Jacqueline de Laporte
I am not normally an advocate for turning the clock back but generations of Nurses did their excellent training in the In House School of Nursing. We were proud that we trained at such a such hospital and wore our hospital badges with pride. There was never a staff shortage as student Nurses were the bulk of the workforce.
However all degree entry has been a long fought battle which some political leaders wish to abolish. I feel that degree level entry is so important but there is no loyalty and feeling of belonging to a training hospital. A hybrid of university and hospital in house training could be the answer. I agree that having a second level qualified Nurse would solve some of staff shortages and restore pride in Nursing. The emphasis must be on qualified with recognised non degree training. This could be an entry portal for top up courses to degree level and level 1 registration for those not able to access, for various reasons, a degree course. I also agree more part time flexible courses would stop the loss of committed future Nurses.
I too was a Brownie and Guide and visited hospitals to sing carols etc at Christmas. I also did so when I was in a Youth Club. I didn't need a degree either when I trained in the 60s. However, I now have several including a teaching qualification. What I did back in the 60s and 70s bears no relationship to Nursing today other than the core skills of caring and compassion. However we were supported on the wards in those days by excellent Enrolled Nurses who did a two year training. Those who showed potential went onto do a conversion course to become a Registered Nurse. Surely the very excellent Health Care Assistants who are level three can do extra training and receive a recognised qualification to become a second level nurse. Thus solving the shortage of Practical skilled nurses so sorely needed for care of the elderly.
I started my Nurse training in 1966, (I am still registered), my experiences were not dissimilar to Marjorie's as we trained at that time on the 1952 syllabus! We still had glass syringes and reusable needles and sent our own ward rolled cotton balls and and hand cut gauze swabs, packed into drums to be autoclaved. Things changed dramatically over the following three years but the paternalist care of staff still remained. Things change and progress as technology and knowledge advances, generally for the good. The turnover of patients is now frantic. The only thing I miss from my days as a hospital Nurse all of those decades ago is the care and nurturing of the staff. Regular breaks, regular hot meals cooked and served on the premises. Uniforms carefully laundered and rest areas for well deserved breaks.
If only we could combine today's caring knowledge and skills with yesterday's values of staffing levels and staff welfare we wouldn't have the problems of Mid Staffs. Carrots not sticks generally work.
Comment on: ‘Babies have fluid levels?’
As an SRN, who did 12 week placements in obstetrics and children's nursing as well as the usual medical and surgical placements I felt I had a well rounded training. I am still working as a Practice Nurse, I draw upon my many years of experience as well as my qualifications to underpin my practice. However, there is always something new to learn.
I rarely tell a Patient that I don't know anything about the particular thing they are enquiring about, instead I say "this is not in my field of expertise" . I then say I will find out and let them know or refer them to someone whose field of expertise it is. That way the patient generally leaves happily and feels their problem has been dealt with appropriately.
Have newly qualified Nurses ever been 'fit for purpose'? Surely becoming an educated Registered Nurse is the first rung on a very long ladder of life time learning and adjustments. However Junior Doctors were not fit for purpose either and relied upon the skills and kindness of Senior Nurses to help and guide them.
I am afraid I pre date 1974 by some years and also remember post op patients staying in bed for weeks. Very different skills and competencies were required then. However the basic skills and knowledge of A & P, continuously updated over the decades, have stood me in good stead. Inspirational Nurses have also guided me.
I have in the past been a Manager and I have been a Nurse Tutor but I am at my happiest now working autonomously in General Practice. All of my knowledge, skills and judgement and education are put to the test daily and I love it.
What saddens me though is that there is no one, other than my patients, to share this with. Whilst the emphasis today is moving more and more care into the community and primary care, we never see student nurses, newly qualified nurses or indeed medical students. It seems such a wasted educational opportunity.
Therefore I agree, education is not keeping pace, the future is in primary care as well as with Consultant and Specialist Nurses. We give holistic care to the whole family, not just adults. Skills and knowledge of Mental health, learning disabilities, family health and child health and care of the elderly are all as equally important as adult nursing.