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'Clearing up poo will not help me learn' - student nurses reject basic care

  • 158 Comments

Student nurses are rejecting essential elements of bedside care because they feel it is not a worthwhile learning experience, research published by Nursing Times has found.

The research found widespread conflict between student nurses and qualified staff over the tasks students should do on placement.

Tasks normally carried out by HCAs, such as making tea, washing patients and cleaning, were not seen as valuable learning opportunities for student nurses keen to gain experience with more technical roles like administering drugs.

As a result, many senior nurses feel that students are qualifying with significant gaps in their basic skills. One interview participant said: “I sometimes feel in despair that by the time students have qualified, they still haven’t gained some of the practicalities and common sense - things like time management, basic assessment skills - that we would have been doing on our first round.”

One student was reported to have told a staff nurse: “I keep being asked to do things which won’t help me learn - clear up poo, mop up blood, give patients tea and toast. I realised that I needed to be more focused to learn, and I don’t do those sorts of things now.”

Click here to read the research in full

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  • 158 Comments

Readers' comments (158)

  • Students do see the learning opportunities in basic nursing care, we understand about learning to observe and communicate with patients, to begin to learn what is noraml and signs that something isn't right but we also see the opportunities in other nursing care.

    Newly qualified nurses are not only expected to undertake basic nursing care, we are expected to manage our own patients, complete admissions and discharges, undertake patient specific practices AND basic nursing care.

    Its a matter of balance, student nurses are expected to undertake the same roles as an experienced nurse (with the exception of enhanced practices of course), how are we supposed to feel competent in all aspects of care this involves if all we have been allowed to do is basic nursing care.

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  • As a newly qualified nurse who has recently been told by the ward sister 'don't do washes and toileting, thats the HCA's job' i really feel that student nurses need to be prepared for the fact that they will often be too busy to perform these tasks, and that in their third year especially they need to be doing the other things (drugs, IV's, and all the mountains of paperwork) instead of washing and toiletting. I hate the fact that i don't get to assess my patients through washing them and spending time with them, it means i don't know about their skin and level of mobility. However, i simply do not have the time on an extremely busy emergency assessment unit to perform these tasks and had I not had great placements in my third year as a student which allowed me to practise the more technical skills i would have had some sort of breakdown by now. I have absolutely no problem with washing patients etc and in fact wish i could do more of it, but the plain fact is that nurses don't do so much of these things anymore. Therefore its useless to use students as HCAs and not train them to do what they need to do on the ward when they qualify - drugs, time management, liasing with dr's etc. The students used as HCA's will not be up to scratch when they qualify - they need to be prepared to wash when needed but accept the fact that mostly they will be doing other things. As someone who is having a hard time getting used to the new role and finding it very stressful, i can't imagine what it would be like if i hadn't been as well prepared for it. We're not too posh to wash, we're just too busy!

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  • I am a hca ive been one for 12 years I have to say student nurses do not like to do hands on care they have got worse over the years ( not all ) when they become nurses they think they are too good to do hands on care too good to wash is right. I sometimes wonder why they have become nurses.

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  • Again I find the Nursing faternity in turmoil over Nurse education - Students must learn basic care before progressing to highly skilled and technical issues.
    What is missing here is the fact the each student is unique and has thier own learning objectives - and mentors who whilst doing thier JOB also have to accomodate these - as with all people some willingly take this on board and some dont - As a senior Nurse manager I see students who can happily change a blocked infusion pump but still dont notice the bed needs strightening to prevent skin damage - I had a Newly Q Nurse recently who could not understand Odematus and celluitus in a 90 yrs Old - who said I am mental health trained not general!
    As long as students remain outside the health care arena - they will only learn what the Universities have on the TICK box of learning outcomes.
    1st Year should provide basic care skills as a foundation to the next 2 years learning higher skills - but hey 1st years students in Intesive care and 3rd yrs in care homes?
    Not good learning in my view - what is needed is dedicated mentors through out the clinical areas for these students

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  • When I first read this article I was utterly shocked with the attitude of Student Nurses. After giving it some thought however, and recalling my days a SN, I fully understand and appreciate why they are so disheartened.

