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Avoid the UK

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fantastic point Phil,

I am a NUM in Australia and within my hospital I am an anomaly because in the acute setting our executive director of nursing does not belief that there is a place for the EEN. I disagreed, and rebelled as I report to my DON ops not the EDON (strange management structure, I refer to her as the queen, a nice, older lady that meets other important people from around the country and internationally but we are not sure what she does...). I handpicked 3 EENs for my new ward that I opened 18 months ago. Those 3 EENs had all been working in sub-acute services such as geriatric rehab, 1:1 nurse specailling and the like.

They have an amazing set of skills - 1 is doing her RN conversion and is able to apply to practice what she is studying, another spent 10 years mostly specialling and has the ability to de-escalate the most agitated of patients and the other previously worked in transitional care so has a skill set with nutty families. Yet of my 4 graduate RNs on their rotation with me, 1 worked as a HCA in aged care and cannot seem to shift from tasks to critical thinking, another loses time all over the place (doing a work follow with her was painful), the third is actually quite good and the last one cannot cope with blood...bit of an issue on a liver / GI ward :)

While there is absolutely a place for academia - I am studying for a management masters currently, I have one nurse who is studying a masters of clinical nursing who I have put into a role as a chronic liver CNS part time and is creating some amazing stuff. I have other nurses with post grads and masters that are quite happy on the floor as they don't want to go to the "dark side" of management or away from the bedside.

The lack of critical thinking is my concern, one of the unis that we have students from has them following protocols & logarithms for everything, one 3rd year student from that uni couldn't work out how to get a glass of water into a patient who wasn't drinking..mind you same student lied to my face about something else...

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This is so true, and I couldn't agree more. It is all a farce. I had issues getting registered with the NMC and when I appealed to the Department of Health, they said it was none of their business and washed their hands off it. Meanwhile, Jackie Smith, the head of the NMC, said I wasn't safe to practice even though I have a BSN from the USA and I passed the NCLEX-RN and had excellent references and above average GPA in nursing school.

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Phil, I'm sorry but I do not consider it 'unjustified and needless to academicise British nursing'.Do you really think that nursing is just mopping fevered brows and giving out bedpans? Surely it is better that nurses know why they are doing what they do, have in-depth knowledge of pharmacology/anatomy/physiology etc. Would you want other staff, eg. physio's, paramedics, doctors, etc to have some sort of low level apprenticeship type training - I think not. Nursing has changed a lot since I started training in 1971 and it has changed for the better.

If nursing wants to be recognised as a profession in its own right then the training must be degree level and higher.

I'm pretty sure I learnt all of those things in my Diploma, the idea that a degree nurse has the monopoly on those is deeply insulting. Having mentored these degree nurses there is zero difference in their knowledge or skills than when I did mine, absolutely none.

The OP is quite correct in a lot of things, excluding safety, the UK is no less safe than anywhere. You certainly will be safer sending your kids to school without the threat of some nutter going off.

I would also argue that we're not autonomous practitioners in our own way, try working in Australia.

The NMC is mostly incompetent.

The OSCE process is appalling.

Pay is low.

Staffing levels plummet.

Patient levels rise.

Funding continues to be inadequate.

Don't make this your first choice US nurses.

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It was unjustified and unnecessary because... and this is not rocket science... those nurses who wanted to pursue an academic path already had access to further development.

There were already existing degree paths in nursing science. Most Trusts already offerred financial support and study leave for their staff.

The UKCC - as it was then - were 'addressing a problem' which didn't actually exist.

The drive to academicize British nursing took one entirely valid career option... and tried to make it the norm for the career development of all RN's.

In doing so, they managed to eradicate the State Enrolled Nurse discipline entirely - something that should have been entirely beyond their remit to decide.

It's not just my opinion that this was a retrograde step:

The re-introduction of non-RN para-nursing disciplines shows that the genuine, real-world need for clinically trained but sub-degree nursing staff still exists.

I thought it was horrifyingly obvious right from the get-go that the workplace gap left by the needless discontinuation of SE-nursing would have to be filled.

(Maybe I'm psychic...?)

Of course, the concern remains that AP's, ODA's etc are unregistered.

And the NMC stands ready to address that by floating ideas for registration of para-nursing staff!

At which point, the wheel will have turned full circle, and we will start looking elsewhere for new ways to flush the NHS budget down the macerator.

"Mopping fevered brows and giving out bedpans"? Really? Cheap shot, Madeline. ;)

But let's turn it around: Do you really think all nurses need to be able to identify in which respects their clinical area satisfies Kolb's defined paradigm of the 'Behaviourally Complex Learning Environment'?

Yeah. That's going to heal a whole lot of venous ulcers.

But make no mistake - I was, and remain, firmly in favour of genuine advancement of Nursing as a profession.

