Maintain pressure on reforms to protect NHSDon't let them eat cake, do let them have degrees
Beyond the Bedpan is pining for less sensitive times, and the all-graduate debate takes another unexpected turn
Such sensitive times we live in. What with students quibbling over a mere £10,000 worth of personal debt, the government cracking down on nurses calling in sick, and hospitals getting their wrists slapped just for letting a few too many patients die, there isn’t much going on that someone, somewhere isn’t outraged about.
But the management at Royston Hospital in Herts have really taken the biscuit, not to mention the cake.
Every year for the past 24 years, the charitable souls at Royston Runners club have organised a festive 10k run. Instead of an entry fee, runners are required to bake a cake. The cakes are then auctioned off with the proceeds, and any remaining cakes, going to Royston hospital.
But this year, the long arm of health and safety rejected the baked goodies, presumably due to fears of a fatal food fight breaking out among staff, or a comely young lady leaping out of a cake and sending male patients’ heart rates into dangerous territory.
Refusing to give up, the philanthropic joggers called for back up in the form of the League of Friends of Royston Hospital, who promptly persuaded the hospital to change it’s ridiculous stance.
Degree divisions
The all-graduate profession debate refuses to die. Since last week’s column noted nurses’ near universal opposition to the move, readers have delivered a blow to Beyond the Bedpan’s reputation as barometer of national opinion - by coming out in favour of the move.
“An experienced nurse educated to degree level generally knocks spots off an experienced nurse without any academic qualifications. Academic achievement and safe compassionate care are not mutually exclusive.” writes Una Adderly.
Says Ellen Nicholson: “I would like to see nursing being more supportive over its own development, rather than comments about why we shouldn’t change. We have much to be proud of in nursing, lets celebrate it and move into the future.”
And finally, the most damning critic of the degree-deniers chooses to remain anonymous, probably for the best: “You don’t want to be doctors’ handmaidens, you want more specialist nurses, yet you think that nurses shouldn’t have a degree! Get a grip.”
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Readers' comments (18)
shelly waters | 28-Nov-2009 10:52 am
I have worked with nurses who are degree level trained that have no idea how to look after a patient, and i have also looked after diploma level trained nurses are fantastic! Having degree does not automatically mean that you will make a good nurse. I am a diploma trained nurse and i feel that i am just as capable in my job as any degree trained nurse!
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Anonymous | 28-Nov-2009 10:56 am
So if we get rid of all the nurses without degrees, will there be anyone left to look after the patients!
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Anonymous | 28-Nov-2009 12:00 pm
I have a BSc Hons Degree in Nursing - it has made no difference to my pay or opportunities in the workplace
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Luke Carter | 28-Nov-2009 12:57 pm
The degree course is not different enough from the diploma! do people honestly believe it makes any difference to a persons ability to be compassionate? it should take a little more to squeeze all the personal skills out of a budding nurse!
Maybe the nurses used to highlight the argument against degrees would be better in another profession if they have a degree or not.
It seems that nurses fear degree only nurses coming up through the ranks and over ruling their practice etc which is not bore out by reality (or an evidence base if you like).
I want nursing to be taken seriously and this is a good first step. I reject the theory that degrees make no difference. A degree only profession will have more control over its destiny and will make it a more coveted career.
I would say however that a more selective, stringent interview method for entry onto nursing courses is needed. A degree or diploma is irrelevant if your not giving it to people with appropriate "life experience" or people skills as niether degrees or diplomas in nursing imbue people with these.
I often heard when I was an H.C.A that nurses dislike change, maybe there is an emerging body of evidence for this? I may write my dissertation on that very subject!
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susan rust | 28-Nov-2009 1:14 pm
Like many mature students, I entered nursing via the diploma route after 16 years working as an HCA because of financial implications - the diploma offered a bursary and my family were dependent on my income - it is as simple as that. I am now working for my degree via further training at uni - have done Mentorship and now doing Respiratory.
Since most student nurses these days are of the mature variety, I am most surprised that the powers that be think that they will continue to get enough applicants if it goes to an all degree entry.
I agree with a previous point - degree or diploma, applicants need to be better interviewed, the drop out rate on my course was about 40% and most of those were obvious from day 1. The quality of students that I am now mentoring doesn't seem to have changed at all!
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cheryl mundur | 28-Nov-2009 3:41 pm
To degree or not degree,that is the question??
