Nurses need degrees, like a hole in the head

20 November, 2009 | By Gabriel Fleming

Do you need to go to university before you become a nurse? Beyond the Bedpan tries desperately to sit on the fence, but readers’ minds appear to be made up

Beyond the Bedpan has been unable to hear itself think lately, such is the deafening roar of the all-graduate nursing debate.

In case you have been seconded to the moon for the past week and missed it, here are the basics: The Nursing and Midwifery Council, backed by the Department of health, has recommended that all new nurses should require degrees before being allowed to join the profession.

The move either escalates nursing to a the lofty intellectual heights it deserves, or condemns patients to wallow in their own filth while the nurses that used to look after them ponder the abstract philosophical principles of post-modern Bauhaus management techniques.

The latter point was picked up with predictable vigour by the tabloid press, including Eamonn Holmes of the Sunday People, who lamented the attempt to turn nurses into “doctors on the cheap”.

This was quickly slapped down by the government, namely health minister and former nurse Ann Keen, who told Nursing Times: “Eamonn Holmes may want nurses to hold his hand and empathise with him, but he would also want us to be exceptionally knowledgeable about his condition and to make sure we administered safe care. For that you need a clever nurse, so the case has already been made.”

Whether “clever” necessarily requires a degree is up for debate. And debate it you have, dear readers.

“It will fail in its aim and only assist in driving wedges between staff,” said one.

“This is going to lead to some excellent young people, who would make great nurses, being barred from the profession,” said another.

“Having a a degree won’t change the fundamental flaws in the NHS system. The system is antiquated, not it’s nurses.”

In fact support for the proposal was thin on the ground, but one nurse did say it was “the only way to go if we want to be seen as a true profession not a vocational career”.

It would seem the jury is still out. What do you think?

Readers' comments (79)

Anonymous | 21-Nov-2009 9:19 am
I am a nurse who trained in the 70s and work in a small community hospital. I do not think I am a worse nurse for not having a nursing degree. I find our degree nurses students only learn how to nurse when they are on clinical placements. I am academically well trained without a degree and how can a degree enable a nurse to be compassionate to a patient as this comes with practice on the wards.
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Jessamy Vincent | 21-Nov-2009 9:53 am
I just want to say....what is wrong with having a vocatioanl career? I do not have a degree but am passionate about a job I love and whilst endeavouring to acheive my degree, that is for my own personal acheivement not for the sake of the NHS. I agree with whomever said “This is going to lead to some excellent young people, who would make great nurses, being barred from the profession,”.
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Anonymous | 21-Nov-2009 10:38 am
I am a clinical nurse specialist who started out on my career in the early 70's with the grand title SRN. I have a wealth of knowledge and experiance as a result of working in the clinical areas and learning the acedemic side for myself....on the job........as I went along.........!!! This consolidates the learning and experience is the reason I have the ability to look at situations globally and think about the impact that decisions will have on other areas and services. There is not a degree in the world that will ever replace hands on care and a knowledgeable teacher in the clinical area
CT
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William Anderson | 21-Nov-2009 10:40 am
Yes - lets advance nursing as a career, and be equals with our professional colleagues

but at what cost? think of all those we will exclude because we are setting the entry level too high. There is nothing wrong with vocational entry into nursing.

The same scenario is currently being played out with our paramedic colleagues; as they too are moving to a more academic route.

do we need 'hands on' carers, or do we need 'thinkers'

Personally, I think we need both
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lesley_frater@hotmail.com | 21-Nov-2009 11:31 am
As always nurses are their own enemy when it comes to advancing nursing!
And can we please stop using the word 'Vocation' as if it is something sacred! See Oxford dictionary for meaning and this over used noun '1) a strong feeling of suitability for a particular career or occupation.
2) a person’s employment or main occupation, especially one requiring dedication.
3) a trade or profession.
I originally came into nursing in the 70's and left after 18months, so did not complete my training. I returned in 97 at age 42 after completing an Access course and chose to take the Diploma route due to family and financial commitments. I now work as an Advanced Clinician in General Practice (first contact only), have completed a degree, MSc and looking forward to my PhD as I feel this is the right way to drag nursing into the future and been seen as equal professionals.
No where have I read that nurses who trained differently are bad nurses, as that was what was available at the time and we all feel protective for the way we were trained. Nurses also need to stop stabbing nursing colleagues who have trained differently in the back, instead use your expertise and experience to welcome the differences we have! People are always fearful of the unknown but we have to remember that we are adults and move forward and use the energy to ensure that the new degree programme is fit for purpose!
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Una Adderley | 21-Nov-2009 11:58 am
Whether we like it or not, the financial pressures of the NHS have forced nursing to change. Much ‘hands on’ work which was the mainstay of the registered nurse now has to fall to the healthcare assistants. While all nurses and healthcare assistants should be capable of delivering compassionate and skilled hands-on care, we need our nurses to also have the skills and knowledge to undertake a high level of clinical decision making. This usually requires extensive experience coupled with academic study.

