What I Learned As A 70s Cadet Nurse And How The NHS Might Benefit From Them Now

“Cadet schemes are part of a wider strategic intent to provide more flexible career opportunities that enable and encourage people with different backgrounds, groups traditionally not well presented in the healthcare workforce to access preregistration nurse education offering an alternative route into Nursing with a vocational approach to learning.”

Gill talks about her experience as a Cadet Nurse and tells everything she thinks they could bring to modern Nursing.

Topics covered in this article

Cadet Nurses Are A Great Idea

What Were Cadets In The 1970’s?

How Cadet Nurses Were Different To Modern Day Nursing Associates?

How I Became A Cadet Nurse And What My Role Was

My Transition To A Registered Nurse

Where Could Cadet Nurses Fit Into The Modern NHS?

How RCN Nursing Cadet Scheme Is Different To The 1970’s Cadet Nurse

Conclusion

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Cadet Nurses Are A Great Idea

From my experience I think reintroducing Cadet Nurses is a great idea. Although modern day Cadet schemes are totally different to the 1970’s the advantage of having an enhanced awareness of what Nursing entails and a greater understanding of what is expected is still relevant.

What Were Cadets In The 1970’s?

In the 1960’s – 1970’s many hospitals ran cadet courses which varied from region to region.

The Cadets were aged 16-18 years old and were employed to work in hospitals but officially approved educational programmes were not provided.

The Cadets were used as general helpers and were employed in various departments in the hospital before going to work on the wards.

On the wards Cadets learned basic skills, bed-making, giving out bedpans, washing, dressing, feeding, and talking to patients.

When more confident they could move on to more clinical skills, temperature, weight, blood pressure monitoring and assisting with dressings.

There was no specific hospital training in place other than learning by observing a skilled practitioner.

Generally, after 2 years the Cadets could then go on to commence their State Registered Nurse training.

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How Cadet Nurses Were Different To Modern Day Nursing Associates?

Nursing Associates role is to bridge the gap between Health Care Assistants and Graduate Nurses and provide a route for career progression to those who wish to become a Registered Nurse.

They have to complete a Foundation Degree, typically 2 years of higher education.

On completing the course all Nursing Associates are required to register with the NMC if they want to continue working in a Health and Social Care setting in England.

Nursing Associates are able to contribute to most aspects of care in a supporting role, taking on appropriate responsibilities freeing up RN’s to lead, co-ordinate care and deal with any complex care needs.

However, they are unable to prescribe any medications.

As previously documented Cadets were employed to work in hospitals but officially approved educational programmes were not provided.

Cadets generally attended college 1 or 2 days a week to achieve the qualifications required to complete their Registered Nurse training.

They worked in the hospital Departments as general helpers and completed basic tasks on the wards with no added responsibilities.

How I Became A Cadet Nurse And What My Role Was

I know this may sound rather “cheesy”, but I always wanted to be a Nurse.

At my senior school we had art classes in an old house overlooking the grounds of the local hospital and I used to watch the Nurses in awe with their starched caps, aprons, and capes tied in a red cross.

When I left school at 16, I started my Cadet Nurse training in August 1973 at the local General Hospital.

I worked from 8am until 5pm Monday to Friday and my salary was £40 per month! (£10 of which I gave to my mum)

My contract of employment was with Whitley Council and I did not need to have a Medical prior to commencing my role.

Cadet Nurses certainly stood out wearing below knee pink dresses, unlike current times as different hospitals have several different coloured uniforms making it difficult to identify their role.

As I lived locally my first placement was at the nearby Convalescent Hospital for 6 weeks which I absolutely loved although I had to walk across a field full of cattle when I got off the bus!

Due to being the first cadet Nurse to ever work at the hospital I was thoroughly spoilt by all, even Matron allowed me to wear my very bright, colourful, comfortable shoes as my work pair caused blisters.

The hospital had a variety of patient’s, ladies who were recovering from gyneacological surgery, post stroke patients who required further rehabilitation and long-term patients with disabilities.

One of the gentlemen who was wheelchair bound and had a history of removal of the larynx due to cancer became a great favorite of mine.

The grounds of the hospital were beautiful, and I used to take him for walks regularly.

He also loved to complete very large jigsaws and allowed me to help him which was a privilege and not granted to just anyone!

My placement came to an end, and I transferred back to the local hospital where I met up with the other Cadets again.

