About Nursing - Training

History - Where are we today? - Diploma or Degree? - Funding -
Entry Requirements - Modularisation - Careers in Nursing - The Grading System

History

Student nurse training has undergone many changes in the last decade since Project 2000 was introduced in the early 1990's.

Prior to Project 2000, nursing and midwifery training was carried out within a School of Nursing which was physically at the site of the hospital where the nurses carried out their studies and practical ward work. Qualified nurses became State Registered Nurses or Registered General Nurses (RGNs) and as such were registered with the NMC. A second shorter and more practical training concluded with the qualification of Enrolled Nurse.

Project 2000 aimed to establish nursing in a more professional light, and transferred nurse training into higher education, within a university setting. It was felt that in order for nursing to be regarded as a serious profession a more academic approach to training was needed. As a result nurses were encouraged to study to diploma or degree level. Enrolled nurse training stopped and schools of nursing could no longer be found within a hospital. Hospitals had to pay universities for the education and training of student nurses, and in turn the universities would provide nurses who were academically sound and 'fit for practice'.

Where are we today?

Pre Project 2000, a large part of the ward workforce was made up of 1st, 2nd and 3rd year student nurses, who were on the ward rota and part of the ward team. With the introduction of Project 2000, student nurses became just that, students. Most of their time was spent in study and a greatly reduced amount of time on ward work gaining practical experience. The government compensated for the reduction in the work force by increasing the number of health care assistants (non or semi-trained care staff).

Almost every university runs a programme of study for nurse training, usually within the Department of Health or the Department of Life Sciences. Both the diploma and the degree level courses now take three academic years. The entry requirements for the diploma and the degree course differ and prospective students should contact the University of their choice for details.

Diploma or Degree?

Diploma and degree courses in nursing are run at different academic levels, however there is an element of overlap. Diploma level students can transfer to degree courses or can opt to come back and 'top up' their diploma in nursing to a degree at a later stage. Whether you do a diploma or a degree in nursing depends largely on your qualifications on entry. To check which path you could take click here. Whichever course you decide to take you will begin work as a D grade Staff Nurse on the same salary.

Funding

Nursing and midwifery students on diploma-level courses receive a non-means-tested bursary. This is a flat rate maintenance grant with no contribution required from the student or their family.

Degree level nursing students, as with all degree students, receive their support in the form of a means-tested bursary, supplemented by a reduced-rate repayable student loan.

The NHS meets the student liability for tuition fee contribution. Older students, single parents and those with dependants are liable for additional allowances and students can claim the travel costs they incur while on clinical placements.

The basic rates (from 1 September 2001) are:

Diploma Course (non-means tested bursary):

• London - £6,232

• Elsewhere - £5,305

• Parent's home - £5,305

Degree Course (means tested bursary):

• London - £2,578

• Elsewhere - £2,098

• Parent's home - £1,717

You may be entitled to a student loan to cover the balance of your living costs as NHS means tested Bursaries are not intended to meet all your maintenance requirements. You should apply via your local education authority (LEA) for a loan before your course starts. For more information click here.

Entry Requirements

Due to the nationwide shortage of nurses, the government proposed a system of 'widening participation' in order to encourage more people to enter training who may previously have been put off by not having formal academic qualifications. Below is a brief outline of the routes open to an individual who is considering applying for a nursing course at a university. It must be stressed that universities differ in the standards they set, though general guidelines should apply:

• Standard: minimum 5 GCSE's (diploma) and 2 'A' Levels (degree)

• An 'Access to Nursing Course', run at many Institutes of Further Education.

• National Vocational Qualifications (NVQ), in care.

• Accredited prior learning (APL), where a university may take into account, courses previously taken by the applicant.

• Accredited prior experiential learning (APEL), where a student's work experience in a relevant field may be taken into account, in lieu of more formally recognised qualifications, as mentioned above.

Universities use a system called Credit Accumulation and Transfer Scheme (CATS). Credits are a points system which acts as a form of educational currency which can be accumulated to count towards qualifications. The Credit Accumumlation and Transfer Sheme (CATS) means that credits gained at one university can be transferred to another, at any time. Individual universities have different methods of accepting CATS.

Modularisation

Courses are now made up of a series of modules. Each module carries a certain number of credits, usually 10 or 15.

Certificate level - Level 1 = 120 credits

Diploma level - Level 2 = 240 credits

Degree level - Level 3 = 360 credits

What do the different academic levels mean?

All academic courses run on a tier system, whereby a student is taught the basics, during the first year and the knowledge and skills gained are then built on during the next two years. The different academic level definitions used by the universities are outlined below;

Level 1

Learning experience at level 1 (Usually 1st year degree courses and 2nd year diploma courses are run at this level) involves the acquisition of basic knowledge, skills and competence, and is characterised by:

• Raising awareness of

• Introducing to

• Beginning to develop

• Exploring

• Describing

• Beginning to recognise

• Work should be referenced in modified Harvard system.

