Really stupid?

I don't! I spent ages when Mum was in hospital trying to find someone to take her to the loo - the nurses wouldn't but there was no-one else to ask!

kitty the nurses wouldn't? [incredulous emoticon]

If it helps them to realise caring is main part of nursing good dea! Surely any decent nurse should know that. Going by nurses at our surgery they vary a Lot!

I fel bad idea making degree requisite for nursing. practical caring IMO does not need a degree it should be natural and probably can't be taught should be obvious! Sadly not from what we hear about old people left to go thirsty and not helped to eat wash or go to loo dreadful really.
I have also seen nurses on their mobiles!
Surely this is not allowed?

I agree with the idea completely. I do however think a year is too long before starting University. I think 3/6 months would be about right.

Why do I agree. Like Kitty and I suspect many other GN's I have first hand experience of poor quality nursing care, as well as good. If you are seriously interested read the relevant report on sub standard nursing care, it will shock you.

I believe that having an 'apprenticeship' so to speak will give a wonderful opportunity to a potential nurse to find out 'IF' infact it is the vocation for him/her. It is a part of the job and why go through 2 years at university only to take a nursing position and find out you can't stand the job. I'm sorry to say it but I do belive there is such a thing as 'too posh to wash'.

I think the drop out rate for new nurses would fall and those who complete their training and subsequently obtain a nursing position will know they are upto the challenges that giving personal care involves. Like a lot of jobs the practice is not the same as the theory and it can only be good to have the insight before dedicating so much of your time, energy and money and know you are the right person for the job.

The likes of North Staffordshire, George Elliot Hospital etc. are proof that the nursing profession needs to go back to basics. Whilst the unions may disagree I think there may be an awful lot of older nurses who are shouting out 'About Time'.

Anyone too posh to wash should not be in nursing why should they not spend time on the ward doing basic care ?

I must admit that when I was in hospital for 12 days the nurses I encountered were very caring and did take me to the loo when I needed support. The older ones seemed to be more old school and more caring tho.

I don't know about recent nursing training in the UK, but my gd in NZ tells me that there is a very large academic content to the three year degree course she is just about to complete. Nurses have to know a great deal about pharmacology as they have to check dosages, etc (incredible as it may seem, doctors do make mistakes).
Can you teach somebody to be loving, kind and caring?

Yes, I think you can Greatnan, in many cases. I don't mean you can change someone's basic instincts but you can, by example and by the ethos in a particular job/environment develop the attitudes pertinent to the job, especially at the training stage.
There will always be those who bring to the profession the best of both worlds but we can't allow the academic nature of current nurse training to result in the attitude that they are too highly trained to perform basic tasks.

Very well said orca regarding pharmacology the pharmacist trains for 4 years really feel nursing should be that they give out drugs not dispense them they are not needed to check fr interactions that will have leeway been one greatnan.

Always bugs me that doctors prescribe wrong meds and pharmacists ave to correct it! Am I biased as oh is pharmacist? Probably!

My son is coming to the end of his 3 year psychiatric nursing training at uni. He has done general nursing and specialised in mental health, doing lots of bank work at weekends in both general and psych units, and his many placements have been in A and E, dementia and community nursing. He has wiped bottoms, bed-bathed, cleared up every type of bodily fluid, vomit and faeces, mopped floors when cleaners had finished for the day, and sat holding the hand of dying and distressed patients.

His last study stage is managing cases, and the emphasis is on delegation, managing records, psychiatric intervention methods, accessing resources and moving patients through the system. He feels quite upset about the way students are encouraged to move away from the personal care and support as they reach qualification, and says he would always be prepared to get stuck in to cleaning and menial tasks, but is afraid that the job won't let him - bosses say the auxiliary nurses and psych support workers do this, but there are never enough on the wards, and many are agency workers with no investment in the job. Plenty of managers, though!

celebgran Greatnan nurses here in the UK often spot doctors' prescribing mistakes, having learned dosages and medication types on the job, although they only get a fortnight on pharmacology during training (good for NZ that they get more input on their courses). Patients then have to wait till either the doctor comes back, or the pharmacist arrives on the ward.

Thirty eight years ago I spent 5 weeks with my then 2-year-old in Birmingham Children's Hospital. In that situation, the nurses did not only have to deal with ill and distressed children but often with worried, even distraught, parents. I don't know if their course in paediatric nursing covered working with parents but these young women, few of them out of their 20s, and many of them still in training, were among the most kindly and empathic people I have ever met. The ward sister was an example to all of them. She took me into her room and handed me a box of tissues when I was at a low ebb. Have things changed? Or do the ones with a real vocation still become children's nurses?
Thanks to all of them and a wonderful surgeon, the 2-year-old is now a hale and hearty 40-year-old and himself a father of two.

