Opinions about nurse training are like haemorrhoids. Sooner or later every arsehole develops one.
With the news that all nurses in England will train to degree level from 2013, we’ve had a whole slew of opinions across the media about whether this is a good thing or a bad thing. Some of these opinions have been informed and well-reasoned. As for the other 99%…..oh dear.
As a degree-educated nurse myself, I’m in favour of the move. That said, I can recognise that it’s entirely possible to construct a valid, knowledgeable argument against making nursing a graduate profession.
Sadly, none of the following are making valid, knowledgeable arguments. I present to you now the run-down of the most stultifying uninformed commentators on nurse training. The winner shall receive a 1950s-style nurses hat and a 1930s enema kit, or possibly a job as editor of the Daily Mail.
(Credit to Militant Medical Nurse for trawling through the Times, the Spectator etc to find these articles. I would have done so myself, but quite frankly I wanted to retain the will to live.)
And now, in reverse order…
4th Most Stultifyingly Uninformed Commentator
A runner-up prize goes to Melanie Phillips, for deploying a reductio ad Florencium – that well-used dictum that everything a nurse does in 2009 can be undertood purely in terms of how Florence Nightingale said it should be done.
This is because nursing is not a job but a vocation. That means it is governed by a sense of moral duty to the patient rather than by the self-interest of the nurse. That is why, in Florence Nightingale’s seminal Notes on Nursing, published in 1860, she wrote that ‘the greater part of nursing consists in preserving cleanliness’.
It was not just that cleanliness was essential for recovery and health. Keeping both hospital and patients clean meant the nurse needed to have the most elevated of motives to put the care and dignity of her patients first. Accordingly, lowly functions such as washing, dressing and administering bedpans — where dignity was most fragile — were the functions that in nursing were invested with the highest possible significance. Simply, these were moral acts.
Auntie Flo had a lot of admirable qualities, and yes, feeding, cleanliness and other basic care are vital. But modern nurses now have to do a lot of things that Flo didn’t. Flo wasn’t administering medications that can kill you if you get it wrong. She didn’t work with IVs, tracheostomies, defibrillators…you get the drift. Morality alone isn’t enough in 2009. Nurses also have to know about and understand a range of complex conditions and interventions.
That said, it’s worth noting that Florence Nightingale was also an accomplished statistician who invented the polar area diagram and analysed mortality rates in military hospitals. If Flo was around today, Dr Crippen and co would be lambasting her as a graph-wielding nurse consultant.
3rd Most Stultifyingly Uninformed Commentator
Bronze medal goes to Minette Marin in the Times for suggesting that people will be unfairly excluded from nursing simply because they’re too dense to string a sentence together.
All sorts of people who might make excellent nurses will be put off, and lost to nursing: anyone who is not particularly academic; anyone who — frankly — is not particularly bright
Yep, that’s what we need in nursing – more thickos. If I’m going into an oculogyric crisis, a cardiac arrest, a hypoglycemia or an epileptic seizure, I want to make sure that the nurse who has to take immediate action is someone who’s “not particularly bright”. I definitely wouldn’t want them to know what they’re doing.
2nd Most Stultifyingly Uninformed Commentator
Nearly at the winning post is an actual doctor. Sadly a fancy education didn’t stop Ferret Fancier from coming up with pearls of wisdom like:
The same is the case for nursing training, the ward hours and apprenticeship has been lost at the expense of satisfying politically correct mumbo jumbo spewed forth by educationalists.
The ward hours have been “lost” from nurse training? I’ll take a leaf out of Auntie Flo’s book and apply a bit of maths.
Regardless of whether a student nurse does the degree or the diploma, it’s a three year course, of which half is spent in university learning a mix of theory and clinical skills, and half is out on clinical placements.
If 50% of nurse training is on placement doing 37.5 hour weeks and the three year course has a 45 week academic year (student nurses don’t get the insanely long summer holiday afforded to other students) then a bit of back-of-a-conti-wipe calculations reveal that a student nurse has to do 2531.25 ward (and outpatient clinic, and community team) hours before they’re allowed to qualify.
Oh, and the margins allowed in that total for sick leave etc are ridiculously narrow. If they’ve been off sick more than a couple of weeks, then they have to make up the hours somewhere, or they don’t qualify.
I’d say the ward hours haven’t been lost from nurse training at all.
