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Too posh to wash?

Una Adderley discusses the debate that has been running in one corner of the nursing press this week as to whether or not student nurses are now "too posh to wash"!

The debate was initiated by an observation that student nurses were now viewing basic nursing care as being the remit of healthcare assistants rather than nurses.

The student voice weighed back in defence saying that it wasn't that they saw such care as beneath them. Their view was that if they spent too much time delivering basic care they were not left with sufficient time to develop an adequate level of skill in other essential nursing skills such as the administration of medication, delivering diagnostic procedures or an adequate aseptic technique.

As always, the truth will probably lie somewhere in the middle. A minority of student nurses will view fundamental nursing care such as washing patients as beneath them and a minority of qualified staff will see student nurses as just an additional pair of hands.

However, I suspect the vast majority will do their best to help each other out. Most qualified staff will strive to find meaningful clinical experiences for their student nurses in order to help them achieve their learning outcomes. Similarly, most student nurses will willingly roll up their sleeves on a hectic day and pitch in with the essential work.

However, the student nurse experience in community nursing is often very different to what is being described in this debate. Most practice nurses, district nurses and health visitors deliver care alone, even if they are part of a wider team.

Therefore, a student nurse on a community placement will not usually be sent out on their own to deliver care. They will usually have the luxury of working in close partnership with their qualified colleague. Even when the day is busy, the relative quietness of a patient's home or GP surgery consulting room (compared to a ward) encourages the sharing of knowledge.

Patients are more likely to confide in a nurse within the privacy of their own home and nurses are more likely to be able to give the patient their full attention if they are not distracted by the clamour of a ward outside the curtains.

Furthermore, the inevitable journey between patients provides a wonderful opportunity for reflecting on the care that has just been given, planning the care that will be delivered to the next patient and asking and answering clinical questions.

I don't want to give the impression that community nursing still functions at the leisurely pace of ten years ago. However, it strikes me that such placements provide a rare opportunity in nursing education to deliver a very high level of mentorship and support to the next generation of nurses.

Since this is apparently becoming increasingly rare, it would seem that we have a particular responsibility to protect this experience for the benefit of our student nurses.

Your comments (terms and conditions apply):

"As a clinical community-based midwife, I agree that extremely valuable lessons are learnt in the home environment. As a facilitator of home birth I cherish the privilege of attending women in their own home and have very positive feedback from the experience of our students. We 'deliver' the whole caring package, therefore students have first-hand experience of mopping up a variety of bodily fluids as we ALL work together to care" - Louise Webb, Reading