Dr Crippen reckons he’s got the answer, in the form of an email from a “soon to be ex-student”, allegedly, complaining about the nature of her course. Apparently, there’s too much “theory” (don’t know what of), not enough information on sticking tubes and needles into people and - oh the horror - far too much emphasis on communicating with patients. Something like that. I glazed over, I have to admit, as we’ve all heard this sort of stuff time and time and time again.
Attrition is a multi-factorial issue, one that doesn’t lend itself to glib explanations and easy answers. Nor should it always be problematised. For some students, dropping out will be exactly the right thing to do. Either they find out they don’t really want to be nurses, or they discover that they’re actually more interested in something else, or they decide that it’s just not the right time in their lives to be studying. Would that more students came to the same conclusions before they found themselves staggering and struggling, already burnt-out and miserable, through the second and third years.
For other students, yes, it may well be the case that the course doesn’t meet their expectations. There’s not really a great deal that can be done about this. No matter how carefully you might explain what the course consists of, it’s never going to reflect adequately the actual lived experience of being on it. You can’t please all the punters all of the time.
But there is a significant number of students for whom attrition is brought about by crap like this. A few highlights of the kind of comments faithwalker has had to endure from a “nurse” for having the temerity to agree with a patient’s comments about a porter: -
“I hope the relative makes a complaint, because when they do we’ll be sending it to your university to deal with and you have caused it. And when it ends up in court- it will be you that gets sued by the porter for what you said about him when you had no right. NO RIGHT.”
“You are an immature and unprofessional bitch to sit there and say all these lies about a porter with a relative. You’ll never get a job on this ward when you qualify. I don’t know what you might say about my nurses.”
“I shall be making sure you don’t get a job in this trust when you qualify. People will look to me for references from your placement and I will tell them what you have done.”
This is bullying, plain and simple. Unfortunately, it’s not all that uncommon in the NHS and I would suspect students are particularly vulnerable to it being very junior, transient members of the team and probably of the opinion that they’re pretty much powerless to do anything about it. Some very wise person way back in the mists of time once said that nursing ‘eats its young’ and faithwalker’s experience illustrates all too vividly the continuing truth of that statement.
18 comments
July 9, 2008 at 8:13 pm
Pingback from Mental Nurse / Weekly Handover (3)
April 10, 2008 at 12:50 pm
Jan
The attrition rate’s high once people have qualified too…….
April 10, 2008 at 8:18 pm
TheShrink
Is the course run over 4 weekends, now?
April 10, 2008 at 9:28 pm
zarathustra
Now now Shrink, don’t make me take away the jammy dodgers again…
Anyway, the issue of bullying of student nurses. I think student nurses shouldn’t see themselves as “powerless”. In fact, in some ways I think they have much more power than a HCA or staff nurse experiencing bullying on a ward. This is because they’re only there for a short period of time, and can (or at least, should be able to) call upon the support of their university tutors.
I’ve been involved on the sidelines of incidents where student nurses were bullied on wards. In those incidents the university took a *very* dim view of this, were willing to move students to other wards and gave very pointed feedback to the ward managers. In some cases, I’ve known the university to inform a ward that they would not place any more students on that ward until issues were addressed.
If you’re the ward manager, imagine what kind of a professional slap in the face that would be - to be told that the university don’t their students anywhere near your ward. That’s where student nurses have power.
Student nurses - don’t be willing to be treated as minions or punchbags. That’s not acceptable practice in any setting.
April 10, 2008 at 9:32 pm
DrJCrippen
Apologies - put under the wrong post
DrJCrippen
Posted April 10, 2008 at 8:31 pm | Permalink
Oooooh
“allegedly”??????????????
Can’t let that pass
Tin hats on, guys!
John
PS I am not a “team” and …… rant? tush, how dare you. NHs BLOG DOCTOR is The Lancet of the internet!
April 10, 2008 at 9:40 pm
zarathustra
Lancet of the internet?
More like Bella magazine if you ask me.
April 10, 2008 at 9:55 pm
dazedandconfused
Nothing wrong with ranting. What’s the Lancet?
April 10, 2008 at 10:04 pm
zarathustra
The Lancet is the journal of Belgian weevil collectors. It has a regular wordsearch themed on the different varieties of semolina. It sometimes contains breasts.
