Imagine you're left in the middle of the Mayan jungle with no tools, limited water and only CornNuts for food. Your task is to construct shelter, avoid crocodiles and compete in daily physical challenges. Mosquito swarms and 120-degree heat add local color. Your companions are a hotel doorman, a make-up artist, a sportscaster and a magician's assistant - and they're out to get you.

That's the scenario family nurse practitioner Margaret Bobonich played out this fall on the CBS reality TV show Survivor: Guatemala. The 43-year-old NP from Charon, Ohio, held her own through six prime time episodes before 18 million viewers, treating her teammates for heat exhaustion, puncture wounds and insect bites even as she demonstrated her cunning and athletic skills in tug of war, rowing and balance competitions.

After she left the show, Margaret talked with ADVANCE about what viewers at home didn't see.

The Game
Survivor pits two nine-member teams, or tribes, against each other in a harsh environment for 39 days. Each day the tribes compete either for a reward, such as food or tools, or for immunity - the chance to keep all its members. The tribe that loses an immunity challenge must vote one of its members off the show. Last person standing wins $1 million.

As straightforward as that sounds, most of the show's entertainment value arises from behind-the-scenes intrigue, alliances and betrayal. Teammates gauge each other's strengths and weaknesses, assessing group assets and personal competition. Viewers get to see it all, because each tribe is dogged by two camera crews taping players' every move.

Some of it is ugly and personal.

"I'm usually pretty easygoing and roll with the punches," says Margaret. "But it's a totally different level of emotion when you're dehydrated and you're malnourished and you're sleep deprived. That puts everybody's nerves affray, and things that normally wouldn't bother you do. . I think people's true personalities come out. So when you're used to hiding those nasty habits that you have or those nasty moods you can get into, there's nowhere to hide."

But viewers don't see everything, says Margaret. With a 45-minute episode and a narrative to create, the show's editors have to choose what to air.

"For instance, you might miss the before and after that really complete the story. . What they air is somebody says to me, 'How are doing this morning?' My response is, 'I'm wiped.' But what you don't see is that I've been up for 2 nights in a row as the only tribe member keeping the fire alive, and that was day 10 of diarrhea for me, . and I'm the only person who would get firewood in the morning. . So, yes, I'm wiped, but you don't really see the whole story."

Still, she laughs, "You can't deny some of the things you do, because you do them. It is 100% us. It's actually far worse in real life than what you see on TV."

Thorns, Heat and Dehydration
Despite the entourage surrounding them in the jungle, Survivor contestants did risk pain and injury. After a 24-hour, 11-mile hike, Margaret's tribe was worse for the wear.

"Blake had a thorn tree break over his shoulder, and he was going into what appeared to be asthma attacks," Margaret remembers. "And then Bobby Jon became so dehydrated with heat exhaustion that he was borderline into seizure."

Margaret's presence was a boon for her teammates and the show's producers. "[The producers] didn't plan for the severity of the environment this time around," says Margaret. "There were times when it was more than 120 degrees, and we were playing a ball game. They didn't plan for the severity of the environment, and they'll never do that again. But what they did like is that I was there to kind of set the gauge" for the seriousness of the situation.

Viewers saw Margaret examine Blake's wound, remove the thorns and later tend to him when he vomited in reaction to the pain. She counseled rest and hydration for her exhausted teammates, and she managed Bobby Jon's seizure.

"The nurse-lady was right there and talked him through it," a tribe member told viewers.

The game discourages players from admitting their injuries, says Margaret. Asking for medical help can make a player appear weak, and appearing weak can get a player voted off the show.

"There is medical help available," explains Margaret. "But you have to call for it.

"If you call for it, they will come and look at you; and unless it's life threatening, they're not going to pull you off [the show]. You would have to quit. . People don't call for medical help despite the asthma attacks or the sprains and strains and cuts and . severe dehydration, because to call for medical help puts a target on your head as a weak individual and not worthy to stay and keep your team strong."

Not wanting to appear weak was behind teammate Judd's enmity toward her, Margaret believes. "Judd did get sick [with dehydration], but according to Judd, he just got sick for an hour, he threw up and he went on. But that wasn't true," reveals Margaret.

"He didn't want any help because he didn't want to look weak. The second part of that is that Judd used the illnesses of, for example, Blake and Bobby Jon to his advantage. Because when they were ill, he went to the front of the line. And then when I helped the guys get better, he had to step back. So my help, not only did he not want it for himself, but help for the other members of our tribe put him into the back of the pack."

NP Ambassador
Margaret says she didn't set out to appear on Survivor to promote the NP profession, but she found ways to do so.

"It started from the second I stepped out there," she says. "I remember they were going to list the credits as 'Margaret, 43 years old, nurse.'"

Instead, Margaret asked CBS to list her occupation as a nurse practitioner.

"I said, 'I worked very hard to achieve the profession I'm at. Please give me credit. It's like . calling the Pope a priest.'"

As a result, whenever Margaret appeared on screen, the caption read, "Nurse Practitioner."

That small victory was important her, she says. "In Ohio, nurse practitioners aren't as prominent. We just got our prescriptive privileges a while ago, so we know what it's like to come from the bottom up and earn our place in the world. I wasn't going to lose any ground."

Further opportunities to promote the profession have opened up now that she's left the show, and she says she'll pursue some health reporting assignments. If she'd won the grand prize, says Margaret, she would have liked to spend more time volunteering at a free clinic in town.

After leaving the show, Margaret is finding that she's a minor celebrity. She's returned to work at a family practice, and she laughs about the reactions of her patients who are just discovering that she was on television.

"They'll say, 'You didn't tell me you're Margaret!'" she says.

"Well, I am Margaret, but I'm also your nurse practitioner."

Jill Rollet is associate editor and online editor at ADVANCE for Nurse Practitioners. Reach her at jrollet@merion.com.