Ian Birrell: It is patients who will end up losing out

Nursing is a practical profession. It is not something that can be taught in universities

Share
Related Topics

Nurses are the lifeblood of the health service. Without good people on the medical front line, all the technological breakthroughs, genetic advances and brilliant doctors are meaningless if infections are allowed to spread, patients left in fouled bedding or their families treated in a callous manner.

Nurses also have an image problem. Those angelic stereotypes don't necessarily match a job that can be very tough, with anti-social hours, sometimes degrading work and often difficult patients. And, until recently, the pay was lamentable. No one should be under any illusion that nursing is easy.

Women still make up 90 per cent of the nursing workforce, but they have many more career options than in the past. They are also more likely to take career breaks, work part-time and retire early. This partly explains why nursing is in crisis, with a fast-ageing workforce, high staff turnover and substantial decline in new applicants.

The Government's solution, encouraged by the main nursing union, has been to turn it into a graduate profession, with some tasks taken over by nursing assistants. The hope is that improved status will attract more applicants from both sexes, and that they can handle more complex roles. But patients may well be the losers.

Already there is concern over falling standards of care. Good nurses – the vast majority – ease the trauma of an operation or coping with a sick relative. But like many people with a family member in long-term care, I have seen too many disturbing incidents. These range from the minor, such as nursing staff chatting away when patients are calling them, to the major, such as ignoring my daughter during a potentially life-threatening seizure despite her screaming and thrashing around in bed.

I have one friend who repeatedly found her disabled daughter left in soiled nappies and desperate for a drink after overnight stays in hospital. Another discovered his dying father covered in blood and faeces; the nurses had even forgotten to give him morphine that he desperately needed for pain relief.

In August, the Patients Association issued a damning report filled with cases that left Claire Rayner, its president and a former nurse, sickened by "cruel" nursing failures. Since then, the association has been inundated with harrowing new cases, and many of those suffering the worst neglect are the most vulnerable: the old, the disabled and the terminally ill. It fears there is too much emphasis on academic lessons for graduate nurses over practical training.

When I wrote about my family's dismal experiences of the NHS three months ago, I received scores of emails from people complaining about nurses. Perhaps this was to be expected, since nurses have the most to do with patients. But the tales of filthy wards, of festering wounds, of elderly people left hungry, were awful all the same.

Less expected was the barrage of emails from nurses. Many said the introduction of Project 2000 in the early 1990s, which switched training from the bedside to the classroom, had led to an influx of well-educated nurses untrained – and sometimes uninterested – in basic everyday care for the sick.

"Nursing is a practical profession. It is not something that can be taught in a university. We had student nurses three months away from their final exams asking how to make a bed," was a typical response. Another spoke of ambitious young nurses focused on senior specialisms "rather than bedside care supporting bereaved, sick, sad and often lonely people."

It is not just personal testimonies. While most NHS patients receive good treatment, more than 160,000 people a year rate their care as poor. And the number of complaints against nurses is rising even as the number of graduate nurses increases. Last year there were nearly 20 per cent more referrals to the investigating committee of the Nursing and Midwifery Council than the previous year.

Additionally, many of the best nurses abandon the places they are most needed. Some move into private practice, others into management where the hours, pay and prestige are better. Despite recent efforts to improve the career structure for senior nurses, this will increase as more graduate nurses enter the profession saddled with heavy student debt.

But not all nurses need degrees; indeed, it makes little sense to exclude candidates for a profession facing shortages. We need a range of people entering nursing, well-trained and with differing ambitions. There are also wider questions to resolve about attitudes to the old and disabled, and the shortage of Britons willing to do vital caring jobs in an ageing society.

More immediately, the varying quality of nursing degree courses must be tackled. One email I received was from a student who quit after learning to write beautiful essays but little about patient care. "To this day, I don't know how to do first-aid or put on a bandage – they whizzed through those two subjects on half-day courses," he wrote. "It seemed that the powers that be were trying to change the nurse from being the doctor's sidekick to being a profession. The casualties? Nurses and patients."

i.birrell@independent.co.uk

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Recruitment Genius: Finance Director

£65000 - £80000 per annum: Recruitment Genius: Finance Director required to jo...

