King's College London

Nurses have to possess the expertise to deliver care to everyone, everywhere

Nurses are essential in transforming healthcare and health systems. Being educated to degree-level ensures nurses are well equipped to provide high quality care. It also prepares them to take the lead, inform and design health services delivery, decision making and policy development.

The theme of this year’s International Nurses Day is Nurses: A Voice to Lead – Health for All, which champions the crucial role of nurses as a patient advocate, providing appropriate, accessible and evidence-based care.

In today’s world, the healthcare needs of populations are increasingly more complex. People are living longer can have multiple or long-term conditions (or both). Multidisciplinary care is required and there is a shift towards delivering care closer to home and the need to keep people with long-term conditions out of hospital.

Nurses work in a wide range of settings and roles bringing services to patients and populations in schools, homes, the workplace, clinics, prisons, field hospitals and shopping centres. They provide hands on as well as digital care.

This changing landscape means that practitioners now and, in the future, will need a deeper knowledge of mental health, child health and learning disabilities, and will deliver care independently or as part of a well organised multidisciplinary team.

In delivering and co-ordinating high-quality care today, the ‘basics’ nurses have a deep understanding of spans multiple subjects, including anatomy and physiology, pharmacology, sociology, psychology, research methods and economics. They deliver care to a diverse population and people and their families rely on them to translate, navigate and support them through worrying times. A degree-level education is a minimum requirement for nurses to provide this wealth of expertise.

Keeping ‘anti-intellectualism’ at bay

Anne Marie Rafferty is Professor of Nursing Policy at King’s and President of the Royal College of Nursing and has long been championing the proven benefits of degree-level education in nursing and continued professional development of nurses throughout their careers.

Over the years, Professor Rafferty has authored key research in workforce and policy, quality of work environment and nurse and patient outcomes. In a study published in the Lancet, Anne Marie and her co-authors demonstrated that nurses qualified to degree-level can reduce the number of preventable hospital deaths. Last spring she also contributed to a student-led commission which considered the future of the NHS and in March 2019, she joined the NHS Assembly to help deliver the Long Term Plan for the NHS.

Disagreeing with those who doubt the need for nurses to go to university, Professor Rafferty explained how her degree has opened the door to a wealth of opportunities.

She also encourages the next generation of nurses that they must fight to keep ‘this wave of anti-intellectualism’ at bay.

‘We must never lose sight of how lucky we are to study at university, and how a university degree affords us the opportunity to critique our practice and to investigate issues such as leadership and politics.’

When Professor Rafferty was studying in the late 1970’s, nursing degrees were viewed with scepticism and university educated nurses only made up a tiny minority of the profession.

‘This scepticism had to be challenged and combated with vigour and robustness’, adding that some thought degree-level nurses like her were ‘too posh to wash’ or ‘too clever to care’.

Re-thinking funding cuts to nurse education

However, Professor Rafferty also recognises that government cuts to nurse education have resulted in fewer student applications, leaving the future supply of nurses under threat. The removal of the bursary has made prospective nurses think twice about applying to university and that debt caused by a lack of financial support is also putting qualified nurses off continuing their studies. All at a time when there are almost 40,000 registered nurse vacancies in England’s provider sector and pressures on the current NHS workforce are reflected in the high turnover of staff.

Professor Rafferty has called upon the government to ‘look again’ at how it supports nursing students in England, taking heed of and implementing the evidence-based solutions to hand. In March, she was appointed to the NHS Assembly to support the delivery of the NHS Long Term Plan. Professor Rafferty will be sharing her knowledge, skills and experience to advise the Boards of NHS England and NHS Improvement on delivery of the improvements in health and care set out in the Plan. As President of the RCN, Professor Rafferty promotes the #FundOurFutureNurses campaign, which calls for a minimum of £1bn a year to be put back into nursing higher education.