'Students should spend longer on a general grounding before they specialise'

Pre-registration training should give students a broad range of 'basic' skills applicable across all the nursing branches, says Shape of Caring Review author Lord Willis

The chair of a major review of nurse education told RCNi many graduates do not know how to do the 'basics' such as take blood.

Lord Willis, who headed the Shape of Caring Review published today, said the current model of training in which students spend a year learning many of the practical skills before specialising in one of the four professional branches would not be fit for the future.

Lord Willis
Lord Willis. © David Gee

Instead, the Liberal Democrat peer said nursing students should spend the first two years of their degree developing a solid grounding before specialising in their third year. After graduation, employers should provide a year of preceptorship.

Describing situations his review had observed, Lord Willis said: ‘There is the whole issue of nurses leaving training with a degree, yet feeling inadequate to do lots of what I’d call quite basic things. For instance, cannulation was left until they had finished their training and started working. Many felt insecure doing simple things like taking blood. When you drilled into that, it was because they were spending far too little time working with patients in terms of the whole person.

'I want to raise the bar and inspire tomorrow's nurses so they are confident, wherever they go. We must not have a situation where a mental health nurse goes into a home to treat a patient but does not have the skills to deal with their physical problems. I met mental health nurses who could not dress a wound because they did not feel competent.'

Lord Willis added that nursing students should learn about physical and mental health as part of a two-year grounding. He claimed more experienced as well as new nurses he had met felt unable to deal with mental health issues.

RCN head of policy Howard Catton said: ‘There is a powerful case Lord Willis makes for the importance of holistic care, ensuring people have a career preparation to deal with a wide range of physical and mental health care needs. However, the risk is if you move too far to generalism you might squeeze out time on specialist skills and knowledge.

‘We have got to make sure we have the balance of those skills and competencies across physical and mental health.'

A faster route into nursing for healthcare assistants (HCAs) is included in Lord Willis's report. He said HCAs should be able to use experience gained at foundation degree level to count towards a nursing degree, so they could complete that within 18 months.

'The idea that people will go off for three years to do a degree in their thirties or forties, with a young family to look after, is, quite frankly, fanciful,' said Lord Willis. 'We have experienced, clever and passionate care assistants who are being told to put everything on hold for three years to go to university, and that is not the real world.

'The standards of a degree-based registered nurse are absolutely unchangable, full stop. But we have to be smarter about being able to allow people to use their prior learning and expertise towards a final degree course,' he added.

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