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Are student nurses too posh to wash?

  • 63 Comments

The debate over what student nurses should and should not do on clinical placements has given Beyond the Bedpan plenty to think about

Student nurses of yesteryear were made of sterner stuff. The would rise at 3am and walk 18 miles to their clinical placements, over hot coals and under heavy fire from the Germans.

Once there they would roll up their sleeves and make tea for everyone, before getting down on their nobbled knees to scrub blood and excrement from the floors with their own toothbrushes.

All this would be done with a smile and a cheerful, giving nature that channelled the spirit of Florence Nightingale.

Nowadays, they get up at 11am from a drunken stupor and, on the rare occasions that they can be bothered to go to work, demand a lift from their long-suffering parents and show up in hotpants and leather boots.

Change a bedpan? Make tea? Pull the other one, they scoff, before happy-slapping the nearest HCA and taking over the responsibilities of the senior nurse consultant.

That’s one way of looking at the debate currently threatening to crash nursingtimes.net, and possibly the whole internet, with its sheer volume of traffic.

Another way of looking at it is that these poor, long-suffering lambs of the nursing profession are treated as cut-price HCAs by their unscrupulous superiors, who ignore their learning requirements in favour of banishing them to the cleaning cupboards.

So who is really getting the short end of the stick here? The truth, boringly, lies somewhere in between.

Student nurse placements are supernumerary roles, meaning that they are explicitly there to learn, and not to be traditional members of the hospital workforce.

They arrive on placements with clear instructions from their universities about precisely what they should be learning. If they are not being given the opportunity to meet these objectives, it is only right that they speak up.

But it can go too far. In the research that started this whole debate, one student was reported to have told a staff nurse: “I keep being asked to do things which won’t help me learn - clear up poo, mop up blood, give patients tea and toast. I realised that I needed to more focused to learn, and I don’t do those sorts of things now.”

But cleaning up poo, making tea and providing “basic care” for their patients is and always will be a fundamental part of nursing. The fear is that if these skills are neglected, students will go on to become the type of “hands off” nurses the profession dreads.

A student reader is unequivocal in her riposte: “What a load of hogwash. I’m a third year student and I have no problem with performing fundamental care on patients and I understand its importance. What I do not like as a student is being constantly used as an HCA - there are other things to learn along with fundamental care. Please stop attacking us students.”

Good point, well made.

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Do students do enough 'basic care' on placements?

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  • 63 Comments

Readers' comments (63)

  • As a nurse teacher for 20 years (and yes... I have worked clinically as well for most of that time before you ask!), I would take an extremely dim view of any student who didn't see the provision of nursing care (forget the 'basic' or 'fundamental' description - it is ALL nursing care) in any shape or form, but I get equally angry that the NHS still hasn't got over the fact that students are not there to be a source of cheap labour. I DO speak up in either case, so as you say, the truth lies somewhere in the middle. It is a 'some' (and I choose the word carefully!) students (and 'some' qualified nurses!) don't seem to know the meaning of nursing anymore. Time to go back to basics. Doe anyone actually remember Henderson's definition? It is ALL nursing care folks. Not just the high tec stuff!

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  • I fail to understand the relevancy of the photograph used for this article to the subject matter. Is it supposed to represent a typical student nurse? Perhaps there are some sweeping generalisations being made in this debate as illustrated by the picture. How disappointing for everyone!

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  • I am sorry but since the move of nurse education into the university system there has been a decline in the standard of nursing. Yes there are a lot of caring nurses around, but yes student nurses do feel that basic care is below them. I have been trained for 30 years now and still do a full assessment of my patients, I hate to think of how many nurses do not look at patients pressure areas, or check to see that they have been eating and drinking. To be honest I never saw a pressure sore during my training, today they appear to be a fact of everyday nursing

    The question I would pose is what do some nurses want to do?

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  • I am another third year student! Just finished a placement on oine of the busiest wards I have ever comer across.

    The team work was excellent on the ward and I could see this from the first few days. I made the decision that I would work as hard as any other member of the team, HCA, or nurse. After 14 hour shifts I would return home to an assignment, but still have a big satisfied grin on my face. I had spent the day making people feel better and indeed actually get better. I did more paperwork than I knew what to do with! It was great!

