Popular images of nursing, largely based on Victorian ideals, have tended to ignore the role played by the unqualified nurse. Yet nurses' aides have been described as providing the backbone of health services and in many clinical areas have traditionally performed the greater part of basic nursing care. Demographic pressures, including increased numbers of elderly people with health care needs and the reduction in the number of school leavers entering nursing, together with reforms in nurse education, will mean that the demand for nurses is likely to continue to outstrip supply. The nurses' aide is likely to remain indispensible to nursing provision in the United Kingdom. Despite the contribution of unqualified nurses, little attention has been paid historically to their training needs. Studies have attempted to compare the effectiveness of qualified staff with that of nurses' aides, even though the latter have received little or no training. The validity of such approaches is questionnable since ‘unqualified’ and ‘untrained’ have been accepted as synonymous by the nursing profession. Other studies which have looked at the caring abilities of unqualified staff suggest that despite their lack of training they have the potential to deliver therapeutic care as long as trained nurses provide appropriate role models within a therapeutic unit philosophy. The value of the qualified nurse may in fact involve the organization of care rather than hands on care alone.