It seems many years ago that I stood up and told a meeting of nurse lecturers that they would eventually price their product out of the market.

They were keen to make nursing an ‘all degree profession’, a phrase that was continuously repeated in the meeting. They had planned their move to universities, away from their (hospital associated) nurse training schools.

Larger salaries and brighter lights awaited.

Some, I believed, genuinely thought it a good thing to go the degree route, wanting to make nursing a ‘profession’, not just a job, rather like doctors, who were ‘professionals’.

Only one person made a case that this proposal would benefit patients.

The problem now facing the recruitment and retention of nurses is one of economics.

It simply costs too much.

Half the NHS budget is spent on staff costs. The government have obviously targeted this area for trimming. They have made up their mind. The die is cast. The tide can not be turned back.

The decision to scrap nurse bursaries and introduce tuition fees follows this economic rationale. Whether you agree with it or not is irrelevant, because nurses do not have the power to dissuade.

Nurses, midwives, occupational therapists, and radiographers can march around Westminster every day until the Four Horsemen appear. Government ministers are not exactly experiencing night sweats of panic. They are not one iota bothered about the vested interests (called unions) supporting (very limited) action against tuition fees.

Yes, there will be a drastic decrease in applicants for nurse training. The government do not see this as a bad thing for patients, as many unsuitably qualified (in compassion) apply for nurse training only because it is a freebie.

Many have no intention of making nursing a long term career. Those that do are forced out of nursing after five years or so, because economics dictate short staffing and overworked staff. Flog a horse too much and it is only good for the knackers’ yard.

We train enough nurses.

We do not provide them with safe working environments, then punish them for making minor mistakes within these hostile environments, when it is those that create them that deserve punishment.

The government’s rationale necessarilly leads to questions about what is ‘nursing’. Can it be broken down to areas of speciality, in which people can be trained at lesser cost than the current three year degree course.

It is a no brainer. 18 month diploma courses. 40% reduction in labour costs.

Save your shoe leather.

Alea iacta est.

Only the finer details have to be decided, such as whether training goes back to (hospital based) nurse training schools. The vibes from Hospital Trust managers suggests that they would favour producing the product they want at a low price. Which is to say, they naturally reflect the views of their political masters.

And what will be sold to Joe-Public will be: “it’s better to have ‘specialists’; “wouldn’t you want this for your mum and dad, your sick child”?

It’s immaterial whether you disagree with the meaning of what they will term a ‘specialist’.

March all you want, if it helps let off steam, but above all else be realistic.

They only read their own research.

Nursing does not exist in a vacuum. It is shaped by the forces of what your rulers call ‘economics’, the notion that money, as digits within computers, is in short supply; as if anything electronically created can not also be increased, or so called debts not eradicated at the click of a mouse.

Nursing is part of this Dream World.

Nurse training is going the budget route.

The real question is, will this necessarily lead to worse patient care? It is this question that nursing has to face up too, honestly so, cutting out all self preservation crap that has littered decades of debate about what a nurse is or is not.

lenin nightingale 2015


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