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March 3, 2004 -- Today The Guardian ran an article by John Carvel about the negative reaction of U.K. nurses to a new Channel 4 drama called "No Angels" and an "image-repair exercise" that the Royal College of Nursing (RCN) would be undertaking to show the public what nursing really is. Nurse Vici Hoban, writing in The Times of London on February 28, had explained that the new show about four young nurses in Leeds had purportedly aimed to "explode the myth of angels by the bedside" and provide "a witty and truthful expose of nursing in the modern [National Health Service (NHS)]," but the first episode in fact showed the nurses "laughing over a corpse that they have warmed up in the bath to disguise the fact that the patient died, unnoticed, hours earlier," as well as "tricking colleagues into taking drugs, showing off visible panty lines to doctors and having sex in cupboards." Well, is that all? Our British nursing colleagues are so picky.

The Guardian piece, "Show's bedside failings prompt a nurses' charm offensive," does a pretty good job explaining nurses' concerns about "No Angels." It uses lengthy quotes from RCN general secretary Beverly Malone, who is careful to note that she is not so concerned that the show uses humor or depicts nurses' personal lives as she is that it largely ignores nurses' interactions with patients and gives "so little insight into what being a modern day nurse is about." The piece also includes excerpts from some letters provided by the RCN journal "Nursing Standard" in which nurses explain what they really do, and notes that the magazine has appointed a number of nurses as "ambassadors" to respond to "No Angels" in media interviews. The story notes that series creator Toby Whitehouse has defended the show on the basis that it has been advised by a "nursing professional with more than 15 years nursing experience" and that each event in the series is "inspired by something one of our advisors told us."

Hoban's generally well done piece in the Times, "Reality check-up," expressed regret that in trying to "explode" one stereotype about nursing the show "felt it necessary to reinforce others." She explained that despite the misconceptions about nursing fostered in shows such as "Holby City" and "Carry On," she had hopes for "No Angels." But the show's inaccuracy disappointed her. In addition to the problems noted above, Hoban argued that show appeared to be using "only the most extreme examples," along with "urban myths," to produce a show that is "stuck in a rather disturbing time-warp: the nurses sit around with barely enough patients to distract them from their gossiping, while doctors bark orders and patronise their opinions." In fact, Hoban noted, today's NHS nurses are "professional, accountable and respected," and there are "even nurses performing invasive procedures, prescribing drugs and making diagnoses."

We wish we could take comfort from Hoban's "doubt" that the show "will be taken seriously enough to dent nursing's image," or her (presumably) joking speculation that "by depicting nursing as one endless, fun-fueled party, it may yet succeed where many an NHS recruitment campaign has failed." Even the most outlandish television drama contains elements that viewers may have little reason to doubt (e.g., that nurses report to physicians, that they spend much time gossiping) and that may establish a base for events that may be taken less seriously (sex in the cupboard, laughing at the dead). Most people cannot tell exactly what is plausible when it comes to something as poorly understood as nursing, and even a sophisticated viewer might simply conclude that "doctors would never let nurses get away with being so lazy or irresponsible," or perhaps that "nurses would never be so obvious about wanting to seduce the doctors."

See the Royal College of Nursing's media image campaign Nursing the Future.

See John Carvel's article "Show's bedside failings prompt a nurses' charm offensive" in the March 3, 2004 issue of The Guardian.

See Vici Hoban's "Reality check-up: A new nursing drama leaves former nurse Vici Hoban ill at ease" in the February 28, 2004 issue of the Times.

Also see Gareth McLean's article "Saints misbehaving" in the March 1, 2004 issue of The Guardian who expresses happiness about the death of the angel stereotype. But it doesn't appear as if he realizes that other stereotypes about nurses can also be damaging.

Also see David Brindle's article "Fallen angels?" in the January 14, 2004 issue of The Guardian, which includes great detail about the Mori poll surveying 2000 U.K. adults on their attitudes about nursing. From the article we quote:

...81% considered nurses "caring and understanding", but only 42% judged them "well educated" and just 23% thought they had "a lot of social status". Almost three in four wrongly believed that nurses could not prescribe medicines.

Questioned on which famous nurses they knew, only two people named Beverly Malone, RCN general secretary, while 21 recalled Charlie Fairhead, the charge nurse character in the BBC series Casualty. Way ahead was Nightingale, named by 1,627 people.

The poll asked interviewees if they would ever consider becoming a nurse. Only 9% said they would (although another 4% were already nurses), with 79% saying they would not, and a further 7% replying that they had considered it, or had even started training, but had decided against. These responses may, however, have had something to do with a general ignorance of how much nurses can earn: offered four options, just 7% of all those surveyed - and presumably that included the 4% who were nurses - correctly identified the basic salary range as between £16,000 a year (the starting salary for a qualified D-grade nurse) and £107,000 (what a nurse can earn as a chief executive of an NHS trust), while the most popular choice (32%) was £12,000-£25,000. According to the Department of Health, average total earnings of a qualified nurse were £24,500 in 2002.

In the past, the RCN and other nursing unions were skilful players in the annual pay round, drawing on the deep well of public sympathy for nurses. The advent of the Agenda for Change programme for NHS pay, including a three-year deal for nurses, has done away with the posturing - and the publicity - so that only 30% of the Mori respondents thought nurses "do a lot to improve their pay and working conditions", compared to 42% in a previous poll in 1999.



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