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'We must not compromise on the quality of educational opportunities'

Emma Heron
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Despite her assertion in 2010 that “there’s no doubt about it, registered nurses should have degrees”, the Rt Honourable Anne Milton MP has now expressed “regret” over the move to university-based nurse education.

When it was announced in 2009 that nursing was to become a degree-only profession, Peter Carter, then general secretary and chief executive of the Royal College of Nursing stated in The Independent that “All nurses need to put quality care at the centre of what they do, and they also need extensive knowledge, analytical skills and experience to work in a range of settings. Many nursing roles are demanding and involve increasingly advanced levels of practice and clinical knowledge. This is not about restricting entry to the nursing profession, in fact we must ensure that the door to nursing continues to be as wide as possible.”

The Guardian University Guide 2020 recently caught the attention of many nurses on Twitter in how it profiled nursing and midwifery careers. The less than alluring promise to “learn what’s needed to assist doctors” and a stock photo of someone pouring what appeared to be soup left many of us perplexed.

Dismay was expressed that prospective nurses might see the insipid description of our role and run the other way. A lost pool of potential talent perhaps? This is not the nursing we know. My profession is bold, it pushes boundaries, it is fuelled by compassion. Complex decision making is common-place and the patient is at the centre of all we do.

The Nursing and Midwifery Council (NMC) has recently welcomed 489 registered nursing associates; we do not yet know the proportion that will become registered nurses. Nursing associates must be allowed to embed their role and their developing professional identity. We should not align our expectations of it with a role that no longer exists, for example that of the enrolled nurse.

Nursing apprenticeships bring an alternative route into the profession; students using this pathway are expected to achieve the same standards as other student nurses, according to the NMC. However, using apprenticeships as a way of “filling the gaps” as Ms Milton has suggested, does not get to the heart of why these gaps exist.

In the drive to expand the workforce in this way we must not compromise on the quality of educational opportunities these students will be exposed to and their supernumerary status should be protected.

There is nothing wrong in looking to the past, but the temptation can be to stop at a point in time with which we are familiar. Echoes of history can help determine our future. But history is a frame. 

In 1949, the Nurses Bill debate took place in the House of Lords. Lord Moran referred to an “abiding anxiety” focused on the shortage of nurses. They wanted solutions to fill the gaps. During the speeches, Lord Moran referenced the quality provision of nurse education that was rising up – teaching hospitals that were progressive and showing “courage”; sending nurses out to places where they set up new standards benefitting the whole country. This was the “growing edge of nursing” of 70 years ago; he urged that this edge should not be blunted.

“We need to be comprehensive in our understanding of the reasons for the current shortage”

As we reflect on how to plan the future workforce, we should be mindful of what the modern growing edge of nursing looks like. We need to be comprehensive in our understanding of the reasons for the current shortage. It is important that in diversifying our educational opportunities, we do not compromise on the safety of our patients and the drive for excellence within our profession. 

Emma Heron is research nurse, University Hospitals Bristol NHS Foundation Trust

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