Short abstract
Channel 4, 31 January at 8 pm
Rating: ★★
The “undercover angels” of this documentary's title were Norma Ndebele and Charlie Smith, a nurse and a health care assistant (HCA), who spent three months apiece working at the Royal United Hospital, Bath, and Ealing Hospital, London, as HCAs wearing hidden cameras. Their six months of filming was distilled into a one hour programme trailed by Channel 4 as “a damning catalogue of inefficiency, neglect and substandard treatment.”
A different director's cut might have shown a heartwarming catalogue of happy patients basking in wonderful care given by dedicated professionals, but that wouldn't have made the newspapers. The shock-horror build-up was duly fulfilled with distressing scenes of patients being fed against their will, left to lie in beds soaked with urine and faeces, and treated without respect or love. There were no spectacular dramas but a long litany of dreadful humdrum failures, including a woman sitting cold and wet for hours on a commode; medication left on a locker long after it should have been taken; and lack of routine precautions with patients with methicillin resistant Staphylococcus aureus (MRSA).
The atmosphere was surreal, with the queasy jerkiness of the hidden cameras and faces out of focus to avoid identification. The disembodied voices were most striking—patients' miserable repeated calls for help, muted protests, inarticulate moans, and whimpers. All were elderly and passive, helpless and alone. This viewer's distress turned to rage when Norma or Charlie would finally find help to tend a patient, prompting a stream of self-justifying chatter over the patient's head, punctuated with an occasional token question, “All right, my love?” that never waited for an answer.
So were we simply seeing a minority of uncaring and lazy nurses among the hundreds of thousands of dedicated ones, as the narrator unconvincingly reassured us in the name of “balance”? Having collected compelling data, the analysis was weak and inconclusive. Occasional commentary from Norma and Charlie, nursing experts, and the inevitable Claire Rayner offered some disjointed insights—take your pick: nurses are too busy trying to be ersatz doctors; all that university education and book-learnin' has made them too posh to wash; nursing is going downhill; nursing is in crisis.
“It wasn't always like this” was the programme's own take, showing the also inevitable 30 year old clip of starched nurses listening to Sister. That nursing student could have been me, and of course it was like that. The failures filmed today were as common then and well documented, if not always tackled.
This knee-jerk nostalgia for nursing's mythical golden age simply will not do. It precludes the close scrutiny needed to understand and prevent abuse. Problems like poor hygiene, sloppy infection control, irregular supplies, and bad record-keeping result not only from individual fecklessness but also from systems failures. Yet we saw no doctors and only one manager, whose response to reported abuse was feeble and defensive.
What we did see was the nursing subculture, portrayed as an unappealing world of filth, plastic aprons, and rubber gloves, where everyone is tired, fed up, unsupportive, ducks responsibility, and skives when possible. The programme left me wondering, as so often, why anyone would want to do this job; the attrition rates prove that many do not. As one student nurse in the film put it, you have to regard being up to your armpits in poo and pee as a learning opportunity, and say bollocks to the paperwork. Sister would have disliked the language but applauded her spirit.