‘You’ll find the NHS very different from American hospitals,” a friend told me, “but the nurses are wonderful, much more caring. They really have time for you.” Really? That was not my view after two weeks in a prestigious central London hospital. And I have had 10 years’ “experience” as a patient with a complex autoimmune disease.

In London I couldn’t work out which nurse was responsible for me or who was in charge of the other nurses. There was a squadron of them hovering around my neurological ward, yet nobody I could rely on to know my diagnosis.

One night nurse’s actions summed up the experience. He twice brought me the wrong medication, couldn’t work the IV pump (“Don’t you know how to use it?”) and didn’t know to flush my vein with saline before administering medication; the vein collapsed.

So no, I didn’t like British nursing. (I was in a private room, as my visa doesn’t entitle me to free treatment, but I was in an NHS hospital, staffed by NHS nurses.) And I decided to find out what lay behind the fear and neglect I felt during my stay.

Nursing officials acknowledge there is a crisis in nursing, but see it as a crisis of quantity, not quality. At the Royal College of Nursing (RCN) congress this year, Beverly Malone, its general secretary, proclaimed that the nursing crisis “is nowhere near sorted”. Gail Adams, head of nursing at Unison, the largest nursing union, agreed: “There are large numbers of people going into nursing training; the same numbers aren’t coming out.”

The government claims it is getting the problem under control. The Department of Health recently reported that, as of September 2002, the number of nurses working in the NHS is up by 4.9% on the previous year, and in July Tony Blair announced that up to 50,000 new nurses have been recruited to the NHS since Labour came to power in 1997.

But who are these nurses — and how permanent are they likely to be? Last year, for the first time, more nurses joined the register from overseas (16,155) than from Britain (14,538). For NHS trusts, foreign recruits are a quick fix. It takes three years to train a British nurse, but an overseas nurse can practice in Britain after only a three to six-month adaptation course. The problem is not that foreign nurses are inferior to British ones. It is that many of them are footloose. If Britain can poach nurses from poor countries, other rich countries can too. Foreign recruitment is a shaky prop.

Alongside foreign nurses, the other short-term solution is agency nurses. They plug the dyke but cost NHS trusts up to 30% more than staff nurses — money that would be better spent on increasing staff salaries to improve retention. Many trusts also worry about temporary nurses who must quickly find their way around unfamiliar equipment and regimes.

But the biggest staffing problem is that nurses are leaving the NHS in droves. In October 2002 a Unison study found that half of all nurses were considering resigning, often for more lucrative careers. Although pay has risen it is still meagre: starting at £16,525 for a newly qualified nurse, at £19,585 for an experienced staff nurse and at £23,110 for a ward sister. And according to an RCN study, 100,000 are also due to retire in the next five years. The government’ s solution is no more than running fast in order to stand still.

However, the problem in nursing recruitment and retention is not the real crisis. That is about quality. What was profoundly wrong in my hospital was that nursing in its most basic sense — care — was almost entirely absent.

When I was in hospital I couldn’t sleep because I was in pain and because I was terrified. I had been prescribed a heavy-duty painkiller and sedative, and had been told to ring when I needed it. Every night I would postpone the moment, dreading the uber-efficient nurse who would march in, bark at me to roll over, yank down my pants, stab me with the injection and march out — with rarely a “good night”.

One night I had an agency nurse, who asked me what was wrong. I was so shocked at being treated kindly that I burst into tears, and after giving me a shot — “There, baby, that wasn’t too bad, was it?” — she pulled up a chair, took my hand and told me stories of her native Mauritius until I stopped crying and started to doze. She was gone the next day.

There is something in nursing that runs absolutely counter to the instincts of the modern world. Our age concerns itself with empowerment, personal rights; nursing, when it is done properly, is about self-abnegation. Modern nursing has tried to stamp out the idea of a “calling”. Theory, bureaucracy and an obsession with status have replaced the old duties of corporal charity that bound a nurse.