To agree with David Cameron

(127 Posts)
McNewPants2013 Mon 22-Apr-13 20:23:04

I think it is a good way to ensure that the patients get good quality nurses.

A year as a HCP before commencing a degree in nursing sound a brilliant policy.

McNewPants2013 Mon 22-Apr-13 20:23:19
scarlettsmummy2 Mon 22-Apr-13 20:25:42

Well as nursing really is a vocation I think this would be a good way to make sure you cut the mustard before embarking on a degree course.

BrianCoxandTheTempleofDOOM Mon 22-Apr-13 20:26:39

YANBU, I don't think I have agreed with him before but this makea sense.

I come from a family of nurses (general, mental health and auxiliary's) they all think its good idea

timidviper Mon 22-Apr-13 20:26:40

I kind of agree that something needs to be done to make some nurses more aware of general care but who will pay for all these HCAs and who will train/supervise them?

It's just another bandwagon for Shiny Dave to jump on. YABU to ever agree with him. EVER.

McNewPants2013 Mon 22-Apr-13 20:29:06

I never thought I would see the day I would.

NoWayPedro Mon 22-Apr-13 20:30:23

Has anyone experienced the arrogant 'telling' bedside manners of some doctors recently? Funny how there doesn't seem to be any suggestion of communications skills training/a year as a HCA for them.

Nurses do a great job

AtYourCervix Mon 22-Apr-13 20:30:38

Who's going to pay for them? Or will they be expected to work for nothing?

Hospitals have no money to magically create new posts.

Students won't be able to afford to work full time with no bursary or grant.

Who will give these new HCAs trainig? The overstretched nurses who already have to do hours of student mentoring in their own time?

marjproops Mon 22-Apr-13 20:31:38

If Scameron put more money INTO the NHS then yes. but he doesnt .

too many cutbacks and not enough staff/resources/training/pay.

AtYourCervix Mon 22-Apr-13 20:32:56

If there was more money Trusts could employ HCAs who actually want to be HCAs and train them properly.

NoWayPedro Mon 22-Apr-13 20:33:26

I'm loving this - Shiny Dave and Scameron (grin). Two new names I've learned today

McNewPants2013 Mon 22-Apr-13 20:33:50

I agree, of course in all jobs you get the good and the bad, but my experience generally nurses do a good job.

I think by being a HCP it would mean perhaps a years nursery isn't wasted by people who have made an error in choosing a career.

fatfingers Mon 22-Apr-13 20:34:16

I agree with this idea too. Why can't they look at encouraging existing HCAs to train as nurses? This will free up HCA jobs for potential nurses to take up. At the moment though, nurse training seems to be too focused on the academic, which is preventing people who would make good nurses from entering the profession.

McNewPants2013 Mon 22-Apr-13 20:36:29

The money could come from scrapping the access to nursing course

Plus3 Mon 22-Apr-13 20:37:23

Well I don't agree. It is a fantastic way to devalue the job that health care assistants do - many need & should be qualified to do their job properly.

Better nurse - patient ratios are the way forward, then nurses would have time to do all aspects of the job.

I am delighted the RCN have spoken out about this. I work in Intensive care deliberately in order to deliver a high standard of one to one nursing care.

AtYourCervix Mon 22-Apr-13 20:41:09

The point of nursing being academic is so nurses can continually develop their practice by using research and up to date information (very basically).

You wouldn't want to be nursed by someone who qualified in 1970 and who has done nothing since.

Scrap access courses and wipe out a large amount of people who are able to do a degree but who are mature and gaven't been in education for years.

Pobblewhohasnotoes Mon 22-Apr-13 20:42:46

It's going to be free nursing care. Why pay for more HCAs when you can use students.

What we need is more staff. But that costs money.

AtYourCervix Mon 22-Apr-13 20:45:39

But nobody is going to be able to work for free.

Most student nurses work to pay bills and survive (on top of the practical and academic stuff). Who is going to be able to do full time HCA-in and work for pay?

flangledoodle Mon 22-Apr-13 20:47:18

Nursing is not a vocation, it is a career like any other. Nursing degrees take 4 yrs, so with this extra year training would effectively take 5 years - the same time it takes to train as a doctor.

I am a nurse - a good one too although I say so myself - and if that had been the rule when I was considering training I prob would have done something else. That said I did have a lot of experience caring prior to doing my training (student w/end and holiday jobs). Maybe could be an idea if experience like that could be counted rather than having to do a formal year in a hospital. Having said that, you would have thought that if the recriutment process was good enough suitability for the role would have been assessed at thst stage rendering this extra year unnecessary.

ivehadaverybadday Mon 22-Apr-13 20:47:38

It's another Tory policy that seems to make sense, aka the bedroom tax, which will be a disaster as no thought, and more importantly, money and support, will be given to implement it. I just wish they would think, just for one second, about the reality of the things that they propose, and see what the real issues are - lack of money and staff are they main problem. This will just add to that.

Samu2 Mon 22-Apr-13 20:48:24

I want to be a HCA but the hospital near me turns me down every single time sad

I want to be a HCA more than anything but I can't get my break.

marjproops Mon 22-Apr-13 20:49:20

noway Scameron? that came up a few threads ago about him. a witty mnetter thought that one up. can't remmebr who though.

AtYourCervix Mon 22-Apr-13 20:49:53

And it would be another wedge between fundamental patient care (will be done by HCAs) and 'nursing' computering, paperwork, arguing with bed managers and social workers.

nenevomito Mon 22-Apr-13 20:53:07

What about the people who are already employed as HCA's or want to work as an HCA without going on to do nursing? Surely hospitals want people who are going to come in wanting to do the job and stick it out rather than just see it as a taster and then feck off to do nursing.

Why not just make sure that there's an emphasis on care etc as part of the nursing degree and training.

Why do politicians think that they know better than nurses and their statutory bodies at what needs to be done?

pointythings Mon 22-Apr-13 20:54:52

I don't trust the government on this, I'm afraid. I see this as a way for them to get free HCAs - a nice shiny new cohort every year, and of course they won't need to be paid as they have a vocation, don't y'know, and shoudl be grateful for the opportunity. As a result, thousands of HCAs will lose their already low-paid job. Win-win for the government, lose-lose for everyone else.

By all means let nurses in training do real hands-on work on the wards (and I find it hard to believe that they don't already, I mistrust the government on this too). But not this subtle devaluation of yet another profession.

flangledoodle Mon 22-Apr-13 20:55:07

Why does everyone assume good nurses need not be academic. I am a CCU nurse and that is a highly skilled and very resposible job. You really wouldn't want to be nursed in a critical care area by nurses unable to think critically, understand complex pathophysiology and be able to manage and titrate dangerous drugs.

All this puttingvthe caring back.into the job is of course important but the answer is not to prioritise beibg a caring person over academic capability.

IThinkOfHappyWhenIThinkOfYou Mon 22-Apr-13 21:01:04

I don't know if I'm just being dense but whenever I've been in hospital a good chunk of the actual 'caring' sort of nursing has been done be HCPs. If they are replaced with students who will do it for a year, max, then how does that bring standards of caring up?

McNewPants2013 Mon 22-Apr-13 21:06:45

Perhaps it does need more thinking out, but could the care aspect be part of the 4 years training. Where a QN has to sign to say the student has proformed the care component and it be a requirement to pass the first year.

lyndie Mon 22-Apr-13 21:08:04

Stupid idea, knee jerk reaction again. Who will be paying for this? Are these posts in addition to the current HCAs or will they make them redundant?

