The badges above are a representation of my nursing career over the past 30 years. There are a few missing, but they embody the 14 posts I’ve held, most in general surgery.
I qualified, aged 23, in 1985, from Stoke Mandeville Hospital in Aylesbury. I was in one of the last cohorts to train ‘traditionally’; employed by the hospital, on a low monthly salary.
During my training as a Registered General nurse (RGN), we completed 8 week ward placements, including Obstetrics, Paediatrics, and Psychiatry; every 16 weeks we had a 2 week stint back in the nursing school to prepare us for the next 2 placements. When we qualified, the hospital guaranteed everyone a job. There were no interviews, you would just ask the relevant ward Sister/Charge Nurse if they had any jobs going and please could you have one… my first formal interview was in 1990 at Addenbrooke’s wearing a particularly fetching gold and black suit.
Project 2000 nurse training began in 1986; brought in by the UKCC (the registration body prior to the NMC) in order to begin to professionalise nursing. For the first time students were supernumerary when on placement, and paid a bursary in lieu of salary.
Coming to the present day, nursing is now a Degree only profession, as it had to be. There were fears when the diploma training finished, that it would exclude those students coming from poor educational backgrounds, mature students with families or those with previous careers. But that did not happen and access courses, secondments, with clinical and educational support, have meant nursing has continued to attract a good quality and number of candidates.
Throughout the last 30 years I have mentored student nurses training via all of these different methods, and have found no difference in their ability to care, enthusiasm, compassion or competency. The fact that nursing is now a degree course does, however, mean that nurses are now able to look other health care professionals in the eye, question decisions and work more collaboratively because nursing is now based on evidence and research. We can talk to other professionals in the same language, and our qualification has status; allowing those that wish to move the profession forward, to go further in pushing the boundaries of nursing. Today, if you wish to progress higher than Sister or Charge Nurse there is an expectation that you will have a Masters Degree.
Yet, though we are more educated and are taking on more diverse roles and responsibility we have not had any significant pay rise since 2008, and our standard of living and salary has dropped in real terms by 14-20% since then.
To add to this, on the 25th November the Chancellor, George Osbourne, made a statement in which he removed £800m from the nurse education budget, moving Student nurses from free education, supported by bursaries, onto annual loans of £9,000. He claims this will remove the cap on student nurse places, and will allow 10,000 more nurses to be trained annually, on top of the 20,000 currently. He does not state how this figure was estimated, though Universities claim they turn down 5 for each nursing student place. The cap is one which the Secretary of State for Health is responsible for, and could be raised, but there is a problem here…Universities already struggle to find meaningful placements for students, with enough trained mentors to support them. Where are these additional mentors and placements going to come from when the student population is increased by a third?
As others have pointed out, a nursing degree is not like any other. Apart from academic study and assignments they have their placements and competencies to complete, which means they have no time available to take on part time jobs to assist them in paying living costs, which will mean taking out further loans to pay for rent and food. Where is the evidence that there are students waiting to take on up to £65,000 in debt, on a starting salary of £21,692, and on which they will begin paying back immediately, now with an interest rate between 3-9%?
In the South, Nurses now find average house prices 10-20x their average salary, with rents taking 78% of their monthly income. Without a significant wage rise, nursing will not be a viable career choice, and nursing students cannot be saddled with loans and repayments by this Government.
There is some good news. As a direct result of the threat to nursing education, and the removal of bursaries, nurses are becoming politicised. There has already been one march on the Department of Health, organised by current student nurses, King’s College London Nursing and Midwifery Society and it’s President Danielle Tiplady.
The next demonstration to be held in London is on the 9th January 2016, and is being supported by the RCN, Unison and Unite, as well as Natalie Bennett and MPs Neil Coyle and Wes Streeting; the NHA Party and the Peoples Assembly. Junior Doctors will also attend in support, whilst also fighting their own battle to maintain patient safety and safe working conditions.
Protest and opposition is growing to these attacks on NHS staff and the institution itself, and these will continue whilst £22b savings are made to a service which has a £2.6b overspend this year; whilst A&E and elective targets are missed and the patient experience deteriorates.
Articles and references
Independent, 25th November 2015 – Government faces legal challenge over controversial plan to make students pay £6000 extra on loans
slc.co.uk – interest rates
gov.uk – Chancellor George Osbourne’s spending review and autumn statement 2015 speech
rcn.org.uk – NHS pay scales 2015-16
theguardian.com – average house prices rise 8.8 times local salary in England and Wales
The Nursing Times, 11th June 2012 – it feels strange to be the last of the nursing diplomas’
The Nursing Times, 12th May 2008 – Nursing in the 1990s
theguardian.com – George Osbourne considers axing student nurse bursaries