A degree in nursing? Why not?

Training nurses partly in universities might solve some of the profession's current problems. By Martin Harris
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The Independent Online
Worries that would-be nurses are put off entering the profession because the training programme is "too academic" were clearly not borne out last week by the new application figures for nursing degrees in the UK. There have been around 18,500 applicants, up nearly 3 per cent on last year, a healthy picture by any standards. Along with their colleagues who apply for nursing diploma courses, they see universities as attractive places in which to train, and they have every reason to do so.

Universities are well equipped to educate nurses; indeed many, including my own, Manchester, have been doing so successfully for many years.

Why should universities train nurses? The nursing profession needs the same standing as other health professions that already enjoy the benefits of training in a higher education setting - doctors, dentists, physiotherapists and so on. Indeed all nurse education across Continental Europe and in the US is now delivered by universities.

What added value does university education bring? As with all other health professions, it encourages the culture of evidence-based practice. It enables broader professional training to take place at both initial and postgraduate level, by drawing on a wide range of expertise.

Some critics say the "university" approach focuses too strongly on theory and not enough on practice. In real-time terms this is clearly not the case with student nurses, who spend half their time working on clinical placements. But to these critics I want to make a suggestion.

It may be asking for trouble to suggest that nurse training could learn anything from that of doctors, but the enduring strength of the UK tradition of medical education has been the synergy of teaching, research and patient care. Clinical academics and NHS consultants bind together practice and theory through the daily activities of working practitioners who are also teachers.

This should also happen in nurse education, but it is not yet widespread. I should like to see NHS Trusts and universities offering many more joint appointments, where senior nursing and midwifery staff also spend time in a teaching and research environment.

Such appointments would also benefit students on clinical placement and in their first post-registration months. Student nurses need support, and in the currently over-stressed and hectic life of a ward, clinic or community practice, they often do not receive as much as they should.

Another area of cross-fertilisation would be through closer involvement by senior nurses in curriculum design within universities. Again, this does happen in some cases. The role of the "clinical educator" at Nottingham University is a good example.

The arrival of nurse education in universities is already helping to develop the inter-disciplinary working that is central to the Government's agenda for a primary-care-led NHS. This is not easy. As the Council of Deans of Nursing, Midwifery and Health Visiting stated in its "Breaking the Boundaries" document: "The reality is that everyday practice is influenced by professional boundaries and compounded by issues of gender, power and the rewards associated with each profession."

However, there are excellent examples of interdisciplinary ventures already in place. St. George's Hospital in London runs collaborative learning programmes with Kingston University, including study modules bringing together nursing and medical students. Bournemouth University's Institute for Health and Community Studies brings together nurses, midwives, social workers and GPs in a testament to team-building.

Despite suggestions to the contrary, nursing education in universities does attract a wider constituency of entrants than most other subjects. A quarter of all students are accepted with qualifications other than A-levels and there is a host of different progressive routes to nursing for young people. Wolverhampton University, for example, guarantees places for "cadets" who have worked and studied to NVQ level 3 with the Sandwell Health NHS Trust.

The average age of a new nursing student is 27. They come from a variety of backgrounds but with one main motivation - they want a job in which they can care for people and help them be well. The recent excellent BBC series Nurse tracked student nurses in Newcastle for their full three years. It showed the life they lead, warts and all: the juggling of essay- writing and ward duties, and the struggle to manage their finances.

I am not sure that the BBC team realised, when they arrived on Tyneside to begin this study, that it was spotlighting a shining example of nurse education. The students were all from the University of Northumbria which has undergone a thorough NHS review of its programmes and gained a glowing report. Perhaps unsurprisingly, it also has healthy application levels and low drop-out rates.

Lifelong learning for nurses is flourishing in universities. We see many experienced nurses returning to the classroom for continuous professional development (CPD) throughout their careers, bringing new opportunities to nurses and midwives to specialise and update their skills.

There is clearly much work to do in establishing more flexible and portable elements to CPD and more inter-university co-operation so that nurses can continue their post-registration education wherever they are, but the basic pattern is clear.

Hospitals are seeing many more patients for shorter periods and many more receive health care services in their own homes and communities. The new NHS has placed additional responsibilities upon nurses, who have risen to these new challenges with professionalism and dedication.

I believe universities can contribute hugely to the education of nursing professionals, equipping them to rise to challenges throughout their career.

Professor Martin Harris, vice-chancellor of Manchester University and chairman of the Committee of Vice-chancellors and Principals, will give a key address, 'Nursing in the Learning Society', at the Royal College of Nursing Education Conference in Torquay on 6 February