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Tories say nurse degrees should be an 'aspiration' not an 'entry requirement'

A degree should be an aspiration for nurses, rather than an entry requirement, shadow health secretary Andrew Lansley has told Nursing Times.

Mr Lansley also said that nursing should not be something that only nurses do and professions should not be defined by “workplace demarcations” but by professional competencies and qualifications.

The man most expect to be the next health secretary should the Conservatives win the general election was making a speech to the Nursing Times Summit. The full text of the speech can be read exclusively here.

He said: “It’s clear that for nurses to meet the professional standard we seek they must be educated to an advanced level to equip [them] with the skills to plan, lead, manage and deliver evidence-based nursing care.

“But we also know that there are some people who have all the skills to make great nurses who would be deterred by the apparent academic requirements of a degree.

“I am in no doubt that nurses should – or be able to – become graduates, especially to lead and develop nursing services; however there are many of those involved with the care of patients who do not need a degree for the work that they do.”

Mr Lansley said the structure of qualifications should “reflect the wide range of roles and requirements of the service”, adding that nursing carries “all the hallmarks of professions which we would generally now regard as at graduate-level”.

But he said: “It is however not necessary to ensure that a degree is an entry requirement to the profession, rather than the level of qualification which nurses should achieve as a result of their education, training and practice.”

His comments come as shadow health minister Anne Milton writes in this week’s Nursing Times that nurses who have fed back to the Conservative consultation on the future of nursing had given mixed feedback on the move to a graduate-entry only nursing profession. Ms Milton writes: “All of these are legitimate concerns and we must make sure that any policy to make nursing a degree only profession deals with them.”

Mr Lansley said nurses’ knowledge, skills and competences must be clearly defined. “There will increasingly be overlap between staff groups in the tasks they do; doctors and nurses or nurses and therapists.

He told the Nursing Times Summit: “It is important to distinguish between nurses and nursing. Not everything that is nursing is done by nurses. Let’s be flexible about that and not conform to rigid demarcations of practice.

“If there are those in positions to provide aspects of that care, we should support a professional structure that allows that and not try artificially to have a rigid structure that says if you do nursing therefore you must be a nurse and therefore you need a degree. That would close out people… who have a great deal potentially to offer.”

He said this was “a priority task” and urged nurses to get involved in its development. “I urge the nursing profession to take ownership of this. Do not think it is for government – any government – to prescribe to you,” he said.

NHS staff are its greatest asset, and nurses “are at the heart of providing great care”. Mr Lansley said the public needed a better understanding of the role of nurses’ today and that the onus is on government and NHS employers “to deliver positive images of nursing as a dynamic 21st century career to the public: to show that there is a wide range of jobs in nursing, including senior clinical and management roles”.

Mr Lansley’s comments came on the day that the Nursing and Midwifery Council launched a major consultation on the future of pre-registration education, with a particular focus on the move to a graduate-only entry profession in England.

The regulator is seeking views on the knowledge and skills that nurses of the future will need to practice. The three-month consultation will end on 23 April.

Readers' comments (35)

  • Any reason not to be paid in line with other graduate professions. Everything I read makes me regret ever becoming a nurse, it's turning out to be an embarrassment. I'd never proudly admit that I am a nurse, as I'm treated like someone who had learning disabilities at school and couldn't get a proper degree.
    I already had a degree before I even started nursing. To be told getting a degree should be an aspiration is laughable. Just confirms why everyone asked me "WHY are you doing nursing?!" The job is about the patients 100% but my life doesn't revolve around "the patients". I want financial compensation for the job and hours that are expected of me, like anyone else.

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  • This chap is another one of those that dosn't know the difference between an 'health care assistant' and a 'registered nurse' and of course, he is a tory.
    thatchers legacy is the NHS we have now. Do I need to say more? I think not.

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  • I think he is speaking a lot of sense even though I am not generally a fan of the tories. I have come across a lot of nurses who hate the idea of studying and who do not have the ability to study to degree level. Why should nurses be forced to undertake a degree if they don't want to? Further study for nurses is of course essential, but I don't feel that I am a better nurse because I have a BSc, in fact unless you prectice in a very acute setting, most of the modules on offer are a bit of a waste of time. I have despaired of some of the degree students I have come across in Clinical Practice. Many of them could write decent essays but their abiltiy to carry out confident patient care was severely lacking probalby due to the fact that since the implementation of project 2000 there is much less time spent on placements learning essential skills. I feel nursing has suffered greatly because of this change in training and will sadly continue to do so.