A massive core of the nurse training course is already hands on care, an extra year will put some people off, they could go and do a degree in a profession allied to medicine in a shorter period of time.

The President of the RCN was on the radio this morning - he said you could have Florence Nightingale on the ward, if he or she is over stretched they cannot provide good care.

It is ALL about staffing ratios, the sooner the powers that be accept that the better, instead of faffing about trying this and that and making cuts try mandatory staffing levels before its too late.

NameThatTuna Mon 22-Apr-13 21:08:20

The answer isn't making students do a year as a HCA. First year students on placement do that anyway.

By the time they reach 3rd year, they are on 'management' placements. That's how it is in our Trust anyway.

What's the point in making a student work as a HCA when once they qualify, they won't have time to do the basic hands on care because if the paperwork etc anyway.

AtYourCervix Mon 22-Apr-13 21:11:21

They do already McNew.

Students do do a lot of hands on care. They are supernumary and have the time.

McNewPants2013 Mon 22-Apr-13 21:18:22

I guess IABU and everyone here has made some very good comments.

AtYourCervix Mon 22-Apr-13 21:21:57

It sounds great.

Patients get better care.

More HCAs working.

Students get a good grounding in patient care, bathing, feeding, talking, caring.

Until you have a think about who and how, where and how much?

MrsKoala Mon 22-Apr-13 21:24:28

I used to recruit nurses from access course/A'levels onto Dip/Deg nursing courses. IME The majority of those on access courses were older people who had worked as carers already. They would not have been able to do A'levels so without access courses would not have gotten into nursing. They are already scrapping the Dip course - i think (i left working in that field 3 years ago) so the access course credits will need to be higher (60 at level 3 rather than 45 as i recall).

The nursing course is 50% community of practice. This should be sufficient to gain caring skills with patients i think. If after 3-4 years of 50% of a full time (and nursing courses are full time - unlike other uni courses - no long summer hols etc) you still do not have the requisite people skills then i think you never will.

In the interview process i oversaw there was a massive focus on the caring side (the academic was judged on results and numeracy and literacy tests). Then the student nurse was continually assessed throughout the course. Then on completion of the course another application/interview process would have to be passed to get a job as a nurse.

Bue Mon 22-Apr-13 21:27:39

It's a ridiculous, knee jerk idea. Not to mention unworkable. It doesn't take a year to learn basic patient skills and how to 'care'. And nursing students do a lot of hands on care anyway, and they work with HCAs some of the time to get this experience - it's a complete myth that they spend all their time in an ivory tower!

I say this as a student midwife, by the way. Maternity care assistants do a really valuable job and I really enjoy working in a team with them and learning from them. But I didn't need to spend a year doing their job in order to care about women and to learn how to care for women.

BadDayAtTheOrifice Mon 22-Apr-13 21:38:14

Typical, stupid, poorly thought out 'solution' for 'uncaring' nurses.

Nurses haven't lost the ability to care, they do not need this. Want they need is adequately staffed wards, and a reduction in the paperwork which serves little purpose except to make the CNST auditors job easier.

sleepyhead Mon 22-Apr-13 21:38:59

I don't know. I've just spent 6 days back in hospital after developing a postnatal infection.

Plenty of HCAs - meals, cleaning etc all ran like clockwork. Midwives were like hen's teeth and I missed several doses of my IV abs because no one was available to hang them. A hundred more "caring" HCAs doesn't solve that.

My experience was that the qualified staff cared hugely, and if they'd had the luxury of time would have loved to have sat helping me to latch ds on (they would say "buzz the next time you feed him" but you'd buzz and there'd be noone free for at least the next half hour), or sit and talk through my worries about being away from ds1 for so long, or whatever - but there were too many patients for too few staff.

My worry is that this is a great way to say - "look at all the new staff we've recruited" while continuing to erode the ward skill mix.

Anyway, I know many nursing students who work as HCAs either part time or as Bank staff to help fund themselves through their nursing course already. There aren't the jobs for everyone to do it though.

sleepyhead Mon 22-Apr-13 21:40:46

Plus, we should value experienced HCAs - a couple of the Maternity Assistants in my hospital had decades of experience. One was an amazing source of good bf advice.

Would you get rid of them to have a continually rotating supply of nursing students?

ivykaty44 Mon 22-Apr-13 21:47:42

Where are allt he HCA jobs going to come from?

if a prospectus nurse doesn't manage to get a ob as a HCA does that mean they can't tdp the course?

If prospectus nurses can't get on the course due to t not being able to get a job as an HCA will this result in a shortage of nurses?

if there is a shortage of nurses who will suffer?

If there is a shortage of nurses will they be employed from abroad?

Will nurses from abroad be made to work as an HCA first?

SimLondon Mon 22-Apr-13 21:51:19

"Samu2 Mon 22-Apr-13 20:48:24
I want to be a HCA but the hospital near me turns me down every single time I want to be a HCA more than anything but I can't get my break"

Have you asked them why you keep getting turned down? or got someone else to check over your application before you submit it?

Sometimes you have to be persistant :-)

IThinkOfHappyWhenIThinkOfYou Mon 22-Apr-13 22:03:36

Well a quick search of nhs jobs website shows 39 vacancies for HCAs nationwide. Some of the adverts are for more than one job, so maybe 50-60 posts altogether, 4 of which are for 'trainee' or 'apprentice'. Some are for senior or 'experienced' and some probably wouldn't cut the mustard in terms of Scameron's plans ie day units, eye surgery, sexual health outreach for LGBT. Not enough bathing/feeding/bed making experience. I would guess that maybe 10 of the jobs would give suitable credit for getting onto a nursing course and would be suitable for someone with no experience. Are there more than 10 people nationwide who apply for nursing each year? If there are than that could be a flaw in the plan.

GeorginaWorsley Mon 22-Apr-13 22:08:12

I trained 30 years ago almost,under 'old' system.
Whilst things have changed enormously and nurses now routinely perform tasks that doctors used to,there is something to be said for how we trained back then.
A 'friend' recently commented how she could nurse,it was only a case of reading the manual.
Oh how I laughed.Not.

ivykaty44 Mon 22-Apr-13 22:11:58

so 39 vacancies

did you look to see how many nurse jobs are going?

Samu2 Mon 22-Apr-13 22:21:02

SimLondon.. I haven't asked them, that is a good idea though.

I have had a few people look through my application but to be honest, I had children young and have very little work experience. You only need GCSE's to apply but I have heard that with the way the economy is now more people with a lot of qualifications are going for these jobs. It sucks, I would be great at it, I really know I would be and all I want is an interview to prove how willing and passionate I am about becoming a HCA.

I apply every time the post comes up, get turned down and cry a little grin I asked if I could volunteer even but they aren't taking anyone on voluntary. I am now learning to drive and then I will try to get a job in caring going to peoples homes or volunteer so my CV looks better but they all require you to drive so I have to pass my test first.

girliefriend Mon 22-Apr-13 22:26:39

The government need to legalise staff to patient ratios, that imo would do more for basic patient care than anything else.

Its very hard to give one to one care, wash, feed and ensure patients are comfy and not in a soiled bed when its one nurse to twelve patients sad

pointythings Mon 22-Apr-13 22:33:26

girliefriend agreed, but they would need to look at the specific care situations. A geriatric ward would need higher ratios than a general adult ward. A paediatric ward would also need higher ratios.

