TODAY'S nurses need more than a tender bedside manner to qualify for the modern NHS.

The minimum requirement is a three-year course combining university study with practical secondment to a hospital which will lead to a diploma or degree, but that is only half the story.

Many student nurses, working long hours on shift patterns at the hospital plus writing up reports and case studies to fulfil course requirements at uni, still need to put in additional hours on secondary jobs to supplement the bursary payments they get.

But many of them will tell you it's worth it.

Lizzie Smith is in her third year at Bournemouth University and is currently with the regional plastic surgery unit at Salisbury District Hospital, on Laverstock ward.

She combines her training with juggling family life she is married with a four-year-old son and holding down a Saturday job working as a carer in a nursing home in Salisbury.

In fact, it is her empathy with older people that led her to opt for adult nursing specialisms like midwifery, mental health nursing, learning disability nursing, adult or children's nursing are chosen at the outset of study.

Student nurses select the hospital for their clinical placement and Lizzie chose SDH because of its proximity to her home, although she has found other advantages in its relatively small size and willingness to listen to new ideas.

Like her fellow students, she spent her first term in college, but since then follows a pattern of five week blocks alternating college study with working in the hospital.

"We have to shadow a registered mentor on their shifts to give us an understanding of 24-hour care," says Lizzie.

"If they are competent, a student can do all the things that the mentor can, but with supervision, except administer intravenous drugs.

"We're assessed on everything and we're given a greater level of responsibility as training progresses.

"While we're at the hospital, it's not just a day of practice and go home we have to write it all up relating theory to practice."

Assessment takes many forms from written examinations and case studies to research reports and video assessments.

Presentations to the trust are also part of the course.

In Lizzie's case, she and a group of colleagues were due to present their findings on the way the trust currently assesses risk of patient falls and suggest the implementation of another assessment tool they have developed in conjunction with key trust personnel.

"We did a pilot study and certainly the elderly care wards have been very positive about it, " says Lizzie.

"We had to do a lot of background research and looked at other audits, and I am really pleased that it looks as though it's going to be implemented."

This is one of the things she finds rewarding about working at SDH.

"We have a great team of practice educators here and all of our ideas are encouraged, regardless of student status" she says.

"You feel valued."

Empathy, communications skills and the ability to make the patient feel safer all contribute to the making of a good nurse, reckons Lizzie.

"If your heart is in it and you're getting something from it," she says, "it really shows and the patient sees it and it makes such a difference to them"