A Nurses' Place Is By The Bedside, UK

Main Category: Nursing / Midwifery
Also Included In: Medical Students / Training
Article Date: 19 Feb 2008 - 3:00 PDT

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An all graduate profession will not deliver better patient care and is not the future for nursing warned UNISON, the UK's largest health union. UNISON's response to the latest DOH and Nursing and Midwifery Council (NMC) consultations on nurse training found that the overwhelming majority of nurses see their place as by the bedside.

The union is calling for a wide entry-gate into nursing to encourage more people into the profession and to nail the "too posh to wash" scenario.

Gail Adams, UNISON Head of Nursing, said:

"There is no evidence that having a degree makes you a better nurse. We believe that the balance of diploma and degree courses is in the best interests of the NHS and the patients.

"The NHS needs to attach more importance to workforce planning and simply cannot afford to exclude willing recruits. For example, the diploma route is often more attractive to mature workers who may have masses of experience, often working in the NHS, but don't have the academic qualifications needed to go for a degree. The emphasis should be on the competence of the nurse not on unfounded notions about academic ability. There are problems with the existing programme which need to be addressed before to ensure that they are fit for purpose before we start introducing baseless costly change.

"There is a growing global nursing shortage, exacerbated in the UK by the aging profile of the workforce. We need to ensure that any proposed changes don't make this situation worse. In any case the quality of patient care needs to be at the heart of any changes to recruitment or training."

Ann Moses, Chair of UNISON's Nursing Sector, said:

"Most people come into nursing because they love the day to day contact and care of patients and they want to keep that hands-on approach. Many nurses fear that the proposed changes would lead to a reduction in the number of registered nurses, and their role becoming more supervisory and co-ordinating.

"Many nurses already feel that they don't have enough time to spend with their patients."

UNISON key points from NMC consultation on the future of pre- registration training

- UNISON members do not support the idea of an all-graduate profession and wish to see the entry gate maintained as wide as possible. The more fundamental concern for us was to look at the competencies which were needed to nurse and to ensure that adequate support was available within higher education institutes.

- The service cannot divorce its responsibility for ensuring fitness to practice at the point of registration, especially as clinical placements take place there.

- UNISON members wish to see greater investment in clinical tutors and nurse educators, with the requirement that they work with the students in clinical placements during each of their modules.

- UNISON wishes to see a return to salary status for all students and a requirement that they are accountable to both the HEIs and their employer.

- UNISON members believed that patients want practitioners who are fit for purpose in caring for them.

- Many respondents felt that moving to an all-degree programme would lead over time to a reduction on the number of qualified nurses in bands 5 and 6 and only a slight increase in bands 7 and

- However, stronger views were held by nurses very much wanting to retain their participation in direct care rather than be diverted into supervising and co-ordinating others' work.

- There is an urgent need to address the issue of regulation of healthcare assistants. Discussions commenced some 15 years ago on this issue and it is unacceptable for this to continue to be allowed to drift in the breeze.

UNISON key points from DOH consultation on post-registration nursing careers

- Members highlighted the need for sufficient funding to deliver a framework and support mentoring and clinical supervision. In addition, capacity is needed to release registrants from the service to undertake training and arrangements must be out in place to allow for backfilling of posts and ensure no negative impact on the service.

- Any framework has to tie into the outcomes of the Darzi review and concerns were raised about the language focusing predominantly on illness rather than living independently with a long term condition.

- There is a clear need for strong and effective workforce planning. However, we would argue that this can only be achieved with improvements in the monitoring of student attrition.

UNISON