The Staff Nurse

Role of Staff Nurse 1981 to 2026

The failure of the Nurse education system.

4 year degree in Nursing has become similar to Social Work degree due to Educationalists attempting to divorce Nursing from Medicine.

Nursing is both Art and Science.

R.G.N qualification dumbed down thanks to Universities.

Transcript

SPEAKER_00 0:00

In my last episode, I spoke about the ward sister, you know, the historical and um the historical ward sister and how she's developed into the current ward manager, etc. And how really there's no um no um linkage really between the traditional ward sister and what we currently have and what we call ward managers now because of the change in the health service and the change in the managerial structures, etc. But in this episode, I want to speak about the staff nurse, the role of the staff nurse, and how that has changed since when I first qualified in 1981 to what we are dealing with now in 2026, how the role has changed, and it has changed dramatically, and it has been very um slow and progressive, but also very hidden how the role has changed. So I just want to talk about it and express um my views on it, etc., and let you know how things used to be in the in the good old days, as they call them. Now, back in when when I qualified in '81, the role of the role of the staff nurse was seen. It was a big deal for you to be a staff nurse, and that is the honest truth. Back then in the early 80s, if you were a staff nurse and you just qualified, you were seen as somewhat of an expert kind of a creature uh on award. Because you've been through the three years of the um traditional training, you had uh acquired a degree of expertise in in the nursing field. And I don't want sound that to sound big-headed or anything, but when you did qualify and you did your estate final exams, etc., and you obtained a job as a staff nurse on a ward, you did know what you were doing. Um you within reason, like you you might not have much experience, but you knew how to do certain clinical tasks, and that has changed um completely to what the current situation is. And the other thing to remember is on these wards in the in the uh late 70s, early 80s, there were very few staff nurses. There were only, I'd say, four or six now uh and big wards might have eight staff nurses on the team. That was to cover days and nights. So um 24-7. So um there was a lot less positions available for a start on on the wards and in departments. And this was because you had the army of student nurses that have talked about in the past, the third years, the second years, the first years, um doing the the work. Plus, you had auxiliary nurses, and you also had um uh some unenrolled nurses, and I've spoken about about them in the past. They did a two-year training, and they were very practical nurses, and they were like staff nurses, but they're just they didn't do the exams of the staff nurses. But with they were the backbone of the health service in in Britain anyway. I don't think they had enrolled nurses in the Republic of Ireland, but they were the backbone in Britain. You'd have, you know, two, three, four enrolled nurses on on each ward as well. And uh so you had a large workforce that the staff nurse supervised. And this is how it has uh changed over the years. Now, as a staff nurse, even as a newly qualified staff nurse, your opinion would be sought by third year student nurses asking your advice. And if you say you were a staff nurse in charge of a ward and the shift, etc., you would be getting calls from third year student nurses that were in charge of other wards, not just on night duty, this happened during the days as well, because you're talking about earlier and late shifts and weekends and all this kind of thing. Um asking your advice what to do in this situation, what to do in that situation, etc. So the the the staffness was seen as supervisory as well as educational, and so this the work of a staffness was basically supervisory and educational. It's only gradually over the years that the role of the staffness has changed from being um supervisor to worker bee, and that is the reality. Now, in the in the days when I first qualified, except the staff nurses wore the female staff nurses I'm talking about, male staff nurses, we always wore white, and now in the hospital I trained in, it was white trousers and a white top, and after that, but all all hospitals, um the male nurses wore wore a white, you know, tunic, etc., maybe with epaulets on on it. But the female stuff nurses were generally in a pale blue dress, short sleeves, as I said, to say they were kind of worker bees as such, um, an apron, a hat, uh, you know, a linen hat, starch linen hat, and they had this um buckle, and I've talked about that in the Ward Sister um episode. But the staff nurse's belt would be light blue generally, light blue and elasticated, and but they would have this buckle, silver buckle on it, and that was very important if you were a staff nurse. As I've said previously, the career pathway for for staff nurses was very, very different to what it is nowadays. You know, there was a lot less opportunities, educational opportunities and courses, etc. A lot less in those days than there is nowadays. Generally, a lot of the female staff nurses have qualified, I'd say 30 to 40 percent of them would immediately go off and do midwifery. Now there might be a staff nurse on a medical or a surgical ward for six months to a year while they uh preparing to go on the midwifery course. And midwifery was a year's course. I remember that post postgraduate years course, and then they could come back into general nursing as a staff nurse. But the main skills that you would try and achieve talking back in 81 would be advanced resuscitation, and that's what it