Controversy continues to rage over nursing as a graduate entry profession, but this move is a necessity to deliver healthcare in the 21st century, says Sue Bernhauser
The demands on the nursing profession in the 21st century are far more complex than those of the past. Historically, nursing has sometimes been viewed as a low status profession, but this must change if we are to embrace the challenges ahead (see this week’s In depth article).
Over the next 15 years and even beyond, nurses will meet challenges relating to changes in demography, disease patterns, lifestyle, public expectations and information technology. We will see the greatest demands in healthcare met by nursing or other therapy care. There will also be a growing need for healthcare professionals with advanced practice skills and they will need to develop these from a graduate knowledge base.
The announcement that nursing would become an all degree profession by 2013 was greeted with concern by those whose image of nursing rests in the past rather than in the future. Nursing is not – and should never be – simply the carrying out of uncomplicated tasks under the direction of others. Nor is it a vocation for which short term technical training will suffice. It is a profession that requires highly knowledgeable and competent individuals.
Changes to pre-registration nurse education will equip nurses to lead and deliver compassionate care and ensure that the practitioners of the future are equipped to work in a modern healthcare system. Such developments will bring nursing in line with other healthcare professions in the UK and with the requirements for entry to the profession in several other countries in Europe and elsewhere. Midwifery moved to an all graduate profession years ago and Wales has already moved to having an all degree nursing profession.
Research findings that support graduate level nursing can be found over decades and in different countries. Studies in England, Scotland and Northern Ireland have shown that graduate nurses spend longer working in clinical areas than their non-graduate counterparts. American studies have found that graduate nurses stay in the profession on average four years longer than non-graduates and, in addition, they tend to stay at the bedside more often, working with older people and those who are terminally ill. Research in the US has also noted that graduate nurses acted more independently and took more responsibility for their professional judgement and, additionally, took on advocacy roles. They were better than non-graduate nurses at making nursing diagnoses and evaluating the effects of nursing interventions.
Moving to an all graduate profession has important implications for social and economic change in the UK, since upskilling our profession to graduate levels will probably increase the proportion of women and black and minority ethnic groups in higher education and the health service. It is important that access to degree level provision should continue to be broad, to ensure a healthcare workforce that reflects and is responsive to the diversity of its patients. Universities work hard to enable people of all ages, backgrounds and attitudes to receive formal recognition for the skills and knowledge they already possess and value the experience of colleagues within the existing workforce.
Looking forward, rather than simply focusing on whether nursing should be an all graduate profession, our attention must now move to how this can be successfully implemented in England, while maintaining wide participation. Universities should look forward to meeting that challenge in the months ahead.
Sue Bernhauser is dean of the School of Human and Health Sciences, University of Huddersfield
Citing this article
If you cite this article as a reference, please use the following, as published in Nursing Times magazine:
Bernhauser, S (2010) Degrees will equip nurses to meet future challenges in healthcare. Nursing Times; 106: 21, 8.