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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:
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x2boys · 25/11/2019 12:24

my friend is doing a nurse associate course she still.seems to have a fair bit of academic work ,in fact it seems to be more academic then my project 2000 ,diploma in the 90,s ,I don't think the role is properly defined yet though.

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TheCountessatHotelCortez · 25/11/2019 12:26

I am currently a HCSW in community nursing and am desperate to do my nursing. Unfortunately going to a brick uni full time will not work at the moment with young children so the open uni is ideal for me. I applied and got to interview stage but then didn’t get a place because of lack
Of spaces, no because I didn’t do well at interview or because they didn’t think I was suitable but because of no space. Perhaps make more spaces available to those of us who can’t go to uni full time

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Kazzyhoward · 25/11/2019 12:39

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

Can't they? Any links? My niece has been trying for a couple of years to get onto a Uni course, but despite having the required qualifications can't get offered a place. The feedback from the Unis she's applying to is that they're grossly over-subscribed. I wonder if it's a regional thing? Are there any areas where the Unis are known for being short of applicants - I think she'd be willing to move just about anywhere.

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MrsCasares · 25/11/2019 12:39

A thousand times no. Nursing should be a degree profession (and this comes from a retired SRN SCM who trained in the traditional way.

Nursing is a much more complex profession than it ever was in my day. Patients have more complex needs, patient turnover is far higher, nurses do junior doctors jobs.

We need to get to the nitty gritty of why so many nurses are leaving the profession. My guess is that they are so abused by the system - long days, no breaks whilst on shift, poor staffing levels etc that they throw in the towel. Recruitment is one thing, retention is so much more important in my humble opinion.

Research has shown that patients fare so much better mortality wise the higher the education of the nurse caring for them.

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Stompythedinosaur · 25/11/2019 12:48

I think that paying nurses properly and treating them better would have a bigger effect.

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doublebarrellednurse · 26/11/2019 20:08

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.


The mid staffs report would have triggered the neglect course. A lot of the nurses there in that report, if you read the NMC reports had over 15 years as nurses. Long before the degree came in.

What's hilarious when this gets trotted out though is the bit about degree nurses not seeing patient care as part of their job unlike those heroic nurses before them. Cause who signed off the degree nurses placements? Those who were in the jobs before them.

Failure to fail is on the experienced nurse and not the trainee.

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doublebarrellednurse · 26/11/2019 20:13

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.

All unis are different but most have a placement in the first 3 months of term. I started in Sept and was on placement by Oct.

There's approx a 40% drop out rate/failure rate. Plenty realise it's not for them (or are told it isn't)

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RandomMess · 26/11/2019 21:20

Presumably the number of degree places is restricted by the number of student placements available.

I wish the universities could work with hospitals to offer some sort of pre degree course camp/summer school to raise awareness and get some experience prior to starting a degree course.

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Elieza · 26/11/2019 21:56

Nurses who qualified in their home countries where English is not their first language need to do a conversion course over here to work as nurses here.
A couple of years ago at Indian friend wanted to do this but there was not a single college or university in the whole of Scotland doing the course.
He left and went abroad elsewhere to continue his nursing career as all he could get here was minimum wage hca jobs. Sad. So many capable nurses that just need a course.

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ironickname · 26/11/2019 21:59

I imagine that paying them a decent wage would help. Nurses are massively undervalued, no doubt because it's a traditionally female job.

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Stupiddriver1 · 26/11/2019 22:05
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Reallybadidea · 26/11/2019 22:08

You're massively missing the point OP. There's no problem getting people to apply to train as nurses, it's having the capacity to train them which limits numbers. And then retaining them afterwards when working conditions are shit and pay is relatively poor, especially in the most expensive parts of the country.

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ListeningQuietly · 26/11/2019 22:17

THe 50,000 new nurses comprises
18000 forced to retire later
20000 brought in from abroad
7000 who are already in training
and only 5000 new funded places

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Stompythedinosaur · 26/11/2019 23:58

I firmly believe that the crux of the nursing shortage is difficulties in retaining staff. My colleagues are leaving in swathes. Pay nurses fairly for the work they do, tackle the understaffing and ideally stop people assaulting us regularly.

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LucheroTena · 27/11/2019 09:16

This is one of the daftest suggestions I’ve read and it’s embarrassing that it’s come from a nurse.

We should be arguing for MORE education for nurses, not less. Sick patients need their main advocate to be a critical thinker and with education and status on a par with the other HCPs involved in their care. There are lots of specialist nurses now and it’s essential they are properly educated and active in research.

