Ask yourself this. Why do young (and a few not so young) people go into nursing? Do they want to look after patients, or do they want to “interact with clients”? Do they want to read long discourses on the psychodynamics of inter-personal relationships, or do they want to care for patients who are ill? And by care, I mean hands-on care. Day to day patient contact. Nursing is a caring profession, a noble profession if that does not sound too mawkish, that was founded on the concept of caring for fellow human beings. Skills learned by apprenticeship. It’s all gone now.
Leaving aside the fact that it hasn’t all gone now, and that nurses still learn by apprenticeship, this, according to Crippen, is the reason why 25% of student nurses drop out - the courses are crap, they aren’t practical enough, they don’t meet the expectations of young people who want to look after the sick.
Back in 1976, the entire certificate-level course was dominated by a kind of apprenticeship training whereby student nurses worked on the wards - much the same as they do now, except back then they were salaried employees of the hospital, part of the staff establishment and generally filled in the gaps in the duty rota. There was very little education, it was mostly about doing what sister told you to do, scrubbing bedpans and medicine pots and filling in for the qualified staff while they ate cakes with the junior doctors. This is the kind of training I endured as a student RGN back in the Stone Age and this is the kind of training that people like Crippen generally hanker for.
So, if Crippen’s right that student nurses drop out because of the nature of nursing courses nowadays, one would imagine that the old-skool training might have some sort of advantage, in terms of attrition.
Well, an editorial from the Journal of Advanced Nursing in 1976 has this to say: -
“For many years a wastage rate of over 30% was considered the norm. ”
Granted, the editorial then goes on to say that the wastage rate has dropped, which the author considers to be a function of increasing job insecurity in the country rather than any dramatic change in nurse training. However, it bears repeating that, in 1976 - which was a prelapsarian paradise for student nurses, if people like Crippen are to be believed - it had been accepted that a drop out rate of over 30% was the norm for many years.
Just saying…
Oh, the reference for that editorial is Smith, J.P. (1976) Editorial Journal of Advanced Nursing 1 (5) , pp339–340
16 comments
April 20, 2008 at 4:11 am
Pingback from the profession of nursing
April 11, 2008 at 8:59 am
Mr Ian
Our cohort was a 50%. I was one of the last ‘traditional’ trained in early 90s
April 11, 2008 at 11:29 am
Mandy Lifeboats Adrift
Having, this morning, had a conversation with a student nurse, I want to big up the student nurses.
My experiences of dealing with them is that they are keen to do right and want to help. Some might be a bit wet behind the ears but when I have been in hospital, I haven’t minded that because what they lack in experience they make up for in care and they go that extra few inches, sometimes miles, that make all the difference.
Old hack nurses can look to them…to remember what it was like to have hope and enthusiasm…and I know that is damn hard in a system that wants to grind us all down!!!!!
April 11, 2008 at 11:30 am
Mandy Lifeboats Adrift
When it comes to agency staff..NOW that is another matter entirely.
Nuff said!
April 11, 2008 at 11:49 am
warrior
I qualify in September (with a bit of luck and a following wind) and of the 12 of us who started in the MH branch in Sept 2005, there are 7 of us remaining.
Of the five who have left us, none of them cited the course structure as their reasons for quitting. But maybe we’re just “lucky”…
April 11, 2008 at 1:59 pm
oldschoolbaby
It doesn`t require an Oxbridge intellect or the history taking / investigative skills of a genius to determine that Mental Nurse is multi authored but Crippen`s finally realised. He`s that eager to put his overinflated opinions into print he doesn`t stop and think. Not a characteristic I`d want in my own GP.
I`m a Mental Nurse author and I have regularly conceded that I fundamentally agree with him on this issue. He doesn`t acknowledge that.
He didn`t stop and think when he directed the braying fools from DNUK onto Nurse Ratchet. He didn`t cut her any slack as she was a new kid on the block and think that perhaps she was simply courting a bit of controversy to get her blog off the ground. We`ll never know, she was intimidated out of the blogsphere. Similarly there`s no generosity of spirit directed towards Fat Lazy Male Nurse. He`s shot down as soon as he pops his head over the blogging parapet.
Crippen, you`ve become as boorish as you are boring. I`ve always called for moderation in these medic - nursing spats but I`m fed up now.
To paraphrase yourself
FUCK OFF YOU TWAT !
I can`t get on to Crippen`s threads I`d be grateful if someone could cut and paste this over there, with OSB attached of course.
April 11, 2008 at 3:22 pm
beakie
OSB: ever get the feeling Crippen has a few - ahem - “personality issues” of the ICD-10 variety?
He certainly seems to love lighting the blue touch paper then wallowing in the attention.
April 12, 2008 at 12:13 am
azulinebloo
Most of the time I think Crippen sounds like he’s long since burnt out and too full of the “in my day”.
Things change and move on, the past was never perfect and never will be!!
