Attitudes Toward Basic Care

At the start of the programme it appears that most students accepted the need to master and apply basic care skills. This was most often due to student’s awareness of their deficit in this area as a result of having no prior experience in health care. Working alongside HCAs provided the opportunity to gain this experience. The majority of participants presented a positive view of basic care tasks at month two, describing them as a clinical skill which provided the means to develop significant relationships with patients that enabled more individualised care. As previously stated, Janine represents a deviant view in this area as she disclosed from the outset that she found the tasks themselves repetitive and dull, which initiated self-doubts as to her commitment to continuing on the course. In relation to another manifestation of anti-intellectualism, at seven months, Rachel, Chloe and Samantha described an acute awareness of the stereotypes associated with nurses who are academic, as being reluctant or unable to engage in basic care. Therefore, their motivation to engage in these tasks changed at this point to become a purposeful performance strategy that aimed to pre-empt or challenge these views.

I mean, it’s like as well with all the headlines they say, ‘Too Posh To Wash’ and everything so you’ve got to prove that you’re not. (Chloe: Interview 2)

I think I’d do it (essential care) anyway, but that’s what makes me even more want to get involved. Because I don’t want people to say, ‘Oh no, she won’t do it, she’s graduate entry,’ I don’t want people to say that. I would do anything that anyone tells me. A HCA as much as a nurse or a doctor, I’ll do anything that they ask me to do, I’m not going to say ‘no, I’m not going to go and help you change that person.’ Because I don’t want people just believing those articles that they read? (Rachel: Interview 2)

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Additionally, engaging in basic care was viewed by Chloe and Gwen as a means of gaining acceptance amongst the team, by appearing useful and hardworking. It was acknowledged that this popularity was used to improve access to more advanced and relevant learning opportunities. This suggested that basic care was not viewed as part of the nursing role, but more a means to achieving the desired opportunities. Chloe and Jenny were frustrated by the need to satisfy requests to engage in basic care at the expense of being involved in opportunities which they viewed as more relevant to their development.

I’m always willing to help and want to do stuff but I sometimes feel like I am basically just training to be a HCA. It helps if a nurse is doing something that they don’t think you might have done before and they say to you, ‘Oh, have you seen one of these being done? Would you like to come and see it, or, so and so’s going down to x-ray, do you want to go with them?’ You know, rather than just sort of saying ‘Oh, someone’s buzzers going off, you go and check the buzzer’ and sometimes you want to say ‘Well, I was going to go down to see this, I’ve not seen this before,’ ‘Yeah, but someone needs the toilet.’ In my mind I’m thinking that’s not really my job but I can’t not go take someone to the toilet, if they really need the toilet to do whatever it is, even if I want to. But if it’s something that I think, I’m only going to have this particular opportunity to do it, then I should say, Well, please can I just go do that, but if it’s something, that happens sort of three times a day, like someone’s taking blood or something, then I’ll just think, Oh well, I’ll do it another time, it depends entirely on the situation. It also depends on how brave I’m feeling and how grumpy the person is. (Chloe: Interview 3)

The discussion of basic care within interviews and diaries was frequent at months two and seven, but featured less at subsequent data collection points. Gwen continued to discuss this issue at month nineteen. However, this was to identify how she continued to utilise basic care as a performance strategy. It is possible that others continued to do this, but by this time it had become accepted as the norm and therefore not viewed as a significant issue to raise at interview. In Rachel’s case, however, the safety she gained from focusing on this area of work was seen by her as a barrier to her development that she needed to address if she was going to achieve the required level of competence.

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