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

Lilimax,I think you've missed the point.When I started training in 1980 the wards were reasonably staffed,mornings were hectic.
The afternoons after lunch were quieter times,no visitors.It was used for teaching ,tidying the ward and personal things like washing the hair if bed bound patients.I remembers doing hair as a student and learnt a lot talking to the patients and I hope they felt better .The wards are too busy now and we feel as frustrated as the patients that some of the personal touch aren't possible now.
I went into nursing to be the best I could be and the sense of satisfaction having made a difference is what kept me in the job.It us harder now but whether you've helped with a patient's recovery or help them and their family through their death it's the small things that show you care they they remember.
So please Lilimax,don't dismiss those who went before you.Times were different and while doing hair was one side of the job we had procedures then that would horrify you now,some things have improved vastly but the staffing levels and reduced patient time in hospitals have made nursing so much harder.
The only be major negative though is that in the bad old days I had to know everything about every patient so when a relative rang up a ward they got an accurate report as to how the patient was Non of this 'I'm not their nurse'.
My mother in law was in hospital and despite calling numerous times never got the right nurse,others couldn't help and we only found out what was wrong with her when she was discharged.

It unlikely as it’s more complex than the training part of it. It’s the terrible pay and hours, compounded with lack of support from senior managers. Consequently it’s hard to retain staff at most places

I can totally see that having time to do a patient’s hair in the past would have been a big part of holistic care. I bet the patients loved it. It would really have made them feel valued and cared for.....which is very important.

But it isn’t just the fact that nurses don’t have time to do hair anymore.....it’s what that represents. That there isn’t the time to spend with patients anymore.

Teachers get a huge bursary to train but aren't tied to any one role or location, why should nurses?

Do they? I never witnessed this?

From Gov.uk
^
There are three types of funding available for teacher training - depending on your circumstances, you could receive all three:^
1. Tax-free bursary or scholarship
2. Tuition Fee Loan and Maintenance Loan
3. Additional financial support if you’re a parent or have a disability

Just a sample of the amounts below. £26000 if you fancy doing physics 😳

I didn't even have to look very hard.

Nursing, like certain teaching subjects, is a shortage subject so why isnt it treated Like one? It's literally the only thing I can think of where we had too few and the government scrapped funding.

30 years ago I worked in a fairly high dependency area so lots of IV therapy and sick patients, there certainly wasn’t time to do hair other than a quick brush. I think modern nursing has gained time from having HCA support and certainly in my hospital nurses don’t do cleaning, bed changes and other unskilled jobs. We also used to do a lot of drug prep that pharmacy now do. But patient dependency and bed turnover is higher and people keep complex packages of care to go home. Also feels like junior doctor continuity is awful and nurses are doing lots of jobs that would have traditionally fallen within their remit. Specialist nurses run their own practices in some areas, which would have been unthinkable back then.

The issue is retaining staff, not recruitment. It’s a leaky bucket. A new starter isn’t going to replace a nurse with 10,20,30 years experience. There aren’t enough mentors for the students and newly qualified. The job is harder and the risk is the ability among those left to do that job won’t be there.

@doublebarrellednurse, wow. How can they justify doing that for teaching but not nursing? I honestly think it’s ingrained in sexism.

Degree level educated but student loan wiped out after 5 years FTE service to the NHS.

@Lolimax I am somewhat appalled at your attitude and clearly your net very far into training.
Far from doing patients hair being beneath you, you need to understand that the skills off providing primary care is the very essence of good nursing practice. No point learning to be a CNS carrying out endoscopy if you’re too grand to provide care that is vitally important to patients.

Doing hair is a time for observation, for providing reassurance and explanations. Imagine being on a respiratory ward and helping a frightened patient understand why their CPAP machine is so important because you’ve included that relaxed discussion whilst doing their hair. Imagine the difference that untangling and de-nitting, then conditioning and putting into braids the hair would make to a neglected and homeless twelve year old admitted under a PPO or detained under the MHA. Imagine the opportunity to gain trust and build a relationship.

You are likely to in in breach of the Code with that superior attitude.
“1.2 make sure you deliver the fundamentals of care effectively”.

Retention is an issue. Opportunities for good registrants are endless and they can have their pick of jobs.

Many trusts (the very best) do find time for providing good basic care. They have sufficient staff and recognise that providing high quality care is actually cheaper than providing poor care. A better ratio of qualified nurses improves outcomes, reduces length of stay, results in more ‘harm free’ care and improved Safety Thermometer data. That means less pressure damage, fewer falls, less infections all of which costs a small fortune. It’s better for patients too.

Far from staff reductions and asset stripping, the way to reduce costs is to increase staffing. Proven time and again.

Lolimax if I was your mentor on the ward I would be taking you right back to basics and the first thing I would teach you would be some humility.

I think @Lolimax may have taken the quote a little literally. The caller was lamenting not being able to do full and holistic care for their patient. Doing hair isn't about doing hair but about time to chat less formally, get to the root of worries, discover things that can be used for planning beyond your care etc.

