Behind the scenes, a Spaulding nurse helps Hollywood get healthcare right

How much urine should be in a catheter bag, and what color should it be? A film crew on set in London needed to know urgently.

To find out, they called Martha Rafferty, DNP, MSN, RN, associate chief nursing officer for Spaulding Rehabilitation Hospital Boston.

Rafferty had been tapped to serve as a medical advisor for Love of Your Life, a romantic drama released by Amazon MGM Studios last month. Directed by Rachel Morrison, the film stars Margaret Qualley as Maya, an emergency room nurse who works at the fictional Boston General Hospital during the COVID-19 pandemic and experiences a life-shattering loss.

While scenes inside the hospital were filmed on a set in London, Spaulding Rehabilitation Hospital Boston has a cameo in the film. Its main entrance in Charlestown serves as the backdrop to one of the film’s more emotionally wrenching scenes.

Rafferty recalled being at work one day last year when a member of Mass General Brigham’s External Communications team asked if she would be interested in the opportunity to share her expertise with an unconventional audience.

“He said a film production company was looking for an advisor — someone who lived through COVID and could help them understand what nursing was like and working through the pandemic,” she said.

While Rafferty now oversees Spaulding’s inpatient nursing practice, her background is in emergency nursing. Earlier in her career, she worked in Salem Hospital’s Emergency Department (ED) for 12 years before leading emergency nursing at Lowell General Hospital and Emerson Hospital. She joined Spaulding four years ago.

“I really wanted to get into a large health system,” Rafferty said of making the jump from community hospitals and emergency nursing. “Seeing this end of the continuum of care has really been amazing because, for the most part, in the ED you treat whatever the problem is and move along. It's been really rewarding to witness the outcomes of that care here at Spaulding.”

When Rafferty agreed to advise for the film, she wasn’t sure what to expect — maybe a conversation or two about her former day-to-day work as an ED staff nurse.

“Little did I know I’d work with them on designing the ‘unit’ they were going to create to film the scenes in the hospital,” she said. “The director of the film reached out immediately and put me in touch with the set and costume designers.”

From Spaulding to the silver screen

The crew strove to make the setting feel as authentic as possible, Rafferty says, and no detail was too small — hence the sudden call from London about catheter contents. Set and costume designers asked for her input on scrubs, privacy curtains, precaution gowns and even where an oxygen gauge should be positioned.

Qualley and one of her co-stars, Tamara Lawrance, who plays another nurse in the film, also spoke with Rafferty several times before filming about her experiences as a nurse.

“It was fun, and they had such incredible respect for nursing,” Rafferty said. “During one of our talks, Margaret told me she was going to channel that energy when she did her nursing scenes. It was really cool to see how she translated everything we talked about into her acting. Overall, it was really nice to hear the entire production team express their gratitude to nursing and everything that nurses did during COVID.”

Rafferty says the genuine gratitude for her contributions gave her the confidence to speak up when she noticed something amiss as the cast and crew shot a scene outside Spaulding. The scene takes place during the height of the pandemic; people are lined up, single file, in front of a temporary tent set up outside the main entrance, presumably for COVID testing.

“I noticed that there was an extra standing to the side of the tent, not really having a reason to be there,” Rafferty recalled. “I told the director, ‘If that person doesn't have a purpose at that tent, they should not be in the shot.’ The director called for the assistant director to move that person out of the scene, and in the final film that person is not in the scene.”

At one point, a producer offered Rafferty the chance to be an extra in one of the scenes outside Spaulding. Morrison, the director, overheard and quickly cut in.

“She said, ‘No, I need her behind the camera,’” Rafferty remembered with a laugh.

Although Spaulding’s big cameo lasts only a few minutes, the cast and crew spent more than 12 hours there to prepare the set and film multiple takes.

“There was a lot of excitement here in the lobby. Everyone was hoping to get a glimpse of what was going on,” Rafferty said. “It was chilly that night, so it was funny — Margaret would come into the hallways between takes to do jumping jacks and warm up.”

Amplifying the voice of nursing

The film provides an unvarnished view of some of the impossible scenarios healthcare professionals faced during the pandemic, notably the realities of closing hospitals to visitors to prevent the virus’ spread.

Reliving those memories with the cast and crew — and seeing them brought to life on screen — was difficult but important, Rafferty said.

“It was a period of time in healthcare that if you lived through it, you’ll never forget what it was like,” she said. “It definitely brought back some of those emotions, especially the conversations around how we couldn't have family members come into the ICU. A big part of what we did as nurses was making sure we could somehow connect the family or loved one to their patient by phone or, as you see in the movie, with iPads.”

Yet reflecting on that time, Rafferty added, was also unexpectedly rewarding.

“Healthcare made it through these events, and we can now tell a story about it,” said Rafferty, who worked at Emerson Hospital at the beginning of the pandemic. “We banded together as a team every single day, and we did it overnight just because none of us really knew what to expect.”

The night before the film’s premiere, Morrison emailed Rafferty with a note of appreciation for her contributions: “I hope we do you proud.”

Watching the film at home after its release on Amazon Prime, Rafferty says she felt that and more.

“I think the voice of nursing isn't always heard loudly enough,” she said. “I felt honored — not only as a nurse but also as a member of MGB — to help share our story.”