Sunday, 15 November 2009
Who will do the nursing?
Much talk has taken place in recent days on plans for all nurses to be trained to degree level from 2013. I think a lot of the chatter and debate has missed the point. 'Degree level' is just a label, it doesn't mean a great deal on its own, I think the problems with nursing training are similar to the problems with medical training that have become apparent in recent years.
Good old fashioned basic nursing has become devalued as an entity in recent years, it seems that an apprenticeship in one's trade is simply no way to learn the ropes in our current politically correct times. Basic things such as feeding patients, washing patients and attending to bedpans are beneath some modern nurses. A little knowledge can be a dangerous thing, a quick superficial glance at the science behind medicine seems to have inspired quite a few nurses to bit off a bit more than they were able to chew.
I do not wish to single out nurses, the same types of problems exist with the training of doctors. The basic science has been dumbed down, the apprenticeship has been lost and the ward hours are just not there anymore. The same is the case for nursing training, the ward hours and apprenticeship has been lost at the expense of satisfying politically correct mumbo jumbo spewed forth by educationalists. The subspecialisation of educationalism is to blame for a lot, invariably idiots who were not very good at the job end up doing all the teaching despite the fact that they haven't been on the front line for years.
This loss of the apprenticeship and the reduction of basic standards is a direct result of one thing, money, the government does not want broadly trained competent workers who have learnt the ropes adequately, they want to isolate individual competencies and shift work down to people who have had way less training than in years gone by. To see this in action all one has to do is see who does most of the basic nursing on wards, it is done by 'health care assistants' who have had very minimal levels of training, they are the modern day nurses.
Nursing is no longer good enough for modern day nurses, a lot of them now go into nursing as an easy route to becoming a quasi-doctor or 'noctor'. In life you get what you pay for and less training and knowledge inevitably results in a lower quality of service for patients. Many nurse specialists who specialise in areas which are suited to their skills and training, for example stoma care nurses, district nurses or various sub speciality liaison nurses, are a great asset.
The problem comes when nurses are promoted into jobs that demand a broad based understanding of medical diagnosis and management, for example the nurse in the Walk in Centre who practises independently or the scarily 1984-esque nurse 'consultant'. Some experienced nurses can just about get away with it, some of the time, however when inexperienced nurses are given these roles the consequences can be rather disastrous as well as expensive. One example is the massive failure of nurse-run Walk in Centres to reduce referrals to other health services.
The government cares not for quality of care, all is interested in is privatising the NHS and selling it off to private corporations. Breaking the medical profession's monopoly on doctoring has been part of this corrupt privatisation process. A side effect of this has been the devaluing of proper nursing which is sad to see. There is a real need for patients to be properly nursed and in the future we'd be better off having nurses doing nursing, rather than letting anyone with a couple of weeks training take their place and moving trained nurses into jobs that are outside of their expertise and training.