Margaret Haywood was struck off as a nurse after she secretly filmed the neglect of elderly patients on an NHS ward. Four years on, she's finally been reinstated, and is about to start work

The leaf-strewn streets are empty in the afternoon, and a visitor to this modest terrace cannot be missed; Margaret Haywood comes to the door and lets me in before I have a chance to knock. She lives just round the corner from Anfield stadium in Liverpool, but even as she makes a cup of tea, before she sits down on the pale leather sofa, she makes it clear that is not where her loyalties lie. Three walls in her living room are taken up with framed memorabilia from Goodison Park – a picture of legendary Everton centre-forward Dixie Dean, along with a copy of his birth certificate, a signed team photo and a ticket to a first-team training session.

Light flickers in the fireplace, and the front window is filled with a fresh bouquet of flowers – orange-red roses and lilies. She is just back from an awards ceremony in London. "Oh, it was absolutely fabulous," she says, still enjoying the afterglow. "Very glitzy and glamorous black-tie event." What did she wear? "Oh, a long black dress from Monsoon. Cost me a fortune. And I had all the bling on as well. Oh, it was lovely – free-flowing champagne, and a lovely meal. And then I realised I had to get up on the stage and go and collect my award, and my knees were knocking!"

The Nursing Standard Patient's Choice award is just that – an award for the British nurse that patients believe must be recognised for the work she or he has done for them. The vote is public, and thus unambiguous approval for Haywood, who was, earlier this year, struck off the nursing register for placing her loyalty to patients above her loyalty to colleagues by filming undercover on a failing NHS ward while she worked there between November 2004 and May 2005. The resulting Panorama documentary, Undercover Nurses, aired in July 2005, showed one elderly cancer patient screaming in pain because medication hadn't been administered for hours; incontinent patients left lying in their own urine; a woman with cancer who did not eat because there was no one to help her (she died alone, unnoticed); Ivy, a dehydrated and deaf 96-year-old who wanted nothing more than to be allowed to go. Where? Haywood asked her. "To heaven." More than 4 million people watched it and more than 2,000 viewers phoned in, questions were asked in the Commons, the Royal College of Nursing began urgent research into issues of patient dignity and a whistleblowers' hotline was established.

Haywood did not go to work until after she married and had three children (she has seven grandchildren as well now, ranging in age from 20 months to 19 years). But since she married young, at 19, that meant she began at 25 in the kitchens of "what used to be called a hospital for mentally handicapped kids – learning disabilities, now". Her manager was a psychiatric nurse, and when she told him she had always wanted to be a nurse too, he encouraged her to try.

Her father, a taxi driver, encouraged her too, and when the hospital across the road offered her a training place he was thrilled. But then he was diagnosed with lung cancer, "probably because of all the smoking the Woodbines he'd done for years. And the way it worked out my dad got buried on the Friday and I started my training on the Monday. And the very first ward I was allocated on was the ward where my dad had died." She had a serious wobble. "I started thinking, 'Can I do this, after all that?' And I thought, 'Well, he was happy that I'd got in, so yes – I'll do it for him.'"

She qualified in two years, and worked with the elderly and in orthopaedics before moving to A&E. Her career since seems to have consisted of a series of happy side-trackings. She became a registered nurse specialising in intensive care, which she loved. This was followed by a job managing the occupational health unit at Cammell Lairds shipyard in Birkenhead, then another with a private health company, which sent her all over the country screening Ministry of Defence staff for cardiovascular disease. After Panorama aired she went to work in a care home in Sheffield, where she became a manager, and then training manager, which she liked so much she has now got herself a teaching qualification.

Along the way she picked up coping strategies – gratefulness for the camaraderie of colleagues, the ability to balance the need to care with the need to stay a step away from complete emotional involvement, and a tendency to chat to patients, tell them jokes, even if they were on life support and couldn't hear or reply. Even "when somebody's died, you're encouraged to talk to them as though they're still here. I think that helps you deal with it. So when you're washing them you say, 'I'm just going to wash your hands and face now.'"

Methods of training have changed a great deal since she qualified, and she is ambivalent about the results. She was pitched straight on to the wards, and taught theory in tandem, to consolidate what she'd seen and heard; these days, she says, nurses can receive up to 18 months of theory, which can change their relationship with their duties. "I've heard the statement, 'too posh to wash'. I've certainly come across that. They expect the healthcare assistants to give the bedpans out and to help wash the patients. That's part of holistic care, but some of the newly qualified nurses don't see it like that."

What does she think of the government's announcement, this week, that as of 2013 all nurses will be required to attain degree-level education? "To be honest I think all you need as a nurse is common sense, and I think sometimes people with a degree can be a bit lacking in common sense. The basic requirement is that you need to be a caring person, and to have a bit of empathy. I do think the vetting system could be better, at interview level. To try and establish what kind of person they actually are in the first place. [As for theory] you can learn as you go along. All you need at the moment is five GCSEs. And that is really all you need." She sees the new rules as a cost-cutting exercise. "They're training health assistants up to do more practical work in the same way that they're training nurses up to be like junior doctors."

