1
Royal Society of Health Journal VOLUME 99 NO1
NURSE LEARNERS’ STATUS WORKING Group, by The Briggs CoCommittee completed its report in 1978. The brief of the working party was &dquo;to re-examine the status of the nurse learner&dquo;. Competence in nursing was defined as &dquo;a mastery of a number of elements, each of which have a knowledge and a skill
ordinating September
set up
inter-related
component&dquo;.
Professor Asa Briggs in his Report on Nursing in 1972 clearly recommended that nurse learners should be accorded full student status. In many parts of the country senior managers and nurse educationalists examined, debated and spent a lot of time on this report, but no positive action was agree upon, pending DHSS decision on the Briggs recommendations for nurse leaders. However, the recommendations contained in the report have taken effect nevertheless. In a high number of nurse training schools the block system of training is being phased out and in its place we have seen the introduction of modular training i.e. theory followed by the appropriate practical experience. No one can argue but that from the educational point of view, the modular system (re-emphasized again by the EEC requirements) is the preferable course of learning for student nurses, since it effectively relates theory to practice. But modular training, no matter how educationally desirable, has brought havoc upon service managers. The reasons for this havoc, which in many instances is largely responsible for bed closures, are as follows: 1. nurse learners continue to be regarded as em-
ployees
2. learners are counted when staff to patient ratios are calculated 3. financial allocations made for the provision of nursing service become unreal Because of modular training a totally false service manpower availability is projected for the provision of patient care in hospital wards. Learners are absent from the general wards for the following reasons: 1. obstetric module 2. psychiatric module
3. community module 4. sickness 5. annual leave This constitutes an approximate total time loss of 211 weeks in a calendar year. In addition we anticipate the introduction of a 37~ hour week in the forseeable future. An enormous sigh of relief would go up from nurse managers if learners were given full student status and nursing education bursaries instead of salaries, as at present. Everybody would know where they stood and what could be reasonably expected of them. While the
FEBRUARY 1979
majority of service managers fully agree that the modular training is to be preferred on educational grounds, the present continumg state of indecision is causing severe difficulties with service provision to patients. Changes in training patterns cannot be accommodated without parallel financial and learner status changes, and yet the nursing profession is asked to do exactly that. Although the working party could not be ignorant of the factors mentioned above, the following are given against change: employees, students and pupil nurses properly enjoy rights under the employment protection legislation; if their status was changed to that of student, these provisions would not apply.&dquo; Students in Colleges of Further Education, Polytech-
arguments 1. &dquo;As
nics and Universities continue to exist without emp-
loyee
status.
pupil nurses might be less well equipped to fulfill the role of a qualified nurse on completion of training because during their training programme they had gained experience under controlled conditions and so had not been subject to the full weight of service pressure.&dquo; This could be overcome by introduction of a period of supervised practice with employee status. 3. &dquo;Little work has yet been done in devising a feasible system of grants and in studying the detailed implications for recruitment a change to, 2. &dquo;Student and
student status could involve.&dquo; It cannot be beyond the wit of man to devise a grant system and to set up pilot projects. 4. &dquo;As the Health Service does rely on the service contribution of student and pupil nurses, the reorganization consequent on learners having student status would incur costs, which, though not easy to quantify, would probably be high.&dquo; It is already apparent that the provision of nursing service to the wards is going to cost more if the same level of care is to be provided for the same number of patients, because modular training requires the removal of the learners from the general wards. Expenditure on student grants would be considerably less than current expenditure on learner salaries and the majority of the tutorial staff and nurse educators are in post and functioning. One cannot escape the feeling that this continued state of indecision is to be regretted.
