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Chief exec raises fresh concerns over nurse numeracy skills


Qualified nurses are being turned away from jobs in the NHS because of poor numeracy skills it has been claimed.

Hospital providers have claimed some nurses are not able to pass numeracy and literacy tests as part of the recruitment process, which includes testing their ability to correctly calculate drug doses.

“There is a problem with nurse training when so many qualified nurses are unable to do basic drug calculations”

Claire Murdoch

Health Education England has now appealed for evidence of the “anecdotal” problem amid greater focus on the education and training of qualified nurses following the Francis Report into care failings at Mid Staffordshire Foundation Trust.

Central and North West London Foundation Trust tests nursing applicants for numeracy and literacy, and regularly sees failure rates of 50-80%.

Trust chief executive Claire Murdoch, herself a registered nurse, said: “You have to say there is a problem with nurse training when so many qualified nurses are unable to do basic drug calculations.

Claire Murdoch

Claire Murdoch

“We as providers share responsibility for this along with the universities. HEE needs to be tougher in their expectations of universities in who they are recruiting and how they are training them, as does the Nursing and Midwifery Council.”

Professor Kath Fenton, chief nurse at University College London Hospitals Foundation Trust, has also previously criticised variation in nursing applicants with around a third of applicants rejected before interview.

Sam Jones, chief executive of West Hertfordshire Hospitals Trust and a former nurse, called for more structured education and support for qualified nurses similar to the foundation programme for junior doctors.

“It isn’t good for patient care or for those individual nurses”

Peter Carter

Royal College of Nursing chief executive Peter Carter said the recently announced Shape of Caring review into nursing education, which is being led by Lord Willis, should examine the issue.

He added: “It is obviously a worry and what we need is not to get defensive, not to start arguing, but instead sit down and talk about it, because it isn’t good for patient care or for those individual nurses.”

Professor Ieuan Ellis, chair of the UK Council of Deans of Health, said: “Student nurses graduating from UK higher education institutes have excellent employment prospects.”

He said between 81-100% went on to graduate level jobs. “If there was evidence of a widespread problem we’d be happy to follow it up but this view is simply not backed up by the data,” he said.

Professor Ellis added: “Prospective students are tested for numeracy and literacy as a first step before they get to interview and throughout their course. If there are issues with graduates from particular universities then there are local mechanisms in place to ensure this is addressed and educators, service providers and commissioners should work together to do this.”

Professor Ieuan Ellis

Ieuan Ellis

A spokeswoman for HEE said: “There have been anecdotal claims for some time that nurses are qualifying but not being offered jobs.

“This is an historical position that Health Education England has inherited and we would be very keen to hear about specific circumstances so that we can ensure future training provides the right people with the right skills, values and behaviours.”

The first cohort of nurses to qualify following changes to education standards by the NMC in 2010 will join the workforce later this year.


Readers' comments (7)

  • michael stone

    There does seem to be a particular problem, with 'maths': it seems that 'bad early experiences' make some people 'panic at the mere sight of numbers' from then onwards.

    This means that some people see 'doing maths' as a formulaic process, not as a 'thinking it out' process - they end up trying to fit numbers into equations, without 'understanding the equation'.

    This is a common, as I understand it, issue - but unless people 'understand the formula' they shouldn't really be doing drug calculations (unless you understand the formula, you won't spot [obviously] wrong answers).

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  • How does one qualify without being able to undertake simple calculation(s)?

    Some BIG questions need to be asked of the "universities"

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  • How is it that tertiary graduates can not complete basic calculations (and let's face it- drug calculations are not applied calculus)? As a profession, we need to take a stand against this. Sadly this might mean that some graduates are not employable as registered nurses. The public must be protected from those without the requisite skills to perform competently and safely. A nurse unable to perform calculations correctly and independently is surely limited in their capacity to to problem-solve in other areas of their work independently and safely.

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  • Is it the tests that they are taking that is the ptoblem are they being given scenario/simulation? or is it written calcs tests in an exam condition|???

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  • Having studied mathematics to degree level and taught this subject, I found that
    the majority of the nurses I've worked with do not have Mathematics grade (A-C) at GCSE level. These nurses are then taught by numeracy skills tutors who I often found not good at maths themselves.
    I feel that it is important for nurses to at least have a grade C in GCSE Mathematics.
    Drug calculations is a big part of safe drug administration. Also a foundation in maths helps the nurse to problem solve in a more analytical way.

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  • I was saddened to read this article. I trained as a nurse 30 years ago, when student nurses worked on the wards. I recall being set some drugs calculations by a staff nurse who argued with my answers but was herself incorrect. She was not the only one - it was a constant problem. And it appears that little has changed.

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  • My maths is not great, but I ain't killed anyone! During my nurse training in the 70's, I bought a drug calculation book and learnt the formulas - simple. You don't need a degree to work this out. However, I feel drug calculations should be taught as part of nurse training. And... whats wrong with a calculator? Kids are allowed to use them in their maths exams! We should also go back to 2 nurse drug rounds - checking correct drug/dose is given.

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