[Incidentally, the placard I am holding in the photo is not the one I eventually marched with, as whilst I agree with the placard sentiments entirely and am horrified at the damage that the UK government is doing to the NHS in England and Wales in particular, the combination of the size of the placard and the wind on the day meant that I was worried about bopping my fellow marchers on the head!]
It also reminded me of a rant I had before the UK election last year after reading an article in the Nursing Times on one of David Cameron’s campaign trail pronouncements about nurse training. This pronouncement came hot on the heels of another one about Tory proposed changes to access to teacher training (this is a press release from university think-tank million+ about it) where Cameron had stated that graduates from ‘elite’ universities would take precedence over those from more ‘lowly’ universities in entering the teaching profession, implying that in the field of education, academic elitism was to be favoured over the more practical and vocational. In contrast, for nursing Cameron was saying that academic elitism was a bad thing and the more practical and vocational was to be favoured. This is the substance of my previous rant:
Now, I have a number of problems with this. A disclaimer here: I realise that I am on the more academic side of things, and I responded well to much of the academic side of nurse training, whereas many absolutely brilliant nurses aren’t so into the academic side of things but are still fantastic at what they do and shouldn’t be discriminated against by a lack of academic aptitude (having said that I do think that a GCSE/O’level C grade in maths is essential for pretty obvious reasons – I don’t want any doses of drugs being calculated by people who can’t multiply or divide – but I digress).
My concerns are severalfold. Cameron’s statement that there was “too much over-academicised training and not enough hands on training, not relevant to what they were doing on the ward” is far too simplistic. The issue of academic versus hands-on has been going on for ages, certainly while I was training in the mid-1990s it was a huge issue with “old hands” moaning that newly-qualified nurses didn’t have the practical skills to do the job whilst many nurses really appreciated the chance to expand their knowledge and – and this is the important bit – apply it to how they practised nursing. What really bothers me about this statement though is in many ways much more basic. Firstly, I and many many hundreds of other nurses haven’t worked on a ward for years. What is relevant to ward nurses is much less relevant to community and general practice nurses, who work in different ways and often are looking at health, illness and wellbeing in a totally different light (complementary I might add to the hospital system, not in opposition to it).
My biggest concern is that, when I look back at my nurse training, the biggest discovery for me and the thing that really sparked my interest in working in communities, looking at health inequalities and trying to work towards improving health at a community as well as individual level was sociology – in particular looking at the Black Report of 1980 which showed how social class affected health outcomes (the report was commissioned by the Labour government of the 1970s but published in August 1980, just after the Conservative government of Mrs Thatcher took power. It was published on a Bank Holiday with only a few hundred copies, and was basically hushed up, as the findings were so compelling that inequalities in health were inextricably linked to social class inequalities). And this is, I think, precisely the sort of “academic training” that Cameron has in mind when he talks about over-academic training. He’s not going to slash lecturing posts in anatomy and physiology, it’s the more political stuff he wants to get rid of, like sociology. It’s all very well having nurses with amazing practical hands-on skills – indeed it is vital, of course it is. But if we have a generation of nurses who are only trained to do practical things with individual patients, what is lost is the focus on inequality and injustice. I just think it would be awfully convenient for the Tories to have a nursing profession that is so focussed on being professionally and practically brilliant at what they do that they have so much less time or knowledge or understanding to challenge the real issues of inequality and exclusion on a wider level.
Yes, I was marching about pensions on November 30th. Despite what is being said in the media, on my current salary the last thing I am expecting my pension to be is ‘gold-plated’. But I was also marching to say that absolutely, nurses need to stay political not just for our own benefit but precisely for the people we work for, our patients, clients and students.