So you need a degree to be a nurse now? I thought it was all about bedside manner ...

Nursing has changed since the Carry on stereotypes. It is possible to take a diploma or degree course to qualify as a nurse, but a degree will become the minimum requirement from 2013. It is expected that in future, more nurses will be working in community settings, promoting public health, and treating people outside hospital. The Department of Health expects graduates “to be able to deal more readily with increasingly complex care in an increasingly challenging health and social care system”.

So what tasks do nurses perform now?

More than you’d imagine. They include roles that previously would only have been done by surgeons or doctors, such as prescribing medication or leading teams of specialist medical staff.

What does training involve?

Education is provided by universities, with placements in local hospital and community settings. The course is half-and-half theory and practical, the detail of curriculums varying. The first year introduces basic principles of nursing. Students then specialise in adult, children’s, mental health or learning disability services. Full-time diploma courses last three years. Degree courses last three or four.

Won’t the new graduates just be “too posh to wash” or “too clever to care”?

The Department of Health hopes not. Already, nearly a third of nurses are graduates . “All new nursing graduates must have the knowledge, skills and attitudes to nurse with care and compassion,” the department says. Some of the basics may now be done by healthcare assistants — who only require a NVQ or similar qualification to start work. Medical leaders have expressed concern over the lack of regulation for this role. “It is for local employers to decide what skill mix they need to deliver their services,” health officials say.

Does this mean that nurses with a diploma are not suitably qualified?

No. Their education and registration are not in question. Throughout their career, all nurses have to demonstrate continued professional development and keep their skills up to date. Nurses will also continue to enter the NHS at Band 5 on the pay scale.

How much do they get paid?

An average starting salary of £24,000, although this can rise to up to £75,000 for a senior nurse (band 7). In present circumstances, unions have been pretty content with a three-year deal that secured pay rises of 2 per cent a year, but they are concerned that nursing is failing to attract school-leavers. The average age of a nursing student is now 28. About 40 per cent have previously worked in another profession.

Who’s in charge? What happened to the all-powerful ward sister?

There are now five “bands” of nurses operating above the humble healthcare assistant on hospital wards: staff nurses, senior staff nurses, junior sisters, sisters and senior sisters.

There are also positions that exist above the ward, such as the clinical nurse manager — reponsible for overseeing more than one ward, and the “modern matron”, who is in charge of all nursing within a department.

Modern matrons — the post was created to reassure patients that the vocation is maintaining its traditions — have received a lukewarm response from frontline staff.

Alongside district nurses there are also nurse consultants, community matrons and case managers.

Will there be enough graduates?

Although the proportion of nurses with a degree is increasing, about 35 per cent of applicants this year had a diploma-level qualification. The department insists that it will not cost more to train nurses to degree level, and intends to promote nursing “as a worthwhile and privileged career”.

Are nurses happy with their jobs at the moment?

Not entirely. Evidence from the Royal College of Nursing suggests that nurses are “ under undue pressure” to meet government targets, such as the four-hour maximum wait in A&E.

The RCN is also concerned that nurses are being pressured into manipulating data and falsifying information about targets. It is encouraging members who suspect that targets are being manipulated or that box-ticking has more priority than patients to call a “whistleblowing” hotline.

Sources: RCN, Times Database

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