1 INTRODUCTION Whilst nursing and midwifery are often talked about in unison it is important that any student interested in either subject is aware that they are in fact different disciplines. Nursing concerns itself with caring for those who are sick or in recovery, often working with patients of different ages, backgrounds and race. Midwifery s primary concern is the general health and wellbeing of an expectant mother and her unborn baby, and it is the midwife who delivers the baby unless there are complications. It is important to note that pregnancy is not an illness and that midwives will only spend a small proportion of their time dealing with sick women. Whichever field a student chooses they should look for a course which can provide them with all of the necessary practical and theoretical knowledge required along with full registration to the Nursing and Midwifery Council (NMC). At present there are four possible fields of Nursing practice that a student can opt to study adult, child, learning disability or mental health. From September 2012 these can be studied as either a BSc (Hons) degree or as a diploma, each taking three years, with 45 weeks per year of study. However, it is important to note that the diploma is currently being phased out with the last intake scheduled for January 2012. After this date all nursing courses will be taught at degree level. Upon successful completion of their initial qualification students can then undertake learning beyond registration courses in order to specialise in a related field. For example, children's nurses may specialise in neonatal nursing, an adult nurse might do an intensive care course or mental health nurses may choose to specialise with the prison service. Nursing is an ever-developing field all nurses are required to take part in some learning post-registration in order to ensure that their knowledge and skills are up to date. For those students who wish to become a midwife there are two routes which they can follow. Most will opt to enrol on a Midwifery BSc (Hons) degree which in line with the nursing pathways is three years of study. If a student is undecided at application stage they may complete a qualification in adult nursing (three years) followed by an 18 month midwifery course (they must have worked within the NHS for at least a few months before applying). All of the courses outlined above will involve a mix of theoretical learning and practical assessments at both the university and within hospital and community placements. Nursing and midwifery students should be prepared to commit to long hours, shifts including night duty, working weekends and undertaking various different placements in order to maximise their university learning.
2 CAREER PATHWAYS Both the nursing and midwifery degrees enable graduates to practice as nurses or midwives anywhere within the UK and the EU but also in Commonwealth countries such as Canada or Australia. Under some circumstances graduates can also practice in the USA. As previously mentioned upon successfully completing their initial undergraduate qualification students can then opt to undertake a whole range of post-registration courses which will allow them to specialise further and to follow specific career paths and interests. Throughout their careers nurses and midwives are required to attend a variety of courses to ensure that their knowledge and skills remain current. This additional study is normally funded by their employer and the individual can opt to study up to one module per semester a total of three over the course of an academic year. There are many areas which they can study, for example, a nurse may choose to focus their career on caring for patients suffering from diabetes and associated complications. This will need to be negotiated with the employer based on patient/business needs. Students interested in any of the fields should be prepared for a lifetime of continual learning and monitoring of key developments and advances that may influence the way in which they work. GRADUATE DESTINATIONS AND POSTGRADUATE OPTIONS After completing their undergraduate qualification some students will choose to continue their studies with a Master's degree. There are a variety of options available to them including courses such as Midwifery Practice MSc, Advanced Health and Professional Practice MSc and Palliative Care MSc. All nurses should be engaged in continuing professional development activities, it is one of the requirements of maintaining professional registration with the NMC. Without this a nurse cannot legally practice in the UK. Learning beyond registration provides a means for this. These courses reflect the needs of both the practitioner and the services in which they work to deliver patient care. The employment rate of graduates from these courses is extremely high with more than 98% of students in employment or further study within six months of graduating.