Arguably with the diversity and challenge of registered nurses in the current NHS,an academic mindset is going to prove relevant in questioning best practise,moving forward developements set at national,regional level,using an analytical approach in audits,teaching new staff,students,de-coding complex research protocol for patients on clinical trials,etc etc.
However it wont teach,instinct,empathy or an ability to cope with pressure when you are the only trained on duty with bank/agency staff,very sick patients,phone going and a doctors round etc.
Just being able to have/do a degree doesn't make a nurse.There has to be a best practise method at selection before the training starts.
Instead of hospitals being absent at this stage,they should be actively involved,right at the beginning.It is as if these are two separate entities.
Maybe if this were the case course drop out rates would not be as high as in some cases 40%.
Ok everyone hates reminicing about "the good old days" there were things from my training days that i would not like to see again for love nor money.
However what there was from my training at a school of nursing 1979!!! was a sense of belonging and pride in the hospital i was attached to.
Also i feel the supernummary status should stop at year 3.This would help prepare for the real pressures of wards work,the reality.
Another preparation strategy before "university training" but as part of the course could be a 6month stint as an auxiliary/support worker,non suppernummary,to learn basic skills (i met a 2nd year student nurse who did not know how to take a temperature!),interact with patients,relatives,other staff members as team member as part of a ward.They could get sense of everyday pressures and this would im sure stand in good stead.
It would also assess if they were really suited to nursing,maybe it would save a waste of time and money on high drop out rates.
At the end of their 6months they would have a written assessment for their porfolio, and more importantly ....insight.
I also feel that Nhs trusts should be committment to supporting newly qualified nurses and provide employment for one year,(after all its not untill you've passed your driving test,that you learn how to drive!) Too many newly qualified have to fight for a trained post,really unprofessional and implicitly shameful way to treat our staff of the future.
Enough of my ranting!!!
A Staff Nurse of 30 years,trained at Sussex Downs Schools of Nursing,work in acute hospital trust still!! No degree.
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tim stokes CAMHS | 28-Nov-2009 5:34 pm
i am concerned at what i am reading in this article. i do not believe that opinion was against nurses getting degrees but was against nursing requiring a degree at entry as the experience is needed to validate the education.
i think more opportunity should be given to qualified nurses who can tailor their academic interest to their professional interests and skills, while a diploma or even apprentice level entry will give bright non-academics a way into a profession that they can develop in over time
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Anonymous | 28-Nov-2009 8:00 pm
Yes, non-degree nurses can be just as good (or better) than those with degrees. But the reality is that they are never going to be viewed as serious professionals who command a serious salary unless they have one. Just look at how well the US nurse practitioners & CNSs are thought of and paid!
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Anonymous | 28-Nov-2009 8:05 pm
Having qualified as a nurse with a diploma, I have since completed a degree in nursing. I feel that many capable canidates for nursing will be dismissed from even entering the profession because they can't get on to a degree programme, as higher academic qualifications needed to join. Having a degree has made me a better nurse but I don't think that would have been the case when I qualified, experience and continued professional development has achieved this. Do we need to return to a two tiered system?
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Anonymous | 29-Nov-2009 7:44 am
I am still haunted by the training days , where I felt bullied and made thought I was not going to pass my last mentorship. I was told after the fact, by my mentor, that he had to be tough with me, but today, he doesn't know how it affected it me mentally , that fact that some mornings when for example, he did not say good morning to me, still haunts me and other memories of my training days. The experience for me and the most experiences I had with my instructors, were too tough, and today because of it, I do not want to work in a hospital. I opted for my diploma because I did not want to bullied anymore and believe just because a person is sensitive, they have to be molded into something different. Now I know, its better to be sensitive , to be as empathic as one can to a patient's reality, But today, I want to get my degree to have more opportunites to reach a PHD level so I could research and publish my experiences and or to reach more goals that I thought I could not reach just because I was too sensitive.
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Luke Carter | 29-Nov-2009 11:01 am
Leading on from the last comment rather than making nursing degree only and leaving it there, I feel there is a need to revise many of the fundamentals of the training.
The problems found by many students, those of being at the mercy of the mentors personality e.g. their prior experiences with students and their general approach to life can be highly turbulent.
The gaps between (what i've been told are) the sterile university education and the swamps of the clinical environment
seem vast.