I really do think that looking at (and investing in) safe staffing levels should be the first outcome of the review. It strikes me that what is coming out of government at the moment is all about blaming nurses to deflect attention away from the way staffing has been eroded to cut costs.

fruitnfibre Mon 22-Apr-13 22:34:47

Can`t believe what the goverment is trying to do with nursing, makes my blood boil!!!!
If there were actually more trained nurses and less HCA maybe the trained nurses would actually have time to nurse patients and mentor students, properly.
I became a nurse to actually nurse - the stress and frustration of not being able to do my job properly was making me ill, so I`ve given up.
Dread to think what it`ll be like by the time I`m old.

milkysmum Mon 22-Apr-13 22:38:40

I am a community nurse and think this is a really poor idea and would put lots of people off a career in nursing- and as everyone else is pointing out is likley to be highly unworkable in practice as HCA jobs few and far between already. Minimum staffing ratio's are a much much better idea and would improve patient care hugely in my opinion

XBenedict Mon 22-Apr-13 22:42:37

I'm not sure it's a great idea. I also trained under the "old" system over 20 years ago. I have just returned after a career break to have my children and I would love to work on the wards. All my past experience has been ward based right up to the role of ward manager but I can't get a job on the wards as I am not prepared to sign a 24 hours a day 7 day a week contract. Unfortunately I need regular hours so secondary care is no longer an option for me. I can't be the only mum that would prefer this. Is there not a way of making the NHS more flexible and entice some of its experience back? Just my musings while I retrain in primary care.

IThinkOfHappyWhenIThinkOfYou Mon 22-Apr-13 22:43:54

ivykaty 1766 job adverts with 'nurse' in the title

AmandinePoulain Mon 22-Apr-13 22:44:59

I'll be honest, I wouldn't have done my training had this been necessary when I started 13 years ago, unless the year could be done in paediatrics, which I doubt as most children's wards use nursery nurses rather than HCAs. I did 3 weeks on an adult oncology ward during my training and hated every minute. The rest of my time was spent in the community or on children's wards. Adult nursing is not for me, I have utmost respect for those that do it but it's wildly different from my job (NICU). I like to think that I'm good at my job. My babies are well looked after, and I certainly care for them, I honestly don't think I could have made it through a year on an adult ward.

Legal ratios are what's needed. (And neonates should be provided with one to one care like on PICU and adult ICUs - I think it's shameful that we aren't staffed to provide that at the moment angry). But I'm sure that once again David Cameron et al will know better than the RCN - they know better than anyone about anything after all hmm.

Fleecyslippers Mon 22-Apr-13 22:46:38

In the words of the RCN, a really stupid idea hmm

Invest some money into the NHS to allow ward managers to increase staff ratios and employ more of the really good, compassionate staff nurses who are are already trained to a high standard and who can provide holistic care , including washing, toileting, feeding etc without getting caught up in the mountain of shitty paperwork.

I trained as a psychiatric nurse quite a while ago (I later went into teaching and other roles with the early years) - anyway after I got my place to do nursing I had 6 months on my hands before the course started and got a job as a nursing assistant before my training started. It didn't really make any difference one way or the other as the training involved 3 month stints on different wards anyway.
If there is a problem with the general, practical, and emotional care offered to patients (for example, in my experience, on the post-natal wards) then this needs to be addressed as part of a review of nursing and review of training. It won't be solved (in as far as it needs to be) by a quick, gimmicky idea like this.

HolidayArmadillo Mon 22-Apr-13 22:49:39

It's a stupid idea and won't work. Midwives and nurses don't need to be taught the basics before being allowed to do the course, that's what the bloody course is for. Once qualified it matters not a jot whether you've worked as an hca or not, if you're the only qualified member of staff on duty you can't do everything.

Fleecyslippers Mon 22-Apr-13 22:50:39

'if you're the only qualified member of staff on duty you can't do everything.'

This ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

"they know better than anyone about anything after all"

It does seem that that's their thinking doesn't it Amandine.

Like Ms Truss goes to France on her hols and comes back saying they manage their nurseries with far fewer staff and the children are much quieter and better behaved, so let's do it like that here hey Dave - and save a few bucks whilst we're at it !

(disclaimer - I've no idea how she got the French idea in her head, maybe it was a proper tax funded research trip i don't know hmm)

And sorry for the jaunt onto another thread - it's also on discussions of the day BTW

AmandinePoulain Mon 22-Apr-13 23:03:38

And Gove appears to know more than teachers about educating our children too wink hmm

serin Mon 22-Apr-13 23:15:05

Am going to sound pedantic now and haven't read the whole thread thoroughly (so apologies if this has been mentioned) but there is a difference between a HCP (Registered Health Care Professional) and a HCA (Health care Assistant).

The government wants potential nurses to spend time as a HCA, not a HCP.

I have worked 22 years in the NHS and have met the most amazingly talented nurses. They may not have time to hold peoples hands as much these days but I have never seen a bunch of people work so hard or so efficiently. Multi task? They invented it!

See I do agree a little though that the hand holding is important too.
When I did my nurse training (in psychy) during the 3 months I did on a general ward I felt there was no time to stop, including to stop and talk with the patients. I just didn't feel that they were getting the best out of me with their non-stop ultra efficiency approach to things. Perhaps it's better now with the first 18 mths as shared training across the different nursing disciplines ?

SueDoku Mon 22-Apr-13 23:58:20

Dave & Jeremy appear not to have done their homework again as all nursing degrees already consist of a 50-50 split between academic work and placement on wards or a variety of healthcare providers (community nursing, continence teams etc), so nurses already get approx 2 years experience of practical hands-on care as part of their training. My daughter is a nurse, and watching her try to work a tough f/t job (with shifts) while writing assignments and revising for exams at the same time was awful... Nursing degrees also run for 44 weeks a year, not 36-38 like other degrees, so it really does take a lot of hard work to graduate with a good degree.

pippibluestocking Tue 23-Apr-13 00:02:11

I spent the whole morning today interviewing people for places on a nursing degree. Virtually all of them already had some experience of working in a health care environment, be it paid as an HCA or voluntary work. Scameron's idea is pants and completely superfluous. The whole point of the interview is to assess motivation, attitude and commitment to the role. Places on nursing degrees are very oversubscribed these days and the universities can really cream off the best, there's no need to make everyone do a year as an HCA first, there aren't sufficient positions and you potentially could end up with a shortage of applicants for the degree (because they haven't been able to gain the prerequisite experience), potentially leading to universities being forced to take anyone regardless of attitude just to ensure they fill their quotas, which would take nursing back 20 years and will be com

pippibluestocking Tue 23-Apr-13 00:05:02

Completely counterproductive in terms of driving up compassion. Agree that this is cheap underhand trick to cut costs and undermine nursing by a bunch of amateurs who are creating policies based on very little substantiated evidence. They are like a bunch of children in a Lego shop!

nooka Tue 23-Apr-13 05:21:11

Seems to me a cheap PR trick to get people talking about 'the good old days when nurses really cared' instead of wondering why the government isn't implementing the actual recommendations from the Stafford review. There were almost 300 recommendations in that review, so if the review team had thought nurses needed more basic experience they had plenty of opportunity to say so. However I see that the government are leaving the response to the review to individual trusts, so effectively completely passing the buck.