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  • Maryam Omitogun

    Nursing that I know before I joined nursing profession are well respected by the public. I believe we are equal with Doctors and other health professional and we are to work together for the improvement of our patients and clients.Its onlly that ach individual went to read courses of interest
    Nursing involves training both theoretical and practical.
    I can remember very well while I was been trained as a general nurse-There are many subjects that we were taught and I will mention some- Anatomy and physiology, Medical and surgical nursing, pharmacology, public health, microbiology, behavioural science
    But nowadays because nurses has forgotten their professional academic level and are not even willing to demonstrate the knowledge,experiece skills they have on this profession, this has been bringing down the prestige in nursing.
    Nirses that have degree has not been giving priority to function on the level of their education,instead those that are not educated to degree level will be jealous and be pushing those that have a degree back,they will never allow the degree holder to perform on the leadership level and within their competency and education.
    This type of problems does not occur in other higher academic profession. Doctors support themselves and respect the skills of their member probably because all Drs are degree holder.
    Its high time we nurses wake up and lets practise our profession like an academic and medical staffs. Lets support ourselfs to work more independently, because I believe a trained qualified professional are to work independently with the level of their competency and education.
    There shuold be different from a trained nurse and non traned staff.
    We should try to respect our profession so that people will help us to respect it.

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  • This is yet again a saddening and disappointing indication of what we might come to expect from the Conservatives getting in Government.

    Heed the comments as a warning that he is totally out of touch with what Nurses really do on the front-line everyday without even knowing it most of the time.

    Yet again Nurses are given the 'there there' patronising pat on the back that 'one day, you might be able to get a degree...one day...'.

    RUBBISH! A degree is not some big scary, unachievable, elite qualification! There is funding and access to degrees everywhere and it is the only way we can stand united as a profession and be counted, compared and respected like other professions such as Medicine.

    This speech is full of sound bites and potential vote winning attempts thinly disguised in patronising rubbish. Nurse need and should have a graduate foundation on which to build their career. Universities cannot do enough for students that need extra assistance such as personal tutor time and one to one sessions if required. We should be promoting this, shouting that a degree is open to everyone and will be undertaken in a supportive flexible way, NOT describing it as an 'aspiration' which again underpins the elitist, hard to reach lofty qualification which it is not!

    I agree and understand a degree does not make a nurse a better nurse, it helps to equip him or her with the right skills and tools to develop their career and deliver better care.

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  • Martin Gray

    I agree with what Mr. Lansley says, nursing is not all about academics and the ability to learn at degree level, it's about caring for patients. I have no interest in which political party has run the country in the past; what each should be doing is learning from the mistakes of their opposition and delivering on promises of reform that are of benefit to society as a whole. Health care is a rapid growth area as people live longer and we have more births and immigrants. The challenges are still there and getting bigger, but not one political party has yet made any inroads to finding practical and affordable solutions.
    Any person that wishes to become a nurse, or be involved in caring for patients, needs to be actively encouraged to do so. By dictating it has to be a degree only profession DOES put people off, not just because of the academic requirement but the financial implications. The better qualified a nurse becomes the more pay they should receive; they should also be prepared to accept the increased clinical responsibility and liability that such remuneration demands.

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  • lesley_frater@hotmail.com

