Saturday, January 12, 2008

Is it time to bring back hospital nursing schools?

The convergence of a number of circumstances in my life has lead me to ponder this.

1. We have a severe nursing shortage which is leading to cancellations of cases in the OR which is of course affecting my income. (This would be nice if my income was reduced by just working less; however a significant proportion of the lost time is time sitting around seeing if they will be able to do your case.) The reason is that years ago when it was decided that healthcare was too expensive and that the work of a RN could be done by cheaper workers, many nurses were laid of, retired, took up other jobs etc. Of course after reading about layoffs of nurses there was very little incentive for young people to go into nursing and secondly because we were lead to believe that RNs were unnecessary, nursing programs were reduced. Now in order to train the number of nurses necessary to run the system at it's present capacity, we are told that it will be necessary to have more academic nurses which means that we will actually have less nurses involved in patient care before we have more.

2. My wife is retraining as a nurse after being out for about 10 years. (Any nurse who reads this, no matter how bad nursing seems or how good life as a housewife looks, DO NOT let your registration lapse; work the minimum necessary to keep it; read on). This has involved over a year of home learning with periodic exams mostly covering irrellevent information, some of it incorrect (the parts dealing with anesthesia, which I know a little about, for example). Now she is in the middle of a one month unpaid practicum after which I am lead to believe if she pays her fees she will be a RN again.

3. My son is taking engineering at University. One popular option at his and other Universities is the co-op program where they get work experience and earn a little cash while pursuing their degrees.


Historically most professions learned their craft on the job by apprenticeships or other forms of servitude. This includes doctors, lawyers, accountants and nurses. Around the turn of the century (20th that is) doctors, lawyers and accountants began to go to universities although there was still some form of servitude involved.

While there were university nursing programs early in the 20th century, most nurses were trained in hospital schools. In addition to lectures, they worked on the wards and were considered an important part of the staffing of the hospitals involved. They lived in nurse's residences, got free room and board and were paid a small stipend. Gradually these hospital schools were closed and the only route to becoming a nurse was thru universities, community colleges and technical schools. (When I joined the CofE, there was still a hospital school attached which graduated its last class the year I started). Many nurses I work with now are graduates of these hospital schools and speak fondly of their experiences, both learning and social

Now many nurses would argue that nursing is a profession as dignified as medicine, law, accounting and others that now require degrees and I have no arguement with that.

However as mentioned above, many university professional schools now offer co-op programs which are surprisingly like the old apprenticeship programs that these professions evolved away from. So why not start some type of co-op program for nursing where after some basic training they can hit the wards, and help out while getting some valuable experience. They would receive some type of stipend for their time. They could be affiliated with universities of professional schools. After getting their RN, they could have the option of obtaining a BSN either by attending university full or part-time.

I think that besides being an immediate partial solution to the nursing crisis, this would enhance the practical experience of the graduate nurse.

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