EDUCATION MATTERS
Nursing in universities: does it matter? Fiona Ross
© 2014 MA Healthcare Ltd
T
his is my last column for ‘Education Matters’. It has been fun but I am now moving on from being the Dean of a large faculty, a multiprofessional provider of education for health and social care professionals, to be the Research Director of the Leadership Foundation in Higher Education. This means branching out and working across the entire higher education landscape, albeit with familiar issues. I am taking this opportunity to reflect on the position of the practice-based disciplines in higher education and, in particular, nursing. What have been the achievements and what are the future challenges? Nursing is a relative newcomer to universities. In the UK, Edinburgh University launched an integrated degree in nursing in 1965 and a handful of other Russell Group universities followed suit in the 1970s, e.g. Manchester, King’s and Southampton. But it was not until the 1990s, following the introduction of the purchaser–provider split and employer-led commissioning that the mass move of nurse education from the NHS to universities was achieved and it was only in 2013 that degree education became mandatory in England. Nursing in the UK has, therefore, had a short academic history, a less welldeveloped research tradition and, consequently, is said to lack visibility in the university setting (Meerabeau, 2005). The funding routes and commissioning for nurse and allied health training programmes are different to other university courses (paid for now by student fees repayable at a certain level of graduate income). Education for nursing, on the other hand, is determined by employer requirements and service need. In April 2013, commissioning responsibility was delegated by Health Education England to Local Education and Training Boards (LETBs). It is these employer-led bodies that determine student numbers and monitor performance outcomes such as recruitment, progression and employability. Therefore, the political context within which nursing, and the other practice disciplines, operates is different to mainstream university courses. While nursing is a ‘newbie’ in higher education, there are many things it does very well and often better than comparator degree programmes. Firstly, it delivers well on key
British Journal of Nursing, 2014, Vol 23, No 7
performance indicators such as widening participation, values-based recruitment, progression and employability. Secondly, it has a track record for innovation in studentcentred teaching methods, personal support for professional development, simulated learning and being responsive and flexible to change, whether that is from employer demand or adaptation to service needs. Thirdly, the academic workforce has mostly come into university employment after an established career in clinical practice.This ‘dualcareer’ model means academics offer a broad perspective that is grounded in and brings meaning to learning, as it draws from a value base of care and the experience of providing support to people at vulnerable moments of their lives. Nursing lecturers often use their interpersonal skills and experience of externalfacing work to contribute behind the scenes, to the wider university. Fourth, and contrary to some media opinion, nursing is one of the most popular subjects offered at university. In my own institution, we have ten applicants to one place. Finally, the research base within nursing is growing and will continue to do so if the Research Excellence Framework continues to measure social impact from research, which plays to nursing strengths. If these are some of the achievements, what then are the challenges? My recent study of nurse leaders in UK universities provides a glimpse into the challenges and tensions for nursing (Ross et al, 2013).We found that for many, it was a challenge to establish academic credibility and authority within the university senior management as well as with NHS nurse directors and managers. Nurse leaders, for example, reported the need to demonstrate their own personal academic credentials and research outputs, but also their role in leading and supporting research capacity. As nurse leaders are responsible for demonstrating quality, performance and outcomes for commissioners, professional bodies and the university, there are continuous and often overlapping requirements to deliver processes of audit, contract management and quality assurance. As financial pressures for both universities and the NHS become increasingly stringent, the pressures of meeting targets will get ever more relentless and leadership complex.This is a tough environment for nurse
academic leaders as instability in the funding context will mean shifts in the way different disciplines are valued and positioned within universities. Under the current fee regime, the perception is that students will be calling the shots and voting with their feet. The fear is that subjects like the humanities will be challenged by the new trends of student consumerism valuing university education as a pathway to employment. Nursing has advantages here and it has to make the most of its strengths as a vocational discipline. Universities are having to reshape their missions and respond to changing demographics, customer and employer demand and become more entrepreneurial. The practice disciplines are a significant part of an expanded university system. They have done well for universities in terms of the access agenda and civic engagement as these subjects are embedded within communities and practice. Nursing as an academic practice discipline has come a long way in a short time. Its values and social purpose define its position within the university setting and provide meaning for students as they prepare for the world of work in health care. It may not always feel like it, and there will always be arguments about resources, but I would say that nursing matters for universities because it offers quality and relevance and is employer-facing. On the other side of the coin, university education and research should matter to the nursing profession, because this is the only way that quality and standards can be assured. Beware the voices that lament the good old days of the Hospital School of Nursing and its narrow/ siloed approaches of ‘sitting by Nellie’ training and cheap pairs of hands on the ward. There is no evidence that this delivered compassionate BJN care—let’s not go backwards. Meerabeau L (2005) The Invisible (Inaudible) Woman: Nursing in the English Academy. Gender, Work & Organization 12(2): 124-46 Ross F, Marks-Maran D, Tye C, Collington V, Hudson A (2013) Leadership of practice disciplines in universities: the case of nurses and teachers (discussion paper). Leadership Foundation for Higher Education, London: 35
Fiona Ross Dean and Professor of Primary Care Nursing, Kingston University and St George’s, University of London
375
British Journal of Nursing. Downloaded from magonlinelibrary.com by 129.031.207.006 on October 4, 2015. For personal use only. No other uses without permission. . All rights reserved.