And finally, we come to The Winner…
Most Stultifyingly Uninformed Commentator
The prize goes to Iain Dale, for this masterpiece of analysis.
I once spent a year working as a nurse. There, that surprised you didn’t it? Admittedly it was in Germany and was in a private clinic specialising in spinal injuries, but it was still nursing. I had no qualifications, no training and certainly no degree (it was my gap year).
So, not actually a nurse then, but a healthcare assistant. For all I know he may well have been a very good healthcare assistant, but a healthcare assistant nonetheless.
But there’s more from Not-A-Nurse Dale:
So when I heard this morning that the NHS was now going to insist on a degree before nurses could train, I was dumbfounded. Not all nurses are academically gifted and would want to do a degree. Does a degree in astronomy make a nurse better able to do his or job, than four years hands on training? I’d have thought not, and yet all the nursing bodies seem to approve of the policy.
Noooo, Iain! The degree is in nursing, not astronomy! They’ll be doing a degree when they train, not before.
Epic Fail. And for that Iain, you receive the trophy.
I’m not looking for support, OSB, simply stating my opinion. As for the rest of your brainfart here pfft, you’re not even trying any more are you? You write this sort of bollocks on auto-pilot don’t you.
Oh, and I see you’re still totally incapable of mounting an argument for maintaining the status quo, only of raging against change and insulting me, your co-workers, the world, and anyone else who gets within flecking distance of your spittle-soaked diatribes.
Zero points for Beakie for lack of effort.
I`m not mounting an argument for maintaining the status quo, you fuckwit. If it was left to me I`d be looking to reduce the length of psychiatric nurse training to 2 years maximum ( I know that means your beloved homosexuality and schizophrenia lecture would hit the cutting room floor but never mind, eh ) however it`s not up to me. I`m simply asking, for the umpteenth time. What is to be done about the seemingly crippling amounts of student debt newly qualifieds are accumulating ? And what reassurances are there that quality people won`t be deterred / disqualified from registered nursing due to academic hurdles. I don`t give a fuck if your pressure sores need dressing nor if the man from Domino`s is due at the door, are you ever going to bother addressing those points ?
I have no idea what this comment is about. One point just in case.
I`m not mounting an argument for maintaining the status quo
Er yes, I know that, hence me pointing it out to you. Do you see?
If it was left to me I`d be looking to reduce the length of psychiatric nurse training to 2 years
For no good reason whatsoever. I’ve ignored the little childish wibble that follows this.
What is to be done about the seemingly crippling amounts of student debt newly qualifieds are accumulating ?
From what? They don’t pay fees, the NHS does. They’re given a bursary (unless they’re doing the degree and they can afford to pay their own way). So what “crippling” debt? And even if you could provide evidence of “crippling debt” (which you can’t) what do you think should be done about it? Prevent people educating themselves just so they can avoid debt? Get out more, OSB, talk to people other than your reflection and your OSBJugend troop and you’d be aware that young people have aspirations above and beyond the mere avoidance of debt.
And what reassurances are there that quality people won`t be deterred / disqualified from registered nursing due to academic hurdles
As I’ve said many times before, I have yet to meet someone who is excellent clinically and poor academically. They are a figment of your imagination.
Beakie said: As I’ve said many times before, I have yet to meet someone who is excellent clinically and poor academically. They are a figment of your imagination.
Agreed.
By the way. Reading your comments to eachother is so funny. I always make sure I have some popcorn when I check out the comments on Mental Nurse.
Just to recap then,
You don`t live in an ivory tower
You talk to nurses every day
You know a good few keen to work on the continent
There is no evidence of crippling debt
Nurses who are clinically excellent but who struggle academically don`t exist
My humblest apologies. I accept that I need to get out a good deal more. In fact, I need to pay an immediate visit to your wondrous urban utopia. What an absolute tragedy that this backwater has been left so far behind. I blame Prince Edward and the white middle class. Bastards.
This one is particularly funny. Is anyone else keeping count. I was trying to but ended up laughing so much I seem to have some kind of coffee snotter mix all over my front.
I am amazed they finally seem to have made up.
I do *not* think they have actually made up.
Made up? No, OSB has simply admitted defeat. The better man won.
My humblest apologies. I accept that I need to get out a good deal more
You certainly do and not just camping on the moors with your Brownie pack. Dib dib dib!
It`s my Ray Mears and Hugh Fearnley – Whittingstall evening, I`m out tomorrow, then back in work so I`m bowing out.
