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'Let’s not reinvigorate the “too clever to care” debate'


The noise about students in the Francis report threatens to distract people from some of the most important issues outlined in those 290 recommendations.

Of course, the plans to see prospective students spend three months in a hands-on care role pre-training is to be applauded, as are plans to improve selection of the right kinds of candidates to become student nurses.

But let’s not pretend that every bit of poor care that happens is by nurses who are “too academic”

But let’s not pretend that every bit of poor care that happens is by nurses who are “too academic”. Let’s not reinvigorate the “too clever to care” debate.

In the past few days, I’ve heard several news reports decry the “cleverness” of nurses.

People have said that they “just want to be mini-doctors” and that this move to “graduates” had made nurses less focused on the practical. There was talk on BBC’s The One Show last night of a student nurse who had never been on a ward.

I wonder what year that nurse was in or if the course they were on did a higher ratio of academic study first before putting students on clinical placement. Some do front load their students with more knowledge to try and ensure they are safe to care and can understand more by the time they hit the wards.

The truth is that 50% of student nurses’ time is still spent on practice, they do spend lots of time on placement, and this is a vital part of the training.

Our Student Nursing Times Awards celebrate brilliant students

Our Student Nursing Times Awards celebrate brilliant students, and the placement providers, mentors and educational establishments teaching them. And judging these has proved to me that excellence does exist in student selection, education and practical training.

That’s not to say it’s consistently perfect and that it couldn’t be improved. Or that these new recommendations won’t enhance training.

But we must not let Francis be about keeping nurses “in their place”. We must not let it add more fuel to the debate that nurses have no right to “know” or “understand” but just to do. They are not and should never be considered doctors’ handmaidens. They are patient advocates, and healthcare professionals who must put patients first.

Patients will be safer if they are looked after by competent, highly skilled, highly trained nurses. Nurses who can spot what is happening to a patient when they do their observations. Nurses who see, who understand and can interpret.

Knowledge is not a bad thing. It is a positive force, let’s not pretend otherwise.


Readers' comments (6)

  • Education and compassion are complementary not mutually exclusive and both are essential to be an effective nurse. Without knowledge and understanding all the compassion in the world will not produce high quality care. No one seems to question the need for doctors to have an education, why should this be any different for nurses who spend more time with their patients and must be able to understand their condition and care, make sense of the observations they are making, take critical decisions, explain things to their patients and families. I have worked in intensive care for very many years and without appropriate education I would be unsafe, I need the critical thinking skills and knowledge that my degree level education has given me and the life-long learning philosophy it has instilled in me. Education does not take away my compassion but supports it and strengthens it. The total package makes me a better nurse. I went into nursing because I wanted to care for people and I still do.

    Unfortunately as a body we are not adept at using our education to show why it is essential we keep our bedside, direct care role. Instead we are increasingly being dragged away to paperwork, administration and a 1001 indirect care tasks many of which could and should be undertaken by non-nurses. This has happened a little less in intensive care but even there the rot is insidious. Direct care is where the education and compassion of nurses is best employed because that is where the real skill is needed - at the human and therefore vulnerable and unpredictable front end of the NHS.

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  • I agree with Bridget, nurses today must be well educated and highly skilled to function at the level required in the ever changing world of health care. However compassion cannot be taught, you either care deeply about people and how they feel, or you don't.

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  • Bridget Harris | 9-Feb-2013 9:28 am

    Carol Ellison | 9-Feb-2013 8:47 pm

    I agree with both your excellent comments.

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  • Years ago care and compassion was at the heart of the motivation for being a nurse . How do we as professionals selecting new applicants to nurse training in our universities measure these qualities in the present day ??????

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  • My theory may be incorrect, I but I wonder whether acquisition and development of the values and qualities needed to care for other human beings and for any of the caring professions do not go right back to early upbringing onwards, social environment and education and are also modelled on the behaviour of parents and possibly even siblings and the wider circle to which children are exposed.

    If these qualities are not present in young adults I am not convinced they can be taught in a school of nursing. if they are already existent they can surely be further developed and continue to develop with experience life long influenced by all the situations we face throughout our careers and personal life.

    Maybe we need to examine candidates more carefully prior to entry for any training courses for entry into the health care professions.

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  • There is nothing wrong with degree education, but this shouldn't be the only focus in moving nurse training forward. Patients remember nurses with care and compassion, degree or no degree. I agree with Carol Ellison, "However compassion cannot be taught, you either care deeply about people and how they feel, or you don't." If education and compassion are nurse requirements, then both should be considered in selecting students suitable for training. Some people don't perform so well at school, but that doesn't mean they don't have it in them to blossom educationally at a later date. I left school with one O level, and ended up with a Masters degree, but feel I have always possessed compasion and the will to keep myself up to date. I hope I never hear a student saying what I heard recently, that they would never accept a mentor who didn't have a degree. We learn from everyone in the team and most of all from the patients, some of whom will have left school at 15 with no qualifications. If their wisdom and knowledge is dismissed then heaven help us.
    "We must not let it add more fuel to the debate that nurses have no right to “know” or “understand” but just to do." Just because you don't have a degree doesn't mean that you don't know and understand what you are doing.
    "They are not and should never be considered doctors’ handmaidens." I thought this vision of nursing was buried years ago.
    Using these 2 comments is detrimental to our profession and fuelling outdated debates. Stop bringing them up, this is why we are "put in our place."

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