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By definition, an epiphany is the sudden revelation of an ordinary object or scene in an illuminating way. Well, it appears that at least one medium, television, has indeed had an epiphany. Now, when you turn on your TV, an ordinary nurse is revealed, in ordinary nurse-type settings, yet she is strong, smart, and dynamic. Aha! And there is an added surprise: It just so happens that her name is Epiphany!

It’s no secret: Nurses have been slamming the media for decades for their inappropriate portrayals of nurses as everything from servants to temptresses to bubble-headed accessories in medical settings. “When will someone portray nurses as they really are – hard-working, dedicated

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

patient advocates and not the readily available playthings of licentious doctors?” outraged nurses have historically lamented. Well, take heart, outraged nurses, and allow us to introduce you to Epiphany.

When nurse Epiphany Johnson joined ABC’s daytime drama, General Hospital, we saw more than an ordinary nurse. We saw an extraordinary nurse whose entertaining portrayal of the role keeps the integrity of nursing intact. If you are a fan of General Hospital, you know who Epiphany is and why fans love her. For those of you who haven’t had a chance to catch Epiphany’s performance, quick, find a friend with TiVo!

Actress Sonya Eddy plays the role of Epiphany Johnson on General Ho

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

pital, or “GH,” as fans call it, a daytime drama that has been on the air for 43 years and is watched by many people who work in healthcare. Eddy’s character, Epiphany, is a no-nonsense, confident, knowledgeable, experienced, and slightly dominant nurse who keeps the rest of the GH characters in line. Fans love her for it.

Apparently, nurses love her, too. We caught Sonya Eddy on her way to the gym and asked how she feels about the enthusiastic feedback she’s getting from nurses. “I had no idea, none. It’s a privilege to have positive support from the nursing community.” Eddy offered an explanation for her convincing portrayal of a nurse: Not only do several of her family member

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

work in healthcare, but Eddy herself is a licensed vocational nurse (LVN). She explained that her training as a nurse helps her keep it real on TV, “because I really can take your temperature and blood pressure.” Maybe this ability is subtly picked up on air, she suggests; she has worked in the field, so her actions come across as more genuine. And the best part? She is humble in the face of praise, giggling, “I’ll be floating on the nine cloud today!”

Epiphany’s role is clearly one of the more accurate portrayals of nurses in a hospital setting in the media today. Epiphany interacts with physicians and others as an equal member of the care team and takes risks on behalf of her

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

patients. She voices her opinion, and it is valued, listened to, and respected. As Eddy sees it, Epiphany’s foremost interest is the professionalism of her job – and nothing gets in the way of taking care of the patients. Sometimes, the really fun times, she gets right up there in another character’s face, whether a physician or the chief of staff or another nurse, to make sure that things happen the way they should. This is not some subservient nurse just “following doctor’s orders.” This is Epiphany. Serendipity or strategic planning?

So, was this turnaround in the media’s classic portrayal of nursing intentional? Did GH actively plan to write in a nurse every bit as integral

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

and respected as the doctors on the show? GH’s Emmy award-winning head writer, Robert Guza, Jr., lightheartedly explains, “I actually think that Epiphany thinks she’s at a bigger, higher level than the doctors.” Guza details what he had in mind for her. “The thing we wanted to do with Epiphany was to make her somebody extremely confident, somebody very good at what she does. No nonsense – she just has no tolerance for that, you know? So, in particular, (she encounters) a new doctor on our show who is arrogant and a womanizer, and she just sees right through him. She has no time and no interest and is constantly putting him in his place, which is really kind of wonderful.” Guza gu

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

hes over the public’s response to Epiphany, “There’s been a huge response to her, which is just fascinating!”

