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Interview: Jo Brand

With recent scandals calling into question the care and compassion of nurses, ex-psychiatric nurse Jo Brand talks to Jenny Chou about how the profession has always had to struggle with image

Following a recent spate of scandals including at Mid Staffordshire and Winterbourne View Hospitals, an image of nurses as lacking in compassion and having lost their moral compass has been painted, contrasting with that of selfless devotion presented in television programmes such as BBC 2's Great Ormond Street.

Speculating that nurses are perhaps receiving a disproportionate amount of negative press attention, queen of comedy, ex-psychiatric nurse Jo Brand says: “It's almost as if nurses are semi being turned into social workers who have always been the ones beaten up with a stick because they can't seem to do anything right. If they save a child no one notices, if they don't save a child then they get castrated for it.” 

“Nurses have always been painted in such extreme ways - from the angel, you know the kind of Florence Nightingale type - and that's totally unrealistic - all the way through to the right goer who's almost desperate to bed a doctor. They're all ridiculous. I think nurses do have a problem struggling with the image imposed on them from the outside.”

Indeed, evidence gathered by the inquiry into Mid Staffordshire, which includes neglect of the most basic elements of care such as patients being left unwashed for months at a time and patients being left in soiled sheets, could not contrast more with their heroine portrayal through characters such as Frankie, a dedicated district nurse, and Kirsty Clements, a feisty mental health nurse from Casualty.

In truth, the picture is not so clear-cut. With reductions to funding, a shortage of nursing staff and a culture of placing the meeting of targets above care, it would appear that neither the demonisation by the press nor the archangel stereotype created on the screen can adequately address the issues that nurses face.

As an ex-psychiatric nurse who worked for ten years at the 24-hour psychiatric emergency walk-in clinic at the Maudsley Hospital in South London prior to becoming a comedian, Jo is no stranger to the stressful circumstances that nurses work in.

Talking about her role as a psychiatric nurse, Jo says: “They were some very difficult times because obviously it was the sort of place where people who were at the end of their tether would come really. They could have any sort of problems to do with mental health including anxiety, drug and alcohol abuse, verbal abuse…People were basically desperate by the time they got to us, so inevitably there were times when people's behaviour would be very out of control. Also we managed the section 136's for the whole of South East London... there were a lot of issues there. There were people with knives, people with guns… so quite exciting!” 

Section 136 of the mental health act gives police officers the authority to put an offender into a place of safety - a hospital for example - if they are suspected of having mental health issues that will endanger themselves or compromise the safety of others. 

There are now nine pilot schemes across the UK involving mental health nurses in street triage so that people suspected of having mental health issues detained by the police can now be assessed and directed to the right services before being put into protective custody.

Jo says she became a nurse due to the influence of her parents. 

“My mum was a psychiatric social worker and as kids we would spend time at the hospital she worked at, so the whole issue of mental health never held any fear for me despite the negative way that it's portrayed by the tabloids and others. So it was never something that frightened me, but something I found interesting. Also, my dad had a depressive illness for a very many years which I realised much later.”

Noting the social deprivation that existed in parts of South East London in the 1980s, Jo, said she could easily understand how people's lives had disintegrated into the realm of drug and alcohol abuse and that she had found that side of the job quite difficult.

Jo also highlighted the importance of being well trained and being equipped with the sort of skills required to deal with the pressures of the job, which aligns with concerns for the need for ongoing training and professional development for nurses. 

She recounted an incidence when their team had been given a member of staff from another area of the hospital against their advise, and how within a few days the member of staff had got her nose broken as she had dealt with a situation inappropriately.

Of her shift from nurse to comedian and TV personality, Jo says: “Although it's a bit of a cliché, I do believe it that you only have one life and that you've got to pack as much into it as you can. But also along with that I felt that I worked in a very high stress area and that actually nurses who do that sort of job for too long become slightly immune to people's pain really and they get a bit blasé or go a bit blank, not really caring so much, and so I always feel it's a good idea to move on after a certain period of time to something else. “

Jo adds that there has always been a bit of the comedian in her saying: “I've always liked making jokes and mucking about, and so it seemed like an attractive job.”

However, while she may have left her role as a psychiatric nurse at the Maudsley Hospital, she carried on this role as mental health nurse, Kim Wilde, on screen, in the Bafta winning drama, Getting On, a satirical British sitcom, first aired in 2009, set against the backdrop of a bleak general ward in an NHS hospital co-written by Jo and two of the core cast.

Talking about why comedy can work so well despite the irony in making light of a serious situation, Jo said: “It's combining that everyone knows what hospitals are about with quite extreme situations. That's what comedy does well with, examining people in situations where there're under lot of pressure for one reason or the other. It addresses the pain of it, the difficulty of it, but gives you a kind of get-out clause. By laughing you sort of relieve some of the stress that's associated with it.”

Set in a depressing overlooked corner of a derelict NHS hospital, Getting on, pokes fun at the NHS, examining a range of issues from struggles to find beds to the meeting of performance targets.

While episodes revolving around the categorisation of a fecal discharge found on a chair and having to fill a form about it and trace it back to the patient it came from cannot seem to be other than for humourous effect, it nevertheless highlights prevalent issues of bureaucracy in the NHS. 

With the emphasis on meeting performance targets, additions in the number of performance indicators and ways to earn financial incentives, medical staff are increasingly finding themselves inundated by paperwork, taking time away from the care of patients.

And while the setting of the show is often mistaken for a geriatric ward due to the number of elderly that feature in it, it is actually set in a general ward, highlighting the problem of an increasing number of elderly who take up bed space despite not having a serious need as they cannot cope on their own at home.

In report by MPs in early September, it was revealed that six per cent of all acute beds in the NHS are occupied by patients who are ready to leave but are not being discharged. The Health Select Committee report said these “delayed discharges” were “both a symptom and cause of poor bed management in hospitals or a failure at the interface of health and social care”. 

Commenting on the issues surrounding care of older people Jo said: “The message seems to be that the services the elderly are taking up don't really need to be taken up. We need to look at creating a more appropriate environment for the elderly who don't need services but need some sort of supervision and that's a difficult thing to work out.”

An ambassador for the Alzheimer's Society, and one of the first participants of Alzheimer's Friends, a programme which aims to spread awareness about Alzheimer's through workshops and presentations, Jo says that similar issues apply for the care of sufferers, who have been found to take up to a quarter of hospital beds across the UK.

In this period of upheaval for the NHS, there has been an increasing number of reality programmes depicting events on the wards including 24 Hours in A&E, Midwives and One Born Every Minute, placing the NHS is under more scrutiny than ever before.              

Talking about why there are so many programmes and dramas set against the backdrop of a hospital Jo says that they are major institutions that everyone recognises:

“People are fascinated by hospitals. It's something that we all have in common. At some point or another, we'll all go to hospital-there's women having babies, you have relatives in there, you might get a broken arm-whereas you couldn't say that we're all going to a squash club at some point in our lives.”