NHS Apprenticeships

cs2019 · May 13, 2019

Id be interested in learning more about what you find out as you move foreword with your research. Thank you

Leedeedee · May 15, 2019

Unfortunately it doesn't look like I'll get a direct response to this from either NMC or NHS England. There is guidance for Nursing Associates trained outside the EU though, so they are considering foreign qualifications to see if they're similar to Nursing Associate standards. Unfortunately I think it'll take someone having their LPN/Enrolled nurse qualifications evaluated to find out if it works. It looks like there's the dreaded OSCE to contend with too. I will keep trying to get an direct answer though. https://www.nmc.org.uk/registration/joining-the-register/register-nursing-associate/outside-eu-eea/eligibility-and-qualification-evaluation/

osceteacher · May 23, 2019

If it looks like a duck and quacks like a duck its probably a duck. The NA role IS the enrolled Nurses, its a desperate ploy to prevent understaffing because they realised they messed up with the lack of bursary and the removal of diplomas. Those in certain brackets (Ages, qualifcations and financial mostly) were excluded immediately from nursing and so all these competent excellent HCas who wanted to progress now had nowhere to go.

So the answer was to go back to a failed 1980s idea of enrolled nurses so they can inflate 'nursing staff' numbers with NAs.

I have nothing but respect for Enrolled nurses and NA's to do the job they're given, but its entirely unfair to make these competent staff be paid less for the same work (excluding some skills like IV drugs) all so the government can pretend like they didn't balls up.

GrumpyRN, NP · May 24, 2019

23 hours ago, osceteacher said:
If it looks like a duck and quacks like a duck its probably a duck. The NA role IS the enrolled Nurses, its a desperate ploy to prevent understaffing because they realised they messed up with the lack of bursary and the removal of diplomas. Those in certain brackets (Ages, qualifcations and financial mostly) were excluded immediately from nursing and so all these competent excellent HCas who wanted to progress now had nowhere to go.
So the answer was to go back to a failed 1980s idea of enrolled nurses so they can inflate 'nursing staff' numbers with NAs.
I have nothing but respect for Enrolled nurses and NA's to do the job they're given, but its entirely unfair to make these competent staff be paid less for the same work (excluding some skills like IV drugs) all so the government can pretend like they didn't balls up.

I'm not too sure it was a failed idea. I was an Enrolled nurse in the 1980's and it enabled me to get into nursing as I had qualifications from industry but not from school (I had 'O' levels but no highers). Once in nursing I was then able to bridge to RGN. (This backs up your point in the first paragraph). However, back to the point. Enrolled nurses were the hands on nurse. I did drugs, ward rounds, took charge of the ward. Everything a staff nurse did, I did. Was once even told by a senior charge nurse, when I was a staff nurse, that when I was working with a particular Enrolled nurse that SHE was in charge not me. Had to point out that that was neither hospital nor NMC policy. Even then I was told that because she had more experience than me, she was in charge.

The Enrolled nurses in my trust are classed as "registered nurses" and are paid accordingly as Band 5's. (I personally disagree with this, they should be band 4). Was a patient in a ward and the Band 5 Enrolled nurse who was on over night had to call for a Band 5 Staff nurse to come and give IV drugs. I once had an online discussion with an Enrolled nurse who was a Band 6 or 7 and wanted to know if she should stay where she was or go back and bridge.

So to sum up, I think there is a place for the Enrolled nurse as long as they are labelled as such and work to the role. They should be a band 4 and have their scope of practice limited accordingly. There should be ample opportunity for them to "bridge" to RN. A lot of people like myself leave school with only a few qualifications but once they are older they realise what they want to do and this is one way of allowing people who are older into nursing with less financial worry. We should also treat nursing students as employees the way I was but that is a whole different discussion.

Sorry this is a bit rambling but I hope you see what I mean and what my point is.

Fiona59 · May 26, 2019

Grumpy, I'm an LPN (Canadian version of an Enrolled Nurse).

