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COMMENT

'How a university’s attitudes destroy professional practice'

One morning recently, I attended my biennial mentorship update, led by a representative of the local university. By the afternoon, I was wondering whether to follow my wife’s lead and give up mentorship.

The grounds would be that, whatever I may do to help shape useful and effective nurses for the future, I am going to be undermined by their teachers if my expectations don’t exactly match theirs. And, as a result of this, useless individuals who should never have been accepted for training become qualified practitioners, despite any protestations I might make.

In the usual death by PowerPoint presentation, we were reminded that, if a student is failing, it’s our job to make sure the correct paperwork is completed and an action plan drawn up, because otherwise the door is open to an appeal. Fair enough.

However, when I raised previous incidents where the university had bypassed the process - for example, by moving a failed student to another area and to a perhaps less stringent mentor, to be passed (and eventually to qualify) - the response was: “Well, let’s move on.” There are shades of moving and handling training here - the organisation’s main concern isn’t about patients getting hurt - it’s more around people taking legal action against it.

A discussion saw “professionalism” die a death too. Body piercings are, it seems, perfectly acceptable because “we must remember that this is their culture”.

So is green-dyed hair. We must ignore, then, the effect on patients and their trust in the people looking after them.

Bad language? Well, “shit” seems to be moving back to its Chaucerian status as an acceptable word in everyday discourse. Not informing the ward of an absence because of bereavement? Well. “These are young people.”

The apparent inability to answer the telephone in a way that sounds vaguely professional? Not to worry - the tutor has a teenager who communicates in grunts. It’s how they talk, apparently.

Well, it seems I’ve finally become what I dreaded: the old nurse coming up to retirement who remembers the perfect, good old days, where the sun always shone and life was grand.

I cannot understand why anatomy and physiology isn’t taught until midway through training. I don’t quite get how a student can land on a placement without having read a word beforehand about the speciality practised there. The tutor’s response: “Perhaps you could prepare an orientation pack for them?” Mine: “Perhaps they could open a book.”

At the risk of getting hippy-dippy, I’ve always seen mentorship as an honour and a privilege. I can look at nurses whose raw potential has produced skills I’d let loose on me and mine.

Part of me says “do your little bit for the future” while another part says “use that time to improve the standards of those who have qualified recently, and correct the shortfalls for the present”. I don’t know. I really don’t know what to do. 

Brian Booth is staff nurse in a community hospital

Readers' comments (51)

  • tinkerbell

    thanks for making me chuckle. Although you're making a serious point. I've been wondering too 'what the hecks going on' down through the years. It started for me about 20 years ago when I asked a lecturer why he was sending me second year students who were clueless. He said it was my job to teach them, I asked 'what's your job then?'.

    I love being a mentor, passing on the baton and all that, when you get a keen, enthusiastic student it's great, but when I get one who seems the opposite, tells me they can't do shiftwork without leaving the children 'home alone' and I start to feel concerned that I may be asking too much that they spend 40% of the placement working along side me on the ward on my shifts, try everyway to accommodate their circumstances, change my shifts to suit them and they still don't turn up, I do start to wonder however did they get on the training course to be a nurse which on some placements will involve shiftwork. Didn't anyone mention that to them at their initial interview to start nurse training.

    It's about extremes sometimes too, those turning up like footballers wives with all the bling, false eyelashes, jimmy choo designer shoes to those turning up like werzel gummidge, with body piercings and half body tattoos and a different wig for every day of the week.

    I don't know maybe we're just a bit too long in the tooth. Still get very motivated though when I get a keen student with a good attitude regardless of what they look like, cos that's something that can be modified.

    I'm sure I made some howlers as a student nurse with my shiny black patent shoes with bows on that the ward sister asked me not to wear anymore as it wasn't standard uniform, seems a bit tame to me now in comparison to today but then I guess it's all relative.

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  • I agree wholeheartedly, what is nursing becoming! I appreciate that students financially support themselves and try to fit student life around work, however nursing is 24/7 if they can't work weekends or evening shifts etc they miss important elements of the daily running of a ward. I work on a psychiatric ward and weekends and evenings are vastly different to 9-5, in psychiatry many nursing interactions take place that cannot take place during the day because of occupational therapies, care teams and the like. It's about time that students remember that we give care around the clock, and if my students don't meet the grade then tough I do fail them!

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  • I know wards that get students in most weekends . . . saves paying a bank HCA? . . .free labor! NOT WHAT WE ARE THERE FOR!! it is no reason to fail a student if they need to work elsewhere to get some money to live. staff need to be aware the bursary amount these days!

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  • tinkerbell

    None of our students were forced to work weekends to save money and they were always supernumery,supernummery, numary, supermummery, (sorry can't spell that word today) oh heck, you know what I mean, it's bad that students are being exploited this way but sadly not surprising.

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  • If this is your attitude then yes, I agree you should give up mentorship.

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  • Well unfortunately most students don't get the luxury of having a good mentor, they are there but can't be bothered, especially on busy medical wards, I know of some that will bring students in at the weekend, so the HCA's can have it off. Students can be very exploited at times, and basically ignored unless it's to help with bed baths and turns, all very important to patients care I might add, that all staff should take part in, however students are training to be Registered Nurses, not Healthcare assistants.

    I feel students aren't given good placements throughout their training, they either get threw onto a busy elderly ward, or are lucky to get community, intensive care etc specialist places where staff have time to teach and build a rapport.

