Public Service - analysis_opinion_debate

Nurses will need degrees from 2013

Thursday, November 12, 2009

Nurses who start work in the English health service from 2013 will have to be trained to degree level, health minister Ann Keen has announced, claiming that this will make them better equipped to improve the quality of patient care.

While many other professions within the NHS have for some time needed a degree to do their job, such as occupational therapists, nurses have only needed to have a diploma but the Nursing and Midwifery Council (NMC), the professional regulator for nursing, has recommended that this needs to be upgraded to a degree.

However, critics have pointed out that if nurses had training in basic care they would be able to offer a much higher quality of service to patients. Every year the NHS is inundated with complaints from people that their relatives are not receiving the most basic of care that enables them to keep their dignity and remain independent while in hospitals.

Other critics have suggested that the move may be intended to cut down on the number of nurses who come to the NHS from abroad. Upgrading the entry level could mean that many who cannot study to that level will be excluded from the profession.

Keen said: "Nurses are the largest single profession within the health service and are critical to the delivery of high quality health care. By bringing in degree level registration we can ensure new nurses have the best possible start to meet the challenges of tomorrow. Degree level education will provide new nurses with the decision-making skills they need to make high-level judgements in the transformed NHS. This is the right direction of travel if we are to fulfil our ambition to provide higher quality care for all."

The move has been welcomed by the Royal College of Nursing, whose chief executive & general secretary Dr Peter Carter said: "This is an important and historic development, which the RCN has been in support of for many years. All nurses need to put quality care at the centre of what they do, and they also need extensive knowledge, analytical skills and experience to work in a range of settings."

He added: "This is not about restricting entry to the nursing profession, in fact we must ensure that the door to nursing continues to be as wide as possible."

Gail Adams, head of nursing at the Unison, said that a commitment to care and compassion was more important than a degree. "Our concerns [are] ... that we're actually reflecting the society that we care for and ... the right emphasis is placed on the care and compassion that nurses give and that shouldn't be solely based on their level of academia."
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This development only serves to further confuse the purpose of university degrees and vocational training. Nurses look after the whole person whilst the specialists provide specific interventions. This requires levels of knowledge but skills in meeting the needs of the whole person. Universities are places where education is provided as opposed to vocational skills. If these developments continue we shall ratchet up the continuing professional development stream that will see the need for masters level degrees for relatively low levels of expertise and vocational doctorates for higher level skills. Many will feel this is a desirable move forward; I don't. I can see the day when a new degree - at a higher level than vocational doctorate being the benchmark for higher levels of professional nursing positions - and this will be out of step with other countries, drawing scare nursing resources away from there to here.
The question is why? Is it because the manpower planning for doctors has been so inaccurate that the standards of medical practitioners is being compromised and nurses will be expected to take a greater interest and involvement in medicine? or is it that the costs of running Universities are set to increase and there is a need to widen the scope of activities of universities for them to survive in their current numbers? or is the strategy to combine training for all clinical professions as a means of making the training more cost effective and as such everyone has to have a degree as the award for entering a clinical profession? This development further reduces the choices available for people in pursuing their chosen careers; it reduces the options should people wish to change their careers. The development doesn't fit comfortably with portfolio careers that, for some, will include nursing at some stage in their lives. This development will block that for middle aged people - the age of wisdom, concern, compassion and personal interest - the kind of people who make brilliant nurses.Other professional groups that have gone down this route - clinical psychologists for example - find themselves performing tasks well below their level of training, making them expensive and opens up the engagement of non-psychologists performing psychological therapies without appropriate supervision and depth of understanding over the efficacy of what they do. Is this what's going to happen - minimally trained nurses coming on stream because the degree level nurses are too expensive to engage in the public sector, and those who are engaged become exasperated because they are expected to perform tasks below their expected knowledge level? I can't see this working out happily for anyone - nurses, doctors or patients.
Derek Mowbray - Winchcombe, UK, OrganisationHealth

I am not in favour of the nurses who are already qualified and experienced to study for a degree in Nursing. Having come from the profession myself in the past and having taught Nurses I found the training pre-Project 2000 to be absolutely thorough and fully professional. The Nurse training should have as much practical experience which prepare nurses for anything unexpected on the ward. With due respect, graduate nurses who are fully equipped with the ability to write assignments and pass exams but they lack many practical experience. Unfortunately, this is what is expected of nurses in any aspect of nurses job hosptitals. How many graduate nurses come on the ward and are ready to administer any injection, do a wound dressing or bandage? They have little or no experience of how to deal with emergencies, intepersonal skills and lack many clinical practical experience. Nurses who were trained as RGN, RMN or even SCM were confident in communication and many interpersonal skills and were in charge of the wards either straightaway or very soon. They have been fine all this time and the hosptitals have run with their skills and expertise all along. The degree in nursing does not match all the practical skills and confidence that nurses with conventional training had. Another important point to note is many nurses have a family and they work different shifts and many unsocial hours to make ends meet and also their work contracts. The burden of having to do a degree must become an undue stress. It should only be put to those who voluntarily want to do it.
Kishore Teelanah - Oaklans College, Wewlyn Garden City, Herts