Knowing how to do a job within the sphere of medicine is something only a very dedicated bunch of folk have to really think very carefully about. Every aspect of nursing is governed for example by the statutory quality levels laid down. All student nurses need to have been to university, unless they want to remain absolutely on the bottom rung, as an auxiliary care assistant. The career nurse will have got her best possible degree and then followed up every additional and associated training opportunity thereafter. My own daughter was an orthopaedic nurse for years, havig gone from school to university, the course being attached to a huge teaching hospital. After many years, she decided to add midwifery to this and took 18 months additional training. The e-learning and back up via online courses was absolutely essential – all this was fitted in around current duties and family requirements.