Nursing is the new Media Studies

paul hughes

Hello. I'm not sure my nurse wife would agree. She not only administers injections but can prescribe a limited range of drugs. This requires more of an education than did the nurses of old. I'm not sure that you understand the complexity of nursing these days. Many of the more "mundane" duties of doctors have been handed to nurses, in order to free their time for other matters.

My wife's degree comprised components in psychology, counselling, and in a multi agency approach to holistic care. Nuses don't just jab people up the khazi, hand out the drugs and empty bed-pans anymore.

With regard to training vs education, architects have long been "trained" at university. Should that no longer be the case? Doctors and vets are also trained there. They may not be let loose on patients, but training is taking place and has done since time immemorial.

Perhaps we differ in our definition of training. I believe, however, that you are confused.

Tiberius

Recent experience indicates to me that nurses increasingly need to acquire the skills that go with telling patients why they can't have an appointment with a GP working fewer hours for more money.

A degree in "non-patient interfacing" seems a must these days.

paul hughes

Sorry, I'm going to carry on for a while. My wife used to handwrite her essays (being a poor typist), and I typed them up for her and so I'm just thinking back to the content of her course.

OK, so your "learn by rote" comment would imply a "patient cuts arm, nurse applies bandage like so" method of training.

My wife has the power to buy different products from a range of suppliers and on the stereotypical topic of bandages alone, there are manifold types which must be applied using different methods in differing circumstances. Nurses then need to appraise how well the wound is healing and how to correct the problem if the current treatment is failing. It really isn't as simplistic a vocation as you appear to imply.

That's just one example of how nursing requires a degree of diagnostic skill to which a "learn by rote" scenario does not lend itself.

District nurses will find themselves in situations where the patient will have had a fall, for instance. Such a patient will require medical treatment but will also require the input of many different agencies in his or her recovery. Nurses, particularly those in the community, are more akin to medical social workers than the "let me help you wipe your butt" stereotype of twenty years ago. Counselling skills will be needed to reassure worried and elderly spouses and to motivate patients who lose the will to look after themselves. Stern matronly types just don't cut it anymore.

Anyway, that's enough. I think my point is made.

Carl Gardner

@ paul hughes: I think you mean jacksy, rather than khazi.

Republican Tory

Catch up! My wife took a degree in nursing in 1996 as part of the nurse 2000 project. It was a fast track one as she already had a degree (2:1 BSc in Environmental Sciences from UEA) She viewed it in the same way we saw Sociology degrees-in the toilets above the loo roll holder it used to say "sociology degree-help yourself"

Paul

Perhaps you and Melanie Phillips should start drafting your letter of apology to about 400,000 nurses now, as well as the Health Care Assistants/auxiliaries that work with them?

Is Spectator journalists unfamiliar with the concept of basic background research? Have you never heard of Project2000, the initiative begun in around 1992 under which nurse training would move into Higher Education, of which this is the logical conclusion?

bill

carl

thank you for bringing a smile to my face on a wet afternoon. thinks now of other synonyms.

Bruce, UK

The Khazi ruled Kalabar and the British Residence was at Jacksi, I believe.

paul hughes

Cheerfully conceded, Carl.

Simon Too

I think Paul Hughes has pinpointed the issue. Nurses need a degree of diagnostic skill, not a degree IN ...

I am not clear whether this proposal is degradation of nursing or a degradation of academia - but it is very hard to see what good it will due for nursing or its perception by patients. Patients do want doctors and they do want nurses - do they want a half-cock doctor who is too grand to nurse? The Royal College of Nursing seems to be trying to muscle in on a role that could be performed cheaper and more effectively by a machine.

anne allan

So it now takes four years to learn to speak to patients (clients, customers?) and then ignore the fact that they're hungry or dirty.

Dr Iago

Hmm I don’t always agree with Melanie Philips but she does have a point on this one, as does Mr Blackburn, with whom I am also happy to disagree with on large number of issues. During the last academic year we had 88,875 students training for nursing degrees in the university system. Whilst a case can be made for a relatively small number of high level nursing professionals such as Paul Hughes’s wife studying nursing as a degree subject there is certainly no need for the current numbers given that much of the very necessary grunt work involved in running a ward is relatively unskilled but vital to patient welfare. Much of the work that is required and sadly now missing in wards is essentially low skilled (cleaning, changing, wheeling round food trolleys) or requires skills that can be developed (basic patient care etc) through training as Paul Hughes suggests. Based on my own recent experience in two Liverpool A & E wards it is exactly this type of work that is neglected by the constantly yacking nurses who seemed to find it beneath their graduate dignity to consider such matters.