So, what is the key to Epiphany’s credibility as contrasted with the media portrayals we are used to seeing? Could it be Eddy’s actual experience working as an LVN in a hospital? “I’m just channeling other older nurses that I worked with. When I was new to the hospital, I watched the veterans for guidance,” explains Eddy, suggesting that what nurses pick up as more authentic is “just me putting my experiences into the character.” Eddy tells the story of her aunt, also a nurse. “One day my Aunty was working with a young doctor who was just barking out orders like an idiot

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

My Aunty said, ‘I’ve been nursing longer than you’ve been alive!’” (Doesn’t that sound just like something Epiphany might say?) Eddy says that after that incident, the doctor came to realize that her aunt could be a wonderful resource for him. Epiphany… well, make that Eddy… just really “gets it.” In fact, back in the beginning of the role when Eddy wore white quite a bit, she was so convincing that she was often mistaken for a nurse consultant on the set. Nursing is something she’s comfortable with, something she knows.

Just like with Epiphany, Guza deliberately creates other complex characters. “We do this with Elizabeth, too (nurse Elizabeth Spencer, played by Rebecca Herbs

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

). We show these people in a hospital, in a work setting. It’s really important to see what these women do for a living, and you see them being very good at what they do in the hospital. And then, of course, they have to deal with enormous problems (because it’s a soap opera), and these personal difficulties frequently come up when they are still in the hospital.” It is creating this multilayered type of character that keeps GH authentic rather than using stereotypical tricks to portray professionals.

Sidestepping those stereotypes

Is it fair to say that GH steers away from exaggerated or false representations? “I think that’s accurate. If we are going to do it and we fall pre

and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ

to that bad storytelling or bad characterization, it’s almost always somebody who you see somewhat violated, like a gangster’s moll or something, who isn’t grounded in a real situation, a real occupation.” That is how GH has avoided some of the mistakes that other shows have made, mistakes that have angered nursing professionals. When his characters have depth, Guza says,“We can see one way the nurses are with patients and their coworkers and then see them be completely different in their personal life.”

Do nurses and fans sound off if they see something that departs from nursing reality? “Oh, constantly, constantly!” Guza replies. “Years ago, when I first started with Carly, s

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

e was a physical therapist. I can’t remember exactly what it was, but Carly was saying something disparaging nurses, like, ‘I’m a physical therapist, I’m better than nurses.’ And we got deluged with phone calls, letters, and emails. Everybody was coming down on me, and I’m like, ‘It’s Carly; that’s the way Carly thinks! Of course it’s not true!’”

Guza says that the GH audience is very responsive and “savvy to all sorts of things. If we get something medically wrong, they’ll let us know about it, so we really have to be prepared.” Still, this is a television show, not a documentary on the Discovery Channel, and we watch it primarily for its entertainment value. And for that reaso

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

, Guza explains, they have to be able to take some license, but all within the bounds of reality. “They call you up and tell you, ‘This never happens; we would never do it that way.’ They really do keep you honest, but in a nice way.” That makes Sonya Eddy especially valuable in this role – an internal control, so to speak.

Just as with Eddy, the influence or life experience that individual writers have had with nurses, doctors, or hospitals will come through in the way they write for a character. In turn, that portrayal is passed on to viewers.

So, what experience did Guza have that influenced his creation of Epiphany, Elizabeth Spencer, or any of the characters on GH? Guza el

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

borates, “I guess I have a very positive take on nurses. I’ve had some experiences in my own life, and I’ve always liked them a lot. I love the fact that they have to balance a personal caring, a bedside manner, if you will, with medical expertise.” Keeping it true to form

Through the years, General Hospital has been saluted for its approach on some groundbreaking medical subjects. In 1996, GH had a character named Stone Cates, who died from end-stage from AIDS after passing the virus to his girlfriend, Robin Scorpio. Ten years later, Robin is a physician living with HIV and having a relationship with Patrick Drake, a surgeon who incurs a sharps injury while performing a proced

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

re on an HIV-positive patient. This is an opportunity for GH to present accurate information about the transmission of HIV as well as treatment options for those who have been exposed. Guza explains that, to stay current and accurate, they do an enormous amount of research, for example, incorporating into the characters’ dialogue how much HIV protocols now differ from what they were when Robin was diagnosed.