Level 2

Level 2 builds on level 1 and involves an extension and reinforcement of those experiences. (Usually 2nd year degree courses and third year diploma courses. Also, many post registration courses are run at level 2).

• Increasing awareness of

• Developing greater/deeper understanding

• Observing and reflecting on

• Beginning to analyse (formally)

• Beginning to recognise (and classify)

• Explore and reflecting on

Work should be referenced in modified Harvard system.

Level 3

Reflects the synthesis of knowledge, skills and competence and equips students with tools of analysis and evaluation. (Third year degree level and some post registration courses are run at this level)

• Investigating, critically appraising

• Monitoring, reviewing and evaluating

• Using relevant material to show awareness of different perspectives through reflection

• Critically examining and reflecting on theoretical perspectives and their relevance to practice.

Masters Level differs from first degree level in the depth of analysis/understanding and the level of original/innovative thought which is expected will be achieved by students.

Study at advanced, professional postgraduate level demands:

• Reflection on the significance and inter-relationships of knowledge derived through scholarship as well as from the professional experience of the student

• Formulation of original and innovative ideas in professional practice

• Initiation of change on the basis of such original ideas and proposals involving both personal professional activity and in the wider context of health and social care delivery

• Demonstration of a considerable degree of autonomy enabling them to initiate, plan, carry out and evaluate their own, and others professional development

• Making significant contributions to their place of work through research development, scholarship and the application of advanced skills and knowledge.

Careers in Nursing

Once qualified there are any number of different career paths for a nurse to take. A nursing qualification opens the door to many attractive opportunities in life. From a traditional, often specialised career within a hospital or community setting, to management and paid and voluntary overseas work, to a career in nurse education - the list is endless.

For a nationwide job site, and opportunities for nursing overseas visit NursingNetUK or HealthJobsUK.

The Grading System

In order to better understand the grading system within a hospital setting, the following guidelines have been set out below. Written by the author they are not intended to be definitive, merely a guideline. The pay guidelines come from the Department of Health and are National Scales, therefore exclusive of London Weighting and extra payments for unsociable hours i.e. weekends, night duties and bank holidays.

It is perhaps important to mention here that most hospitals now employ nurses on a contract that includes 'internal rotation'. Internal rotation means that the staff rotate their shifts from day duty to night duty, in order for the ward to be covered 24 hours a day with the correct skill mix. (The skill mix on each ward is made up of a mixture of different grades of staff, outlined below). The day shifts are either divided up into early and late shifts, or long days, which can involve a 12 or 14 hour day. The type of shift depends on the ward, hospital or NHS trust that you are applying to and must be a serious consideration when job hunting.

'A' grade nurses (Pay scale from £9,735 to £12,220 from 1st April 2002)

Untrained nurses, known as Health Care Assistants or auxillaries. 'A' grade nurses carry out many of the practical functions of ward work and the job entails a lot of 'hands on' nursing care.

'B' grade nurses (Pay scale from £11,455 to £13,485 from 1st April 2002)

Also untrained and known as Health Care Assistants or auxillaries, 'B' grades usually have either many years experience or have completed a National Vocational Qualifications course in care.

'C' grade nurses (Pay scales from £13,040 - £16,005 from 1st April 2002)

Some 'C' grade nurses are qualified to enrolled level (for a description of enrolled nurse click here a brief history).

'D' grade nurses (Pay scales from £16,005 - £17,670 from 1st April 2002)

'D' grade nurses are either enrolled nurses or is the grade that a newly qualified, registered nurse starts at.

'E' grade nurses (Pay scales from £17,105 - £20,655 from 1st April 2002)

An 'E' grade nurse has usually had a minimum of 6 months post registration experience, but more usually a full year. Many specialities such as Intensive Care Units (ITU) or Accident and Emergency (A and E), will train their 'E' grade nurses in the speciality they have chosen. Nurses specialise by undertaking post-registration courses. 'E' grade nurses should be encouraged to gain valuable management experience, with supervision and guidance from more senior nurses.

'F' grade nurses (Pay scales from £18,970 - £24,565 from 1st April 2002)

'F' grade nurses are known as senior staff nurse or junior sister. They have usually one or two post registration courses and have specialised in a particular area of nursing. An 'F' grade nurse will have a considerable management role to play and in a ward setting, may be left 'in-charge' on a regular basis.

'G' grade nurses (Pay scales from £22,385 - £27,245 from 1st April 2002)

'G' grade nurses are 'Sisters' or 'Charge Nurses', (the title traditionally given to senior male nurses). It is usual for a 'G' grade nurse to have responsibility for an entire ward or unit and all the staff. They have a considerable management role to play, which invariably consists of more paperwork than 'hands-on' nursing, though of course this varies between specialities.

'H' grade nurses (Pay scales from £25,005 - £29,990 from 1st April 2002)

Once a nurse has reached this grade it is usually a management position and involves a lot of personnel management, as well as budgeting, recruitment and training.

'I' grade nurses (Pay scales from £27,695 - £32,760 from 1st April 2002)

This grade is personnel management, decision making, planning and policy.