Unfortunately this doesn’t sit well with either the knowledge economy narrative or the frankly moronic social mobility for everybody drivel that has been pedalled by this farcical administration. It might fly in the face of established economic reality (Britain has, is and is likely to remain in low skills equilibrium) and common sense but that doesn’t matter because New Labour don’t want to have anybody having to do anything that might be mundane or unskilled in this utopian nation of all the talents. They might end up being categorised on a census as uggghh “working class” (cue Islington shudder, blanching and hyperventilation). Incidentally I spent a year living with three nurses who were the amongst the first to undertake a degree training in the UK, it was very clear from everything they said about the course that much of the course had a ideological feminist underpinnings. Whilst I had and have no problem with such courses (although if that’s how people choose to waste three years they might be less dangerous studying sociology) I do have a problem with net negative impact that followed this new generation of empowered degree level educated nurses, long on theory, short on basic hygiene had on the wards (C Diff, MRSA), but then that’s probably just a coincidence….

Ps Have just watched today’s edition of the Daily Politics where Neathergate was referenced – can we please have an article and discussion on this as requested (and promised) or an editorial explanation as to why this issue is being ducked by Coffeehouse. Fraser based on your consistently excellent journalism and analysis I had high hopes for your stewardship of this publication but if you can’t/won’t address this core issue then I have to conclude with regret that in my opinion you are simply not the right man for this job.

Sarah

I want to put in a good word for Media Studies. Although my own subject is English Literature I know several colleagues in Media Studies and it is most certainly an academic subject which involves advanced critical and analytical skills.

John Skinner

if you've been in hospital recently, you'll know that nurses don't do "nursing" anymore.
You only see them when they bring the drugs trolly or need to take your temperature.
You can hear them though, particularly if you're a light sleeper, as they chat and gossip throughout the night.

Tiberius

Carl G: well the Afghan president does seem to be refreshing blogs other leaders cannot reach.

Norman Dee

This is an appalling critique of todays modern nurses, and I just hope you do not need treatment in hospital soon.

Fergus Pickering

You are labouring under the delusion that the modern degree is academic. Here are a number of degree subjects: Business Studies, Accounting, Nursing, Occupational Therapy, Physiotherapy, Golf Studies, Sports Studies. Now I am not knocking any of these. They are all useful qualifications that will help you get a job. A bloody sight more useful than... well, I should say more useful than a modern B.A. in English Literature, say. But they are none of them academic. They are, for the most part, training. Every three-year-course is now a degree. So don't get on your high horse about nursing. Of course most degrees are not academic. Do you really suppose that over 40% of eighteen-year-olds can benefit from an academic course of study? You must be mad. Or lefty of course.

Hattie

Nurses may not, any more, just give injections, feed and help to the loo as needed. However those are usually basic patient needs and somebody must provide that care. Nurses are not meant, or trained, to be mini doctors. I too prescribe from a limited formulary and have been a nurse for 30 years. Like many of my contemporaries I deeply regret the loss of bedside training and the over emphasis on degrees. I do have a degree but the best training that I received in learning to be a nurse was the SEN course.
The pendulum has swung too far. Alas.

Andy

When all nurses are graduates, who are they going to get to clean the wards, feed the patients and empty bedpans? Will there be a new grade of nursing auxillary?

Verity

Great headline.

Hereford

I think my Daughter, who's graduation as a BSc Hons in adult nursing I will be attending on Thursday next would disagree with you. And so would I.

Her studies covered a wide range of subjects including psychology, physiology and specialist areas such as palliative care. She worked herself to a standstill academically, went through several placements and wrote a fine dissertation on palliative care.

As a staff nurse she takes personal responsibility for the wellbeing and care of a number of patients which she does brilliantly.

She deserves her degree, is proud of her achievements and is probably, no certainly worth 20 hack journalists.

DavidDP

They'll be insisting Doctors have degrees next.

Oh.

