Thursday, January 18, 2018

Nurses – why degrees are not the answer for NHS crisis

The graduate demand for nursing is a filter excluding many who used to go into the profession. My mother was a nurse, my sister was a nurse for 30 plus years – neither would now have got into the profession because of the academic entrance demands. Working class youngsters, in particular, are being excluded and I do not believe for one minute that they are unsuitable. The nursing shortage is not only caused by this hurdle but it has been exacerbated by the need for a someone who wants to be a nurse to get University entrance qualifications, spend years at University, then exit into a relatively low paid profession, with a huge loan.
Alan Ryan, who was a nurse for 20 years, and knows a thing or two about training in the NHS, said something quite profound in Berlin recently. “All of our jobs (in NHS) are, in practice, apprenticehips, from consultants to cleaners”. His point was that healthcare is an eminently, practical affair. He supports alternative routes into healthcare professions.
In truth Higher Education in the UK has land-grabbed vocational education, mainly on the basis of increasing their revenues. What were adequate, shorter and more experiential, training courses are now degrees, making them longer and far more expensive, whether for the state or individual.
Universities may claim to be about critical thinking but a glance at some of the degrees on offer show that this is far from the truth – Dentists, Doctors, Nurses, Lawyers, Engineers and so on. In truth, as Roger Schank tells us, Universities are about “creating Scholars”, and, as he says “we have enough Scholars already”. I’d add that there may be a surplus, as shown by the ease at which adjuncts can be hired to do the ‘teaching’ even in top Universities. This is not the environment into which nursing easily fits.
We have many nurses from other countries, even the EU, such as Germany, who are hired without going through this University experience, so it is not as if it is a necessary condition for success. Those who deliver such courses will claim that a nurse’s job is more complex than it used to be and of that, I have no doubt. But complex does not necessarily mean more lecturing and theory. 'It is difficult to get a man to understand something, when his salary depends on his not understanding it’ said Upton Sinclair, and it is difficult to get something out of the world of lectures and essays once ‘Lecturers’ get a hold of it.
There are many causes to hte current nursing crisis:

  • failure to plan for demand
  • degree course entrance qualifications
  • abolishing bursaries
  • new English tests
  • agency costs
  • foreign country demands
  • working conditions

But part of the solution here is to reverse this policy of Nursing degrees, not by demolishing that option but opening up alternative routes, especially apprenticeships. A vocational route is badly needed, and should have been opened up years ago. In practice, we depended on migrant labour and extortionate agency fees. We didn’t have to pay for their education, which is neither good for us or the countries from which they came, but that is not a good excuse for the failure to train our own nurses. Brexit will at least slow that process bu we need an alternative route. The nursing assistant route is a start - we need much, much more.

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