Back to the future: could enrolled nursing be a career pathway for healthcare assistants?

 “If I could turn back time,” runs the lyric of a popular song. It’s a good question: what would you do if you could “turn back time”?

When it comes to nursing, there’s one simple thing I’d do – or rather wouldn’t have done. I would never have got rid of Enrolled Nursing training.

I was lucky enough to train at a time when ENs were still around, and I learned a great deal about practical nursing from them. Many of our excellent healthcare assistants could easily fulfil similar roles.

I realised this recently when I went to the GP for an over-50s health check. (If you’ve reached that age you should be getting one too; contact your GP if you haven’t heard about them). These checks are a Good Thing. They feel like a real move towards making the NHS more a) patient focused and b) preventive in its approach.

An HCA carried out my check. She took my blood pressure, weighed me, asked me some simple questions and took blood for cholesterol levels.

She explained things clearly and told me what to expect. She was personable and understood the limits of her competence clearly – there was a minor, age-related issue (varicose veins), and she dealt with it: so I now have an appointment with my GP.

She was brilliant at the blood test too by the way. I didn’t feel a thing.

Gone are the days when we used to debate the value of the graduate nurse. But there’s plenty of room for the nurse who doesn’t want to/can’t do a degree for whatever reason. We should get over our limited attitudes to meritocracy. People have different abilities and skills, and different home circumstances. And they are good at different things, too.

The new Shaping the Future consultation by Lord Willis makes various suggestions about HCAs and providing them with an entry to nursing. Also as Nursing Standard reported recently, the new Care Certificate may allow greater standardisation of HCA skills.

But it sounds so complicated. Why not simply provide second-level nurse training for those whose skill and expertise lies in hands-on care, and give those who wish to the opportunity to attain this?

Those who have the time and/or the capacity to go further in higher education can easily be given the chance to study and attain degree-level nursing.

My HCA could easily be an EN and benefit from a defined training plan and a career path, as well as greater recognition of her skill and expertise. Sadly the rush to “professionalise” nursing seems to have robbed her of that opportunity.

There’s no need to “turn back time”. We should simply recognise the mistakes of the past, and make things better for the future.

About the author

Ed Rowe trained at St Mary’s Hospital in Paddington, London, in the late 1980s and practised in general surgery. He now works on Nursing Standard’s Art & Science section as a clinical editor.