In response to David L, Leeds UK, I would like to say that to become a staff nurse I obtained a first class honours degree in nursing - such a modest qualification!! As for the down-trodden looking people, in our department they are treated with care and compassion when required and we all know all is not well with the world! As nurses we knew what we were to be paid and the shifts we were to work before entering the profession,although the environment is less than comfy, we do not use this against our patients. As professionally competent people we will give a smile where a smile is due, in certain situations we will even laugh!

Staff Nurse, Northampton, UK

Why should I smile. I have given 31 years to the NHS starting as an auxillary nurse in 1976 and now as Service manager for children and young peoples services. I am a qualified midwife, health visitor and school nurse and on the 30th june will become redundant as is many of my colleagues. Just at the moment I cannot find much to smile about thanks to the reorganisation of the PCT's that this goverment has implemented. I certainly will not be smiling when I wake up on the 1st July having realised that all I have worked for has meant nothing to my employer, the NHS..

Christine Pickering, Horley, UK

I am not surprised that the government has spent money on yet another survey! And, that that survey shows nurses to have yet more faults. We are humans and cannot be expected to smile inanely for hours, patients will see through this and will not give the impression of caring, more in fact, the opposite!
I have had a complaint made about me for exactly that. Smiling!! I was not giving bad news, more the opposite. We cannot win.
In todays nursing climate maybe the governments money would be better spent, if not on a pay rise, then actually supporting us (nhs workers in general). The majority of us work hard and care what happens to our patients. Yet, we deal with agression in some form or another on a a daily basis and the culprits go unpunished!! In fact,we are expected to continue smiling!!!
The increased demands, and reduced support/acknowledgement is beginning to wear thin.

Suzanne , Peterborough, England

As a mental health nurse does the government want us to smile when we have just instigated a Section on someone? I don't thinkm this would go down too well. Perhaps the police should smile more when they arrest people. Even better when nurses etc have to deliver bad news to someone, ie you have weeks/ months to live lets all smile and show we care!

Martin Holder, Bridgend,

Nurses are individuals, the same as the rest of us! Some of them have a true vocation and are caring and wonderful, most will be somewhere in the middle, and some (i have met them) don't give a monkey's whatsits about the patient.

Although I do believe they are underpaid, I do take issue with the comment that 'all we are asking for is fair pay and fair pensions' and the other comments saying nurses should have a guaranteed job after training; no-one else gets this kind of deal! It is unrealistic. I get good pay in the private sector and don't have to deal with the conditions nurses do, but I have a huge student loan, no pension whatsoever, and when i have children I won't be able to work part-time. It's all swings and roundabouts and you know what you are letting yourself in for when you choose a particular career, so there's no point complaining about it afterwards!

Alison, London, UK

how can they ask us to smile. we will smile when they pay a better bursary so we dont need to work riduclous hours, guarantee every student nurse a job on qualification and stop squandering taxpayers money on rubbish.

Charlie sloan ANS EXEC MEM of scotland, glasgow, scotland

I wonder how much it cost the government to have this survey done. It's not smiling more that will help save the NHS it ensuring that investment is directed to the correct areas. So much money has been wasted by bringing in lots of middle management positions within hospitals ( pen pushers) who are not at the front line of patient care.

At the moment after nurses received such a derogatory pay rise and the threat of redundancy morale is very low within the profession. We work hard in very difficult situations so smiling can be inappropriate at times. Then again politicians can always fake a smile when required.

Valerie , Dundee, Scotland

I note many thousand of Nurses have been made redundant, many thousands of Newly Qualified Nurses cannot get jobs. This year again we have been given a poor pay rise. We have more and more privatisation of the NHS. If this govt. was a Tory govt. we would have many more protests ffrom the Public supporting us! We don't and this Govt. is Tory with a Red tie.
I would ask that the public support Nurses we will soon be extinct as will the NHS.
Nurses should smile more ? I can't even add up how many free hours I've done for the NHS. To take leave I often have to do double the amount of work pre and post leave and it makes me think I'm better not having any time off.
I love my job and it saddens me that many Nurses are not given the respect and the pay they deserve.
I wish the NHS was free of Govt. meddling.
It is time Hewitt went and quick.
I wonder will someone ever listen to the Nurses and Doctors ? We don't ask a lot just fair pay, fair pensions and money to do the jobs we need to

Simon J. Greasley, Barnsley, UK

Nurses are overworked and underpaid and at risk of redundancies. we have nothing to smile about

Anne Wells, Stevenage, Herts

As a Nurse of 8 years the thing that make me smile now is going home to my wife and family, after another excrutiating day at work.On a daily basis I will have been asked by 5 different managers (no doubt on far more money than I) how many beds I have available today and why i`m not discharging more people. If the focus was more on the care for the patients I have and not so much about who I have to discharge then maybe i`d smile, as this is the job that i originally wanted to do.