Dawndonna Tue 23-Apr-13 07:42:59

What training do you get to be a Member of Parliament and spout unresearched, unviable shite?

Melty Tue 23-Apr-13 07:59:53

I qualified in 1992.
there was a shortage of nursing jobs at the time, not so much a shortage of caring nurses.
The nurses we have nowadays are still caring. Still empathetic.
But there is a limit to what 2 qualified nurses on a shift can do. No matter how caring they are.
These days, with shorter doctor working hours & more HCAs to make up the numbers (and save money) the extended roles of the nurses mean that there is less time for actual nursing.

Most nurses are brilliant. You do of course, as in every profession, get the ones who really should be doing a different job.
But I am now an Intensive Care trained nurse, and there is no way in hell I would go back to ward nursing, because at least in ICU the skill mix is still 1 nurse to 1 ventilated patient/level 3 patient.
The skill mix on the wards is dangerous.
And if our ministers (who seem to know everything) took some time to read the research, of which there is plenty, nurse to patient ratios are directly related to patient mortality and length of hospital stay.

Itchywoolyjumper Tue 23-Apr-13 08:29:40

This really is one the most stupid ideas this government has come up with.
In most wards I've trained or worked on a good proportion of the long served staff are care assistants. These are the people from whom student nurses learn how to care for their patients. There are only so many jobs so if you bring in a massive pool of prospective student nurses the numbers longstanding HCAs are going to plummet.
Some of the HCAs who trained me had been doing the job longer than most of us students had been alive and had a fund of knowledge going back decades. Even now I've been qualified for 7 years I'm still learning stuff from guys like this. This will all be lost if they're flooded out of the job market by people whose motivation is to do 1 year and move onto their training.
Then, when something out of the ordinary daily run of things pops up there's a much lower chance that someone will have had first hand experience of it and we'll all have to learn it out of a book - which is what I thought that wazzock Dave was trying to avoid.

Erebus Tue 23-Apr-13 08:38:39

An idea: Why not ascribe every patient a points value according to their medical condition, degree of ability to self care, complexity of other needs etc etc- and set up a nurse:number of points per shift ratio? So more complex cases accrue more points. Hey Dave? How about that?

Oh, hang on! That might go some way towards addressing the actual problem rather that 'populist knee jerk' spouting.

Stafford wasn't, when push comes to shove, caused by those nasty nurses (though yes, the RCN should have taken their members concerns on board)- it was caused by a management that thought they were doing exactly what their brief stated: 'deliver the 'health care' under this budget at whatever other cost'.

FWIW, you know what? If I were a patient, I wouldn't necessarily want my bedbath being done by a reasonably well-paid, degree trained professional. I think I'd see that as a waste of resources. I'd like it to be done by a properly trained HCA, one with experience, commitment and a desire to do that job not just as a step to 'something higher'.

There used to be a system with Auxiliary nurses, Enrolled nurses and Registered nurses; 3 tiers with the ability to move up through them if you demonstrated aptitude, but it was deemed that 'the public' didn't want those 'lower level' nurses looking after them; degrees became the only way to go professionally (my own HCP had to go 'degree' because it was made quite clear to us by the government that we wouldn't be a) treated as 'professionals' without it, and b), nor would be get the pay rises of other HCP groups who'd 'gone degree'- so we did) and guess what? Yes, you are likely to get some people entering these HCPs who consider that a degree absolves them of bedbathing and toileting every day; but you'll also get a valid argument that should 'we' be paying these people this sort of money to do highly necessary but not-particularly-skilled jobs?

My manager goes ape if she sees us portering patients around the hospital. She rightly states that we don't get paid from £12 ph to do a job someone on minimum wage could do (however, we point out that if the Trust employed enough porters we wouldn't need to do that job in order to fetch patients ourselves so we can do our £12ph + job!).

There is now a gulf in the middle of nursing care: degree trained nurses above; sometimes only minimally trained 'helpers' at the bottom. Nothing in between.

Final point- I wonder if you might see a nose-dive in nursing applications if they brought this system in? And why not insist pre-medical students do this too? Oh, hang on, that'd be because many dyed in the wool Tories have DC who are aiming for medical school straight out of their private school. Wouldn't want their futures patronised, would we?

Itchywoolyjumper Tue 23-Apr-13 08:57:12

Erebus, your points system is a work of genius.
Also you manager is right but sadly there seems to be an attitude that if a task in the hospital can't be done by any other group the nurses can do it. I once went from cleaning diarrhoea from the floor and walls of a toilet (because the cleaners weren't allowed to touch body fluids) to taking and interpreting an ECG because the junior doctors didn't have enough working hours to do it.

Some of the best doctors I've ever worked with were HCAs first, it really does them a lot of favours.

Twattybollocks Tue 23-Apr-13 09:12:39

The problem with bringing in legislation re minimum staffing levels is that it requires someone to monitor it to ensure that it's being adhered to. And that person will need paying, which then takes more money from the pot so less money for staff actually doing the work. If there was the money there to pay for the staff, I don't think there would be a problem. personally I think we should go back to the old system where clinical staff were responsible for staffing levels. The problem with non clinical staff doing it is that they don't have to work in the ward which is chronically understaffed, they don't go home at the end of the day worrying because there just weren't enough hours in the day to give mr x a bed bath, or that mrs y hadn't eaten again because there was no one available to feed her, or that someone had been sitting in their own shit for 4 hours and now had a sore, or that someone has missed their iv meds because no one had time to administer them! All of the above situations occur daily in pretty much every ward in every hospital in the country.
Nurses are perfectly capable of giving adequate care, they have been trained to do it, they just don't have time to do it because there arent enough of them! Please let's not have more legislation, it won't solve anything, what we need is more money to pay more clinical staff to do the actual thing that the hospital is there for, to diagnose medical problems, treat them, and care for the patient whilst they are being treated!

JakeBullet Tue 23-Apr-13 09:14:56

This all makes me very sad. I went into nursing because I wanted to care for people who were at a vulnerable time in their lives. I absolutely LOVED my job. The wards were staffed well (ish) and I had time to give to my patients. I can remember that between the early and late shift there was a switchover time of about 90 mins when double the number of nurses were on the ward. That was the time I could do extra things like go and give an elderly lady or man a foot bath and massage their feet (you can tell an awful lot about someone's health my looking at their feet), it also meant I could talk with them, find out how they were feeling, if they felt their care was being managed properly and address any concerns.
All that went out of the window with the Tory Govt of the 80s and 90s and the Labour Govt did NOTHING to address it when they came to power either. In short, our Governments of both persuasions have let patients down. I am not convinced that what Shiny Dave is suggesting will address anything.
As a student nurse I worked as part of the ward staff numbers and learnt by working alongside a qualified nurse or experienced HCA. I a assessed on asepsis, drug administration, my interaction with patients, my understanding of illness and disease and how nutrition impacted upon health. But no, we have to have degrees (fine), we have to become managers of wards with HCAs and virtually no other qualified staff (utterly unacceptable for both qualified staff and HCAs). How can a nurse keep her eye on the ball when he/she never gets near the patient?

Instinctively I now distrust politicians and Dave is stupid to ignore what the RCN are saying.

VenusRising Tue 23-Apr-13 09:29:25

Sounds like he wants free labour! I think Shiney Dave hasn't a brain in his enormous head.