SHIFT WORK AND HEALTH N A MODERN industrial society requiring services the clock, where continuous operation is essential in many industries and commercially desir- , able in others, it is inevitable that a number of people have to work when others are asleep or enjoying their leisure. It is socially reasonable that the load of anti-
round
Downloaded from rsh.sagepub.com at UNIV OF TENNESSEE on August 14, 2015
Royal Society of Health Journal VOLUME 99 NO1
NURSE LEARNERS’ STATUS WORKING Group, by The Briggs CoCommittee completed its report in 1978. The brief of the working party was &dquo;to re-examine the status of the nurse learner&dquo;. Competence in nursing was defined as &dquo;a mastery of a number of elements, each of which have a knowledge and a skill
ordinating September
set up
inter-related
component&dquo;.
Professor Asa Briggs in his Report on Nursing in 1972 clearly recommended that nurse learners should be accorded full student status. In many parts of the country senior managers and nurse educationalists examined, debated and spent a lot of time on this report, but no positive action was agree upon, pending DHSS decision on the Briggs recommendations for nurse leaders. However, the recommendations contained in the report have taken effect nevertheless. In a high number of nurse training schools the block system of training is being phased out and in its place we have seen the introduction of modular training i.e. theory followed by the appropriate practical experience. No one can argue but that from the educational point of view, the modular system (re-emphasized again by the EEC requirements) is the preferable course of learning for student nurses, since it effectively relates theory to practice. But modular training, no matter how educationally desirable, has brought havoc upon service managers. The reasons for this havoc, which in many instances is largely responsible for bed closures, are as follows: 1. nurse learners continue to be regarded as em-
ployees
2. learners are counted when staff to patient ratios are calculated 3. financial allocations made for the provision of nursing service become unreal Because of modular training a totally false service manpower availability is projected for the provision of patient care in hospital wards. Learners are absent from the general wards for the following reasons: 1. obstetric module 2. psychiatric module
3. community module 4. sickness 5. annual leave This constitutes an approximate total time loss of 211 weeks in a calendar year. In addition we anticipate the introduction of a 37~ hour week in the forseeable future. An enormous sigh of relief would go up from nurse managers if learners were given full student status and nursing education bursaries instead of salaries, as at present. Everybody would know where they stood and what could be reasonably expected of them. While the
FEBRUARY 1979
majority of service managers fully agree that the modular training is to be preferred on educational grounds, the present continumg state of indecision is causing severe difficulties with service provision to patients. Changes in training patterns cannot be accommodated without parallel financial and learner status changes, and yet the nursing profession is asked to do exactly that. Although the working party could not be ignorant of the factors mentioned above, the following are given against change: employees, students and pupil nurses properly enjoy rights under the employment protection legislation; if their status was changed to that of student, these provisions would not apply.&dquo; Students in Colleges of Further Education, Polytech-
arguments 1. &dquo;As
nics and Universities continue to exist without emp-
loyee
status.
pupil nurses might be less well equipped to fulfill the role of a qualified nurse on completion of training because during their training programme they had gained experience under controlled conditions and so had not been subject to the full weight of service pressure.&dquo; This could be overcome by introduction of a period of supervised practice with employee status. 3. &dquo;Little work has yet been done in devising a feasible system of grants and in studying the detailed implications for recruitment a change to, 2. &dquo;Student and
student status could involve.&dquo; It cannot be beyond the wit of man to devise a grant system and to set up pilot projects. 4. &dquo;As the Health Service does rely on the service contribution of student and pupil nurses, the reorganization consequent on learners having student status would incur costs, which, though not easy to quantify, would probably be high.&dquo; It is already apparent that the provision of nursing service to the wards is going to cost more if the same level of care is to be provided for the same number of patients, because modular training requires the removal of the learners from the general wards. Expenditure on student grants would be considerably less than current expenditure on learner salaries and the majority of the tutorial staff and nurse educators are in post and functioning. One cannot escape the feeling that this continued state of indecision is to be regretted.
SHIFT WORK AND HEALTH N A MODERN industrial society requiring services the clock, where continuous operation is essential in many industries and commercially desir- , able in others, it is inevitable that a number of people have to work when others are asleep or enjoying their leisure. It is socially reasonable that the load of anti-
round
Downloaded from rsh.sagepub.com at UNIV OF TENNESSEE on August 14, 2015
