Where are all the nurses?

Public beliefs that a career in care is vocational rather than professional are largely to blame for the shortage of nurses in the NHS, the Royal College of Nursing claims.

The notion that "it requires nothing but a disappointment in love, the want of an object, or incapacity for other things to turn a woman into a good nurse" as noted by Florence Nightingale, may be nothing less than laughable in today's working climate. But, says Anne Eaton, education adviser to the RCN, "there is still a feeling that to care, you can't be educated as well".

"The media haven't exactly helped," says Ms Eaton. "Ever since nurse education was moved from the arena of hospitals into that of higher education 10 years ago, there have been frequent headlines such as 'Too Academic To Care'. Much of the public winds up believing that while nurses might be able to write endless essays, they are incapable of providing adequate medical assistance - and it is for the same reasons that potential nurses stay away from the profession."

The NHS is a staggering 12,000 nurses short of its full complement of 247,000 but rather than advocating a return to more practical training as a possible short-term solution, the RCN is campaigning for nurses to be educated to even higher levels. Currently, 80 per cent of nurses study for the Project 2000 diploma, while 20 per cent take a degree course - whereas the RCN believes nursing should be an all-graduate profession.

Josie Irwin, senior employment relations manager at RCN, explains: "The stereotype is that nursing is a 'calling' and isn't a serious career option for those with intelligence or initiative. But the reality is that nursing is now an increasingly autonomous job with a great deal of responsibility, including the possibility of leading large projects and schemes. And since every other health care professional has a degree base, we believe nursing should too. Indeed, student nurses today are no longer learning to do things the way they have traditionally been done. To achieve this these new nurses require a background in communications studies, psychology and sociology, as well as an in-depth of knowledge of clinical skills."

It may not be an instant solution, admits the RCN, but it is hoped to raise the status - and pay and career opportunities - of NHS nurses in the long term. Given that morale is at an all-time low, not least because salaries are poor compared with the private sector and because of severe staff shortages, it is a move that the RCN claims is essential.

Reflecting this long-term vision is the plan announced this month for top pay for nurses on the ward to rise by a third to pounds 40,000 a year. As part of the Government's aims to keep more of the best-trained staff in the NHS, this pounds 50m initiative will offer no more instant fixes than the RCN's educational aims, says Ms Irwin. "But that doesn't take away from the fact that it is another vital step towards changing the image of nursing in the future."

In fact, to begin with, only a few hundred of the new super-nurses will be appointed, working on pilot schemes jointly run by the Royal College of Nursing and the Department of Health. Ultimately, however, the aim is to have one in charge of 50 nurses - meaning that 5,000 would eventually be needed.

Frank Dobson, the Health Secretary, claims it is part of the most comprehensive strategy ever produced for improving the status, training, pay and job opportunities for nurses. "In the past, many of our most experienced and qualified nurses have hit a glass ceiling when their skills and abilities are at the maximum," he said. "If they wanted to progress further with better pay, they had to leave the wards and go into management."