Alison Spurrier: Does the nurse that makes a difference need to be educated to degree level?

Alison SpurrierA recent editorial in the BMJ discusses mandatory graduate entry to nursing in England. Does the nurse that makes a difference need to be educated to degree level?

This question is not straightforward due to the complex relationships that nurses enjoy with their patients and the multi faceted nature of nursing.

There are subtle but tangible skills which separate out those who are able to deliver nursing care in a professional and meaningful way. Nurses need to develop relationships with patients which demonstrate trust, maintain dignity, enable communication and ultimately deliver high quality care. They must also have in depth clinical knowledge, well developed clinical skills, be analytical, and have the ability to assess situations and make clinical decisions.

Currently in the UK nursing is not an all graduate profession. Does this mean the standards of care are compromised? If you observed  nursing care being delivered in the UK today you would see nurses from many different backgrounds and specialties. An individual nurse’s  knowledge, skills, and experience obviously makes a difference to the quality of care, but the key to delivering a quality service is not reliant on having all nurses educated to degree level

Nursing is frequently a “team effort,” and the quality of care depends on how well the team is supported. Teams led by nurses who are clearly interested in what they are doing, share their knowledge at the bedside in a way which others understand, and explain how a certain outcome can be achieved, are invaluable. The creation of a work environment which encourages learning and strives to improve care being given by all members of the team truly makes a difference.
We need people who take an interest in their work, have the patient’s best interest at heart and strive to deliver appropriate care in an individualistic way.

It not always the most obvious actions which bring comfort to sick people. It can be a look, a gentle touch, or smile at the right moment that makes the difference. These are skills of humanity and can’t be learnt.

Modern healthcare is complex and the nursing profession is underpinned by a vast body of knowledge which gives us the skills to deliver high standards of care. Only by greater understanding of our profession can we hope to continue to improve the care we give. The foundation of that is certainly education.  An all graduate profession? Yes, it’s heading that way. But let’s not lose some of our most valuable staff along the way.

Alison Spurrier is a nurse. She has been practising in the NHS for 25 years.