Beakie, If the University`s own figures reveal that the average nursing student sacking it in year one has debts of over £5k then it`s not unreasonable to conclude a number of students qualify with debts, of all kinds, of £15k. Bank / agency options are drying up as are opportunities for career progression. You are going to struggle, quite desperately, to achieve your aspirations with that millstone around your neck. It is a serious problem. Being aloof and dismissive makes you look a cock.
In this part of the world nurses who are excellent clinically and poor academically exist, in spades. They do in the 3 other regions of the country I have worked in. Believe me. Thick degree students aren`t thin on the ground either.
I like being a Brown Owl and I`m never happier than when I`m camping. You don`t like being a fat bastard. See the difference ? If you want to stick me in the ribs, you`ve got to work a bit harder.
Boys Boys boys.
Let’s see. When did they start saying that Nurses in the US would all have to have the BSN degree……I think it was 1970 thereabouts. And every year or so afterward they have said “Oh yes, in two years it will definitely be BSN only, definitely, without a doubt”. Seriously, they have declared this officially every two years since 1970. Most of the old diploma schools have closed down but there are still some that churn out RN’s. The associates degree program is still pretty popular and that is less training than a BSN. Britain will not take USA RN’s from associates programs. They will not allow them to register with the NMC.
Employers over there prefer the BSN grads for their new hire RN’s and are telling new recruits “Top of the class cream of the crop BSN’s only, all others need not bother to apply”. The job market is tough for new grad nurses, even the BSN’s unless they are top of the line academically. Diploma and ADN’s are struggling to get jobs anywhere outside of nursing homes. Makes me wonder about this “nursing shortage” that everyone bleets on about. I know it’s annoying when I go on and ON about the states but what goes on there will come here.
Anyway I am delirious with flu so I’ll sum it up. A. It won’t happen. Shortly before 2013 they’ll find a reason to delay the nurse degree mandatory thing and B. The whole problem isn’t about degrees being mandatory. It’s about people thinking that a thick caring nurse is a good one and not understanding what a nurse acually does.
Correct me if I am wrong OSB but on page one we mentioned drug calculations. I know nothing about mental health so feel free to rip my head off but what kind of calcs are you all doing other than the old desired over have X volume equations?
Feeling a bit more coherent than when I wrote my last comment. Here goes again.
Mental health drug calculations are absolutely bog standard.
Predictions:
I strongly suspect we will go to all degree nurse training as per plan. The diploma training will be phased out. The Universities I suspect want to get all their students in the nice little standard student box, as much as they can. Fairly rapidly the nursing bursary will be done away with and students will be expected to get loans like everyone else. All part of the wonderful money saving plans. All degree training will not particularly produce better nurses, nor will it produce academic too posh to wash nurses. It will without a doubt produce less nurses. (at which point my theory about the return of the EN will be activated)
Most of the positives I have read about all degree training are potential and based on evidence every bit as sound as most of mental health nursing.
My preferred choice would be to see multiple routes to becoming a qualified nurse ranging from diploma to advanced degree. Nursing is a big fat profession and needs all sorts in it. As long as everyone meets the required standards to practice I don’t really give a monkeys if they have a degree or not.
My theory is there are plenty of people out there, perfectly capable of passing a degree, who feel they can’t; and therefore be unwilling to even start. These people may well feel less threatened by a Diploma course, I would count myself amongst that number.
The degree course only adds to the diploma academic skills; as Beakie said essays being graded at a significantly higher level. Why does the degree course not also include proof of advanced practice, as measured by mentors on the ward, for example. Newly qualified adult nurses could be trained in a number of advanced techniques (phlebotomy) from the start, mental health nurses could receive advanced hiding in the office and drinking coffee training, midwives could receive training in how to be horrible to their clients … Ok scratch the last one.
Neither do I see a solid link between academic proof of intelligence and actual practical intelligence. Being able to construct a wonderful (and potentially useful) research project does not make someone a better staff nurse able to organise a run a busy shift on an acute admissions ward, it probably does make someone a better nurses researcher. I do wonder how much crossover in required skills there is between the two.
OSB – nursing students are fabulously well-funded in comparison to other students, such as medical students who qualify with debts of about 30 grand, I believe. That’s debt that accumulates as a direct result of being a medical student, not debt that accrues through such things as having a social life.
