Few nurses are 100% 'Jackie'

It is common for high-functioning addicts to hide the substances they abuse in food or drink, Summers says. Jim Adams, associate professor of pharmacology at USC, explains that this hides the bitter taste of the drug. Addicts who are doctors or nurses like Jackie can obtain controlled-release pills, which they then break into tiny pieces in order to get higher blood levels of the drug, Adams says. Addicts are tolerant and can withstand doses that could cause breathing difficulty or seizures in a non-addict. Narcotics (especially morphine) are used against chest pain caused by a heart attack, because they dilate the blood vessels and decrease the work of the heart. But these drugs can also stop breathing. Giving your stash of Percocet to an undiagnosed individual is reckless criminal behavior.

A fall cannot cause an aneurysm (a ballooning of the wall of a major artery such as the aorta), says Dr. Mark Adelman, chief of vascular surgery at New York University Langone Medical Center. But it could cause a different condition known as a dissection (a disruption between the layers of the wall of the artery), which can rupture. "This would almost never be audible by a stethoscope," Adelman says. "A CT scan or ultrasound would be used to make the diagnosis."

Catching physician errors, advocating for patients and making sure physicians are making the right diagnoses are among the most important job responsibilities of a nurse, Summers says: "Nurses are legally and ethically required to protect patients in this way. Nurses are an important check on physician power. Nurses are science professionals who save lives and improve outcomes through their independent assessments and interventions. Rarely, until 'Nurse Jackie,' have we seen such a depiction on television."

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Siegel is an associate professor of medicine at New York University's School of Medicine.

marc@doctorsiegel.com