But let's say it goes ahead, well then, I agree with the previous poster who said that doctors would need this too.
Most nurses I've met have been lovely, and competent, the doctors have been offensive, high handed, and unbelievably arrogant.

Plus3 Tue 23-Apr-13 09:51:55

I don't believe this is about degrees - I did a four year Bachelor of Nursing, and a large proportion of time was ward based, learning the job from the experienced nurses/HCAs.

Nursing has changed - we do so many more medical jobs now, which ironically is supposed to enhance the patient's experience. It means that the nurse caring for you can administer all your medication instead of waiting for a Dr to come an do it, ECGs can be done and problems flagged up immediately etc. this doesn't mean that basic care is ignored or deemed unimportant. But, if you cut the number of nurses on shift, then those roles will take priority for the qualified member of staff, leaving the less qualified doing the more basic aspects.

It's completely rubbish - so much can be gained from doing the bed bath, sitting and chatting whilst obs are recorded...

I will say this again - poor, uncaring nurses should be complained about. If they have got so burnt out that they don't care anymore, then move on.

Better patient-nurse ratios will improve things dramatically. But you know? It's going to cost some money. Better nursing care would reduce length of hospital stay, therefore money saved. who knew?

Erebus Tue 23-Apr-13 10:12:09

Q: "The problem with bringing in legislation re minimum staffing levels is that it requires someone to monitor it to ensure that it's being adhered to. And that person will need paying, which then takes more money from the pot so less money for staff actually doing the work. If there was the money there to pay for the staff, I don't think there would be a problem."

Actually, the thing is, in our modern age- and this isn't just in health care, it's in every other aspect of state life, it is an absolute imperative to be able to prove you need the staff/the money/the new curriculum/the benefit etc. Just saying you do, or saying 'well, it's obvious, isn't it?' -won't do. You need the evidence. Evidence based practice. Then you have to show that you're 'doing it'. That's 'accountability', so, yes, it does need someone to see that the staff:patient ratio is 'adhered to'.

It, sadly, can be shown that once you take accountability away, there can be a tendency to let things slip. "Oh, ward H4 is a trained staff member down today, but I don't want to dip into that cash to pay for a bank nurse, so they'll just have to make do. Oh- they've been short all week? Who's counting?". If the management knew that in the same way they get fined if an A&E stay exceeds 4 hours, or the MRSA rate goes over a set level, they'd get fined for running wards with say 'x' points worth of patient on it with too few staff to meet those needs, they'd sort it. FWIW I think the MRSA rate and 4 hour thing in A&E are stupid. They are a crude weapon which can only lead to the sort of creativity ' that can cause Staffords to happen.

To do away with all that, to let hospitals, or schools run themselves completely autonomously would take an act of governmental will we're unlikely to see again in our life-time (note Academies are supposed to do that but they aren't free of the endless testing and numbers game of state education, are they?- and they aren't really about freedom, are they? they're about privatisation.). If all the staff on a ward from the head nurse down to the cleaners and porters belonged to that ward, with only the trainees moving between work areas, you might see a greater team spirit; instead, everyone who can be contracted is, because taken as a whole, it's cheaper. You won't see the same cleaner or porter twice. Your nurse may not have 'done' your speciality before (or even know her way to say Pharmacy having been drafted in from elsewhere that morning). You won't see her again, either.

Perihelion Tue 23-Apr-13 10:28:34

I'm sure I heard on the radio that the idea was to work for a year as a HPA to be eligible NHS funding for a nursing degree...This doesn't appear in the BBC article.
Cynically, I'm thinking this is a way to bring in fees for nursing degrees.

FreedomOfTheTess Tue 23-Apr-13 11:11:53

I agree with the RCN, it's a stupid idea.

It already takes four years to fully qualify as a nurse, adding another year to that will put some people off going into the profession.

I have two cousins who are nurses, both say that basic care is covered within the current training, as part of the four year degree. There is no need for this extra layer of training. They say what is needed is MORE nurses and LESS paperwork/admin/faffing about doing things that take nurses away from actual nursing.

duchesse Tue 23-Apr-13 11:47:16

I think it's a very good idea indeed. I used to think the nursing qualification was enough. After a few stays in hospital in recent times I'm beginning to think it's not.

It also models what teachers are asked to do before applying for a teaching course.

FWIW I think prospective doctors ought to as well.

duchesse Tue 23-Apr-13 11:49:15

And of course the year would be a paid year! It's not free labour. It's simply requiring a workforce to go into a career with their eyes open. Many people working as TAs realised close up what teaching is really like and decide not to train as teachers after all, and that's good.

AtYourCervix Tue 23-Apr-13 11:58:23

Paid for by who?

NotYoMomma Tue 23-Apr-13 12:00:56

I WOULD MAYBE agree if they didn't ignore the actual recommendations about minimum staffing levels

You can be the most caring nurse in the world but if you have to deal with 3x the number of patients because there is no maximum quota then I think it's all Tory Bullshit smoke and mirrors

"What training do you get to be a MP, and spout ...."

Classic DawnDonna grin

Loveiswhereitfalls Tue 23-Apr-13 12:08:51

Its a knee jerk reaction - agree with the RCN its stupid.
All of those applying for Nurse Training/Midwifery have always had to show at interview /selection that they have previous experience and show aptitude. So they are often found working as HCA/Carers already as are those hoping to go into Medicine.

Will they be paid? The current salary for a level 2 HCA is £14,295 -£17,425 .Whats the betting that they will be "given the opportunity" hmm ie not paid or paid less .
What about the training? HCA undergo training before they can start ,who is going to provide this .
We are the only country without a LEGAL minimum Nurse/Patient ratio. Why is this recommendation of the Francis Report not being addressed?
This will be a cheap way of Dave n co "increasing" staff on the wards without any thought to what is actually needed.
Patients deserve more.

FreedomOfTheTess Tue 23-Apr-13 12:10:54

Adding an extra year's training doesn't fix the problem of nurses being overstretched though does it?!

What is the point of having that extra year, if patient/nurse ratios are still not adequate, because hospitals (for whatever reason) are unable to recruit the required number of nurses?

You could add three years to the start of the training, but if at the other end, the nurses are going to be overstretched and overrun with paperwork/admin, those extra years will make NO difference.

It isn't a training issue - the current qualification is more than adequate - it's the fact that sadly nurses are sometimes too overstretched to give every patient the due care and attention they deserve.

The hospital that one of my nurse cousins works in, is so short of nurses at the moment, that my cousin has been working far and above the hours she should be doing. After I saw the report on nursing numbers/working hours on the news the other day, I spoke to her and she admitted, that just a couple of weeks ago she worked a shift after just TWO HOURS sleep. She said it has got to the point where her heart sinks when she sees it's the hospital calling on her mobile.

So again, I repeat what I said before, the extra training will make no difference without changes the other end. In fact, I go as far as to say, making changes the other end is FAR more important.