Rhoda Klapp

I've had good nurses, and a few who were not so good. Why is it that when giving an injection or taking blood, every last one of them without fail or exception says ' a sharp scratch'? It isn't a scratch. It's just a little prick. Can't see why they don't say that. Or why their training requires them to have special phrases to say, isn't that just a little micro-managed? You want fries with that?

quadratus

The first proper Matron that I encountered defined Nursing as '..applied common-sense'

Nicholas

"Many of the more "mundane" duties of doctors have been handed to nurses, in order to free their time for other matters."

And many of the more "mundane" duties of nurses, like keeping the patients and hospitals clean, have been handed to minimum wage contract cleaners or are not being done at all. So people die - mainly old people - in filthy hospitals which the lame-brained, narcissistic young idiots who seem to run things now don't much care about.

We don't need more bullshit, soundbites, clipboards and stupid bits of paper, or more public workers full of their own importance and sense of self status, but instead mops and carbolic and disinfectant and a bit of honest hard work.

"Nurses". Hmm. let me see. It means to "nurse" patients doesn't it? Making sure they are looked after, kept clean, properly fed, not exposed to filth and contamination? Oh, silly me, of course that was in the "old" days, before all the "progressive improvements" bullshit we have been relentlessly fed for 40 years. Let's not look back (we might like what we see too much) - let's look forward, blindly, re-invent the bloody wheel again and make up some more catchy, trendy soundbites to show how much we care.

Chuck Unsworth

@ Carl Gardner

Nice to see a proper appreciation of correct terminology - and the fine points of the English language. Well done.

David Ossitt

On this subject Melanie Phillips ended with:-

“Truly, under the mind-bending camouflage of ‘progressive ‘ideology Britain is going backwards into a pre-modern, unenlightened, crueller age”

On radio 4 this morning John Humphrys; posed questions to The Chief Nursing Officer Christine Beasley and Head of Nursing at UNISON Gail Addams.

The waffle and doublespeak that he uncovered in his interview was truly horrific.

It became obvious that in the future the nursing as in, “The work of caring for the sick or injured or infirm usually under the supervision of a physician” will be done by support staff.

I suggest that we welcome these changes; and that we recruit these support staff from that body of young men and women who do not have an academic degree, who see the care of the weak the sick and the needy as a high and extremely worthy calling.

I also suggest that these support staff be trained to the standard and in the same way as those we used to call SRN and that we call these support staff “Health Carers”.

In no time at all these “Health Carers” will be loved and respected for the care and comfort that they will bring back to that most important of jobs, nursing the sick.

Paul Hughes

Nicholas, the failures of the private sector cleaners and Health Care Assistants does not mean that the redistribution of medical tasks is not a good thing in principle. Yours is a Daily Mail argument devoid of any real merit.

Paul Hughes

Chuck, since when has "jasksi" constituted either proper terminology or a finer point of any language?

St Bruno

With the introduction of Degrees for nurses will there also be higher degrees MA, PhD.
How nice a nurse with a PhD, could it be Doctor Nurse?
Just think of the debt to start a career in nursing.

Janus

This article is patronising towards students both of nursing and of media studies, about both of which the author is clearly ignorant. I can assure you that even his much-maligned media studies courses demand a 'critical intellect' in excatly the same way as 'fine arts' and literature courses. Now journalism, there's a degree course hardly worth the name, judging by this ill-informed piece of 'work'.

De Rigueur

Anyone know how to get this through to the editor?

Can't remember who said this, no offence intended, but ....

"Fraser based on your consistently excellent journalism and analysis I had high hopes for your stewardship of this publication but if you can't/won't address this core issue then I have to conclude with regret that in my opinion you are simply not the right man for this job."

Spot on. Now let's see if it goes through - eh,

Beer Moth

Paul Hughes

"...multi agency approach to holistic care."

Can't they just cut out all this pratspeak and get down to the business of making people well again?

As the young Frankie might have put it: "You've either got, or you haven't got, piles."

j H Holloway

It's already happening. Feminist theory can be dispersed via the giant and mostly female NHS, they will have jobs for life, guaranteed flexible working and on-site creches (for the majority of future nurses will be single mothers).

They are and will be brainwashed by state feminism but not well educated enough to think the flaws through. The whole point of Harman feminism is to ensure that women can have children without the need for a father (other than for a few essential minutes).

