Tuesday, 26 March 2013

A thought

So, nurses are to be forced to spend a year wiping bottoms so that we can make sure that they are suitably caring people to become nurses.

I can see the sentiment, and agree with it.  But the means seems to be a little obtuse.  Is that the only way of making sure that someone is a caring person?  Can we not, perhaps, watch them in action for a while to make sure?  Do we need to take (ex hypothesi) skilled and intelligent people and make them waste a year of their time proving a point, when they could be doing something more valuable instead?

And where does the precedent take us?  Doctors work alongside nurses in delivering care, I am told.  So why not make them work as a healthcare assistant for a year before starting their medical degree?

I hear also that the working conditions in the Mid Staffs NHS Trust were unconducive to staff who wanted to warn management about problems.  Obviously the NHS managers did not care adequately about the patients.  Should they have spent a year working as a healthcare assistant first?  Surely, what is good for the nurses is good for all the other hospital staff first.

And what of the Minister for Health?  With responsibility for so many caring professionals, with oversight of the system for caring for the entire UK population,... well, the logic is inescapable.

And one last, quiet worry.  What about the healthcare assistants?  If the nurses are too posh to wash because they were never healthcare assistants, what does that say that we think the healthcare assistants are?


  1. If nurses are not wiping arses, what do we need them for???

  2. I watched them in action caring for my mother in her last days, FT. They do a lot more than that.

  3. I Know. I have recently retrained as a Care assistant. I still do not see the difference between nurses and C.As.

    WE give medication, we inject, take blood,keep medical records, etc etc.

    All nurses appear to do differently is draw more pay every month.

  4. Of course most medical students have done a lot of that already because to get into med school you have to have a CV full of stuff showing you care about medicine and people, etc..

    But I agree with your main point, do we have to force people to eat shit before they can possibly become good at their white collar jobs?

    It's a tough one. I think a lot of people would say that a range of experience makes for better judgement. But should that be made mandatory by the state? Possibly not.

  5. There has been, reportedly, a significant problem with NHS hospitals around Stafford. But elsewhere, NHS hospitals are providing much higher levels of care. If the problem were a lack in the general training and motivation of nurses, would that difference be the case?

    So, with a lack of evidence that general training and motivation of nurses is the problem (rather than the suggested, and reportedly evidenced, errors in management policy), the reaction of the Health Secretary and his department is to call for improvements in the general training and motivation of nurses.

    Thus there will probably be a greater lack of nurses (most of them good nurses) and, through this, reduced staffing levels (which strikes me as at least partially the problem, and that being contingent on a lack of money).

    But the lack of money is not just from a lack of funding, but also from spending those funds one does have on things that do not pay their way: in this case in delivery of adequate care of patients.

    Best regards

  6. I'll say what I already said on Twitter - you can't train compassion, you can only select for it.

  7. Obviously the NHS managers did not care adequately about the patients. Should they have spent a year working as a healthcare assistant first?

    No. Just snap their femurs and let them be patients for a couple of months.

  8. I think that nurses (and also teachers) should serve an apprenticeship of some kind in order to see what the job is about. Far too many study first, then start work and find that the job is not for them, but also that their qualifications are of little use elsewhere. Surely it is better to spend a year learning the basics, from which they can drop out at any time, than waste three years and then, for financial reasons, be effectively forced to do a job for which they are unsuited.

    1. That is why, here (Germany), you have 200 hours training, AND a ten to twelve week "Praktikum" (Where you do the job, but do not get paid.... what that is in English, I have forgotten).

      Only AFTER that, do you get your "Pflegepass" (Licence to be a "Pflegassiatant"/"Care assistant" (Nurse to us oldies)).

  9. I used to be a qualified nurse (started training in 1990 - completed in 1993). I was one of the last nurses to go through the "traditional" training which was very much ward-based.

    At around this time, we had Project 2000 coming through in certain areas of the country.

    Project 2000 training was far more academically based. Less time on the wards, more time in classrooms.

    As every Project 2000 trained nurse came through with a Diploma in Nursing, the next step was for more people to do the Nursning Degree.

    What we ended up with were a lot of highly-qualified nurses who knew the theory and the science behind nursing but who couldn't tell one end of a patient from the other.

    I hate to make such a generalisation but it really wasn't difficult to see the Degree and P2K nurses from a mile away.

    The traditionally trained nurses would just get stuck into the dirty work but many of the more "academic" nurses would look aghast, "You want me to do *what*!?"

    Many of these people didn't really want to be nurses as such, they saw the degrees and the diplomas as a fast track straight into management, research and clinical specialist type positions where the work is more office-based, better paid, better hours, better conditions and not one dirty bottom in sight.

    It is for this reason that I don't lose too much sleep when I hear how the nasty government is going to "axe 5,000 nurses" or whatever.

    They're probably not even nurses, if truth be told.