Nursing: Make a career out of caring

Nurses make a difference. The NHS needs more nurses" proclaimed the adverts in the Government's recent campaign to recruit more nurses. There are thousands of nursing vacancies in the NHS and Frank Dobson, the Secretary of State for Health, aims to employ up to 15,000 more nurses and increase student places by 6,000 over the next three years.

For anyone who is interested in becoming a nurse there are many different routes into the profession, as Sally Thomson, the Assistant Director for Education for the Royal College of Nursing explains: "Students can enter nursing through the traditional route with GCSEs and A-levels or they can come into nursing because they have a degree in a relevant subject such as sociology or biology. Working mothers can do an access course at a university or do work that demonstrates how caring for a sick or dependent relative informed her learning and developed her nursing skills." For young school leavers there is the chance to study under the cadet scheme whereby they can work as care assistants in a local hospital, be financially supported and at the same time study for an NVQ to enter nursing.

There are two types of qualification for nursing - the diploma and the degree. The period of study for the diploma is three years and for the degree it can be three or four years, but with both qualifications students emerge as state registered nurses and will earn the same basic starting salary which the Government has just increased from pounds 12,855 to pounds 14,400. The main difference between the diploma and the degree course is that diploma course students receive a bursary. As Sally Thomson says: "Nursing students who do demonstrate considerable financial hardship and diploma- course students are eligible for a bursary of between pounds 5,000-pounds 7,000 according to their age and the number of dependents they have." Degree course students are only eligible for a means-tested bursary, but they can apply for a student loan and for student awards.

Sue Montague is the Principle Lecturer in Nursing at the University of Hertfordshire and she describes the attributes of a good nurse as someone who is "intelligent, articulate, has a sense of responsibility, wants to be involved with caring for people, has the ability to develop good interpersonal skills and has a concept through work experience of what the job involves."

Gemma Hale, 22, is a student nurse at King's College, London, in the fourth year of her degree, and she agrees that it is very important to "get some work experience before you apply to become a nurse so that ou have some idea of what will be required of you. It is a good idea to look for work in local residential homes for the elderly or do some voluntary work in hospitals".

She has found her course hard work, but enjoyable as well. "It has made me grow up a lot. It is deeply satisfying to see someone come into hospital really ill and then go out able to lead a normal life again."

Gemma thinks it is a good time to be in nursing: "Nursing is so dynamic at the moment - there are so many changes happening and I can be part of that changing process. I like the technical side and being stretched academically."

Lee Ranyard, 21, is doing a diploma in nursing at the University of Northumbria in Newcastle and he also didn't really know what to expect. "I was worried at first that I wouldn't be able to cope but tutors said I wouldn't be on the course if they didn't think I could do it."

After the first 18 months spent on the foundation programme "getting the general grasp of what nursing involves" he is now studying care of the elderly which he finds particularly rewarding. "I am on an elderly care placement in hospital, looking after patients who can't take care of themselves and helping them to get back on their feet before going home."

Lee first decided he wanted to become a nurse when his grandmother became ill and he spent "quite a bit of time looking after her and saw what a valuable job nurses did". He made some inquiries about nursing and he has been pleased with his decision ever since. He has been surprised at how many men there are in nursing.

"There are five men on my course out of a group of 40 and out of 100 students in my year about 30 of them are men." His advice to anyone who wants to be a nurse is not to be put off. "I failed first time of applying so I went and got some nursing experience in a residential home and I got in."

Once a student has qualified and started work as a nurse he or she still needs to carry on learning. From 1994 there has been a statutory requirement for professional updating in nursing. This ranges from the minimum requirement of 35 hours post-registration work over three years to a wide variety of postgraduate courses covering all aspects of nursing and healthcare, and it is up to the individual practitioner to decide what training they would like to do. Sian Wade is the senior lecturer at Oxford Brookes School of Healthcare. She teaches nursing courses at undergraduate, post-registration and postgraduate level and her specialist subject is geratology in which she studies the elderly.

Part of this course is the life review module which focuses on how to understand a person based on their life history. She gives the example of one patient "a gentleman who was injured in the Second World War and whose wife had cared for him his whole life. He was admitted to hospital very ill and wouldn't eat anything. We found out that his wife was feeding him when she came to visit. She was so used to looking after him that she felt she had to carry on."

Families do not always inform nursing staff about everything to do with a patient, and the postgraduate course in geratology teaches students how to elicit information out of families and deal with the key issues of "problem solving and decision making".