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EDITOR’S COMMENT

'Nurses must never be talked out of their role'

  • 10 Comments

Last week the media reported the apparently novel news “discovered” by the Cavendish review that most hands-on nursing care is provided by unregulated healthcare assistants (page 2).

The review into the role of healthcare support workers, carried out by The Sunday Times journalist Camilla Cavendish, was prevented from looking at regulation of these staff by its terms of reference. HCA regulation was recommended by Robert Francis QC and is widely seen as a move that could have the greatest impact on standards of care. However, it was rejected by the government.

The Cavendish review is making noises about standardising training. It contends that, if HCAs get a thorough grounding in the “fundamentals” of the job, the public’s receipt of consistently compassionate, high-quality care will dramatically improve.

No surprises there. As nurses have taken on more of doctors’ responsibilities, the work traditionally done by nurses has drifted into the job description of HCAs. So let’s hope the proposed “nursing assistant” title does not confuse people further.

We do not want the Cavendish review to make it easier for the government to replace more nurses with cheaper, unregulated nursing assistants

However, the nursing profession must be careful not to relinquish too much of its role to others. Nursing is not just a set of tasks to be completed, and nurses can contribute enormously to patient outcomes and safety by maintaining their involvement throughout the patient pathway.

What we do not want this review to do is make it easier for the government to replace more nurses with cheaper, unregulated workers. This would undermine the profession’s standing.

While it is right that trusts are assured of HCAs’ competence, they must respect nurses’ three years of training (four in Scotland) and continuous professional development. That cannot be easily substituted.

Nurses have knowledge, skills and expertise, much of which they can share with HCAs to improve care. But much of their work can only be done by a qualified, regulated nurse.

I know of HCAs with huge talents in providing compassionate care and superb clinical skills. But let’s not allow anyone to suggest that a few days’ training will make it safe for HCAs to take on the more difficult aspects of nursing.

The public will always need nurses, and nurses should never allow themselves to be talked out of their role or substituted.

Strengthening the nursing workforce with training is to be applauded. But replacing nurses is most definitely not.

Jenni Middleton, editor

jenni.middleton@emap.com. Follow me on Twitter @nursingtimesed

  • 10 Comments

Readers' comments (10)

  • I agree with this article, but there needs to be clear indication on every ward in hospitals who is the nurse and her role within patient pathway and who is the H.C.A. and their role. Because at this time the roles are blurred and as such can be very confusing for both patient and families, if they need to seek out professional help and support. This needs to be addressed now.

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  • "The review into the role of healthcare support workers, carried out by The Sunday Times journalist Camilla Cavendish, was prevented from looking at regulation of these staff by its terms of reference. HCA regulation was recommended by Robert Francis QC and is widely seen as a move that could have the greatest impact on standards of care."

    however, camilla cavendish has expressed an opinion about hca registration,

    "http://www.bbc.co.uk/programmes/p01cjsqn

    "my view on that is that we saw terrible things happen at mid-staffs where nurses were registered, and i don't think that registration on it's own actually solves this problem, i think what we need is proper leadership and management, which is in every care home and every hospital, where employers are held responsible for the quality of those staff and they're held responsible for meeting certain basic standards of competence and caring and i think that's more important than actually just registering on it's own."

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  • michael stone

    Lots of sense in this bit by Jenni, and also a term I had not spotted before: 'the patient pathway'.

    I can only hope, that this term is useful, has a sensible purpose, and isn't just a term being used to allow allow authors to waste words (like 'shared decision making' and 'stakeholder').

    Giving a fancy name, to something you don't understand, does not allow you to understand it any better: uttering a fancy name, can give a false impression that the speaker knows what he/she is on about, even if that isn't true.

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  • The future....a cheaper more economical nurse......wink...wink.....

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  • It looks as if the role of the nurse and nursing in the future could look very different if the NHS progressses the way the government seem to intend at present, and to what cost in terms of financing and particularly safety and quality of care.

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  • tinkerbell

    the future doesn't look particularly bright, healthcare provided by the lowest bidder with staff on the lowest wages with the least amount of trained staff if any.

    What could possibly go wrong?

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  • Senior Nurses are as guilty as anyone in devolving nursing clinical skills to HCAs with just a few days training. This is done by the senior nurses to save money and to prove their "worth" to their non-clinical managers in an attempt to save their jobs or as brownie points to move up the promotion pole.
    E.G I have argued that urinary catheterisation is more than a task but have been shot down in flames as "obstructing progress".

    They convince themselves that patient safety is not compromised but by the time it all goes wrong they have either left or taken redundancy with a good pay off.

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  • "obstructing progress"

    what an utter disgrace when it is playing about with other peoples' lives. such cases should go straight to the NMC.

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  • It would be nice if nurses could be 'talked INTO' their role.
    That is, whilst they are on duty, the patient should be at the centre of what they do. All actions should arise from that tenet.
    The fact that nurses have not taken to the streets in their thousands to protest against the abusive policies which daily put their patients at risk is a sad reflection on our profession.

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  • tinkerbell

    Anonymous | 22-Jul-2013 2:12 pm

    it's good to know that some of us are as perplexed as each other that there are others who just don't seem to get it, the 'IT' being that 'peoples lives are at stake here'.

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