While I agree that novice nurses with a degree have a lot to learn from their experienced non-degree level nursing colleagues, an experienced nurse educated to degree level (especially if that degree has been obtained following their initial training) generally knocks spots off an experienced nurse without any academic qualifications.

Academic achievement and safe compassionate care are not mutually exclusive! I manage a team of highly qualified specialist nurses – their passion and dedication to the needs of their patients is remarkable. However, it is their academic knowledge that enables them to identify the best possible care for their patients and the means by which to deliver such care. This is the future of nursing. We should be embracing it, not arguing against it.
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Anonymous | 21-Nov-2009 12:18 pm
I trained in the 70's SEN, SRN, RMN. I do not feel a degree other than a degree in experience is essential, though a degree in nursing is something that can be studied for post reg maybe. I feel that nurse training is about study consilidated by practical experience and that this should take precedent.
Though I do not have a degree I have maintained my educate throughout my career, there is plenty of opportunity for post reg education/training for those who take their profession seriously.
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Ellen Nicholson | 21-Nov-2009 12:33 pm
Thank you, thank you Lesley and Una for your perceptive comments. It's wonderful to know that I'm not alone in thinking we should move forwards in nursing. Interestingly over the last week whilst following the discussions online I have also had the explain the idea of a 'degree nurse' to many friends and patients. They are watching what we say and do very closely, so be careful fellow nurses what we do and don't say about our profession, words do have the power to influence. Personally, I would like to see nursing being more supportive over its development, rather than littered with comments about why we shouldn't change, it would certainly help our professional image rather than this constant back biting, we have much to be proud of in nursing, lets celebrate it and move into the future.
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Anonymous | 21-Nov-2009 12:43 pm
I did my training in the 70's when nursing was a vocation and have worked abroad as well in this country without a degree.
I have worked with many students some good and some bad and a degree doesn't make a nurse, it's dedication, empathy,and an honest caring attitude towards people when at their most vulnerable.
I once tried to teach a student how to take a B/P manually rather than relying on the dynamap, his reply to me was "I know it in theory and don't have to do it in practice". If this is the caliber of nurses for the future then I fear the day when I have to be treated by them.
Many have no initiative or common sense nor even seem to know how to wash the hands and face of a patient. As for basic nursing care of seeing that your patient is comfortable pain free and has met their nutrtional needs seems to be beneath them and they say that it's the support workers job. I have been told by such students to my face that they are not going through university to clean someone's bottom. I am completely horrified by such comments. I wish so much that the traditional training were back and students showed more respect for the trained staff that are trying to teach them.
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Anonymous | 21-Nov-2009 1:12 pm
I wish, I wish, I wish I had done my training under the old system. I have a degree, for all the good it did me. When I qualified two years ago, I felt absolutely lost on a ward, mainly because I had not had the mentorship and full clinical experiences on placements which I should have done.

A degree is a piece of paper, no more, no less. It does not make a good nurse and may quite possibly deter a lot of potentially excellent nurses who do not believe they are capable of taking a degree course. Can we please get back to teaching the basic tenets of nursing? This more than anything, would bring the profession of nursing back up to the high standard I believe we are in danger of losing.
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Peta Kerrigan | 21-Nov-2009 1:33 pm
I have a degree. I didn't do degree level entry as it wasn't available when I trained, but I do object to the idea that all nurses with degrees will not do any basic care and are too academic. I give care , I manage and I feel that the things I have learned via my degree have made more able to take on other professions when advocating for my patients. Having said this I do wonder whether we should have some sort of pre nursing course so that those who can't cut it on a ward are whittled out before they start their nurse training.
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Anonymous | 21-Nov-2009 1:35 pm
I recently qualified (with a degree) as a children's nurse. The three months I have spent being independent and accountable on the ward have taught me more than all the three years of my training put together. As a very late comer to university (I qualified at 50) and having done better in my academic work than I had expected, I undertook the BSc conversion in my final year. This was a personal challenge and I became the first member of my family to obtain a degree of which I am extremely proud. But, the study I was expected to undertake to acheive this award has not helped me 'survive' the last 3 months one jot. I understand and agree that it is important that nurses have the academic clout to contribute to research in our field, but this could be obtained after the groundwork of practical experience has been achieved. Seeing nursing life from the other side of the laptop has been scary but exhilarating. I don't think I will consider futher academe, excepting my CPD, for some time to come.
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Anonymous | 21-Nov-2009 3:28 pm
I wish, I wish, I wish I had done my training under the old system. I have a degree, for all the good it did me. When I qualified two years ago, I felt absolutely lost on a ward, mainly because I had not had the mentorship and full clinical experiences on placements which I should have done.

