All courses leading to the registered nurse qualification will be at degree level by 2013. While this move could increase the status and inluence of the nursing profession, it has implications for diversity and equality.
Black and minority ethnic students are less likely to study at degree level and more likely to take vocational qualifications than white students (Unison, 2007; Tribal 2006). The move to all degree entrance to the profession could mean that fewer BME students take nursing courses. A two tier workforce, with BME workers over represented in the lower tiers as healthcare assistants, could emerge. We could struggle to produce a diverse workforce, which could make culturally appropriate care less likely.
There is evidence that BME nurses are at a disadvantage compared with their white colleagues in terms of promotion, and a two tier workforce will make this worse (Unions, 2008; Tribal, 2006).
This is not only an ethnicity issue. Mature students and those from poorer families are, likewise, less likely to do degree courses and, traditionally, we have depended on the valued perspectives of these nurses in care practice.
The financial pressures that plague university students disproportionately affect BME students, mature students and students from poorer families. The government has yet to confirm the funding arrangements for nursing degree courses. However, any reduction in financial support might make it more difficult for these groups to stay on degree courses than younger students, white students and those from more advantaged social backgrounds.
Nursing’s wide entry gate has allowed a range of talented people access to a worthwhile career. Protecting that tradition cannot be left to chance. Without delay, higher education institutions should review their recruitment, selection and admission practices, which have sometimes disadvantaged groups like BME students.
Retention strategies should address the financial burden minority students face on degree courses. For this, we may need to learn lessons from US scholarship programmes that specifically and aggressively target under-represented groups.
Other factors that will challenge recruitment and diversity. The Prime Minister’s Commission on the Future of Nursing and Midwifery in England exposed the public perception of nursing as low status and low paid, and of nurses being mere helpers to doctors. Stories of poor career advancement and discrimination also make the profession unattractive to some BME students and their parents.
The nursing profession must act now to ensure that the increased educational qualifications needed to access degree courses, admission and selection procedures and that the financial burden of degree study do not exclude under-represented groups from gaining the degree level RN qualification.
Stacy Johnson is lecturer and course director, School of Nursing, Midwifery and Physiotherapy, Queen’s Medical Centre, Nottingham
Tribal (2006) A Review of Black and Minority Ethnic Participation in Higher Education. Summary Report. Greater Manchester: Tribal.
Unison (2008) Creating the Nurses of the Future. London: Unison.