According to the hallowed pages of Wikipedia, the NHS is the fourth largest employer on planet Earth. Only the Chinese People's Liberation Army, Indian Railways, and Wal-Mart employ more people directly. So.., if this morning's "Guardian" is telling the truth then the precendent to be set by enforcing smiley nurses might soon influence the rank and file of the CPLA, Indian Railways and Wal-Mart.

I don't know what mental image either the Chinese People's Liberation Army or Wal-Mart conjure in your mind, but I'm sure delighted chortling grinning conscripts is not one of them. Perhaps it is though, perhaps you are one of those people who eschews the prudery filter on your "google image" search engine and as soon as you type in "happy nurse" all you get is stethoscope pornography.

How does one (meaning you!) discern a sincere smile of a person happy to see you from the contented almost beatific countenance of another person who thinks only of easing your pain and woe from the supercilious lofty smirk of the more than averagely pretty modern nurse who feeds his or her smack or amphetamine habit by substituting your hourly injections with watered down ketamine?

How indeed.

The idea that happy smiley employees and upbeat cheering environments can ease illness or suffering is not new. Nor alas is the notion that such promoting employment behavioural guidelines which impose what are supposed to be spontanous and sincere human emotions wallpaper the cracks of institutional failure. I remember choking on my meusli last year upon reading that the Her Majesty's prison service was considering painting the interiors of prisons pink as some US jailors had already done in an attempt to dampen down aggressive macho attitudes. Though in fairness to Her Majesty's houses of pleasure the US wardens dressed their inmates in pink jumpsuits, not only as another example of "cruel and unusual punishment" their constitution outlaws for the jolly good reason that they seem to have a prediliction to inventing ever new ways to cruelly and unusually castigate. (c/f  http://news.bbc.co.uk/2/hi/uk_news/magazine/7138110.stm  http://www.foxnews.com/story/0,2933,294030,00.html )

I suggest that if you have time to have a go at the NHS - you don't begin with the facial muscles of nurses. Nor do you begin with the frankly perverse setting of uninforceable standards of homogenousity - we may not tell a man or woman who is not happy to smile nor more than we can tell a specialised surgeon it's time s/he cleaned a toilet -

For, as most nurses and even medical students know - & certainly anyone with even a passing interest in psychology or any job involved in assessing truthful emotions in others -

YOU CAN'T FAKE A SMILE.

That was properly intellectually discovered and written up in leather bound volume editions by Guillaume Duchenne (1806-1875) a French neurologist after whom the sincerely cheery zygomatic muscular contractions were named "Duchenne smile".
You may see an illustration of his sterling work with this article.


Of course it is true that if you laugh a lot you might, just might, avoid getting sick. So rather than apply the paliative measure of smiley nurses instead of solidarity poor surgeons - we could encourage people in wider society to laugh more. Let's rule out pink jumpsuits except for surgeons. Yes. that's the way to go. Dress Harley street in pink and issue hourly broadcasts of its finest unblocking toilets.

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The history of the NHS can be read here :-
be warned it's heavy reading.
 http://en.wikipedia.org/wiki/National_Health_Service_%28England%29#Scandals

"Nurses to be rated on how Smiley and Compassionate they are"
 http://www.guardian.co.uk/society/2008/jun/18/nhs60.nhs1