Student loans are only repayable once you start earning a certain amount of money, and are repaid at a highly favourable rate. It’s by no means a perfect system, but it’s better than what went before, which largely kept university a privilege of the few paid for by the many. The avoidance of debt is not the be all and end all of life.
Nursing students are also in a much better position at the other end of their courses, when they are pretty much guaranteed a job in marked contrast to students on other programmes who struggle in an increasingly competitive graduate market. But again, the avoidance of periods of unemployment is not the be all and end all of life either.
You think I’m being aloof and dismissive. That is because you don’t get out in the real world enough, where people take risks to get what they want. Get out of your office once in a while, talk to people who aren’t either obliged to agree with you or face your spluttering rage, or aren’t in thrall on one of your youth outings and you might see that young people aren’t deterred from university by the thought of debt.
And finally, you seem to think academic ability is a fixed attribute, that sort of freezes in place around the A level mark. It isn’t, people’s minds can be improved (not all people’s minds, granted, as your posts show), they can go on learning right up until the day they pop their clogs.
WHY DON`T YOU FUCK OFF, YOU FAT OBTUSE KNOBHEAD ?
I am very well aware that nursing students are “fabulously well funded” in comparison to others. I have never questioned it. ( That hardly means they are fabulously well funded, full stop, does it ? Are you going to address the question of how long you think the bursary is going to last now ? )
I am very well aware that student loans have favourable interest rates. I have never questioned it
I am very well aware that nursing students have huge advantages in finding employment. I have never questioned it
I am very well aware that risks and indebtedness are obstacles that have to be negotiated in life. I have never doubted it.
IN THE FUCKIN` REAL WORLD. I have colleagues having their homes repossessed, filing for bankruptcy, married and living with their parents, competing vigourously ( to say the least ) for night shifts, driving unroadworthy vehicles and living on 9p noodles for the fortnight before pay day. I`ve no doubt they would all like to guillotine Marie Antoinette.
Comparisons with medicine are wholly invalid, the rewards fully justify the risks in that sphere.
Don`t fuckin` tell me debt avoidance isn`t a worthy pursuit. I fuckin` know. If you can manage to live mortgage and debt free the rewards are fantastic.
You fuckin` get out there are thousands of horrendously indebted young people out there who wish they had never heard of University
THE NATIONAL DEBT IS RISING ( from a very unpleasant start point ) BY £30,000 EVERY SECOND. THE FUTURE DOESN`T LOOK ROSY AT ALL. NURSING REMUNERATION DOES NOT, AND WILL FUCKIN` NOT, JUSTIFY TOO MUCH RISK TAKING.
I don`t have an office.
You need to calm down, dear. Get out of your office and have a nice walk in the real world.
A small tip. If you`re looking to cast off your dismissive, aloof Marie Antoinette persona transforming yourself into Michael Winner isn`t a smart move.
But you really do need to take a powder and chillax dude
Three points for comic genius.
With reference to the discussion about intelligence and nursing. Does anyone out there know of any research investigating the relationship between nurses percieved or measured intelligence and their “people” or “interpersonal” skills or abilites? Many would argue that these skills are crucial to nursing practice. People may be highly intelligent and yet be very poor at relating to others.If someone does not have these skills, it is very difficult, if not almost impossible to help people acquire these abilities.This is not for a second to raise the old ( well discredited ) chestnut of “lots of brain = no commonsense” or ” being big hearted = being thick ” We will all possess these qualities in variable quantities and to varying degrees.
Intelligence is obviously vital for a nurse if she/he is to be a competent (now there’s a word we don’t here much of nowadays ) practitioner. Yet intelligence alone may not be the sole Guide to, or predictor of the quality of nursing care. Could it be that personality and aptitude are also are very relevant to the provision of good nursing? I’m sure the arguement is more complex than simply discussing intelligence alone.
Dazedandconfused:- further to your comment about madwives. What’s the difference between a pre-menstrual rottweiler and a midwife?———————-Lipstick.
“chillax dude ” ???. We`re all convinced that you get out now you`ve proven you`re fluent in street speak. Twat !
Negative two points for missing the point just a little.
Dear sweet baby J, OSB, will you take a deep breath FFS.
mental d – that’s a good and interesting point. We rely largely on students’ practice placements assessing their practical skills and attitudes as that is the most appropriate arena for those factors to be evaluated. I’ve taken part in university-based exams which were intended to assess students’ communication skills, but they are inevitably decontextualized and do not adequately reflect the real practice situation or the students’ real life capabilities.