3 CHOOSING THE RIGHT COURSE The curriculum for both nursing and midwifery courses will be closely monitored by the NMC, to ensure that students are developing the essential knowledge and skills to be able to work in a variety of health care settings. As a result of this, courses offered by different institutions will be very similar. However, as with all students, potential nurses and midwives should still invest a significant amount of time into researching the university that can fully support their academic ambition and also work to provide them with an overall positive student experience. This may involve having certain facilities in place, dedicated teams to help secure placements and a reliable network of tutorial support. During the first year of study some modules may be taught through shared learning, incorporating students from all branches of the nursing degree and diploma as well as midwifery. As a student progresses into their second and third year of study they will find that their work becomes much more specialised into their chosen field. Some universities, such as DMU, employ inter-professional education (IPE) into their syllabuses. This allows students to work alongside others studying related fields such as medicine, pharmacy and physiotherapy and to gain a strong understanding of how the different disciplines should work alongside each other to create the best possible care for the patients. Opportunities such as this should be sought out by students as they research their university options. Other areas of consideration include placements and accommodation. Because such a significant amount of these courses are dependent on the successful completion of placements students should look for a university that has substantial and well-established links with local healthcare facilities. For example, DMU currently has links with five hospitals, local primary care NHS trusts and a wide range of community health care providers. Being able to guarantee students access to a wide range of placement opportunities allows universities to enhance their experiences and give them a taste of nursing and midwifery from multiple viewpoints. Due to the intense work load, heavy timetables and long placement hours some students find living amongst undergraduates from other course areas challenging. Many universities, DMU included, offer designated optional housing open exclusively to nursing and midwifery students. This is designed to place students amongst others who are sympathetic towards their study arrangements and familiar with the pressures of such a course.
4 TEACHING Nursing and midwifery courses are taught through a mixture of classroom-based learning and practical placements in local hospitals and healthcare settings. A student s chosen university should ensure that their students are fully prepared for the challenges and experiences that their placements will bring. Some universities, (DMU) included, offer mock hospital wards and clinical skills practice labs which allow students to experience this environment, practise some of the techniques that they will be using on placement and understand restrictions surrounding areas such as hygiene. Placement allocation teams are responsible for liaising with hospitals, NHS trusts and primary care trusts to secure students with appropriate placements relating to their chosen fields of study. A strong placement team with excellent links can offer students the best possible options for their study and this should be considered when researching university decisions. While on placement students are continually assessed on their progress and development making up their professional portfolio. Alongside this students must also complete a series of written assignments (including reflections on their placements, case studies and research critiques) and a third year dissertation. Finally students will also be assessed through exams at the end of each academic year. A DAY IN THE LIFE Students studying nursing and midwifery can expect their timetable to be heavily weighted towards seminar learning as opposed to lectures. Unlike a large percentage of other undergraduate timetables, nursing and midwifery students can expect a full week (ie, 40 hours) of scheduled learning, split between theory-based classroom sessions, group work in clinical skills labs and a variety of placements in hospitals and the community. This allows students to work in groups in the clinical skills labs (often practising techniques on each other) or to meet and discuss topics that may have been covered in a lecture or arisen on placement. The course will comprise of a mixture of theory, placements and reading weeks all designed to give a comprehensive overview and experience of the student s chosen field. The placement element of the course will be worked in shifts, reflecting the reality of a career within this sector. At DMU, midwifery students work on four different shift patterns, an early (7am 3.15pm), a long day (8am 9.30pm), a late (1.30 9.30pm) or a night (9pm 7.15am). This working pattern is not suitable for all students yet it is an integral part of the course and prospective students should be made aware of this. TYPICAL MODULES NURSING First year Second year Third year Induction including health and safety, essential nursing skills, essential study skills, life sciences (biology, anatomy and physiology, psychology, sociology etc). Introduction to nursing, exploring practice, professional requirements Impact of disease, disorders and interventions, nursing approaches to enablement and rehabilitations, nursing in acute care facilities, nursing in community settings, analysing practice, professional requirements Transition to professional practice, nursing with specific, differing and specialist care need, professional requirements MIDWIFERY First year Core skills, foundations of women centred care, promoting healthy outcomes Second year Holistic midwifery care and practice, diverse childbearing 1, diverse child bearing 2 Third year Women and midwives partners in care, professional enquiry, the proficient midwife
