Views And Reviews Acute Perspective

David Oliver: Why shouldn’t nurses be graduates?

BMJ 2017; 356 doi: (Published 14 March 2017) Cite this as: BMJ 2017;356:j863

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

I completely agree with Dr Mandlik that safe staffing and skillmix are crucial to patient care and that the percentage of graduates in a nursing team is only one factor alongside staff patient ratios. I have written about this before in the BMJ, with some key references and links in the piece below. Indeed workforce recruitment, retention and workforce planning are crucial across all clinical disciplines and are a major issue right now in UK health systems

I also agree that there should be a variety of routes along a skills escalator to encourage and support a diverse range of applicants into nursing, medicine and professions allied to medicine. And that it's especially important to give people who aren't school leavers and have played other roles in our outside healthcare a chance to enter the caring professions at a later stage.

None of this invalidates the premise of my argument - namely, that nursing is a skilled endeavour requiring a theoretical underpinning and a research base and doesn't just rely on some kind of innate traditionally "womanly" virtues of care, compassion, commonsense and communication. And therefore a degree in nursing should have just as much weight as one in an Allied Health Profession or Pharmacy or Social Work, not least because nurses are the people in most frequent daily contact with patients and the largest and arguably most visible staff group.

Most of all, i have yet to see a shred of evidence to support the notion that somehow higher education or qualifications make people unempathetic. or unable to care. Look no further than the work of skilled palliative medicine doctors working in hospices after 5 years undergraduate and 8-10 years postgraduate training, or caring speech or occupational therapists and you can see that its a bizarre assertion.

Many of the attitudes to degree level nursing are I suspect ingrained in good old fashioned sexism and snobbery and undervaluing of the role and its skill.

David Oliver

Competing interests: No competing interests

20 March 2017
David Oliver
Consultant Physician