Nurses lose their halo

These days all vicars are randy and all nuns are harridans. Is it really such a surprise that nurses

Nurses, having enjoyed an extended run in the national consciousness as angelic, selfless individuals, have suddenly started to get quite a bit of flak in the media about their shortcomings. It strikes me that there are a number of reasons why.

Apart from anything else, it would have been impossible for them to maintain their angelic reputation - which, thanks to Florence Nightingale, has been burned into the national consciousness - for ever. Before Florence N, nurses didn't have a great image: by all accounts they were a lazy, dirty and incompetent lot. Then the great lady swung her lamp and everything changed. Nurses stepped into line, washed their hands, stopped gobbing everywhere, put their fags out and earned themselves a ticket to heaven, which, until now, very few have dared to challenge.

Nurses' saintly image could only ever have lasted so long. Look at nuns and vicars. They were supposed to be altruistic and godly. But with the help of the tabloids, it didn't take too long for vicars to turn into randy old pervs, or for nuns to become sadistic harridans intent on terrifying children to death. Likewise, some chipping away at the unrealistic expectations we all have of nurses was bound to happen sooner or later.

Anyway, it is unrealistic to expect an entire profession to be completely good. There are bound to be some individuals who are stressed, who are unkind, who are a bit rubbish at their job, who are in the wrong career.

But what matters is where these individuals sit in the hierarchy of the NHS. A bad nurse on a back ward in a small town may not cause too much damage, whereas a bad nurse running a large teaching hospital can sully a huge section of the system.

In recent years there has also been a change in the way nurses are trained: they all study up to degree level now. I have been told that some people in the NHS feel this has caused a rift between qualified and unqualified staff, because some nurses feel that tasks such as changing beds or clearing up messes of various kinds are beneath them.

When I did a degree and a psychiatric nursing course, we were considered so bright (ho ho) that we didn't need the usual three months' training at a general hospital to brush up our physical skills. As a result, lots of us were crap in this important area.

Whenever there was a physical emergency such as a cardiac arrest, you could spot the degree nurses a mile off, legging it in the other direction - we were terrified of getting to the emergency first and not knowing what to do. And we were clumsy at injections and the like. One poor woman once said to me, after several appalling attempts to inject her bottom with a particularly viscous fluid: "Please, nurse, can't I take a tablet?"

As a nation we focus on the negative. Our newspapers are full of bad stuff, as we all seem to consider good news the epitome of tedium. So the nurses who do their jobs properly and care exquisitely for those in their charge will always be overshadowed by the ones who are incompetent, or worse.

Nonetheless, whistleblowing is punished, which sends out a mixed message to nurses who observe cruelty, neglect or downright sadism, but feel they are powerless to act.

I have seen good nurses and bad nurses. They existed along a continuum: from hard-working, kind and competent people, to office-hugging, bone-idle types, to apathetic, disengaged automatons.

A good culture in a hospital can absorb and manage a few bad nurses, but once the culture becomes bad in itself, bad nursing practice is much harder to hide. Filthy wards where cleaning staff - who earn a pittance and don't have enough hours to complete their work - set the tone are becoming too common. And unless you have some scary Hattie Jacques of a matron who comes down on dirt like a Valkyrie, demoralisation and pessimism set in at a very basic level.

All too often we hear stories of neglect in the NHS, particularly of the elderly. It strikes me that this is the product of an inability to empathise, to put oneself in the position of the patient. A lack of imagination. This may well be because the service emphasises pathology rather than humanity. Some of the most caring nurses I have met are the unqualified ones, who obviously aren't in it for the money and, I suspect, don't get a huge amount of respect from those higher up the ranks.

So it seems we can add a category to the stereotypes we already have of nurses - good-time girls and rigid, bulky old bags. Now we also have the uncaring, feckless neglecters.

But the most important thing is that we get to the nub of what is going wrong and change it. Rather that than throw out more archetypes for the media to seize on.

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