Letters

I was most interested in your article 'Learning the hard way' (pages 26-27, 18 November), which identified 'significant discrepancies' between nursing students and others. The key questions are: why do we still treat nursing differently, and why do we make things so much harder for nurses than others?

How do we justify the fact that while all other health professionals are prepared as undergraduates, 90 per cent of nursing students have to make do with a diploma? Or that after registration, nurses may 'top up' their diploma to a degree - but on top of a demanding job and paying for themselves?

Why do nursing students have to cram 4,600 hours (including the 50 per cent clinical practice requirement) into a three-year programme?

Why do we expect newly qualified nurses to 'hit the ground running' when doctors, social workers and teachers get a mandatory period of supported practice?

The explanation lies in the issue raised in the article's final section: 'Does the consortium, representing NHS management views, want a professional staff with a strong research and questioning approach to their work, or do they want to see qualified recruits who possess competent practical (ie ward) skills from day one?'

For nurses the answer is clearly the latter. The tragedy is that while the specifications of NHS consortia may produce short-term fodder for the labour shortages on acute wards, they will not meet the nation's long-term needs for community-based multidisciplinary care of an ageing population.

Most so-called 'practical skills' are quickly acquired through vocational training and supported practice, but they are of limited use unless underpinned by the cognitive skills needed for knowledge-based clinical decision-making - which is the core of professional practice.

Dame June Clark Professor of community nursing University of Wales Swansea

Topics