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


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


Are student nurses wrong to reject basic bedside care while on placement?

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Readers' comments (158)

  • I am currently undertaking a return to Practice course having been out of practice for 5 years and can see both sides of this argument. As a nurse we are all there to work as part of a team to provide the best possible patient care and agree that students have a responsibility to provide basic patient care. What I do object to, as happened to me recently, is being used as a pair of hands to clean lockers and change rubbish bags on bed tables while the HCA's sit chatting at the nurses station especially when there were procedures requiring to be carried out by trained staff that I could have been doing and therefore gaining in my experience and being a useful pair of hands.

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  • thought id add my 10 pence worth.
    im a first year nursing student, my feeling is that the way in which we are trained now is indicative of how the government wants the NHS run in the future. it comes as no surprise to me that student nurses apparently display this 'too posh to wash' attitude when they are faced on the wards with a barrage of paperwork from uni and then from the placement, with no real understanding on how to complete either.
    some of you with remember the old style training 6 weeks theory then 6 weeks ward, you had a chance to learn a little bit at a time, now we are filled with overviews of lots of stuff and expected to go away and research them leading to i think incomplete and disorganised learning, hence when reality hits, all that holistic care stuff falls by the way side when the student sees the qualified spend two hours on a drug round then sit at a desk doing the paperwork, never actually spending time with patients.
    in order to have good nurses, we need good mentors that have the time to teach. students are supernumerary why arent the mentors - because its too expensive thats why, so the status quo will continue until the NHS is dead or private. so dont blame the students we dont know any better, you qualified staff are our role models start acting like it.

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  • The issue here is not about whether students need to learn basic/direct nursing care or not. It is more about the dissatisfaction students face on their courses.
    Nursing courses by and large are utter nonsense in this country. Compare out education to any other country and you will find their education is based in science, the body and pharmacology - with the frankly obvious points of direct nursing care demoted to where it ought to be.
    Washing and dressing is not an aspect of nursing, it is an everyday activity that has nothing to do with us other than to judge whether someone can do it alone or not. the process ends there.

    What students want is an indepth education in science, not idealistic (and unpracticed by the previous gneneration) rhetoric regarding policies, psychology and sociology. THis has no practical value unlike for example teaching in depth about the heart or the kidneys. Previously it was assumed that we needn't know that (what we were told at my uni) but clearly students do and that is what they are asking for and being attacked for.

    As with the thoroughly ill thought out and unwanted future seperation of the branches, these policies lack the practical and joined up thinking that will provide competent nurses in the future and the profession is simply ignoring them.
    perhaps because they have spent their entire professional life 'over the barrel' or 'under the thumb'. THese younger modern assertive nurses who are graduating are no longer prepared to hide the fact that their training was utterly devoid of substantial material and this is filtering back to the universities and in this subject, two things are paramount.

    1. Nurses don't learn indepth science because the people teaching nurses in universities don't have that knowledge or qualifications themselves.

    2. Students have a near universal level of apathy for their courses. Too many students emerge qualified saying elements of the course were a 'waste of time', 'stupid', 'pointless' etc. We should listen to them, why would they lie?

    On the unit i work on patients observations are deferred in favour of slavish washing and dressing routines, regardless of the fact that cleaning people does not allow you to assess anything other than the outside of them.
    Yes you can look at pressure areas, skin quality and so on, but those aren't the mechanisms responsible for keeping that person alive, nor are they markers of sudden deterioration.
    These elements clearly can be performed by unqualified staff, but instead of forging closer links and control over their work our profession is allowing them to more further AWAY from our control giving them their own function - again rhetorical guff.

    Nurses priorities in acute care are drugs, obs, fluids, food, communication/documentation. Basic nursing care doesn't even make the top five becaues it has no real curative effect. confusing making people FEEL better with making the better is the real issue and these modern thinkers ought not be chided from those with moral rather than professional opinions.

    this is the mantra students need to know.

