Check out today’s YEP letters.
Nursing plans: ‘don’t just open the floodgates’
Michael Lowry, PhD RGN Lecturer in Nursing, Leeds
The National Health Service employs more nurses than any other group of workers and competes for this scarce resource with private healthcare and jobs overseas.
The current training of nurses offers students a bursary and free fees for their three year degree. Whilst this appears highly attractive on first glance especially when compared to alternative degrees, there is a dangerous downside in that some applicants are less attracted to being nurses than with the opportunity to get a free degree.
The result is that some of those qualifying will have limited commitment to nursing as a career and arguably make poor quality nurses, whilst others won’t even bother to work as nurses but will move onto something else. The remaining majority who qualify are likely to be successful in their careers and for them the future is good in terms of job opportunities, options for choosing where and when to work, and several specialist roles when more experienced.
In order to prepare these nurses, there needs to be a suitable educational environment with expert lecturers to provide skills and theory, and enough clinical placements to support their learning whilst engaged in practice.
Current demands on clinical placements are significant, made worse with a shortfall in numbers of qualified nurses to act as good quality mentors to students. Add to this declining funds available to ensure support staff are in clinical placement so that students may be truly supernumerary and you have a cocktail for inefficiency in training and concomitant effects on morale and patient care.
The government has decided that we need to train more people to become nurses, and has decided to remove the financial bursary upon which so many have relied. The notion of increasing numbers is laudable, however without the plentiful availability of clinical practice placements and qualified and experienced mentors, the proposal will stall. In addition, the prospect of having to immerse in what is potentially around £30k of debt before entering the nursing workforce, will dissuade some able candidates from applying for places on pre-registration courses. Therefore the projected increases are unlikely to work out as proposed. Historically nurses did not receive a bursary nor as a rule did they engage on academic nursing training.
Instead, to become a registered nurse required the student to be counted within a ward or other clinical area’s workforce numbers and they received a stipend which they did not have to repay at the end of training.
This has at least two benefits: first that the health service had a ready supply of regular attendees who could practice according to their level of skill and place on the training continuum.
Second, the numbers of health care support staff were less crucial, as more students were in each clinical area, thus delivering care whilst learning.
By the time that training was complete, these nurses had significant clinical experience, backed up by modular theoretical study which was tailored to the stage of training and types of placement. Another factor to be considered is the relative immaturity of most nursing applicants. It would be worth considering asking candidates to demonstrate insight into their chosen career by first having a period of direct experience as a Health Care Assistant prior to applying for a place to study. This will bolster numbers of interested workers, and stabilise both the workforce and its future professionals.
If the chancellor really wants to increase the nursing workforce, then he needs first to take advice from those who have direct relevant experience of training nurses, not just to open the floodgates and hope for the best.
Second class bus service
Nick Palin, Garforth
Whilst I am not a frequent user of buses I am a regular user.
It is my perception that bus services in West Yorkshire are becoming increasingly unreliable. Recently there have been a number of buses I have attempted to catch that have simply not turned up. Not a major inconvenience if your service runs at least every 10 mins if not more frequently; more so if your bus only operates every 20-30 minutes.
Whilst much of the blame for this maybe down to the bus companies themselves the role of the West Yorkshire Combined Authority cannot escape criticism.
The so called realtime bus departures suffer from buses which simply disappear off the screen without turning up. Some of these monitors are so old and decrepit they would not look out of place as a museum piece!
In addition there are a number of so-called disruptions still shown on their website which are cleared. Talking of disruption, when there was a recent fire on Kirkgate by necessity buses were diverted.
Unbelievably, some buses from east of Leeds did not stop until the railway station; why on earth were a few car parking bays not closed off outside Leeds Minister to provide a temporary bus stop?
And then we come to the Leeds-Bradford cycleway. Whilst I have no objection to the principle of a cycleway per se, it is difficult to anticipate that it will be used to the extent as to justify its cost.
However, what cannot be justified is the disruption caused to bus users by extensive lane closures delaying services, which, of course, impacts on other road users but more significantly, the fact that it must be nine months since most of the bus shelters on York Road disappeared to facilitate its construction (and presumably on the Leeds-Bradford Road).
So since then prospective bus passengers have had to stand out in all weathers getting soaked waiting for the bus, even though at many bus stops construction has yet to commence.
This fact must be a major deterrent to bus use, particularly when there is a viable alternative. Just imagine the outcry if all the shelters were removed for months on end at one of our local railway stations!
Whilst I appreciate there are some positive initiatives from the bus companies and the authority, I cannot help but feel that our bus service in West Yorkshire is becoming a second class service for what are perceived as second class citizens.