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I love what I do, I love being a student nurse and being challenged by university and my placement to broaden my learning and knowledge.
However find myself obliged to defend student nurses after reading How student nurses’ supernumerary status affects the way they think about nursing, Are student nurses too posh to wash? and Clearing up poo will not help me learn on nursingtimes.net this week.
At RCN Congress Gordon Brown said nursing is a “profession where you work with your head, heart and hands at the same time”. I agree, nursing is a profession that is demanding and rewarding. I cannot imagine myself doing anything else. We may be students, but we do work hard and we are continually challenged on every level to use our heads, hearts and hands.
As a student nurse, I have never, ever refused to participate in basic nursing care. I have each and every time thrown myself into the role of student and willingly learnt about bedside care from HCAs and staff nurses.
I was lucky enough to have a fabulous mentor on my very first placement. She had only been qualified about 18 months ago but she made sure I understood how important the basics were. Every day she came and did the care round with me and ensured I understood the importance of dignity, respect, examining the patient, communicating, and making sure the patient was comfortable.
Life lessons
The lessons she taught me will stay with me forever. Yes, while at university we had a skills session on performing a bed bath. Performing bedside care on a dummy is vastly different to performing it on a real life human being. No matter how hard university tries – it can’t simulate the real life experiences that you get as a student on the wards.
But university can help you learn the reasons for what you do; it’s up to the individual to apply the theory. University equip us with the knowledge we need to become nurses, but practice comes only with experience. The universities give us the text books to read and the essays to write in the hope that we will broaden our knowledge and be educated practitioners.
“I don’t believe student nurses are too ‘posh to wash’, and I do believe we should know the basics”
But writing a good essay does not a good nurse make.
Being supernumerary means we are additional to the clinical workforce, and we undertake placements in clinical areas to learn; we are not counted as members of staff. I have never found being supernumerary detrimental to my status as a student. Being supernumerary has allowed me the flexibility to muck in as HCA, to do the drugs round with the qualified staff, to be able to go and watch procedures or attend appointments with patients. When I’m qualified I won’t have this flexibility, so I like to grab every learning opportunity that I can.
Back to basics
As for student nurses refusing to perform basic care? Perhaps this has been misconstrued.
When we go on placement we have paperwork to complete, this sometimes becomes the focus of a students attention as without this paperwork being signed off, we cannot pass the placement. I feel that the emphasis university place on having the paperwork completed can result in some students losing sight of other things, especially if they have a mentor who doesn’t have the time to complete the paperwork.
But I also acknowledge that the paperwork has to be there as a form of assessment for the mentors, placement areas and universities to be able to assess our competency in practice. We stress about the paperwork, we have tonnes of it, it is perplexing and perhaps at times repetitive - but it needs to be done. As I rapidly approach my 3rd year with a skills log with over 200 competencies that need completing, I am starting to panic.
I don’t believe student nurses are too ‘posh to wash’, and I do believe we should know the basics. Mentors have a massive responsibility in this regard. A good mentor can challenge and develop a student; and help them understand the importance of the basics. I have been incredibly lucky with all my placements and had superb mentors.
And don’t forget we aren’t just student nurses. The majority of us study full time and we also have jobs, kids to look after and our own dramas. But whatever we are going through, the majority of student nurses are here because we are passionate about what we do. We want to learn and we want to be good nurses.
We are perhaps cocooned in the safety of student status. Qualifying, and being suddenly accountable, is a very scary thought. When I qualify I don’t expect to be a ‘supernurse’ who knows everything. I hope to be a safe nurse who understands the importance of the basics.
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Readers' comments (22)
Anonymous | 13-Nov-2009 10:37 pm
Extremely well said, and thank you for speaking up for us students who are more than happy to throw ourselves into basic care!
It's hurtful to read articles the one about students being 'too posh to wash' that when you're doing your best to become the kind of nurse you would want for yourself or your loved ones.
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Sandra Joyce Powell | 16-Nov-2009 9:00 pm
i was studying in Scotland for my diploma in Adult Nursing as a SEN,this seemed the only way forward for me to continue in nursing. as i was unable to get a conversion course.