    That was the whole reason I came in to nursing. Its not a job, it is a way of life. :-)

    Despite all the 'menial' tasks I still managed to achieve all my competencies. I say roll your sleeves up and get stuck in.

    What I would moan at is one nurse in hand over claimed that she had to clean up a patient and bed bath him twice that day as he was doubly incontinent. In fact it was an HCS and myself that had cleaned him twice. Some students show up the nurses as they are often to qualified to wash!!!

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  • I am offended by the photo used - that looks more like a patient than a student nurse! Also I would like to point out that I am aware of the importance of basic care needed - but I really don't need to spend 3 years practicing making toast and washing patients - I will be just as competent and enthusiastic when I qualify as I am now. I want to use my placement time to learn more complex clinical skills so I am competent with all aspects of nursing. If it is quiet (which is a rarity) then I am more than happy to muck in and help the HCAs, especially as it gives me a chance to learn from them too. On a recent mother and baby placement which was only for a day, the first thing I was asked to do was to help the HCA with OBS and beds. I said that was ok but I pointed out that that was not the point of this day on the maternity ward - I was there to have a day observing a midwife and that I had already done 3 months being involved with daily tasks on a surgical ward. At that point a senior midwife walked past and jumped in to back me up and immediately posted me off to observe another midwife's morning checks. Later I sat in with the baby doctor's clinic and observed advice and support sessions with the new mums - fantastic! OBJECTIVES MET!

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  • I am dissoppointed the picture they used for this topic which is never ever presented me as a student nurse... a few object may be in this life style but it doestin give right to put this kind of picture.. yes I agree basic skill are fundamental and we all neet to meet patient basic skills and look after them holistically...some clinical area use as as a part of NHS staffing and this load couse stress and delays to meet our learning outcomes... something is not right and need to be look at it .

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  • I trained when student nurses were employed by the hospitals and as such could be expected to be a "pair of hands" Having said this, it was definitely the best way for me to learn. Having an allocation of patients every shift meant I had to learn how to plan my workload, prioritise and be flexible to meet the ever changing patient need.
    A few years ago it seemed that newly qualified nurses were ill equipped to function as such because they didn't work with patients when a student; they wanted to see every diagnostic test, operation and procedure going. They did not spend time learning how to give the "basic" care day in, day out. To become good at what you do tale repition. Washing a patient once or twice doesn't make you an expert. However, it has got much better recently so perhaps some universities are addressing the problem.

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  • It is not just if a student can wash a patient but how they do it! After 30 yrs in the profession I am still having to teach second year students how to perform basic tasks.It amazes me that they will wash a patient without removing nightwear or stripping the bed and leave the window open allowing a draught to freeze the patient. As for my nurse tutor saying hot water and plenty of it, many students dont seem to know the meaning of hot water.

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  • I am another 3rd year student nurse who feel offended by the photo and article. I am a mature student, a mother who does not go out drinking (not that it is wrong), turns up for all lectures and every day at practice. I work very hard both at the University and on the ward whatever it involves. I would never ever dream to say I am not doing basic care firstly because it is part of the job I signed up for but also it helps to build a rapport with clients. Does it mean that I am a nurse from the Mars??????

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  • Our duty is to care for our patients, holistically. Fundamental personal needs must be as eagerly embraced to the coordination of medical interventions and drug administration. As a very newly qualified nurse it has become only too apparent how student nurses must be included in all the skills associated with qualifying as on registration many duties are EXPECTED of you.
    It appears 'placements' for student nurses relies upon who your mentor is, whether they embrace the role or address it as an additional chore. For example I was showed and explained the contents of a resus trolley only once in three years training, that in retrospect is at the core of acute nursing.
    It is imperative that student nurses experience varied duties within their placements for them to be able to survive the transient period of preceptorship. Universities requesting evidence of applicants working within the role of HCA/NA/HCW would fullfill the certainty that nursing students are more than capable of fundamental care. This would leave placements open for the additional teachings of the necessary additional knowledge and workings of the nursing enviroment that can only be absorbed and learnt from willing and eager participators. For 'gold standard nurse training'. the NMC and NHS must appreciate that qualified staff need time to exercise this need.

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