Not knowing the difference between an EN and an RN - check.

What?

Nurse, patients and other individuals did react, of course. However, the universities and the professional bodies, hitherto the monopoly suppliers of certain professional qualifications and credentials, hardly uttered a squeak …. and nor are they likely to.

The Howard government got the signal it was waiting for.

The highway is now clear for private corporations to become the issuers of professional qualifications in competition with [or instead of] the universities and professional clubs. Do you fancy putting FRASFO behind your name? Fine. Just front up with the dough, fill in the tick-and-flick exam paper and - Shazam!! - you become an instant Fellow of the Royal Regional Australasian Society of Feral Onanists; you can hang out your shingle, hire a Senior Counsel to tell you how close to the wind you can sail with you advertising claims and then charge the suckers patients a fortune, all with the full blessing of the health insurance corporations and the government. Meanwhile, the government will have a green light to slash university funding even further [and perhaps even abolish it altogether].

There will be the inevitable angry letters-to-the-editor, petitions with thousands of signatures and street demonstrations by university staff [good target practice for water-cannons] …. but all too late.

My immediate thought was that is terrible, but then the light went on - exactly, which state ALP government was thinking of abolishing penalty rates of pay for nurses? Because when you think about it, most nurses are employed by state hospitals and those who are employed within the private sector must have in recent years achieved pay parity due to the skills shortage.

Not if federal funding for hospitals is made conditional on nurses being pushed onto AWAs

My sister is a nurse educator and is currently training personal carers for work in the home for the aged and disabled. She talks about how difficult it is to teach something properly when there is often 6 months between theoretical knowledge and actually carrying the task out. She is obviously thinking about the skill level her students will have when they eventually get work.

As well, I’ve had a friend go through a lower level personal carer training program as run by an employment agency, and she described the lessons in learning to shower clients where they had to team up with a fellow student and have them undress and shower each other. It was a joke nothing like the actual experience of caring for a sick person in a home setting.

When you think about all of the tasks nurses need to perform it is easy to see the benefits of hospital based training and the wisdom of re-introducing these kind of programs.

“Also, Indian and Chinese doctors often see work relationships in strict hierarchical terms, where nurses are at the bottom”

That is one of the reasons I proposed, some time ago, a COMPULSORY!! MANDATORY!! YOU-DON’T-GET-A-PRACTICING-LICENCE OR ENTRY-TO-STUDY UNTIL-YOU-DO fortnight-long intensive Australian Cultural and Social Awareness course!! I got really fed up with arrogant, ignorant and sometimes downright incompetent twits treating me [an experienced R.N.] like a mongrel dog and yet crawling and grovelling to white Australian residents and registrars!!; their attitude to ordinary patients was often much worse. Recent scandals have shown that the ones who decide who does and who does not get to work in the Australian health system are the ones far removed from the harmful effects of their flawed decisions; this is one of the reasons health administators too should be made to do the year-long compulsory basic health care course I suggested above]..

Jinmaro:
It all depends on the situation. For instance; if you are a male “F.W.C.” alone at night in an Aboriginal community that had recently had the benefit of hit-and-run upper-class white do-badders sharing their views of how Aborigines should conduct themselves towards white invaders and oppressors, then things can get really exciting. [fortunately, that particular night, the worst that happened was a lot of commotion - and the good thing is that the patients did get treated and they did recover …. and nobody landed a punch on me at all ]. Another time, in a major city hospital, I overheard lurid, grossly offensive descriptions of my hard-working, highly-qualified colleages by a bunch of relatives. It was with some pleasure, a perfectly straight face and a dignified voice that I asked them to kindly stand back so that I could close the curtains and give the patient an injection - and that polite request was in the superior register of their own language L-O-L. [Somebody should compile an anthology of funny nursing stories].

Also, Indian and Chinese doctors often see work relationships in strict hierarchical terms, where nurses are at the bottom. That was a factor in the Jayant Patel case. Patel mocked and scorned the nurses who complained about him, and the hospital administration followed his lead.

Stop Telling Us To Cope:

“Student enrolled nurses who basically go to TAFE for a year - when they finish and come to the workforce they’re part of your workforce and you’re responsible. They are unskilled but you’re responsible so with your delegated work load and highly acute patients you have to take care of the ENs as well.”
Current Nurse, Westmead. Female, Surgical Nurse in Western Sydney.

“Those that come [into Accident and Emergency] because they’re not going to pay the doctor [General Practitioner] they’re the ones that are abusing you because they’ve got to wait for 4 or 5 or 8 hours. In the 80s people actually respected us as nurses. Now they walk in the door and say ‘well how fucking long do I have to wait?’ That’s how you get greeted.”
Current Nurse. Male, Orthopaedics Nurse.

Sorry for lengthy post, phew, I really needed to get this stuff off my chest (consider yourselves my therapists for tonight!)
Over and out now.

In my own experience, it’s not “you’ll just have to cope” it’s “you’ll just have to stretch yourselves”.

That would make such a nice change after all the squanderng of health budgets by the slash-and-burn cost-cutters and by the money shovellers.

Whopping great big savings. When huge amounts of money are not being dumped down so many plug-holes, they will be available for effective health care. Howard’s stunt [for it is nothing but an ad-hoc stunt] will only exacerbate the current problems and make it harder for those seeking workable reforms.

