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Radcliffe:‘Is the latest NHS long-term plan simply out of despair?’

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I was 27 when I began nursing. I had a degree in philosophy, and lived in a low-rent social housing flat. I actually applied for mental health nursing, speech therapy and social work all at the same time. I felt it was time to do something ‘useful’ and get out of my head, which was full of nonsense and easily distracted by stories and songs

In truth, I have never felt that mental health nursing is characterised by a single approach, belief or set of attitudes. I have known nurses who exist to service psychiatry and others who can barely tolerate the industries that coalesce around acute distress and simply see their job as skilled companions. They are all on the register, they are all called nurses, they have little in terms of philosophy, politics or sense of purpose in common.

In fact, I would go so far as to say that the title mental health nurse has become so diluted, ubiquitous and generic that it does not in itself mean anything other than common regulation by the Nursing and Midwifery Council and some legal responsibilities. Given the pressure on services, that is perhaps the point: there are thousands of nurses holding responsibility for risk. I do know those branches of nursing attract all sorts of people for all sorts of reasons and, traditionally, it has attracted slightly older candidates.

Perhaps the alleged proposal in the overdue NHS long-term plan to offer mature students in mental health and learning disabilities £5,000 ‘earn and learn support premiums’ or what we might call, ‘sweeteners’ makes sense. Recruits to nursing are down (32%), recruits from more mature applicants are even more down (40%), fewer people are being drawn to mental health and learning disability nursing programmes. Why wouldn’t we encourage recruitment if we can?

Granted, it doesn’t quite cover the £28,000 fees that students have to pay now, or even the first year of the bursary that nurses don’t get anymore, but it is better than the original proposal, which amounted to 20 minutes a month on the communal foot spa and all the pickled eggs you can eat.

If you were 24 and thinking of becoming a mental health nurse would you wait a year now? If you were 23 and planning to become a learning disability nurse would you wait two years? Or would you think ‘I’d best get on, the way things are going we won’t have a health service in two years?’

More pressingly, is this proposal a halfhearted, shrugging response to the abject failure the removal of nursing bursaries has been? Or might it be an attempt to state the special value attached to those particular branches? If so, perhaps they might like to back that up by getting quotes from existing mental health nurses – the ones with the really big caseloads – talking about how valued they feel? Alternatively, might this policy simply be despair. A sort of ironic pre-NHS plan illustration that there really is absolutely no plan.

Personally, where recruitment is concerned, I think reason left the building some time ago. And it was riding a unicycle. I am never going to say that it was better in my day. It wasn’t. But it was easier, much easier. I worry that underpinning our attitude to nurse education is an unreflective masochism, not only is the course hard, the work hard, the services massively under resourced but you must also be hungry and in debt. We are unkind and our policies are abject rubbish when it comes to students. Wouldn’t it be nice if this year nurses took charge of those policies and looked after their young?

Mark Radcliffe is author of Stranger than Kindness.

Follow him on twitter @markacradcliffe

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Readers' comments (1)

  • Wow Mark talk about going for it there!

    Nursing in someway is a localised and small community and probably no more so than mental health nursing in so far as its nature has a lot of dependency on being able to communicate effectively. It would be no surprise that the potential of many to be recruited would already come from families or communities whom already have links to those working in the field or have in another way experienced it. To really get to grips with this relevant care organisations need to not only understand marketing, the incentives they put in place but also the nature of the nursing community itself. In a sense your best recruiters are often the people whom already work for you. And despite whatever great messages institutions or organisations put out there to recruit if your workforce or students know something else - this is the where the real pitch lies.

    The lack of finance is definately an issue and that is not going to go away soon. The dynamic is interesting in so much as there are now many coming through the door that are already in debt before they get into nursing, i.e access courses with already £4,000+ in debt. The government need to be looking at how they can minimise debt before student nurses or nursing associates even enter into training - a little thought about problem.

    But also the nature of your recruiters - whom are often not encased in the field itself and so will not be able to convey or understand the diverse nature of mental health or any other nursing. NHS or any other org should get to grip that recruitment should be able to truly represent the field itself. Yes you are right recruitment is not particularly great whereby you have gov management not really trained in the field of recruitment and what good interviews truly like. It starts at the very point of applying - for example how often do applicants experience a lack of flexible chose in interviews itself. The choose the interview time option on NHS jobsites followed by actually one slot is only available is not a great advertisement of flexibility or your org.

    The value based approach to interviews and recruitment is sorely lacking + doesn't really tell you about agency. And the ability to retain new and experienced nurses is certainly a problem. The loss of national training (or band 6 plus only) and who is first attitude to training is a problem in itself.

    Care orgs are slowly catching up but where the percentage of the workforce is female and has family commitments the old nun approach to working is sorely outdated and putting people off working in the care sector (overnights nurseries are not perfect but would definately help - New York has some great ideas on this). But also the term of nurse flexibility is a safe term in reference to working elsewhere and whilst it can be right if you dig a little deeper out come terms such as lack of support and staff. But also to whom does flexibility suit, is it the employer or employee?

    And to be honest I don't think in general nurses fit so neatly into boxes of following strict government approaches to psychiatry or almost anti approaches - when you delve a little deeper it can often be a messy understanding, balance and unease. Sometimes you have to look outside the bigger box of what constitutes the nurse and these can often be the changing dare I say market and politics of nursing itself.....

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