    I can clearly remember working my backside off on placements, providing basic care to patients, sweat pouring off me; getting paid a pittance whilst seeing REGISTERED staff sitting at desks chatting with colleagues, drinking tea and getting paid good money to do so. I used to feel that I was sometimes used as a HCA and was given little opportunity to learn or develop other important nursing skills. I used to feel infuriated that registered staff abused my position and the purpose of my placement.

    At the end of your Nurse training, when you receive that little bit of cheap card (that you pay a fortune for each year) from the NMC, you are then in a RESPONSIBLE and ACCOUNTABLE position. You should feel confident that your skills are good in all areas listed in your competences, not just basic care.

    Schools of Nursing need to come up with a better ways to ensure Students get the experience and skills they require to become well rounded professionals. Mentors need to lead by example to set good standards, attitudes and encourage and motivate students. If a student is to be seen to be providing basic care, then so should you be. You should also remember that the student may be working for your organisation one day and you will be EXPECTING them to know what they are doing.

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  • There is no ideal situation during one's training, as there will always be a ward that is too busy or one that provides good learning. There will always be both good and bad mentors. However, if the student feels he/she has an issue, it should be discussed with the ward manager or their practice tutor - don't just whinge about it, that will only get you labelled as having an attitude. Ihave been qualified 18 months having worked as a HCA prior to training but throughout and to this day, I still wash and clean my patients. This gives me the chance to talk to them and create a patient/carer relationship, which helps me to find out what needs they have. It is also an opportunity for patient assessment - which includes looking at any output from the patient (I assume students (as do RGNs) don't only check urine for colour/quantity/consistency etc). This is called holistic nursing care and is what RGN's are expected to carry out for their patients. I remember my student days 18 months ago very clearly and am now a mentor myself. I am always looking for opportunities for students to learn and would not ask them to do anything I wouldn't. So to those students who feel it's not fair to ask them do do basics, please don't generalise about mentors, it is not fair to them either. In addition, when I take a student, I am signing for the skills and learning objectives but also assessing wether he/she is suitable for qualifiying as a nurse. How can I sign them off if I have not observed them as willing to undertake the basics of the job? I have worked on a busy 3 ward unit and am now specialising, and all the nurses I have worked with will wash and "clean up poo" so why shouldn't students within reason.

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  • It is a shame that this subject comes up time and again and that a few students can cause such a debate. I have been nursing for over 30 years and there is always someone who will not do the basics when necessary. People come in to nursing to look after patients and if there are only 2-3 nurses on the ward and someone needs cleaning/bathing then that should be done as soon as possible using all skills verbal and practical. I will never forget the student who said to me 20 years ago after a patient vomited. I don't do vomit in front of the patient. Need I say more!!!!!
    To the nurse who is leaving the NHS after 15 years. Its a total shame that good hard working people feel that is the only way is to go but I do not blame you. The government and senior management really has to be ashamed at how things are in the NHS and if I had not only 4+ years to go before retirement I would too.
    To all who read this we are here to CARE and HELP those that are vulnerable in whatever capacity.

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  • As a newly qualified staff nurse I feel this is no longer the case. The course I undertook was altered so that in first year, student nurses could focus on all the aspects of basic care and get to grips with them.

    On the other hand and it can also be attributed to the staff on the wards as well. With so many Universities now offering Nursing courses it is hard for staff to keep up with which students know what as there is no uniform standard.

    I remember as a student having to explain on every placement what skills we could and couldn't do. However if these findings are what is happening in the world, shouldn't all Universities let the nursing students get to grips with basic nursing care and nothing else so that this is not the case?!

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  • * However if these findings are what is happening in the world, shouldn't all Universities let the nursing students get to grips with basic nursing care and nothing else in their first year so that this is not the case?!

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  • I have been fortunate enough to work with very caring student nurses and have witnessed not so kind qualified nurse behaviour at various times in my nursing career. I feel sorry for the student nurses. Being supernumary is not much fun. I was teaching 3rd year student nurses recently and discovered there are so many practical skills that they are not allowed to do until they qualify. For example, taking blood, checking drugs, things that I had done during my training over 30 years ago. Is it any wonder that newly qualified nurses take at least another year to become confident enough to run a ward let alone become a ward sister 3 years later, which is what is happening in some hospitals. The training is full of too much paperwork and not enough practical skills. When will the NMC and the universities realise this fact?

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