I have mixed feelings about this issue. I think it is a good idea for nurses in training to have plenty of hands on experience early on to ensure they have chosen the right career, and are suitable for it. I have 3 young friends, two of whom are nurses and the other one a doctor, who all worked part time in the 6th form at a local residential home, taking care of elderly people and performing basic tasks of cleaning and feeding. All 3 have attested to the value of this experience. However, I wouldn't like to see nurses used as a scapegoat for all the ills endemic in the NHS system. There's no point in stressing the value of care and compassion unless nurses are given the time and resources to put these values into practice.

I too have mixed feelings and have some concern that this suggestion has a slightly punitive feel to it.
NHS cuts are leaving some wards seriously understaffed.
The NHS is not currently able to staff itself with UK trained nurses.
I think it is the management of the ward that often makes the difference in how the nursing staff behave, rather than the particular style of training they have had. if the ward manager (sister/charge nurse) believes basic care like toileting is a priority then it will be.

Does anyone else think it might all be a negotiating tactic? Government says a year, RCN says rubbish, they negotiate and agree a shorter period.

I think it likely that most people going into nursing want to care for people but can be affected by the environment in which they work. this has to be led from the topp imo.

So that anything else sounds better? It would not surprise me.

My gd, Lara, has worked in a care home several nights a week and at weekends during her nursing training. She needed the money but she also loves the work, which includes all the usual personal care jobs. She stays on in her own time, unpaid, to play the piano for their sing-songs.
Her mother found her in tears when one of the old women died - she was 93 but had been very bright and sparky.
They get plenty of hands-on opportunities in their placements in hospitals, nursing homes and hospices.
She has found, as I did when doing teaching training, that most young people are really dedicated and hard working, but there a few who are just doing the course because they can't find anything else to do. We can only hope that they get fed up, or the people in charge of them suss them out before they qualify. The mature students tended to be the most focused and swept the board when it came to prizes.

I think a year working as a care worker, with the employer's reference forming part of the material considered by a university before accepting a candidate for a nursing degree would be very sensible.

The year functioning not as part of the degree studies, but as a part of the qualifications for the nursing degree.

Nurses may get all sorts of hands-on opportunities during their training, but it clearly is not effective, otherwise there would not be so many complaints about the indifferent and poor care many patients, especially elderly patients, are getting.

Well said FlicketyB

I have had a great deal of experience of hospitals since 1979, both as an inpatient and as a carer of various family members in the last part of their lives. My Mother had MND and as such I had to attend the hospital 12 hours a day when she was in their care as no-one would feed her or deal with her 'peg' machine at all, toileting her was considered beneath them. I have lost count of the number of times I cleaned toilets over the years before I would let 'one of mine' use them. As an inpatient myself in recent years I am now terrified of being helpless and hospitalised. One very recent experience saw me being moved to 7 different wards in 8 days. I have had occasion when there was no breakfast or lunch for me as they had 'run out' (I am diabetic) and was told to get my own from the WRVS cafe in the hospital. I could write a book about the shockingly poor standards I have experienced over the years. Many times I have found myself acting as carer to others in the ward when I was a patient myself. I clearly remember one elderly lady begged for a cup of tea which was never forthcoming so I got her one myself, am I glad I did as she passed away later that night! I do however know all there is to know about which staff member fancied which Dr and who they had slept with, what holidays they had been on etc, etc. Better training has long been needed and a return to good old fashioned Matrons who do not tolerate gatherings around nursing desks which use up most of the shift while patients suffer! Rant over

Sad but true. It is a fact there is good hospital care but that is not the point. There is a lot of poor nursing care and it is responsible to admit that it happens.

Why should there be no attempt to address the problem?

It is a problem that has been in situ for years and it is time for all political parties to stop attacking each other and point scoring at the expense of patient welfare. The Francis Report sums up a lot of the issues that are at the root of the proble and it needs heeding to.

HISTORY OF THE CATASTROPHE IN NURSE TRAINING

Back in the 1980s Blair's New Labour recalled all nurses into university demanding they pass a degree in nursing.

Labour only replaced half the nurses (continuing to be ward based trained therefore) but replaced the other half of the nurses lost with Hospital Healthcare Assistants that have no medical training but do the direct patient care today.

HEALTHCARE NURSES USED AS CHEAP NURSES

The HCAs have been telling the Royal College of Nursing that both management and university trained nurses are requiring them to undertake medical tasks, along with the direct patient care, for which they have no training.

The HCAs are paid little more than the cleaners.

