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Nursing

My first blog entry. What do I blog about? Well the one thing I feel passionate about, nursing.

Nursing is my vocation and has been for 25 years. I trained in the olden days, you know when Florence was swinging her lamp down in the Crimea.

My School Of Nursing was on site at the hospital as was my living quarters, we couldn’t escape.

It was tough. A thrown in at the deep end sink or swim kind of training. You survived or you didn’t, simple. My set started with 12, finished with 10, not bad and unusual at 5 women and 5 men.

We had Matron, just before she had to re-apply for her job as Manager, had a breakdown and retired poor thing. She was one scary woman but boy she ran it well. The re-org near on killed her.

So what has bought about this reminiscence? Well last week I had the pleasure of inducting a lovely newly qualified nurse into my workplace, a 25 bed nursing dementia unit. High, complex needs. I thought it was perhaps a good idea to do the medicine round together. I was not surprised to reach the end and realise that she had very little if any pharmaceutical knowledge. After 3 years training and a degree she could not tell me anything about ranitidine, domperidone and gaviscon, the very basics. This is something I have encountered again and again with both new nurses and students. So how did we get to the point where a nurse/student can tell me all about govt policy but not the medicines he/she is actually giving on a daily basis?

Back to ancient history. We were the penultimate set prior to the great saviour of nursing - Project 2000. We were told all about the disaster that was awaiting us in the new Millenium. An ever increasing elderly populous with complex medical needs and a complete lack of young nurses to care for them. It was obvious nurse training needed to change. So a bright spark thought that moving nurse training into university was a great way to go, much like the US. Except it soon became apparent that this was not going to work. Too much time in lectures and not enough time on practical skills resulted in nurses who were poorly prepared for qualified life. So a re-think was ordered. Now student nurses spend much more time ‘on the floor’ as it were, which is just as it should be. So much so that we had student nurses on placement in a previous nursing home of mine. They were there to learn washing, bathing, continence needs, nutrition and hydration, simple wound care, pressure area care, communication, record keeping, prioritising, medicines and team working. If a nurse does not have these skills early on she has little chance of developing assessment skills which are crucial in caring for people. Most of the students enjoyed it, some fell by the wayside but then they didn’t want to ‘nurse’ I have always maintained that nursing is a practical job, pure and simple.

There still appears to be little preparation for these students when they qualify. Their pre-ceptorship as it’s now called consists of all the things I learned in my 3rd year in preparation for running a ward. This is of course not the nurses’ fault at all.

Did the overhaul in training increase UK trained nursing numbers? No. In fact in the early 2000’s the Philippine govt place a moratorium on the numbers of nurses the UK could recruit such was the impact on their own hospitals. We are still recruiting 1000’s of overseas nurses each year. The NHS and private care homes would cease to function without.

On a side note. En’s. Yes Enrolled nurses. Wonderful, skilled, competent nurses. Scrapped as part of the overhaul. This was a major error in my opinion. The back bone of many wards these were the staff nurses back up, fabulous assets. Gone….but not forgotten by me.

Of course university training means a racking up of the entry requirements. A levels and GCSE’s in maths, English and a science essential. Forget about common sense, an eagerness to learn, a congenial personality, well presented, good communication skills and an unfailing willingness to want to help, nope, A levels is what cuts the mustard.

In some areas the diploma is no longer available and eventually nursing will be an all degree vocation. This makes my soul cry. There are so many young people out there who would be amazing nurses. Yes I know nursing has come a long way with technology and science however the principles of nursing have not changed one iota.

I’m happy that nurse training changed. My training was dangerous and risky and we had little prep for what we would encounter. I do not look at it with rose coloured spectacles. Some of my experiences still give me nightmares. Did the powers that be go too far? Yes….it does now appear they have noted their error. However they have a long way to go to produce competent newly qualified nurses who don’t need another years training to bring them up to scratch.

So what did I do with my lovely but pharmaceutically challenged nurse? I sent her home with a list of the most basic medicines to learn before we move onto the more complex ones and lord help me…drug calculations! 

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