There are worries about the debt young nurses will incur, that this will make it even harder to recruit. One of the problems on the ward Haywood filmed was understaffing – nurses were so overworked that a couple were signed off with stress, and "one or two just sort of ducked and let it all happen – their coping strategy was 'I don't care anymore, let it go over my head, let it go on until somebody else does something.'"

Her first contact with the BBC was as a consultant on a TV programme about care homes, which prompted thousands of letters and emails pointing out similar problems in the NHS. The BBC wondered if she was interested in helping them investigate, and when she said yes, they put her on contract. She became a bank nurse – like supply teachers, bank nurses fill in when wards are short-staffed – and applied for jobs in seven or eight failing hospitals across the country. She had worked in five or six by the time she came to the Peel and Stewart wards in the Royal Sussex county hospital in Brighton.

"As soon as I walked on that ward I knew there were problems. It was the smell of urine and faeces. Blood on the curtains in between the patients. A certain lack of staff. No real managerial support most of the time. None of the patients had a care plan, so none of the patients had continuity of care. Some of the patients weren't getting appropriate nutrition, or any drinks. One lady was blind and she just got her meals on a tray in front of her and then somebody came along half an hour later and said, 'Oh, aren't you hungry?' They weren't even aware that this lady was blind. So I went back to the BBC and we decided I needed to get the evidence. Because what was going on there was abuse and neglect."

The lens of the camera they gave her was disguised in an ink spot on the front of her uniform. The controls were in her pockets, and "I didn't film anything intimate. I could turn the camera off and on when I wanted to. I always made it clear to the BBC, right from the very start, that my professional responsibilities and accountabilities always came first – the filming was a secondary issue." She had to learn to stand 6ft away to get people in shot, and, because batteries and film only lasted an hour or so, colleagues thought she had a urinary infection, she said.

One of the arguments against her, once the programme had been aired, was that she should have informed a manager. "I informed the manager. When I could find her." But shouldn't she then have gone up the ranks, looking for someone internal who might listen? "Yeah, but again, what I was afraid of was that it would have been brushed under the carpet, that they would have just got rid of me and carried on."

It was a legitimate fear. A May 2009 poll by the Royal College of Nursing (RCN) found that while 63% of nurses said they had reported concerns about patient safety or neglect, only 29% said their employer took immediate action. "Worryingly," noted the RCN, "more than a third (35%) said no action was ever taken." Three-quarters of those polled said they feared victimisation or reprisals, while more than a fifth had been actively discouraged from reporting concerns. Just this month the Independent on Sunday reported that some NHS trusts were spending millions of pounds gagging whistleblowers; according to the independent whistleblowing authority, Public Concern at Work, two-thirds of health workers are accepting non-disclosure clauses in severance agreements, to avoid years of financial and emotional distress.

"The legal protection for whistleblowers does not work," Peter Gooderham, lecturer in law and bioethics at the University of Manchester told the paper. "The NHS is littered with whistleblowers whose lives have been destroyed."

How about the issue of confidentiality – the reason she was struck off by the Nursing and Midwifery Council? Haywood had been expecting official censure for the last four years, so there is a vociferousness to her answer that isn't necessarily prompted by my question. "Part of my professional code of conduct is to maintain the confidentiality of the patient, and I've always maintained the code of practice, and I've always maintained confidentiality, but for this it couldn't be like that, because confidentiality is a secondary issue if we're talking about neglect. The neglect and the abuse has to take priority."

Did she not feel she was betraying her colleagues, hanging their collective dirty linen out in public? "Um – I did, yeah. I did feel like a double agent and that's exactly what I was. But I had to keep in mind that there was a good reason why I was doing this. I was convinced it was the right thing to do. I'm still convinced it was the right thing to do."

So convinced you were happy to risk your job? "Absolutely. Absolutely. I had to have the courage of my convictions."

Realistically, however, she thought the most she would get was a year's caution, so when she was finally struck off, in April, she was shocked. "Nursing's been a big part of my life for 25 years. I worked hard, and always acted in the patients' best interests. It was devastating." She wells up as she remembers going home, in a daze, and looking up who else the council had struck off. "People who'd had inappropriate sexual relationships with patients. Nurses who had administered the wrong drugs. One was even charged with manslaughter. To put me in the same bracket as them! It really upset me."

The first days afterwards were "awful, and without the support of family and friends I would have been ill". People wrote to her from all over the country. The BBC put her on a temporary four-month contract to tide her over until her appeal was heard. The RCN set up a petition to gauge public support, and nearly 40,000 people signed it. Ben Bradshaw, then health minister, described the penalty as "unduly harsh".

What would she have done if her appeal had been rebuffed? "I tried not to think of the worst case scenario because I think that would have tipped me over the edge." But when she heard last month that the appeal had been successful (a negotiated agreement, eventually, which sees her receiving a one-year caution that expires next year), she cried. "I was just so relieved. I thought, 'Now I can get my life back in order.'"

On Monday she begins a new job, training nurses and carers for a private company in Birmingham. Would she ever go back to ward nursing? "It's difficult. It depends in what capacity. I enjoy the training as well as the nursing, and with this job I can do both."

And the NHS? A pause. "I don't know if they'd have me in the NHS now. And I suppose that's understandable."