Cruel Britannia: A personal critique of nursing in the United Kingdom
Roger Watson
School of Nursing and Midwifery, University of Sheffield, Sheffield, United Kingdom; Hong Kong Polytechnic University, Hong Kong
Linda Shields
Paediatric and Child Health Nursing, Curtin Health Innovations Research Institute, Curtin University of Technology, Perth WA; University of Queensland Brisbane QLD
PP: 42 - 54
Abstract
The United Kingdom (UK) once led the world in nursing but because of the exigencies of the funding mechanisms of the National Health Service (NHS), it has fallen a long way behind other countries.
We aim to raise awareness inside and outside the UK about the decline in nursing as a profession there. We are purposely contentious, in an attempt to raise questions, both for the UK and for countries which are recruiting British nurses who are leaving because of job losses caused by the funding crisis in the NHS.
This paper discusses where the problems that have led to the decline have come from, where nursing is going and poses questions for the future. We hope that the UK government and those who infl uence the development of nursing will bring it back to the standard it once had.
Keywords
politics, nursing, debate, nursing education, UK, National Health Service
References
Aiken L, Clarke SP, Cheung RB, Sloane DM and Silber JH (2003) Educational levels of hospital nurses and surgical patient mobility. Journal of the American Medical Association 290: 1617-1623.
Australian Nursing and Midwifery Council (2006) National competency standards for the registered nurse 2005. Accessed 01 May 2009 at http://www.anmc.org.au/docs/1Competency_standards_RN.pdf.
Bach S (2004) Overseas recruitment of health workers sparks controversy. European Industrial Relations Observatory Online. Accessed 01 May 2009 at http://www.eurofound.europa.eu/eiro/2004/07/feature/uk0407107f.html.
BBC News (2000 June 15) GCSE maths blamed for nurses' blunders. Accessed 01 May 2009 at http://news.bbc.co.uk/2/hi/uk_news/education/792162.stm.
BBC News (2004 April 5) Training nurses to do surgery. Accessed 01 May 2009 at http://news.bbc.co.uk/2/hi/health/3580453.stm.
BBC News (2007a April 15) Nurse union condemns NHS job cuts. Accessed 01 May 2009 at http://news.bbc.co.uk/1/hi/health/6552249.stm.
BBC News (2007b May 28) MPs back calls for nurse pay rise. Accessed 01 May 2009 at http://news.bbc.co.uk/1/hi/uk/6697167.stm.
BMA (2008) Polyclincis Q and A. Accessed 01 May 2009 at http://www.bma.org.uk/patients_public/polyclinicsqanda.jsp.
Bradshaw A (2001) The project 2000 nurse. London: Wiley Blackwell.
Council of Deans and Heads of UK University Faculties for Nursing and Health Professions (2007) Briefing on the funding and commissioning of nursing, midwifery and allied health profession education in England, June 2007. Accessed 01 May 2009 at http://councilofdeans.org.uk/Data/Sites/2/GalleryImages/docs/Updated%20briefing%20on%20healthcare%20education%20funding%200607.doc.
Dean M (2005 May 18) The NHS goes global. The Guardian Wednesday. Accessed 01 May 2009 at http://www.guardian.co.uk/society/2005/may/18/politics.publicservices.
Department of Health (1999) Making a difference. London: Department of Health.
Department of Health (2008) A high quality workforce. London: Department of Health.
Dreaper J (2008 March 25) Many UK nurses quit for Australia. BBC News. Accessed 01 May 2009 at http://news.bbc.co.uk/2/hi/health/7308073.stm.
Duffield C, Roche M, O'Brien-Pallas L, Diers D, Aisbett C, King M et al (2007) Glueing it together: Nurses, their work environment and patient safety. University of Technology, Sydney, Accessed 01 May 2009 at http://www.health.nsw.gov.au/pubs/2007/pdf/nwr_report.pdf.
