Wednesday, 18 January 2012

Nurse training

In one of my earliest posts I commented on the degree nursing course, and how I felt that nurses as a profession had been conned. That they had been so blinded by the status of a degree qualification that they had had the financial tables turned on them completely. In pre degree days nursing was taught in parallel with ward work, for which they received a salary, albeit small. But now they are considered students, and have to pay out for their course like any other student. The reality of this was brought home to me this week in, of all places, Tescos.

As I was at the checkout I got chatting to the young lady at the till, who told me she was a nurse in training, working at Tesco to fund her way through the course. The true reality of the situation stunned me, that she should have to do this. If she has to work to support herself why can’t she be employed on the wards, where she would get an income as well as valuable experience with hands on patient care. I came away feeling even more strongly that modern nurse training is a complete bag of shit.

And that realisation is starting, finally, to dawn on the nurses too.


  1. This comment has been removed by the author.

  2. Can't say I've noticed an unwillingness to work up here. Must be an English problem.

    2/3 of 2500 nurses say????? What 2500, who are they? I was not asked.

    According to NMC in 2008 (the latest figures they have on their site) there are 676,547 registered nurses in UK. The Independent puts it at 400,000 in 2009. According to this,
    there are about 300,000 qualified nurses in England alone in December 2011 so 2500 hardly representative.

    Students are students, you want to turn them back into apprentices. I fail to see how that makes nurse education shit. Also, Students have been doing degree courses in Scotland since the 1970's also without pay but with a grant.
    Students up here can apply to be put on the HCA bank to earn money, gain experience and also network. And of course, being Scotland, no tuition fees and a small bursary every month.

    Usual nurse bashing by the press I'm afraid.

  3. the a&e charge nurse19 January 2012 at 09:44

    I trained under both systems - first as an RMN (old model) then RGN (branch of P2K). Personally I didn't find the course content that different, although P2K did entail a bit more testing, albeit testing that was not especially demanding if students could be arsed to read a few books.

    I certainly agree that a training salary allowed students nurses to keep body & soul together while learning their trade, and it is a disgrace that this is now being out sourced to the likes of Tescos (on top of a full working week, of course).

    Money aside, what I think really has changed (and this affects doctors just as much as nurses) is the working environment that newly qualified staff are now expected to adapt to - take A&E for example, how often is it said that today's new SHOs (or FY2s if you prefer) are not a patch on those of yesterday. Put simply these young docs are accused of being theory rich and skills poor.

    As it happens I spent a year teaching medical students during the so called PDS (personal development spine) - I was astonished to learn that med students now have to buy into reflective practice - they even have diaries to record reflective episodes - this sort of guff has been around in nursing for a long time and in my experience is held in almost universal contempt.
    If nurse training is shit why are med students playing the same game?

  4. I paid my own way through Nursing school in the United States. I don't think it was a con at all. The science courses I took there really help me in practice as a ward nurse.

    Doing apprenticeship style training will not prepare a person to handle a shift as the only qualified Nurse in acute care. It just won't.

    Your little friend at Tesco's still has to work on the wards doing unpaid shifts for 4000 hours in order to graduate. If she is working in Tescos rather than as a care assistant on a ward it is because there are no ward jobs. Hospitals don't want to pay for frontline staff. She probably won't get a job when she qualifies either.

    Do you have a problem with physios, nutrition and dieticians, respiratory therapists, and social workers having degrees too? Does OT really need a degree to help someone hold a teaspoon?

    I am surprised that you think an old fashioned apprentice style training would prepare a new RN for all of the critical decision making and knowledge that she will need as a general ward nurse these days.

  5. I do however have a problem with UK nursing being sociology based rather than science based. Now that is dumb. Their schooling should be science based as it is in the USA and Australia.

    In Virginia I had to start University courses and take microbiology, chemistry, and anatomy and physiology right along with non nursing students. I had to get top grades there in order to get accepted into nursing school. It was very competitive.

    That was to qualify as a ward nurse who can take charge of actioning doctors orders for acute patients in a hospital. If I wanted to be an NP like GrumpyRN I would need about 3 more years of school on top of the 4 I already did.

    I think your post proves my theories that doctors do no realise how much a Nurse needs to know and understand about medicine in order to function as a plain old ward nurse.

  6. the a&e charge nurse21 January 2012 at 11:57

    "I think your post proves my theories that doctors do no realise how much a Nurse needs to know and understand about medicine in order to function as a plain old ward nurse" - there is certainly an element of truth to such claims - having said that nurses, or managers who act on behalf of nurses, must shoulder their share of the blame.

    After all nurses are meant to be both professional and educated, while according to Peter Carter some 400,000 nurse belong to a trades union - if we cannot take collective responsibility then the horrendous conditions on some NHS wards will not change very much so long as there is somebody at the bedside keeping a lid on the worst excesses.

    Some might regard sociology as an irrelevant component in nurse training but sadly political ignorance is a vital factor in maintaining the unhealthy status quo - 'knowledge', as they say, is power? Perhaps a generation of nurses with slightly more political savvy might have the organisational skills, or more importantly the political will to put their collective foot down and say enough is enough?

  7. The only way the Nurses can put their foot down and say enough is enough is to strike. But if we did that, we would kill people.

    Agreed however that a lot of today's problems are down to a lack of educated Nurse's in previous generation.

    My opinion is the that upcoming generations need to be taught how to take responsibility for their own health and medical care. if they want good nursing care they should demand that their hospitals are staffed with enough qualified nurses and they should also be prepared to pay for that.

    Militant medical nurse (not logged in)

  8. the a&e charge nurse22 January 2012 at 10:22

    "if we did that, we would kill people" - we already ARE killing people, or at least are directly or indirectly complicit with a system that leads to horror stories likes Mid-Staff's as well as others

    Nurses remind me of 'the proletariat' in Orwel's '1984' - immensely powerful (potentially) but unable to escape a culture of victimhood and political naivete?