The reason i am writing is in the hospital they have real people who volunters themselves for the students to practice on it was great ,how about it coming to England and Wales.
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Sandra Joyce Powell | 16-Nov-2009 9:08 pm
Nurses today are no longer trained they are classed as students studying to be a nurse. this way the government managed to get away without paying a living wage ,students do not get wages,so as a compromise they said that student nurses could be awarded a bursary, of around £6,000 how can a full time student nurse manage on this paltry wage it just about covers expensive books and travel expenses.
The student nurse should have a living wage and then they will be able to put there efforts all into studying instead of moonlighting to bring up their income. Give them a living wage.
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TRACY MCDONALD | 17-Nov-2009 9:51 am
I’m a student nurse and I’m not too posh to wash!
Thank you for defending us student nurses. I feel that student nurses are receiving a lot of bad press lately. I’m a third year student nurse (Qualify in March!! Scary!)
I don’t think people realise the effort and sacrifices student nurses have to make!
Firstly there are the full time clinical placements, with a portfolio of competencies to complete, the never ending essays, university, and on top of this there are the personal sacrifices, the extra jobs we have to work to make ends meet! The biggest sacrifice for me has been what i have put my family through during the last three years. Having to write essays instead of spending time with my children, working long hours for a pittance of an income that barely covers their dinner money and my travelling costs!
Why do I do this? I love my job; I love to be able to make a positive difference to someone’s life, to know that I made that patient feel better, even if its cleaning up poo!
Nursing is not just about medicine rounds and clinical procedures; nursing is about ‘holistic’ care.
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Anonymous | 17-Nov-2009 10:40 am
When I started my training over 2 years ago I had no nursing experience. However, thanks to a fantastic mentor, other staff nurses and nursing assistants I learned basic care from scratch. To me it has been invaluable in my training and reminds me that it is an honour to care for someone who cannot do things for themselves, and how difficult it must be for the patient to have someone else taking care of these needs.
I have never come across another student who feels that they are 'too posh to wash' and I hope I never do. Although our training incorporates other areas, providing sensitive personal care to another human being reminds us why we are nurses.
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Anonymous | 17-Nov-2009 10:42 am
I am a student nurse who has been homeless since september. I am on placement, have tons of essays to write and have to wait til new year to move into affordable accommodation (not state provided). I am lucky enough to have friends who I stay with but couch surfing is all I can afford and it has been a complete nightmare. I turn up on time to placement and get top grades for my work, and think I deserve a bit more respect than what is being dished out at the moment. The amount of people that have dropped out of the course for not putting the effort in, either in attendance, attitude, or commitment maybe should have never been allowed on the course, and maybe a few more of us could live an easier life, financially and in the press.
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Anonymous | 17-Nov-2009 10:49 am
I am a student nurse,and I am not too posh to wash,I always do the best I can while on placement.
I work as hard as I can,juggling family,work study,and yes the bursary we receive is very small compared to all the things we do.
Hopefully all this sweat,tears and sacrifices will be worth in the end.
Bye for now.
p.s. I need to rush for my lesson. Not time to hang around.
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Philip Peter James | 17-Nov-2009 3:51 pm
i feel this is a well thought but sensitive piece of journalism.
To be a Nurse, and to be responsible for the "holistic" care of people and to be responsible for the actions and omissions of the Support Worker looking after that person, is it not essential to have an advanced knowledge of bedside nursing and what you would expect the Support Worker to do in their role?
The term "Holistic" means looking at the whole, which is not possible if you are not wllig t oo at the skin, change pads, feed people and be involved in th provision and mantinence of the daily living activities "we" as a profession strive to achieve!
In my first year of nursing these were the core elements we looked toward achieving and addressing.
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Louise Ody | 17-Nov-2009 5:19 pm
What is all this silly rumours about students being too posh to wash. I can not speak on behalf of all students but from my nearly 3 years experience trusts would be lost without students! Never in my time of placements and bank work have I seen a student refuse to do anything, I think the point from these rumors could be is that students are asked to do things by every single member of the team, because we are singled out as the "student can do it". I have no problem with doing any task as long as I am competent in carrying it out, however there is nothing more annoying than a student running around when other people in the team are not pulling there weight too.
