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STUDENT EDITOR BLOG

'Why I think a year as an HCA for student nurses might be worth considering'

  • 5 Comments

Student nurse, Mikey Whitehead, argues for the case of asking potential student nurses to work a year an HCA before starting a degree course

Nurse training is notorious for it’s large dropout rates. In fact, in the medical circle it is quite famous for it. A lot of people know that many student nurses will not see the whole three-year course through until the end.

Before I make a judgement on the recent government recommendation that student nurses should have a year’s HCA experience before they start a degree course, I’d like to know how many students drop out because they realise nursing is not what they thought it would be.

I have been nursing as an HCA for four years, and I have seen many student nurses drop out for all sorts of reasons. A common reason is because what they saw in reality didn’t match up with what they saw on Holby City or Casualty. Nursing wasn’t what they expected.

At times, I’ve felt disappointed too, but it hasn’t caused me to want to drop out. Why not? Because I loved every minute of my four years working as a HCA and that prepared me better than any university lecture.

So why hasn’t it been made mandatory for student nurses to have HCA experience before?

One argument that could be used against the proposal that all students must first have HCA experience, is that there is no evidence that this will actually improve compassionate care in the NHS.

But this is so difficult to prove. I don’t think there is any way you can ever obtain actual evidence that compassion will improve.

For me, a good nurse is one who knows what they’re going to get and has realistic expectations. And I think a year’s experience as an HCA won’t do any harm and might even help.

  • 5 Comments

Readers' comments (5)

  • I don't agree that students drop out because they do not appreciate what nursing entails. In fact, I was so upset by that suggestion when the government's response first came out that I did my own research and what I found is that there is little statistically significant research to suggests that attrition rates are directly linked to a lack of previous work experience. There is some research that would suggest that there is a link but only when other factors, such as family life, finances and academic ability are also present. Some research would even go as far as saying that it is academic ability which results in the highest attrition rates. How would working as a HCA address this? So, no....I don't believe that working as a HCA prior to starting a nursing degree is worth considering for a hundred reasons, but mostly because a person doesn't just learn care, compassion and nursing skills through working as a HCA and because not all nursing is clinical. It's not a matter of "it will not do any harm" but one of what difference will it actually make when the problem is not student nurses. I'm afraid I see this as the complete wrong answer to the wrong question.

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  • According to Buchan and Seecombe 2012, in english universities (not including London) in 2009/10 only 8% of students had dropped out by the end of their second year.
    I think if students had made the wrong career chioce they would drop out before the third year. Could it be the poor culture, the workload and the general lack of appreciation that makes students drop out?

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  • As a mature student mental health nurse in my third year of study working towards qualification as a registered nurse I have worked throughout my training as an HCA. I now feel compelled to add my view to this discussion. The roles of nurses and HCA's are fundamentally different due to the accountability attributable to the professional practice of registered nurses who have to be able to demonstrate and justify every decision made in support of the care they or HCA's, who have no professional accountability and to which care tasks are delegated, undertake under their supervision. HCA's, through their lack of comprehensive professional training are often ill prepared for the expansive roles they are expected to undertake. They do not have the theoretical and practical knowledge underpinning their practice when making nursing decisions regarding care given. This can lead to poor care resulting in poor patient outcomes. My experience of contemporary nurse training suggests it does not provide adequate development of student nurses to become leaders and supervisors of HCA's upon qualification, particularly when some HCA's have many years clinical practice experience and are unwilling to develop and evolve their own clinical practice. As students moving into professional practice registered nurses are expected to challenge such entrenched attitudes and behaviours but I believe largely lack the knowledge to do so effectively. I see little evidence of management supporting registered nurses to challenge poor care, attitudes or beliefs. Add into this the fact that often staff are not regular employees, working on temporary contracts from outside agencies. This can reduce their sense of belonging and team solidarity, creating further challenges in the supervision of care delivered. Until nurses are trained to lead and supervise effectively and management are prepared to support their trained professionals through robust and fair performance management practices and reduce their dependence upon temporary staff then I don't believe much will change.

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  • I do agree that the role of a HCA to that of a nurse can be very different, not due to what their official roles are but like someone else said, due to what only nurses are qualified to do, and what they will most likely delegate. Saying that, nurses are not all like this and some are prepared to do the "dirty work" every day. The government is creating its own vicious circle and by trying to solve a problem they are just digging deeper into the pit we are in. By saying that nurses should have HCA experience before they start their degree (which now for the same reason has ridiculously high entry requirements) they are creating a false illusion that there is a reward of a higher status at the end of it all- so instead of preparing students for the role, they are setting them up to expect higher pay, do the more glamorously perceived jobs and have the power to delegate what they would rather not do. While the NHS struggles on finance, they would rather employ HCAs which do exactly what trainee nurses used to do, because its cheaper. So instead of having a more highly trained workforce in hospitals there is now just a massive divide in nursing staff, and sadly, the patients see more of the HCAs (who don't get the thorough training they deserve) and less of the nurses which all this money is being thrown into improving. Bring back matrons and trainee nurses, or just let the actual hospital staff make the decisions on how hospital rather than some externally employed manager that stares at paper all day long.

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  • I do agree that the role of a HCA to that of a nurse can be very different, not due to what their official roles are but like someone else said, due to what only nurses are qualified to do, and what they will most likely delegate. Saying that, nurses are not all like this and some are prepared to do the "dirty work" every day. The government is creating its own vicious circle and by trying to solve a problem they are just digging deeper into the pit we are in. By saying that nurses should have HCA experience before they start their degree (which now for the same reason has ridiculously high entry requirements) they are creating a false illusion that there is a reward of a higher status at the end of it all- so instead of preparing students for the role, they are setting them up to expect higher pay, do the more glamorously perceived jobs and have the power to delegate what they would rather not do. While the NHS struggles on finance, they would rather employ HCAs which do exactly what trainee nurses used to do, because its cheaper. So instead of having a more highly trained workforce in hospitals there is now just a massive divide in nursing staff, and sadly, the patients see more of the HCAs (who don't get the thorough training they deserve) and less of the nurses which all this money is being thrown into improving. Bring back matrons and trainee nurses, or just let the actual hospital staff make the decisions on how hospital rather than some externally employed manager that stares at paper all day long.

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