It was a bit of a shock to the system compared to the convalescent hospital I had been placed at although it was a small local hospital, and very sociable where everyone knew everyone!

The first of my 2 years involved going to the wards for an hour 8am until 9am cleaning lockers, refreshing the water jugs and on the female wards sorting the many, many vases of flowers.

I took a great dislike to flowers as we had to change the water and use several trolleys to take them back to their owners on the ward.

Flowers were allowed at that time but removed from the ward overnight as it was believed that they would take all the oxygen from the air!

As the male patients did not usually receive flowers, we had to collect, wash, and replace the urinals which were plastic back then. We had a half hour break before going to the Departments allocated to us.

The Departments included Medical Records, Physiotherapy, Occupational Therapy CSSU (where the surgical instruments were sterilised manually) Xray, Ophthalmology, Dietetics, Speech and Language, Orthopedic Outpatients. Working in the different Departments provided an excellent all-round knowledge of the background support in the hospital.

As I had the required qualifications to meet the criteria to commence my nurse training (5 GCE ‘s) I only attended College for a year, one day a week to complete an English Literature A Level course, whereas several of my colleagues had to attend 2 days a week to gain the required qualifications

The senior nurses were Nursing Officers and the one allocated to Cadet training was scary! I missed the 7.30am bus one day and rather than being really late for the wards I decided to stay in the locker room until 9am.

Just my luck the scary Nursing Officer came to the room showing a new recruit around. I received a severe reprimand and told to work all Saturday morning on one of the wards for 5 hours when I only missed 1 hour but there was no arguing!

When I commenced my second year, I worked full time on the wards which was very interesting and exciting!

My first placement was on the female Geriatric ward which I loved!

The staff were all friendly and the atmosphere was great. I used to chat with the elderly ladies and was fascinated learning about their past lives, looking at old photographs realising that this little old, confused lady was a person who had been married, brought her children up and lived through 2 World Wars.

One lady in particular used to be so polite when the Nursing Officer completed her regular ward rounds then stuck 2 fingers up behind her back making us all laugh!

Although I was not part of the “numbers” on the ward, I used to help with the daily routines.

There were no Manual Handling procedures in fact the better you could “lift” a patient the better Nurse you were.

Those lifts we used are all deemed illegal in modern times and Hoists were not in use until several years later.

My next placement was working on the male Orthopeadic Ward which was mostly full of young men with football injuries to their knees or ankles, and motorbike accidents. So, the ward was very lively! There were also some elderly patients with fractured hips, and they were usually treated conservatively.

A Thomas splint and traction was applied and again I assisted by lifting the end of the bed to insert the frame which facilitated the weighted traction.

It’s no wonder really, I have chronic back pain!

The Charge Nurse Mr. C had been on the ward many years there was actually a photograph of him in the middle of the ward by a metal fire and chimney during World War 2!

He consistently smoked a pipe all around the ward oblivious to anyone.

Supporting Mr. C were 2 Senior Enrolled Nurses who had also worked on the ward for many years and actually ruled the roost appearing very stern and strict.

I made the mistake of stripping and washing a patient’s bed as he had been discharged and was sitting in a chair awaiting transport.

Because he had not actually left the ward, I received a very strong reprimand by one of the Senior SEN’s who was shouting around the ward trying to find the culprit!

How very different to the current wards, the beds are still warm waiting for the next admission.

Another Cadet and I completed bed baths. I particularly remember a certain male patient who just lay back and enjoyed 2 young girls washing him! However, when it came to the private parts I said, “We will wash up as far as possible and down as far as possible and you can wash possible yourself!”

Becoming part of the ward staff was great I felt sorry for the first-year students as they were regularly sent on “fools errands” e.g., go to Estates for a long stand/ weight, elbow grease or a bucket of steam or go to pharmacy for some Bowmans capsules and most of the students actually did it!

As I said there were a lot of young men on the ward some of whom had been an inpatient for several weeks and missed being with their girlfriends or wives.

One of the male Staff Nurses used to joke that he had given them Bromide in their tea which did not impress!

However, there were serious times on the ward, I experienced seeing my first cardiac arrest which horrified me!

I was hiding away from all the activity in the sluice very anxious and worried.

Unfortunately, the patient was unable to be resuscitated and died so I also saw my first death on this ward.

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My Transition To A Registered Nurse

The experience of being a Cadet for 2 years gave me the knowledge of the hospital which in turn helped my confidence.