Doubt it. These things always have the habit of costing more money than they save.

David:
Whopping great big savings. When huge amounts of money are not being dumped down so many plug-holes, they will be available for effective health care. Howard’s stunt [for it is nothing but an ad-hoc stunt] will only exacerbate the current problems and make it harder for those seeking workable reforms.

Jinmaro:
Didn’t ignore them. It was the brevity of a blog post that compelled me to omit mention of relatives’ [and patients’] attitudes and expectations, headhunting of staff by the corporate world, the influence of TV, litigation and several other important aspects and issues. Violence? Sorry but there are some staff who do bring it on themselves by neglecting to look at the situation from the patients’ perspective, especially if patients are in pain. Much violence is also caused by bad administration, bad policies and by bad architecture. I had a lot of violent, noisy or confused - even murderous - patients over the years and managed to get all of them calmed enough to be assessed and treated; since I didn’t have any magical powers at all there must be something people like me did right …. and just maybe it was in using a set of easily-learned skills and attitudes that did not wind-up the patient or put myself at risk.

Wages? Taxes? How about, just for a change, SAFE staffing levels, rosters …

Once those things are given attention, the money will roll in …. and you won’t have to worry much about wages and taxes - or staff retention.

I agree we should look at ways to improve rosters, etc. However, I can’t see how this would make money roll in. But either way, this is irrelevant to whether Howard’s measure will also mitigate the problem (albeit only slightly). I think we need to look at lots of measures.

As I suspected, it’s the testosterone thing.

Now, here’s a question - how many F-111 pilots are there in Australia whose lives depend on their ability to handle a plane in the highly predictable - oops, unpredictable - conditions of combat? Now how many patients are there in hospitals around the country whose health and welfare depend on the competence of nurses?

Please try to stick to the argument. The fact that flying an F111 is complex has nothing to do with testosterone or the number of people whose lives depend on their services.

And while I’m by no means rusted on to the idea that university is the only place where complicated skills can be learnt, I don’t think anything is gained in this discussion by -

- dismissing university nursing training as “Bedpans 101″;

Can you try to make it clear what commenter you are talking about, because it certainly wasn’t me who said that. I don’t think that kind of contemptuous reduction is helpful. But perhaps you should follow your own advice before you parade your own ignorance by reducing piloting to:

expensive machines that go whoosh, occasionally ack-ack-ack and on really special occasions get to drop the machine that goes ka-boom.

….but just because there is a relative paucity of historical material in English about French and German nurses prior to Flo’s time, they tend to be overlooked.

Not by her though, Graham. If you read her writings you’ll see her acknowledging the contributions of German and French and Italian nursing and recommending the adoption of their practices. She is a victim of her PR, not of her making, in Victorian England where she was sentimentalised as “the Lady with the Lamp” while her real agenda was to bring scientific method to nursing in England and to drag it out of the medieval state it was in.

She gets much disservice done to her by those who know about the Victorian sentimentality and therefore in these times see her as a candidate for cheap shots rather than making the effort to find out what she was on about. If they weren’t too lazy to make the effort they’d be surprised at just how much she said and did one hundred and fifty years ago is relevant today.

But then, as I often find here, the easy path of cheap shots born of sublime ignorance is the easy and fashionable one. Doing the hard yards of finding out about people like Florence Nightingale is not so much in evidence, to put it kindly.

Bullet-proof glass in emergency departments in city hospitals is now an OH&S requirement. Surgeons, radiologists, radiographers, nurses, night duty staff all face an increasingly violent, demanding, litigious citzenry demanding non-problematic, successful medical treatment. And why do you think that is? And what can be done about it?

David [at 6;27pm last night];
Wages? Taxes? How about, just for a change, SAFE staffing levels, rosters that don’t break up marriages/relationships, predictable hours [great for doing part-time courses to advance onself], professional respect, autonomous decision making, meal breaks that actually do happen, being firm with pharmaceutical and ethical supplies corporations, SAFE staffing levels, TWO professionals on every ambulance and in every community nursing vehicle, SAFE staffing levels, cracking down on Rort Central [the exclusivemedical specialist colleges/societies], post-discharge follow-up for all patients, time to sleep and recover after night-shift, an emphasis on realistic health education, SAFE staffing levels?

Once those things are given attention, the money will roll in …. and you won’t have to worry much about wages and taxes - or staff retention.

However, the transition to university-based training was thoroughly bungled [mainly due to the greed and the lack of forethought by university administrators] and we are now really paying the price for allowing that bungle to happen.

Instead of waiting for politicians, spin-doctors and “health” fund CEOs to come up with one ratbag or momey-grubbing scheme after another [especially just prior to elections], why don’t we all take a good hard look at what we really do need in our own health care system …. then go around the world cherry-picking the most appropriate bits for Australians out of each country’s health care system.

Maybe it’s polyclinics in Singapore; maybe it’s disabled care in Hungary; maybe it’s hospital management in the Philippines; maybe it’s A&E in South Africa; maybe it’s the ambulance system in Russia; maybe it’s optometry in China - who knows? But whatever we do, we must break out of that narrow vision of health care imposed on us by the Florence Nightingale mob and by the Australian arm of the old British Medical Association and we must also break away from all that slavish adherence to the failing American one …. and that will mean swallowing our pride then trying to learn from people which Australia’s failed elite usually assumes are our “inferiors”.