Recruitment Genius: Medico-Legal Assistant

£15000 - £25000 per annum: Recruitment Genius: This is a unique opportunity fo...

Ashdown Group: (PHP / Python) - Global Media firm

£50000 per annum + 26 days holiday,pension: Ashdown Group: A highly successful...

The Jenrick Group: Quality Inspector

£27000 per annum + pension + holidays: The Jenrick Group: A Quality Technician...

Day In a Page

Read Next
William Hague with his former special adviser, Christopher Myers  

Who needs special advisers? We all do

John Rentoul
Vivienne Westwood and her son Joe Corré deliver an anti-fracking letter to No 10 last week  

From noble to narky, the fall of the open letter

DJ Taylor
The week Hollywood got scared and had to grow up a bit

The week Hollywood got scared and had to grow up a bit

Sony suffered a chorus of disapproval after it withdrew 'The Interview', but it's not too late for it to take a stand, says Joan Smith
From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?

Panto dames: before and after

From Widow Twankey to Mother Goose, how do the men who play panto dames get themselves ready for the performance of a lifetime?
Thirties murder mystery novel is surprise runaway Christmas hit

Thirties murder mystery novel is surprise runaway Christmas hit

Booksellers say readers are turning away from dark modern thrillers and back to the golden age of crime writing
Anne-Marie Huby: 'Charities deserve the best,' says founder of JustGiving

Anne-Marie Huby: 'Charities deserve the best'

Ten million of us have used the JustGiving website to donate to good causes. Its co-founder says that being dynamic is as important as being kind
The botanist who hunts for giant trees at Kew Gardens

The man who hunts giants

A Kew Gardens botanist has found 25 new large tree species - and he's sure there are more out there
The 12 ways of Christmas: Spare a thought for those who will be working to keep others safe during the festive season

The 12 ways of Christmas

We speak to a dozen people who will be working to keep others safe, happy and healthy over the holidays
Birdwatching men have a lot in common with their feathered friends, new study shows

The male exhibits strange behaviour

A new study shows that birdwatching men have a lot in common with their feathered friends...
Diaries of Evelyn Waugh, Virginia Woolf and Noël Coward reveal how they coped with the December blues

Famous diaries: Christmas week in history

Noël Coward parties into the night, Alan Clark bemoans the cost of servants, Evelyn Waugh ponders his drinking…
From noble to narky, the fall of the open letter

From noble to narky, the fall of the open letter

The great tradition of St Paul and Zola reached its nadir with a hungry worker's rant to Russell Brand, says DJ Taylor
A Christmas ghost story by Alison Moore: A prodigal daughter has a breakthrough

A Christmas ghost story by Alison Moore

The story was published earlier this month in 'Poor Souls' Light: Seven Curious Tales'
Marian Keyes: The author on her pre-approved Christmas, true love's parking implications and living in the moment

Marian Keyes

The author on her pre-approved Christmas, true love's parking implications and living in the moment
Bill Granger recipes: Our chef creates an Italian-inspired fish feast for Christmas Eve

Bill Granger's Christmas Eve fish feast

Bill's Italian friends introduced him to the Roman Catholic custom of a lavish fish supper on Christmas Eve. Here, he gives the tradition his own spin…
Liverpool vs Arsenal: Brendan Rodgers is fighting for his reputation

Rodgers fights for his reputation

Liverpool manager tries to stay on his feet despite waves of criticism
Amir Khan: 'The Taliban can threaten me but I must speak out... innocent kids, killed over nothing. It’s sick in the mind'

Amir Khan attacks the Taliban

'They can threaten me but I must speak out... innocent kids, killed over nothing. It’s sick in the mind'
Michael Calvin: Sepp Blatter is my man of the year in sport. Bring on 2015, quick

Michael Calvin's Last Word

Sepp Blatter is my man of the year in sport. Bring on 2015, quick