Nursing » Hospital Dr

Posts Tagged ‘Nursing’

Newbies won’t know their arses from their elbows

By Bob Bury - 7th January 2010 2:29 pm

I said in my blog last time that I’d probably be acting the old curmudgeon (love that word) so this week I’m on the government’s case about its half-baked scheme to make nursing training all degree level by 2013.

Before Christmas, Hospital Dr editor Mike Broad referred in a blog to a letter I wrote on the subject to The Times. There were other letters in The Times - several from nurses - making the same point and only one opposing voice, that of the President of the RCN (as you might expect, given that the driving force for the change is the hankering of RCN apparatchiks for more professional status).

While Mike described it as an “interesting” letter, he had the temerity to disagree with its main premise that mandatory degree entry was a bad thing.

However, the week after my letter this article appeared in the same paper, confirming the fact that degree training is not appropriate for many of those who currently enter nursing, and that making it mandatory will only exacerbate the shortage of nurses in the UK.

I also know that I’m right because I recently discussed the issue with the only two people who can hold a candle to me when it comes to curmudgeonliness - my wife and daughter. Lin is a retired midwife and school nurse, and my daughter Kate is a practising midwife (yes, I share my house with two ‘madwives’ - I’m not going for the sympathy vote or anything but…).

Anyway, Kate was bemoaning the fact that trainee midwives get so little practical experience on the wards now and I was saying that it’s getting that way with medical students.

This set Lin off reminiscing about the days when we met at the Central Middlesex in the early seventies, and how there were so many medical students and junior doctors on the wards that the student nurses would often latch on to the informal teaching that was going on, or even buttonhole an SHO and ask them for a quick tutorial on something they were finding difficult to understand. And, of course, both the nurses and medical students were doing stuff as well as listening; they were acquiring the practical skills that were essential to their respective roles. Not any more, it seems.

We’ve become familiar with the concept of qualified nurses who can’t wash a patient’s dentures because they haven’t done ‘the course’, and we seem to be going down the same path with medical training. For example, as far as I can tell, today’s medical students don’t learn any anatomy - I expect they’re all too busy with their empathy workshops - and we risk producing doctors who are lovely little communicators but who don’t have anything useful to say.

It really worries me that, just when I’m likely to start needing medical attention myself, the doctors providing it will, literally, not know their arse from their elbow.

Tags: Juniors, Nursing
Posted in Bob Bury | 8 Comments »

“Nurses are already as important as doctors”

By Paul Thorpe - 22nd November 2009 9:29 pm

So, all nurses are going to have a degree now. How depressing. The ability of the nursing hierarchy to destroy all that is good about their own profession in a vain attempt to be seen ‘as important as doctors’ and taken seriously politically never ceases to amaze me.

Most nurses are good at their job. I meet nurses who are great at their job every day, as I am lucky to work in a darn good hospital. Those nurses who went in to their job to nurse, I mean to actually look after patients - most of whom don’t have a degree - think it is a pointless and ridiculous idea.

Let’s stop trying to pretend that nurses are as clever as doctors. You have to get better GCSEs and A levels to get into medical school than you ever will to get into nursing school. Doctors will have a higher IQ than nurses. However, if that means that doctors are somehow more important than nurses, then you are - like the RCN - simply nursing the large chips balancing on both shoulders.

Nurses are already as important as doctors in getting the patient through their healthcare experience but their roles are different.

Patients and families don’t want nurses to have done research, or to be too specialised or clever to answer the call bell and make sure that they get their analgesia, or don’t get a pressure sore.

Other health professionals don’t want nurses to be too important to be able to tell them what is going on with a patient that day.

The nursing profession would do better to focus its attention on improving the remuneration and career progression for its members for actually being a nurse. It is terribly frustrating that the only way to currently achieve significant career progression in nursing is to stop doing it, pick up a clipboard and a Blackberry and become a manager. Some of them go on to become very effective managers; many are not, but who can blame then, when the bottom line tells them it’s the only way to climb the greasy pole and get a decent salary?

If we actually helped nurses progress up the bands for staying in their caring role, and didn’t try to populate wards with as many inexperienced band 5s as possible, then standards would rapidly improve with the number of experienced nurses actually on a ward rather than in the boardroom.

Secondly, the key point about being a professional is about being supported and encouraged by your professional structure to take professional responsibility for your decisions and actions. Doctors have this in spades - it is part of the core and fabric of how we work, and it why we will always have impression of ‘being more important’.

However, this is only in the same way as a fighter pilot is seen as ‘more important’ as an aircraft engineer. The job has a more sexy PR profile, but if the aircraft engineer can’t deliver their piece of the team role, the steely-eyed killer sits firmly on the ground polishing the Ray Bans. Nurses are often terrified to take professional decisions, as they often receive very little understanding and support from their professional hierarchy if something goes wrong.

Finally, the most annoying aspect of yet another ridiculous government attempt to solve all the problems of the health service is that it will be - like nearly all of their previous attempts - ineffective and also hugely wasteful. Nursing Standard has obtained the government’s own figures showing that current nursing degree courses are experiencing huge drop out rates. It’s up to 51% in some universities, and up to 78% on some specialist nursing courses.

There are, of course, complex reasons for why this is happening, but it is a criminal waste of money and of people’s enthusiasm to try to shoehorn them through an academic process which has not been designed to deliver appropriate education, and to which they are obviously not suited.

To any nurse who reads this, I hope you don’t feel this is in any way saying that doctors are ‘superior’. What I, and the patients, want, is for you to lobby and petition your political representatives to support and remunerate you for actually doing the things that first drew you into your very important job - nursing.

