Guest blog post by Gail Beer, Director of Operations, 2020health
The Royal College of Nursing has come out firmly against the proposal that those wishing to enter the nursing profession should work for a year as a Health Care Assistant.
Speaking as an ex nurse, like the RCN, I consider the proposal flawed. I cannot see how it will raise standards of care and improve outcomes for patients. I struggle to understand how it will enhance learning and improve the understanding of care for those wishing to enter the profession.
Who will pay the prospective nurses while they complete the year? Does this come at the loss of other staff as Trusts struggle to keep the pay bill under control? How will they be taught in the clinical area and by whom? what supervision or mentoring will they receive? Will there be a structured educational programme? Will those providers offering placements need to be accredited? Will the prospective nurses become cheap unsupported labour? These are just a few of the questions and there are many, many more that need to be answered.
Without a massive number of safe guards we are in danger of employing prospective nurses who learn bad habits before they enter training, some that may be difficult to remove. On the plus side, the prospective nurses will have a taste of nursing and be able to decide if this is the right career without wasting a university place.
To my mind the more sensible thing to do is to make sure we get the balance between clinical and academic training absolutely right. We must improve the clinical teaching provided and make sure that nurses are well supported while they train, this will require additional resource. Busy qualified nurses do struggle to train and supervise students. Clinical placements require time and one to one teaching, certainly at the start of training. More importantly areas where care is substandard should not be allowed to train nurses. Indeed areas providing poor care should be managed properly by credible nurse leaders empowered to act with Boards held to account where poor care is tolerated.
Perhaps another solution might be to make sure we are appointing sisters and charge nurses who are properly trained and prepared to be clinical leaders. Is it time to move nursing into a career structure similar to that of medicine where promotion comes after a proscribed and time bound experience and the passing of practical and theoretical assessments. It is good nurse leaders that will really address the issue of poor care.
Finally, this proposal makes it appear that washing and feeding patients requires no teaching and training, can be done by those who have no understanding of what they are doing and why. It reinforces that the role of the qualified nurse is not to undertake these basic tasks.
The proposal might seem appealing – we do need to do something to restore the public’s confidence and yes it is important that nurses are not ‘too posh to wash’, – but we might find that a more successful approach is to get the training right. Once the training is right, we can ensure that there are the right role models in place and let the good nurses act.