5 ENTRY REQUIREMENTS Applications to all areas of nursing and midwifery are fiercely competitive, arguably fuelled by the excellent graduate employment rates, generous NHS funding packages and the students' own desire to invest their time into a caring profession. This issue is further compounded by strict restrictions set down by the NHS on the number of students that universities are allowed to recruit and train each year. As a result, demand for places far outweighs the supply of them and any student considering further study in these areas should be working throughout their FE years (and often even earlier) to enhance their application. To begin with securing the right academic portfolio is crucial. Entry onto all degrees will be dependent on the student having a minimum of five GCSEs at grade C or above, including maths, science and English language. Equivalents such as key skills may be considered but at present some universities are no longer accepting these qualifications and therefore emphasis should be placed firmly on GCSEs. Currently there are no set subjects that students must choose at FE level, however, there are some that may be viewed as more suitable and/or advantageous. For example, studying a science or health-based subject would provide a foundation of knowledge which students can apply to their HE course and build upon throughout university. Displaying a natural aptitude for relevant subjects may also enhance a student s overall application. Most universities will consider applications from students studying for A Levels, BTECs, Access to Learning and the International Baccalaureate. If a student is considering studying a different course it may be advisable to check that this is widely recognised by universities. Entry grades/ucas points vary between institutions but most will be between 220 280 UCAS points, so students should be encouraged to work to the best of their ability throughout their sixth form/college years. As well as satisfying academic criteria students will be expected to perform well at interview. This is the university s opportunity to ensure that successful candidates are suited to their chosen profession, that they are aware of the work that is expected of them and that they posses the necessary skills to excel in both. At this stage students will also be asked to complete the necessary paperwork for a full CRB and health check. This is a pre-requisite for undertaking placements and if they therefore cannot pass either of these checks then they will not be allowed entry onto the course. In addition to a strong academic background, admissions tutors will be looking for extra curricular activities (in particular relevant work experience) that a student has undertaken and that have equipped them with skills/ additional knowledge which will be of benefit on their course. Whilst work experience is not necessarily a named element within the entry criteria, admissions tutors will certainly be looking for a commitment to the subject and a thorough understanding of what the job entails and this is often best illustrated through work experience.
6 APPLICATION SUPPORT Applications to these courses are at an all time high. School leavers are competing not only against their peers but also against a large cohort of mature students who may bring a wealth of previous work experience with them. Consequently any student hoping to gain entry to a course in this area must place a tremendous amount of effort into the three key stages of the application gaining the appropriate qualifications, their personal statement and their performance at interview. Through their personal statement candidates should demonstrate that they can recognise the necessary skills required of them and also provide examples which demonstrate where they are currently putting them into practice. They should be able to discuss with confidence the role of nurses and midwives in society, current issues that may be affecting their jobs and new developments in their fields. Evidencing this commitment can be hard, students often struggle to articulate their passion in a strong manner and are left with statements that refer only to their desire to help others, without strong sentences to demonstrate their deeper understanding. Perhaps the easiest way of combating this issue is for a student to acquire substantial work experience in a related area. This will not only indicate their interest level but will also provide a wealth of examples that can be used to illustrate their understanding of core issues within the healthcare professions. While there can be many setbacks associated with obtaining work experience within these fields it is important to keep trying. Many students find caveats surrounding age or CRB checks in place and become frustrated. For example, students will not be able to physically witness a baby being delivered but they may be able to attend community antenatal classes, interview a midwife about their daily routines and read up about new developments using online journals. Students should also document any organisation who they contact seeking a placement and keep hold of any rejection letters/emails that they receive. Both of these records demonstrate that the student tried and persisted to secure work experience, even if they were not successful. As a general rule students with a wide variety of placements working with different ages in different settings are often the most attractive candidates.