Paul Tinnion, West Derby, Merseyside

A true smile is an involuntary response. If you are a politician, and fake all of your smiles, you may not be aware of this.

Dr Mark Massyn, Bournemouth, England

Perhaps giving them a proper level of pay, and proper job security may help.

Or is that "beyond the scope of the study"?

Ragnar Vagmornasson von Brandenburg-Preußen, Berlin , Preussen/Germany

My Wife in a Special Care Baby Unit often comes home from work stressed and sad - another baby died she will say, probably due to the fact that the mother smoked or drank alcohol during her pregnancy.

She has nothing to smile about under these highly stressful situations. The work coupled by the ludicrous amounts of paperwork and unpaid overtime do leave her wondering if there is anything else she could do with her training and experience.

Fortunately for the NHS she has a vocation

Husband of nurse, UK, UK

I know a nurse who told me she'd rather her daughter became a lap dancer than a nurse, as at least she'd get some respect!! Nursing done well is a very demanding job. Nurses clean excrement, filth, and pus while other, less qualified, Brits are starting to feel that other service jobs, for example catering, are beneath them (hence the Government welcoming East Europeans). They do this in an environment of risk from disease and blood borne viruses, while maintaining a significant proportion of the responsibility for patient safety. They encounter anger, despair, bereavement, joy, and other emotions that can be exhausting in their intensity. This while working in an infrastructure that is complex and increasingly dominated by rules and political intrusion. They face ever rising aggression - a patient recently produced a gun demanding drugs where I work! And I know of a surgeon who paid his patient's taxi fare to prevent a cancelled operation! How much has Patricia Hewitt been smiling of late?

Dr Anwar Shah, Birmingham,

I wonder how many hours were spent by these so-called 'bright minds' from Downing Street to come up with this 'ground-breaking' idea !!! , and how much they were paid for 6 months to come up with this 'idea'? Only a buffoon would even think it worth commenting upon! I have been a nurse for over 30 years and have recently given up my vocation because nursing is no longer the job it used to be. Quite frankly, I am not surprised that present-day nurses do not smile much or appear to care, because of the changes and demands made on them (not least in the unbelievable amount of paperwork that has to be completed, taking us away from the caring that we want, and are trained, to do). If the Government would actually LISTEN to those who do the jobs and know what is best from experience, instead of commitees of beaurocrats who haven't got a clue about the reality.
It will take more than a smile to improve the Health Service! - this country is in melt-down in nearly ever aspect of life.

J.Barker, Perth, UK

Having just been offered a ludicrously small pay rise by Patricia Hewitt I can't see many nurses being happy enough to smile at work. This government is definitely living in la-la land !!!

Mike, Denia, Spain

I don't go into hospitals often, but when I do I am struck by the glum and morose expressions of the nursing staff. They look defensive and resentful and give a strong impression of wanting nothing to do with the public. This may be justified by the increasing levels of violence they incur, but really, given that they mostly have only very modest academic achievements, they are quite well paid for a 37-hour week in a comfy environment, and ought to look a lot happier.

The queues of down-trodden-looking people waiting for treatment seem to have gone to hospital as sinners go to church, to confess their weakness and receive absolution. To have nurses smile at them will reassure them that what happens to them is important and that all is well with the world. An improved mood will improve health. In medicine as in romance, being nice can save you money.

David L, Leeds, UK

I am sure people would also like to be served ice cream on a regular basis and have a back and neck rub. But it does not show people care. Believe me when I say that the nurses if anything care to much and give their souls to thier patients. Sorry that they do not always seem happy and relaxed enough to smile all the time.

Always impressed Doctor, Melbourne, Australia

my colleague and i are just finishing a night shift after nursing patients who have undergone bone marrow transplants. considering the quality of life some patients have during their ordeal to survive treatments it can sometimes be very hard to rustle up a smile as we quite often go througth their journey with them as we get very attached, even though we do try, honest! this is apart from the shift work, staff shortages, poor pay etc. i hope they choke on their cornflakes!

Vicky Lisowiec, Leeds,

Will someone please wake me up after the next general election. Goodnight.

Steve P, Leeds, England