that Akalitus is working alongside his former colleagues, as he probably would have had to move elsewhere to find a position.
In another episode, Akalitus stays up late to supervise Jackie making schedules, having noticed that she always seems to be working with friends. One of the responsibilities of the hospital administrator is maintaining the budget. The hospital administrator would be responsible for the hours of supervised nurses.
Finally, Gloria Akalitus seems to work alone. This is definitely true. Often there is only one hospital administrator in a small hospital, and larger hospitals need only one administrator for each department. All Saints, the fictional hospital where Nurse Jackie works, looks like a big hospital. As a result, it would be common for a health care manager to oversee the entire department alone.