Cut clinical hours to attract students, says leading nurse academic

Linda Aiken, professor and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania in the US, said a way of attracting more people into nursing education would be to make it more like the traditional university experience.

“We have half of the required clinical hours in our university programmes than you do and we have great nurses”

Linda Aiken

She said: “The best and the brightest in both of our countries are often wanting to go to the university, like everybody else wants to go to the university, but nursing schools are really not university programmes, they are not integrating with the university.”

Addressing a nursing workforce conference in London on Thursday, Dr Aiken said the US had “put a big focus” on making degree-level education for nurses the same as other students.

She highlighted how student nurses in the states were required to complete 868 clinical hours over a four-year course, compared to 2,300 hours over three years in England.

“We have half of the required clinical hours in our university programmes than you do and we have great nurses – nobody’s criticising our nurses for not being good,” she noted.

“You are sort of taking that apprentice idea that through education you have to drill these things into people when things are changing so fast in education by the time they graduate there will be a whole new set of things they have to do,” said Dr Aiken.

“So, think about, do you really need all these clinical hours and could you move to something that looks more like education for other people,” she added.

Dr Aiken was speaking during an event hosted by leading think tank the Health Foundation called Bridging the nursing gap: addressing the workforce challenge in the short term.

She noted that over the past 20 years the US had solved its nursing shortage, adding that it was “much bigger” than the one England was now facing.

Nursing was now the number one career choice in the US, said Dr Aiken. She said this was achieved in part through upskilling nurses.

“There are so many jobs for nurses, there are so many people that want them – that has really been generated by expanding the roles of nurses,” she told delegates.

She suggested England was lagging decades behind the US on this agenda. “England is, I would say, 40 years behind the US in the use of nurses in expanded roles,” she said.

“The message today…. is that having nurse practitioners and really leveraging the role of having nurses being able to move up into a higher level of practice has brought nurses into the workforce and into nursing schools,” Dr Aiken said.

The respected nurse academic also championed the idea of mandatory nurse staffing requirements, highlighting how one year after California adopted nurse-to-patient ratios it had eradicated its nursing vacancies.

The University of Pennsylvania – which has been ranked number one across the globe for nursing education for three years running – is evaluating the introduction of safe staffing legislation in Queensland, Australia.

Dr Aiken said findings showed that as well as addressing staff shortages, the law had resulted in nurses in the state taking care of one less patient on average and mortality rates declining by 12%.

The conference was held following the recent release of the major Closing the gap report by the Health Foundation, King’s Fund and Nuffield Trust.

The think tanks warned that if nothing changed, England’s nurse shortage would hit 70,000 by 2023-24 and could rise to as high as 108,000 in a decade.