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To think the nursing crisis could be helped by

257 replies

CurryBelly · 25/11/2019 07:30

Going back to the old secondment system?

Get rid of the degree requirements, train HCAs, pay them whilst they work. Keep the degrees for nurse prescribers and specialist nursing.

I’m a nurse and have always found that most HCAs would make better nurses that the people fresh out of uni, some of who have very little caring experience.

Going to uni, especially without the bursary is just impossible for a lot of people who would make excellent nurses. The associate program seems to be doing well but I think we’d encourage far more people into nursing if we scrapped the degree

OP posts:
brummiesue · 25/11/2019 08:25

Absolutely not! Nurses have worked hard over the years to be recognised as a profession. Jobs in advanced nursing (eg prescribing) usually require training to masters level anyway now. If people cannot manage with the degree level requirements then they can try for a band 4 associate practitioner role. It is so frustrating when people try and send nursing back to the 70's!!! Things are so different nowadays in terms of expectations and opportunities, none of which are possible without a good academic base.

TheFairyCaravan · 25/11/2019 08:27


DS2 and his girlfriend are both nurses with degrees. They did a lot of caring hours as well as uni work. They were lucky enough to get a bursary but it wasn't enough for either of them to live on. The Govt should bring it back and increase it.

When I go into hospital, which I do frequently, I want people capable of passing the exams looking after me. If someone said "let's solve the teacher crisis by teaching TAs on the job" people would be up in arms, and rightly so.

x2boys · 25/11/2019 08:28

I trained between 1993 and 1996 too Geekster , under project 2000, I'm not sure the bursary was ever enough to live on though !

weaselwords · 25/11/2019 08:34

I’m quite interested to see what comes out of the apprenticeship route. I think it may be a good way of getting people into all areas of health care at both degree and MSc level, but without the high cost to the person doing it.

x2boys · 25/11/2019 08:35

Student Nurses have always had to pass exams though even before diploma training became the norm and people still.had to have five Olevels or Gcse,s at grade C or above or Pass the DC test to be able to train as a nurse .

SpotlessMind · 25/11/2019 08:37

Nursing is a complex profession that requires critical thinking as well as caring skills - it requires degree level skills. Not for a second am I suggesting that an HCA won’t have those skills but the only way to ensure it is for someone to be evaluated at degree level. HCAs can (and do) train as nurses, there is nothing to stop them doing that. I Excellent HCAs are excellent at their jobs, why do we want to covert them all to nurses? Maybe we should value the title HCA a bit better and create more opportunity for progression within that role.

doublebarrellednurse · 25/11/2019 08:39

The way to solve the nursing crisis is to respect the work that nurses do. I have read countless handwringing threads on here about DC who want to do nursing instead of medicine and how should their DM persuade them not to!

Absolutely this. I manage the care of 14 very complicated ladies. I don't have a doctor instructing me I run it. Lots of nurses are in this position but it's degree level training that allows us to be more than carers and actually direct care.

We would be devaluing the profession entirely if we took away degrees. Nurses are expected to understand pharmaceutical interactions and pharmacology, plan and execute care, lead change and ensure quality, we are an evidence informed profession which needs to be constantly learning. My CPD adds up to nearly 600 hours this year alone.

It was made a degree profession to ensure quality. It says something that there is a 40% drop out rate, from my course that was generally 18 year olds who had no idea what they were walking into. Those who had been HCA did very well (myself included).

I know academia is not for everyone which is why the courses are split. 2300 hours practice and the same in the classroom. I ended up with nearly 2800 hours practice as they build in extra and I did a summer placement.

I had help with academics as am dyslexic and was more than supported. Ended up with a first class BSc and on to a MSc in adv practice.

I truly believe if you're going to be in a position to keep people alive, sometimes autonomously you're not going to be taken seriously or have appropriate levels of knowledge without a BSc at least. As for pay...can you imagine if it wasn't a degree profession?

SimonJT · 25/11/2019 08:39

My cousin is a nurse, she works with some nurses who wouldn’t be academic enough to have trained via the degree route. Three that she regularly works with are unable to calculate basic things such as percentage body weight loss.

Deskilling nurses will not at all be beneficial.

polkadotpixie · 25/11/2019 08:40

I would love to be a nurse. I currently work in the NHS as admin and I have a degree so I am capable of degree level work but I simply cannot afford to do another 3 years at uni unless they bring back the bursary, hopefully they will and I can actually do it!

I know the bursary isn't much but at least I wouldn't be accumulating debt whilst training

Selfsettling3 · 25/11/2019 08:44

If you lower the qualification level, wages will be lowered even more through lack of pay rises and this will increase the people leaving.

Ellapaella · 25/11/2019 08:47

The new nursing associates are precisely this. I'm not sure we need to go back to taking away the academic side of nurse training g but I do think that tuition fees should be scrapped.

TheBigFatMermaid · 25/11/2019 08:47

Every other professional that nurses interact with has a degree! Why would a nurse, who is the coordinator of all other services, be less qualified than those they are dealing with?

