Would you rather have your leg ulcer dressed by a non-graduate, skilled, caring practitioner who knew what she or he was doing, or by a graduate who didn’t? I have mixed feelings about recent proposals to make nursing an all graduate profession.
I can find three arguments in favour or introducing compulsory graduate status. First, as the role of nurses has clearly changed over the past 50 years, with nurses now doing more and more tasks previously only undertaken by doctors, a degree could theoretically give (or acknowledge) greater clinical knowledge and expertise. If nurses are being asked to do more, then clearly they should be trained to a higher level, and that training can be recognised at graduate level if appropriate. An improved education may help some have the confidence for the decision-making skills needed to make high-level clinical judgments.
Secondly, an all graduate profession is likely to enhance the self-esteem of nurses, and of the profession. It may also help nurses argue for better pay.
Thirdly, an enhanced nursing profession involving nurses taking on more clinical work is likely to have a long-term cost benefit for the country. Just as teaching assistants are cheaper than teachers, nurses - even graduate ones - are a lot cheaper than doctors.
While I can see these arguments in favour, it feels as if the proposals are largely missing the point, especially when it is argued that such proposals will benefit patient care. As a someone who has seen the inside of the health service quite a lot recently - literally at the sharp end - the academic status of the nurses has never ever been a key issue, whereas the levels of nursing available, the degree of practical skill, and the presence or absence of a caring attitude have all been crucial. If these latter three things were addressed when they were absent, the level of patient care would dramatically improve. A degree will do little to change them. The level of care is largely determined by management decisions about staffing, by human compassion, and by practical skill.
If the move to a graduate profession deters some good people from choosing nursing as a career, that may be an unfortunate unintended consequence.
The people who are nurses/become nurses won’t be different people though, they’ll just (in some cases) have more certificates, and like you say, more self esteem/confidence and maybe more money! The profession will still attract the kind of people who want to care for others. Surely the degree acknowledges the level of responsibility nurses have now rather than detracting from the human side of the work they do?
Flinderella
I am in broad agreement with you. I think my main concern is that the graduate entry proposals were partially being sold as improving patient care. My main point was that other more basic issues need to be addressed in improving patient care that have nothing to do with graduate status.
I don’t feel that I know enough about the structure of the nursing profession and the type of training that the vast majority of new entrants actually take now, to be able to give a particularly informed view.
My gut reaction was similar to yours. I can see the positive side to it but selling it as a means of improving patient care does not seem genuine. There are two levels of care - practical care ie the changing of the dressing (and it seems a little harsh to suggest a graduate might not be able to do that properly just because s/he has undertaken a degree rather than a diploma) and other medical procedures but yes also the nurturing, empathy type of care that is so important when you are dealing with worried and vulnerable people. Having a degree may well improve nursing skills as such (or it may not) but I cannot see how it will improve the caring attitude as that is about the people themselves.
I think I am right in saying that current training of nurses involves them receiving a bursary of some kind to offset the costs? the biggest problem as far as I can see is that requiring nurses to undertake a degree, even if you allow for measures that enable those with lower academic qualifications but a vocation for the role, to join the course is that the level of debt they will incur will put off many suitable candidates. But perhaps they are no longer seen as suitable candidates?
But it is the way that things are going - many countries have moved to graduate-entry only so I guess it would be a strange decision not to follow. It would make harmonisation of qualifications and the ability for nurses to work in other countries difficult for one thing. Not that I believe in doing things just because “everyone else” is doing it.
Reluctant Blogger
I hadn’t thought of the debt angle - that’s interesting. I’m sure in the long run it will be good for the profession, but just annoyed that they are trying to establish a dubious causal link with patient care. And I do think that several very good nurses that exist now would never have gone into the profession because the prospect of a degree (and debt) would be too daunting. If the training is significantly funded for nurses, I wonder if that would attract would be graduates who would see the opportunity of getting a paid-for degree, but who would have little intention of staying in nursing.