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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:
Reallybadidea · 27/11/2019 15:13

@IheartNiles I totally agree that losing the bursary puts off mature students and that their life experience is very valuable. Is there any evidence that they are less likely to quit nursing than younger newly qualifieds?

I trained in an allied health profession as a mature student - tiny sample size I know, but of the 20 people who started my course 2 dropped out before qualifying (mature students), 2 never worked in our profession after qualifying (both mature students) and 2 of us left within 5 years of qualifying (both mature students). AFAIK all the young graduates are all still working.

endofthelinefinally · 27/11/2019 15:16

I ended my working life as a band 7 clinical nurse specialist. I have taught and trained medical students, junior doctors, GPs, HCAs ,nurses and lab technologists.
I would bring nursing training back into university teaching hospitals with a basic wage, longer training time to allow sufficient time for lectures and studying as well as plenty of practical experience.
I would add a conditional contract to work for the NHS for a minimum of 10 years post qualification.
We need degree level nurses, practical nurses and HCAs. Further training should be available for people who are capable. I did extra training in my 40s in order to take on more responsibility.
I trained a really good HCA for my team and really wished she would go on to do nurse training, but she just couldn't afford it.

PaintDiagram · 27/11/2019 15:25

I agree with above that nurses should be better respected as they’re intelligent- gosh if you see the amount of machines they can set up and how they know their stuff - they’re not just pull pushers and taking blood pressure these days.

However I feel they should bring back the nurses houses like before. Both of my grandmothers reminisce about moving away at 16 to nurses houses; having lessons during the mornings and experience during the afternoon; my Nan didn’t become qualified until she was 21. I think they had to pay for the first year of study but from then they were paid and therefore for the working class girl it was perfect.

We have a shortage of nurses and we also have a gap of suitable apprenticeships especially for women. Around here the only apprenticeships are either in mechanics, trades, childcare or retail.

My niece hated school as it seemed pointless; learning poems and what not. She’s got so much common sense, copes well in an emergency and is smart. She’s desperate for an apprenticeship as she loves working and feels her peers are immature.

I also know a medical student who offered to do arts and crafts at my out-of-school club but when I asked him if he could do basic first aid instead he said that he doesn’t really know enough. He’s been at Cambridge for three years and has placements at hospitals.

ItMustBeBedtimeSurely · 27/11/2019 15:31

Paintdiagram nursing really isn't a career for people who can't manage at school. Sure, there are some who flunked school for various reasons and came back to education as adults, but academically it was tough on them. And the younger nurses I trained with had mostly done a levels and done well.

It is a tough job, intellectually. You can't do it with just common sense and kindness.

LucheroTena · 27/11/2019 15:33

There are nursing apprenticeships @PaintDiagram, there are in fact lots of different routes into nursing. But to register as a newly qualified nurse you have to be able to pass the degree. You will then be expected to study further your whole career to maintain registration. This is the professional requirement. If a person is unable to do that but wants to do some nursing tasks then they can become a HCA or nursing associate but their pay will be capped at band 4 or below.

LucheroTena · 27/11/2019 15:35

@Reallybadidea, we tend to retain mature nursing students. It’s a tough job and more of those with life experience and previous work experience cope better with the burden.

Reallybadidea · 27/11/2019 15:50

OK, assuming that retention is better with mature students, is that just because they're more resilient or because they have made a greater psychological investment in their training and have given more consideration to the commitment that nursing entails before applying? It may be that tuition fees themselves have a similar effect on younger applicants, so that they think harder before applying and are also mindful of the debt that they are carrying. This could inadvertently increase retention of younger graduates. Don't get me wrong - I'm totally opposed to the removal of the bursary, I'm just not sure that its effect on nursing numbers is clear cut.

CAG12 · 27/11/2019 16:20

There hasnt been one person on this thread thats stated WHY they think degree nurses are less willing to do basic care. Those who believe it have just stated it as a fact with no reasoning behind it.

Its starting to feel a bit like inverse snobbery

Emmacb82 · 27/11/2019 16:44

@IheartNiles of course I’m not saying we should limit to diplomas, my comment was aimed at the few that basically said in so many words that if you don’t have a degree you are less educated and I don’t believe that to be the case.
The way that students are now trained has changed massively and I don’t think it’s for the better. Yes, they get a degree at the end, but they have less time in practice which is where the real learning begins. They no longer have a base ward so instead of following a student through the 3 years of their training and being able to pick up on weaknesses and really work hard with them to make them the best they could be, they spend those years in lots of different placements with lots of different mentors. Yes, they have a variety of experiences but no stability. That’s just my view point, others may disagree.

@CAG12 I’m not sure why people are saying that nurses with degrees don’t do basic care?! The job is the same whatever qualifications you have surely. But I do find that degree students have a different air about them (and I’m not writing them all into the same page just what I’ve experienced). They act almost more entitled because they are paying for the course, some turn up when they feel like it, go on breaks when they feel like it, go home when they feel like it and generally don’t always have the same work ethic as the old system.

CAG12 · 27/11/2019 16:50

My god - they'd be crucified for that behaviour where I work! The matron wouldnt stand for it.

CAG12 · 27/11/2019 16:56

I also dont know one nurse who just wanders off shift when they feel like it?! Or turns up to shift when they feel like it?!

Are you talking about nursing students here? Or registered nurses?

Emmacb82 · 27/11/2019 16:57

Students!! And believe me they have been roasted for it on their next shift. They waited till everyone was in handover to walk off the ward - shocking!