    And if so many second year students are bad or clueless, then it's poor mentorship as well, they had to be passed in first year to get to second. And of course universities should be more supportive and proactive.

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  • Agree with Brian on all his points. When I spoke to one student and explained that her appearance broke the uniform policy and may have a bearing on how the patients perceived her, she replied "well that's their problem innit?".

    Oh dear, of course, silly me.

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  • tinkerbell

    I watched the student tv programme last night, thought they were a great bunch of students. Look forward to watching it next week. Yes, I know they have probably picked the best teaching wards and mentors but good to know they are out there, still.

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  • tinkerbell

    Sarah Brooklyn | 15-Feb-2014 11:46 am

    'Silly me' Made me chuckle, thanks, followed by a deep sigh

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  • I have read all comments, mentorship is a partnership between the ward mentors and student . Sometimes this does not work for any amount of reasons but students should work all shifts including weekend and nights after it does show them what there work life will be like when they qualify. Bursaries aren't much but how much do you think we use to earn when we were training?????.

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  • Anonymous | 15-Feb-2014 1:43 am

    It saddens me your attitude about Care of the Elderly Wards as being thrown in and not being a good placement.

    You are wrong, Geriatrics is a specialty, a very important one. Unfortunately you are not alone in feeling this hence the lack of funding in the unsexy Geraitrics; the Cinderella Service of the NHS

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  • Students may well be supernumery, but end up manning the wards whilst others take their breaks together!

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  • I have been in the nursing profession since 1974 .Surely the basic nursing care skills still need to be taught to our students! this would incorporate 24hr care
    We worked long hours split shifts nights days whatever was asked if you are not prepared to do this Why come into the profession!!!!!
    Once you are qualified you can then choose your hours of work to fit around family,by then you appreciate the total care planing needed. I now work as a health visitor so see care from yet another angle.

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  • I have been nursing for 25yrs: 20yrs as a ward nurse in every grade from student to ward manager and the last five years as a clinical nurse specialist. I still work alongside very committed and dedicated student nurses, who take every opportunity given to learn how to do the job they are in training for properly and with confidence; be it working with a Registered Nurse, Health Care Support Worker or other members of the health care team.
    So, where are they teaching you that you are not responsible for the provision directly (by your own hands) or in a supervisory role (provided by others) for bed-baths, toileting, dressing, feeding patients and skin care? Tasks, which in modern Health Care tend to be delegated by the Registered Nurses to the Health Care Support Workers they are supervising.
    You are being taught a mis-service by your tutors and mentors if they are teaching you that direct patient care is not part of ‘nursing’ a patient, and I fear once qualified, you will find yourself in a difficult situation when in Coroner’s Court or a N.M.C. tribunal trying to defend yourself legally and professionally.
    In health care ‘delegation’ of a role or responsibility to another party does not leave you any less accountable for it. I can speak from vast experience that the easiest way to check on the ability, attitude and appropriateness of any care giver (whatever the grade) is to work along side them jointly providing the care.
    As the Registered Nurse they are YOUR Health Care ‘Support Workers’ or Health Care ‘Assistants’; the Registered Nurse is responsible for the quality and appropriateness of the care provided for those patients in YOUR care and more importantly your registration with the N.M.C. depends on YOUR ability to manage this situation effectively. Therefore, I cannot stress enough how important these opportunities to work with all members of the Health Care team are for your experience and learning as a Student Nurse; to master how to become skilled at doing this with an ever changing set of staff on a daily basis, without appearing intrusive, inappropriate, undermining and ultimately alienating yourself from other members of the health care team, who you need to trust as your registration and ability to be employed a qualified nurse depends on it!

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  • Helen O'Donnell | 16-Feb-2014 7:21 pm

    Well said!

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  • I recently mentored a student who seemed to be having difficulty coping with some of the emotional trauma of caring for very sick patients. When I spoke to her, I discovered that although she was only six months from completing her training, this was her first hospital placement, all her previous placements being in the community. How can newly qualified nurses be ready for life on the wards with so little exposure to real life?

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  • i worked with a student who completed her second year and she couldn't even manage one low dependancy patient for half a day, even after going through his notes with her and being there for support - SCARY!!!

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  • It appears that Universities do not always 'get it', when it comes to recruiting the right sort of person that shows RN potential. Why are students allowed to choose their own placements sometimes? They need to be exposed to a wide variety of patients, in order to develop their knowledge and skills. What was so wrong with hospital nursing schools? It's high time we bring back the clinical nurse tutors too - they were so vital in their day. I am so glad I am not a student these days.

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  • Mentors should not try to fail students, nursing is a learning process, mentor with 20yrs experience and a student with 1 or 2yrs experience are not the same in terms of practical knowledge. l have been on a placement on stroke ward my mentor never dicuss anything with me about stroke never involved me on medications rounds l was there as an HCA. I know some mentors are as bad as the bad students , mentors should not forget to fill the action plan on how to make that student meet his/her competence.

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  • I am a 2nd year student nurse and feel that the attitude shown towards students in the original post is too harsh. Yes, of course there are always those students swearing with green hair ... but I have met many-years qualified nurses showing just the same 'qualities'. Anatomy and physiology is taught right from year 1 and continues throughout training. Also, the many media criticisms of poor care are generally not levelled at students, but at nurses who have become hard-hearted, cynical and jaded.

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