    Anonymous 3-Feb-2010 11:39 am
    You say you have come across a lot of nurses who hate the idea of studying and who do not have the ability to study to degree level. If this is the case then they should get out of nursing. Nursing needs academically as well as caring nurses to lead future change and improved care for patients!
    Why should nurses be forced to undertake a degree if they don't want to. Nurses should not be forced to take a degree, so become something else that does not require a degree. Nurses needs to continually update keep themselves up to date and that requires learning!
    You don't feel that you are a better nurse because you have a BSc, in fact you stated, unless you practice in a acute setting, you feel most of the modules on offer were a waste of time.
    I'm shocked that after completing a degree yourself that you have taken nothing from it and implemented it in practice, this is a condemnation of your practice not an issue with the degree.
    An aspiration for any nurse should be a respected profession and MSc, PhD not a degree!
    We are being thrown under the bus and unfortunately the degree is being used as a smoke screen.
    You also claim that you have despaired of some of the degree students you have come across in Clinical Practice. Claiming many of them couldn write a decent essay, but their abiltiy to carry out confident patient care was severely lacking probalby due to the fact that since the implementation of project 2000!
    No severely lacking due to poor mentorship! It is no good harping on about project 2000, as training has changed a few times since then and there is no going back, if as a mentor you found a student lacking certain skills it is your job to ensure she leaves with those skills in place, it is no good just passing the buck!
    As mentors we are forming the next generation nurse which is a massive responsibility and should not be taken lightly, we need to instill excellent clinical practice, so if we throw muck at the students of today we also need to realise that we are also dirty for not stepping up to our responsibilities as nurses!

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  • Mr Lansley's speech has clearly highlighted his lack of understanding of the difference between a nurse and carer. There are no professional carers, and as such, you do not need any qualification to be a carer, let alone a degree. I am sure that even he can be a carer if he tried. What affront to suggest that a degree should be an aspiration not an entry requirement into the nursing profession.

    It is interesting that Martin Gray agrees with Mr Langley but deems it fit to point out that ''Health care is a rapid growth area as people live longer and we have more births and immigrants''. I am hard pressed to find out how Martin thinks we can meet these challenges without an adequately prepared nursing workforce, sound in both theory and practice.

    To Anonymous | 3-Feb-2010 11:39 am, Lesley Frater has given you comprehensive response. I must add that the fact that you did not gain much from your BSc training, is your problem not the programme.

    It would be nice to know if Mr Langley and Martin Gray think that their views in relation to the nursing profession, also apply to the medical profession.

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  • Patients of degree educated nurses at the bedside have higher survival rates. Full stop. If you can't handle it then become a health care assistant.

    The problem is (as another poster pointed out) is that these guys cannot tell the difference between a health care assistant and a nurse. They believe that the degree requirement means that all the people who work on the ward caring for patients will have degrees. This, of course, is not true. Only the very few staff who are actually nurses will have this level of education.

    If this country is not prepared to have highly educated RN's at the bedside, doing all aspects of nursing care, for a safe number of patients then we are sunk. Nurses need safe ratios, then they can do all their patient care rather than being FORCED to delegate it to the health care assistants.

    My hospital will often not pay for more than one RN to be on duty at a time for large wards. The rest of the staff is comprised of health care assistants who miss the boat completely. That poor nurse is on her own with 90% of the workload.

    That lone RN has to have sh*t hot critical thinking and analytic skills to function. I do not want this person, this lone RN, to be someone who is "nice" but "not academically gifted". Not if I am the patient!!

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  • I rarely agree with tories, but this is spot on. There is no need for nurses to have a degree. I see no difference in the performance of nurses with degrees over those with a diploma. It doesn't make me a better nurse because I have a degree. How many of those so vocal in their desire to see nursing an all graduate profession feel that way so they can complain long and loud about how much money we should be getting rather than improving care. If we chose nurses by the strength of their character and caring nature rather than their academic ability, patients would be far better served.

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  • It seems to have been overlooked that an all degree profession has been implemented in wales since 2004 and has worked very well.
    The course is 50% theory and 50% practice and students are monitored very carefully and have to be competent in both theory and practice and also have all the attributes of a good nurse in order to practice as a fully qualified nurse!
    An aim of the degree is to create an awareness and understanding of evidence based practice so that nurses are equipped to ensure that the care they provide is best practice. Surely this is a good thing?
    I qualified under this system in 2007 and am not saying it has made me a better nurse but I feel that it works!
    There were a few people on my course that actually failed because although they were very good academically they were not very good when it came to providing care, so i hope this alleviates any concerns raised that nurses doing degree level nursing dont make good nurses! I find that statement very insulting. I come across nurses who are very poor at what they do at times and these include nurses who qualified under the traditional system and some who are intolerant to change at least with the degree change is underlined as being the future!

