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Life on Mars

April 13, 2015

OK, people. I know this is supposed to be a blog about nursing and politics; I also know there’s a general election just weeks away. The rules of logic are screaming in my face, reminding me that this is my time. Locked away with a live news feed, shooting up cans of Red Bull and energy bars made of pure sucrose, I should be relaying to clamorous readers right now my shit-hot analysis of the various parties’ latest policy statements and what they’ll mean for us at the sharp end. My friends, I know all this – really I do – but sadly, it’s not happening. Family problems have completely overwhelmed me in the last few weeks. The election has seemed like something that’s taking place on Mars.

Despite all that though – there is one fact so striking that it has pierced even the thick fog of bereavement and worry about elderly parents that currently envelops my over-stretched mind. It is this: politicians don’t have a clue about nursing. Clearly underlying the pronouncements they make – and I include all parties in this – is the assumption either that nursing is just the same as the nine-to-five Monday-to-Friday jobs they’ve mostly been used to themselves; or that nursing is so simple that you could do it standing on your head, and it beats us why nurses don’t just stop moaning and get on with it.

Take Eric Pickles’ bad-tempered performance on Radio 4’s Today Programme on 10th April. Brought in to discuss the Conservatives’ ‘Big Society’ proposal that – provided they win on 7th May – anyone employed in the public sector will be entitled to an extra three days paid leave per annum to do voluntary work, he kept insisting that wards would be able to cope with the absence of participating nurses because “it’s no different to employees arranging with their employer their annual leave”.

Er…Eric? Hello? Of course it’s different! Individual nurses’ annual leave entitlements are knowable and predictable and are factored into ward establishments. Numbers who want to take advantage of this new scheme will be fluctuating and far less predictable. Plus, if volunteers want to be involved in children’s activities, it’s likely that these will be taking place during school holidays – a time when, as any nurse can tell you, annual leave is always heavily over-subscribed as it is.

And when Pickles says ‘three days’, what does he mean? Literally that: three whole days, non-negotiable? Or can it – like annual leave – be broken down into hours? Could you, for example, go home early from a late shift so that you could do your voluntary activity in the evening? What would be the point of that, especially as you probably wouldn’t get off on time anyway? You’d just book an early or a day off wouldn’t you?

I could go on about how much use charities are really going to get out of people who swan in for three days and then swan out never to be seen again, and what this says about the Tories’ conception of voluntary work, but this is supposed to be a piece about politicians and nursing. Instead, I’ll turn to Labour’s Health Care Manifesto, launched at the weekend.

Now I’m not going to be mealy-mouthed about this: I’ve read the whole document and there is plenty to like. But with respect to Labour’s specific policy pledges on nursing, there is also a lot to question. One example is the expansion of nurse education that is advanced as the answer to the current chronic shortage of nurses. Of course it would be welcome, and of course it is an important part of the solution. But it’s not as simple as Labour would have us believe.

The Manifesto states that ‘as part of our Time to Care Fund, Labour will train 10,000 more British nurses above current training levels so that we achieve an average 21,000 training places a year in the next Parliament’. So far, so good. But then Shadow Health Secretary Andy Burnham re-iterated this commitment to The Observer newspaper, with a vow that ‘on “day one” in power he would increase…training places, with a goal of 20,000 additional nurses over the next five years’.

So the message we’re getting here is that ‘nurse training’ (as the Manifesto repeatedly refers to it, rather than ‘nurse education’) is so basic and so simple that numbers can be increased more or less at a snap of the fingers. There is no indication of how these extra places will be funded. There is no mention of the need to identify high quality placements with properly prepared mentors, or recruit enough credible lecturers to teach to the standard students and future service-users deserve. Nursing preparation is via a degree. You can’t just squash more students onto existing courses and cross your fingers that it will all be OK. You have to ensure quality.

So although I don’t have a problem with people doing voluntary work if they want to, and I don’t – of course – have a problem with proposals to increase numbers undertaking nursing degrees, I do have a problem with the way politicians talk about nursing. It isn’t like other jobs. You can’t simply import a template that works for jobs with office hours and expect it to fit nursing. To imply that you can just shows the depth of your ignorance. But it is complex and highly skilled and today more than ever it calls for both depth and breadth of knowledge. Giving the impression that degree places can be magicked up more or less overnight does it a disservice and is yet another depressing example of politicians’ failure to understand our profession. And if they don’t understand it, how can they ever convincingly address its problems?

  1. I’m afraid their ignorance extends beyond nursing, to the entire health sector. A gross lack of understanding (or deliberate choice to disregard it) exists about the state of the NHS, especially in the South, and the damage their policies have created. It’s woeful and disgraceful and the idea that you can magic nurses up so simply would be laughable if it wasn’t so depressing. As for the extra leave to undertake 3 days voluntary service a year, I’m not sure what planet the person who dreamt that up is on – possibly disoriented in a ring or two of Saturn? Puff………..

  2. I agree that there can sometimes seem to be wilful ignorance. But I also feel that many of these pronouncements about nursing are actually born of a covert (and probably unconscious) sexism. The professional man’s traditional Monday-Friday 9-5 working week is clearly Eric Pickles’ point of reference. He doesn’t seem to understand that women’s working lives often don’t fit that model and that designing policies around that model won’t be successful. And when they are not, no doubt the finger of blame will be pointed at nurses themselves, for not wanting to ‘engage’ with the Big Society idea.
    It’s the same with Andy Burnham. He is sending a message that nursing is easy. It’s just taking patients to the toilet and moping their fevered brows. What’s difficult about that? Find the right sort of person (for which read ‘girl’) and you can probably train them up in a few weeks. This lack of candour about the reality of nursing plays straight into the hands of the Daily Mail. My fear is that it will result in a dumbing down of nurse education by the back-door.

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