I commenced my SRN (State Registered Nurse as it was then) training in 1975 which was for 3 years and involved extensive training in the hospitals’ own School of Nursing.

I also gained beneficial experience working on all wards and departments throughout the hospitals i.e. Male and female Surgical, Medical, Orthopeadic, Geriatric wards. Children’s ward and Gynecological ward.

I also had the opportunity to work in Theatre and A& E. As 3rd year Student Nurses, we had to work 8 weeks of nights,8pm until 8am and 2 x Students were actually in charge of the wards!

The night Manager would complete a ward round and ask the diagnosis, treatment, and progress of each patient.

The wards were Nightingale style and could have around 24 patients’ at times we were expected to be able to report to the night Manager about every patient at the end of each bed, so much for data protection and confidentiality!

The male medical ward which I worked on had a “Cardiac Unit” which consisted of a bed separated by screens with all the equipment present in case of a Cardiac Arrest.

Everyone assumed that night shifts were quiet because all the patients slept not the case!! I used to dread going on duty and there were empty beds on the ward as you could guarantee they would be filled by morning.

Elderly ladies and gentlemen so pleasant during the day could turn in to aggressive, confused patients who would be awake all night trying to get out of bed! Of course, the day staff couldn’t believe it when informed on handover as they came on shift.

I passed my Hospital Final Examination in November 1977 but due to falling pregnant was unable to take my State Finals.

I gave birth to my first child January 1978 and my friends took their State Finals in February 1978, so close but so far!

I tried to return and complete my training but had to work another 10 months and regrettably it did not work out.

A big set back to my goal having a navy-blue uniform!

However, I did not give up and took my State Enrolled Nurse Qualification as an external candidate at another local hospital in 1980.

This hospital was managed completely by SEN’s at that time, but I returned to my local hospital working 3-4 nights per week.

Unfortunately, due to family problems I had to take a break from nursing to work alongside my Husband in his own retail business.

I worked with him for almost 9 years but always kept my registration fees updated because in my heart I really wanted to return to Nursing.

I decided to try and work in the NHS by joining the BNA (British Nursing Agency) again starting as a Band A Care Assistant on the wards at my local hospital, progressing to a Band B in the community caring for patient’s in their own homes. In 1999 just by chance I spotted an advert in our local newspaper regarding a Return to Practice Course at the hospital where I sat my SEN qualification, so I applied and succeeded in gaining a place.

The Course was for 3 months and after completing it I was offered a permanent position on one of the Orthopeadic Wards working day shifts.

As stated previously this hospital was managed by SEN’s in the 1980’s but many of them had completed a Conversion Course to upgrade to SRN status.

I decided to look into the Conversion Course and found it would be expensive without support therefore I approached the HSA Charity and successfully managed to obtain a grant from them which paid for the Course.

The hospital allowed me to have a fully paid day release of 1 day a week for 2 years at University.

I commenced my Conversion Course in 2001 and successfully completed it in 2003. At last, I had my State Registered Nurse qualification and although it took until 2009 to finally have my navy-blue uniform (alas without the belt, buckle, apron, cap but policies change) I was so proud and glad my determination helped me to get there eventually!

Where Could Cadet Nurses Fit Into The Modern NHS?

The first modern Cadet Scheme was 1997.

Cadet schemes were formed as a response to two major issues evident in recent human resource and workforce planning policies in the NHS – a commitment to a new model of health professional education and a shortage of qualified health professionals.

They are seen as a contribution to achieving a number of Government broad policy objectives by bringing into the NHS people who in the past would not have considered nursing as a career.

Cadet schemes are part of a wider strategic intent to provide more flexible career opportunities that enable and encourage people with different backgrounds and qualifications to acquire Nursing skills and competencies, as well as boosting overall numbers.

Alongside this, there is also a desire on the part of some for significant change in the way in which health professionals are educated. In response to a concern that, since the decline of the apprenticeship form of training in the 1990s, newly qualified nurses do not possess the practical skills expected of them by employers, there has been a move to re-focus education on outcomes-based competency principles (UKCC 2001).

Cadet schemes clearly fit this model, with the emphasis on vocational qualifications, competency-based approaches and a large element of skills learning from the outset.

Nurse cadet schemes are locally developed initiatives which prepare participants for entry to preregistration nurse education.