SusanneLinder Tue 23-Apr-13 13:51:29

My DH is a nurse, and my daughter a 1st year Student. DD's first placement was spent following the HCA's about. All emphasis on CARE for the patient.But as others have said, if there is shortage of staff, how can nurses NURSE?

unlucky83 Tue 23-Apr-13 14:23:31

What about having to have work experience before being taken on a nursing degree course? So it can be as HCA for a year or an equivalent role....
I can see why this could be seen as necessary ...
I read somewhere recently (can't remember where) about a relative asking for help for a vomiting patient and the nurse said 'I have a degree, I don't do vomit' sad I'm sure (in fact I know) this isn't true about most nurses - just the bad examples get a lot of attention...
I actually think the whole thing is a result of professions like nursing/teaching/police being paid too much - got into a position that the state can't afford we end up with HCAs, teaching assistants and community officers to do a lot of 'their' work but at much cheaper rate...and some (emphasis here -probably young recently qualified) - then feel they are superior to their 'helpers' would demeaning to do their work...
And before I get flamed for that comment about being overpaid ...a lot of the reason for the increased salaries is inflated house prices...(thanks Gordon Brown!) ... with house prices doubling/tripling ...think a £50k house would cost you £3.5k a year (even with current low interest rates) - that house (now £150k) will cost you £10.5k a year more could earn £7k less and still be as well off...

well personally I think it is a great idea, I think it is the route most nurses used to take anyway, certainly most of the nurses I work with started as HCA's. I am a HCA and I love my job, however I feel that it is a role that is looked down upon as being for the unqualifed and uneducated. I have a degree, I am hoping to be a midwife one day butt I have applied twicce and can not get on the course, 1500 applicants for 48 places, how is this going to mean that there are not enpoough applicants. I am certainly not thick, I actually enjoy patient care and feel that it is an essential part of nursing, the thought that it is below nurses in astounding. (although I know not everyones opinion I have certainly heard it)

What about having to have work experience before being taken on a nursing degree course?

I'm yet to meet anyone who has trained in the last few years who didn't have relevant work experience! It is astoundingly competitive to get onto an NHS-funded course (midwifery, nursing, OT, ODP etc) and universities can already afford to be very picky about who they choose.

Making a year's experience as an HCA compulsory will do nothing to change the qualities of applicants and has lots of reasons for being a very bad, poorly thought out gimmick.

I actually think the whole thing is a result of professions like nursing/teaching/police being paid too much

Newly qualified nurses (or equivalent) start on 21K. How is that too much??! These are graduates who are expected to have graduate-level skills. There aren't many jobs in the private sector which are graduate-entry only and which pay so little.

Watto1 Tue 23-Apr-13 15:37:03

I did my nurse training 2004-2007.

A lot of people seem to assume that student nurses spend their entire time in a university lecture hall without ever setting eyes on a patient. In fact the course is precisely 50% theory/50% practice. You cannot qualify unless you have done the required practice hours and there are specific objectives that need to be achieved on each placement.

My first year placements WERE pretty much working as a HCA. I learnt a hell of a lot from the HCAs. However, if working as an HCA for a year was compulsory, it would have put me off applying to study nursing.

Plomino Tue 23-Apr-13 15:48:01

21k for a starting salary for nurses . 19k is now the starting salary for police officers who now , in order to be able to apply , either have to PAY to do a college course in policing studies , or work for a year UNPAID as a special , so they can get a years policing for free .

Looks like one idea fits all professions for this one trick goverment , doesn't it ?

I'm just waiting for the next profession be asked to do the job for a year for sod all . MP's perhaps . After all we're all in it together .

mouldyironingboard Tue 23-Apr-13 16:22:34

I think the problem is that a very few nurses have the wrong attitude for the job and need to be weeded out.

An elderly relative of mine died a few months ago. During his final illness most of the nurses were fantastic. Unfortunately, there were several who really didn't want to do the basic care of feeding, changing, turning and washing him. My family and I had to be at the bedside at all times day and night because we didn't know if there would be proper care or not as it depended who was on the ward.

Most nurses are extremely caring and professional individuals. They do a very worthwhile and difficult job under stressful conditions. It would be better to move the 'nurse ratchet' types into a job where they can do less damage to their patients than make all nurses do hcp training.

mouldyironingboard Tue 23-Apr-13 16:44:14

*hca training

than make all nurses do hca training.

But the irony is that there is no standard HCA training! Some hospitals have very good in-house training schemes, others do not. A HCA can be on the wards looking after patients on their first day in the job with no training at all. One of the recommendations of the Francis report was that HCAs should be properly trained and regulated but Jeremy Hunt has decided to ignore this and make student nurses work as untrained HCAs for a year. How will that help?!

FreedomOfTheTess Tue 23-Apr-13 16:50:47

I'm sorry - I don't mean to be rude - but I'm laughing my arse off at the comment about nurses, teachers and police officers being paid too much.

They are three of the most important jobs in our society, and quite frankly, to pay them any lower would be a joke.

It's bankers and their ilk who don't deserve their fucking sky high salaries.

Leave the nurses, teachers and police officers alone!

Quite. I was going to reply fuck off to that post but thought it would just be deleted grin

JakeBullet Tue 23-Apr-13 17:00:55

Arf @ nurses being paid "too much".

Come and try the job and THEN tell me nurses are paid too much. What a joke!

awaynboilyurheid Tue 23-Apr-13 18:38:43

Terrible idea, why no mention of poor NHS management and over worked nursing staff, no lets blame it all on nurse training, ridiculous.

Erebus Tue 23-Apr-13 19:05:27

I actually don't need to respond, aghast, to ..."actually think the whole thing is a result of professions like nursing/teaching/police being paid too much" do I? grin- others have done it eloquently, including the 'f' word.

83 it isn't a question of anyone feeling 'superior', it's to do with entry levels, responsibilities, legal positions etc. I am 'superior' to my band 4 Assistant Practitioner in that, as a band 6, if, whilst working with her, I fail to supervise her to the extent she screws up, I am liable. Call that 'superiority' if you like. I call it my legal position, and my responsibility to her.

Erebus Tue 23-Apr-13 19:14:59

And 83, shared ownership came in because the government of the day suddenly realised that HCPs/teachers/policemen etc were relatively so badly paid, many areas would be left without HCPs/teachers/police officers unless they acted to help these people onto the housing ladder, such was their low level of remuneration.

How about paying HCAs etc more to close that gap, rather than HCP less?

House price inflation wasn't a result of those nasty nurses (are you a DM reader, perchance??! Or maybe the Torygraph?) you know.

But one reason we have such rampant, run-away house prices is because we refuse, via our government, 'very relaxed' or not, to tax the hyper rich and/or multinational companies, terrified that they may not subsidise whoever's in power if we make them pay their way- they may leave !shock (to wreak the corrupting force that absolute wealth brings with it on someone else who also cannot see it as being anything other than a blessing...)- but, in fact, they were and are the top of that bubble when it comes to house prices- not those nasty nurses, buying up 3rd homes in Mayfair and charging their mortgages, effectively, back to taxation. Grr!

killerrobot Tue 23-Apr-13 19:16:30

Why not make pre-medical students do a year as an HCA as well?

That might be a less ridiculous suggestion if medical students received anywhere near the level of support and incentives to train that nurses do. Just to remind anyone that doesn't know, this is what is available for nurses...

All students on university courses in nursing leading to registration with the Nursing and Midwifery Council are eligible for financial help from the NHS while studying.

All eligible students will usually:

have their tuition fees paid in full
receive a £1,000 grant each year
be eligible to apply for an additional means-tested bursary of up to £4,395 per year. Students in London will qualify for more (up to £5,460)

While if you train to be a doctor you get, er...fuck-all. It's tuition fees all the way until final year when the NHS deigns to give a fees bursary. No grants or help with living expenses. Future doctors are already £45k-£56K worse off than nurses just in terms of fees.

