Editor-At-Large: Nurses are not heroines. They are professionals
There's been plenty of hand-wringing over the news that from 2013 all new nurses will have to spend three years studying for a degree to qualify. At present the majority train for two or three years and are awarded a diploma. Critics claim these higher standards mean that trainee nurses will spend time sitting in lectures when they could be learning practical skills on the job, and widespread concern has been expressed that the profession will attract the wrong kind of applicants, more concerned with their careers than carrying out menial tasks.
I can't honestly see the problem. The very mention of the word nurse results in a knee-jerk reaction from so many people. Nurses are right up there with the RSPCA, donkey sanctuaries and Princess Diana when it comes to being sanctified. Sure, most nurses are highly committed to their jobs, but at the end of the day, they are specialised workers, not quasi saints or trainee miracle workers.
Medicine these days is increasingly high-tech. Surgeons operate using robots and lasers. Aftercare involves a vast range of sophisticated gadgetry. The combination of drugs that doctors prescribe these days is complex and the dangers of administering wrong combinations or an inaccurate dosage should never be underestimated. The old notion of nurse holding your hand and offering a few words of emollient chat while taking your temperature is completely irrelevant and arcane in today's modern hospitals.
A few years ago I took part in a television series that involved spending a couple of weeks working in Barnsley General Hospital. It was crystal clear after one day that hard-pressed nurses couldn't possibly do everything they were supposed to. I saw at first hand that what the NHS needs is a two-tier system, with far more nursing auxiliaries carrying out daily routine tasks plus a whole army of cleaners and other helpers, working in teams led and directed by highly qualified nurses.
Increasingly, hospital wards are full of people who shouldn't really be there at all – old people who should be in care homes or hospices. The terminally ill, who would be much more comfortable at home or in a hospice. Dementia sufferers, who need specialised care. General wards should only be catering for patients preparing or recovering from an operation or a procedure which means they are bedridden. Everything should be geared to limiting their time in hospital, where they are vulnerable to all sorts of infections, to as short a stay as possible. Add to that the fact that hospital food is generally repulsive and most elderly patients suffer from malnutrition, and it's clear that a hospital is not somewhere you want to spend much time in.
Highly qualified nurses are needed to police standards and to speed up the recovery process. They must understand the latest developments in patient care, as well as being trained to direct a team and take decisions. That doesn't mean they are not compassionate and caring, it's just that in a modern hospital leaderships skills are essential. Giving patients a bed bath and feeding them are tasks which should be carried out by assistants, who at the moment, are very poorly paid with a starting salary of just £13,000, a pittance for very challenging work in unpleasant circumstances. On some of the wards in Barnsley, there were only two people helping to feed up to 15 old people at meal times. No wonder the patients didn't want to eat – food was usually cold.
The nursing profession needs to attract more men, and more high-calibre entrants who will take it forward and enable it to shed its out-of-date Florence Nightingale image. In the past year there has been an increasing amount of complaints about nurses who have failed to treat patients with respect and whose levels of care leave a lot to be desired. By elevating the profession to graduate status, as well as increasing pay for assistants, patients will get a better deal. I encountered both good and poor nurses when my sister was seriously ill in hospital, and it's too tempting to generalise.
It seems the nursing profession is one that no one can discuss dispassionately – but insisting that nurses obtain a degree is a welcome step in the right direction.
Mrs Speaker Sally can do the talking if she wins for Labour
It was the votes of Labour MPs rather than those of his own party which secured the plum job of Speaker for former right-wing Tory John Bercow. He's already been criticised for spending thousands of pounds in expenses making his lavish quarters "child-friendly" – he and his wife of seven years have three small children. He has also appointed a load of toadies to the committee overseeing expenses reforms. Now, the Tories are outraged to find that Sally Bercow, an advertising executive, is to stand as a Labour councillor in Westminster. The Bercows certainly seem, to have been on a long journey of self-discovery: they met in 1989 when she was social secretary of Oxford University Conservatives and Mr Bercow went to speak. Seven years later, Sally switched political allegiance, and since then she's been credited with masterminding her husband's conversion to Labour Party favourite. With these skills, surely she should be aiming for a seat in the House? Perhaps she can't face her hubbie being able to tell her to shut up in public? Mind you, he may be out of a job if he loses his seat at the next election – bumptious UKIP leader Nigel Farage is standing against him in Buckingham.
Captains of industry are adrift
Chris Smith used to be my local MP, a likeable bloke who probably wasn't ruthless enough to survive long in government. As Culture minister, he oversaw the introduction of the lottery and managed to find the money for museums to offer free admission, but was replaced by Tessa Jowell after the 2005 election. Now he sits in the Lords, and is chair of the Environment Agency.
Chris is a well-known walker and former President of the Ramblers Association – but I wonder if he has left his sense of reality in the bottom of his rucksack. Speaking at the agency's annual conference he announced that the only way to meet climate change targets was with "personal carbon allowances" for each member of the population. That way we would have to ration our holidays overseas once we'd exceeded our quota.
