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University chiefs call for 'realistic' debate on nurse education model


Proposed changes to nurse education that may include a move towards more general training before specialist learning, could lead to a trade-off between these two skillsets, nursing academics have warned.

The Council of Deans of Health, which represents the heads of UK university faculties for nursing and midwifery, said that a “realistic” debate was needed on what could be achieved within the duration of an undergraduate course.

It said it was open to looking at the benefits and drawbacks of the four strands of specialisms that are currently on offer to students – adult nursing, children’s nursing, learning disability nursing and mental health nursing.

“We need to be realistic about what can be achieved in a three-year course”

Jessica Corner

However, the body noted that course leaders already had to work hard to integrate practice for students across these four fields within three years.

“If the plan is to keep initial education at its current length, we need to be realistic about what can be achieved in a three-year course and the trade-offs between generalist skills and specialism,” said Jessica Corner, chair of the Council of Deans.

Professor Corner’s comments come in response to a panel debate at the chief nursing officer for England’s summit at the end of November in Manchester. It discussed Health Education England’s current major review of nursing education, which is being led by Lord Phil Willis.

Speaking as part of the panel, Lord Willis – chair of the Shape of Caring Review – said he was looking at a new model of training that 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.

He suggested student nurses might undertake two years of general training before moving onto their preferred area of specialism in the third year, adding that there could be a wider range of these on offer.

Dame Jessica Corner

Jessica Corner

Lord Willis also hinted that the review might recommend students are offered a further year of preceptorship once they have qualified.

Professor Corner added that discussions around undergraduate education should not deflect from addressing other issues around post-registration training.

“Pre-registration education is only the start of what should be a life-long experience of learning, but one that currently often lacks structure and funding,” she said.

“The Shape of Caring Review gives us a significant opportunity to address this, which we must not miss,” she added.

The review is due to publish its recommendations in spring 2015.


Readers' comments (22)

  • Please....just go back to the way it was !!!! Our training in the seventies was amazing and we had such a broad spectrum of knowledge gained on the wards as well as in the "school of Nursing". We were far more grounded and our standards were so high !!! I think the problem now is that nurses are expected to be junior doctors and HCAs are expected to be Registered Nurses !!! Cheap labour all round really....

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  • I'm with Jennifer Stillibeer; the training i received in the early 80's was light-years away from the mess they have made of training today! We had a comprehensive rotation through emergency,medical, special medical, surgical, specialized surgical, paediatrics, surgical paediatrics/infectious adult/paediatrics, mental health, geriatrics and a final run-through in medicine and surgery in the final year. I can still remember nearly every aspect of my training and it left me prepared to work in virtually any area of acute care nursing. It is a pity I cannot say the same for the new graduates that come out of university today; elite, too special to give hands-on care, too educated to give real bedside nursing, too arrogant to take the time to interact meaningfully with patients in order to make comprehensive assessments. Time to turn the clock back and get rid of the mess they have made.

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  • Well said Phillipa !!!! There's nothing better than learning on the to speak... Too many people now on the admin side doing what I call " empire building " and protecting their jobs ... Sad because the nursing has gone out of nursing !!! When I trained..we were able to run a ward ..efficiently and confidently our third year !! I don't think you could say that about the students of today ???

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  • Absolutely agree.
    The rot set in when Project 2000 was developed and then not evaluated as the pilot that it was - it was just rolled out by an incompetent UKCC.
    The Welsh National Board in the nineties to its end in 2002, and was raising issues of concern about fundamental nursing care then, but to no avail as no one was listening as the WNB which then became Health Professions Wales for a short period was then abolished. Government and the public did not see the need to monitor the content of nurse education properly.
    The Welsh Nursing Academy in its first year in 2005 produced a good debate about generalist versus specialism but with weak leadership from the regulator this debate was not listened to either.
    Good to know that these debates and concerns are now being revisited - but sad to know that quality of care and leadership in nursing practice has suffered to this point.

