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J R Soc Med. 2007 March; 100(3): 117.
PMCID: PMC1809167

The demise of nursing

I am disappointed that the JRSM published the article by Shields and Watson,1 and as an Operating Department Practitioner (ODP) I was deeply offended. It is clear the authors are ignorant of the role, training and history of my profession; otherwise they would have known better than to use the surgical role as their example. To appreciate the folly of this example, one must understand that for many years the theatre nursing hierarchy sought to deny ODPs the opportunity to practice in the surgical role—claiming this ‘a purely nursing function’. My profession was then predominantly associated with providing care as part of the anaesthetic team, where patients are initially conscious, often fearful and requiring both psychological and physiological support.

As far back as the 1970s our syllabus incorporated patient care (e.g. ‘Respect the dignity and rights of the patient; Principles of ethics and etiquette; Psychological reaction of patients to surgery and the theatre environment’). These were introduced early and developed throughout the course. Today's qualification has developed these themes into the modern era, with emphasis on the assessment, planning and evaluation of care. Caring is not genetically implanted into nurses, but taught to all professions with caring responsibilities.

The notion that ODPs are ‘expropriating nurses’ knowledge and skills' is laughable. We had the first nationally organized course in operating department practice in 1951. In 1989 Bevan2 noted ‘only 13.8% of nurses working in theatre had received post-registration training in operating department and/or anaesthetic nursing.’ Throughout the 1990s the NVQ in Operating Department Practice, the ODP's primary qualification, was taken by many perioperative nurses as their preferred postgraduate qualification.

The authors of the article are at least 30 years out of date with their prejudices and I and my profession deserve a full public apology from both the authors and publishers of this article.


Competing interests BK is a Council Member of The College of Operating Department Practitioners.


1. Shields L, Watson R. he demise of nursing in the UK: a warning for medicine. J Roy Soc Med 2007;100: 70-4 [PMC free article] [PubMed]
2. The NHS Management Executive Value for Money Unit. The Management and Utilisation of Operating Departments. London: HMSO, 1989

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press