How bloody ridiculous! The City is ablaze with light. The towers at Canary Wharf have every floor illuminated at 5pm on a Sunday, air conditioning on full blast. Why should ordinary members of the public sacrifice their hard-earned leisure when our captains of industry do bugger all?
Gobbledegook at the Beeb
The BBC's decision to publish the salaries and expenses of 100 senior staff might have seemed a chance to demonstrate how "transparent" it is, but it seems to have backfired. Forty-six employees earn more than the Prime Minister, and many receive this vast remuneration for running a branch of the entertainment industry, not something affecting national security or the health and livelihoods of the population. So self-important is the BBC it's invented a special opaque language to dress up quite ordinary jobs and make them sound highly sophisticated, requiring skills which mere mortals couldn't possibly do. There's a Reward Director on a whopping £196,550 – he's in charge of pay – and an Organisational Development and Change Director who handles targets and contracts. There's even an Employee Relations and People Strategy Director. The list is endless, setting new standards in meaningless pomposity. Weird how the BBC exists to communicate – but speaks a language no licence payer understands.
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Comments
My daughter is a graduate nurse on a neuro surgery ward. Contrary to the stories being bandied about she did not spend 3 years in University. She spend at most 45% of her time in lectures/off ward study. The rest of the time was on hands on ward based training and placements in a variety of hospitals.
She is dedicated, compassionate and caring but has so little time in the way she has to work to wandere around like Florence Nightengale handing out homilies and comforting chats.
After being qualifies for only 12 months she often finds herself the only qualified nurse on a ward and very often cannot take a single break on 12 hr shift. This week she had to stay on for an extra 4 hrs after a 12 hr shift because there was no qualified nurse to take over on the following shift.
After only a year she is already exhausted and highly stressed enough to be considering leaving for the type of better paid and cushy jobs most of the critics of graduate nurses have.
If people want better care than they get they need to be prepared to pay for it or force the NHS / HMG to reform hospitals so that more resources get to the first line carers.
This basically involves cutting staff numbers and finding ways to make the remainder work more hours for less pay. Much of the actual care is carried out by low paid auxiliaries and there are less and less trained staff on to share decisions and responsibility. Cheap labour basically, usually from abroad.
If they cut the management their salaries alone would pay for a considerable number of extra front line staff actually caring for the patients.
Whilst not a nurse myself, I did qualify for the original project 2000 by passing the UKCC test, and I was accepted into the Training for Midwifery. My best friend also took the exams, and he is now an EMP having spent the last 13 years in one of the busiest A&E departments in the UK.
Neither he, nor I, had ever had any "Calling" into nursing. We were working as partners in business trying to scrabble together a living in Thatcher`s Britain in one of the poorest areas in the country.
We both saw Nursing as a "career" choice.
As the qualification requirements were raised, so were the wages and the career prospects, and like us, the majority of applicants in the project 2000 cohorts had never felt any heart-tugging pull towards the nursing profession, we felt the wallet and purse-tugging pull towards a career with guaranteed promotion prospects.
Previous to this , if you wanted a "career" in medicine, and had the "smarts", you went to University and studied to become a doctor. Nurses required only dedication, a strong back, an even stronger stomach, and a genuine wish to help others.
I`m not a cynic (well, maybe a little) but I am a realist, and regardless of what idealists would have you believe, the majority of Nurses in the UK now feel that they should be compensated financially and rewarded promotionally on an annual basis. This really does not leave much room for "vocation".
The vocational nursing is done, mostly, by Auxiliary nurses. Their aspirations and expectations are pre-limited by their own realisation that they do not have the academic abilities to fulfil the required standards.
Unfortunately, even this is flawed.
Many of the Auxiliary positions that once were held by well meaning and vocational applicants from resident Brits, are now filled by applicants who`s first language isn`t English.
So even a two-tiered nursing system, as suggested perfectly reasonably , by Janet Street Porter, is flawed.
Sadly, this is reflected right across the work market... more and more applicants for fewer and fewer jobs, and subsequently the bar is raised in academic requirements. We find less and less people doing jobs they actually "want" to do, and more and more people doing jobs they have little interest in but pay enough to compensate them for the work they put in at college and University.
I just wish I had the answer, if I did, I`d be a very rich man.
Those in the profession of nursing beg to differ with Ms Porter.
Additionally, those that are currently at the teaching end of nursing have indicated that what they are currently teaching as a diploma is actually just going to be stretched out to cover the three years of the proposed degree course.
In effect we will have equally well educated individuals but with a year added and a degree scroll chucked in.
Oh and I wonder who will be paying for all the additional costs ? And would this money not be better spent on us, the end user patients ?
So Ms Porter a little more research and a little less bluster will do us all a favour.
Not least your good self.