Nurses are not carrying on

November 27, 1998

As applications for places fall short, and NHS shortages reach crisis proportions, nursing education is undergoing its own Dearing-style review. Julia Hinde assess the state of health

Nursing now trains most of its new recruits to diploma level - just the sort of sub-degree work that higher education minister Baroness Blackstone has repeatedly said the government wants to see more of.

But there have been calls from some for nursing to be made a degree-only profession; others disagree strongly. A major review of how nurses are trained is under way.

In June, the body responsible for regulating nurse education - the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) - established an education commission to review and prepare a way forward for pre-registration nurse and midwifery education. The review comes a decade after the introduction of Project 2000 diploma courses and the move of nurse training away from hospitals and into higher education.

Gone are the days when student nurses learnt the ropes by working alongside qualified colleagues tending the sick on hospital wards. Now nursing education is firmly embedded in higher education, though students spend significant time in hospitals. The last traditional nursing school shut in 1995 and was replaced by university provision. Now 87 per cent of would-be nurses embark on three-year Project 2000 diplomas. The other 13 per cent do three- or four-year nursing degrees, all of which are based in universities, not hospitals.

The principle behind the shift away from the wards was the perceived need to create a new breed of nurse professional for the 21st century. They were to be trained to think for themsleves and make their own decisions, to cope with the changing National Health Service and its move to primary care, to interact with professional colleagues and to respond and react to rapidly developing medicine.

But a decade on, the NHS faces the "worst nursing shortage crisis for 25 years", says the Royal College of Nursing. The number of new nurses registering to practice has declined year on year for a decade. There are at least 8,000 nursing vacancies reported across the country, and nine out of ten trusts face recruitment problems.

The RCN says that to meet demand for nurses in the next century, intakes to nurse education courses need to double by 2011.

It is alarmed that in 1996-97 there was a shortfall in applications for nurse education places for the first time: just 15,400 applications for 16,100 places at university departments. On top of this, reports suggest that up to one in three nursing students drops out during the pre-registration course.


* In 1997, 17,200 students started nurse and midwifery training.

* The movement of nurse training into universities involved an influx of women to the higher education sector. Women still make up more than 90 per cent of nurses, though there has been an increase in male nurses, withthe percentage of males on the UKCC register rising from 8.3 per cent in 1989 to 9.38 per cent in 1998.

* Men now make up 11 per cent of nursing students (English National Board annual report 1997/98)

* Forty-nine UK universities and colleges of higher education offer nursing degrees and diplomas. Among thebigger players are Thames Valley University, Sheffield University and Leeds Metropolitan University.

* It costs Pounds 35,000 to train a nurse (RCN).

* The Department of Health wants to increase the number of nurses on diploma and degree courses by6,000 in the next three years.

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