There are far more pressing concerns surrounding nurse training than the level of achievement. If such problems are not addressed it will not matter if it is degree or not.
As a mental health student I assume that universities are given funding for every student in a cohort, up until they drop out?
Also much of the background work needed to inform students about the many grey areas in ethical practice etc are expected to be conducted under one's own steam and only examined within their essays.
It is a possible interest of mine to, once qualified assist in the restructuring of nurse training to make it more realistic and reality focused. Degree or not we all know the people who will make great nurses and those people CAN pass at degree level with the appropriate support!
More nurses and students need to turn their attentions to solutions rather than obstruction. Degree only will come and it is nurses and students who will make it work or not. It would be good we can rise to these challenges instead of decending into a civil war.
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Anonymous | 29-Nov-2009 8:29 pm
the big difference between diploma and degree is that as a degree student I am still paying off the loan I hd to get top complete the course, and increased mortgage (as I had to re-mortgage twice to complete as I had a family to keep!) yet you would think after all this and with Agenda for Change supposed to be rewarding us I would earn more, not a chance biggest mistake we made was agenda for change
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James Iddon | 29-Nov-2009 9:33 pm
It is important to be realistic. Until recently it was not possible to obtain a bursary for a degree in England. Many of the nurses who have diplomas made that choice because of financal factors. It is also important to take into consideration that in real terms the only difference between a diploma and a degree trained nurse is a dissertation: meaning a few thousand words. Give all student nurses the finance they require along with the knowledge, skills and confidence then give them a pin number once they have proved themselves competent. Give them a degree or a diploma or a medal or a hug.
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Jacqueline Hickman | 30-Nov-2009 2:46 pm
I wish there had been degree courses for nurses when I qualified in 1964. Although our 'apprenticeship' style of traing was more rounded, nurses then were expected to be doctors' 'handmaidens'. I cannot count the number of times that I was reminded that I was 'only a nurse' over my 44 year nursing career.
Maybe a probationary period between qualification and registration is the best solution, as happens with newly qualified doctors.
This would give newly qualified graduate nurses the opportunity to work, rather than study , but without the responsibility of registered nurses.
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Anonymous | 1-Dec-2009 10:08 am
Degree vs. diploma - I am still undecided, but I wholeheartedly agree with two previous posts when they referred to the need for a more stringent interview process.
I am a first year mature diploma student who plans on transferring to the degree program during my final year, for my own personal gratification. I am finding the quality, behaviour and knowledge of at least 60% of the nurses on my course to be absolutely appalling. These students are not only at risk for dropping out, but are hindering the learning experience of those students who have the study skills and personal awareness to become great nurses.
The field of medicine is constantly growing and changing, and as a result it is necessary for nurses to continue to update their knowledge and skills to match this growth. Do we really want nurses who lack the ability be self aware or lack the drive to continue learning outside of University to be responsible for the healthcare of ourselves or our family members in the future?
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Anonymous | 1-Dec-2009 11:33 am
I'm sorry, but since when has having a diploma made anyone more compassionate? Academic qualifications have nothing to do with caring or empathy but they provide a better and deeper knowledge base on which to provide informed, evidence based care. You are either a caring person or not.
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Anonymous | 2-Dec-2009 4:08 pm
I am a HCA who has just started a Foundtaion Degree in Health and Social Care and cannot believe the amount of resistance I have met from my so called work colleagues - registered or not.
Nursing is important , why do we fight change so much ? would you be happy with a Teacher, Doctor, Dentist, Lawyer without a degree edcation teach your child, treat your medical problems etc ?
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Anonymous | 5-Dec-2009 11:44 pm
I completed a diploma programme and I thought my training was excellant.. I met many degree students who tended to look down their nose at diploma students and were not nearly as skilled or experienced as myself and my fellow diploma nursing students. I am working towards my degree now because I know that to progress I need to improve my academic calibre. I completed a mentorsip module and mentored students who did not seem to be interested in basic nursing care and were more interested in getting off early from shift! I had one student complain about me because she thought I was bossy but I was in charge of a coronary care unit and did not think it right that nurses were sitting around whilst patients were requiring assistance!
I myself plan to go into private practice as I have had enough of the poor staffing, poor pay and complete lack of support from the NHS. When will these bureacrats wake up and do something and support the front line workers!
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