FDF (2007) Retail sector Foundation degree: Tesco setting industry standards. Accessed 01 May 2009 at http://development.bhmgmarketing.co.uk/fdfpress/Retail%20Fd%20launch_FINAL.pdf.
Finch J (1999) CVCP's response to the consultation on making a difference and midwifery preregistration education (HSC 19991219). Leeds: CVCP.
Fryer R (2006) Beyond inequality: Widening participation in learning in health care. Accessed 01 May 2009 at http://www.wideningparticipation.nhs.uk/docs/Beyond%20Inequality%20-%20WP%20in%20Healthcare%20120707.pdf.
Griffiths R (1988) Community care: An agenda for action. A report to the secretary of state for social services. London: HMSO.
Grimston J and Robinson K (2008 April 13) Get a BA (2 for 1) at Tesco. The Sunday Times. Accessed 01 May 2009 at http://www.timesonline.co.uk/tol/news/uk/education/article3736231.ece.
Hall C (2004 May 11) Young nurses too posh to wash. Telegraph. Accessed 01 May 2009 at http://www.telegraph.co.uk/news/uknews/1461504/Young-nurses-'too-posh-towash'.html.
Hall C, Jones C, Hilton D, Davies S and MacDiarmid I (2005) A study to evaluate first year student nurses use of a national numeracy resource to develop key skills for nursing practice. The Higher Education Academy. Accessed 01 May 2009 at http://www.health.heacademy.ac.uk/projects/miniprojects/hall.pdf.
Hallett C (2008) Colin Fraser Brockington (1903-2004) and the revolution in nurse-education. Journal of Medical Biography 16(2): 89-95.
Health Direct (2008) Clostridium difficile rates rising. Health Direct official NHS blog. Accessed 01 May 2009 at http://www.healthdirect.co.uk/blog.html.
Jukes L and Gilchrist M (2006) Concerns about numeracy skills of nursing students. Nurse Education in Practice 6(4): 192-198.
Kirkup J (2008 April 9) Labour sticks to 50 per cent university target. Telegraph. Accessed 01 May 2009 at http://www.telegraph.co.uk/news/uknews/1584495/Labour-sticks-to-50-per-centuniversity-target.html.
Klein R (2007) Outcomes of variation in hospital nurse staffing in English hospitals: A lesson for policy makers. International Journal of Nursing Studies 44(2): 167-168.
Loder N (1998 October 9) Dobson re-opens nurses' wounds. Times Higher Education. Accessed 01 May 2009 at http://www.timeshighereducation.co.uk/story.asp?storyCode=109329§ioncode=26.
McKenna H, Thompson D and Watson R (2008) Health care assistants: An oxymoron. International Journal of Nursing Studies 44(8): 1283-1284.
National Health Service (2007) 2007/08 bursary rates for new students. Accessed 01 May 2009 at http://www.nhspa.gov.uk/sgu/news/NEW%20STUDENTS%20rates%202007%2008.pdf.
Newman M (2007 July 27) Jobs axed after NHS cuts funds. Times Higher Education Supplement. Accessed 01 May 2009 at http://www.timeshighereducation.co.uk/story.asp?storyCode=209749§ioncode=26.
NHS Careers (2008) NHS pay: Agenda for changepay rates: Pay rates from April 2008. Accessed 01 May 2009 at http://www.nhscareers.nhs.uk/details/Default.aspx?Id=766.
NHS Employers (2007) Facts and figures. Accessed 01 May 2009 at http://www.nhsemployers.org/pay-conditions/pay-conditions-251.cfm.
Nursing and Midwifery Council (2008a) International English Language Testing (IELTS). Accessed 01 May 2009 at http://www.nmc-uk.org/aArticle.aspx?ArticleID=2656.
Nursing and Midwifery Council (2008b) The Code: Standards of conduct, performance and ethics for nurses and midwives. Accessed 01 May 2009 at http://www.nmc-uk.org/aArticle.aspx?ArticleID=3056.