Nursing in universities: does it matter? Fiona Ross
© 2014 MA Healthcare Ltd
T
his is my last column for ‘Education Matters’. It has been fun but I am now moving on from being the Dean of a large faculty, a multiprofessional provider of education for health and social care professionals, to be the Research Director of the Leadership Foundation in Higher Education. This means branching out and working across the entire higher education landscape, albeit with familiar issues. I am taking this opportunity to reflect on the position of the practice-based disciplines in higher education and, in particular, nursing. What have been the achievements and what are the future challenges? Nursing is a relative newcomer to universities. In the UK, Edinburgh University launched an integrated degree in nursing in 1965 and a handful of other Russell Group universities followed suit in the 1970s, e.g. Manchester, King’s and Southampton. But it was not until the 1990s, following the introduction of the purchaser–provider split and employer-led commissioning that the mass move of nurse education from the NHS to universities was achieved and it was only in 2013 that degree education became mandatory in England. Nursing in the UK has, therefore, had a short academic history, a less welldeveloped research tradition and, consequently, is said to lack visibility in the university setting (Meerabeau, 2005). The funding routes and commissioning for nurse and allied health training programmes are different to other university courses (paid for now by student fees repayable at a certain level of graduate income). Education for nursing, on the other hand, is determined by employer requirements and service need. In April 2013, commissioning responsibility was delegated by Health Education England to Local Education and Training Boards (LETBs). It is these employer-led bodies that determine student numbers and monitor performance outcomes such as recruitment, progression and employability. Therefore, the political context within which nursing, and the other practice disciplines, operates is different to mainstream university courses. While nursing is a ‘newbie’ in higher education, there are many things it does very well and often better than comparator degree programmes. Firstly, it delivers well on key
British Journal of Nursing, 2014, Vol 23, No 7
performance indicators such as widening participation, values-based recruitment, progression and employability. Secondly, it has a track record for innovation in studentcentred teaching methods, personal support for professional development, simulated learning and being responsive and flexible to change, whether that is from employer demand or adaptation to service needs. Thirdly, the academic workforce has mostly come into university employment after an established career in clinical practice.This ‘dualcareer’ model means academics offer a broad perspective that is grounded in and brings meaning to learning, as it draws from a value base of care and the experience of providing support to people at vulnerable moments of their lives. Nursing lecturers often use their interpersonal skills and experience of externalfacing work to contribute behind the scenes, to the wider university. Fourth, and contrary to some media opinion, nursing is one of the most popular subjects offered at university. In my own institution, we have ten applicants to one place. Finally, the research base within nursing is growing and will continue to do so if the Research Excellence Framework continues to measure social impact from research, which plays to nursing strengths. If these are some of the achievements, what then are the challenges? My recent study of nurse leaders in UK universities provides a glimpse into the challenges and tensions for nursing (Ross et al, 2013).We found that for many, it was a challenge to establish academic credibility and authority within the university senior management as well as with NHS nurse directors and managers. Nurse leaders, for example, reported the need to demonstrate their own personal academic credentials and research outputs, but also their role in leading and supporting research capacity. As nurse leaders are responsible for demonstrating quality, performance and outcomes for commissioners, professional bodies and the university, there are continuous and often overlapping requirements to deliver processes of audit, contract management and quality assurance. As financial pressures for both universities and the NHS become increasingly stringent, the pressures of meeting targets will get ever more relentless and leadership complex.This is a tough environment for nurse
academic leaders as instability in the funding context will mean shifts in the way different disciplines are valued and positioned within universities. Under the current fee regime, the perception is that students will be calling the shots and voting with their feet. The fear is that subjects like the humanities will be challenged by the new trends of student consumerism valuing university education as a pathway to employment. Nursing has advantages here and it has to make the most of its strengths as a vocational discipline. Universities are having to reshape their missions and respond to changing demographics, customer and employer demand and become more entrepreneurial. The practice disciplines are a significant part of an expanded university system. They have done well for universities in terms of the access agenda and civic engagement as these subjects are embedded within communities and practice. Nursing as an academic practice discipline has come a long way in a short time. Its values and social purpose define its position within the university setting and provide meaning for students as they prepare for the world of work in health care. It may not always feel like it, and there will always be arguments about resources, but I would say that nursing matters for universities because it offers quality and relevance and is employer-facing. On the other side of the coin, university education and research should matter to the nursing profession, because this is the only way that quality and standards can be assured. Beware the voices that lament the good old days of the Hospital School of Nursing and its narrow/ siloed approaches of ‘sitting by Nellie’ training and cheap pairs of hands on the ward. There is no evidence that this delivered compassionate BJN care—let’s not go backwards. Meerabeau L (2005) The Invisible (Inaudible) Woman: Nursing in the English Academy. Gender, Work & Organization 12(2): 124-46 Ross F, Marks-Maran D, Tye C, Collington V, Hudson A (2013) Leadership of practice disciplines in universities: the case of nurses and teachers (discussion paper). Leadership Foundation for Higher Education, London: 35
Fiona Ross Dean and Professor of Primary Care Nursing, Kingston University and St George’s, University of London
375
British Journal of Nursing. Downloaded from magonlinelibrary.com by 129.031.207.006 on October 4, 2015. For personal use only. No other uses without permission. . All rights reserved.
