Health reporter, BBC News
The NHS is facing a nursing recruitment crisis unless it does more to attract school leavers into the profession, union leaders say. The Royal College of Nursing says over the next decade 200,000 nurses will retire – a third of the total number. It said school leavers were snubbing nursing as a career, and called on ministers to run campaigns in schools to tackle the problem. The government admitted more should be done to promote nursing.
Previous research has shown that student applications by the under 20s are declining with nearly half of all nurse students now over 30, suggesting that more and more nurses are entering the profession after working as something else beforehand.
An RCN poll, published at its conference in Harrogate, of more than 8,600 seven to 17-year-olds showed nursing was the least preferred career in the public sector – behind police, teachers, doctors and fire-fighters.
Only one in 20 said their preferred career choice was to be a nurse.
The most common reasons for not wanting to be a nurse was a belief it was a dirty job or not liking blood.
Many said higher pay would make nursing more attractive – the average starting salary is still just over £20,000.
RCN general secretary Peter Carter said he wanted to see the government doing more to promote nursing as a career option in schools.
“It’s clear that the image of nursing does not reflect reality.
“Modern nursing is a dynamic career, providing an incredibly broad range of opportunities and a real chance to have an interesting, successful career that makes a real difference to other people’s lives.
“Often older recruits join the profession after becoming disillusioned with seemingly more popular careers and wish they had done so years earlier.
“We want more young people to join the profession and experience all it has to offer.”
Saffron Brown, a second-year nursing student at the University of Northumbria, who went into training straight after school, agreed.
“Too many people think nursing is about working in hospital, but it is much more diverse than that. There are all sorts of jobs in the community you can do.”
Health minister Ann Keen admitted there was more that could be done over recruitment.
The Department of Health has recently set up a commission to look into the future of the profession. Part of the remit is recruitment.
Ms Keen said: “Having started my career as a nurse, I have seen first hand just how rewarding a career it can be.
“The range of opportunities available to qualified nursing staff is among the broadest of any profession.”
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There is, they said, sound evidence that exercise and a healthy diet can lower levels of inflammation as measured by the high-sensitivity C-reactive protein test, known as hs-CRP. But – and this is where it gets a bit tricky – it has yet to be proved beyond a doubt that patients who reduce their inflammation levels through lifestyle changes have fewer cardiovascular emergencies.
Still, when Dr. Paul Ridker tells patients they have scored dangerously high on the test he created, this is his recommendation:
“The first, second, third, and fourth intervention for anyone with elevated hs-CRP is get to the gym, lose a few pounds, throw away the cigarettes, and start thinking about a healthier diet,” Ridker said. “That remains overwhelmingly the most important intervention for lowering cardiovascular risk.”
Just how important? A 2006 study by University of Massachusetts Medical School researchers showed people with fiber-laden diets were 63 percent less likely to have inflammation problems than people whose diets were low in fiber. An Italian study had similar findings, saying patients who consumed lots of whole grains, fruits, vegetables, and nuts significantly reduced their inflammation readings.
Dr. Ira S. Ockene, a preventive cardiology specialist at UMass and an author of the fiber study, said 30 grams of fiber is considered the benchmark for a healthy diet. You can get as much as one-third of that, he said, by eating a hearty bowl of pea soup.
“And if you want to lower your CRP and you have a big gut,” he said, “the best thing to do is to exercise and lose weight. When you lose weight, a whole bunch of good things happen.”
While researchers long recognized that physical activity reduces risk of heart attacks and strokes, the underlying reasons were not always so clear. A Brigham study last year yielded important clues, finding that lower inflammation levels matter most.
It doesn’t take a lot of exercise, Ridker said: A half-hour a day of aerobic exercise will do.
“I take a fair number of patients who travel quite a bit, and I tell them, ‘It’s as important to put your sneakers in your briefcase as it is your laptop,’ ” Ridker said.
It makes a world of sense that exercise and diet should contribute to reducing inflammation and, by extension, heart attacks and stroke, said Dr. Michael Lauer, of the National Heart, Lung, and Blood Institute.
“But I have to be honest,” Lauer said, “this is a hypothesis at this time – and a very good hypothesis – but I don’t think it’s a proven one.” And it won’t be, he said, until a study demonstrates for sure that an inflammation-reducing lifestyle changes result in fewer heart attacks and strokes.
At Cleveland Clinic, doctors don’t just preach about exercise and diet; they take patients on outings to restaurants to reinforce good habits. Patients are asked to be honest about whether they’re likely to heed the advice to eat well and exercise.
For some patients, “pills are an answer, but it’s not all of the answer,” Cho said. “I tell my patients all the time that pills are supplements, not substitutes, for a healthy lifestyle.”
Sponsored by Memorial Sloan-Kettering Cancer Center, this class for cancer patients has been around for some time, mostly in a league by itself. But in recent years, following studies that found exercise to be beneficial in combating the effects of cancer, the class has gained some company.
Gyms and fitness centers have begun stepping in to meet a small but growing demand for programs designed to not only hasten recovery but to address the fatigue of chemotherapy, the swelling of lymphedema and the loss of muscle tone.