Nursing must become a graduate-only profession if it is to attract applicants, university nursing departments said this week.
The Council of Deans and Heads of Universities' Faculties of Nursing, Midwifery and Health Visiting has called for a rethink on nursing and health professional training. It wants proper clinical career paths for nurses and nurse academics and a clear code of conduct between NHS consortia that purchase nurse education and the universities that provide it.
In its report, Breaking the Boundaries: Educating Nurses, Midwives and Health Visitors, the council, which represents 64 university nursing departments, also demands better workforce planning and moves to stop pre-registration nurses leaving.
Up to one in seven trainee nurses do not seek registration. The council blames this partly on students giving up but also because of poor pay and career prospects. It calls for an investigation into "workforce planning that continues to feed more students into the system but continues to leak them on graduation".
It is also becoming harder to recruit trainee nurses on to three-year diploma courses, which are run alongside nursing degrees in universities, says the council.
It argues that nursing must become an all-graduate profession over the next ten years if it is to compete for students. Fewer than one in ten nurses is a graduate.
The fear that graduate nurses are a poor investment has been proved wrong, it adds. But graduate status must be coupled with a sufficiently rewarding clinical career path for nurses. A suitable clinical academic career must also be developed.
The council says that nurses are trained too much for hospital work despite forecasts that primary care will soon be at the core of the health care system. "A system that needs to re-educate its professionals to work in primary care is wasteful," it says.
The council also highlights problems with purchasing nurse education. In England this is done by NHS consortia. Contracts are being renegotiated for the first time and the council says this has been marked by "uncertainty".
Even though the damaging effects of competition may be being phased out of NHS service it is not being phased out of education provision, it says. The shorter fixed-term nature of contracts with the NHS prevents universities from attracting staff who are seeking a long-term career in education and research.
The council also warns that the power vested in NHS purchasers can undermine academic freedom. The relationship between the two sides is "finely balanced, insufficiently developed and requires further and ongoing consideration and attention". It calls for a group to be set up to develop a code of practice between education providers and purchasers to safeguard academic freedom.
The council wants a high-level, long-range forum to debate the future of nurse education and workforce planning. It says present planning is insufficiently multi-disciplinary.
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