In my opinion, however, academia was absolutely NOT the way to go.

I think the profession, and our patients, would have been much better served by a drive to advance clinical skills.

I'm happier working with nurses who may not be able to define levels of abstraction in interactions between concepts - but who are not baffled when confronted with a vacuum-dressing set-up.

Less nursing theorists - more nurse prescribers!

Thing is, though... clinical skills are hard.

Hard to perform effectively, requiring regular practice to stay effective, taught and evaluated by highly skilled and experienced practitioners, and with actual, serious clinical repercussions when they go wrong.

Who wants that, right?

I mean, sure 'nursing wants to be taken seriously as a profession', but only insofar as we can achieve it by going and sitting in a classroom.

The thing is that this change actually created the TNA role, an even less academic role that will replace the role of a lot of nurses on wards in the future. The short-sightedness of seeing academic study as a means to validate the profession has led to the dilution of the profession, so these nurses who didn't want to or couldn't go down the academic would have spent 3 years doing a diploma are now doing 2 years to be a TNA instead.

The future structure of the ward is likely to be a band 5 ward nurse in charge with multiple TNAs and HCAs, so making things more academic has had the complete opposite effect to what was supposed to happen. So I categorically disagree with pretty much everything Madeleine said.

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I 1000000000% agree with this post!!

I am a Canadian trained nurse who moved here to the UK two years ago. I did obtain nursing registration here but it was not without (many, MANY) problems. I have yet to practise as I gave birth to my son, however my husband and close friend work for the NHS so I am now quite familiar with nursing here (going for an interview this week, though not overly excited about it!)

Thank you for putting this information out there so eloquently.

Top statements that I completely agree with:

- NMC is awful for too many reasons to list

- Nurses are underpaid (essentially minimum wage which I find incredibly disturbing and disrespectful)

- Nursing is not a respected profession here

For these reasons alone, avoid the UK!

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I 1000000000% agree with this post!!

I am a Canadian trained nurse who moved here to the UK two years ago. I did obtain nursing registration here but it was not without (many, MANY) problems. I have yet to practise as I gave birth to my son, however my husband and close friend work for the NHS so I am now quite familiar with nursing here (going for an interview this week, though not overly excited about it!)

Thank you for putting this information out there so eloquently.

Top statements that I completely agree with:

- NMC is awful for too many reasons to list

- Nurses are underpaid (essentially minimum wage which I find incredibly disturbing and disrespectful)

- Nursing is not a respected profession here

For these reasons alone, avoid the UK!

NMC are awful :- Can't comment as I have had nothing to do with them other than give money every year. I understand that if you are foreign trained then you can have problems.

Nurses underpaid :- Absolutely, BUT, please don't tell lies. A simple 30 second google tells you that minimum wage is £7.83, bottom of band 1 is £7:89 and as staff nurses START on band 5 that makes it £11:32 (In Scotland; £8:47 band 1, £11:48 band 5).

Nursing not respected :- Don't know where you are but I have never found this to be true. Politicians don't respect us but the public do.

If you have yet to practice in the UK as a nurse you really can't comment that you are "familiar with nursing." You are going by hearsay and second hand evidence. I am assuming that you gave birth in an NHS hospital? How did that compare? How much were you asked to pay?

If you are going for an interview that "you are not overly excited about" I would advise you to cancel. This type of attitude comes over in interviews - I know, I have experienced it from the interviewers side.

To Phil, Osceteacher and Madeline, I was an Enrolled Nurse. It was the only way I could get into nursing, my qualifications were engineering based.

The training was extremely rugged and I learned about anatomy and physiology exactly the same as the RGN students. I learned about the disease process and why we did what we did. I was not trained for ward management.

THAT was the difference between EN and RGN training. Plus, it meant I was paid enough to look after my wife and 2 children.

At that time (1980's) there were degree courses available if you wanted to do that - they were treated the same as all university courses; students were given a grant BUT had to work on the wards during holiday times when they were paid as nursing students. These students were looked upon as the 'future nursing management'.

Once qualified I could, and occasionally did, take charge of a ward if I was the most senior person on duty, I did ward rounds and drug rounds. I was treated and expected to be part of the team.

The Enrolled Nurse was a bedside nurse who knew HOW to do things with less emphasis on WHY things were done.

Edited to add;

Having nurses with degrees did not (and has not) made us better nurses. It should make us better professionals although I see little evidence of this.

I met a nurse last year who informed me that she had 3 masters degrees but got a bit ticked off when I reminded her that everything she did had to signed off by a doctor. (She was in the community)

My simple BN allowed me to autonomously see, treat and discharge patients without recourse to a doctor as that was my role. So I'm not sure 1) what her 3 masters were in and 2) why she bothered to do them.

Edited by GrumpyRN
To add;

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