TheFairyCaravan · 25/11/2019 08:49

When I did Project2000 in 1992-1994 (I left because DH was posted and I was pregnant) my bursary was £360 a month. DS2's qualifies 18mths about and his bursary was £348 a month, his girlfriend got £80 a month because she lived at home and because it's means tested.

TheFairyCaravan · 25/11/2019 08:50

*DS2 qualified 18mths ago. It should have said

WhizzingFizzbee · 25/11/2019 08:50

A lot (if not all?) nursing degrees require a certain number of hours of care work for admission, it’s not academic entry only.

Nursing now is not the same as in the 70s, we do a lot of jobs now that were previously done by junior doctors. A lot of it is patient management too, when I was on the wards the HCA’s and probably now the nursing associates would be the ones giving personal care as that’s mainly what they do. Not that we don’t know how obviously, it’s just that we have other things to be getting on with that are more complex.

Orangesox · 25/11/2019 09:30

Absolutely not! Good lord, we’ve just about clawed our way up the greasy pole to the point that some (but not all) would consider nursing a profession rather than a vocation.

I get it that some people have a wonderful caring nature, and I’m sure would make excellent healthcare assistants, assistant practitioners, nurses etc. But the simple fact is, that nurses are no longer “the hand maidens of Doctors”, modern nursing requires high levels of education and critical thinking skills as a bare minimum, both of which can be learnt, but certainly not by osmosis of being physically in a healthcare environment. Caring and being academic are not mutually exclusive neither unless there is there some level of insinuation that Nurses are not intelligent enough to be both, and that only those who are both caring and academic go on to study medicine? FYI, the 2300 hours of practical hands on experience during their degree should remedy concerns about little caring experience Hmm

Equally so, without wanting to be hideously offensive - if someone can’t cope with the pressure of an exam, I really cannot comprehend how they can cope with the pressure of a career in healthcare...

Are there issues with the current system? Yes! But I don’t think downgrading the profession is going to do anything for that!

Would I like to see clear progression opportunities for HCA’s and AP’s to be able to study further to obtain a Nursing degree? Absolutely!

Do I think this country undervalues it’s nurses leading to mass outward migration, poor uptake of nursing places and nurses leaving the profession in droves? Yes I bloody well do!

Geekster1963 · 25/11/2019 09:34

x2boys I think it was enough for me especially for the first 18 months when we were allowed to live in the nurses accomadation. We got £360 a month and paid £60 for the accomadation. So that was all bills apart from food. I didn't have any outgoings then like a car. It was a bit more of a struggle when we moved into a shared house but I managed.

ClockworkNightingale · 25/11/2019 09:42

If your nurse has a bachelor's degree, you're more likely to survive your stay in hospital. Healthcare has become more complex and demanding over the last several decades, and although nurses who trained under previous systems have had time to grow and adapt with the system, novice nurses need the theory of a degree behind them to cope.

I think it would help if hospitals offered return-to-practice courses with guaranteed term-time only contracts at the end. Hospitals really need to tap into their ability to offer nurses flexible working; I honestly think it would be a big draw.

Beseen19 · 25/11/2019 09:49

As said before you need 2300 hours supervised ward experience to qualify. If you are not 'caring' enough then that should be weeded out through placement learning experience. There are some amazing HCA's out there and many of them do go through to do their degree especially in Scotland. However there is a massive difference between the role of a registered nurse and a healthcare assistant, the responsibility and management of care. Making nursing no longer a degree subject would be incredibly dangerous.

Everyone struggles out of uni as there is a big jump from being supervised by a mentor to going it alone as a responsibly practicing nurse. It is nothing to do with care experience.

geordiejock · 25/11/2019 09:51

Some of the best nurses I ever worked with didn't have degrees, once it became a requirement those with degrees often saw patient care as beneath them.

Then we were all sent on a course to remind us NOT TO LET THE PATIENTS DIE OF HUNGER AND THIRST! I assume they didn't learn this whilst doing their degrees? I know loads of people with degrees I would trust to clean my toilet.

geordiejock · 25/11/2019 09:52

Would should say wouldn't.

QueenofmyPrinces · 25/11/2019 09:55

The nursing crisis isn’t related to entry to the profession.

The NHS is in such a bad condition that nurses are stressed, over worked, exhausted, ill and working under extreme pressure and probably in unsafe conditions (all for no reward or recognition) to the point that nurses are leaving the profession. It’s unworkable and nurses all over are struggling. The above problems exist whether nurses are degree trained or not.


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Toddlerteaplease · 25/11/2019 09:57

I don't think that the new Nurse associate thing is the answer either. I want proper nurses not ones who can only do half the job.

Toddlerteaplease · 25/11/2019 09:59

I agree that the bursary needs to be brought back. The standards of some of the students coming through my local school of nursing is terrible. I don't know how some of them get accepted in the first place!

fedup21 · 25/11/2019 10:01

No-keep nursing as a degree entry job but scrap the fees.

Same with OT, radiography, physio therapy, speech therapy etc

Two of my kids would do those degrees and work for the NHS if the fees were gone.

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