The Joker, ideal murse or disgrace to murses everywhere?

Just about any murse you talk to has seen "Batman: The Dark Knight" one of the most memorable things about the movie was Heath Ledger's portrayal of the joker. But, one of the things that is often overlooked when reminiscing about the movie is that the joker had a very important couple of scenes where he impersonated a murse. Lot's of people have artistically broken down Heath Ledger's performance, but I don't think a single person has looked at how well the character of the Joker did in pretending to be a murse.  So I will be grading the following clip in three categories giving the joker a score of 1-10 in each category and averaging those scores together to see if the joker could cut it as a murse, remember 73% is a pass!!!

The categories are as follows:

Murse-ness: Murse-ness can be hard to define. But, it is essentially the unique qualities that set the murse apart of the common nurse. For example, a patient complains of severe neck pain. A nurse might gather more info or give a PRN med, but a murse (realizing the severity of the situation) quickly hits the emergency call light and starts compressions while singing "Another one bites the dust" at the top of his lungs. For further reference on murse-ness see the previous blog post "The Mursing Code"

Classic Nurse Skills: Just about everyone knows what these are how will did he do things like follow contact precautions and communicate therapeutically *yawn*

Faking it till you make it: Ahhhhhhhh a classic category for any good mursing student, how will did the joker pull off pretending to be a nurse and convincing those around him he knew what he was doing


Here's the scene, lets get to analyzing

Ok so we have four different sections to break down: cop scene, in the patients room, leaving the hospital, and outside the hospital

Cop Scene: Alright so pretty quick scene gonna be a quick breakdown. Now the Joker is obviously going over patients records is this scene and everyone knows that the #1 rule to mursing is ALWAYS FOLLOW HIPPA. Therefore, the fact that the cop burst into the room un-announced means he kinda had 2 to the chest coming to him. Also, the joker did have a mask on but no gloves. I think those two things cancel each other out skill wise (we don't know if there was a reason for the mask maybe he had a cold, maybe there was some mrsa going around WHO KNOWS). Finally, the cop A. thinks the joker is a NURSE B. Refers to him as a her. Great faking it if you ask me. Lets move on.

Patients Bedside: Ok there is LOTS going on in this scene. So right off the bat there are a few things going on.

• we see that the PT has wrist restraints which raises severeal questions. Is there a standing order? Is the patient a danger to himself? etc etc
• The joker again has on a mask but no gloves, again hard to judge without knowing the situation
• The hair is definitely a little long for the professional environment and shaking it out bedside is not hygienic
• Pretty good example of therapeutic communication here. Definitely on the patients level and very real. Absolutely teaching the patient to captain his own ship by giving him a gun
• Good empathy as far as communicating sorrow for the patients loss
• Taking the wrist restraint off is poor nursing judgement gonna get deducted for that one
• One of my favorite things about this exchange is that the joker is really letting the patient decide his direction of care. Patient centered care is crucial and he NAILS IT
• Not much in the way of faking it till he makes it, the patient realized he wasn't a murse pretty quick :(

In the hallway: 

• Good hand hygiene
• Blowing up the hallway seems extreme at first, but we dont know there could have been a serious SARS outbreak and the joker might have been just trying to stop the spread. Tough to judge

Outside the hospital:

• Again blowing up the hospital is definitely a boss move but its tough to jusdge the nursing rationale behind the idea
• The TV people seem to think he is a murse which is a plus

SO LETS GRADE THIS

Murse-ness: Starting score= 5

• +3 for protecting HIPPA by any means neccessary 
• +1 for making the patient the captain of his own ship and giving him a gun
• +1 for eliminating a potential SARS outbreak (remember safety first)
• +2 for destroying the hospital (again SAFETY FIRST)
• No deductions leaving a final score of 12/10. Absolutely a great role model for aspiring murses A+ job a true murse among men

Classical Nursing Skills: Starting score= 5

• +1 protecting hippa
• +1 face mask
• -1 No gloves
• +1 therapeutic communication
• +1 Empathy
• -3 No gloves coming into contact with patient
• -1 took mask off
• -1 Hair hygiene
• +1 patient centered care
• +1 hand hygiene when leaving the room
• -1 didn't sound fire alarm or use RACE protocol with fire
• Final score 4/10 FAILING. Definitely needs to review contact precautions that really knocked down what could have been an excellent score

The score so far is 16/20 he's passing but it all comes down to if he can fake it till he makes it (just like mursing school)

Faking it skillz: Starting score= 5

• Fooled the cop into thinking he was a murse and a woman +2
• Didnt fool the patient -1
• Fooled the bystanders +1
• DIDNT FOOL ME -1
• -1 white coar, classic noob murse give away
• Final score 5/10. A good actor, but not a great one. Definitely could tell he was still a murse in training

After a great start he comes back to earth with a 21/30 or a 70%. Time for some remediation