Nursing and Midwifery Council (2008c) Confirmation of principles to support a new framework for pre-registration nursing education. London: NMC.
Open University (2008) Foundation degree in health and social care. Accessed 01 May 2009 at http://www3.open.ac.uk/courses/bin/p12.dll?Q01G05.
Rafferty AM, Clarke SP, Coles J, Ball J, James P, McKee M et al (2007) Outcomes of variation in hospital nurse staffing in English hospitals: Cross-sectional analysis of survey data and discharge records. International Journal of Nursing Studies 44(2): 175-182.
Roxburgh M, Watson R, Holland K, Johnson M, Lauder W and Topping K (2008) A review of curriculum evaluation in United Kingdom nursing education. Nurse Education Today 28: 881-889.
Sastry T (2005) The education and training of medical and health professionals in higher education institutions. London: Higher Education Policy Institute.
Shields L and Watson R (2007) The demise of nursing in the United Kingdom: A warning for medicine. Journal of the Royal Society of Medicine 100(2): 70-74.
Shields L and Watson R (2008) Where have all the nurses gone? Australian Journal of Advanced Nursing 26(1): 95-101.
Singapore Nursing Board (2006) Standards of Practice for Nurses and Midwives (2006). Accessed 01 May 2009 at http://www.snb.gov.sg/html/1153709353750.html.
Staff and Agencies (2007a February 14) New nurses work for less than minimum wage. Society Guardian. Accessed 01 May 2009 at http://society.guardian.co.uk/health/news/0,,2012732,00.html.
Staff and Agencies (2007b January 26) Campaigners condemn plea for nurses to work unpaid. Guardian Unlimited. Accessed 01 May 2009 at http://society.guardian.co.uk/health/story/01999623,00.html.
Staines R (2008 February 21) Unions accept unsocial hours payments for nurses and NHS support staff. Nursing Times. Accessed 01 May 2009 at http://www.nursingtimes.net/whats-new-innursing/unions-accept-unsocial-hours-paymentsfor-nurses-and-nhs-support-staff/758043.article.
The Nursing Council of Thailand (2004) About us: Code of ethics. Accessed 01 May 2009 at http://www.moph.go.th/ngo/nursec/aboutus.htm.
Thompson DR and Watson R (2003) Advanced nursing practice: What is it? International Journal of Nursing Practice 9: 129-130.
Thompson DR and Watson R (2006) Professors of nursing: What do they profess? Nurse Education in Practice 6: 123-126.
Triggle N (2008 March 4) Average NHS wait up under Labour. BBC News. Accessed 01 May 2009 at http://news.bbc.co.uk/2/hi/health/7271772.stm.
UKCC (1987) Project 2000: The final proposals. Project Paper 9. London: UKCC.
UKCC (1999) Fitness for practice. London: UKCC.
Watson R (2001) Elitism, advanced practice and the charge of the light brigade. NT Research 6: 791-796.
Watson R (2002) Clinical competence: Starship enterprise or straitjacket? Nurse Education Today 22: 476-480.
Watson R (2006) Is there a role for higher education in preparing nurses? Nurse Education Today 26: 622-626.
Watson R, Deary IJ, Thompson DR and Li G (2008) A study of stress and burnout in nursing students in Hong Kong: A questionnaire survey. International Journal of Nursing Studies 45: 1534-1542.
Watson R and Thompson D (2003) Will modern matrons carry on regardless? Journal of Nursing Management 11: 65-68.
Watson R and Thompson D (2004) The Trojan horse of nursing education. Nurse Education Today 24: 73-75.
Webster P (2008 March 1) Nurses denounced as dirty, lazy drunks. Times Online. Accessed 01 May 2009 at http://www.timesonline.co.uk/tol/news/politics/article3462808.ece.
Weir R (1996) A leap in the dark. Penzance: Jamieson Library.
Woodham-Smith C (1951) Florence Nightingale, 1820-1910. London: McGraw-Hill.
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