Fact or Fiction: Gloria Akalitus as a Hospital Administrator
Edie Falco, who portrayed Carmela Soprano is HBO's The Sopranos, has crossed networks. Now responsible for one of Showtime's biggest hits, Nurse Jackie, Falco doesn't quite conform to the Nursing Code of Ethics; Jackie doesn't believe in following the rules, she believes in saving lives.
Photo credit: The Internet Movie Database
Nurse Jackie is home to The West Wing's Anna Deavere Smith as Gloria Akalitus, a nurse-turned-hospital administrator. Akalitus is the butt of many a joke in the show, getting giddy off of Jackie's Percocet-laced coffee, accidentally tazering herself in an elevator, and questioning a gay nurse about how to obtain adoption papers for a child left at a nursing station.
Where lies the line between fact and fiction in the characterization of this hospital administrator? Frankly, the line zig-zags. The hospital administrator is responsible for keeping the hospital a well-oiled machine. But in a dark comedy like Nurse Jackie, Akalitus is a walking punch line, providing a much needed dose of laughter amidst so much darkness. However, if her employees behaved themselves, Akalitus would most likely seem like an average nursing supervisor.
In one notable episode, Akalitus urges Jackie Peyton to make a dying man vacate a bed due to overcrowding. Jackie engages Akalitus' more compassionate side by asking her to see the man not as an insurance payer but as a dying man. Akalitus allows Jackie until the end of the day to find him another place to stay, because she realizes that he'll be dying soon.
This aspect of Akalitus' character may be legitimate. This makes sense, as it is plausible that a nurse could be promoted. Many hospital administrators started their healthcare career after completing a nursing degree with specific interest in administration. However, it's not a simple jump from nurse to administrator. Masters degrees in Health Services Administration, Public Administration or Business Administration are among the prerequisites for the position. Hospital administrators with financial backgrounds may go on to become Chief Financial Officers or Chief Executive Officers.
Education includes a year of interning in a health care center, and most administrators begin as administrative assistants for large hospitals, before pursuing higher positions in smaller institutions. Therefore, it's unlikely that Akalitus would be working alongside her former peers, as she probably would have needed to move elsewhere to find a position.
In another episode, Akalitus stays late to oversee Jackie making the time schedules, having noted that she always seems to be working with friends. The hospital administrator is charged with responsibility for the budget. The hospital administrator would be responsible for the schedule of the nurses being overseen.
Finally, Gloria Akalitus appears to work alone. This is definitely true. Small hospitals generally don't need more than one hospital administrator, but large hospitals may need at least one in every department. All Saints, the fictional hospital at which Nurse Jackie works, comes across as a large hospital. As a result, it would be common for a health care administrator to oversee the entire department alone.
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