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The big question: should student nurses spend one year as healthcare assistants?


Ministers are considering whether to require aspiring nurses to complete a year’s caring experience before they are accepted onto a degree course.

In his the Mid Staffordshire Foundation Trust Public Inquiry report, published last month, Robert Francis QC recommended that student nurses spend at least three months working on direct care of patients under the supervision of a registered nurse.

He said it should be a “pre-condition for continuation in nurse training” and could include work as a healthcareassistant.

However, ministers are going further than Mr Francis’ recommendations and instead favour a period of at least one year, with students taking on a role equivalent to that of a healthcare assistant.

Is the idea workable? What do you think?


Readers' comments (10)

  • I do not agree with this. I left school at 17 and I'm currently doing my training. The other students who had previous experience are in the same position as I am- it's a completely different experience which offers more responsibility than a healthcare assistant's job does. If anything, this recommendation would help to build the confidence of nursing students but isn't that what you do throughout your training anyway?

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  • Quite frankly I think Ministers have missed the point completely. The issue of "restoring" compassionate care is not fundamentally about Student Nurses but about registered nurses regaining control of their profession. We must allow nurses to nurse without distractions and in an environment where their voice is heard and valued. Then we can see if they lack compassion or if it is merely a symptom of the conditions they are at times expected to work in.
    We need to be clear about the root cause of the problem. Focusing only on symptoms will never lead to a cure.

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  • It sounds like we could use a study. Maybe we should train 16 and 17 year olds interested in nursing to be HCAs, and have them work one-year post school while taking nursing pre-requisites for Uni.

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  • Would it not make more sense to ensure that any prospective Sudent Nurses have direct caring experience before they are accepted on a course? This could be paid, unpaid, voluntary etc but goes back to the principles of ensuring the right people are selected in the first place - if someone does not have the right qualities - sending them to work as a HCA on a ward for any amount of time is not going to give them those qualities.

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  • I would welcome a brief 3-6months HCA work period pre-nurse training. This will reduce the high attrition rates and help ensure student nurses know what they're are getting themselves in to. I myself wanted to get care experience before starting nursing to make sure I could handle it but couldn't find a job.

    However you would have to ensure there were enough of these short term posts for every aspiring student. Which would mean massive increases in HCA numbers and a streamlined program for getting people into these posts. Without massive changes to the whole system this won't work as there aren't enough jobs. make too many hoops to jump through and you will lose the best candidates as they have other options.

    I agree with all the comments about changes to nurse training having little to no effect on real practice. I believe we become a product of the environment we work in. we learn to cope, and in chronically understaffed, poorly managed areas this leads to even the best nurses cutting corners or letting their professionalism slip. Happy nurses = better care. show me the NHS ward based staff nurse that is happy with their work environment.

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  • michael stone

    Marion Collict | 26-Mar-2013 12:29 pm

    Charlie Spencer | 26-Mar-2013 2:54 pm

    Both of you raised the issue of whether it is that some nurses do not 'care', or are they prevented from caring - as Marion wrote:

    'We must allow nurses to nurse without distractions and in an environment where their voice is heard and valued. Then we can see if they lack compassion or if it is merely a symptom of the conditions they are at times expected to work in.'

    I hope this fundamental issue does not get brushed aside, because it isn't really related to nurse training: it is much more related, to empowering frontline nurses to 'argue' with their managers, without the fear of 'retribution'.

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  • Here's an idea! How about a study into why ministers waste so much money in expense claims, that could be used in the NHS for improving staffing levels and thereby allowing nurses to give quality care.

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  • Some people would have looked after other family members for years, such as parents, grandparents, siblings, their own children or their friends. Will these experiences not be worthy as relevant caring experiences? I think they are even more so as family pressures could be much higher and volatile.

    The thing about a tick box culture is that boxes can be ticked, but nobody's there to get the job done as they're too busy elsewhere looking after someone else.

    If politicians fiddle expenses, break any laws, lie under oath, etc they should work their sentence off as community service until the debts are repaid in full, at the same rate as frontline trainee staff. After work hours still return to hmp or at home with tracking bracelet.

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  • Thought part of the problem was skill mix and not always adeqate support and training for healthcare assistants so how will this benefit patients or potential student nurses. Not a bad idea to have caring experience before entering the nursing profession,but can not help that front line staff, nurses and doctors are being used as scapegoats for inept politicans who refuse to acknowledge the real crux of the problem which is understaffing and poor skill mix, shame on our professional representatives who have been so weak in campaigning for minimal staffing levels and skill mix.

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  • Whilst I believe Nursing is about care and compassion and not degrees and diplomas, Im not sure the government are looking at what they are saying, they have ignored numerous recommendations made in the Francis report especially ones that may need monetary commitment ie: looking at defining a safe staff patient ratio, and have almost put the blame of Mid staffs at the feet of student nurses, what we need is good role models for students for aspire to, along with a return to hospital apprentice based training with an opition of further education in conjunction with universites. Many of HCAs today work at an "enrolled nurse level" without the recognition or the financial recompense. We need to relook at nursing as a profession and question are we looking for caring compassionate people with a desire to help and support the sick, or are we looking for a purely academically focused work force. I think our first task is to decide this , and then build on the outcome. We had a nursing profession that was the envy of the world,is this still the case? I fear not,so have we progressed? Student nurses are not to blame for a lack of care, however is there something about training held outside of our hospitals that may not embed the behaviours and attitudes so crucial for giving us the nursing workforce our patients deserve.

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