Doctors’ use of phrase ‘acting down’ offends nurses

Medical staff in survey were describing when they undertook nursing tasks

Medical staff in survey were describing situations when they undertook nursing tasks

A doctor inserting an IV line. Picture: iStock

Doctors in a survey have said they regularly ‘act down’ due to staff shortages – meaning they undertake tasks usually carried out by nurses.

The phrase, contained in a report by doctors' regulator the General Medical Council (GMC), has offended nurses who say the term implies superiority.

The RCN described the phrase as ‘insulting’ to nurses, but the GMC said it was not meant to be pejorative and instead conveys the pressures on all healthcare workers.

Common occurrence

The GMC’s annual report examines the state of the UK’s medical education and practice. 

In the latest edition, nearly half (48%) of the 700 doctors surveyed reported ‘acting down’ at least once a week by doing a job normally carried out by nurses.

Conversely, around three out of 10 doctors said they regularly see nurses or other healthcare staff ‘acting up’ to perform tasks usually completed by a doctor, to help ease workload pressures. 

Nursing reaction

An RCN spokesperson said: ‘Doctors and other healthcare professionals are now being roped in to plug gaps left by the increasing number of nursing vacancies. However, describing this as "acting down" is insulting to nursing staff.’

London South Bank University chair of healthcare and workforce modelling Alison Leary wrote on Twitter:

Having read this again, in full, it is under the header "acting down".
It is an unfortunate view of colleagues worth but not a surprising one. The @gmcuk needs to address this.

— Prof Alison Leary PhD RN (@alisonleary1) December 10, 2018

Children’s nurse educator Rebekah RNchild said:


No task should be seen as ‘acting down’...if it is required & you are available at that moment to do so, then do it. Anything else implies superiority...medicine & nursing are separate professions working collaborarively. So I thought anyway. Disappointing

— Rebekah RNchild (@reboverend_RNc) December 9, 2018


Workforce pressures

A GMC spokesperson said: ‘We are in no doubt that those doctors describing the situation as "acting down" were doing so not in a pejorative manner, but as a means to convey the pressure that all healthcare teams, regardless of role or seniority, are working under.’

The report highlights that although ‘acting down’ may imply the doctor is overqualified for the task they are undertaking, this is not necessarily accurate. It notes that doctors are not trained to provide the nursing interventions needed for high-quality specialised critical nursing care.

Read the GMC’s report

The state of medical education and practice in the UK 2018

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