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MARK RADCLIFFE

'Students must be supported, not put off before they even start'

  • 11 Comments

Sometimes you can ask the right question and get the wrong answer.

Sometimes you can ask the right question and get the wrong answer. “What sort of care plan would you suggest for this patient?” is a reasonable question for example, and “Plans are for people who build large buildings. I take a freer, make-it-all-up-as-I-go-along approach, then see if they get better,” is the wrong answer.

Other times you can ask the wrong question and get the right answer. Wrong question: “Why are we even bothering with that grumpy woman in bed four?

No matter what we do she is still miserable and annoying”; right answer: “Here is an application form to be an estate agent and there is the door if grumpy, ill people don’t appeal.”

And in these increasingly confused times, when we appear to believe that those with disabilities and those who are poor are the enemy of the common man, and that repairing the economy is more important than repairing the society it is meant to serve, we may occasionally bump into something that manages to combine the wrong question and the wrong answer.

In asking the wrong question (“What can we do to make a student nurse’s life more difficult?”) and coming up with the wrong answer (“Let’s make them work in unsupported environments on low wages for a year just to earn the right to get on a course”), we have a festival of wrongness that will help nobody except the accountants - which appears to be the real motivator for current health policy.

The suggestion that students’ pre-course experiences are responsible for the difficulties at Mid Staffs is both distracting and insidious. There is no evidence that emerged from the Francis report to suggest students were anything other than the most caring of those in attendance. More importantly, if we want to ask questions about education - and, under the circumstances, we should surely ask questions about everything - isn’t it post-registration education we need to look at? We need to be investing in supportive, focused CPD for qualified staff. Training that keeps them fresh and engaged and makes them feel both invested in and valuable. Those budgets are being slashed and that training has never been so unavailable - yet that need has never been so pressing.

And then of course there is the elephant in the room. What if the culture of care in which new pre-student nurses finds themselves is a poor one? What if the HCAs with whom they work are tired, uncaring, rubbish, burdened, cruel, unsupported? What if the students we receive now, who usually have some experience in caring and a great desire to nurse well, are poorly shaped by their year of cheap labour? What if the habits they form are the wrong ones and we (lecturers, nurses and mentors alike) have to spend three years trying to undo them?

Is it feasible that the ability to feel compassion - and, perhaps more importantly, the ability to express it in a meaningful and helpful way - is going to be enhanced by employing a prospective student nurse as an unsupported care assistant and hoping for the best?

I started nursing in 1986 and in all the time I have been in or around it I have felt one thing has remained constant: we eat our young. We blame them when things go wrong, we punish them when we can’t do what we need to, and we make them live with the illusion that no matter how hard they work they will never be as good as us. This is just another example of that. Anyone would think we were trying to put them off. That can’t be the case, can it?

Mark Radcliffe is senior lecturer, and author of Gabriel’s Angel

  • 11 Comments

Readers' comments (11)

  • michael stone

    I have definitely come to appreciate that it is usually crucial to work out what the 'right question' is, and then to actually check whether the person answering it is indeed answering your question, as opposed to a variant.

    'The suggestion that students’ pre-course experiences are responsible for the difficulties at Mid Staffs is both distracting and insidious.'

    Did Francis suggest that ?

    'What if the culture of care in which new pre-student nurses finds themselves is a poor one? What if the HCAs with whom they work are tired, uncaring, rubbish, burdened, cruel, unsupported?'

    The question makes sense, but Julie Bailey has repeatedly said that in her experience the HCAs and more junior nurses, seemed (on average) 'more caring than their senior nursing colleagues'.

    Isn't 'what happens to any nurse who finds him/herself immersed in an awful culture ?' a more interesting question ?

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  • I totally agree with the title but it begs the question in the current climate, why start at all?

    as for the questions, there nothing worse for anybody who approaches their subject or their job with an enthusiasm to learn who are fobbed off by their so-called 'professional' superiors or even their peers with a shoddy and sometimes rude or put down answer or one made up on the spur of the moment without any evidence of its correctness because the other does not wish to admit they do not know. it is only demonstrative of arrogance and of a closed mind where they probably won't learn anything new either. In a society in which we all live we all learn from each other all of the time no matter who we are or our perceived status or self image.

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  • michael stone

    Anonymous | 21-Apr-2013 1:10 pm

    I see you have answered my:

    Isn't 'what happens to any nurse who finds him/herself immersed in an awful culture ?' a more interesting question ?

    I can't answer your 'why start at all question' - because many applicants do not understand the reality ? Huge dedictation to doing good ? It isn't one I can answer, not having ever trained as a nurse.

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  • DH Agent - as if ! | 22-Apr-2013 10:05 am

    from Anonymous | 21-Apr-2013 1:10 pm



    "Isn't 'what happens to any nurse who finds him/herself immersed in an awful culture ?' a more interesting question ?"


    a more interesting question than what?



    'why start at all question'

    a harsh question, but one worth considering as from all one reads in the press and the comments it does present the question why people still want to go into nursing in its present state when there must be other easier and more attractive alternatives.

    I never regretted my choice but was fortunate to have gone through far more good times than bad. However, in latter years when it was too late to retrain I sometimes wished I had become a clinical psychologist instead with better working hours, probably a good salary, good people contact and more organised and slightly less unpredictable work. I know many with a nine to five job and no weekends. Also there are other branches of psychology in almost every walk of life now so possibly easier to get or change jobs - I am not sure what the competition is like.

    I am not sure why there are not more psychologists working in politics and in government as I am sure they would be good at resolving many of the conflicts there and invaluable in inter-party politics!

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  • michael stone

    Isn't 'what happens to any nurse who finds him/herself immersed in an awful culture ?' a more interesting question ?

    better than Mark's

    ''What if the culture of care in which new pre-student nurses finds themselves is a poor one? What if the HCAs with whom they work are tired, uncaring, rubbish, burdened, cruel, unsupported?''

    which was probaly the same question, but stated differently.

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  • DHAgent

    far too complex for my little brain?
    which side did you get out of bed this morning?

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  • michael stone

    Anonymous | 23-Apr-2013 5:33 pm

    Probably the wrong side, as usual.

    What is pretty clear, is that Mark is a member of 'The Disgruntled Club' as am I !

    I'm probably much too keen on 'defining the question', even when I need not, having had a lot of experience of my asking a very precise question, and receiving an answer to an entirely different question.

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  • Pre University experience seems a good idea and should be adopted by more professions !

    Architects should spend a year digging foundations as a labourer

    Vets - maybe a year mucking out pigs

    Prospective Doctors should spend a year as assistants to undertakers to ensure they know what happens when it all goes wrong !

    Managers? I am sure you can think of a suitable pre Uni punishment for them !

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  • Anonymous | 6-May-2013 7:50 am

    good one, especially the doctors!
    :-)

    am still wracking my brains for the managers.

    Reminds me of the 'Heaven is where the police are British.......... Hell is where the cooks are British........'
    (found by Googling the first phrase for those unfamiliar with it).

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  • Anonymous | 6-May-2013 7:50 am

    from Anonymous | 6-May-2013 8:41 am

    Managers

    how about prison warden assistant to gain experience in psychopath spotting

    "Where have all the normals gone"

    http://www.huffingtonpost.com/allen-frances/jon-ronson-ted-talk_b_2978686.html


    video no. 1 refers!

    (Jon Ronson, author of the book 'The Psychopath Test'




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