By Aminu Adamu
On her first day in a British operating theatre, Nurse MJ did not expect the mop.
She had trained as a Registered Nurse in Nigeria, worked in high-pressure surgical environments, mastered clinical judgment, patient safety protocols, and the unspoken choreography of theatre teamwork. She had assisted surgeons, coordinated with anaesthetic technicians, and trusted that when an operation ended, other professionals, cleaners, porters, technicians, would step in, each performing a clearly defined role.
Then, in 2019, in a UK hospital she had long imagined as the gold standard of healthcare systems, the list finished its first case.
As the theatre fell quiet, the team began damp-dusting. Routine. Efficient. Then she asked the question that would follow her for years.
“How do we get the cleaners to come and mop the floor?”
The team leader looked at her, confused, not by the question, but by the assumption behind it.
“Oh, we do that,” she said, lifting the mop.
Nurse MJ froze. Then she ran forward, instinctively trying to take the mop from her superior’s hands.
She was not offended. She was not being “too posh”. She was shocked.
Because back home, she had never held a mop at work not because cleaning was beneath her, but because roles were clear. In the Nigerian operating theatre where she trained, anaesthetic technicians handled machines and systems before and after procedures. Cleaners came in professionally once surgery was complete. Porters conveyed patients. Scrub nurses scrubbed. Circulatory nurses circulated. Everyone knew where their responsibility ended and another’s began.
In the UK, she discovered, those lines were blurred.
A Culture Shock That Goes Beyond Cleaning
The shock Nurse MJ experienced was not really about mopping floors. It was about what the mop symbolised.
Back in nursing school in Nigeria, one message was drilled relentlessly: clinical judgment, patient care, professional boundaries. Nurses were trained as clinicians, skilled, specialised, accountable.
In Britain, she found herself part of a system where a Registered Nurse could be short-staffed, overwhelmed, responsible for multiple patients, and still expected to perform domestic tasks.
“This is not about pride,” she insists. “It’s about role clarity, patient safety, and using skilled professionals where they add the most value.”
Her question is deceptively simple: If a system trains nurses as clinicians, why use them as cleaners?
It is a question that has quietly unsettled migrant nurses across the UK, particularly those from countries like Nigeria, Ghana, Kenya, and Zimbabwe, healthcare systems where hierarchy is strict, roles are defined, and professional identity is tightly guarded.
And it is a conversation the nursing profession has largely avoided.
The NHS Reality: Teamwork or Role Erosion?
To British-trained staff, the answer often comes easily: teamwork.
In many UK hospitals, especially within the NHS, the culture emphasises flexibility. When time is critical, when cleaners are stretched, when a spill occurs, clinicians step in. Doctors empty urine bottles. Consultants porter patients. Nurses clean bodily fluids. No job is “too small”.
“It’s about safety,” one UK-based anaesthetist explains. “What if someone slips while you’re waiting for domestics? You act.”
Others point to Florence Nightingale herself, whose emphasis on sanitation revolutionised care during the Crimean War. Cleanliness, they argue, is foundational to nursing.
But migrant nurses push back not against teamwork, but against normalisation.
They describe a system where nurses routinely perform the work of healthcare assistants, domestics, and porters, while other professionals remain tightly within scope.
“I was trained in the UK,” one nurse says. “And even here, nurses are expected to work as nurses, HCAs, and domestics. Meanwhile, other professionals stick strictly to their roles.”
Another recalls her first shift cleaning commodes and patients’ backsides. “If you saw my face that day, you’d laugh,” she says.
For many, the discomfort is not about the act itself, but about frequency, expectation, and invisibility.
Cost, Efficiency, and the Economics of Care
Part of the explanation is economic.
In the UK, cleaners are paid hourly. Having dedicated theatre cleaners on standby 24 hours a day is expensive. Hospitals are under relentless pressure to cut costs, reduce waiting lists, and keep operating theatres running on time.
In theatres, time is currency.
“If you wait for a porter or domestic, the list runs behind,” a theatre nurse explains. “Patients get cancelled. Management doesn’t like that.”
In such environments, nurses become the elastic workforce, stretchable, adaptable, endlessly available.
But critics argue this flexibility comes at a price.
Who handles deep cleaning after cases involving MRSA, C. diff, or Covid? Who ensures infection control standards are met if cleaning is improvised? And what happens to patient care when highly trained clinicians are diverted to domestic tasks?
These questions linger uncomfortably in understaffed wards and overstretched theatres.
Migration and the Quiet Loss of Professional Identity
For Nigerian nurses especially, the experience cuts deep.
Back home, healthcare systems are hierarchical, often excessively so. But hierarchy also confers identity. A nurse knows who they are. A cleaner knows who they are. Boundaries are policed fiercely, sometimes to a fault.
In Britain, migrant nurses encounter a flatter system that promises dignity for all roles, yet often delivers role dilution for some.
“In Nigeria, JOHESU would rather go on strike than mop,” one commenter notes wryly. “Here, you mop with respect, and even add extra.”
Some embrace the humility. Others feel diminished.
“The UK will humble you,” a doctor laughs, recounting fetching water and dressing beds. But for migrant nurses already navigating accent bias, subtle racism, and professional deskilling, humility can feel like erasure.
The irony is stark: many left home seeking professional growth, only to feel their specialised skills underused.
Not One System, But Many Realities
It is also clear that no single UK experience exists.
Some nurses insist they have never mopped a floor. Others say they do it daily. Some trusts have robust domestic cover. Others do not. In some theatres, blood and bodily fluids fall strictly under clinical responsibility. In others, cleaners are ever-present.
Culture, leadership, and local staffing determine everything.
What troubles migrant nurses is not difference, but silence.
“This isn’t an attack on the UK or Nigeria,” Nurse MJ insists. “It’s a conversation we keep avoiding.”
The Bigger Question
At its core, this debate is about how modern healthcare values labour.
Who does what. Who is stretched. Who absorbs the gaps when systems strain.
In an era of global nurse migration, collapsing workforces, and rising demand, the mop becomes more than a tool. It becomes a mirror, reflecting how systems quietly shift burdens onto those least empowered to refuse.
Is this holistic care? Or quiet role erosion?
There is no easy answer. But for nurses like MJ, the shock of that first mop has never fully faded.
And perhaps it shouldn’t.
Because until healthcare systems openly confront how they define, distribute, and respect nursing work, the most important questions will continue to be asked, not in policy rooms, but in operating theatres, between cases, mop in hand.