The new Cadet scheme covers main areas, they are required to have a full risk assessment, Corporate induction, Mandatory training including Basic Life Support and Infection control.

The scheme helps the Cadets to develop professional and personal skills, for example communication, teamwork, and presentation skills.

Unlike the Cadet training in the 1970’s the modern Cadet scheme emphasises on vocational qualifications, competency-based approaches and a large element of skills learning from the outset.

How RCN Nursing Cadet Scheme Is Different To The 1970’s Cadet Nurse

The RCN Prince Of Wales Nursing Cadet Scheme was created when His Royal Highness the Prince of Wales, as an ambassador of the NHS, approached the RCN in 2017 with a proposal to work with the Nursing profession to widen the opportunities for young people, who would not otherwise consider following or be eligible to follow a course in nursing or other health and social care related careers.

Supported by HRH Prince of Wales, the scheme aims to develop and prepare them for life and to support them in employment towards Nursing by offering a blended and transformational learning opportunity for cadets, helping them to improve their confidence, skills and knowledge and helps raise awareness of health care careers, including Nursing.

The RCN Prince of Wales Nursing scheme enables the RCN and Army Cadet instructors to work together and give young members of uniformed organisations an introduction to potential careers in Nursing and other health care professions.

The scheme runs alongside their usual uniformed organisation activities, combining guided online and experiential learning.

This includes learning modules and a clinical observational placement within their local health Care Region.

Once they have completed this the Cadets submit a portfolio of reflection and gain a certificate.

They are then supported to take decisions on the next steps which can include a level 2 or 3 related diploma a foundation degree or an undergraduate nursing degree.

July 2021 Fifteen RCN nursing cadets aged 17 and 18 years from Holly Lodge Combined Cadet Force are undertaking their clinical observation placements.

Lindsay Meeks, Regional Director, RCN West Midlands, said: “These young people are our future workforce and it’s fantastic to see the partnership between Sandwell and West Birmingham Hospitals NHS Trust and Holly Lodge Combined Cadet Force working so well for the nursing Cadets.”

During their placements Modern-day Cadets had so much support from the Staff, especially from the key members of Staff who made sure any issues or problems were solved either on the spot or on the day, motivating them and wanting the Cadets to get the best of the scheme.

However, in the 1970’s there were reports of hostility in some areas towards Cadets whereby, they were seen as a burden and extra workload for hard-pressed qualified staff.

Compared to the Modern-day Cadet Nurse schemes 1970’s cadets attended a local college for 1- 2 days a week to gain the necessary academic qualifications to begin Nurse education.

With these early schemes, there was no undertaking to accept cadets into Nurse education and no official monitoring of the programmes no risk assessments, inductions, mandatory training in my experience I only had the training when I became a student Nurse.

During the first year on the wards Cadets were more like Domestics!

But I still loved the experience.

Conclusion

During my research for this article there is evidence to support my view that reintroducing Cadet Nursing schemes in the late 90’s has been successful and beneficial to both the NHS and the young people participating in the schemes.

Cadet schemes are part of a wider strategic intent to provide more flexible career opportunities that enable and encourage people with different backgrounds, groups traditionally not well presented in the healthcare workforce to access preregistration nurse education offering an alternative route into Nursing with a vocational approach to learning.

The schemes can be designed to allow participants to begin preparation for a career in health care without the usual entry requirements for higher education courses.

They can prepare participants for the demands of preregistration programmes, allowing them to demonstrate the academic competencies required.

Cadet schemes can thus be seen as one way of meeting a number of the government's broad policy objectives by bringing into the NHS people who in the past might not have considered nursing as a career.

An article produced in June 2021 by a Cadet Nurse who participated in the RCN Cadet Scheme stated: “If I were recently asked whether or not I thought the RCN Nursing Cadet scheme was worth the time and effort; I would say 100% yes, because it offers so many different opportunities and qualifications as well as life skills.

To anyone thinking about pursuing a career in health and social care I would say that this is the scheme for you as it gives an insight into what you could be doing in a few years’ time.

Even if you are not sure you want to pursue a career in that field there are so many transferable skills that you will learn and opportunities to gain experience.”

Another Nursing Cadet not part of the RCN Scheme said: “The Nursing cadet scheme has been so good. I’ve learned so much and gained an insight that health care roles are much more than just treating patients.

The placement element is so important because you get to see what you’ve learned in practice, and actually see it in a “real-life scenario."