View from the Chair

Published: 26 March 2013

There is no doubt that February was a very dark month for nursing and health care. As we are forced to acknowledge the appalling failings outlined by the second, independent inquiry by Robert Francis QC into the failings at Mid Staffordshire NHS Foundation Trust, it is important to reflect for a moment about what this means for education in nursing. No one can condone the terrible findings of the Francis inquiry. For education to be effective in supporting the NHS and its workforce at every level, educators must now also take the same steps that all involved in the care of patients and the support of the health care workforce do.

The students we recruit must demonstrate that they hold values commensurate with the 6Cs which were identified by the Chief Nursing Officer for England in her report Compassion in Practice: Nursing, Midwifery and Care Staff: Our Vision and Strategy. However, crucially, the 6Cs must be explicitly demonstrated in the care, respect and support we give as role models for our students. These are the same qualities we expect our students to display in return. The 6Cs also apply to the nurses and patients we work with, as well as to each other - all day, every day, wherever we are and for all to see.

It is puzzling however, to see that nursing education has been identified by as “the one strand of spaghetti” Paxman (26 March) in the Francis inquiry which the Government response has chosen to target through an intervention to make future students of nursing undertake health care assistant work, in the belief that making nursing candidates work as health care assistants will instil a missing compassion.

It is puzzling because successive evidence culminating even recently in the Willis Commission Report (2012) identified that there is no evidence to suggest that nursing students are not compassionate and caring or that contemporary nursing education fails to instil such values. There is, however, longstanding and compelling evidence about the dysfunctionality of systems and teams and of burn-out in workers (including nurses) which impacts on their emotional intelligence and capability (Maben 2013). There is also significant evidence that an increase in registered nurses (not health care assistants) is commensurate with improved mortality rates and patient satisfaction. All of this rather supports Council of Deans’ view of 26 March that the Government response “is the wrong answer to the wrong question”.

As identified by Peter Carter, this is also a missed opportunity; would it not be better to spend the effort and money supporting proper time out for mentors to assess and facilitate student nurses in their practice learning, rather than adding this on to already busy shifts or their own time? This is a Congress resolution proposed by the Education Forum and is on the Congress agenda this year. Providing funded preceptorship and clinical supervision for all new nurses to enable them to become effective in their caring and their leadership for the benefit of patients could also be added to the shopping list. These interventions will enhance the patient experience, while there are many questions about how having a workforce of temporary health care assistants who leave after a year to become nurses will work.

For nurse educators, it is critical to acknowledge our role as one which is a fundamental part of the nursing community alongside those in direct patient care, leadership and management, research and innovation and many others. We have a part to play in enabling a future which is right for patients because it is right for our caring communities. This includes the way we select prepare and support students of nursing, including the development of their knowledge and values. Join us at our Congress event to discuss this critical issue further.