On the unit I work, the difference between myself and the RN is minimal (well, financially, we differ by $15/hr). I cannot be Charge (thank god), or hang blood (which is a moot point because blood requires a two nurse hang (so I identify my patient, the RN cosigns that we have done the checks, hangs the bag and walks away, leaving me to monitor the transfusion)

Currently, the education for a PN is the old diploma RN course with a few extra university credits thrown in. The RN designation can only be earned by completing a four year degree. The seats in both programmes are limited and both are hard to get into and yes, both sets of students leave with large student loans.

I work with a lot of nurses who went through college and got the two year RN diploma (it ended in 2009) or were trained in hospital programmes.

It's truly disheartening to the LPNs. We are trained to a very high level, we insert IVs, push drugs through IVs and hang medications. We are belittled by fresh new grad RNs from the local universities (we in their eyes have no real knowledge and are just practising skills).

I'm old enough to remember when the degrees were relatively new. The plan was for degree educated RNs to be managers, leaving the bedside role to the diploma RNs and care to the LPNs.

In the two decades I've been working, my skill set had doubled and continues to increase each year. The problem basically is in my province the union who bargains for RNs have simply priced them out of work. A top tier RN makes just under $50 before shift premiums. A top tier LPN makes just under $35. With limited healthcare dollars, you can see what this mean.

osceteacher · Jun 3, 2019

As I said, I have no intention of belittling or disparaging enrolled nurses or the new NA's. I feel these guys are competent and capable enough to be band 5 registered nurses.

The failed idea I talked about was paying people less money to do the same job, not that enrolled nurses were failures. Right now NA's do a nurses job except for IVs and that constitutes being a whole band down? I do not buy that at all.

Calling a registered nurse to do IVs? I had to do that as an agency nurse because the trust wouldn't let me do them until I'd done a course with them. These limitations are arbitrary and are set for no apparent reason, I don't agree with them and NA's should be allowed to administer them. The NA's did more classes on medicine than I ever did.

Bri1231, BSN, RN · Jun 8, 2019

The NA role....aaaaaah. When I first came back to the UK after nursing in the US I could not believe the country did not have second level nurses anymore. I really could not. Here I am seventeen years later and what I said would return would return, and they just have a different title. Enrolled nurses are back. Much to the dismay of a lot of band 5 nurses who, the ones that never worked with the ENs before where so against the idea. I openly advocated for it.

These band 4 'nurses' will most probably be the best of the registered nursing professions crop!

Basically every other country in the world have always had them.

Four year apprentices for aspiring RNs. Good! It never should have been moved to a university only training system. There are other ways to strenghten the profession, this was one of the big reasons for moving it to university. The best nurses I have ever worked with are those who trained in the old style training system. I have seen the difference because I have worked alongside both and nursing got progressively worse post 2012 degree only. It attracted the worst of the worst the I do not really want to be a nurse but I will get a degree type and a few people actually said that is why they did it. And whilst they are academically smart nurses, they are super bad 'nurses' !

I hope the NMC does allow LPNs LVNs division two nurses etc to come and work here.......there is always a place for you in nursing and I openly advocate for back to hospital based training again.

osceteacher · Jun 10, 2019

Aye, I am definitely happy the role exists now, I am not sure sure about the 'best of the crop' thing.

Personally I think they should have kept the Diploma but I'd rather see these guys paid a band 5, but maybe restrict the band 6 role for the RN's?

Bri1231, BSN, RN · Jun 10, 2019

I just think it all went a little big wrong post degree. I for sure have always found most of the time that old school nurses whether is be diploma or certificate made much better nurses.

Should they be paid band 5? No. In line with all other countries in the world that have level two nurses I think they should remain at band 4 and be permitted to progress to band 5 via a bridging course if they choose too. I always believe that nursing should be provided like this.

A Nursing Assistant

A Nursing associate/Licensed practical nurse/division two nurse whatever the title

A Registered Nurse

Because some people are happy being NAs some a RNA and some RNs and there is a place for all of them.

osceteacher · Jun 10, 2019

So the qualifier for band 5 payment is IV administration then?

Seems an odd metric to me, having been part of the initial training program for this role I fail to see what else they don't do that a band 5 does.

Bri1231, BSN, RN · Jun 10, 2019

I think for the answer to this you must look at the US Canada and Australia. All places where this role has been firmly lamented in their nursing system for decades.