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David Oliver: Why shouldn’t nurses be graduates?

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j863 (Published 14 March 2017) Cite this as: BMJ 2017;356:j863

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Re: David Oliver: Why shouldn’t nurses be graduates?

I am grateful for all the comments so far and for the considerable online interest in the article, which seems to have touched a nerve.

Ms Pearson of the Telegraph tweeted me yesterday to say that my use of the word "reactionary" was "lazy". In my experience, opinion columnists working in mainstream media never appreciate being criticised, not least by someone like me who only dabbles in journalism.

She told me that her views were in fact those of many readers and voters and that instead of "reactionary" they were "sensible and fair."

These views (see reference 1 and 2 in my column) also include scrapping NHS translation services (because patients should either learn to speak English or bring a friend) and expending time and cost chasing the estimated £300m maximum (less than 0.3% of the NHS budget and much not recoverable anyway) on health tourism.

Given the evidence that graduate nurses make care safer, I will stick by my choice of language.

Meanwhile, although most comments have been supportive, any defence of degree-level nursing (which by the way isn't even an issue any more in most countries the NHS recruits nurses from any more than women going out to work or being able to vote is an issue) is always accompanied by nurses who trained via the old route becoming very defensive.

The line (and I have received a few emails and tweets of this nature) is always "I trained the old way and didn't have a degree and I hope I delivered excellent care and so did my colleagues."

I can't say this often enough or loudly enough. Just because we now think it's a good idea for nurses to have degrees, just as pharmacists and allied health professionals do, that does NOT mean we are disparaging nurses who trained in the pre-degree era or attacking their values.

It is conflating two separate issues and doesn't help.

By analogy there are some first rate teachers who never went to teacher training college and some excellent NHS managers who started before anyone had invented the NHS management training scheme or degrees in health management.

That does not mean we shouldn't have formal teacher training qualifications or developmental programmes for NHS managers.

David Oliver

Competing interests: No competing interests

15 March 2017
David Oliver
Consultant Physician
Berkshire