Difference between HBO and MBO nurses?

[Moshi]

So I have kind of figured out your complex educational system.  

But now I'm confused by HBO education for nurses and MBO education for nurses.

Some sources I read say they both take 4 years and both have official title of nurse (verpleegkundige) at the end. But MBO one should have a lower academic title somehow?

What is the actual difference between them? Is HBO nurse superior to MBO nurse?
What competences does HBO have that MBO doesn't?

MBO nurses don't have specializations (except mental nursing)? You must requalify as a HBO nurse to get those specializations (CCU, emergency room, anaesthesiology, ...) that can get you to work in an ambulance?

And where does verzorgende fit in all this? What is their function?

[xangadib]

You've found one of the great complexities of our educational system.

Your analysis is correct. The HBO nurse is superior to the MBO nurse, but only in respect to the more complex care, that is why you have to be an HBO nurse to qualify for the specializations. That said, in a hospital at least, they both provide bedcare and consult with docters, etc.

Our MBO qualifaction consists of 4 levels. The highest level (4) has the most education and therefor the most independant in his or her professional actions. The verzorgende has a lower MBO qualification and is therefor less independant in his or her professional actions.

All of the above translate in to a system which allows or forbid one to execute certain procedures.

[seh/ic broeder]

a few comments: the highest level of nursing is level 5 (bachelor of nursing) and the lowest is level 2 (care assistent)

Both nursing levels (4 and 5) have the same responsibilities, where the difference `should` be, that the level 5 nurse (HBO) ought to handle more complex care and should be able to have a more birds eye view of the (complex) care rather then `just` following protocol (that level 4 nurses supposedly would do).

That said i (as a HBO nurse myself) find it real nonsens. The Level of care that a level 4 (MBO) and a level 5 (HBO) nurse can give are the same, where in practise it comes forward that level 5 nurses (usually) have less practical experience, but deeper theoretical knowledge.

And both level 4 and level 5 nurses can apply for a speciality (in few cases the hospital especially asks for level 5 nurses), but the level 4 nurse must work and think at the level of HBO. The speciality gives the Level 4 (or 5) nurse al HBO level degree

in the future there wil be a change: level 5 will be named verpleeg-kundige, and level 4 will be named zorg-kundige

[bryanvisser]

To continue on this long going discussion, not in particulair on this forum, but also with our government. The HBO Nurse is educated to standards of different roles. These five roles include: coach and designer. Meaning that the HBO nurse is being taught to improve not only health care of their patients, but also with their colleagues and even up to national work groups in charge of specific nursing-care protocols.

With the MBO nurse the primary focus is aimed on providing health care. In hospital, nursing homes, eldery homes, etc. These MBO nurses often meet up the same job descriptions as for the HBO nurse. So in theory, that would mean that they both get the same salary, and both are required to perform the same tasks. The only difference I can imagine is that the HBO nurse is capable (because she is educated to it) to see the larger picture. Where the MBO nurse did not have this in their training/school.

So yes. Even for us in The Netherlands (and for me in the last year of my nursing study) it is hard to define the differences between one and another.

And discussions such as "HBO nurses are better specialised nurses in ex. ambulance, ER, etc." are based on personal opinions. There has indeed been some research to the quality of care between MBO and HBO nurses, but this leaves, again, many space for free interpetation.

My two cents.

[Moshi]

a few comments: the highest level of nursing is level 5 (bachelor of nursing) and the lowest is level 2 (care assistent)

So if we look at the MBO tree with its levels. If you go study nursing and finish it at level 2, you are verzorgende (nursing assistant, care assistant)?
And if you go up to level 4 you are MBO nurse and if you change trees and go to HBO and finish it you become level 5 HBO nurse?

But in practice, how do you know which nurse is HBO and which MBO? Let's say I'm a doctor in hospital ward and I see a need for some patient to get a central venous catheter. I need a high level nurse (HBO) to assist me. I'm walking down the hall and how do I know now which nurse to stop and ask for assistance? Do they have name tags that say they're HBO level or MBO level?