Why do think child care tokens are being pushed and tax credits are paid to the mother, or that flexible working is being made law or a year's maternity is women only? Or that women are becoming the majority at university and that those women who wouldn't have gone to 'uni' will effectively be forced to do so, as here.

The Harman plan is for the vast majority of women to have degrees, preferably in safe public sector jobs, guaranteed flexible working, state-funded child care, long maternity leave and cast-iron control of the children, even in the face of court orders.

harman doesn't hate men. No, she just wants women to have state-funded and state-sponsored autonomy.

j H Holloway

Ah...sorry, I forgot to add that the Harman feminists are also picking their moment to try and push the idea that women should virtually never be jailed, as their crimes are almost always because they are 'victim' - usually of some man's behaviour.

This process was advanced on Wednesday, according to the Daily Mail....

"Men will no longer be able to use a wife’s infidelity as a partial defence for murdering her, following a landmark vote in the House of Lords last night.

Peers backed down over Government moves to abolish the old defence of provocation, which has allowed some murder charges to be downgraded to manslaughter on the grounds of infidelity"

The result is a victory for Harriet Harman who championed the change in the law, saying it would stop men ‘getting away with murder’.
Labour's Baroness Gould of Potternewton, chairman of the umbrella group the Women's National Commission [who?], said it was 'vital' to ban the use of sexual infidelity as a defence.
She said: ‘Without this clause the Bill will allow men who perpetrate violence against women to operate with impunity.’

egh

"And many of the more "mundane" duties of nurses, like keeping the patients and hospitals clean, have been handed to minimum wage contract cleaners or are not being done at all. So people die - mainly old people - in filthy hospitals which the lame-brained, narcissistic young idiots who seem to run things now don't much care about."

Yes, Nicholas: it's horrifying. Basically I say: 'Bring Back Matron.' However, back then the hospitals treated those nurses rather badly ... physically exacting work, long hours, low pay. And a lot of insults outside the profession - from the usual posturers and nose holders. I think those were things that needed to change.

My recent hospital stay in the US revealed some problems there too. Yes, the hospital was clean - except I wasn't sure about that the bathroom garbage had been emptied before I got there. But especially yes, the pre-med and theatre staff were fantastic - truly wonderful and confidence inspiring. So were the Physical and Respiratory therapists.

But the ward nurses? Tied to their computers on wheels, which some clearly couldn't interpret too well. Cardiac monitoring equipment u/s. Ignoring the I/V alarm ... it went on for hours. Rude remarks about the patient, within earshot. Treating for diabetes, when the patient had none.
Just one really good staff nurse was outstanding in contrast to all the others; and I don't think she was from the US.

So yes: We don't need more bullshit, soundbites, clipboards and stupid bits of paper, or more public workers full of their own importance and sense of self status, but instead mops and carbolic and disinfectant and a bit of honest hard work.

EC

The Student Loan Company must be rubbing their hands today. Trebles all round!

HJ

EC - Tuition fees for nursing 'degrees' are paid for by the NHS (and nurses do not have to pay them back).

The only difference between diploma nurses and 'degree' nurses in this respect is that diploma nurses are automatically paid a bursary during training, whereas for degree nurses it is means tested.

Nurses get an incredibly good deal unlike most other students.

Nicholas

Paul Hughes - you lost it with the Daily Mail ad hominem attack.

It is not so much that my argument lacks merit (and actually it was not so much an argument as a comment) as that you don't like it for the personal and subjective reasons revealed in your previous posts. The fact that your wife happens to work in this profession gives you no special or superior insight to comment (although you clearly think it does). In fact that proposition is infuriatingly common in this age where opinion regularly triumphs over knowledge. I write as one with first hand knowledge of hospitals ancient and modern, from the patient perspective - does that give me an opinion that is that less valid than the basis for your opinion?

The Daily Mail accusation is useful lefty code (and if you are not a lefty you should be ashamed of yourself for using it) to immediately discredit any dissenting views, e.g. they are not rational and therefore not worthy of consideration. This is rich coming from a political ideology that has demonstrated the stark raving bonkers in most of its policies fairly consistently for 40 years.

So Paul Hughes, to pinch another hackneyed lefty phrase, I will take no lectures from you about the Daily Mail (and I am not a reader). The breadth and scope of empirical evidence suggests that the "Daily Mail Melanie Phillips" perception of nursing is grounded in fact whilst yours is narrowly focussed on what you glean from your wife. A single, individual, specific and subjective perception against many, diverse, general and objective perceptions from across the country.

