The functioning of nursing routines in the management of a transient workforce

Project 2000 recommends supernumerary status for learner nurses. This recommendation is derived, in part, from research into the educational effects of the current organization of nurse training. However, little research appears to have been undertaken into how the current training programme influences the organization and implementation of patient care. The research from which this paper is taken, addresses this question. It demonstrates that the allocation of learners to wards gives rise to an unstable and transient workforce. Currently, ward sisters and charge nurses are expected to plan and be accountability for care given. This research suggests that nursing routines provide qualified nurses with a method for maintaining control, stability and accountability for the care given by an unqualified and everchanging workforce. It is suggested, therefore, that the promotion of individualized care in nursing requires a reduction in dependence on the transient workforce which results from including learners in the staffing establishment of hospital wards.