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  • Also just to add, those people who always say that students who want more and to learn more ought to do something else like be a doctor or a pharmacist are simply venting thier own low self-esteem on to others.
    Nurses are terribly insecure as a profession hence why we have no effective leadership and allow anybody to decided what we can and can't do.

    to these nurses who berate students for wanting to learn things in depth i say, keep your intellectual inferiority complex to yourself. just because a student doesn't want the same experience you had is no barometer of who will be a good nurse.

    i would choose a learned modernist who was terrible at the bedside over the mummy bears who had a great manner with patients but was utterly devoid of any physiological and pharmacological management. only one of those nurses has the flexibiity and intellect to do this job - and it sure as heel ain't the latter.

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  • I haven't got time to read all the comments so I'm probably repeating a lot of them, but all this needs is a common sense approach. If you have experience of basic care say so, if not embrace it as part of your learning curve. That's not to say you shouldn't EVER do it though! Strike a balance. I started as a HCA before my nurse training so cleaned lots of poo, sick, and other normal bodily function outcomes. Nurse students should know the difference from being used or taken for granted, and managers should know when to be a good role model. As a manager I have never asked any member of staff to do something I am not prepared to do myself - unpleasant or otherwise!

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  • I was upset by some of the comments on this 'too posh to wash' debate. I think students do see the learning opportunites in 'basic nursing care'. However from a developmental aspect a nursing role is much more than washing and toileting. I feel student nurses are damned if they do and damned if they dont. We all as nurses are accountable for the next generation of nurses so lets support and nurture them into the very best they can be.

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  • Marc Evans

    Students who refuse to perform essential care with the patients should not be allowed to register as a Nurse! simple as that! This is a very important element of Nurse training and something students must get used to!

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  • 33yrs in nursing," the training" (in those good old days) never left me, hands on patient care contact, to document every sign on observation the symptoms being either physical or emotional was to aid the diagnosis of the patients. It was the foundation of nurse training.

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  • The link to enable the reader to read the research on this topic directs the reader to the article on students and supernumerary status - could this be rectified in order for the full research to be read

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  • Jonathan Badder

    Well well well....
    Evidently this is a nationwide issue that all student nurses are feeling and are brave enough to voice.
    My point would be that students are not blasting personal care and care delivery but, that students are relied on too much to deal with personal care. For a student with little or no previous experience, the task of cleaning a patient's bottom can be rather scary.
    However, it is my belief (and I am only a first year) that coping with personal care is an indicative sign that a student does not feel pressured by patient interaction, particularly physical interaction. I also feel that personal care is a solid basis for developing a trusting bond with your patient, allowing them to speak freely with you and give them a little more comfort.
    The task itself can be daunting but when combined with the old 'what terrible weather' conversation, the patient and the student nurse are likely to feel a little more at ease.
    As for learning more technical aspects of nursing, this seems absurd. Although we all need to learn how to administer drugs appropriately, may i remind all students that we cannot actually give medications UNTIL we are qualified!!
    Therefore I think it seems a tad selfish of the student to say, "I won't wipe her bottom, but I'll give her the medication that makes her poo"...
    However, I do not agree that students should be working duties that are usually bestowed upon HCA's or even ancilliary staff. Take for example a deputy sister on my current placement. I was asked to clean down all the comodes in patients rooms as we were expecting an audit of the comodes that particular day.
    Whilst I agreed to the task, I did find myself thinking "What is the learning curve here?" The learning curve, Jonathan, is understanding the importance of hygeine across ANY level of medicine and healthcare and that any equipment used by C-diff positive patients must be cleaned to prevent cross-infection.

    While personal care may seem trivial, it is absolutely paramount that students understand the importance of hygeine and patient care. It is these very actions that aid the irradication of hospital-acquired infections, and especially where MRSA and C-Diff are concerned, prevent a relapse for patients who have only just had the all-clear

    In summary I do think that Staff nurses need to cut students some slack, especially during examination times and assessments. Though Students are heavily relied on, it is necessary for us to experience personal care and become involved, especially if we wish to develop a better trusting bond with our patients.

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