Tags: Managers, Noctors, Nursing
Posted in Paul Thorpe | No Comments »

Graduates “exacerbate lack of skilled nursing care”

By Mike Broad - 15th November 2009 10:44 pm

Dr Bob Bury, a consultant radiologist in Leeds, wrote an interesting letter to The Times last week on the subject of nursing. It was in response to the news that nursing will become degree entry by 2013.

He writes: “Doctors of my age (early sixties), particularly those of us married to nurses of a similar excellent vintage, have watched with dismay as the increase in academic content of nurse training translated into a corresponding decline in the quality of nursing care at the bedside. An insistence on degree training for nurses will simply accelerate this process.”

Bob is eloquently expressing a view I’ve heard many times in recent years, namely the frustration with a perceived deterioration in the standards of basic nursing care.

But let’s not underestimate the benefits that degree entry confers. I was writing about social care when social work took the same step. It catapulted social work up the list of preferred professions for graduates, and has helped counter-balance the bad press the profession has received in the wake of the Baby P case.

There is a now a younger generation of bright, ambitious social workers coming through the ranks that offers some crumbs of comfort for a hard-pressed profession. Inevitably, nursing will reap the same benefits and compete more favourably on recruitment with other professions.

Bob acknowledges this in his letter: “While it is true that some nurses are rightly going on to gain higher level skills and take on some of the tasks previously the province of doctors, there is scope to do this within the current post-qualification training system. Erecting artificial and unnecessary barriers for those entering the profession will exacerbate the lack of skilled nursing care and produce a generation of nurses more familiar with a clipboard than a bedpan.”

This is where the parallels with social work break down. There is a significant difference between the professions - there’s much more ‘dirty’ work involved in nursing.

But, rather than argue against the introduction of graduate entry, we should really be striving to strengthen the roles of auxiliary nurses and healthcare assistants. As many roles within the NHS continue to evolve, they’re now the ones who hold the key to delivering excellent basic care on the front line.

Tags: Nursing, Social work
Posted in Dr Blogs | No Comments »

Jerry says ‘aksya ng oras’ to nurses having a degree

By Jerry Nelson - 13th November 2009 3:31 pm

My God, I think that’s the first time I’ve managed to make Rice Krispies actually come out of my nose.

Headline in the paper: “All nurses to have degrees by 2013.” BWAHAHAHAHAHAHAHAHAHAHAHAHAHAHA!

What a hoot?! And in a related announcement the Health Minister has said that all nurses are to have a massive chip on their shoulder by…oh wait - they already have.

So they’re going make nursing a ‘degree course’, to be studied a ‘university’, giving it equal status with existing intellectual bastions such as Star Trek Studies, Dressmaking and Form Filling In. I can’t wait.

Told Dweeb Urologist Johnson the hilarious news and he came over all serious. Actually that happened the day he was born, but anyway. He said: “Actually, Jeremy this country has been successfully producing graduate nurses for many years now.”

I was flabbergasted! This country produces nurses? I though we stopped doing that around the time of the Festival of Britain. Don’t we get them all from the Philippines now? (And long may it continue if my dalliance with the hottie on Mandela ward was anything to go by).

By the way, in the native dialect tagalog the word for ‘degree’ is ‘titulo’. But, more importantly, the tagalog for ‘waste of time’ is ‘aksya ng oras’.

Tags: Humour, Nursing
Posted in Nelson's Column, Bolg, Blog, whatever... | No Comments »

Nursing to become degree entry from 2013

The Times - 12th November 2009 9:07 am

Anyone who wishes to become a nurse will need to have a degree within four years, in one of the biggest shake-ups of medical education in the history of the NHS.

The government will announce today that all new nurses will need to be educated to degree level in an attempt to improve the quality of patient care. The move, which will be enforced from 2013, is designed to raise the status of nursing and to end the stigma of the “doctor’s handmaiden”.

Critics claim that the changes, to be outlined by Ann Keen, the Health Minister, will create an elitist profession and scare off recruits with the prospect of a long and expensive period of study. There are also concerns that some nurses would be “too clever to care” and refuse to carry out duties such as washing and feeding patients and helping them to the lavatory.

There are more than 400,000 nurses in the NHS, making up the largest part of the country’s health workforce. The minimum level for NHS trainee nursing positions is a diploma - a two or three-year nursing course.

Under the new rules, candidates will require a degree in nursing or equivalent international qualification. The courses, lasting up to four years, will meet standards developed by the Nursing and Midwifery Council (NMC), the professional regulator.

The NMC has carried out a review of pre-registration nurse education at the request of the four UK health departments. The move is supported by all the key nursing bodies.

Nurses call for safer staffing levels in NHS

BBC Health - 19th October 2009 11:03 am

Four out of 10 nurses say staff shortages compromise patient care at least once a week, according to the Royal College of Nurses.

An RCN manifesto to all the political parties says NHS employers must assure themselves they have safe staff levels. The RCN, whose survey covers the views of 9,000 nurses, is warning against job cuts due to possible reduced funding.

NHS trusts said managers were increasingly examining their workforces to best use the skills of their staff.

The RCN has issued its 2009 Employment Survey which shows that more than half (55%) say they are too busy to provide the level of care they would like.

Almost two thirds (67%) consider their workload is too heavy.

Basic nursing care ‘lacking’ in hospitals

BBC Health - 27th August 2009 2:03 pm

A patient lobby group is demanding an urgent review of basic hospital care after highlighting accounts of “appalling” NHS standards.

The Patients Association highlighted 16 cases in England where people, often the elderly, were left lying in faeces and urine and were not helped to eat.

The group’s president Claire Rayner, an ex-nurse, called for “bad, cruel nurses” to be struck off. The government said the cases were unacceptable but not representative.

The latest national survey of patients by the health regulator showed that nine in 10 rated their care as excellent or good - with just 2% saying it had been poor.