Speaking out for Nursing9 July 2012
We enrol more student nurses than almost all other universities in Britain, and this means that the quality of our teaching is paramount. So we were pleased to be asked to submit our views to the Commission on Pre-Registration Nurse Education, currently convened by Lord Willis for the Royal College of Nursing. The Commission’s question is this: “What essential features of pre-registration nursing education in the UK, and what types of support for newly registered practitioners, are needed to create and maintain a workforce of competent, compassionate nurses fit to deliver future health and social care services?” Driving this enquiry is a belief – mostly anecdotal – that newly qualified nurses are disproportionately responsible for the perceived ills of the NHS.
Responding on behalf of the University, Tony Warne, Head of our School of Nursing, Midwifery and Social Work, points out that only about 3 percent of the 660,000 registered nurses and midwives in the UK are newly qualified. Further, the Nursing Midwifery Council reviewed and revised its standards for pre-registration education just two years ago and only approved the first all-graduate programmes for delivery less than a year ago, in September 2011. This has resulted in ten new standards that nursing students must meet to be considered fit for practice at the point of registration.
Given that standards of education provided by colleges and universities have been so comprehensively reviewed and revised, and that the degree-standard curriculum has only just been introduced, it must seem that the Royal College of Nursing is rushing to find a focus of external responsibility for a set of challenges that rather belong in its own backyard. In his response to the Willis Commission, Professor Warne makes the point that “by focusing on current and new students, the Commission risks failing to address the other issues at the heart of the public debate over care and quality, in particular the degree to which the culture of health care organisations (in which students and recent graduates work) facilitates continuous professional learning and development, and personal growth amongst the nursing profession”.
In striving for continuous improvement to the nursing education we offer, we focus on bridging formal instruction and practice, emphasising learning within clinical practice and the “clinical reasoning” – the ability to reason as a clinical situation changes, taking into account the context and concerns of the patient and their carers. Our teaching methods seek to keep students focused firmly on the patient’s experience. Every student who enters our programme attends a service user, carer and student conference, a day aimed at exploring the emotionality of good nursing care. These conferences have been successfully extended to include an annual care and compassion conference, facilitated by services users and aimed at qualified nursing staff. We recognise that the settings that nurses learn to prepare for the future are the result of our partnership with the NHS as, of course, do Schools of Nursing in general.
On a broader canvas our School contributes to improving the harmonisation of nurse education across the European Union member states. For example, the Empowering the Professionalization of Nurses through Mentorship project aims to advance professional nursing in four new EU countries; the Czech Republic, Hungary, Lithuania and Romania. The operational context for this work is the clinical learning experience of student nurses as part of their studies to become registered general nurses.
The ethos and commitment of our staff in the School of Nursing, Midwifery and Social Work is epitomised in Natalie Yates-Bolton’s decision to talk about her own medical history in a searing interview published in a national newspaper. Natalie, who teaches in our School and specialises in dementia, has had four serious bouts of cancer, 10 operations, 30 sessions of chemotherapy and 55 sessions of radiotherapy. As both a nurse and a patient, she knows both sides of the clinical experience only too well. In her interview with the Telegraph, Natalie writes: “we need to stand up for nurses. The media says they are blasé and indifferent, but I can’t think of one who has been like that in all my years as a cancer patient. The student nurses I teach come into the profession wanting to care, wanting to make a difference. They are willing to work unsocial hours and weekends. The papers write that nurses these days are ‘too posh to wash’, and all of that. I don’t see that. It isn’t my experience. If it was, I would be doing something about it.”
Natalie’s reasons for speaking out are clear: “I wanted to put the record straight. We hardly ever celebrate the good care in the NHS. The managers need to take a little bit of time to focus on what is being done well and celebrate that. Nobody is telling people they are doing a good thing.” Stuart Hall, the doyen of critical cultural studies, agrees. Now 80, and seven years on dialysis following renal failure: “How can millions of people have benefited from the NHS and not be on the streets to defend it? Come on. The NHS is one of the most humanitarian acts that has ever been undertaken in peace time”.
Natalie Yates-Bolton, “I’ve had cancer four times, but I’ll keep helping others”. Telegraph, 20 May 2012. http://www.telegraph.co.uk/health/women_shealth/9276753/Ive-had-cancer-four-times-but-Ill-keep-helping-others.html#
Stuart Hall, “The Saturday Interview”. Guardian, 11 February 2012. http://www.guardian.co.uk/theguardian/2012/feb/11/saturday-interview-stuart-hall