CAG12 · 27/11/2019 17:08

Ah but then they're student nurses (not yet nurses - they havent qualified).

Do you work in a uni? Is failure to fail a big thing?

geordiejock · 27/11/2019 17:11

I stated earlier that some degree qualified nurses see hands on care as beneath them. My experience is 15 years as a HCA on psychiatric wards. Some come in with a 4 year plan to make band 7 and never see a patient again. Clinging to the office, refusing to help at meal times ( we HAD to have 3 staff on the floor at meal times) I would often have to practically drag them away from eBay. Nervous of spending time on the ward when it was volatile . One nurse told me she hasn't done a degree to clean shit off the wall and to get the domestic to do it, it's not a domestics job. So I had to do the whole room ( dirty protest) by myself.

LucheroTena · 27/11/2019 17:22

I haven’t noticed graduate nurses doing a worse job or having poor attitudes. They are as caring as anyone else. I do find that they’re much more cosseted than on the older training where it was literally watch one-do one-teach one. This means it takes longer to get competencies achieved and for them to work at an efficient level. But that’s not all bad, I remember as an 18 year old being completely thrown into some really tough situations. I do find them questioning, not sure if that’s the education or better confidence and that’s only got to be a good thing. In the old days it was difficult to question anything and I remember as a staff nurse doing all sorts of tasks which were not nursing, such as cleaning, emptying dishwashers and so on and feeling quite resentful about it. I’m glad people now feel able to stand up to this and protect their role boundaries better.

x2boys · 27/11/2019 17:30

To be fair geordie some nurses have always been like that I was a mental health nurse and some newly qualified nurses have alwsys aimed to.go up the management ladder very quickly often male nurses in my experience anyway.

CAG12 · 27/11/2019 17:32

So the reasoning behind 'degree nurses dont care as much' is based on a couple experiences of bad nurses? Surely thats not fair?

Ive met some really lazy nurses who were trained before the degree's came in. One I work with will sit at the nurses station and the HCSW does all care. However I dont assume ALL nurses who dont have a degree are like this.

hiphiphoorayback · 27/11/2019 17:34

Yes 100% agree! I have never understood why nurses need to have a degree the old system was fine.

LucheroTena · 27/11/2019 17:37

@Reallybadidea I think mature students have usually made the commitment after a lot of deliberation, given up existing jobs to do the course, often worked as HCAs or other experience in the field and experience with the public. So perhaps a combination of maturity/life experience/resilience + knowing what they’re getting into + psychological investment / sacrifice of existing income, job etc.

I think it’s easiest to drop out in the first year and that’s when we lose most of the younger students. It’s quite a shock to go into a hospital for your first job and be faced with all the trauma, demanding people and poor working conditions. It’s a relentlessly hard job. I notice now that for lots of students this is their first job, many haven’t worked with the public before. This is different to the days when we all had Saturday jobs aged 14. So I think it’s quite a shock. I also think young people have higher expectations of employment and are less willing to put up with being treated shoddily. They have good A levels and other, often easier options that they can pursue and I don’t blame them.

hiphiphoorayback · 27/11/2019 17:38

I know lots of Doctors who can not get a Nurse to do anything for them but expect Doctors to be their servants! Grin Controversial sorry in advance!

Waitrosescheapestvodka · 27/11/2019 17:39

My Trust (MH) still does secondments as well as apprenticeships. Don't ask me the difference though Hmm

We need both seconded HCAs and nurses via the degree route, they both bring different things and create a balanced team.

We need the bursary back really. How well get 'home grown' nurses by straddling them with debt for thousands of free practice hours baffles me.

LucheroTena · 27/11/2019 17:41

Absolutely @CAG12, we all remember the lazy buggers who did permanent agency nights back in the day and sit with a blanket wrapped around them all night. There are lazy uninterested people in all walks of life and nursing is certainly no exception. It’s about the individual. I don’t think the training is much different and learning more theory isn’t going to make you less compassionate!


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geordiejock · 27/11/2019 17:43

My experience isn't a couple of examples, but 15 years experience. There have always been lazy staff, some spent half their time hiding to have a smoke. But I did think the degree qualified nurses were often less inclined to get stuck in. It's not a case of protecting well defined role boundaries ( love this sort of NHS catch phrase) .

Biggobyboo · 27/11/2019 17:44

“A conditional contract to work for the NHS for a minimum of 10 years post qualification.”

Really? Can you imagine being conscripted to work in the NHS? Even the military isn’t that bad! Why make nurses work if they hate the job and want to leave? They won’t exactly perform well. How would maternity leave work? Would they be allowed to go part time? What if they were physically unable to nurse (back injury) or depressed? What if their partner got a job abroad and they wanted to move?

Sorry but that’s a terrible idea.

Waitrosescheapestvodka · 27/11/2019 17:46

One nurse told me she hasn't done a degree to clean shit off the wall and to get the domestic to do it, it's not a domestics job. So I had to do the whole room ( dirty protest) by myself.

This is awful. I'm one of the hated B7 graduate RMNs but I'd never refuse to clean poo. I get really angry when nurses do this, personal care is such a basic skill, and in MH you need to treat your team with respect because you need them.

I don't think it's necessarily a graduate thing though. The ward's leaders need to be setting an example and rolling those sleeves up. Newly qualified nurses need support, guidance and lots of role modelling.

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