Nurse Jackie is one of the most popular shows on Showtime this season. With Edie Falco, an HBO veteran of the hit The Sopranos, as an amoral ER nurse dedicated to saving lives while cheating on her husband and indulging in powerful painkillers to combat her back pain, the show transcends the typical popular medicine dramas on primetime television. focusing on those who cure, 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 from Jackie’s Percocet coffee, accidentally masturbating in an elevator, and questioning a gay nurse about getting adoption papers for a child left at a nursing station.
Where is the 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 keep everything running smoothly. But in a dark comedy like Nurse Jackie, Akalitus is a walking joke that provides a much-needed dose of laughter in the midst of such darkness. However, if her employees were to behave, Akalitus would most likely look like your average nursing supervisor.
In one notable episode, Akalitus urges Jackie Peyton to have a dying man vacate a bed due to overcrowding. Jackie asks him to look at the man again, not as a health care manager, but as a nurse. Akalitus allows Jackie until the end of the day to find her another place to stay, realizing that she will soon die.
This aspect of Akalitus’s character may be legitimate. It would be logical for a nurse to become a supervisor. Many hospital administrators started out as health care 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 earn degrees in public or business administration. Hospital administrators with financial backgrounds can become CFOs or CEOs.
Education includes a year of internship in a health care facility, with most administrators starting out as administrative assistants at large hospitals, before seeking higher positions at smaller institutions. Therefore, Akalitus is unlikely to work alongside his former colleagues, as he would likely 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 the maintenance of the budget. The hospital administrator would be responsible for overseeing the nurses’ schedule.
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 healthcare manager to oversee the entire department alone.