My year (only in MH) had a……let me work out the %…….um…………..my training is obviously lacking here…………….um…..40% and we still have 5 months to go. Some have taken time out and plan to come back at some point. Some failed essays on too many occassions and others had other things going on in life. I’m not sure what the answer is, but it’s too easy just to blame the current courses
April 12, 2008 at 2:55 am
Mr Ian
Mandy - your post does indeed remind me of those times where I knew less but ‘cared’ (in the verb) more, and in some ways I miss them - mostly the naiivety. Now I’m aware that the extra few inches often seem to end up at the same stone wall and it pains me to keep taking people up that dead end. Now I’m more experienced I apply my energy conservatively and to higher success probability avenues. In relation to Uni trained students - this is where academia helps - because you have to know how to play the politic of health care in order to get anywhere so many times. Traditionally trained students relied on networking and not so much what you know or who you know - but what you know about who you know - in order to get things done. Now you have to prove a clinical case.
As for Agency nurses. I can readily admit there are some real money grabbing tossers out there. However, there are some genuine ones too and they’re not always easy to spot. The reason for this is simple: I worked as agency nurse little over a year - when arriving at a local NHS place you meet the staff who then run off and hide in their regular corners while you are left with ‘the special’ for a whole 12-14 hour shift. This is not so bad for the patient being specialled because you get to know them pretty well in that time and can almost immediately look at improving their situation - but the regulars don’t care too much - because the special patient is a pain in the arse and means their ward isn’t being easy for them (wtf they expect on acute units sometimes baffles me tho). So when agency nurse comes up with some ideas - deputy charge nurse takes it on board and files it behind the TV guide. Kicking up a stink about it does nothing for the patient - and means you don’t get any more shifts. Many good agency nurses have defaulted to turning up for work and just doing a good shift - knowing that them being there is one less idiot and by not rocking the boat too much; they might be able to come back again.
And some are just lazy greedy useless bastards.
April 12, 2008 at 10:38 am
Mandy Lifeboats Adrift
Hi Mr Ian,
Destracting myself here before heading off to see Dad. It is all a bit traumatic..rightly or wrongly…for me.
I do get some of what you say about having to change to survive in nursing. I couldn’t hack it. Even if I was stable enough. I hate bureaucracy and that condiscending attitutde many shrinks have to staff and patients. Shame isn’t it? Because the empathy and comfort side of what is given by nurses makes all the difference (well it did to me). And yes the practical stuff is essential but without the warm and fluffy stuff it all seems a bit mechanical.
I can only speak as I find about agency staff but most, and I mean nearly all, I have come across couldn’t give a tuppeny fart about the patients on the ward. It is a job. It is money, simple as, for them.
If only mental illness were so simple eh?
April 12, 2008 at 10:39 am
Mandy Lifeboats Adrift
Scuse duff use of language there. I should have written if only mental illness was so simple or mental illnesses were so simple.
Another DOH moment!
And I don’t want Dr Crippen thinking me an illiterate loony do I?
April 12, 2008 at 4:11 pm
Mr Ian
hmm… I think ‘mental illness were..’ is acceptable syntax as mental illness is the representation of a group of disorders and not just one ‘illness’.
And many agency nurses are crap. But there are some not so but appear so - and for crap reasons we understand.
April 12, 2008 at 4:29 pm
beakie
“If only mental illness were…” is actually correct English, Mandy, as you are using the subjunctive tense here which expresses states that do not exist as in “if only things were different”, “if only I were taller”, “he wished he were somewhere else”.
Gawd elp us I should’ve been an English teacher!
April 13, 2008 at 1:39 pm
zarathustra
Just thinking back to how many dropped out on my course.
12 of us started (in mental health branch, that is, obviously there were lots more in adult and child branch).
Of the 12, 3 dropped out of the course. One dropped out because of childcare commitments. One was having personal and health problems. Oh, and one became pregnant.
We also had a student who switched from adult branch into mental health. There was also a student who joined us after having dropped back a year. She barely turned up to either lectures or placements, and generally behaved like a complete waste of space when she did. The words “why don’t you just give up?” sprang to mind.
So, a total of 10 of us passed, with the student who dropped back a year still trying and failing to complete the work. I’d say overall that’s not bad.
There certainly wasn’t anyone who dropped out because “there’s too much sociology bollocks”.
April 13, 2008 at 1:50 pm
beakie
Well, quite, z, me neither.
This whole debate has, however, firmed up a couple of ideas I had for future study, so it’s been very useful for me!
April 14, 2008 at 10:16 pm
amy
My training school must have been doing something right in the early seventies - out of the 47 in my set only 5 dropped out. At our 25 year reunion nearly all of those who attended (and others that didn’t) were in some form of nursing.
I would say we were well taught on both a practical and theoretical level - and in plain english; none of the uni-speak that came in with P2000