7 INTERVIEWS The interview stage is designed to investigate the details discussed within the personal statement. It is at this stage that applicants will be required to display a clear understanding of what their chosen profession entails and what will be required of them as a student. Classic mistakes at this stage include potential midwives stating that they are interested in this career as they want to work with babies and student nurses revealing a phobia of blood and needles! Fundamental mistakes such as these will undoubtedly result in an unsuccessful interview Nursing and midwifery interview styles will vary between institutions so students should be encouraged to contact the individual university in advance if they are unsure what will be expected of them. There are however, a few constants that can be expected in all cases. Firstly the interview panel will be made up of academics from the course (many of whom will be registered nurses and midwives themselves) and in some cases a nurse or midwife from a clinical placement. The formal questioning element of the interview should take approximately 30 45 minutes and will involve the students being asked a range of questions covering everything from decisions surrounding their FE choices through to their decision to study that particular course at HE level. They will be asked to expand on any work experience placements or journal articles that have been mentioned in their personal statement and they should be able to do this with greater depth than initially stated. Students should also make themselves aware of current issues or debates within their particular field as many universities will expect them to have conducted a literature search before the interview. Finally, they are likely to be asked a series of hypothetical questions designed to assess their suitability for the course, for example, How might you cope if a mother had a stillborn baby? Students should be advised to anticipate such questions in advance and prepare thorough answers to them, incorporating wherever possible examples from their own research or work experience.
8 INTERVIEWS CONTINUED When discussing the placements they have undertaken, students should place emphasis on the skills they observed, professionals they admired and scenarios that motivated them. To a certain extent interviewers are uninterested in the logistics of their placements (ie, on my first day I shadowed a doctors receptionist which involved me answering the phone, photocopying documents and filing patient records) and more interested in what these tasks taught them (ie, shadowing a doctors receptionist allowed me to see the importance of keeping accurate patient records or the need to adapt my communication skills to be effective when taking phone appointments from a range of patients of different ages and backgrounds). Some universities may incorporate a group exercise into the interview experience. This may involve splitting candidates into small groups and assigning them a task to complete or an article to review and discuss. This element of the interview may not be seen as important but it will play an integral role in the university s overall decision. In these scenarios interviewers are looking for students that can work well with and interact with their peers in a group setting. Candidates that dominate a group with their ideas and refuse to listen to those of others or those who simply sit back and refuse to contribute to discussions will 'fail' this element of the day. Ideally a student should display good listening, communication and teamwork skills. They should be able to listen to the viewpoints of others, consider their merits and then offer their own opinion either in opposition or in support.
9 NURSING AND MIDWIFERY AT DMU The school was created from the merger of Charles Frears College of Nursing and Midwifery with DMU in 1995. The school s courses have been commended by a recent NMC visit on a number of areas, in particular, practice learning which includes our effective partnership working with Trust colleagues and the excellent work around patient and public involvement within all of our courses. Currently the Mary Seacole Research Centre (MSRC) is based within the School of Nursing and Midwifery. Their award winning research focuses on areas such as developing an artificial pancreas for diabetes sufferers as well as the sociology of disease, minority healthcare and disease, plus thalassaemia and sickle cell disease. They are also in the final stages of a renovation project that will see the school leave its current site and join the rest of the campus in a new city centre location. The new building, which is due to open in Summer 2011, is part of a 4.5 million regeneration of an existing building which will be fully refurbished and extended to provide state-of-the-art teaching space and facilities. The campus will boast multiple clinical skills labs and a dedicated library as part of an ongoing commitment to fully supporting students' learning. The university currently facilitates a bus route between all of our major placement providers. This ensures logistical support for all of our students and enables them to easily travel between placements and campus. ACADEMICS AT DMU All academic staff teaching on the DMU nursing and midwifery courses are either registered nurses or midwives with extensive teaching qualifications and a wide variety of experiences within the health and social care sectors. All academic staff are formally linked to clinical areas covering many specialist services throughout Leicester. They pursue a diverse range of interests including water births, obesity and medical disorders. In addition to this they contribute to wide range of publications, professional journals and conferences, sharing their expertise with others in the field and ensuring that their own knowledge remains current. As lecturers and tutors they work to provide students with guidance, advice and the benefits of their personal work experiences to both enhance and fully support their learning. FOR MORE INFORMATION To find out more about s nursing and midwifery courses, open day dates and to request a prospectus please visit dmu.ac.uk/hls or call (0116) 257 7700.