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Nurse education shake-up will seek to end student specialism 'silos'

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A major shake-up of nurse education could see students spend more years learning general nursing skills than at present but be able to choose from a larger pool of areas to specialise in afterwards.

Current student nurse education that sees them specialise in one of four areas leaves them in “silos” and will fail to “adequately prepare” them for the future varied role that will be required , according to those leading a high-powered review into the education and training of nurses and healthcare assistants in England.

“Four strands do not prepare us adequately for what is going to be a very varied role for nursing in future”

Lord Willis

Speaking at the chief nursing officer’s summit in Manchester last week, members of the group leading the review said they were looking into a new model of training to address such concerns.

Proposals could see student nurses undertake two years of general training before moving onto their preferred area of specialism in the third year, said Lord Phil Willis, who is chairing the Shape of Caring Review for Health Education England.

He said he was considering whether these two years of general training needed to be much more “intense” and “practical” than the current provision.

Lord WillisLord Willis

Lord Willis also hinted that he might recommended students should in the future be able to choose from a wider range of specialisms than the four that are currently on offer – adult nursing, children’s nursing, learning disability nursing and mental health nursing.

One of the extra options could be a community strand, he suggested, adding that model he was looking at also included a further year, post-qualification, of preceptorship.

Lord Willis said: “We are going to see a significant shift into more community and domiciliary care – that’s a fact.

“Much of the evidence I have received so far, right across the country, has said the four strands do not prepare us adequately for what is going to be a very varied role for nursing in future,” he said.

He suggested newly-qualified nurses, who had specialised in children’s or adult nursing, currently “struggled” when working with patients with mental health issues.

Lisa Bayliss-PrattLisa Bayliss-Pratt

Lisa Bayliss-Pratt, director of nursing at Health Education England, said: “Certainly what we’re finding from the Shape of Caring Review – and the work we’ve been doing talking to students, trainee nurses and the public – is there is a feeling that the four branches of nurses need to be explored.

“We are putting people into silos very early on in their career,” she added.

The review is due to publish its recommendations by the end of January.

  • 20 Comments

Readers' comments (20)

  • michael stone

    'One of the extra options could be a community strand, he suggested, adding that model he was looking at also included a further year, post-qualification, of preceptorship.

    Lord Willis said: “We are going to see a significant shift into more community and domiciliary care – that’s a fact.'

    That seems sensible - which makes a change.

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  • WE need to see a full report. What does Lord Willis know about nursing and nurse training?

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  • Adding a community strand could be very helpful in preparing a larger group of nurses for work outside hospital settings as well has raising the status and value of community nursing. There has been a 23% drop in district nurse numbers over the last 10 years and there have been real issues with attracting recruits to undertake additional training, whereas as pre-reg preparation could lay an important foundation for community nurse CPD and specialist qualifications.

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  • Spot on, well said.

    As a student studying mental health nursing I feel under prepared when it comes to dealing with physical health issues, and would love to do more 'general nursing' studies so that I am not limited to a strictly mental health based career path.

    The same applies to other specialisms learning more about mental health, I don't think there is enough focus on this.

    I just wish this would come into practice sooner rather than later.

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  • Interesting to see yet again the circle of education. In the dim and distant 1960 - 1964 I undertook a combined RSCN/SRN training involving 2 years Sick Children's nursing, 1 year General nurse training with SRN awarded and 4 th year RSCN awarded. Also received introduction to other specialities. Very hard work but was commonplace with other specialisms combining such as RMN/SRN, RMN/ RNMD, RNMD/SRN, SRN/ONC, SRN/OND, SRN/BTA, SRN/RFN, RFN/RSCN.I have always thought that psychiatry and community nursing should be a common thread in any other nurse training.

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  • Why is there always so much debate on nursing education and one never sees such debate on medical education?

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  • yes I agree and also basic care wouldn't go a miss
    as you say above you have to put a lot in to get results it is not just three years it is a lifetime it never stops nursing is on going
    its not just for xmas and I find student try to run before they can walk this leads to when so called trained and have to look after a group of patents with medical physical, and with difficultys thay don't know and I have watched them cry with despair.because on paper they can do it but in practice they carnt then all the csw's
    they thought they could dictate to in the first years will not stand by them when trained it is respect from the beginning
    which should be a common thread in all training

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  • Whilst I felt that Mental Health & Learning Disabilities branches were missing the vital general nursing skill by moving to branch. I also felt that Adult nursing, throughout, lacked any training in the brain-mind phenomenon. It was the body without the brain & mind. No interest in the way a patient was spoken to and the impact that this had on their well-being.

    If a General programme is to be re-introduced, let it contain that which has been lacking in Adult branch teaching, and when students go into their respective specialism, it would be helpful to integrate the wider general learning into each. So, Child branch students should also continue to be trained in the mental health & learning disability aspects of training. Teaching around 'generic best practice' should be integrated into all training - i.e. sound travels forward not backwards, so you should face a person when you speak. So, when you find someone has a issue with hearing, you would be better placed by already having some best practice (politeness) in place.

    This is about pre-reg nursing rather than nursing education. It is always students who get it in the neck, but says nothing about what improvements will be made to in-house/post-reg training. Surely, when there are problems within healthcare, it is poor sense not to address these issues regarding present RNs? What of all those qualified nurses who lack the proposed experience? Perhaps some might like the chance to train for a 2nd branch, then to specialise in an area that links these two registrations - i.e. mental heath/community, etc.

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  • Re: Anonymous | 2-Dec-2014 6:49 pm

    Why is there always so much debate on nursing education and one never sees such debate on medical education?

    I think you'll find the medical education journals full of debate about how best to approach preparing doctors for practice. As a nurse educator, I have frequently used this literature.

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  • Full circle again, I am nurse of the old school RGN training qualified in 1987. We had a sound training in all aspects, preparing us to run a ward on qualifying. This is what is needed again and it seems they way they are headed. More time on wards not in class rooms, basic nursing care. I am a practice nurse, 55% of Practice nurses will be retiring in the nxt 5yrs. We need to have nurses who can work in the community, with good basic skills.

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