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Radcliffe: ‘Perhaps nursing is still infected by its distant past’

Mark Radcliffe

I’m going to write about student nurse drop out rates and I will almost definitely get to that in a moment. First, I need to say something about the word ‘passion’ or more importantly, the fact that so many people use it when they are not referring to the fruit, ‘the suffering or death of Jesus’ or the ‘strong and barely controllable emotion’

When my daughter was writing her personal statement for university last year she asked what she should avoid saying. “The word ‘passionate’ to describe your feelings about the subject you are applying for, the university that teaches it, any of your hobbies, your cat, trees, social justice, contemporary dance, wood, the music of Einaudi or black cherry yoghurt. Don’t use it ever.”

“But dad,” she said, for she is her father’s daughter, “It is compulsory, if you aren’t passionate you’re not really interested.”

From students applying to become nurses and feeling unable to articulate why, to experienced managers desperately trying to imbue whatever policy they are selling with something pretending to be emotion, everyone is passionate now, frankly they must be exhausted.

‘Passion’ – if spoken it is accompanied with a thumping of the chest; if written it demands an exclamation mark. It is a motif for dedication, a conversation stopper. When the young person at interview is asked why they would like to study nursing and replies: “because I am passionate about helping people” it is unkind to wince. We may however say, “that’s nice, can you tell me a bit more about that drive please?” And hope for something other than, “It’s passion. I’m passionate. I have long been impassioned.”

Recent figures tell us around a third of student nurses are not completing their courses when they are due to. The figures were drawn from the years 2013-15, before the bursary was removed. Are we surprised? Of course not. Do we have a sense of why? We do, we listen to nurses when they leave. We know that nursing costs, and that the logistics and compromises required can wear people down. We know nurses and student nurses are often poor enough to need food banks. We know it is hard and that many admirable, brilliant young people find they don’t want to do it.

Perhaps nursing is still infected by its distant past. A vocation rather than a profession; a collection of attitudes and habits rather than skills and qualities. A life of sacrifice rather than a transformational endeavour?

Recent events at the RCN certainly suggest some folk are stuck in the 1950s and perhaps that is indicative of wider cultural difficulties. As a long-standing lecturer I have long worried about the extent to which nurse education presents as an obstacle course rather than an educational process.

It seems to me that the thing we demand most from young nurses is a willingness to make sacrifice. To be poor, to have less holiday, more emotional labour, more assessment and less attention.

We don’t always ask them how they will look after themselves but rather insist they show us that they are passionate, that they ‘want it badly enough to make sacrifices’. As if nursing is an endurance test. If you want to join our club let us see you bleed. It is outdated and emotionally immature. It is unkind and unhelpful. Culturally it is toxic.

Want to keep nurses young and old? Be kinder, more respectful, curious and individualise your attention. In short, show them what a good nurse looks like as you teach them how they may nurse. And that applies to when they are in practice or in class. Model thoughtfulness and it becomes more available.

Mark Radcliffe is author of Stranger than Kindness.

Follow him on twitter @markacradcliffe


Readers' comments (8)

  • So agree this article requires us to look at so many areas of how my generation views students. I was 26 when I started my training in 1976 my family had always discussed politics my father a steel worker grandad miner. I was to train to be a nurse in the most treasured achievement of post war BRITAIN. I joined NUPE not the RCN main reason it believed in minimum wage good housing education safe care at work, all areas seriously effecting health. I assumed all I worked alongside felt the same. Wrong, I was to be obedient show deference to my seniors and especially doctors. I was appalled, always gave respect where deserved but never ever went along with this behaviour. I became active , night duty as a first year student I was left alone with approx 30 patients. 1976 I reported to my union this unsafe practice, not one nurse supported me, similar with poor practice on Geriatric wards, no support from my senior nurse managers when I reported scandalous neglect in a private nursing home that I alone fought to have closed down
    Finding two patients on seperate occasions dead in their home from Hypothermia in 1980
    So I turned my anger into my first of 3 attempts to be elected to Parliament.
    The rest is history on my career, nurses are still led by seniors who remain obedient, show deference to so many and do not ever challenge the Political elite of the day. The RCN has never changed. Nursing students deserve much better of all leaders and we must openly show support and be truly passionate about really caring about all of them

