Nurses are required to be highly skilled, educated professionals but they are still seen as handmaidens to doctors. Photograph: Medic Image/Getty Images/Universal Images Group
A nurse?
You want to be a nurse?
There it is again. The surprise, the raise of the eyebrow, the uncomfortable pause. Followed by one of two responses: the overly-enthusiastic and evidently forced good for you, or the honest but, why? Surely youd rather be a doctor?
The surprise is understandable; I dont have the most conventional background for nursing. At school I pursued both science and humanities to A-level before landing a place at Cambridge to read history of art. Wooed by the hedonism of student media, I pursued a career in entertainment television, dismissing my long-standing passion for nursing as a romantic daydream, sparked by the literature of Vera Brittain and Florence Nightingale.
However, with each year my passion grew rather than waned and I realised it was more than a passing phase. So at Christmas I decided to turn my back on an industry I had fought so hard to get into, and applied for the two-year postgraduate diploma in adult nursing.
At first I wasnt brave enough to shun societal expectation and for a while I considered applying to study graduate medicine. I recall one particular conversation with my mother where she described how shed spent her life being just a nurse and aspired for her daughter to aim higher evidence of how the longstanding prejudice surrounding the profession is passed between generations.
After working as a healthcare assistant in a busy London trust my suspicions were confirmed: it was the work of the nurses, rather than the doctors, that inspired me. Seeing nurses on the ward, I grew to appreciate the autonomy of their role; distinct, yet equally valuable as the physicians.
Unlike doctors, a nurse will spend extended periods of time with their patients, building a relationship founded on implicit trust. They are at the bedside from admission through to discharge, relieving pain, easing distress and raising the alarm at any red flags.
Consequently, they are in the best position to observe the subtleties of a patients condition and gain the most holistic understanding of their needs. This unique nurse-patient relationship, combined with intelligent communication with the physicians, is arguably at the forefront of successful treatment and recovery. Therefore, nurses are required not only to be empathetic and perceptive, but highly skilled, educated professionals who can operate independently.
Yet despite this, nurses are still widely perceived as handmaidens to doctors. The stereotypes linger, reinforced by popular culture. Take any glossy hospital hit of the last decade House, ER, Greys Anatomy. Nurses are portrayed as unskilled aides to the deity-like doctors, thats if theyre given screen time at all.
The prejudice also manifests itself in a continued gender imbalance. Just over 10% of UK registered nurses are male, a stubborn figure that barely shifts each year. Its a fact Im reminded of every time I hear the call of sister or matron echo down the ward.
The view of nurses as subordinate seems to be particularly entrenched in the UK, ironic given the founder of modern nursing, Florence Nightingale, rallied against the view of nurses as devoted and obedient (a definition she scoffed might do for a horse). One nurse I work with is considering returning to Nigeria, so disheartened by the lack of trust and respect in the NHS, attitudes that do not exist in her country. Others are attracted by opportunities overseas, notably Canada and Australia, where salaries reflect the higher status of the profession.
There is hope, as the profession has evolved dramatically over the last decade and there are increasing numbers of opportunities to specialise and even prescribe. New titles, including nursing consultant, advance nurse practitioner and clinical nurse specialist challenge the traditional hierarchy.
However, prejudice is so deep rooted that I fear change will take decades and in some cases be met with resistance. Just last week I overheard a consultant say to an impressionable junior doctor: We dont do care, we do medicine. It wasnt so much the statement that was upsetting; it was the delivery. Tinged with disdain, the implication was obvious: the provision of care is lowly, beneath the role of the physician.
We must challenge these views and start to see nurses as partners to doctors, not inferiors. Their unique scope of practice is of equal importance and until we recognise this, we will struggle to retain and attract the brightest talent to the profession.
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