As for the HBO nurse giving more complex care. What does that include? Is the HBO nurse the one figuring nursing diagnoses, setting nursing plans and deciding which nursing model to work with?

And let's say in ICU where there the most difficult patients who need constant care and overwatch. Are there only HBO nurses working in there? Or it doesn't matter at all?

[Job45]

Within de Dutch nursing system you have the following classification:
Level 1: zorghulp
This person doesn't really help the patient himself, this person cooks, cleans, whatever, that kind of work.
Level 2: helpende
This person helps the staff with the care for the patient, they aren't allowed to do any reserved act like medication or injections.
Level 3: verzorgende
This person takes care of patients, give them their medications etcetera, but can only do certain reserved acts. They aren't allowed to give infusion.

Now comes the tricky part;

Level 4: MBO-verpleegkundige & level 5: HBO-verpleegkundige
This person is a verpleegkundige, a nurse. They have the same title, within the organisation and for the law. The only difference is their education. HBO-verpleegkundigen are expected to work in more difficult situation where no protocols are available. MBO-verpleegkundigen are good nurses, but their education is more focused on protocols, while HBO-verpleegkundigen should be able to work without these protocols in more difficult and unexpected situations.

At least, this is what they tell me at school. I'm currently studying for HBO-verpleegkundige.

Hopes this helps.

[bryanvisser]

But in practice, how do you know which nurse is HBO and which MBO? Let's say I'm a doctor in hospital ward and I see a need for some patient to get a central venous catheter. I need a high level nurse (HBO) to assist me. I'm walking down the hall and how do I know now which nurse to stop and ask for assistance? Do they have name tags that say they're HBO level or MBO level?

That's the tough part. In The Netherlands the level of education is not split - at least not with clinical work on a "ward" - into who'm may do what. The level of training a "nurse" has receveived should make her be able to assist in these matters, regardless of their level (4 or 5).

[Moshi]

This is all so interesting.

I must tell you when I was reading how ambulance system works I was so amazed how everything is so perfect there in the Netherlands (compared to Slovenia at least, haha).

But when I decided to take a look at the rest of your education and these MBO and HBO nurses. Wow. Completely opposite. So confusign and unclear. Are there any plans to solve this? Why not just stop the MBO education for nurses all together?? Yes, the zorghulp, helpende and verzorgende can stay at MBO education because they fit in there.

But nursing should move all together in the HBO education. Nurses are having more and more education, training and competencies every year. The education process must show that and only have nursing as a HBO education and slowly move it into the WO education.

[Nachtbroeder]

That's the tough part. In The Netherlands the level of education is not split - at least not with clinical work on a "ward" - into who'm may do what. The level of training a "nurse" has receveived should make her be able to assist in these matters, regardless of their level (4 or 5).

In clinical practice you may see a difference in theoretical knowledge and the ability to act independently in critical situations. There actually is some evidence about greater mortality if there are less level 5 nurses on a ward, however there is a lot of discussion about the research method which has been used in that trial.

I met a lot of very professional MBO nurses with years of experience, however you sometimes can notice the difference in education. These differences are primarily caused by the background of the individual nurses.

In my opinion it is a good thing to review the status and accreditation of level 4 nurses, however we also need to have a look into the education of level  5 nurses. Some students see this as a very hard course, but I think there is room for expansion of the theoretical and practical background within the bachelor of nursing.

[Job45]

But when I decided to take a look at the rest of your education and these MBO and HBO nurses. Wow. Completely opposite. So confusign and unclear. Are there any plans to solve this? Why not just stop the MBO education for nurses all together?? Yes, the zorghulp, helpende and verzorgende can stay at MBO education because they fit in there.

There are or have been plans to change the MBO-Verpleegkundige to "zorgkundige". Then there would be a difference between them. Basically there would be a group "nursing" and a group "caregivers". Nursing would be the HBO-verpleegkundige and the "verpleegkundig specialist (nursing" (just to make it a little bit more difficult ). The verpleegkundig specialist has some of the abilities and responsibilities of a doctor. The "care"group would then be zorgkundige, verzorgende and helpende.