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Graham Dalton | 17-Nov-2009 5:36 pm
We need to face the facts that some students do nstand around and do not get involved with ADLs , but remember many and I mean most nurses do not either. I have said it before, but it is the NAs/HCAs that do all the hard work!
Another part of the issue is probably mentors. Unlike the author of the article I have had some horrible mentors on my placements. Though I have also had many excellenbt ones too!
Nurses, like everyone else, all hgave different characters. I say thank God for that! :-)
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Graham Dalton | 17-Nov-2009 5:38 pm
Sorry about the typos. My new laptop is hard work. :-)
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jemma Cain | 17-Nov-2009 6:20 pm
I agree with Katrina, the basic tasks help the nurse to carry out a lot of other important factors in nursing. A lot of information comes from the "daily wash", as it gives the nurse a chance to chat with the patient, find out how they are feeling (psychological/spiritual aspects of care) can allow the nurse to observe the cognitive and physical functioning, also if there are any new markings or bruisings or if there are any changes to the amount of mobility. It can allow the nurse to discuss any fears, what support is available to them and also provides social contact.
I am a student nurse studying mental health though also work as a HCA in a general ward. I am fully aware of the pressures of being a student though also know how busy and hectic shifts can get and feel that if a nurse misses out on this opportunity they might not get chance to spend quality time with a patient for the rest of the shift.
This being said, whilst at work I have come across students who do prefer not to assist with washes as feel they should be doing something else. So I have to agree with the concept of the original articles (I haven't read them fully) though stress that those it concerns are of the minority. Unfortunately I believe the nursing profession will always be plagued by these concepts, but maybe with the profession becoming wholly degree this may change in future.
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Anonymous | 17-Nov-2009 8:08 pm
Most of the comments to this article have been made by student nurses. Of course we appreciate that there is a lot of paperwork to be done on placement, of course we appreciate that there are essays to write, of course we appreciate that student nurses have a small bursary to live on. However, we have ALL been there, ALL done that and survived to tell the tale.
I am not sure of the relevance of financial hardship to being 'too posh to wash'. In my years of experience as a mentor, few students will actually refuse to do hands on care when asked to do so. However, their post-placement evaluations tell a different story. Quite often a student will say that they were 'used as an HCA', which comment is often made detrimentally to the experience they gained on placement, thereby inferring that there were other, more valuable, things that they could have learnt.
What students, ALL students, need to remember and put at the forefront of their nursing practice is that we ALL participate in hands on care, whether they consider this to be the work of the HCA or not. No one in the nursing team from the ward manager to the most junior HCA, should be exempt from this most basic cornerstone of what being a nurse means. And that includes students. We KNOW that you have your student logs to complete. We KNOW that you have many competencies to achieve. But nursing isn't just about being able to site an NG tube or catheterise or whatever, it encompasses a huge range of care needs, and unless you have the basics firmly in place you have no base on which to consolidate.
I am a ward manager, have been for five years. Not one of my students would get away with saying that they don't do washes, don't need to clear poo or whatever. Unfortunately I think some students ARE misguided and university training does bring some of them to get their priorities a little askew.
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Anonymous | 17-Nov-2009 8:20 pm
hear hear!
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Anonymous | 18-Nov-2009 11:23 am
Extremely well said, thank you for speaking up for us students!!!
I have just gone into my final year of training and am more than happy to perform basic nursing care. I think this is an important role for students and Staff nurses to carryout as it is a way of getting to know your patients, your can carry out an assessment whilst performing nursing care i.e assess skin status etc.
I have just started placement on a general medical ward where qualified staff do not perform basic nursing care in the morning as the have to do the "obs" and "Medication round" at the same time. I disagree with this as to me its just poor time management!! These qualified nurses are supposted to be our role models!!!