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  • Who are speaking to Lord Willis and co? Not the people doing the work but those smug Council of Deans who are 1) not all nurses & 2) so distant from practice how can they be representative?
    I'm a nurse I also have mental health problems. I do not want a generic trained nurse with a bit of mental health added on. I want a mental health nurse with the whole of their training to be mental health.

    Has Willis considered 2 years of mental health with the other bits added? I think the people skills would be much better for the embedding the values really needed.

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  • Yes lets follow the American model. We all know US health care is better than the UK!!! Wake up Willis, Council of Deans and Chief Nurse (who doesn't really represent me as a mental health nurse). The NHS is the BEST healthcare in the world. Despite all the meddelling since Project 2000 was introduced we are still the best educated (not trained) nurses. Think of it from service user/patients perspective. Don't assume adult nursing is the best basis for nursing. I did my general nursing 1st then mental health. I was wrong to do that, The 1982 RMN syllabus was so beautifully client focused.

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  • I firmly believe that we as Nurses' have to change the culture of Nursing in order for it to progress and gain a formidable recognition once again.

    My experience is that of poor comradeship, blame culture is a direct result of negligence amongst ourselves; not nurturing one another as professionals should, and deflecting negative and unwanted public attention by enhancing our practice.

    Before we can set about developing the needs of future Nursing Students, we need to:

    1. Prioritise on what is Nursing, and seek to practice within those boundaries.

    2. Practice accordingly and not have to be reminded by such initiatives as the 6 C's. Besides, we do have to pay our regulator, so we must comply with such stipulations.

    3. Not taking on additional responsibilities that impacts on our time management to deliver safe and effective bedside nursing.

    4. Develop the leaders of tomorrow by going back to basics and actively teaching trainees good practical and critical bedside nursing.

    5. Establish Nursing as a profession which renders care at the beside before considering specialism.

    6. Enhancing and developing our own professional relationships, by working together collaboratively and consistently.

    7. Develop clearer strategies to improve upon communications and handover reports.

    8. Represent and present ourselves with greater knowledge and development.

    9. Raise our profile by working professionally with other disciplines and taking pride in ourselves.

    10. Promote Nursing as a Professional for which it truly represents and not glamorise it; sell it for what it really entails, as we want to attract the right people and retain them.

    11. No one likes a Gorgon of a Ward Sister, but someone needs to be firm and take charge.

    12. The ward is predominantly the nurses' domain and we must take accountability for it, therefore, give us back the powers to effectively manage it. I spend so much of my valuable time sorting out issues caused by staff that fall out my remit and some of them need to understand and develop some respect for Nursing staff. I certainly do not appreciate being given a dressing down by some of the ancillary staff in front of my patients. What does this tell them?

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  • I can only speak for my own discipline, which is Mental Health Nursing. Recently I had to teach a newly qualified nurse how to give a depot injection. I was doing an agency shift on her ward. Since Project 2000, (in 2001, actually) I worked with a nurse with a degree from Oxford Brooks who was allowed to opt out of medicines and drugs entirely on his course. Nurses need to be trained AND educated. If the schools cannot do this they should hand over to someone that can. There should be a practical test for everyone. If people don't have practical skills they should not be nursing.

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  • I think training nurses is the only discipline that undergoes frequent changes in curriculum. look at the curricula of medicine , engineering, law... Do they undergo such frequent changes? I think what we need to do is keep the basics in general training & make new specialty courses so that our profession grow like other professional courses.

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  • Come on Lord Willis, learn from us. We are all telling you that there is something very valuable in an apprentice style training. Looking around me today I see the nurses I most admire and aspire to be like received such training. Oh, and by the way, they all went on to become 'educated' too. There is another way. The Dean's view is only one view. Local schools of nursing can influence their local care services culture for many years to come if they recruit themselves. That will negate the need for Essence of Care and The 6 C's !

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