IT IS billed as a gloves-off, head-to-head clash between the author, commentator and arch critic of modern nursing, Harriet Sergeant, and Beverly Malone, a nurse since 1970 and now head of the Royal College of Nursing (RCN).

Nursing Standard (April 20) brought the titans together for a few rounds of straight talking as nurses gather for this week’s RCN congress.

But for a heavyweight contest this one leaves surprisingly little blood on the canvas, with the two combatants agreeing on several things — for example, that nurses should be paid more to stay at the bedside rather than move up the greasy promotion pole.

They also agree that people should be concerned about the quality of nursing today, although Malone points out that accusations of bad care involve only a tiny minority, while most nurses do their best in difficult circumstances.

But they do trade blows over whether there is too little discipline among today’s nurses. Sergeant decries the “sheer abitrariness of care”, and says that no one seems able either to reward good nurses or punish the bad ones. Malone disagrees, saying that the Nursing and Midwifery Council “has probably been more conscientious about disciplining nurses than any other regulatory body”.

They also clash over graduate nurses, with Malone saying that nurses need to know how to think, not just what to do. “Experience takes you only so far,” she says. Sergeant has no argument with nurses who have “lots of education”, but says they must be taught the right things. A newly qualified nurse told her that she had learnt how to measure blood pressure in 90 minutes while learning about “poverty in Russia” took an entire afternoon.

And the verdict after nine bruising rounds of close questioning? Nursing takes a few blows but is still standing. Expect a re-match.

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