April 10, 2008 at 10:14 pm
yaksley
As a second year student i can appreciate the comments above as well as the possible reasons for drop out rates. I personally feel that “too much theory” equates to the fact that we appear to learn little when in lectures, and not enough when on the wards…. i would personally like more time on some of my placements, but then again, some of the placements dont offer biscuits, so would like to spend less time on those.
I think that if we really want to qualify, suck it up, the course isnt gonna change any time soon
bring on the biscuits !!
April 10, 2008 at 11:40 pm
beakie
It sometimes contains breasts
Z, I think you misunderstood when they said The Lancet was full of tits.
April 11, 2008 at 10:51 am
seratonin sister
Referring to the comment by the soon to be ex student nurse,about not having enough ward based practice I was wondering what you nurses/docs thought about the use of Physicians Assistants in hospitals. Because where I work they seem to be taking on a lot more of the nurse type duties like male catheterisation & taking bloods.
April 11, 2008 at 3:31 pm
beakie
Ah, when I was an RGN student way back in the day, male catheterisation and taking bloods were doctor’s jobs! Speaking as a sometime user of the NHS, as we all are, I don’t really care all that much who’s taking my blood just so long as they do it right, quickly and with minimal fuss. However, if someone were about to stick a tube up my old chap, I think I’d actually want a doctor to do it to be perfectly frank. There’s some delicate structures up there.
April 11, 2008 at 4:47 pm
zarathustra
If we’re talking about having a nurse’s assistant who takes bloods all day, isn’t that basically a phlebotomist?
I think there’s a decent rationale to it: make it somebody’s job to do venepuncture all day, every day, and that should cut down on the “ouch!” factor.
April 11, 2008 at 7:09 pm
seratonin sister
See that’s what I really don’t understand why not use a Phlebotomist for bloods or a nurse.I looked the role of Physicians Assistants & it’s an American idea apparently - wouldn’t you just know it? Originally they was taken on because of a lack of doctors !!! Birmingham Uni is running a diploma course.It says they will be under direct supervision of a doctor (well that’s helpful !!) doing stuff like treatment & diagnosing !!!! Eeek !!! So are they not like Auxilliary Doctors then ?? Wonder what ole Crippen makes of this !!!
April 11, 2008 at 10:03 pm
cellar_door
I think a lot of the problem lies in the uni’s accepting students that are clearly never going to complete the course. Its harsh, but you can pretty much spot those that are likely to drop out after about the first week. I’ve wagered half my bursary on the girl who can’t pronounce ‘negligence’ going before the end of the next semester…not because she couldn’t pronounce it, but because she was afraid to ask anyone before getting up and doing a presentation on it.
I think a lot of students don’t really know what nursing is really about, particularly those without care experience, and the first placement can be a make or break situation. Also, given the size of the Trust I work in, students can face daily commutes of 90mins each way to get to placements. Yes, they were warned before they started, but three months of that coupled with portfolio stress and essays can wear even very eddicated students down…particularly when you could get the same again 8 weeks later…
April 11, 2008 at 10:39 pm
azulinebloo
On the topic of bullying, as usual, I agree with Zed. Sometimes the students have more power, they just aren’t aware of it. They are only there a short time and *should* have their uni to back them up and/or offer support and guidance.
Another thing, if a student makes a mistake, it is up to the Uni to dish out discipline/ support/whatever is necessary, and the mentor is held responsible to the NMC, not the student (that’s my understanding anyway)
Students should be aware of the support mechanisms before they go out. I have met a few who got upset by something on placement so just left the course altogether, rather than even trying to sort it out.
I also agree with cellar door, some students are clearly not going to make it and you wonder why they were ever accepted. Mind you there is still a few in my year that each term I go back I am amazed they are still there!
“do we need references for the research degree essay?” (!!!!!)
I always think students that say “too much theory” really mean, “it’s too difficult for me”, but maybe that’s unkind.
April 12, 2008 at 11:24 am
faithwalker
I told my link tutor about what was said and she nearly, very nearly didn’t believe me. When she saw how upset I was, she had to.
It will be looked in to when I have left that placement, and i have been advised to write a comment about “communication” in my placement evaluation form.
Apparently Sister told my tutor that she told me off and was “quite harsh- but justifiably so”.
Justifiable my arse!
April 13, 2008 at 9:13 am
beakie
I always think students that say “too much theory” really mean, “it’s too difficult for me”, but maybe that’s unkind.
I think you may have a point. I’ve had students ask things like “why do second year exams have to be harder than first year ones?” and being horrified when I told them that their performance in exams was entirely in their power to change.