I trained in the bad old days. We were constantly reminded that our training was inferior to our HCP colleagues, ALL of who were degree educated. It made it very difficult to have an equal say in patient care, or to argue for better pay. That prejudice is still in play today and it was a big mistake not to move straight to degrees with project 2000. We’re still catching up in the hierarchy and people still think we’re mere bum washers and should know our place. The reality is an experienced nurse makes high level decisions, is autonomous and often advises and teaches other HCPs.

Most of us got our degrees later on and it was much harder to work full time and study and took years to ‘catch up’. It makes practical sense to get the degree upfront.

There are several routes into nursing including an apprenticeship. Yes the bursary needs to be brought back to encourage mature students to train. Nursing degrees are heavily practical, alongside the college time students are on regular clinical placements. This is why a bursary is essential as nurse students have very little ‘spare’ time to take a job alongside university.

The main issue for the NHS is retaining nurses. They are leaving in droves and the Brexit vote put EU nurses off. The nurses left struggle with massive short staffing and the only patients allowed to be in hospital are really very sick and high dependency. The working conditions are intolerable and pay is poor, stagnated and subject to national pay bargaining. A massive problem if you live in an expensive part of the country like London.

So the nurses who are recruited and survive their training are then met with awful working conditions. For many it is unsustainable to work as a nurse in the longer term. I haven’t even started on the hierarchy and bullying that is endemic in much of the NHS.

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NoIDontWatchLoveIsland · 27/11/2019 09:58

I think its important that the qualification of being a registered nurse is on a par with a degree, but i think university led degrees are an expensive and unnecessary way to deliver that. On the job, in hospital training is so much more crucial for the role (as it is with doctors).

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LucheroTena · 27/11/2019 10:10

But they get lots of ‘in hospital’ training, both during their degree program and then as post grads. It wasn’t cheaper in the old system as hospitals had to fund their own nursing schools and employ staff to run them. That was far less efficient. The system I trained under was bloody awful educationally and pretty much everything was learned on the job. It wasn’t sufficient preparation.

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Abraid2 · 27/11/2019 10:16

Isn't bringing back the bursary a TOry manifesto pledge?

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Namechanger001 · 27/11/2019 10:18

We're not all degree trained at the moment. I'm not- I'm a diploma level and I have no interest in topping up to degree in my own time for the same pay doing the same job I am currently doing. There is no benefit of me being away from the dept to get my degree to do what I can currently do.

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CAG12 · 27/11/2019 10:30

@CurryBelly please come back to this thread! I think its really interesting

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Rosehip345 · 27/11/2019 10:31

I think they should do a training on the job. I don’t really understand how this would undervalue nurses? They’d all end up qualified to degree level but more people would be able to afford to train if it was like a paid apprenticeship plus rather than ‘placement’ experience they would gain real experience.
Another poster said earlier how everyone would be up in arms if we suggested this for other professions such as teaching. As a teacher I disagree immensely. This is already happening, I trained in this way. I gained real experience which was totally different to the ‘placements’ I also went on. I already had a degree but as I had a small baby going back to uni and not having pay was simply not an option I could afford. I was paid an ‘apprentices’ wage until qualified and then progressed through normal pay scales.
I am one of those teachers that the stretched education system wouldn’t have had, had it not been for this method of entry. We desperately need nurses, plenty more potential ones I imagine could be gained if it were more accessible in this way. Going straight to uni is fine for those without dependents or that don’t need an income, but we’re missing out on so many.

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LucheroTena · 27/11/2019 10:36

They do train ‘on the job’, the university degree is packed with clinical placements. What do you mean by “qualified to degree level”, people either have a degree or they don’t. I agree that nurses need to be paid with a bursary while training as it’s so time consuming. APEL-ing course credits to make up to a degree later on while working on wards full time is really inefficient and hard work and has put a lot of nurses off further education.

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ListeningQuietly · 27/11/2019 10:37

50,000 nurses
of whom 20,000 will be stolen from the education systems of other countries

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Rosehip345 · 27/11/2019 10:43

Those without the degree would still be working as nurses, they’d just be on a lower pay grade with less responsibility. Plus those that may struggle academically could learn more gradually if needs be.
Rather than a bursary, pay an actual wage for actual hours.
It is gruelling I agree, but it’s a way in for those that want to get into the profession that wouldn’t afford to otherwise.

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tillytrotter1 · 27/11/2019 10:45

A relative of mine was in a senior position in a large hospital when this system of graduate nurses first started and he predicted exactly what's happened. If a person has to study to such a high level then they will be unwilling to undertake some of the traditional nursing roles, bed baths etc,.
Under the system of a matron, think Hattie Jacues if you're old enough, ward sisters and SENs there was a clear line of command in the hands of people who knew nursing. It's now in the hands of the untrained management.

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