Pre-registration
In order to become a registered nurse, and work as such in the NHS, one must complete a program recognized by the Nursing and Midwifery Council. Currently, this involves completing a degree or diploma, available from a range of universities offering these courses, in the chosen branch specialty (see below), leading to both an academic award and professional registration as a 1st level registered nurse. Such a course is a 50/50 split of learning in university (i.e. through lectures, essays and examinations) and in practice (i.e. supervised patient care within a hospital or community setting).
These courses are three (occasionally four) years' long. The first year is known as the common foundation program (CFP), and teaches the basic knowledge and skills required of all nurses. The remainder of the program consists of training specific to the student's chosen branch of nursing. These are:
In order to become a registered nurse, and work as such in the NHS, one must complete a program recognized by the Nursing and Midwifery Council. Currently, this involves completing a degree or diploma, available from a range of universities offering these courses, in the chosen branch specialty (see below), leading to both an academic award and professional registration as a 1st level registered nurse. Such a course is a 50/50 split of learning in university (i.e. through lectures, essays and examinations) and in practice (i.e. supervised patient care within a hospital or community setting).
These courses are three (occasionally four) years' long. The first year is known as the common foundation program (CFP), and teaches the basic knowledge and skills required of all nurses. The remainder of the program consists of training specific to the student's chosen branch of nursing. These are:
- Adult nursing.
- Child nursing.
- Mental health nursing.
- Learning disabilities nursing.
As of 2013, the Nursing and Midwifery Council will require all new nurses qualifying in England to hold a degree qualification.
Midwifery training is similar in length and structure, but is sufficiently different that it is not considered a branch of nursing. There are shortened (18 month) programmes to allow nurses already qualified in the adult branch to hold dual registration as a nurse and a midwife. Shortened courses lasting 2 years also exist for graduates of other disciplines to train as nurses. This is achieved by more intense study and a shortening of the common foundation program.
Midwifery training is similar in length and structure, but is sufficiently different that it is not considered a branch of nursing. There are shortened (18 month) programmes to allow nurses already qualified in the adult branch to hold dual registration as a nurse and a midwife. Shortened courses lasting 2 years also exist for graduates of other disciplines to train as nurses. This is achieved by more intense study and a shortening of the common foundation program.
Student nurses currently receive a bursary from the government to support them during their nurse training. Diploma students in England receive a non-means-tested bursary of around £6000 per year (with additional allowances for mature students or those with dependent children), whereas degree students have their bursary means tested (and so often receive less). Degree students are, however, eligible for a proportion of the government's student loan, unlike diploma students. In Scotland, however, all student nurses regardless of which course they are undertaking, receive the same bursary in line with the English diploma amount. In Wales only the Degree level course is offered and all nursing students therefore receive a non-means-tested bursary.
Before Project 2000, nurse education was the responsibility of hospitals and was not based in universities; hence many nurses who qualified prior to these reforms do not hold an academic award.
Post-registration
After the point of initial registration, there is an expectation that all qualified nurses will continue to update their skills and knowledge. The Nursing and Midwifery Council insists on a minimum of 35 hours of education every three years, as part of its post registration education and practice (PREP) requirements.
There are also opportunities for many nurses to gain additional clinical skills after qualification. Cannulation, venepuncture, intravenous drug therapy and male catheterisation are the most common, although there are many others (such as advanced life support) which some nurses will undertake.
Many nurses who qualified with a diploma choose to upgrade their qualification to a degree by studying part time. Many nurses prefer this option to gaining a degree initially, as there is often an opportunity to study in a specialist field as a part of this upgrading. Financially, in England, it is also much more lucrative, as diploma students get the full bursary during their initial training, and employers often pay for the degree course as well as the nurse's salary.
In order to become specialist nurses (such as nurse consultants, nurse practitioners etc.) or nurse educators, some nurses undertake further training above bachelors degree level. Masters degrees exist in various healthcare related topics, and some nurses choose to study for PhDs or other higher academic awards. District nurses and health visitors are also considered specialist nurses, and in order to become such they must undertake specialist training (often in the form of a top up degree (see above) or post graduate diploma).
All newly qualifying district nurses and Health Visitors are trained to prescribe from the Nurse Prescribers' Formulary, a list of medications and dressings typically useful to those carrying out these roles. Many of these (and other) nurses will also undertake training in independent and supplementary prescribing, which allows them (as of May 1, 2006) to prescribe almost any drug in the British National Formulary. This has been the cause of a great deal of debate in both medical and nursing circles.
Canada
History
Canadian nursing dates all the way back to 1639 in Quebec with the Augustine nuns. These nuns were trying to open up a mission that cared for the spiritual and physical needs of patients. The establishment of this mission created the first nursing apprenticeship training in North America . In the nineteenth century there were some Catholic orders of nursing that were trying to spread their message across Canada. Most nurses were female and only had an occasional consultation with a physician. Towards the end of the nineteenth century hospital care and medical services had been improved and expanded. Much of this was due to Florence Nightingale who was training women in English Canada. In 1874 the first formal nursing training program was started at the General and Marine Hospital in St. Catharines in Ontario. Many programs popped up in hospitals across Canada after this one was established. Graduates and teachers from these programs began to fight for licensing legislation, nursing journals, university training for nurses, and for professional organizations for nurses.
The first instance of Canadian nurses and the military was in 1885 with the Northwest Rebellion. Some nurses came out to aid the wounded. In 1901 Canadian nurses were officially part of the Royal Canadian Army Medical Corps. Georgina Fane Pope and Margaret Clothilde Macdonald were the first nurses officially recognized as military nurses. Nursing continued to expand and develop. In the early twentieth century more nursing programs were developed for public health nursing and disease prevention. More changes occurred after World War II. The health care system expanded and medicare was introduced. Currently there are 260,000 nurses in Canada but they face the same difficulties as most countries. Nurses are becoming more scarce and the population is aging which requires more nursing care.
Education
All Canadian nurses and prospective nurses are heavily encouraged by the Canadian Nurses Association to continue their education to receive a Baccalaureate degree. They believe that this is the best degree to work towards because it results in better patient outcomes. In addition to helping patients, nurses that have a Baccalaureate degree will be less likely to make small errors because they have a higher level of education. A Baccalaureate degree also gives a nurse a more critical opinion which gives he or she more of an edge in the field. This ultimately saves the hospital money because they deal with less problematic incidents. All Canadian provinces except for the Yukon and Quebec require that all nurses must have a Baccalaureate degree. The basic length of time that it takes to obtain a Baccalaureate degree is four years. However, Canada does have a condensed program that is two years long.
There are nineteen specialties that a nurse could choose from if he or she wanted to narrow down his or her field. According to the Canadian Nurses Association some of those specialties are Cardiovascular Nursing, Community Health Nursing, Critical Care Nursing, Emergency Nursing, Gerontology Nursing, Medical-Surgical Nursing, Neuroscience Nursing, Oncology Nursing, Orthopedic Nursing, Psychiatric/Mental Health Nursing, and Rehabilitation Nursing. Each specialty requires its own test and competencies. Many tests are offered online through the Canadian Nurses Association.
Public Opinion
Canadian nurses hold a lot of responsibility in the medical field and are considered vital. According to the Canadian Nurses Association, "They expect RNs to develop and implement multi-faceted plans for managing chronic disease, treating complex health conditions and assisting them in the transition from the hospital to the community. Canadians also look to RNs for health education and for strategies to improve their health. RNs assess the appropriateness of new research and technology for patients and adjust care plans accordingly". It is rather uncommon to see nurses with this much independence. In most countries nurses appear to be considered lesser than a physician like in the United States or Japan.