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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.

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.

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.

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

Sounds like a cost cutting exercise to me.

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.

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?

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.

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)

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 !

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

FrozenNorthPole Tue 23-Apr-13 21:52:10

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.

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.

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 21:15:31

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

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.

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