Really stupid?

I also agree with Bags thatBiker has hit the nail on the head and anyone who really knows anything about the true spirit of what nursing is supposed to be about will also agree. Well done Biker.

Yes I agree you need people to do the basic care bags who are competent and kind. Nurses need to ensure that these people are doing their tasks properly.
I don't know what the answer is bags.
The people who use most of the NHS resources are those who have multiple serious conditions from middle age onwards but carry on like that for several decades, not those who live a long and healthy life - they tend to fall apart rather rapidly in their late 80s or 90s . Unfortunately (for the NHS) there are increasingly more people who fall into the former category - those who would, previously, have died in middle age. I can only see this problem increasing.
Really interesting to find out about the two tier system that exists here in Oz.

I understand and accept what you're saying, jess, but there remains a need for people doing basic traditional nursing jobs. If hospitals don't have enough staff to do all the necessary work, then that is the problem, not what the definition of what high tech nursing is.

Yes, it's about money – paying enough people, on various scales, to do the work that needs doing – and that is down to politics. If people don't want to pay enough tax to fund proper nursing, then they can't complain when it fails to materialise.

Tough on those who are willing to pay the taxes though

However bags once you give someone the title "nurse" hard pressed managers, trying to staff a ward, will put in a "nurse" of any kind they can lay hands on.
If you have 3 "nurses" and 12 seriously ill patient some of those "nurses" will be asked to do higher level tasks, and not just basic care. The sort of thing I am talking about is a seriously ill patient that needs complex observations done several times per hour.
My DIL says that working in private hospitals in Australia as a casual nurse she has feared for her registration because there is so much work of this kind to do, you cannot possibly keep up and the chance of something going badly wrong is high. I suspect many NHS wards the same applies.
The issue is about resourcing and management - and politics - in terms of how much money there is - lies behind it. Going back to a solution like SENs that worked in a different world is not going to solve anything.

Biker has expressed what I was trying to say a whole lot better here.

That sounds as if they need more nurses, jess, rather than that the EN's aren't qualified to do the job they are meant to do. Yes, a lot of what might be called medical nursing is very technical nowadays, but we still need people who will simply look after the sick person's bodily needs when they can't do it themselves. At least, that's what seems to be lacking.

I've only ever been in hospital to give birth (and to visit people). Thirty-two years ago the nursing care given to new mums was, I felt, very good. Twenty years after that, when DD3 was born I wasn't impressed with the nursing care, though I was with the medical care. I think we need more nurses whose job it is simply to try and make people comfortable. I get the feeling from discussion on gransnet that that part of nursing has been forgotten quite often in favour of more technical know-how. Hospitals need both.

Yes it might Faye. It is possible that the other driver for change was the increasing technical skill and knowledge needed by nurses these days and that it was not considered a safe option to have "nurses" who could not complete many of the necessary tasks. My DIL is working in the private Australian system as a nurse educator (on the ward) and she (just) told me that the SEN's are sometimes terrifying because training is so basic that they have very little clinical knowledge or experience but they are expected to be able to do same tasks as other nurses. Big thumbs down from her I'm afraid.

Wouldn't it make sense for those who wanted to progress in their careers to study further Jess. The EN course is only for four days a week for eighteen months. Achievable for those who want to do basic nursing. For those who are interested in specialised nursing further training and qualifications are necessary.

Faye the SEN was phased out a long time ago. When I worked in the NHS in a psychiatric unit it was apparent that there were a lot of able SENs who were blocked from progression in their careers because you had to be SRN to get promotion to ward sister etc. I think that was one of the motivations behind introducing a single qualification.
I am still wondering whether the very long post above was written by seeker or whether he/she has copied and pasted it from somewhere (and if so where) - but seeker does not seem to have returned to the thread.

Do they have Enrolled Nurses and Registered Nurses in the UK. Seeing both my elderly mother and my grandson in hospital in the last eighteen months there was a huge difference in the amount of care they needed. My grandson after open heart surgery needed specialised nursing besides having his basic needs taken care of. My mother needed basic care, fed, bathed and toileted. I tried to find if the UK had the two types of nurses who have different roles that they have in Australia.

My youngest daughter has this year started a course as an Enrolled Nurse. She will spend four days a week at the local TAFE (technical and further education) with some hands on time time spent at the local nursing home and hospital in the nearest large town. She wants to eventually become a Registered Nurse but because her youngest is still young and only because she has my help with babysitting, she took the opportunity to at least get some study and experience under her belt and start as an EN. Then when her youngest starts school she will start her degree and becomes a Registered Nurse (RN). Some of her subjects that she will complete at TAFE will be accredited towards her degree.

Doesn't alter the main argument being made.

My pleasure.

Thanks pp. It's very helpful to have the facts.

That is totally untrue, for a fact Tony Blair came in to power in 1997! Project 2000 was bought in by the Tories in the late 80's early 90's and that is when university based training was introduced,. So please get your facts straight. HCA's are paid on band 3 and cleaners on band 1, so, again, get your facts straight please.

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.

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

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?

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.

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

Well said FlicketyB

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.

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.

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

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.

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.