12. Recruiting the right candidates

Suffolk Branch

(R) That this meeting of RCN Congress urges Council to call for all those recruited to pre-registration nursing programmes to have undertaken relevant health and/or social care experience prior to commencing their courses

Result

The resolution was rejected.

For: 19.46% (79)
Against: 80.54% (327)
Abstain: (14)

Debate report

Lisa Mickleburgh proposed this resolution, reporting that more than £100 million is spent each year on nursing students who do not complete their nurse training. Figures from 2008 show that universities have average attrition rates of 45-50 per cent, with 50 per cent of students leaving their course in the first year. Lisa stressed that “the government recommendation that all students should spend one year working as an HCA is completely unrealistic. I propose a period of time spent in a suitable environment prior to training to test if this is the career for them.”

The reason why students drop out may be because the course is free. This was a suggestion put to Congress by Jean Rogers, UK Learning Rep from the North West region, who went on to propose that more robust interviews with practical assessments are introduced.
Lynne Fair of the RCN Older People’s Forum disagreed and asked why the frailest people in society should be the guinea pigs for those ‘checking out’ nursing or to ‘weed out’ the bad? “How does a patient with dementia feed back on these staff?”

Nursing student, Jessica Curtis, reminded Congress that the Willis Commission reported that nurse education was fit for purpose. “You can’t teach compassion and caring” she said.

A passionate debate was closed by Lisa Mickleburgh who said that “we need to look at this in more detail and take a long hard look at why attrition rates are so high”.

Background

The drop-out numbers for nursing students on pre-registration courses are only available for Scotland, where the latest figures from NHS Scotland report an attrition rate of more than 26 per cent (Buchan and Seccombe, 2011). With most students leaving in the first year of study, uncompleted courses represent a cost to the UK of around £100 million (Nursing Standard, 2008). Ensuring that the right candidates are attracted to pre-registration courses is becoming increasingly important.

In its initial response to the Francis report, the Government has said that would-be nurses will need to serve as a health care assistant (HCA) for “up to a year”. This move prompted the RCN to ask where the funding for such a significant move would come from and who would be responsible for tens of thousands of new HCAs.

One method of helping potential students to decide if nursing is for them would be to provide insight via practical experience, and in particular, as proposed in recommendation 187 of the Francis Inquiry, a mandatory requirement for a three-month placement in a health or social care setting. A wide range of clinical and non-clinical work could be undertaken, allowing either participation and/or observation of human development and caring. This could be paid work in a care home or nursing home; voluntary work at a hospice or counselling organisation; or help at a drop-in centre or local children’s group. It is an opportunity to acquire, within a work context, the discipline needed for good time-keeping, reliability and time management; to experience teamwork; and to develop key functional skills such as problem-solving, interpersonal skills, IT and communication.

The implications of this approach would affect both school leavers and mature students. School leavers would no longer be able to move directly from further to higher education, and for all potential students, the affordability of completing a voluntary placement would also become a consideration. With nearly 58,000 students applying for pre-registration nursing courses each year (Buchan and Seccombe, 2011), there would be a considerable demand for paid placements. Making this number of placements available could be a considerable challenge for health and social care providers.

In 2011, the Northern Ireland Practice and Education Council [NIPEC] reviewed the application and selection processes for pre-registration programmes and developed a strategy to support streamlining those processes. Alternative ways of introducing potential students to health care are already in place, with regional colleges providing access courses that are accepted by the University of Ulster as a basis for application to pre-registration nurse education.

In Scotland there has also been a focus on enabling potential students to make informed choices before applying for pre-registration nursing programmes. The Scottish Government, with NHS Education for Scotland, has established a student recruitment and retention delivery group which was responsible for the Extraordinary Everyday website, which gives insight to the realities of nursing in each of the fields of practice and career opportunities.

A statement of character is required for all applicants to pre-registration courses in Wales. This looks at attitudes to a range of areas that relate to the applicant’s ability to work with people in a caring and dignified manner.
 

References and further reading

Buchan J and Seccombe I (2011) A decisive decade:the UK nursing labour market review 2011 London:Royal College of Nursing. Available at: www.rcn.org.uk/data/assets/pdf_file/0007/407257/004170.pdf (accessed13/03/13) (Web).

NHS Education for Scotland (2013) Nursing and midwifery extraordinary, everyday Edinburgh: NHS Education for Scotland. Available at: www.extraordinaryeveryday.co.uk/ (accessed 13/03/13) (Web).

Waters A (2008) Nursing attrition is costing UK tax payers £99 million a year Nursing Standard, 22 (31).