Television: Tough times caring for the nurses

It takes years to make a serious documentary. And it is getting harder. Jenny Abbott, director of 'Nurse', explains why it is uphill work
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On Wednesday it will all be over: the last episode of Nurse will be going out, and what has been a full-time, four-year obsession will end - I still find it hard to believe that I have spent longer making this series than I did at university. It began in the summer of 1994 when the head of documentaries asked if I would like to produce a series following a group of student nurses through three years of training. At that stage Doctors to Be had already been broadcast, and Vicars to Be was in production. I was reluctant to take on what might have been seen as a formula series. I also had my doubts about whether nurses or nursing was that interesting: hadn't we seen it all before?

What did seem genuinely exciting and challenging was the prospect of having the time to follow eight people through a period in which they inevitably would grow, change, succeed or fail - a classic documentary situation. The luxury of time is also something that is becoming increasingly rare in documentary making - even in 1994 it was an exceptional offer, and that was before the advent of docu-soap.

We decided to follow students training at the University of Northumbria, and I moved to Newcastle for three years - the duration of the filming. We had a limited number of filming days per year, and tried to predict from the pattern of the students' course when we should have a crew available. Sometimes it was easy - the students were on the wards for the first time, one of our male students was on placement in the maternity unit and would inevitably witness a birth - and other times it was a question of having a hunch that this would be a good time to hang around with a camera. On those occasions it really was a question of sitting patiently, and often four or five days would go by without us shooting anything.

We were, however, in the luxurious position of being relatively well- funded - the series cost around pounds 180,000 per episode. So we were not under permanent pressure to shoot the first thing that happened. We could wait until we were able to capture something that was true to the experience of students. This certainly didn't happen every day. We all know how hard it would be for someone dropping into our lives for a few days at time to get a sense of the reality of our existence; we all know how much we dissemble; we all know how often the first thing that we say isn't what we really think or feel. On Nurse we had the time to try to get through to something beyond the immediate and the obvious - which isn't to say I didn't panic every day that went by without us shooting anything.

In between blocks of filming the assistant producer and I would spend time on the wards or the locations where our next lot of filming would take place. Over a period of months we would go in every day and do shifts with the qualified staff. We would get up at 6.30am for an early shift, we would be there at 3am on night shift, and where we were allowed to, we would help on the wards, giving out meals, changing beds, mopping up vomit.

It became important for the series to reflect this reality too: nursing is a highly skilled and complicated job, but it also involves hard, unglamorous work. My initial worries about whether or not there was anything new to say about nursing went. We hadn't seen the details on television before. Inevitably this has led to complaints from people who feel it was wrong to include scenes of bottoms being wiped, or patients suffering from dementia being spoon fed and bathed. But even this is a toned down "television" version of what really happens. Hospitals are, by and large, sad and depressing places, and nursing is a job in which you are continually confronted with aspects of life the rest of us would rather not think about. In fact when the students saw the finished series their main comment was that it should have been grittier.

I suppose the current fashion for docu-soap is in some ways responsible for the fact that viewers will complain when confronted with a documentary that reveals a less palatable reality. Too many documentaries now are sanitised, acceptable representations of society which will make popular tea-time viewing. I recently heard of a consultant paediatrician who was asked if a television production could film on his intensive care unit. He was initially in agreement - then the producers explained that they did not want to film any children who were in danger of dying.

Apart from becoming immersed in the details of the training and the job, we also had time to get to know the students that we were following extremely well. We used the same camera crew for all the filming and we were around so much, on the wards and in the pub, that any sense of the students performing for or reacting to the camera quickly went. We became part of their lives, but at the same time tried to allow them to have a life. We weren't interested in boyfriends and discos, and over a period of three years the sense that some things were private was vital in maintaining their commitment to the project.

None of them wanted to take part in the series because of a desire to be on television, and initially it was hard to convince them that their views and lives would be interesting. What they did commit to was the idea of showing the rigours of training to be a nurse. They also felt it would be interesting to have a record of what was bound to be a seminal experience. We had lots of ups and downs - it is hard being filmed when you are about to bath an eighty-year-old for the first time - but we had no serious problems during filming until we were six months away from the end of the project.

As much as we became experts in nursing, they also became experts in the ways of making documentaries, and would often query whether or not a shot would have been more effective hand held or with the camera on a tripod. They also became avid documentary watchers. After watching a series of docu-soaps - Hotel and Holiday Reps were both going out around this time - three of the students became extremely reluctant to be filmed. They were worried that we were only interested in portraying them as "characters" who messed up for the entertainment of others. This was despite the fact that we already had a two-and-a-half-year relationship with them, and had had many discussions about what we all wanted the series to be.

People who take part in documentaries are vulnerable: our students had no editorial control over the material, and saw none of it until all the programmes were completed. Despite the popularity of docu-soaps there is a danger that they will put off a certain section of society from wanting to take part in documentaries - people who don't want to be stars, who aren't exhibitionist, who are worried that they won't be portrayed seriously and that complexity will be sacrificed for entertainment. These are often the people we should be making documentaries about.

I hope that "Nurse" has succeeded in showing viewers what nurses really do. For me, it has been a unique experience. The BBC will always be committed to a certain number of serious, long-term documentary projects, but there is less and less money available for them. A series like this is expensive because time is expensive and because, unusually these days, it was shot on film which gives it a distinctive look and texture. However to make anything that stands a chance of looking beyond the obvious, time is of the essence - both on and off screen.