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Opinion

“Elderly” – an outdated and potentially harmful term?

The term elderly has no clear meaning and evokes stereotypes.

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Healthcare professionals should stop using the term “elderly” and instead focus on providing individualised care.

Dr. Javad Hekmat-Panah, a Professor of Neurology and Neurosurgery at the University of Chicago, claims that the term “elderly” is outdated, conjures up bias, and harms patients.

In an article published by the BMJ, Dr Hekmat-Panah condemns the use of the term as it “has no clear definition” and risks healthcare professionals having a ‘clinical bias against older people’.

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Dr. Hekmat-Panah writes; “Medicine is based on biological science. It has an internationally consistent terminology, which is used for diagnosis, communication, and treatment of diseases based on individual age, severity of illness, and comorbidities. The ambiguous term elderly offers no useful information about any of this.”

Before adding; “In medicine it can evoke false ideas about the person being described as elderly in the listener’s mind, introduce unfair social biases and generalisations, and generate ill-conceived policies. I’d argue that the term elderly is like “imbecile” or “idiot,” which have become anachronistic and offensive; its use must be avoided in medicine. Stating a patient’s actual age is more appropriate and more informative.”

He argues that aging is progressive biological change rather than a progressive disease and therefore the assumption that a patient would not be appropriate for, or tolerate, a medical treatment simply because they have been labeled as “elderly” in unjust and demonstrates a clinical bias.

Dr Hekmat-Panah suggests that healthcare professionals stop using the term “elderly” altogether and instead focus on providing individualised and person-centered care – treating patients based upon their individual age and clinical presentation rather than an ambiguous term.

He adds; “Medicine is the science and art of individualised communication, evaluation, recommendation, and treatment. Each patient has the right to be treated as an individual, according to medical standards based on their specific age, general condition, and comorbidities. To label everyone above a certain age as elderly and to treat them identically defies this principle, which should be at the heart of medicine.”

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Opinion

‘Student nurses graduate with £54k of debt, shouldn’t we pay them a wage instead?’

The Government claims students are “supernumerary” and “not contracted to provide nursing care”.

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Student nurses are the unseen workforce and vital to patient care.

While I am pleased for the thousands of students who will soon be starting their journey to become a registered nurse, it comes with a stark reminder.

In November 2015, ministers announced the NHS Student Bursary and tuition fee payment would be cut in a plan to increase the number of available student places.

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Suffice to say, this hasn’t worked.

Instead, we have seen a consistent decline in the number of student nurses qualifying. Official figures from the Universities and Colleges Admissions Service (UCAS) show an overall decline in applications of 8% since 2015.

There is no debate that nurses need to be degree-level educated – but are student loans the best way to fill an ever-widing gap in our workforce?

The unseen workforce.

Student nurses are the unseen workforce and are sometimes vital to the delivery of safe, compassionate, person-centered care.

Completing over two-thousand hours of hand-on, direct clinical practice over three years – is it fair to ask them to accumulate up to £54,582 (plus 6.3% annual interest) of debt?

With a starting salary of £24,214, this is a debt the majority of nurses will never pay off.

The Government claims that because student nurses are “supernumerary” and “not contracted to provide nursing care” they need to be treated like all other higher education students.

While is it true that the Nursing and Midwifery Council (NMC) mandates that student nurses are considered ‘supernumerary’ – how realistic is this expectation? We hear stories of student nurses, trainee nursing associates and healthcare support workers being used to fill nurse staffing gaps on an almost daily basis.

A self-perpetuating cycle.

With an estimated 40,000 unfilled nursing vacancies in the NHS alone, health and social care services in England are stuck in a self-perpetuating cycle.

Chronic under-investment in services has led to an increased demand on staff and subsequently affected recruitment and retention rates. Universities then fail to recruit enough nurses to meet the current demand and so the cycle continues.

The Royal College of Nursing has called on the Government to invest at least £1b per year into nursing education and come up with a long-term plan after its plan to increase numbers has failed to work.

Matching the proposed apprentice wage while student nurses are on placement would go some way towards alleviating the financial burden the government has placed on student nurses.

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Opinion

A fresh start?

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RCN Congress

I’m excited and I’m nervous. I qualified as a nurse just 15 months ago. I left a career in IT of “quite a few years” – I decided I needed a fresh start.

Now I’m sat on a train heading to my first ever RCN Congress. I’m a voting delegate and will be honoured to carry that responsibility for my branch.

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I’m also excited to finally be meeting people that I’ve solely (or mostly) only ever connected with online.

Finally, I’m looking forward to the various debates and resolutions. Listening to the speakers will further inform my views and I might even share a thought or two myself – fortunately speaking in public does not generally worry me (I’ll be the one with the ukulele).

A brief glance back to this time last year when certain “irregularities” were noticed by some members around the pay deal and communications regarding it.

The train of events that followed uncovered a number of poor practices regarding transparency and accountability and our current council were elected to address these.

I also mentioned I am nervous.

Recently, it has become clear that further “irregularities” have occurred – and questions will be asked.

Tomorrow morning is the Royal College of Nursing’s Annual General Meeting – an opportunity for members to ask questions. An opportunity for the council to demonstrate its commitment to openness, transparency, and accountability. An opportunity for a fresh start.

I genuinely hope the answers to the questions I raise are clear and dispel the concerns many of us have.

And if they don’t? Well, that’s why I’m nervous.

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