was called before ACLS came along. It was called advanced resuscitation skills, you know, where you would learn how to defibrillate and all about the drugs and everything for advanced resuscitation, how to run a cardiac arrest, etc., and all that kind of stuff. So you would try and get that course done um if you could as a staff nurse. But in a lot of hospitals that wasn't available if you were a staphness on a medical or a surgical ward, that was mainly for the ICU and for coronary care, etc. But um, if you were on a ward, it was un un it was unit was not uncommon for a staff nurse to remain on a medical ward or a surgical ward for 10 to 20 years. That was not uncommon, and that was the norm. Like people would go on to wards, they would love that ward, they would become part and parcel of the family, and they would go up the the pecking order on that ward and then become you know a kind of a senior staff nurse on that ward. But um it was on not uncommon at all for for staff nurses to remain on wards for 10, 20 years, and actually 30 years some of them. Um and and and that that wasn't the norm. Like this current situation where God almighty people are lucky if they're in the job a year or two years on some of these medical wards and surgical wards that I've heard of, that was unheard of years ago. Like you would be happy and you know, bloom where you're planted in that ward and and and get on with it, and that's it. Now, some hospitals had um a career pathway where after a certain length of time, say 10-15 years, they would appoint them a person as a senior staff nurse. That would be an actual title given to you. And in some hospitals, there was a monetary benefit to that, slight monetary benefit, but a lot more would be expected of a senior staff nurse. But you certainly wouldn't get the title of senior staff nurse unless you had at least 15 years experience and you were an expert in that area, you know, on a medical or a surgical ward, etc. Um, and some hospitals, as I've said in a previous episode, actually put their senior staff nurses in um a different college uniform, like um the pinks I talked about in in Bartz in London. You see, educational opportunities for qualified nurses back then were rare, and courses were very hard to get on. Like there were courses as the same as what I did, intensive care. There were courses in intensive care, there were courses in coronary care, courses in renal dialysis, and courses in theatre nursing. But they were rare, and only certain big hospitals did them, and there was a big waiting list to get on them. So, again, that was quite hard for a staff nurse to do, and it also meant leaving the job you were in, taking a risk, going to that other hospital, doing the course, and then hopefully getting another job, etc. Because, in some ways, you see, there weren't the opportunities in areas for staff nurses that there are now because people did not leave jobs, and that is the reality. Like staff nurses, I I knew staff nurses that were 10-20 years in a ward hanging around waiting for a ward sister's post to become available on some of these other wards. But like a ward sister, you were waiting for dead men's shoes because the award sister was not leaving. The only way a ward sister would leave would be to retire, and that was really the it. Unless there was a terrible tragedy, and one of them was hit hit by a bus on the way to work, you you were not getting her job, and that was the reality. So, ward sister posts were very rare indeed. So a lot of staff nurses put a lot of energy into their job and into bettering themselves in the job and getting as many courses and experience as they could within their power and to be able to put themselves in a good position so that when a Ward Sisters position did become available, they would have the skills and experience required to be appointed. And going back to the early 80s, I can remember uh being interviewed for some senior jobs, and the interview panels they still had consultants on those interview panels. These were nurse interview panels, and the consultants would still be on the interview panel. That was only got rid of very recently, I think the last 10 years or so. So the consultants would be putting his pennyworth into what he thought was the best candidate for the job, you know, and obviously he's not going to want somebody appointed that he didn't know or that he didn't get on with, um, because as I said, they worked very much in cahoots, the ward's sister and the consultants, etc. And um so there was that difficulty to to be taken into account as well. And can I just say this in the Republic of Ireland, it's only in 1973 did the marriage bar get removed, and that meant that if a nurse got married, she had to resign, she had to leave the public service. So if you got married, you had to choose between getting married or your career. So that got rid of an awful lot of experienced nurses because as they gained experience and if they met somebody and fell in love, etc., and they wanted to get married, that that was all very well. She could get married, but she had to resign. So her post would become available. So most of the ward sisters, without going on about them too much, were single, and um staff nurses certainly, if they had experience, they they tended to be single as well because the married ones had had to leave. And all that explains a certain um element that was in nursing and was in nursing for very, very many years of of kind of you know a lot of repressed stuff going on, and a lot of single people frustrated, etc., in nursing and dominated it. And like people blame the nuns for a lot of things, but it wasn't nuns that did that to nurses, that was the government. But anyway, won't go on about that too much. Like flexible working and