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Training tracks

Am I the only one that is irritated by the implication that changes to pre-nursing practice will avoid another Mid Staffordshire incident? Where is the evidence that working as a healthcare support worker for a year as an entry requirement to nurse training will avoid another such scandal in healthcare? Robert Francis did not make this one of the 290 recommendations in his report in into the failings of the hospital - the government has done so in its response to his report. At best, this suggestion has not been well thought through. At worst, it insinuates nurse training is to blame for the culture within the hospital. My irritation has escalated to annoyance!

In my experience every person entering nurse training has an aspiration to care for others, wants to do a good job and be satisfied with their efforts and commitment. How many qualified nurses can say this happens - regardless of where we work, be it hospital, community or in residential settings?

The reality of nursing today is that patients are increasingly sicker, but too frequently there are inadequate staffing levels to meet their complex needs, we are chasing targets and nurses are feeling overwhelmed and undervalued. This creates a situation where dedicated nurses are unable to give the care they want to. They remain in the team giving what care and energy they can, managing the stress, frustrations and disappointments while not wanting to let colleagues and patients down. Their vision of nursing has become one of hope that the situation will get better before they need a break from nursing to recharge their batteries and enthusiasm.

Considerable numbers of nurses complain they are unable to give the care they want to. This is the situation and culture that the government's proposed healthcare support workers will witness during their year of experience prior to entry onto a nursing degree. Will it put them off making nursing their career? It appears the majority of qualified nurses, nurse opinion leaders and unions think it would - a recent survey indicated 40% of student nurses think it is a bad idea, with 19% saying it would have put them off taking up training. Certainly 49% of the student survey felt they are being 'blamed' for the Mid Staffs hospital failings by the suggestion they should have previous experience before entry onto a nursing course.

There is no clarity yet regarding who will employ, train or monitor these workers but an investment will need to be made from somewhere. I would suggest any available investment would be better made to improving staffing ratios and providing focused training for existing qualified nurses. Better staffing levels improves morale, energy and job satisfaction - to the benefit of patients, nurses and their students. The complexity of patient needs and emerging clinical evidence requires ongoing education and staff development. Yet such investment appears to be increasingly in short supply, cut completely, or staffing levels are so low that nurses cannot be released to attend. What a mess this has become.

We desperately need a good role model of a service that is appropriately staffed by qualified nurses and their support workers, with sufficient ratios to maintain morale and give calming and compassionate care to patients and their families. 

Our potential students need to experience the nursing care aspirations and vision they hold and we all want for those we love. Let's not elongate their entry into nursing with the risk they will be negatively shaped by sub-optimal standards they are likely to experience during their pre-nursing year. We should invest in improved nurse/patient ratios and the clinical expertise of the existing qualified and dedicated nurses in practice. Then they can provide the role models our students need - and deliver the quality of nursing care we all aspire to give and receive.