In this paper, the nature of the psychotherapeutic function of the general nurse is considered in the light of current and future changes in nursing. Important ways in which general nurses can be psychotherapeutic in the course of their everyday work are highlighted and linked with the maternal function. The main thesis is that many apparently progressive changes in nursing occur in such a way that there is no real change in the organisational defences which are used to prevent therapeutic closeness with patients. Possible reasons for this are suggested, in particular that the defences serve to prevent distressing projections from patients spreading up through the organisational hierarchy. This in turn leaves the nurses ‘at the bedside’ without the containment they need in order to tolerate these projections. The denigration by nurses of the maternal function is also considered and it is suggested that this not only plays a part in the defence but also, paradoxically, gives nurses less status and recognition rather than the greater status they seek.