Unqualified NHS staff

There was also a separate incident at the same hospital where a German doctor miss read something and ended up overdose in the patient and killing her.

@lampturnedoff I understand that as an NA you are registered as such, in your own right. And are therefore accountable for any errors. I'd do the drugs myself rather than let anyone risk my registration.

Health care assistants are not nurses, There is no 'register' of health care assistants.

The nurse in charge on a unit/ward is the one ultimately responsible for the patients there -

Nurse associates are however registered.

I remember back in my day the EGN/ENG (Enrolled general nurses - the one's in green), needed 3 GCSE's at grades C and above to get on the course, for RGN/SEN - the one's in blue you needed 5. Whatever happened to the EGN's? Or are they now under HCA? Showing my age.

They were phased out in the 90 s many converted to RGN/RMN etc
However there is now a Nurse associate role which is very simimilar to Enrolled Nurse .

Care certificates and training for Hcas and Social care staff became mandatory in 2015 as the result of the Francis report, introduced as part of the Cavendish report on improving standards of care.
Not really sure why what happened a few years ago is being referenced as relevent now?

No band 4s are responsible for their own patient's. Crazy because is IV one thing they are not allowed to do? I think it's put them up?

Agreed. Band 4s are not health care assistants.

We have nursing apprenticeships and they work really well. It was how nurses learnt and qualified in previous generations. All patient care is supervised until they qualify.

It's a great recruiting method too, the staff are paid whilst they learn so much easier to fill these posts.

As they are training and supervised the quality of care is great.

Will they end up with same qualifications as those that do degree training ?

It is in my trust. I'm qualified and HCAs can do bloods, obs, ECG's, just about anything. I'm not a nurse anymore I'm a podiatrist but HCAs did all the things I used to do as a nurse and more for a ton less money.

ENs did not need school qualifications and RGNs without them could get on the course with s DC test like I did. The nurse in charge of a shift or ward is not responsible for the patients who are under the care of registered nurses who are accountable for their own practice. Ward managers are responsible for managing the staff , making sure they are competent and offered the appropriate post reg training to do their job. Gone are the days when a registered nurse fecked up and tried to say they told the NiC.

I worked on ITU for over 30 years, and the only students we ever got were 3rd years right at the end of their training.
1st years aren't put on ICU for a start and the placement would be useless as you need to know so much about anatomy/physiology.
It would be like putting a physics GSCE student straight into the last year of a physics degree. Too much base knowledge is missing to make it of any use.
Could they be used as a gopher, absolutely? but apart from learning where everything is in the stock room and how to take samples to the lab or get feeds, it's useless to them in the long run and unfair to use them as such when they should be getting basic nursing and confidence building

Funnily enough we have 2 band 3's who care for ITU patients under supervision. Depending on how good the supervising nurse is they can be pretty much left to their own devices. Luckily ours are experienced and will liase with qualified staff as soon as they feel a patient is deteriorating. They don't touch medication but are
responsible for fairly specialised care like suctioning, changing transducers, doing the odd dressing. They tend to care for the pretty much recovering patients. Back in the day (pre covid) they would even take level 3 patients but would work very much in tandem with the band 5/6.

In the Trust where I work, it is common for students who are just about to qualify, to have only had 3 placements in a hospital setting over the course of their training.

Its quite scary really.

Yes! I qualified as SRN in 1976. Been through so many reorganisations, re-inventions of the same roles.
The thing is though, that medical and technical advances since then are huge. Nursing was simpler in many ways back then.
Now you need HCA s- all differently skilled and trained up, technicians, specialist nurses, physician associates, etc. Each area of medicine is highly specialised.
I retired in a role as a peripatetic clinical nurse specialist in a particular branch of nursing.
If I had been asked to go and work in ITU I would have refused on the grounds that it would have been dangerous.
IME of working in hospital, some of the senior management people do not appreciate this and think they can put anybody anywhere. They can't, it is not safe.

This.

People working in healthcare need to recognise that band 2/3/4 (typically, sometimes 5&6 as well) are unregistered not unqualified. Many have lots of qualifications and these should be acknowledged. It's the registration as a HCP that is the key difference.

Back to the OP, a student would not be having sole accountability for an ICU patient.

Just to add my 2 pennies worth, I started my band 2 HCA role 4 months ago and I had to do 3 weeks of (intense) classroom work, then 4 weeks training on the wards and only when I had got all my competencies signed off and my class work signed off was I given my care certificate and was set free under my own steam. If I wanted to train as a band 3 hca that's a further 15 months of training. Hcas are absolutely not nurses but they're not unqualified either.

I work in Paediatrics and the Band 2 (HCA) staff aren’t allowed to do anything clinical. They job is to solely clean, stock up treatment rooms, serve the food, generally make sure the parents are ok and feed/bath a baby in the absence of a parent.

I know a lot of them wish they could work in other clinical environments so they would have the opportunity to learn new skills and feel like they are part of the Heath Care Team.

Yet in our Paediatrics band 3’s can take their own patients.

Our Band 4’s can, but not 2 and 3.

I love reading about how all the different Trusts work in terms of their staff abilities and responsibilities etc.

What a thoroughly unpleasant thread, no wonder there is a shortage of nursing staff in the NHS. Bullying seems to be rife in nursing compared to other AHP's, where there is more camaraderie and appreciation of skill mix. I was speaking to some nursing students the other day who are already fed up of it their treatment on placements and by one of their nurse lecturers in skills sessions. I've seen the Francis report mentioned a couple of times. Serious question, how should the NHS stop history from repeating itself when people are unable to question bad practice or report safeguarding concerns because it is drummed into them by a prevailing toxic culture that they are 'just support workers/NA's/students?'

In my trust they do!

About the same as I feel about TAs in classrooms… There’s a place for unqualified personnel, and they can certainly bring something valuable to a workplace - but the boundaries of their role need to be clearly defined and maintained. Sadly, this rarely happens.