Thursday, November 12, 2009

You will Need a Degree to become a Nurse


We just had a death in the family of the canine type, I have been reading BBC have your say, and I am in a real bad mood.


Here is the BBC article you have all probably read. I have been in mourning so I am behind with all this.


Here are the fucktwits on have your say.


I am in two minds about nurses being required to have a degree to qualify.


Let's talk about the pros first.


First of all a hell of a lot of research has shown that the patients of well educated bedside nurses have higher survival rates. Anyone who qualifies as a nurse will be thrown into a situation where he is own his own dealing with complex stuff, making life and death decisions and having to think fast on his feet with no second chances almost immediately upon qualifying. He will have to handle all this whilst getting interrupted on every 30 seconds or so throughout a 12 hour shift. Support? What a fucking joke. He will be the lone RN for a large number of patients with only untrained care assistants to help. This is how it's been for years. The matrons sure as hell won't come any where near the wards and it will be rare for our newly qualified hero to be on duty sharing a patient load with another qualified nurse to guide him. This is how it has been for years and it is getting worse.



Why are people in this country so silly? Why do they seem to have a death wish? If you don't think that your RN needs to be well educated as well as have a manageable number of patients you must have a death wish. You must want to die. You certainly don't really understand what a nurse actually is.



When I was overseas many patients would throw their registered nurse out of the room if she didn't prove on the spot that she had a university education. "Are you a BSN" "No sir I trained under the old diploma program" "Then get the fuck out of my room lady". Sad but true. Our older nurses are some of the best simply because they have decades of experience behind then and have proven that they have the tenacity to hang on in this hell profession. But people over there seem more switched on and seemed to have more of an understanding of what a nurse actually is. People in the UK do not understand what a nurse is.....

The old ways of training turned out good nurses for their time. The nurses that trained that way who are still practicing are excellent. They have decades of experience behind them and have grown with the changes. If you tried to train today's nurses like that however you would increase hospital mortality rates. The old training would not suffice now. As someone who has a strong desire to live and who will be a patient some day I have thought about this a lot.

I would thr0w a caring and empathetic nurse who couldn't get through pharma maths at Uni out of my hospital room . I don't give a goddamn about how caring or empathetic you are. I want to stay alive. If you are a caring and empathetic but not that bright I have less chance of surviving my hospital stay. I hope you are caring but first and foremost I want you to be on the ball because I know how much information you will be analyzing and how fast you will be moving and it is scary. I say this as someone who has been a nurse for well over a decade. I say this as someone who has seen patients die because their caring nurse was off helping hand out commodes. I say this as someone who wants to live.


Let me link to it again in case ignorant sickos like Jeremy "But what about the caring"Vine happen to be reading. It's all in the link...just scroll down. Or google nurse education and mortality rates.

Research has shown over and over and over again that hospitals that have a higher proportion of well educated nurses on staff providing direct patient care have higher survival rates.

If I had a registered nurse caring for me who didn't catch onto the fact that I was going into renal failure or was pre -arrest because she was lovingly off somewhere else bathing and making cups of tea for her other patients I would get her sacked and get her license revoked. I would also have a strong desire to beat her to death with a hammer.

Actually I suppose my next of kin would be handling that because I would be either in ITU as a result of failure to rescue before the problem got to big...or I would be in the morgue. If my nice caring but not so bright nurse doesn't catch onto my deterioration in condition who will? Anyone who is an RN will find himself alone with a large group of patients and no back up other than untrained carers. The carers won't catch onto my change in condition unless it is blatantly obvious. When it is blatantly obvious it is too late. This is why the nurses need to stay on task with assessments, labs etc. The docs are NOT around to do it, they won't do it and the nurse will take the heat over any failure to rescue screw ups. This is real life not television where the docs are always around the patients and the nurse is just their assisting. That is not real life.


I swear to god that if I , as a patient, caught my RN making tea and making beds rather than dealing with the things that the carers cannot help her with I would be on her ass like flies to shit. I want to live. So should you. The older trained nurses we have now have been around the block about a 1000 time and done a lot of continuing education. They certainly know what they are doing. Don't worry about them. What I am afraid of is a 19 year old here in 2009 who wants to be a nurse getting trained like they did in 1972 and then getting thrown onto the wards in the current situation.


Now that I said all that about dying and needing intelligent nurses let me explain why I think that the all degree qualification for nurses rule is stupid and pointless.



Management does not actually want to staff the wards with trained nurses. On any given shift the majority of staff are untrained carers who do not understand your diagnosis, history, complications, the way your symptoms present and your drugs. The knowledge of all these things is extremely important to nurse a patient properly.


Currently, most of our actual nurses are NOT degree trained. There are 3 kinds of nurses. There are the ones that trained long ago under the old system (most of our current nurses fit into this group), there are nurses who trained in 3 years at uni and obtained a diploma, and there are nurses who trained in 3 years and got a degree (the latter is the smallest group).


I have a degree, my ward sister has a diploma. We are both RN's. We will rarely ever work together because of management. They are dicks. When I am on duty I have a large number of patients with only carers to help and when she is on duty she is also in that situation. They won't ever pay for any more than one RN to be on duty for the same large number of patients whether that RN is old fashioned trained or university trained. Management only wants to hire untrained carers and they want to have as few actual nurses as they can get away with.


This is why nursing care is so bad and a degree won't mean much if they are going to continue to staff the wards in this manner. I want my nurse to be smart, but if she is on her own with 15 patients we are both fucked.


It wasn't too posh to wash registered nurses who wanted these untrained carers brought in to the hospitals. Registered nurses are left with no choice but to delegate all basic care to untrained people. We hate this. It screws things up for me. It screws things up for the patients.


Hope that your nurse is smart enough to get a degree, and hope that she has a manageable number of patients so that she can stay on top of basic care as well as everything else. This is what the nurses want. It is all linked. When this becomes the norm staffing wise, nursing care in our hospitals will improve. Until then, no expensive quick fix band aid will succeed.

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