The original State Enrolled Nurses were ward based trained and did the whole job, with all that practical knowledge learned through the teachings of Florence Nightingale that has now been lost.

We now pay two people to do one person's job.

One costing millions to train in universities and pay them huge salaries but spend most of their day in bureaucracy, and the other being paid a pittance and yet doing most of the work of patient care.

MANAGEMENT FAILURE OVER JUNIOR DOCTOR COVER

Hospital management ignored the medical stress of overwork and worked Junior Doctors the potential fatal (causes heart attack even in the fittest of young people) shifts of over 100 hours shifts.

When the excuse of the European Working Time Directive (when Victorian philanthropic factory owners had reduced working hours to less than 50 hours a week instead of every waking hour, seven days a week over a century ago) reduced the working hours by half, we, in effect, lost half our Junior Doctor cover.

Management is still complaining about this and Junior Doctors are still working up to 100 hours shifts a week, because management will not employ more Junior Doctors. But do they exist out there?

Because the main reason Accident and Emergency units close is due to a severe lack of senior Consultants.

So with all the years of insufficient cover for Junior Doctors, the doctors have not existed to work through experience to get up to being a Consultant.

So this is the history of the root cause of poor care.

NO UNIVERSITY TRAINING OF NURSES AND MIDWIVES

The Royal College of Nursing needs to abandon university training of nursing / midwives and return entirely to ward based trained nurses like the old State Enrolled Nurse, as looking after patients is the core reason for nurses to be employed in hospitals.

We, the patient, are in a hospital bed to be looked after much like a helpless baby.

Otherwise, we would be home with occasional home visits by Carers from our GP.

TURN IN-TRAINING OR EMPLOYED NURSES INTO JUNIOR DOCTORS

When I have put the obvious idea of turning all university courses in nursing and midwifery into training as Junior Doctors and recalling all nurses / midwives still in employment back to university to retrain as Junior Doctors, nurses are very keen.

After all, there have been over 1 million lost posts in all the hospital closures so far.

Many other NHS hospitals will close due to debt, as the precedent has been set with hospitals allowed to go bust.

This then brings a better wage for the Hospital HCA to become a nurse, and for present nurses in training or already employed to gain a Doctor's wage whilst their training is paid for.

This then balances out wages, gives more staff immediately to feed, wash and toilet patients, helps keep wards open by more Junior Doctors that will eventually work through into more Consultants and make poor care a rarity instead of so often in so many places.

If the Hospital HCA include training in Accident and Emergency within their apprenticeship, then they would learn as the nurses did in the Crimea under Florence Nightingale. And the cover for A and E at night would increase.

TURN HEALTHCARE ASSISTANTS INTO NURSES

The current Hospital Healthcare Assistants, prior State Enrolled Nurses and foreign ward-based trained nurses (especially from India and South Africa where they learn medicine in English) can all then start back to basics and be ward based trained entirely.

Those HCAs who do not want more responsibility, could retrain as Hospice at Home and Carers for home-care through your GP of patients, that would end bed blocking forever.

GREEKS INVENTED THE CONCEPT OF MODERN MEDICINE

Hippocratic oath is To Do No Harm.

As the head of the RCN has a Greek name and the Greeks invented the concept of modern medicine, you would think he would have the above good idea. I am Half Greek and have had the idea and my experience as a patient and that of my parents (now deceased from poor care) dates back decades.

Because then the amount of nurses would double at half the cost to the hospital and the betterment of direct patient care.

WARD BASED TRAINING IS PROGRESSIVE FOR OLDER PATIENTS

Have we squared the circle and saved billions yet made things better, when you realise most patients are over 50s?

And it might be nice for ward based training to include as standard all the special requirements of elder care and hospice training without the Liverpool Care Pathway (replaced entirely by Hospice at Home HCAs).

What do you think? Solutions?

Seeker are these your words or have you cut and pasted them from elsewhere?

I do think that the NHS and health care staff need to realise that because of the improvement in people's health through a range of environmental, safety and medical advances the number of young people being admitted to hospital has fallen drastically and that the main users of health care in the future are going to be older and older people, who will have paid into the health service all their working life and now they are older expect that investment to provide them with proper treatment and care.

Looking after older people shouldn't be a bolt on extra module in medical training it should run seamlessly through every course trainee doctors and nurses do because the majority of the people they will deal with in their careers, in hospital, GP surgeries and clinics will be older people.

DD was in hospital for 10 days a few years ago, a long stay by modern standards. Every other patient in her 4 bed bay over that stay was 80+/- Her ward was for ENT and plastic surgery (not cosmetic) patients.