Redistribution of medical tasks - really! That sort of vile management speak resonates with the mindset where the management and process of change or "progress" becomes more important than the management of the outcomes. Says who? The experts earning thousands from peddling the idea.

But let's take it further. Even if we accept your proposition that the quality of performance of cleaning contractors and healthcare assistants is irrelevant to considerations of nursing status, how do ethical nurses endure evident incompetence, squalor and life-threatening filth in (some) hospitals? How do they equate their lofty but nevertheless physical proximity with aged or infirm patients lying in their own filth or with untaken nourishment beside them? Do they turn a blind eye because it is not within their remit to correct or comment upon? Because it "someone else's responsibility"? Something is clearly wrong with their moral code if they do. Or is it, as with most things in this blighted country, a combination of lousy supervision, zero accountability and staggering levels of dumb, insolent apathy?

Fergus Pickering

I don't think so, EC. Firstly most (all) nurses do a degree course already. Secondly their fees are paid. I think all it could mean is one year extra. Think of it as training (which is what it is mostly) and not academia. Most egrees, as I said earlier, have nothing to do with what used to be thought of as academic training. Most? Well, a lot.

Chloe

David Blackburn: “I can’t comment on whether ultra-feminists are responsible for this change because I haven’t a clue who these savage-sounding Amazons are.”

Oh, really? Perhaps you’ve never read The Guardian then.

In fact, you’re not doing a very good job of joining the dots at all, are you?

Remember Major Hasan? Or are you hoping we’ve forgotten that post?

There seems to be a great deal of frustration on your part that the readers have seen through you from the minute you walked through the door and now you’re going through the rite of passage that so many Spectator writers go through (Rod Liddle, Alex Massie, Clive Davis etc) and jealously lashing out at Melanie Phillips.

You’ve become a sort of Peter Oborne-lite.

Better keep in with all the editors in media land because the public can see through all this. Is your wilful ignorance part of a ploy to get some freelance work with Channel 4 (like O’bore)?

Still, what’s one more attack on Mel? She’s become the Spectator’s in-house Aslan, attacked on all sides and yet still she grows stronger.

As they probably don’t say at The Spectator’s editorial meetings: “Go Mel!”

HJ

Fergus Pickering,

In fact, only about a quarter of nurses currently take degree courses. A key reason why more take diplomas is that they are paid a bursary automatically, whereas for degree courses it is means tested.

The diploma and the degree course both take 3 years.

Promise of Avalon

One wonders whether the conservatives will reverse this decision. We have, unfortunately, got to a stage where political decisions are no longer made on what is best for the country, or what is supported by the most people, but what will play well in the media or avoid confrontation and appearing 'nasty.'

Publius

Some good analysis of what's going on from Theodore Dalrymple:

http://www.telegraph.co.uk/education/universityeducation/6558948/Sorry-Florence.-No-degree-no-job.html

David Blackburn

Paul Hughes,

What a fascinating post, and I would like to make it clear that I'm in awe of the nursing profession. I take it your wife specialised without taking an undergraduate nursing degree? If so, that vindicates my point.

Fergus Pickering

I stand corrected, HJ. What's the difference between a degree and a diploma then. II mean all the differences. What advantahes are there to the nurse in having a degree? More money?

Naomi Muse

This all looks a bit like Golgafrincham of Hitchhikers Guide fame where the marketing men were working out what colour they wanted the wheel to be rather than working out what it was for.

A physio known to me for 30 years has an observation that nurses used to nurse better before any of them had degrees and that the split between SRN and SEN was where the divide in the roles was. She says that since they all got so qualified and can all write good patient recovery plans, there is a gap in the work needed which is not dealt with, that amounts to simple care. General nursing is not done by all and patients suffer for that omission.

Martin

A degree in nursing is no less meaningless than a degree in surfing (or other similar aberrations that have cropped up over the last few years). Their introduction is clearly part of an agenda whose objective is to devalue previous achievements by 'degree inflation'. This sort of 'engineering' was also attempted by the 'socialist governments' (the extreme cases being Mao's China and Pol-Pot's Cambodia. They will fail, eventually.