Oh and the only midwife I know is some big burly bloke called Darren, and I don’t remember him wearing lippy LOL
Fair enough, Beakie. House re-possession is hardly worth getting vexed about. You`re entirely oblivious but it`s not always overly pleasant to be living in comfort when too many of your peers are struggling. Still, who cares as long as your small minded, politics of envy objectives are realised.
I don`t know why I bother. I had no intention of contributing to this thread but you had to poke a stick in my cave. Leopards don`t change their spots. It may impress newer Mentalists but as I told you previously tenacity has to be consistently applied to be truly admirable. At heart, you`re still the same weak, take your ball home character you`ve always been. You`re not witty wnough. You`re not scathing enough. Your Eurobollocks / be like the physio arguments have been of a particularly poor standard. Your bare faced lying in claiming to know a significant number of nurses wanting to work on the continent, well, that`s just distasteful.
I`m off to see a fat man from a fantasy land. Don`t put the kettle on, I`m referring to Santa.
And don`t LOL at your own jokes
Plus two points to OSB for reminding me he was expressly invited to this cat fight.
I don`t know why I bother.
Neither do I – the amount of time and energy you put into writing the utter rubbish you do always amazes me.
I think you both make decent points. Keep going.
There are points and there are points. There are very few absolutes in this job and there is virtue to be found in most ideas. However, some things are beyond debate. The nursing salary is pretty decent and we have job security for others to be envious of. We have a lot to be thankful for. However, if you get into financial difficulty it, very definitely, is not a salary which will easily extricate you from the hole you`re in.
The world is a tough mistress at the moment. I`m a big admirer of hard work. I`m a big admirer of prudence. I`m a big admirer of attempts at self sufficiency. If Beakie were to be saying to his students “be careful with your finances, I know it`s tough but if you can augment your income do it, do your utmost to step out as a qualified with nothing to restrain you” then that would be something. What do we get though ? Someone who wants to dress up as Elton John does and declare “what student debt ?” It`s an horrific problem in the sticks. It has to be an even bigger problem in Beakieville as the cost of living is significantly higher.
If you have to go into denial and lie to promote your argument, then perhaps it`s time to reassess your points.
Plus one points for florid lunacy.
Hello all
It’s far too late to join in this now…
Gutted though that I’ve been off sick and watching daytime telly when all this was going on !
To stray completely off topic, I am being considered by many as an antisocial freak because I have decided that I don’t really want to attend my graduation ceremony next month.
I can think of far better things to spend my money on than the hire of a cape and gown and silly hat to celebrate my qualifying as a nurse…well already spent it on a wii fit
Has anyone else on this forum not bothered with it all ?
Will I as many folk tell me, ‘regret it when I am old(er) ?
Does it make me an antisocial ?
Is it cause I is a diploma nurse ?
(sorry..that last one was lame…;-)
The Wii Fit is awesome!
Sorry, nothing more insightful to add at this time of the morning.
Could well afford it. Didn`t bother. No regrets.
I’d like to see Mental Defective’s lippy-wearing rottweiler.
In OSB and Beakie’s courtship ritual one point has got lost. This is the distinction between education and training. Old fashioned of me no doubt but I think people need both. The point of education is to enable people to think, including challenging established orthodoxies. Astronomy was mentioned: if a potential nurse wants to read Astronomy first, more power to their elbow! The Bar Council and the police, to cite but two, now say they prefer people with as wide educational and other experiences as possible. People who try to turn training into education, e.g. by being the course rebel, or education into training, e.g. by limiting their choices to apparently vocationally relevant modules, generally bite the dust in my experience. Is not the awful warning of the medics before us? Do we really want to go down that path of early over-specialisation? And what will happen to graduate entrants? I know there’s a shortened course available at present but would that survive? Personally, I can see mileage in, say, an MSc., RMN course. Teaching people not to use vile sociology-speak (“issues around,” etc.) but to think clearly what they mean and express it accurately would be a start.
OSB, have you considered a drama degree? Beaky, don’t be so bleedin’ smug. You know you both love each other dearly.
[...] from the debate the MN regulars have been? You can’t move for comments from them when they’re arguing about nursing becoming an all-graduate profession (something that will make slightly less than fuck-all difference to patients), but when it comes to [...]