Britain's nurses are not known for anti-social behaviour. The sight of Patricia Hewitt being heckled and shouted down by the normally mild-mannered audience at the Royal College of Nursing congress last week was unnerving, demonstrating their hostility to a government that until a year ago they had seen as their great ally.

What are the nurses really angry about? There are 70,000 more of them now than in 1997, and their pay has risen considerably over the past three years. I tried to track down the two who were the stars of the debacle to ask them about their anger: Cathy Doughty, the woman seen pointing an accusing finger at Hewitt, and Les Miles, the neo-natal practice nurse who painted a bleak picture of trying to care for premature babies with too few staff at his ward in South Tyneside.

Unfortunately, Miles proved elusive. The RCN press office explained that he did not want to talk about his outburst, as he felt that he had 'done enough media'. Doughty, a senior staff nurse in paediatrics at Brighton and Sussex University Hospital Trust, was happy to talk, however. It was she who had shouted at Hewitt: 'You're a brave lady to come here after saying the NHS has had its best year yet.' I asked her why she was so unhappy with the Labour government. 'We try to do the job we were trained for but are forced to do other jobs to hit other targets, ticking boxes on their forms, and making these the priority,' she explained.

Could she give me an example? 'Well, we're a small unit that takes in only children. Sometimes there are patients who come into the hospital who are very close to breaching their maximum time they are allowed to wait in casualty [four hours] so they have to come on to the ward. I work on an isolation unit, so it has to be cleaned, and it might be a difficult time to admit them. If they have a serious infection, then I have to do even more serious cleaning for that area.'

In other words, these difficult, awkward patients get in the way of Doughty running the ward smoothly with minimum disruption.

If you have ever spent four hours waiting with a sick child in casualty, then, like me, you would be glad of the four-hour target - and this is the great difficulty. There are many in the health service who feel that the NHS is run purely for them and their continuing professional careers rather than for the patients, who tend to be ill at such inconvenient times.

There are of course enormous pressures on some wards. There is far too much administration work put on nurses' shoulders, and far too many patients are rushed through the hospitals without staff having the time to sit with them and explain what is happening. Patients and their relatives can be difficult and demanding. There is also the threat of redundancy hanging over many trusts as, month by month, the deficits grow. All these pressures were acknowledged yesterday by Alan Rogers, the medical director of Les Miles's hospital. But he painted a very different picture of the neonatal ward where Miles described having just two nurses to care for 14 babies. Rogers explained that on average they had just five babies in the unit, and that on some days, such as last Thursday, there were none in at all. 'There are times when it can get stressful,' he admitted. 'But that's how it is on wards sometimes, right across the NHS. There are always going to be pressures, it's part of the job.'

Nursing is increasingly about an insistence on professional rights, rather than an insistence on a duty of care. Older nurses I speak to regularly tell me they are worried by the attitudes of younger nurses coming in who cannot do some of the basic tasks they were trained to do, but don't particularly want to learn.

One nurse in her fifties told me: 'Some of them don't even know how to spot a pressure sore. It's such a basic task, but they haven't been taught it. What I find hard to stomach is that quite a few have inflated opinions of themselves and see it as their job to challenge the doctors in everything they do.'

Booing the Health Secretary at their annual conference might be understandable, given that they face the threat of redundancies, but will not get nurses very far. A much bigger question is how they are going to reconnect with patients and prove they can champion decent, hands-on care, before they lose even more public confidence.

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