The current three-year nursing degree provides only enough time to deliver “well-educated technicians”, the immediate past chair of the Nursing Council told an Australasian nurse education conference yesterday.
Dr Margaret Southwick made a passionate call in her keynote speech to the Australasian Nurse Educators Conference in Wellington for the profession to mount a campaign for the nursing degree to be extended from the current three years to four years.
Southwick, the recently retired dean of Whitireia Community Polytechnic’s health faculty, stepped down as chair of the Nursing Council earlier this year. A nurse educator since 1985, she said it was impossible to deliver quality nursing education in just 84 teaching weeks.
She said the pressure of getting through an “impossible” teaching workload meant “humanist” aspects of the curriculum that teach nursing students about how to be caring humans were being squeezed out in favour of “more rules and assessments” of technical skills.
“I’m not saying that that is not important. But that means what we deliver is probably well-educated technicians – it will not deliver you nurses as I understand nursing to be,” Southwick told the 300-strong conference which responded with spontaneous loud applause.
“For now you see graduates who can write exquisite assignments but seem to be 'too posh to wash',” added Southwick which was greeted with even louder applause.
“We eschew working in aged care because it’s not sexy enough. How extraordinary it’s the one area of health care that is almost exclusively dependent on quality nursing care – but it is the one area we don’t want to work in.”
Applause also greeted her comments on recent media headlines about the “rationing” of so-called “basic” and non-essential nursing care.
“How is it possible that nurse managers can talk about rationing of care without understanding they are kicking away the very foundations of our profession.
“Caring is the moral ideal of nursing. It pervades the curriculum and forms its ethical imperative,” said Southwick. “Without practice built on that imperative we are not nurses we are technicians.”
She believed the current compressed degree was “short-changing” students and “by extension” short-changing patients and the profession had to find ways to expand the time available to provide the education that students need and required.
“Or we have to be more realistic about what new graduate (nurses) working in increasingly hostile environments can actually manage,” said Southwick.
“I’m not so unworldly that I don’t hear that the district health boards are cash-strapped and efficiency gains are (needed).
“All I’m saying is that we don’t have to volunteer our heads on the spike all the time. We have to stand up for nurses.”
Southwick said when nursing training first moved to a bachelor’s degree in the 1990s, all nursing schools were polytechnic-based and the teaching year had been 36 weeks long. The two options had been for either a three-year (108 teaching week) programme or a four-year programme with a shortened teaching year of 28 weeks (so 112 teaching weeks). Nursing schools now all operated on a 28 week teaching year, so the nursing degree programme was squeezed into just 84 weeks.
She said she was “gobsmacked” to hear that social workers were now moving to a four-year degree entry programme.
“We can afford to deliver a four year (degree) programme for social workers but not for nurses in this country?”
Southwick, who was also celebrating her 70th birthday, said she wanted the profession to “get angry” about the short-changed nursing degree and mount a campaign to get more time.
“I want you to say this is not good enough.”
Later in her speech, she told the gathering that she believed in “general terms” the Nursing Council was well served by the Nursing Council. But one of the things she believed it could do better was to measure nurse's competencies in not only clinical knowledge but professional comportment.
She quoted from a Welsh health board nursing training strategy that said what people wanted from the health care system was: “do not harm me”, “make me better”, and “be nice to me”.
Southwick said the hardest of those to deliver on was “be nice to me”. She said the curriculum areas focus on developing the caring, humanistic side of nursing were often seen as “soft” and were the hardest areas to “protect and keep” in a jam-packed curriculum.
Southwick, who is of Tuvalu and New Zealand European descent, also made a passionate call for the sector to address the need for a diverse workforce to reduce the health burden faced by Maori and Pacific people.
“In this country, Pacific populations experience third world rates of rheumatic heart disease. That is absolutely unacceptable, absolutely unacceptable.”
“The major burden of ill-health in this country is being paid for by two populations – Māori and Pacific – closely related, of course, to the standard of living, mostly related to the socio-economic determinants of health. We (nurses) have a role in addressing those things.
“If we don’t deal with (them) now we will be dealing with them later and the longer we leave them the more expensive it is going to be. So apart from the human cost there is the cost to you as taxpayers in this country if we don’t deal with it.”
