Media Release

NHS at 70: The nurse training enjoying a comeback

While many practices and processes have become outdated and replaced over the 70 years of the NHS, one route of training which fell out of favour has enjoyed something of a renaissance.

The two-year trainee nursing associate role, which couples employed on-the-job training with a rigorous pathway of learning via an education provider, has strong similarities to the State Enrolled Nurse (SEN) training which was phased out in the 1990s.

Practice development nurse Julia Saunders, who has played a central role in the training of thousands of student nurses and people returning to the profession, believes that, in some ways, training has come full circle.

There were two routes to becoming a staff nurse. The SEN course was two years and those on it were known as pupil nurses. The SRN course (student nurses) was three years and included two vital exam papers.

“It didn’t matter how good you were in practice, you would fail if you didn’t pass a paper,” said Julia.

Julia’s SRN training began in January 1984 when she was 20 and there was a dedicated nursing school at QEH.

Nowadays, in this region, each year about 200 students begin their student nurse training at University of East Anglia in Norwich, in conjunction with hospital trusts.

The number of trainee recruits in the sector is falling but back then there were long waiting lists at Addenbrooke’s (three years), Ipswich (18 months) and Norfolk and Norwich (one year).

At QEH, there were about three intakes per year and Julia was in “quite a big one” of 15 – which started on New Year’s Day! One of the first tricky tasks females had was getting to grips with the folding and making up of the nurses’ hat.

Many trainees lived on site which had a social club and such a strong sense of community that people often grew to know their colleagues’ families too.

“When I started, you were an employee from day one,” said Julia, who lived on site. “Your life was the hospital and you lived by the standards and rules of the hospital. We were part of that culture.

“Whether you were in the school or on the wards, you were a member of the hospital.”

“By the end of the first week of training you were supported by a third-year student to visit the wards. You were mentored by the third-year student – and we were in awe of them. You would go to them with any queries rather than a staff nurse.

“It was hierarchical. I remember that, on some wards, when a consultant was doing their rounds student nurses had to go off the ward.

“Sisters had more autonomy on the wards than they do now. If a sister told you to do something, you did it. But I was coming into the brave new era when you were taught to challenge.”

After a ten-week spell in school, there was an eight-week placement, a week or two holiday, then two weeks in school and another placement. Training covered medical, surgical and all the specialities. There was only one specialist nurse in the hospital – for stoma care. Nowadays the placements are for longer periods and student nurses choose which area they want to work in.

There were overseas nurses – particularly from Ireland and Mauritius – but not the level of recruitment there has been in recent years.

And the uniforms were very different and choosing your belt buckle upon qualification was a big deal.

Julia said: “Your buckle was very special. Only a qualified nurse could wear a belt buckle, which you bought yourself.”

Despite all the changes, Julia, now aged 54, believes a hybrid of knowledge and experience has shaped a thorough and fulfilling training programme today.

“I would like to think that we have learned a lot along the way, taken the best aspects and built that into what we deliver now.”


Photo caption: QEH practice development nurse Julia Saunders (front, centre) with third-year students

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