Recruiting nursing applicants: will ‘Patients First and Foremost’ work?

Abstract

T he Government’s initial response to the Francis report (Department of Health (DH), 2013a) Patients First and Foremost (DH, 2013b) was presented to parliament on 26 March and has caused huge concern among staff in universities. The report states that every student who seeks NHS funding for nursing degrees should first serve up to 1 year as a healthcare assistant (HCA), to promote frontline caring experience and values, as well as academic strength (DH, 2013b). As always the devil is in the detail and this report seems to be built upon a number of assumptions and begs a lot of questions. First, there is an assumption that nurse education fails to equip nurses with the right values so a new approach is required. This is in direct contradiction to the finding of the Willis Commission, which was that there is no evidence that this is the case. There is also an assumption that gaining experience of caring for patients/service users before undertaking a nursing degree will help develop the right values. Registered nurses have multiple responsibilities: caring for patients, mentoring student nurses, and supervising HCAs on NVQ courses and foundation degrees. Where will they find the time to supervise these ‘apprentice’-style students? In addition, there is a wealth of evidence that the quality of mentorship in practice is patchy at best, so exposing prospective student nurses to poor mentorship may not achieve the outcomes expected. At my university we have been using a values-based approach to selection called multiple mini interviews since 2010. Early data analysis suggests that many of the applicants who fail to demonstrate the values we require at interview are currently working as HCAs, suggesting that prior experience of healthcare may socialise HCAs into developing bad habits and attitudes rather than helping them to develop the values and attitudes required. Secondly, UCAS received 212 572 applications for nursing courses in 2012 of which 23 836 were accepted. With the best will in the world, our healthcare systems are not set up to manage large volumes Karen Elcock