Nursing and medicine: cooperation or conflict?

Two years ago a newspaper's foreign correspondent in Russia described her observations of health care in post-communist Moscow. Through her visits to a sick friend in hospital and conversations with her taxi driver, whose mother was in hospital, the correspondent came to see a system of health care based on contractual, material rewards: flowers, chocolates, and perfume for the nurses; crates of whisky for the doctors. Sitting on her friend's bed (for which the patient had to provide her own linen and pillows), the correspondent watched in horror as nurses provided the expected “tender loving care” to some patients—changing bedclothes, taking temperatures, and giving tea—but ignored other patients completely, even if their sheets were horribly soiled and they were crying out for a glass of water. These patients, or their relatives, had failed to give the nurses any presents: no presents, no nursing. The correspondent concluded that we should be thankful for our own NHS.1

But I wonder if the correspondent's horror at the cold hearted contractual nursing she witnessed was the result of her own assumed and inherited expectations that nurses are inducted into a tradition of “tender loving care”? Does she still taste the fruit of a tree which is now almost cut down? British nursing, under the powerful influence of North American sociological, psychological, and educational nursing theory, has undergone a rapid transformation since the 1970s, which makes such assumptions questionable. Indeed the past 20 years have seen a revision of nursing history and a rejection of the traditional nursing ethos. Contemporary British nursing theorists …