Believe me no one would want me to do their hair 😂 I barely do my own but I've gotten "fresh air" with a patient who needed a fag, taken them to activities, worked out with them, and all kinds of "non nursing" activities to get to know them.

MH Nursing gives us this kind of flexibility sometimes though and I try my best to keep it although it's getting harder and harder.

Im a first year mental health student and one of the reasons for wanting to study nursing was the amazing Nurse I had when I was a patient. I had an AVM which meant having intrusive brain surgery, and afterwards my hair was really matted with blood from the drain. One of the nurses went out ON HER BREAK and bought dry shampoo, and spent a good 20 minutes brushing it through whilst chatting to me. That one scenario helped my mental health immensely in hospital and I am forever grateful to that nurse. I would be interested to know whether you have ever been a patient in hospital @Lolimax

Agree OP....I am a Nurse.

Also a nurse here. Now in what is considered a specialist role with a Masters and embarking on PhD. I long for the days when I had chance to paint or manicure patients nails, wash/style their hair for them, do some colouring in with them. It might not sound very "degree level" BUT it gave me the opportunity to do so much. Painting nails meant holding hands - is their skin dry? Does it need moisturiser or are they dehydrated? If their hands are dry there may be other areas of skin that are also compromised and more prone to pressure wounds. Is it cold? Poor circulation? How do they feel about it? Do they feel generally warm enough or do they need an extra blanket but don't want to "fuss" by asking? What about their home life? Do family or friends visit often? What kind of support might they need on discharge? Loose jewellery- have they lost weight? Why? How are they feeling? Are they worried about anything? What? Are they tired? Why? Didn't sleep or a medical reason e.g anaemia, low Vit D? All of these things - and many more - over a simple manicure. When these things are beneath us, when we "didn't get into it to do this," we close ourselves off to the opportunities and we miss things. And that is why I detest the phrase "basic care." Because done properly there is absolutely nothing basic about it. So I agree with the new routes opening up that enable progression from HCA/equivalent. As time went on and nurses were under more and more pressure I, and my patients, have been more grateful than words can say for the HCA's I've been fortunate enough to work with. They've been my eyes, ears and wary warning system so many times and they remember the "basics" of "basic care."

one observation I’ve made is that there are very few older nurses on hospital wards now.
Maybe it’s the pace, workload, other factors.
So nurses may be leaving nursing earlier, with years of experience lost.

@doublebarrellednurse - I would say increasing pay for hcas and nurses may help retention. Also a skills map that holds between trusts for cannulation, phlebotomy, catheterisation with bonuses for these skills would be good.

A modular degree program with good support for multi-module exams would be good. A careers service that helps nurses and other HCPs find a niche if they find traditional ward based work difficult (eg with family life, shifts etc). A good rota software program to allow flexibility in shifts. I came across a few agency nurses who said that they became agency because their managers could not accommodate shifts that fitted with family life (often married to other nurses/shift-workers) - what a shame!

I think recruitment is an important part, but without retention as PP said - it’s a leaky bucket and money used in training will be wasted.

For older experienced nurses - perhaps a chance to get off the rota and doing regular skills/mentoring or just support sessions 2-3 days per week (if they don’t want full time).

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

Oh, those comments! And Suzanna Reid banging on about why 'young girls' don't choose nursing like her mother. God, I'd not choose it just based on knowing I had to treat cunts like those commenting in the Daily Mail.

Nursing has evolved alongside medical science to become more skilled and to require more critical thinking. There is no way a return to hospital trained nurses would be able to adequately teach this. This does not mean that nurses are not responsible for basic care but it does mean that when you have a deteriorating patient or an emergency the RN will be dealing with this while the HCA continues to toilet and wash the other patients. If you want RN’s readily available to provide basic care then you need to pay for more of them.
I’m not surprised there is such a high drop out rate in nursing. It can be very unwelcoming to a new starter let alone a student nurse. When I am assigned a student (absolutely no consultation, neither do I have any qualifications in mentoring or training others) I am essentially being given another job to do when I am already busy. I try my best but if the student doesn’t seem interested or able to learn quickly and if they’re nervous or unwilling to do personal cares I don’t have much to offer them. I need them to shower patients to make up for the time I have spent teaching them how to set up an IV line. I had a male student recently tell me he couldn’t offer Mrs X a shower because she might feel uncomfortable with a man. I was short with him. What will happen when he is practicing? A woman will wash all his female patients?

It is possible to have lectures in a hospital. It is the quality of teaching that matters, not the location.

@endofthelinefinally what has this to do with anything? It’s also more costly to run stand alone schools of nursing.

Pp mermaidoutofwater inferred that hospital trained nurses are inferior to university educated nurses.
I was just saying that it doesn't really matter where you have the teaching.

Maybe I am not explaining very well.
If I am giving a lecture or presentation to students, I can do that in the hospital lecture theatre or the university. It is the same material.
Time spent training in a hospital is pretty fundamental for nursing IMO.

Yes I hear you. But unfortunately the in house schools of nursing didn’t award degrees (they stopped at diplomas) to their graduate nurses.

Why can't they introduce degree apprenticeships for nursing so students can earn while they learn?