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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:
DaisyDreaming · 25/11/2019 10:07

As a patient I would prefer to see more education! I’ve met some amazing knowledgable nurses who not only are extremely caring but know their stuff well (better than the doctors in some cases). I’ve also met nurses who are shocking and I have no idea how they passed the exams, in one small hospital I would only let the Spanish nurses and the old oncology nurse (English) do one of my procedures as the uk nurses who didn’t specialise were shocking! It was interesting hearing the difference between the Spanish and uk training. The Spanish nurses are trained to a much high level medically but don’t do personal care and all the caring side of nursing (to generalise)

Just want to add i think nurses are amazing from all countries!

ItMustBeBedtimeSurely · 25/11/2019 10:10

I believe a large scale study showed a 7% reduction in patient mortality for every 10% increase in number of degree educated nurses - how on earth anyone can look at that an argue for downgrading nurse education.

I think the real problem is the image of nursing- so many people have no real idea what we do and the amount of responsibility we take on. The old doctor's handmaiden image is alive and well.

I absolutely love my job but it makes me despair to see how people who have no clue view us sometimes.

riotlady · 25/11/2019 10:11

No, just bring back the bursary!

SheOfManyNames · 25/11/2019 10:38

No, keep the degree.
But: Bring back a bursary system for nursing, teaching, social work etc, (or at least the government should pay the tuition fees) and encourage people to stay with smaller staff:patient ratios and better pay (for all grades/levels, not just registered nurses).

Kazzyhoward · 25/11/2019 10:43

Let's back track a bit. Are the nursing courses vastly under-subscribed? Are the Uni's struggling to fill their courses?

If not, then I'd say there's no problem with recruitment, so no need to reduce the entry requirements/degree entry system.

Now, IF, Unis are really struggling to fill places, and having to make low offers to get people on their courses, then that is clearly a completely different issue.

If nurses are leaving the profession once qualified/experienced, then that's nothing to do with how they got there in the first place, it must be working conditions etc which are completely different from entry systems.

Let's target the real issues, but to do that, we need to evaluate what those issues are.

EleanorLavish · 25/11/2019 10:43

HCAs should definitely be allowed to progress and expand their role and skills. I my dept and hospital they are very against HCAs going above a Band 2. Its completely ridiculous, and the HCAs just move on to areas where they can get Band 3 and work up.
I would also be up for bringing back a type of EN, perhaps HCAs could work up to that?

Kazzyhoward · 25/11/2019 10:45

how on earth anyone can look at that an argue for downgrading nurse education.

Surely nurses can be educated to the same standard without spending 3 years at Uni first? Why can't the same standard be achieved by working "on the job"? Lots of other professions don't have Uni Degree entry requirements. Lots of qualified/chartered accountants for example havn't been to Uni, but their qualifications are higher than a standard degree.

Kazzyhoward · 25/11/2019 10:46

Sounds like nursing needs different routes to full qualification. I.e. a fast track route following a Uni degree, or a longer/slower route without. Just like many other professions. There needs to be a way for people to progress who havn't been to Uni rather than artificially hold them down.

bevelino · 25/11/2019 10:48

The conservatives say they are going to recruit 50,000 more nurses. Does anyone believe that will happen?

RandomMess · 25/11/2019 10:49

I agree that nurses should have a degree however I think it should be obtained whilst on the job with the first year being in a HCA role so those who realise it isn't for them find out sooner rather than later.

Bring back the bursary for the fees so yep basically the apprenticeship scheme and stretch it out to 4 years if need be.

ItMustBeBedtimeSurely · 25/11/2019 10:50

Because a degree is about critical thinking and weighing evidence. Its critical that nurses can do this, more so than accountants.

And it's also about professional status - how can nurses be the only healthcare professionals without a degree and yet not lose status? And if that happens, they simply cannot advocate and challenge as they need to.

Velveteenfruitbowl · 25/11/2019 10:50

Absolutely agree! There is no reason to demand a degree when a lot of people prefer learning alongside their work. You could even spread the degree across several years so it becomes a part of an apprenticeship. It would make the profession more accessible and the training would arguably be of a superior quality.

Velveteenfruitbowl · 25/11/2019 10:52

@ItMustBeBedtimeSurely you don’t need a degree to be a professional. You can become an accountant or a lawyer (which arguably requires far more critical thinking that nursing, especially in litigation) without a degree.

