I’m confused. Don’t TV producers know that for the last seven years nurses ranked number one in Gallup's annual Honesty and Ethics of Professions survey?

The two nurses they introduced to us this spring definitely don’t fit the profile of top-notch professionals. Showtime’s Nurse Jackie and TNT’s Hawthorne walk on the wrong side of the law or disregard ethics guidelines at least once an episode. Still, I hear many nurses and lots of other TV viewers really like these characters. My hairdresser says he loves Jackie.

Played by Edie Falco, Nurse Jackie is a drug-addicted emergency nurse who is one year into an affair, at work no less, with a Percocet-supplying pharmacist who doesn’t know she’s married to a devoted husband and has two young children. For Jackie, assisted suicide, lies, pill popping, and retribution are all in a day’s work.

Christina Hawthorne, depicted by Jada Pinkett Smith, plays a hospital’s chief nurse, who seems to do everything but run the nursing department. She intervenes in all crises, diagnoses rare diseases, and even resuscitates patients after the physician in charge has ended the code. She’s super nurse. But Hawthorne, as she calls herself, defies the limits of ethical and sometimes legal professional practice when it suits her purpose. Plus, she’s aggravating. She micro manages every situation.

Those of us concerned about nursing’s image in the media are more than unhappy with these programs, and I haven’t even mentioned the cavernous gap between reality and the clinical situations.

I’ve been forcing myself to watch these shows every week to try to make some sense of them, and I’ve come up with a hypothesis — Nurse Jackie and Hawthorne are the new westerns —Jackie and Hawthorne the new cowgirls, flawed but courageous, defending patients, battling and outsmarting the healthcare system instead of capturing stagecoach bandits.

With both these nurses, no matter what it takes, be it illegal, unethical, rude, or beyond defiant, they morph into heroes when they’re advocating for patients and families. They work around over and way outside the system to get what’s needed, especially when the patient is critically ill, emotionally out of control, or destitute. They move mountains, in the form of chief surgeons, CEOs, police officers, and insurance companies for their patients.

These cowgirls, one in scrubs, one in a white coat, know how to hold a patient’s hand, break bad news to families, hug a child, respond to trauma and mental health emergencies, and help a patient die with dignity.

We know from experience that our agenda related the image of nurses and a TV producer’s vision are miles apart, but maybe these shows aren’t just about nurses after all. They seem to tap into America’s frustration and cynicism with healthcare in the United States and with the so called corporate bureaucrats and reams of red tape people resent and fear.

Maybe Jackie and Christina are the Lone Rangers of the 21st century, fantasy figures, flawed just like the cowboys of old, abiding only by a law they’ve create for themselves. Maybe the public likes the way they ride roughshod over the establishment and stand by their patients.

Of course, Nurse Jackie and Hawthorne certainly aren’t going to change my opinion about ethical nursing practice, but I will be watching the shows with a new set of eyes and listening even more attentively to the news on healthcare reform.