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'For mental health student nurses - a year as an HCA doesn't make sense'


Student nurse, Natalie Moore, argues against the case of asking potential student nurses to work a year an HCA before starting a degree course

It’s not the suggestion that student nurses should have a year’s experience of being a healthcare assistant that I am opposed to, it’s the reasons behind why it’s been suggested in the first place.

Coverage of this seems to have focused on general nursing and I think the matter is more complicated for those of us working in mental health.

The recommendation of having a year’s experience as a HCA stems from wanting student nurses to be able to provide basic care to their patients.

I think everybody would agree that this can only be a benefit to the profession. But having worked as a mental health support worker for several years and now as a student mental health nurse I’ve noticed that while there are similarities between the roles, there are also big differences.

Working in mental health, our “basic care” is often providing our patients with an outlet to talk about how they’re feeling and to being able to respond with sensitivity.

My favourite part of being on placement is spending time with patients and I am making the most of being able to do this while I’m studying.

Contrary to popular belief, this is not the only role of a nurse and there are countless other things that mental health nurses have to do to make sure they provide their patients with the best care. Without being able to manage risk effectively, secure funding, or write a thorough care plan our basic care would make no difference to our patients at all.

These important nursing duties have been completely overlooked by the people making these suggestions who don’t seem to fully understand what contemporary nursing entails.

There were 290 recommendations in the Francis Report but this is the one that seems to have created the most furore. One of the outcomes of the report says, and I quote, “failure was in part the consequence of allowing focus on reaching national access targets, achieving financial balance and seeking foundation trust status to be at the cost of delivering acceptable standards of care.”

As far as I’m aware this is most certainly not a nursing duty. So why is it that nurses are bearing the brunt of the Mid Staffs Enquiry? Management failures have been well documented in the reportage of the enquiry yet there is no mention of them having a year’s experience of delivering frontline care.

And what about the doctors, physios and OTs providing care, will they have to have a year’s experience of being a HCA first as well? Yet again, no mention of that.

The word “compassion” is thrown around a lot in discussions like these and this is another justification for having a year’s experience as a HCA. Working as a support worker is what inspired me to take the steps to becoming a qualified nurse. Unfortunately, I witnessed a lot of appalling care and a lot of people who quite frankly didn’t care about their patients. I couldn’t bear the thought that there are vulnerable people being “cared for” in this way. I don’t think being compassionate is a quality that can be taught and if someone isn’t compassionate I don’t think any amount of experience will change that.


Readers' comments (4)

  • I agree with a great deal of this. I am a general nurse of > 16 years experience who began nurse training at the age of 38 with no prior experience of carrying out personal care.

    The benefits, if any, of forcing students to complete a whole year as an over-worked, underpaid skivvy as a precursor to a 3/4 year degree are nebulous at best and a complete waste of everyone's time at worst.

    If the 1st year of University training can't identify who is and isn't suitable to nurse then someone needs to identify smartly and remedy whatever's deficient in the training. One more year as a precursor to a deficient degree is not going to improve anything for anyone.

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  • Phillipe Cook | 7-Apr-2013 2:17 pm

    I think some HCAs will find your comments derogatory, and the care they give as a 'skivvy', is the basic care we are battling to improve. It sends out the wrong message that basic care is beneath anyone undertaking a nursing degree. I actually prefer the term 'essential' care. Also, it is hoped that people suitable to nurse should be identified before giving them a place. Once the course has started, and anyone has been identified as not being suitable, that place is wasted, whereby someone with caring (etc.) qualities, could have taken up that place. It is a huge waste of money. I don't think working as an HCA is the answer, and I can't see how it can be implemented, logistically or financially. Therefore, there needs to be a change in nurse training to ensure these essential skills (yes - skills) are taught, learned and implemeted. The 'old' concept of having clinical tutors working with students on the wards/depts ensured these skills were addressed. I am not saying that is the answer, but many things are being re-invented under a different name. For example, all the 'tick box' exercises that are coming into being, it is not much short of working in a 'task orientated' environment. However it happens, it needs to, and earn back our professional and credible standing.

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  • isn't good nursing all about the ability to identify, anticipate, adapt and respond to the physical and clinical needs of their patients with skill and empathy whatever these are and to assist them, help them find solutions for their problems and any physical or psychological difficulties or dysfunctions related to their illness or disabilities and carry out for them whatever they are unable to do for themselves? Any nurse surely requires training so that they are able to respond at any level of care from the basics up to the advanced procedures associated with their chosen specialisation. how this training is and should be best achieved to accommodate the needs of the patients, the students and the employing organisation requires careful studied consideration.

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  • Sarah Woodcock | 19-May-2013 11:19 pm

    Perhaps you missed the first paragraph. I am a HCA. I do personal care on every shift I have worked. If I didn't like doing it or think it was important, I wouldn't be a HCA & I wouldn't be going in to nursing.

    Anonymous | 19-May-2013 11:14 pm

    I haven't worked on an elderly ward yet, but I plan on visiting one as part of this placement in a CMHT OP. If I am asked to do personal care, I will do it because that's the job.

    A lot of inference going on in these comments.

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