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  • There arent any nurses that i know personally from the 1950s-the only people i know who want the return of matrons and nursing of that era are daily mail readers. Nurses for a long time and certainly of my generation have been expected to become expert clinicians not just doctors handmaidens.vocation is a word i havent heard in a long time -i always felt that it had negative connotations that didnt empower nurses and respect them as professionals .i disagree with the commentator that nurses are led by obedient seniors-nursing has changed a lot since she did her training.i trained 8 years later and over the course of my career it has become a totally different landscape for students and trained staff alike.i have seen a lot of excellent nurses ground down over the years and have their concerns not listened to.
    Drop out rates amongst students are a concern.i thinkssometimes that expectations are different from reality for some and that being realistic you have to tell them from the start that if you do this job there is bad with good.its been a wonderful job and a privilege but theres also been shiftwork, missing so many xmases,its messy ,emotionally draining and after 30 odd years i definitely feel it physically.even in my class the 1st placement saw a lot of people drop out and also the second-if they lasted past that then generally they stayed to the end.if they go in with a totally unrealistic view of the job its inevitable that disillusionment sets in.also and i know ill be pilloried for this the training does not prepare them for working the same as it did-there must be some way for students to gain experience that doesnt involve 8 weeks of their clinical time being spent in outpatients or x ray deptsfor example.i have third years who havent spent any time in a ward and they feel it.dont know that i would have stuck that out if id done that during my training.

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  • Nurse Training does not prepare you for being a nurse. It teaches you to obey and not ask too many questions and that complacency is dangerous. Sadly nurses are not respected and are simply used as a work force and occasionally a scape goat if they haven't had time to document properly because they were actually doing their job rather than writing about doing it. They are small cogs in a big machine and simply are used untill they are broken physically and mentally and because they are powerless to strike and unions are deep in political pockets they don't even get pay that represents the amazing job they do and responsibility they undertake. The result will be sadly patient deaths due to shortages and cutbacks however don't worry let's just find a nurse to blame for it.

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  • In complete agreement with the last two paragraphs in this article. Kindness is essential. Many of the kindest nurses I worked with during 2 years of recent adult nurse training (BSc) were HCA's and staff nurses. However, it was a rare shift indeed to be with a mentor or team mentor that actually had any time to train this mature and serious student. Unfortunately, the least accurately informed and over-worked professionals encountered on two of four placements had too much influence over the fate of others in the training process, and just plain rudeness, to crush enthusiasm. Having managed departments throughout a positive postgraduate teaching career, it is refreshing to have returned to teaching young people. It is a joy to breathe and not to have to "keep my head down" as so many student nurses, particularly mature students with transferable skills and experience, mentioned too frequently. I miss being with the people cared for by ward and community teams. I held dear and understood the privilege of nursing people. However, I have regained my self-respect whilst having considerable respect for all genuinely kind and effective health care professionals.

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  • I agree with all of the above comments. I did my hospital training in Australia starting in 1979. Later I taught as a Nurse Preceptor as the new ‘college course’ came in prior to the degree. Finally, I moved into lecturing on a Diploma course for ENs as well as developing my current career - author of medical English courses and books. I think there are a few things which affect the perception of Nursing.
    1. It is a vocation which one should be passionate (yikes) about. There is still an underlying myth of the ‘caring’ nurse who is female, because ‘women are better at that’. Nursing must be seen as a skilled profession which can and should be considered by both men and women. I would like to see more of a balance.
    2. I think student nurses must have more clinical experience integrated from the very beginning. I have always been an advocate for degree level learning in Nursing - it is essential that nurses receive the same level of education as their healthcare colleagues, however, the profession requires competence in a range of skills involved in patient contact and care. Student nurses must be supported during workplace placements to develop these skills. This is not happening, for reasons already stated.
    3. The obvious ‘elephant in the room’ is money. No one apart from self funders is going to take on a course that will lead them to a Food BAnk. No one is going to take on s profession which can’t feed their family. The projected figures of student nurses required in the next decade are staggering. It is now a crisis which almost seems like Climate Change. Have we reached the point of no return?

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  • Well, I find it absolutely ridiculous that the country is in dire need of nurses and students like myself, who are doing well on placement and in university are told that they have to take a year out of their course because they have failed one assessment at university, a presentation which they were not given the right adjustments for and told that it is an NMC policy that prevents me from carrying a fail through to the next year, but in fact the NMC says that I should have been given 12 weeks to re-do the assessment, which I had failed the week after I lost my last pregnancy.
    I find that university lecturers and universities have absolutely no compassion, and do not care about things going on in students’ personal life, they think that nursing students have to not be affected by anything.
    I am now on that “year out” and do not receive any funding whatsoever from student finance, which has meant that I have had to find employment, at a time when I am not too well mentally, but I need money to survive, as I am a mature student. I hate being patronised by staff at university, who try to tell you what you can and can’t do.
    The course is really difficult and for the prices that we pay; financially, socially, emotionally, and the sacrifice of our time, we are not given enough support, appreciation, choices or compassion from universities in general (I know I feel that way), from the NHS and from the government.

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  • Seems like nothing has changed in the last 20 years since I was last a student nurse. Still all the same problems being discussed as we had back then.

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  • Is there any wonder the nursing profession is in crisis. Instead of giving honours to senior nurses they should be held accountable for the demise of our profession and the ultimate harm it will do to the country.

    "Leading change adding value " "The 6 C's"... what a load of nonsense.

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