To think the nursing crisis could be helped by

[CurryBelly]

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

@endofthelinefinally So nurses cannot become parents for the first ten years of their career in that case.

Jesus! You do know nurses perform operations now don't you. Maybe you would like your gp to skip uni too!

@Waitrosescheapestvodka, why would you think cleaning faeces from walls is a nurses job and not a domestic? Interested to know. It’s not cleaning up a patient and there is no training given in the use of hospital cleaning products.

My grandmother was an SRN in the 1950s before she married and had to(?) leave. She trained at the now defunct Westminster Hospital.

She lived in the nurses home and after board, lodging and laundry was taken out she had pocket money left from her salary as she describes it. She was a grammar school girl as most of her cohort were. Perhaps because it was a prestigious teaching hospital, they attracted “middle class” girls? She remembers lots of written exams and she got a certificate when she qualified. Apparently it was the equivalent of going to university.

In terms of care, they weren’t encouraged to chat to patients. Patients who were feeling low were told to buck their ideas up. The ward sisters were largely bullies and not caring to their patients. Matron was a drunkard apparently!

Routine day case operations now would have been a two week hospital stay back then. Patients in hospital today are very sick and require more care - everybody else is treated at home.

It makes me laugh in the Daily Mail when people comment about the golden era of nursing and hospitals.

@geordiejock I’ve been nursing 30 years and I’m pleased that nurses are starting to boundary their role a bit more. There were far too many years of putting up with doing handmaiden and cleaner jobs and defending this practice is partly why nurses are still so badly remunerated and feeds this perception (as seen on this thread) that nursing is a semi skilled occupation.

Whose job is it to clean the bathrooms in hospitals? I’ve seen midwives telling women to clean their own blood up and refuse to clean the bathrooms as that’s the cleaner’s job. But the cleaner says they don’t do bodily fluids. But they must clean the public loos in the hospital? 🤷🏻‍♀️

My grandmother said that each ward had a domestic to clean the floors and bathrooms but the nursing staff did the beds and medical equipment.

It should be the cleaners job in my view, like you say they deal with loos and all the products in those! Nurses putting up with doing jobs like cleaning equipment detracts them from the skilled jobs they should be doing. Sadly a lot of nurses defend these practices.

It is the cleaner's job. HCAs will clean beds sometimes so turnaround between patients is faster.

How many jobs would you find people insinuating you are lazy and uppity because you don't clean in addition to your actual duties?

I think the degree is still positive, but reducing the barriers to the degree would help. For example, if you've worked in a care home for over a decade and have a family, it's not always feasible to do an access course for a year without financial assistance, and then a degree without a bursary. You might even have a levels or a precious degree, but if it's not healthcare related you won't get in, so you have people with the experience and aptitude, who just can't justify it.

www.bbc.co.uk/news/health-19468770

Surely nurses should be nursing and not scrubbing bathrooms!

We dont clean toilets either. We also dont 'scrub' cubicles that have had infectious patients in them. We call domestics for a 'deep clean'. The domestics would think me absolutely barmy if I started getting involved with them.

Dont get me wrong, its awful to say 'thats not my job' and walk off leaving you to do it. However you cant say all degree nurses are terrible because they wont clean toilets. Its not the job.

SimonTJ
I worked 30 years in the NHS. I had 3 children and looked after 2 sets of sick elderly parents/ pil.
I didn't say those 10 years needed to be worked full time or consecutively.
I do think that if the state pays for your training, you should give something back.
I think that is reasonable.
Alternatively, take out a student loan. I think the loan system is worse.

endofthelinefinally - but student nurses work over 2300 hours for free? Mainly used as unpaid HCAs. Saving the NHS around £20k per student over 3 years!

When I trained student nurses were paid. I never said anybody should work for free.
The first thing I said was that we should go back to paying student nurses a wage plus their tuition.
Of course nobody should have to work for free.
But, tuition costs money. Nursing is a fantastic career. Giving back to the nhs in return for the teaching isn't unreasonable IMO. I understand that people don't agree with me.
My dc are working to pay back their student loans. Although I do know a few people who are aware of strategies to avoid repayment, but I don't think that is right.
I wish everybody could have free education and training but it is just not affordable. Personally I would rather see the money put into early years and schools. But again that is just my opinion.
I really enjoyed my career in nursing and value everything I learned. It kept me employed for many years.

3 years training = 10 years give back to the NHS?! I understand having to give a bit back but 10 years is a bit much. Maybe 3 years give back for 3 years training is more fair?

Domestic would not be responsible for poo on the wall. Bodily fluids is nurses responsibility not the domestic. We can use chlorine based products after wiping it up, then soapy water. I would not expect our domestic to deal with that!

I’m honestly strangely intrigued by who cleans the bodily fluids in the general loos not on the ward? If cleaners can’t do bodily fluids. I looked at some job adverts for cleaners on NHS Jobs and they all specify cleaning bathrooms and fluids and “unpleasant working conditions.”

I’ll go and do something productive now instead.

Ok. 3, 5 years whatever. Presumably it can be costed.
I have a chronic condition and spend a lot of time in hospital. I am mostly looked after by nurses from the Phillipines. They trained there and then come here to work. I worry if this causes a problem for their home country, but I completely understand why they do it. They look after me very well and I respect and appreciate them.
All these new GPs that Boris has promised will probably come from India. Great for us, but not for India.
I worked with a cohort of army doctors in the 80s. The army paid for their training, they signed up for 10 years, but trained in NHS hospitals.They all thought they got a very good deal. The NHS certainly got a good deal.

@IheartNiles our cleaners won't touch body fluids, although oddly will clean toilets. They get paid band 1 and have a long and somewhat impossible list of jobs (not alone there, admittedly). It's a policy of our Trust that they don't clean body fluids, it's not one particular cleaner being lazy. I imagine it's a way of justifying paying them the absolute minimum by foisting the job onto nursing staff.

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

If you genuinely believe this is a good idea you don't understand the modern health service at all.

The thing that would help nursing the most is better pay!

I think the two tier system we used to have, worked. State Enrolled Nurses trained for two years and were more hands on. The State Registered Nurses trained for three years, and moved on to be staff nurses, sisters and specialist nurses. Why they stopped this system, I do not know. The advantage of this system is that all nurses were registered nurses, accountable and recognisable as professionals.

I suspect that nurses are cleaning up body fluids from walls and floors because they have been told it’s their job by other nurses. Of course the cleaners won’t do it if nurses offer. Who do you think cleans up all the spilled urine and faeces in the public areas? Cleaners do, the nurses don’t get called to do that do they? It’s really not in any nursing JD I’ve ever seen.

I would love to be a midwife, or a nurse, but cannot afford the degree. And the hours around my own large family.

I really feel I'm missing my calling in life...

I think some of these comments about having a degree being a necessity in being a good nurse is actually quite insulting to those of us who trained in the old system and have managed just fine without one! I have 13 years of experience so far and that would hugely outweigh a newly qualified nurse who happens to have a degree. Why does having ‘only’ a diploma make me less educated.

It's not though is it? Cause you've had 13 years to learn, develop, do CPD, have experiences and adapt to the changing role.

Nurses coming out of university now don't generally get that chance. They don't have the environment that you would have learnt in and they are expected to know most things to be autonomous from early on.

If a diploma nurse and degree nurse walked out on the floor the same day statistically the degree nurse is more likely to keep people alive (with actual research that backs that up easily googleable)

I was in charge of my ward of complex people just 4 months after qualifying. I didn't have a sister or matron backing me up I was expected to get on with it with 6 HCA staff.