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  • Finally a politician that is not afraid to open up a debate. I have to say that with the exception of equivalent pay then, having a degree makes little difference to how nurses are perceived and also, more crucially, how a good nurse goes about their job. Some graduate nurses are poor, as are some diploma nurses. As a potential colleague of the nurses currently under training, I would value someone who can do the job well, irrespective of level of qualification. I am fairly certain that our patients would agree. Yes, we need proper renumeration for our endeavours but that should not depend on a degree. And before anyone mentions it, I do have a degree but that has not influenced how I do my job.

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  • Are we stepping back in time? Nurses have fought long and hard for pofessional credibility with the aid of a high level of education! Nursing is based on the ability of individuals to provide a high level of care to patients. How do we do that? Education, education, education! How else can we provide evidenced based practice if we are unable to understand the evidence or challenge bad practice. We no longer work to the ethic of ' it's how we've always done it'

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  • I am a supporter of degree level training despite the fact I don't have one myself (yet!) But one of the main reasons I support a graduate profession is that it would allow us to "keep up with the jones's" so to speak, other health professions train to degree level so why not nursing? I do however believe that the emphasis should be on the content of nurse training as oppose to the academic level it is delivered.

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  • I have a degree at Masters level - it was the best thing I've ever undertaken - it changed the way I think and practice. However, I am also aware that had Nursing had a degree level entry when I started at 18 I would not be a Nurse - at the time one had to have a grant supported parental income - my father did not want to support my studies and as I came from a middle class family I was not entitled to a full grant. I studied once I could support myself. To be honest I became a nurse because it gave me opportunity to earn a wage whilst studying - it also gave me a home as Nurses homes still existed then.

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  • Clever Mr. Lansley is simply planning ahead. If nurses all have degrees then we are credible professionals who will require the salaries of credible professionals! No, the Tories have always opted for nursing on the cheap, I remember the state they left the NHS in the last time and as for nurses' pay under their government..........

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  • I qualified in nursing for Learning Disabilities at diploma level on the original Project 2000. I found it a challenge accademically but enjoyed it and continue to enjoy my role as a senior LD nurse. I feel this course gave me all the skills required to do my job competently at the time but obviously we all need to refresh and keep up to date with skills and knowledge. I did go on to complete a degree in Community Health Nursing for LD later in my career but to be honest with you it didnt make me a better practitioner.neither did my masters. Nurses trained at diploma level can be competent and to suggest that they are not as good as nurses with a degree is laughable. Most of my training and skills I have learnt while on the job, with courses, research and some extremely good mentors, who were also trained to diploma level. I agree that Mr. Lansley needs to be clear about the roles of a nurse and a nursing assistant and I agree that as nurses we have to take the lead in this debate, after all, we are the one's at the front line, the one's complaining that we are not listend too or taken seriously as professionals most of the time.

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  • Yet again we are having this argument about degree level nursing. I trained in 1977, and this argument was happening then. Whether nursing goes to degree level or not, the one outstanding fact appears to be that those who are advocating sincerely beleive they feel this is the way nursing should go.
    Nurses should develop themselves, and their A.P.R. should document this. The tools are there to develop the evidence based practice aspect, and the job competancy should reflect this without a degree being necessary
    To suggest, as some respondants have, that those who will not study for a degree are not serving the cause of nursing is cruel and vicious. I would not like to work beside someone with the attitude that because I would not study to degree level I am less of a nurse than they.

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  • For the comments by Anonymous | 4-Feb-2010 12:51 pm and 4-Feb-2010 1:47 pm, I don't believe anyone is saying Diploma Nurses are in any way substandard to graduate Nurses. This is missing the point.

    The point is we now need to focus on the future of Nursing, investing in not only the education to a standard high level, but in the reputation and standing of the profession in recognition of the vast advances we have made 'since the seventies' etc

    If we follow Mr Lansley's archaic ideas we will not only be dragged backwards, but be stuck there for many more years to come.

    I have written to Mr Lansley with a summary of some of the counter arguments to his proposals and it will be interesting to see what the response will be.

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  • i totally disagree with the whole idea, pay us more and maybe we might make patients our priority!!!!!!!!!!!!!!!!!!!!!!!!!!

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