Felicity Stockwell: the popular nurse who wrote The Unpopular Patient

Felicity Stockwell wrote The Unpopular Patient, which is regarded as one of the most influential pieces of nursing research ever written.

Felicity Stockwell wrote The Unpopular Patient, which is regarded as one of the most influential pieces of nursing research ever written.

Author of The Unpopular Patient, and mental health advocate Felicity Stockwell.
Picture: John Houlihan

Published in 1972, it studied the behaviour of nurses on general hospital wards. It was controversial because it revealed that not all patients received the same level of care: rather, it highlighted the fact that the quality of care nurses gave to patients was influenced by how ‘popular’ the patients were.

Reasons the nurses gave for finding some patients ‘difficult’ included:

  • Personality factors: selfish, bad-tempered.
  • Communication factors: uncooperative, grumbling.
  • Attitude factors: unwilling to accept treatment, reluctant to go home.
  • Nursing factors: does not need to be in hospital, not well known.

The Unpopular Patient quickly became a must-read for anyone interested in the field of nurse-patient relationships, and was re-issued in the 1980s.

But despite this success, Ms Stockwell is genuinely disappointed that her research did not have the impact she had hoped it would have. For her, the most important message of her research was about the help that the ‘unpopular’ patients needed, and she feels this has still not been heeded.

In essence, the message she hoped to communicate was that nurses should not only demonstrate that they care for patients, they should also show they care about them.

More in this series
  • Find out more about Ms Stockwell's route into mental health nursing by watching our video interview 

Watch the feature


Social aspects

Early on in her career, Ms Stockwell worked with patients with severe depression. She quickly learned that the social aspects of nursing, the listening, the caring and the kindness, were vital in making a difference to these patients’ lives.

Yet she feels that even now, not enough effort is spent on these elements of the nursing role.

The origins of Ms Stockwell’s views on mental health nursing began in her mental health nurse training when she had learned about the importance of mother-infant bonding and how individuals need to receive comfort and consolation from others.

'It’s not about talking to patients, it’s about listening to them. And a genuine unsolicited smile – they can tell the difference immediately – does wonders too’

‘If they don’t get it they become anxious and upset, and this can lead to them becoming mentally ill. We were taught it was the nurse’s job, knowing about mother-infant bonding, to go to work with the patients as befrienders, with caring and kindness. Just having friendly conversations about other things and look at their eyes and smile, and that was a gift. Make friends with them and be on their side. It worked magically.’

Ms Stockwell acknowledges that The Unpopular Patient is looked on as an important piece of work, but she is not so sure it deserves its exalted place in the annals of nursing research.

‘It identified that there were some people who were misfits and unhappy. I wanted nurses to recognise that and know how to help – but nobody’s done that.’

She says talking to patients ‘as a task or a part of the nursing role’ simply does not work.

‘It’s about coming out of role and behaving in a way that is honest to the patient as a person. You have a totally different rapport, because you are out of role. Inside everyone who is distressed and having unrewarding experiences, there is a vulnerable, lonely, but still hopeful person.

‘But the minute you call it therapy, it destroys it. It’s not about talking to patients, it’s about listening to them. And a genuine unsolicited smile – they can tell the difference immediately – does wonders too.’

‘Every mentally ill person has a “normal” person inside them: it’s a case of scraping the rubbish off and warming the cockles of their heart. It’s such a simple message, but it’s very hard to do.’

Ms Stockwell says she would like nursing academics to look in more depth at the social origins of mental health problems so that nurses will take up the challenge of communicating deeply and meaningfully with patients ‘as people’. She wants the job she started to be finished.

‘The Unpopular Patient  has given me a wonderful life and I’ve met lovely people. And I suppose it’s nice to be popular. I did the research well, but I don’t think it’s done one iota of good.’

Felicity Stockwell’s influence on mental health nursing

Karen Wright is head of the school of nursing at the University of Central Lancashire

'I disagree with Felicity that her work hasn't had any influence on mental health nurses.

'I can say from my training as a mental health nurse in Preston that her work made a huge difference to my group of students. It helped us to address all sorts of issues, including being willing to talk to people we didn’t know what to say to because we were fearful of stuff we didn’t understand.

'What she says about listening, being with somebody, about the use of self, that human warmth: her work was included in some very significant influences in my education and professional development through the years, and I’m sure that goes for many mental health nurses.

'I teach nurses now and I may not specifically mention her work in all encounters – certainly I do in some – but it has made a difference to the way I see the world and the people I care for, and how I see we care for them.

'For me, my view of that relationship, that alliance, was affected early on in my career. Sitting beside somebody, creating that sense of togetherness, that you are going to beat something together, is something that’s really precious, and I think her work had a major influence on that.'

Find out more

The Unpopular Patient is available on the RCN website

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