Caring hearts and minds (1 of 2)

August 25, 2011

Anthea Bain's letter ("No degrees in compassion", 18 August) is yet another depressing diatribe extolling the "good old days" of nursing and demonising current students and newly qualified nurses.

While there is clearly evidence that some nursing care today can be called into question (eg, the Care Quality Commission's reports on nutrition and dignity), there is no evidence that this is due to the introduction of graduate nursing. Indeed, a study last year by the University of Hull's Patricia Pearcey suggested that nursing students were surprised that qualified nurses "cared" for patients much less than they expected.

While CQC reports of substandard care reflect an unpalatable picture of nursing, a substantial literature base suggests that this is more a result of a healthcare culture that is cost-driven, target-focused and goal-centred than a result of the introduction of graduate nurses. Additionally, clinical nursing leaders increasingly are removed from the clinical environment to undertake more administrative activities. These factors have had a far more deleterious impact on nurses' ability to care.

Comparisons cannot be made between nursing in 1968 and in 2011. Today, the requirements of the role are fundamentally different, much more challenging and require higher levels of responsibility, accountability and knowledge. Patients will be much more confident in nurses who can think critically, draw on a body of evidence and know "why" as well as "what to do".

Bain's knowledge of pre-registration curricula is apparently limited. Graduate nurses do not "emerge, blinking, into the sunshine of an NHS ward". All pre-registration programmes require that nursing students engage in practice for a minimum of 2,300 hours (50 per cent of the programme). In addition, they gain significant experience of practising skills under supervision in simulation suites and are required to demonstrate a range of essential skills.

The training does not merely teach students to do tasks but also requires them to demonstrate care and compassion, which is assessed cognitively as well as practically.

Bain draws on the old mantra that nurses are born not made. Nurses must have the capacity to care, but a significant literature base supports the fact that individuals can be taught to care more effectively.

How can being educated to a higher level be a bad thing? Caring and academic achievement are not mutually exclusive. Let's stop blaming the educational status of nurses and tackle the real issues. If we want nurses to care better we have to invest more in giving them the time and continue to educate them in strategies to do so properly.

Jan Quallington, associate head of institute (quality and student experience), University of Worcester

Dot Morrison, senior lecturer, nursing, University of Worcester

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