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Anonymous | 18-Nov-2009 11:20 pm
as a newly qualified nurse i had to have my two pennyworth.... i never ever refused to perform basic care as a student and see it as an incredibly important part of a nurses role. It means you get to assess your patients skin, mobility etc and almost more importantly means you can spend time with your patient. However, as a newly qualified nurse working on an incredibly busy emergency assessment unit, i have to say that i almost never have the time to wash patients. I'm not lazy and don't feel my time management is particularly bad (for a newbie anyway!) but the simple fact is that this is not reallya big part of the role of the qualified nurse anymore. I was extremely fortunuate as a student to have excellent and sensitive mentors who understood my learning needs as i progressed through my course and prepared me for my new role, however i can well understand the attitude of student nurses who don't want to spend the whole morning washing patients when they need to be learning the other things that they will need to utilise when they qualify. Unfortunately students are sometimes used as unpaid HCA's. Which would you prefer if you were a patient, a qualified nurse who understood your medications, could expain procedures to you and advocate for you, or someone who could give you a good wash?
I'm not saying student nurses shouldn't perform basic care, if the patient needs it they need it, However we need to bear in mind the student once qualified needs to be able to perform the other more complex tasks they will, in reality, spend most of their time doing. That is what university and ward placements need to be teaching them.
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Tammy0407 | 27-Nov-2009 11:15 am
Im a student nurse and like most other people have said i am not too posh to wash! I think it is a key role in nursing! It gives you time to get to know your patient and also its a valuble time to make assessments on their condition - do they have a pressure sore? is the skin dry? are they having continence problems? and these are just a couple of the things you can look for.
Unfortunatly i have met someone who is too posh to wash and i have to say he would have made a terrible nurse! He could write essays etc, but as you said writing a good essay does not make you a good nurse! I think it is not just students however, as i have met several qualified nurses who are too posh to wash and would never take part in the morning washes and usually left it to the HCA's or student nurses to do whilst they sat on their backsides and did "paperwork" (or facebook to them)!
Thankyou for sticking up for us student nurses! I aslo have to say that it is hard and you are right people do not realise how much we do! My friends at other unis all say how "you get paid to go to university" and what they dont realise is that i do a full time job as well as full time study! I feel more awareness needs to be made and also that just because i get paid to do a job it does not mea that it is a substantial wage! It pays my bills and thats it! Fortunatley for me i am not in this for the money! I love my job, i love my patients and i love getting up for work in the morning - no matter what the day faces! Im 19 and cant imagine doing anything else!
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Anna Lincoln | 12-Dec-2009 5:53 pm
There is not a problem with "too posh to wash" nursing students. That is a line devised and repeated by the ignorant, and those who want to divert responsibility for the real problems with nursing care.......lack of trained staff on the ground and intentional understaffing by management.
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Anonymous | 5-Mar-2010 12:12 pm
I am currently in my final placement as a student nurse, and have heard stories of students refusing basic care including my current placement. I think that during the provision of basic care, you are providing a chance for your patients to talk to you about their worries, fears or their lives before they needed someone else to look after them which will take their mind off what they are currently going through. It is a chance for us as nurses to build a rapor with patients, and therefore gain an understanding of their own feelings towards their health or social issues. I have heard that the reason for students to refuse providing basic care is that they worked as a health care assistant before starting the course, and they have done it before but when they qualify they have to carry on providing this basic care and they cannot refuse. It's like me saying as a third year student, I have done aseptic technique before - so I dont want to do it anymore. I believe that all student nurses should stop looking at the negatives of basic care, but look at the positive. At the end of the day, we are all training to be nurses to make a difference for our patients, in belief that we can change nursing for the better once we qualify and by doing this, it includes providing basic care for those under our care.
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Victoria Sole | 11-Mar-2010 0:07 am
As a second year nursing student I have been outraged with some of the negative images we are being portrayed as, thank you for someone finally speaking up for the rest of us
I have also never thought i was "too posh to wash"
i understand that 'basic' nursing care is essential and a skill to learn and develop throughout our entire career
HOWEVER, we only train for 3 years to become qualified registered nurses ... as much as 'basic' care is important we do need to have time allocated to us whilst on placement to learn & develop other skills
there needs to be more of a balance
i have worked alongside many HCA's who have been doing their jobs for years & years, i have learnt sooo much from them and their teaching has proved invaluable for us, however there are jobs that HCA's cannot do, jobs that we (once qualified) will be expected to do, hence why we as students need to spend more time with registered nurses than we currently do
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