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An all graduate profession gives nursing skills value


Have I ever told you about my old woodwork teacher? Mr Spooner had the social skills of custard.

I have no doubt that he could knock up a coffee table out of an abandoned tree in no time, but you wouldn’t want to gather round said table with coffee and biscuits chatting with him afterwards. Nope, you’d make some excuse about needing to alphabetise your hair and usher Mr Spooner, his grubby overalls, aggressive nature and collection of chisels from your house as quickly as you could.

Anyway, this was all a long time ago and I’m not bitter. But I suspect Mr Spooner had a degree. Indeed, he may have had a degree in wood management and some sort of teaching diploma. (I can’t help wondering if he might have just been a bloke with some chisels and his own wood and so nobody checked his qualifications, but let’s assume he was allowed to do his job.)

‘Getting a degree must entail doing what we need nurses to do - not what we imagine graduates in geography, media studies or woodwork are doing’

And despite my shrugging contempt for the man, I think it makes sense that he should have to have qualifications to do a job that has something to do with people - even though in this case by people I mean sneering disengaged teenage boys.
It makes complete sense that if we attach value to a job we should attach some sort of social value to the qualification that allows us to do it. So if degrees have social value, making nursing a graduate profession makes sense - as long as what qualifies the nurse for the degree corresponds with what it is that good nurses do. And, surely, if there is controversy over nursing being an all degree profession, it is about tailoring the degree isn’t it? Getting a degree entails doing what we need nurses to do - not what we imagine graduates in geography, media studies or even woodwork might have to do.

When I did my nurse training I didn’t give any thought to how much academic credit the course gave me. However, I remember being told by someone smug that it was the equivalent of a weekend photography course. I didn’t mind. I had already done a degree in something else and I knew that the nurse training had been a more profound, challenging and developmental educational experience than what had come before. However, that profundity did not correspond to anything that was academically measurable.

But academia has now begun to learn to measure the application of skills, and begun to value them. So nursing is not dehumanised by degrees, rather it is the other way round, universities are lent wisdom and humanity by nursing.

Surely, though, the challenge is to drive that change forward, to make sure nursing curricula are full of things that manifest the essence of nursing, lending compassion and kindness, emotional intelligence and a capacity for wise judgement. Nurses should have been better recognised for those abilities in the past. An all graduate profession enables us to reward the next generation for those things, if we remain mindful of what it is that must be at the heart of the education.


Readers' comments (5)

  • How refreshing that Mark has raised such an important argument. We need to move beyond the for/against a degree debate. It is not obtaining a degree that improves nursing practice, but the content of the programme and the ability of practitioners to translate learning into practice.

    The problems with relating assessments to nursing practice have nothing to do with the qualification awarded - surely nursing is such a complex profession that nursing knowledge and practice are worthy of a degree award? It seems that in a drive to "up the value" of pre-registration education and the inflexible regulations of universities in awarding credit against assessed work, schools of nursing were forced to require students to produce many thousands of words of written coursework, removed from the pedagogy of nursing practice. No academic credit could be awarded for assessing students' knowledge and skill by assessment in practice, only by their ability to construct a lengthy and reasoned argument. Now, I believe there is a place for both types of assessment. In fact I believe that nurses must be able to construct such lengthy and reasoned arguments. However, I do believe that all of the other skills we require are worthy of recognition.

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  • It is extremely refreshing to read your comments. I have to say that I completely agree with what you have written, but i'd like to add a little more.

    Any profession within the NHS has a responsiblity to train its staff to a graduate level. It is vital that the nursing profession (profession being the operative word!!!) is not about accepting the knowledge and skills that is 'given' to them, but that every nurse has the academic capability to be skeptical and enquiring. ANY knowledge that is presented (either at work or in an academic paper) to them needs accepted with ONLY a degree of criticality and that the information must be throughly evaluated before it is implemented in to practice. How on earth is it acceptable to ask non-graduates to read academic papers and pass professional judgement on its worth?!?

    Dgeree and masters courses ask nurses to perform this task at an academic level. Why should patients accept anything less?

    The ward experiences and the course contents will (i presume) pretty much stay the same; it will be the level of the acedemic discourse that will differ.

    Frankly, I find the terms 'too pash to wash' and 'too clever to care' offensive. The attitudes described above would be down to the individual and would have nothing to do with whether a nurse had a degree, a masters or a Phd. I have come across many a nurse with little or no acedemic qualifications who would fit the 'not caring' catagory.... Doctors and physiotherapists too

    Let role with the times!

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  • Just read that back- should be - ONLY with a degree of criticality

    Kind of mucks my point up as it is


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  • Here in Australia we've had degree only nursing for many years. You will find that most nurses think it was a mistake. The most common complaint ( and this has been the same complaint for 25 years since they started degree nursing as they phased out hospital training) is that the students don't get enough practical experience during their training. In spite of the problem, the universities have consistently refused to change their courses. New graduates start work with woefully inadequate practical skills. They know nursing theories, they can reflect in/with/on their practice, thay indersatnd how medications work to the molecular level etc. I acknowledge that a lot of this knowledge is useful, and also that most of it is superfluous to their practice. Because someone completes a degree does not make them care anymore. In fact, another common complaint is that basic nursing skills are getting worse and worse. They understand what they are doing, and don't do it well. If degrees for nurses is about inproving nursing care, the evidence here is against it. It also makes a mockery of insisting that nurses get degrees to work on a ward if the employers then employ enrolled nurses. assistant nurses and patient care assistants to do the same work.( I don't have a problem with any of these other health care workers, i'm just using them as an example) This was certainly the case when i worked in the UK, and it is the case here. The push for degree nursing here was not about improving patient care, it was actually about improving the status of nurses. This was meant to put us on equal footing with doctors etc. Twenty-five years later this has not worked either. Barry

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  • I wonder how many of those nurses who are against the degree for a number of reasons have taken the time to look into the contents of today's degree and diploma programme? As a first year student nurse, I am being trained in anatomy and physiology, pharmocology, nursing theory and clinical skills, to name a few.

    I also spend half of my time in a hospital or 'practical' setting. My colleagues who are unertaking the degree programme spend the same amount of time in practice, and study the same things as I do as a diploma student.

    My mum is a nurse practitioner who trained in the 70s. Her training, whilst based in a school of nursing rather than a university consisted of a very similar curriculum as I am now following. It is strange that many of those who are against the move to an all degree profession are those who trained at the same time as my mother.

    If you are encountering students who are not performing as expected, or who have the opinion that they are "too clever to wipe bums", perhaps you could spend your time explaining the importance of such tasks? Student nurses learn from other nurses, both in university (where all our lecturers are practising nurses) and on placement. We rely on you to teach us well and create the type of nurse which patients and our collegues expect.

    Thanks for reading, bit lengthy I know.


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