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I started training as a nurse exactly thirty years ago, and my mother started her training thirty years before that, in 1939. Inevitably, my reflections in 1999 are situated within that historical context, a view from a bridge under which has passed not only my own experience, but the handed-down narratives received from my mother. Of course reflection is always a personal matter and my reflections today will be idiosyncratic, and perhaps provocative; but I hope that, by all of us loosening too tight a control on our thoughts and associations, we may be able to have some creative interchange.
For me the word ‘crisis’ immediately conjures up my mother's accounts of nursing patients with pneumonia before antibiotics were available. My mother explained to me that the crisis was reached at the point when the temperature was at its height and the patient at his most sick. At the crisis, either the fever broke and the patient started to recover, or he continued to deteriorate and died. Could it be that this association of mine is apposite to the condition of today's sick patient, the Nursing profession itself? I do believe that Nursing is, to say the least, extremely unwell. I think that my analogy, of the crisis in pre-antibiotic pneumonia, is useful because the patient was very ill indeed and the two crucial elements in his recovery were his own natural resistance and the skill of his nurses. I shall say more about both of these.
What is this crisis in Nursing about? It can of course be analysed in many ways: politically, sociologically; in terms of pay, working hours, changes in the Health Service, changes in public expectation. Nurses feel badly used and held in low esteem. In this brief presentation I am going to suggest that the crisis is primarily due to the sickness in the Nursing profession, and that this sickness, like many psychological illnesses, is caused by a deficit in professional self-esteem. Of course, no one would disagree that self-esteem in the professi