A degree is a piece of paper, no more, no less. It does not make a good nurse and may quite possibly deter a lot of potentially excellent nurses who do not believe they are capable of taking a degree course. Can we please get back to teaching the basic tenets of nursing? This more than anything, would bring the profession of nursing back up to the high standard I believe we are in danger of losing.
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Anonymous | 21-Nov-2009 3:55 pm
I trained under the 'old' system, and then came back to nursing 7 years ago after an 18-year break. The 'Return to Nursing' course was woefully inadequate to prepare me for a job which had changed so much, and which expected competencies I had not gained in my original training. It should be possible to devise a course which takes knowledge to degree level whilst including sufficient practical hands-on experience to understand basic nursing care. Perhaps the course should be a sandwich course, allowing a full year's placement (as an HCA maybe) to gain experience on the ward, before returning to university for the final year - this is done for many other degrees
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Anonymous | 21-Nov-2009 4:05 pm
It would be much better for those trained in the 1970 to give the necessary support to student nurses on their ward rather than making them work like maid servants and taking the air " in those days my training was bla, bla ......." Furthermore for those who think they have not acquired their qualifications at university, it does not necessarily mean what knowledge they have but who they know and who they go out for drinks on Friday nights.
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Anonymous | 21-Nov-2009 4:32 pm
I completed my training in 2007 and decided to complete my Diploma in Nursing, in this time I have had a variety of clinical posts and feel that rotation with proper structured mentorship can facilitate a greater knowledge base. Having a degree doesn't constitue a "greater, more super nurse persona" - a trained nurse is a trained nurse, we have the same job descriptions and we all have the same aims for the patients. Its seems that degree nurse's have easier progression up the career ladder - what happened to knowledge base and clinical skills experience. Yes, I agree that we should advance and develop our profession, but really is it best focusing on nurses having degree's, should we not look at further strategies such like additional funding for staff education, additional funding for more staff on ward level and encouraging are already trained and knowledgeable nurse's to advance more rather than "stall" at a level and have no interest in progressing any further.
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Anonymous | 21-Nov-2009 4:45 pm
I take offence to Una's comment; "While I agree that novice nurses with a degree have a lot to learn from their experienced non-degree level nursing colleagues"

well excuse me for thinking that as a nurse with a degree, and 5 years specialist experience I am far from a novice nurse! and why exactly are non-degree level nursing colleagues more experienced? can you elaborate please when where I come from we actually all trained together-all completing the same modules, the same amount of practice hours and giving the same hands on care??
why are we destroying our profession from within by disregarding each other's diversity and contribution? i would not dream of labelling a diploma qualified nurse as less experienced than a graduate nurse, each have their own qualities and attributes, it seems on here most diploma-level nurses seem all too eager to slate those of us with degrees-maybe it is your own insecurity shining through??
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joseph mccaffery | 21-Nov-2009 5:27 pm
From Joe Mc Caffery

I've been a qualified Nurse for 27 years and have Nursed in 7 countries on three continents.

Look.... Lets call a spade a spade!

The only way to resolve this argument is to adopt a retrospectve proven model of Nursing Interfacial/Inter-intellectual disphoria......

Ask the doctor!

Ye know the kid who walks on to your ward on his first Monday morning and you send a student to ask him if he has lost his mummy!

Whilst we are AGAIN assassinating each other over some initiative by the department of non-clinical " I'm on 70 grand a year" desk wallahs the Medics are continuing to lord over the provision of health to our people and communities and they are doing so with us as collateral for thier arrogance.

Grow up. If you want to see your role becoming more accepted and professionally regarded, Set your goals outward and expansive, not inward and devisive.

Cheers

Joe
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joseph mccaffery | 21-Nov-2009 5:27 pm
From Joe Mc Caffery

I've been a qualified Nurse for 27 years and have Nursed in 7 countries on three continents.

Look.... Lets call a spade a spade!

The only way to resolve this argument is to adopt a retrospectve proven model of Nursing Interfacial/Inter-intellectual disphoria......

Ask the doctor!

Ye know the kid who walks on to your ward on his first Monday morning and you send a student to ask him if he has lost his mummy!

Whilst we are AGAIN assassinating each other over some initiative by the department of non-clinical " I'm on 70 grand a year" desk wallahs the Medics are continuing to lord over the provision of health to our people and communities and they are doing so with us as collateral for thier arrogance.

Grow up. If you want to see your role becoming more accepted and professionally regarded, Set your goals outward and expansive, not inward and devisive.

Cheers

Joe
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Anonymous | 21-Nov-2009 5:39 pm
you know, i wish nursing was like medicine. there's only one entry route and you can't get into medicine through the back door. so why do people feel like you can get into nursing through the back door? nursing is changing and its not how it was back in the 70's. people need to get a grip and stop thinking that nurses that do have a degree are the worst nurses. i did the same amount of placement hours as the diploma students. the only difference is that i did a dissertation and slightly more work. you don't want to be doctor's handmaidens and want more specialist nurses, yet you think that nurses shouldn't have a degree!
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