It’s time to get over it

University-trained nurses are here to stay, writes Peter Kieseker.

Four second year nursing students from the University of the Sunshine Coast stand excitedly – and nervously – in front of a ward office in Nambour Hospital awaiting their first “real nursing work”.

Ignored initially because of the usual turmoil and business of a ward at handover they start to feel unwelcomed, awkward, and out of place. They begin to doubt themselves. Soon though, their facilitator arrives, introduces them to the team leader, allocates them to preceptors, and their careers begin.

Their preceptors are wonderful; understanding of their slowness, tolerant of their clumsiness and more importantly, giving of their knowledge. The preceptors extend the same level of care and compassion to their students that they extend to their patients. The students want to do their best, they want to become their best, and with a facilitator and preceptors like this, they are on their way.

Rattling around in their heads as they fumble their first bed adjustment, or nervously put the first BP cuff on upside down, are the words of Leanne Davey that “…student nurses sometimes are seen as extra hindrance to already increasing workloads”. This was written by her in 2002 as an undergraduate student of Wollongong University in the article Nurses eating nurses: The caring profession which fails to nurture its own!

They feel this is true as they take too long to find a 20 gauge in the store room, or guess at – and get wrong - pan room etiquette. Their preceptors, though, are professional RN’s who seem to be able to take themselves back into the place of the beginner. Instead of rebuke or ‘the look’, the preceptor RN’s give guidance and support. Still their RN’s are not to be taken for granted. Once told or shown they expect the student to remember and to be able to do; but the four students expect this of themselves and strive to meet the standards of a nurse who may very well form a role model for the rest of their practice.

Over their first tea break they talk and agree Davey had it wrong when she warned that: “Most nurses would like to see themselves as promoters of nursing but are frustrated and disillusioned with their profession. It would seem that the student nurses, as a result of this dissatisfaction, are often devoured by some nurses instead of being encouraged and nurtured in their enthusiasm for nursing.”

So back to work they go, feeling an excitement at learning and the fulfilment of doing real things. Optimistic, full of advanced knowledge in pathophysiology and pharmacology, and encouraged by their RN, they are ready to contribute. And then it happens. The criticism of an embittered few who resent university trained nurses.

The clichés are as boring and redundant as they are universal: book knowledge is not nursing; we are real nurses – we did it the hard way; hospital based training is the only way to be a proficient nurse; how can you call yourself a nurse if you only interact with patients for a few weeks over three years?; you all come out of university full of hot air and theories but you can’t do anything; the higher your marks the worse nurse you will be. And so on it goes.

Well I, as one of those four student nurses, think it is time this small percentage of RN’s and EN’s and AIN’s got over it.

We are from university and we are here to stay. We make no apologies for our studies of science because medicine is science. We make no apologies for thinking of nursing as a profession and aspiring to be as highly trained as we can be. We make no apologies for asking why as well as how. We do though apologise that, at first, we are clumsy and not as fast as you. But if you give us a chance we will learn from your experience and thank you for it.

One would expect all professional nurses to welcome university programs as – finally – recognition of just how much knowledge and expertise a 21st Century nurse needs.

But if a few backward thinking fossils can not accept the change perhaps they could be helped by considering three things:

We cannot be hospital trained even if we wanted to be. Those days are over. That option has gone. Many of us envy the wonderful skills you must have developed during your three years of hospital training. Many of us wish there was much more hospital training available to us. But the fact remains that hospital training does not exist anymore as an option for us so why continue to bleat and criticize students for something they have no control over.

We pay for our learning. Fee paying students could be equally critical as hospital-trained nurses. You were paid for your three years. We don’t get paid to learn. We elect nursing as a conscious choice knowing we will end up with a $25,000 plus debt, and most of us have to work at all sorts of unattractive jobs through university just to feed ourselves, buy books, and pay transport costs to our placements.

Many students are mature-aged who come to nursing later in life. If the disparagers of student nurses appreciated this, perhaps they would not be so quick to term them “useless”. Indeed, in the graduate group I belong to there is a former UN lawyer, another lawyer who worked in medical negligence, a librarian, an international primary health aid worker who led teams in Somalia, an industrial chemist who led a manufacturing plant, three people with biomedical degrees and another with two masters from the UK in biomedicine, a highly experienced paramedical technician, several teachers, and many overseas students who are already nurses in their own country but have saved the $40,000 to pay for the converted Australian RN qualification. It takes a bit of courage to move careers. The sort of courage absent in those in the staff room who “hate nursing/hate this hospital” but do nought except complain and moan.

Unfortunately, Davey was right when reporting that too often students are met with hostility and treated as if invisible. It’s only by a small percentage of nurses, but it’s real. Sadly it can easily end a career for inexperienced students. Younger, just out of school students, don’t have the life experience to recognise this form of pettiness as envy or jealousy or fear of usurpation.

The disillusionment that these few “hospital training is the only way” relics generate can result in potentially great nurses leaving the profession, rather than join the toxic culture evidenced by those who need to get over university training for nursing.

Let’s acknowledge that it is not always one way traffic. Some of the same young, just out of school Gen Y’s are full of the arrogance and condescension of youth. They too readily dismiss the experience and wisdom of the non-degree nurse. Foolish them!

Fortunately they too are few, and with maturity they will, hopefully, learn and respect.
But what excuse can the bitter naysayers of university trained nurses claim, other than being negative luddites who can not make the transition from doctors’ handmaidens to medical professionals? Perhaps this article can serve to thank those who welcome students, who teach us, and whose work and dedication has made our new profession the most trusted in Australia. If the students I writer study with are any indication, we will be doing our very best to live up to the standards you have set.

We will also be doing our best to avoid the small percentage of student-knocking nurses who need to get over it.

Peter Kieseker is a second year student, Bachelor of Nursing Science (Graduate Entry), University of the Sunshine Coast.

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