Doobydoo Tue 23-Apr-13 19:27:17

Nurses don't do this sort of work anymore.I think it is a good idea so that they know what HCA'S do.It is also a way of getting staff in to feed people...It can take an hour to feed one person...we need people to do that.
Most wards have 2 or 3 nurses who run the shifts/do the medical stuff etc.

killerrobot Tue 23-Apr-13 19:35:39

Oh, and before anyone points out about doctors' high pay...

In the most junior hospital trainee post (Foundation Year 1) the basic starting salary is £22,412

That's very little more than a newly qualified nurse.

This isn't about doctors v nurses though. Both doctors and nurses do an amazing job in a difficult system. Both are relatively undervalued, though at least the government is prepared to help future nurses financially through their training.

Comments like this are really unhelpful:

Most nurses I've met have been lovely, and competent, the doctors have been offensive, high handed, and unbelievably arrogant.

You may as well say: 'most nurses I've met have had lovely hair and kind eyes, the doctors have been ugly, hairy and smelly' because it's equally meaningless.

scottishmummy Tue 23-Apr-13 19:53:56

It isn't a francis report recommendation.nor does it necessarily address poor practice
Pivotal is understanding duties,responsibilities and attitude to be good practitioner
Trouble was a minority neglected their professional codes with catastrophic results

foolonthehill Tue 23-Apr-13 20:05:50

There is another factor that needs addressing alongside the nurse:patient ratios in absolute numbers; whilst the ratios have been deteriorating, turn around time for patients has been decreasing so there are more acutely ill patients in each hospital ward with fewer and fewer relatively well people "convalescing" on their way out. This stretches nursing (and doctoring) staff even further as they have more to do on average per patient and even less time to get to know patients and their needs.

My local hospital has been on black alert for weeks now...there just aren;t enough beds. The care of the elderly team has 6 consultants and 3 main wards plus outliers. They are staffed for 250 inpatients (quite a LOT of people!) but currently have 381 do you give quality care in these circumstances i just don;t know.

My nursing friends are driven to distraction and run down and doctoring friends the same, even my local bed manager friend feels despair at the efforts that have to be made to squeeze this quart into the pint pot.

delivering quality care needs enough people, enough beds and somewhere for the "walking wounded" to move on to before home if they are medically well but not yet. All the care standards in the world won;t make a difference if you physically can;t look after the people.

Cherriesarered Tue 23-Apr-13 21:15:31

It won't work if the culture on the ward is crap care anyway. Nurses will just lean crap care.

unlucky83 Tue 23-Apr-13 21:20:15

Nurses etc don't generate income isn't they are paid too much for what they do it is just that the state can't afford to pay them the rate it does - so they replace them with people who are paid less...
If housing prices had been controlled (and they should have been that £21k would be the equivalent to £28k...I never said nurses were to blame for house price inflation - just it should have been controlled by the government and it wasn't...
Ten yrs go a postdoc researcher after studying for 7-8 yrs would have a starting salary of £18-20k - now it is £28k... But there isn't more money in the pot - so instead there are more postgraduate students who get paid less ...and too many post graduates being produced for the number of post doc posts ...

Now look outside the public sector workers get paid what they do and their companies still make money (or they wouldn't get paid what they do) - I don't think that's right ...and not sure how to deal with it (more tax but then they just getting bigger bonuses - but I guess pay more tax - so as long as you cut down on tax evasion/avoidance - maybe that is the way to go?)
In catering a (not media) head chef (locally) gets £20-24k - they are responsible for a team of chefs (managerial) , ensure the public don't get poisoned (and they can be personally liable if they do poison someone) and they are at the top of their profession...the reason they don't get paid more for the long unsociable hours in pretty horrible conditions is that people will only pay so much for a meal ...the business can't afford to pay more ...or they won't stay in business...
Look at workers in private nurseries how much do they get paid? Usually minimum wage - top of their profession is £24k - Average is less than £16k - and you trust them to look after your DCs but you wouldn't want to pay more for childcare...
The above is true for a whole host of professions ...
I said I would be flamed ...all I was trying to say is everything is out of sync and the only reason you don't feel/think you are paid enough is because you are not comparing yourselves to lots of people whose employment isn't state funded ...all made worse by having a massive outlay on accommodation...

Cherriesarered Tue 23-Apr-13 21:21:28

I need to qualify that comment. I am a researcher as well as having being employed in healthcare for 20+ years. When I started my training, people were in hospital longer, there were more beds, but certainly if you when back ten years again earlier, there was more time and more beds available. More time, more beds, more staff doing the right jobs, more appropriate movement back home. What this government, LIKE EVERY government fails to do is invest in high quality social care, therefore, when the community can't cope, the problem is transferred to the NHS. Better community care.

DH worked as a HCA (or their equivalent, back in the day) before training as a doctor. He says the only thing that it achieved was beginning the process of desensitising him to death. Other than that, he says he didn't gain much.

HolidayArmadillo Tue 23-Apr-13 22:02:41

Yes junior doctors start at little more than a NQN/M but after a few years their earning potential far outstrips a band 6 nurse/midwife.

I think the RCN put it best with their 'stupid' comment. Good experienced healthcares are worth their weight in gold, adding a year into the nursing degree to make unmotivated healthcares is one of the most foolish ideas I've ever heard of.

McNewPants2013 Tue 23-Apr-13 22:23:38

Interesting replys and I have got to say that I agree with the poster who say this policy is ill thought out.

I swear MN should have its own policitical party.

swooosh Wed 24-Apr-13 07:05:08

I thoroughly agree with it. The drop out rate of student nurses who've never done that sort of work before is very high.

swooosh Wed 24-Apr-13 07:06:46

frozen the best doctors I've worked with have previously done some sort of other healthcare work, be in as a HCA, qualified nurse etc. They work better within the multidisciplinary team and aren't as 'demanding' as some doctors can be. I'm talking junior doctors here btw.

HolidayArmadillo Wed 24-Apr-13 08:51:04

I don't think that having students do a year of hca'ing is the answer. I think there is something wrong with the interview process if you have a cohort with a high attrition rate. I'm quite involved in the student selecting process and its amazing some of the ones that get through to interview, they've obviously had serious help with their ucas application but have no idea of the actual role of the nurse or midwife, yet for everyone of those who slip through the net there's 10 who maybe haven't been coached how to write a personal statement who never even get to interview stage. There needs to be a more a more rigorous process.

Madsometimes Wed 24-Apr-13 10:01:25

I was in hospital for 10 days just over a year ago.

There were student nurses on my ward, and they were already doing the job of a HCA. They helped make the beds, organise meal times, and were generally just around to have a chat. They also did routine obs. Of course, they also shadowed the nurses doing medication rounds, but I do not recall that were allowed to this job on their own. Since there was one nurse to 8 patients during the day, the nurses definitely needed help. They simply didn't have time to chat to patients.

The length of hospital stays has reduced so much, that to be in a hospital generally means that a patient has to be very sick, and unable to do much for themselves. So nowadays ward nursing must be harder, because there just are not the convalescent patients that there were perhaps 30 years ago. You just have to think about times that people stay in hospital for surgery. I didn't have c-sections, but those who did had about 3-4 nights in hospital, compared to 2 weeks when my mum was young.