So how much does dramatic license trump reality in sensitive clinical areas like this? It does, at times, no question, but the “moral of the story” still supports reality. A recent example was a brief story line that had a hospital employee from accounting wanting to transfe

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

out a critically injured patient with end-stage AIDS because she had no insurance. The accountant thinks that no one will want to assist with the patient’s surgery anyway because of the risk of exposure to HIV. Realistic, no. It would not happen like that. But within the context of dramatic license, they did a lot of valid teaching about caring for patients who have HIV/AIDS, physiologically and psychologically. And the very touching endpoint came when Epiphany reported that they had staffing problems, all right – more volunteers to scrub in than they would ever need. Guza adds, “I wanted, and if I had more money, I would have liked to see all the people show up for the procedur

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

, you know, like 20 people show up volunteering, but I didn’t have the budget for extras.”

Reality check: The financial constraints of producing a show also impact what we see and how we see it. “We have very good research facilities. Whenever we do a sequence where you see the hospital at all, in particular, any kind of operating room procedure, a nurse will be there,” Guza explains. He says that we might even recognize GH’s on-site nurse consultant in the O.R. scenes. Look for her; she is in her late 30s or early 40s and has blond hair. She is a surgical nurse, not an actress, and her technical expertise is in play while they are shooting.

Another strong story was in 1994 whe

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

character Monica Quartermaine battled breast cancer, and much more recently, a younger character, Emily Quartermaine (Monica’s adopted daughter), also developed breast cancer. Did GH consciously make an effort to pass useful information on to young women when Emily was diagnosed with breast cancer? Guza gives us a look into the writers’ minds, saying that they take the responsibility seriously. “When we did the story of Emily with breast cancer, we worked very closely with the Susan G. Komen Foundation. It was extraordinarily moving when people called or wrote to say, ‘You know, I was in Emily’s situation. I was in denial; I didn’t get checked. I watched your show; I went into t

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

e doctor’ or ‘I discovered a lump.’ I felt like that was much more important than getting ratings or winning more Emmys. You actually reach some people. That was one of the most gratifying things that happened during my history on this show.” It’s a wrap

Sonya Eddy made the comment that daytime dramas imitate what’s going on in real life. But if that is the formula for a successful show, when will television portray a successful, professional nurse who is a man? Men account for somewhere between 5% and 10% of most graduating nursing classes. Is that enough to make television writers and producers sit up and take notice? Guza ponders, “We don’t intentionally NOT do it. We’ve had

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

them in small roles, but we haven’t had a male nurse as a principal yet. It’s a good point, actually; I’m scribbling a note to myself saying, ‘male nurse.’” (It’s true, he was scribbling. This could be another GH first, a male nurse in a major role…)

So, is Guza planning to use more of Epiphany? “Absolutely. She’s in for the long, long haul. There are three different story arches awaiting her. Sonya and Epiphany are going to be around for quite a while.” I’d bet that will make Sonya float on the nine cloud!

Before calling this “a wrap,” let’s review: Nurses impacted Epiphany’s life when she worked among them in her career as the LVN named Sonya Eddy. Nurses impacted Robert Guza

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

Jr.’s life through his own experiences, plus years of consulting and research. But the most exciting news is that nurses will continue to influence what we see on GH. “What I love is that I can call them (the nurse consultants) and not say, ‘What could happen if we did this?’ but rather, ‘What I would like is a situation where…’ and then list three or four dramatic things. What they’ll do is come back and say, ‘Okay, here’s what you do with this particular issue; you’ll do this particular surgery.’ They almost help me craft the story, you know what I mean? It’s wonderful!”

Nurses helping to craft their story in the media? Finally, it’s as it should be. Indeed, it is an epiphany

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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