reduction in full-time hours for a staff nurse appointed to a post. That's only come about fairly recently in the last 10 to 15 years, to my knowledge. And before that, then they had things like um job sharing was a big thing. When I was in the matter in the 90s, job sharing amongst staff nurses, that was that was the only way really you could reduce your hours. Share the job, share the full-time job with another staff nurse. She did, say, 26, and you did 24, whatever it was, whatever's the remaining 16 or something. And you split the job in half, you know, half and half, and you got half the annual leave and half the salary, and you did half the hours. And that was a good way of for women especially to encompass um childcare, etc., into their career. Now, back in the day when I was a newly qualified staff nurse, you if you were a student nurse, you see this, if you were a student nurse, you would never address staffness by their first name. That that is again only a modern construct. Um, you'd refer to a staff nurse with the staff, you'd call them staff. Yeah. That only disappeared, I'd say, in the mid-80s, that kind of thing. Um, if you were asked, if you were speaking to a staff nurse and you didn't know her name directly, you would say staff. Excuse me, staff, that's what you'd say, and then ask your question, etc. Um, and over the years you see it's very um it has been very hidden, I think, in nursing. This whole um that the number of staff nurses posts in wards uh you know has dramatically increased, and that's since all the student nurses were removed. So all the worker bees as they were in the 70s and 80s were replaced by staff nurse posts. And we've ended up in a situation, if you look at it from a helicopter point of view outside of nursing, you've ended up due to the changes in nurse education and everything, we've ended up in a situation where we've moved from uh going from novice to expert, which is what we did in the old days, from student nurse to staff nurse, and we've actually gone backwards, I think. We've ended up in a situation now where we're working we're we're moving from expert to novice, because like the the staff nurse used to be the expert, and uniqualified staff nurse used to be the expert, guiding and teaching and passing on skills to the student nurse body, but now you're ending up with the new situation of a registered general, somebody with the title registered general nurse after a four-year degree in nursing, you know, they're qualifying with virtually no clinical skills or experience, and all the clinical skills and experience are having to be gained in the clinical area. So if you're a staff, say on a surgical ward, you have all those clinical skills that are needed to look after those patients have to be um taught and they have to be gained on that ward. Now that was always done during the student nurse period, but now it's being done uh in the staffness period. So there's no comparison now between what was a third-year student nurse in 1980 to what we have now as a third-year student nurse in 2026, because the the RGN qualification has in some ways been dumbed down, and I'm sorry to say that, but it has, and because they have they they don't have the clinical skills to be able to function as a nurse on a surgical ward or a medical ward, and like the degree in nursing has more or less turned into it's virtually like a degree in social work, and I'm not saying that as some kind of um embittered nurse and manager, I'm saying that from from conversations with student nurses and student nurses and staff nurses that the degree in nursing due to the universities, etc., has now turned into like a degree in social work, and they're producing people with the title RGN, staff nurse title, um, that have no clinical skills of very minimal clinical skills, and all the skills that are needed in nursing, because again, it is both an art and a science, have to be gained on the walls um from scratch. And so, therefore, you need all these other people now appointed in hospitals as clinical facilitators to teach, to supervise, to ensure the people are passing their competencies, etc. Um, that was never needed years ago. So I have to say this, thanks to thanks to the nurse education system, they've actually dumbed down nursing. Now, staff nurses in specialized areas, such as intensive care, in coronary care, the emergency department, in the dialysis units, etc., they, I, in my opinion, they should not really be called staff nurses because they are experts in their area. They have multiple clinical skills and specialized clinical skills. And in my opinion, they are all nurse specialists to varying degrees of competency, obviously, and experience. But there is definitely a scale there within those areas of all staff nurses losing that title and being called clinical nurse specialists and being paid appropriately for the specialized skills they they actually do. There's no comparison between, you know, an experienced intensive care nurse and uh, you know, your stuffness on a ward. There's absolutely no comparison. And that's not to denigrate the ward skills, it's just to say the stuffness in intensive care or in the real dialysis unit is a very highly skilled clinical nurse specialist in her own her or his own right, and they should be appropriately rewarded with an appropriate higher pay scale. So that is my overall view of staffness. There's no comparison between the staff nurses of the 1980s and now uh in the lower grades I'm talking about. Um, but but a lot of that is due to the nurse education system, which I think personally, and it's not only my personal opinion, but with 40 odd years nursing experience behind me, has failed the nursing profession miserably. That's my opinion. But anyway, all the best. Bye bye.