KevinFoley Wed 24-Apr-13 10:39:42

As an old git who has worked 25 years in the job I feel qualified to comment. This is a knee jerk poorly thought out proposal. The problems are not with nurse training or lack of compassion and knowing one's place, but the following:

Complexity and breadth of role has increased dramatically and nursing has lost it's identity.

The role of the nurse over the past few decades has changed enormously. it is now in many/most areas a highly skilled technical job and these tasks are hugely time consuming. Junior doctor hours are much less and as a consequence they are less experienced and nursing takes up the slack in terms of both tasks and assessing/monitoring/treating acutely unwell patients. As well as being a technician and junior doctor nurses are expected to do a myriad of other jobs- complex social and psychological care, delivering complex information and education to patients and carers, then the traditional nursing tasks of washing, dressings, making beds, feeding. They are made to complete overly complex paperwork, answer the ward phones, all the while being continually interrupted by relatives, physios, doctors, pharmacists, support staff, etc. They are also expected (in their own time) to undertake masters degrees to progress to any senior grade, while other non nursing staff can get to that pay grade without comparable qualifications.

Patients are sicker and staffing ratios are the same

Our parent's generation spent 10 days in hospital following a normal uncomplicated childbirth. This would mean caring for patients who were completely well. Nowadays these women are discharged the same day. This practice is reflected everywhere. The only people allowed to be in hospital are really, truely unwell and dependent. But staffing levels are no better than when I qualified.

Nurses are lowest profession in the hospital pecking order

If you nurse in a hospital you are basically treated as a slave to be ordered around, by managers, corporate nursing, medical staff, other professions, patients and relatives. Nurses are under represented at every senior level and at best there are token representatives on boards who haven't nursed for 20 years and are chosen as they won't challenge the agenda. Nurses who speak out about poor standards find their words are dismissed and then they are branded troublemakers and treated terribly. Hence the type of situation that developed at Stafford. I can recall hundreds of episodes in my high performing trust alone where nurses spoke out and their concerns were trivialised then they were demonised. Corporate nursing also makes it very difficult for nurses to progress, putting academic obstacles in the way of progression without the support to achieve them, not supporting job plans which might release nurses to research, supporting the concept that the nurse can be and do everything for patients with no additional resources in place.

I would not recommend nursing to my daughter or anyone who asked me and yet i loved the job when I started. There are much easier careers available for better money and satisfaction. Do not underestimate the ability to go home and sleep peacefully. Mine is continually interrupted by feeling one might have made an error costing me my job and more.

Pobblewhohasnotoes Wed 24-Apr-13 11:21:08

Very well put KF.

I genuinely don't think that people have a clue what a nurse's job involves these days.

Plus3 Wed 24-Apr-13 11:24:18

Excellent post KevinFoley

I will say though, that I know that I am appreciated at work by my medical colleagues and by the families I care for. It is the only reason I continue to nurse.

I can hold my head up high and say I am proud to do the job I do, but agree that I won't be encouraging my children to enter either Medicine or Nursing as a career.

TheBigJessie Wed 24-Apr-13 12:00:48

Sounds like free labour to me. hmm I believe the majority of nurses do care. They're horrendously overworked, and expected to do everything, (from answering the phones and giving up-to-date information to each and every one of Mrs Marsh's children, none of which are speaking to each other to administering drugs to 24 patients).

The wards are under-staffed.

Sidge Wed 24-Apr-13 12:07:44

It's a ridiculous idea.

Qualified nurses (on the whole) know exactly how to deliver basic nursing care - it's the core of nurse training. They don't need an extra year tagged on before their degree to learn how to work as an HCA.

The problem is that there aren't enough qualified nurses on wards, they don't have the TIME to do basic nursing care.

Nursing has changed radically since I qualified in 1996 - nurses are more like junior doctors and there are fewer of them staffing wards now; most hospital nurses I know would love to have more time to spend with patients doing basic care but they are tied up doing stuff only a registered nurse can do which leaves the care work to HCAs. That doesn't mean they don't know how to do it.

Sidge Wed 24-Apr-13 12:17:41

Just read the 'nurses are overpaid' comment! Ha ha ha!

I'm a practice nursing sister. I work in primary care, I'm an independent practitioner. I'm highly qualified, have a specialism in respiratory nursing management and many years of experience.

I get paid per hour what many of you pay your cleaners.

Perhaps HCA's could be better trained to offer more support to patients ? - I'm thinking of my experience on the post-natal ward when I'd just had my first baby, and I would have really appreciated someone spending just a few minutes with me asking how things were going & how I was feeling. I felt there was a real un-met need for some emotional and social support - just a friendly approachable person with a little bit of time
The only questions I was asked focused on the physical.
Holistic approach sooo needed on post-natal ward !

And actually if any changes are needed in nurse training I think it could be to spend more time looking at emotional and social support of patients
(Trained as psychy nurse in late 80's)

LessMissAbs Wed 24-Apr-13 12:27:01

flangledoodle Nursing is not a vocation, it is a career like any other. Nursing degrees take 4 yrs, so with this extra year training would effectively take 5 years - the same time it takes to train as a doctor

If it now mainly requires a vocational degree to do it, it is technically a vocation. Doctors take a minimum of 7 years to be trained, as do solicitors - both do two years post-degree vocational training "on the job" before being considered fully qualified.

Most solicitors in fact work for two years on the Law Society recommended minimum salary, starting off at less than £20,000 after 4 or 5 years at university.

Pobblewhohasnotoes Wed 24-Apr-13 12:29:08

The problem is that there aren't enough qualified nurses on wards, they don't have the TIME to do basic nursing care


But it won't change, as providing more staff costs money.

I have friends (also children's nurses) who have to look after 10 patients each. How is it possible to provide even the basic level of care?

HolidayArmadillo Wed 24-Apr-13 12:45:33

Argh! Nursing/midwifery is a vocation is just another way of saying ' you should do it for the love of it not the money, give your all to it'. Nah fuck that. It's a JOB! An amazing job where you can do a lot of good but it is a degree level profession that people work damn hard to qualify in. It's not a pissy little job where if you work really hard and you're a nice girl who is selfless and dedicates herself to the greater good you'll get a little pat on the head. It's not a way of life, it's a job and we should be entitled to do our job to the best of our ability.

Sorry. I'm not being very articulate but generally when people smugly say 'its a vocation' generally they're a martyr to the cause which helps no one.

TheChaoGoesMu Wed 24-Apr-13 12:51:49

Sounds like a cost cutting exercise to me.

DizzyZebra Wed 24-Apr-13 13:11:03

I can see benefits, but how is it going to help care when they won't take on more staff?

And tbh, some people are just arseholes, a year of having to be good at the bottom isn't going to change that for some.

The nurses I know would be fantastic with or without this.

DorisIsWaiting Wed 24-Apr-13 13:53:01

Bravo KevinFoley really well put!

I left nursing as I wasn't happy with the standard of care I was being forced to give, due to the other pressures on my time and a ridiculous staff Patient ratio.

This policy is effectively the emperor's new clothes. Student Nurses primarily spend their first years at uni and on ward placements learning to care for patients, the specialist (A&E / ITU/ Burns etc) knowledge largely comes post qualification.

I can still remember feeding and being fed by fellow students before going to the wards (first few weeks of uni) so we knew how it felt to be vulnerable and fed (think we were blindfolded at one point too).

The biggest problem facing the NHS is sicker older patients, low staffing levels and a lack of beds so everything has to be done yesterday with no time for patients.

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