ItMustBeBedtimeSurely · 25/11/2019 10:57

Well arguably yes, although tbh I wouldn't want a lawyer or a nurse without a degree.

brummiesue · 25/11/2019 11:00

Why on earth should nurses have to work at HCA level for a year @randommess ? That would have sent me running to the hills during my training. If you are more than capable of working at degree level - which many many people are - what help is wasting a year of your training doing washes and obs (massive generalisation I know but students wouldn't be able to do any 'advanced' HCA work like bloods etc). Once on placement and doing many HCA jobs combined with the qualified ones. you will soon realise if its not the profession for you.

CAG12 · 25/11/2019 11:04

For everyone who says they want nurse training to be 'on the job' - a great proportion of the nursing degree is spent in placements. Its just interspersed with degree level modules. What other 'on the job' training would you like? Surely this IS 'on the job' and achieving a degree at the same time?

Beseen19 · 25/11/2019 11:12

@Kazzyhoward the 3 year uni degree is 50% on the job. 2300 hours on a full time basis constantly assessed by mentors. You are at uni from sept to Jan to learn the very basics (vital signs, hand hygiene, anatomy and physiology) then out on placement from a few months into first year. It is essentially an apprenticeship with day release to college however a little differently structured.

There are many routes into nursing, straight into uni if you have the grades, access to nursing through college, open university for healthcare support workers through the NHS. People aren't excluded due to not getting the required A levels/Highers. However there is a level of education required for the responsibility of the job and the nurses who I trained with who didn't meet the standards but were allowed into uni through clearing unfortunately did not have the knowledge to back up their work on the ward and not only struggled with passing exams but also passing placements. These standards need to remain in place.

RandomMess · 25/11/2019 11:13

I guess in the cohort of 2nd year nurses I knew many were still saying "can't stand the sight of the blood", "can't cope with the smell of shit" and so on...

TBF doesn't need to be a year at that level but I think x weeks before they set foot in a classroom would beneficial.

I think it's unfair that so much of the degree is placement based on shifts yet they have to pay full fees!!! Not sure how many have the time to get any sort of part time job to help fund their way through.

So much of the decision to make it a full time degree, as with policing is about government statistics drives me crazy.

Selfsettling3 · 25/11/2019 11:14

Velveteenfruitbowl we don’t have lawyers in England, do you mean a solicitor or barrister?

QueenofmyPrinces · 25/11/2019 11:18

I wonder how many people would be happy
for doctors to just “learn on the job” and not require a degree.

That goes for any health care profession really.

There is no real respect for nurses, their roles, their knowledge and the huge part they play in making decisions about a person’s healthcare hence why some people think that a degree isn’t seen as necessary. I guess we are viewed as just we gloried carers and anyone can do that with a bit of “on the job” learning....

It’s pretty insulting really.

RandomMess · 25/11/2019 11:24

Perhaps what is needed is education about the roles of the various HCA grades, then Nursing Grades?

I don't think it's widely understood that the nurses of today having clinical roles not imagined of decades ago?

SheOfManyNames · 25/11/2019 11:26

You can learn many things "on the job", in fact many of the practical skills can only be learnt by doing them on real people on placement.
But for others, you need to study in a classroom, with a qualified teacher. And even in the 1960s, the time that some people want to go back to, student nurses had theory lessons in a classroom and exams.


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Stupiddriver1 · 25/11/2019 11:31

You don't have to get rid of the degree but you can make changes to make it more accessible. Generally about removal of fees and a change to the loan/bursary.

He's not going to find 50,000 nurses and is deluded if he thinks he can. I'm sure he knows he can't but it's a good soundbite. But if he says unsubstantiated shit about this sort of stuff what else does eh bullshit about?

Most unis struggle to fill their spaces on nursing degrees since intro of fees. I've worked at 2 different unis who both struggle - one has made cuts to nursing lecturers because of drop in numbers. Conditions on the wards are dire and nurses leave faster than they can be replaced in some areas.

RandomMess · 25/11/2019 11:33

I have just assumes the apprenticeship route still has classroom teaching??? Surely it has to?

The biggest barriers are indeed the financial ones.

Stupiddriver1 · 25/11/2019 12:02

Local hospital has just under 400 nurse vacancies! 400!!!!!!!

They can't recruit. Nothing wrong with the particular hospital as such. So must be a similar story elsewhere. There just aren't unemployed qualified nurses looking for work.

The unis can't attract enough for the spaces they currently have, so increasing numbers is stupid talk.

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