The future of nursing: career choices in potential student nurses

Young people leaving schools and sixth-form colleges have the opportunity to choose a career path from an increasing number of courses in colleges of further and higher education. Nursing studies are now competing with a range of health-related disciplines such as health studies, psychology and complementary therapy. Compared with nursing studies, many of these courses appear more exciting and appealing to students who are in the process of choosing a career or programme of study. While the increased choice is a positive move for students, it may contribute to the shortage of students currently entering some areas of nursing. Indeed, some specialties in nursing, including mental health and learning disabilities, are so depleted in students that they are reaching a point of crisis. There is also concern that recruitment into nursing remains predominately female and white British. Given the diversity of the UK population and the reliance on school leavers as a potential source of supply, it is important to understand why male students and those from multiracial and multicultural environments choose, or do not choose, nursing studies. This research study involved a sample of 106 16-year-old students from three secondary schools in the north-west and south-east of England. The questionnaire results, collected in schools, revealed that students held traditional views or knew very little about the nursing profession.     

Working for patients: further implications for nurse education.

The National Health Service and Community Care Act (1990) has focused attention on all aspects of health care. This paper explores the wider implications of the White Paper on nurse education. It examines the issues of student numbers; rationalisation of courses; the impact of contracts; quality control and clinical placements. It further considers the issues of capital assets; educational premises; funding and income generation. The response of schools and colleges of nursing to these challenges has yet to be evaluated. Nurse education is steering an uncertain course in turbulent and uncharted waters. If colleges of nursing are to capitalise on the changes demanded by the White Paper, the prime concern must be the establishment of an advantageous position from which to market viable courses. To this end there must be adequate resources, and control over high quality learning environments. The courses must be educationally led and respond to the learning needs of all students.     

Improving the health of Indigenous Australians: reforms in nursing education. An opinion piece of international interest

AIM: This paper overviews Indigenous disadvantage in relatively wealthy Australia. It describes efforts to increase the recruitment and retention of Indigenous people in nursing and to reform nursing education to be more inclusive of Indigenous culture, health and history. BACKGROUND: Indigenous people on average die 17 years younger than non-Indigenous people and have health problems similar to those of people in some underdeveloped countries. Moreover, social injustice and human rights issues affect their health and well-being and educational opportunities. They are under-represented in the health professions, including nursing, often through a lack of educational preparation and historical, socio-economic and cultural factors hindering them from entering and succeeding in university studies. METHODS: In 2000, a project was funded by the Australian commonwealth government and led by the Indigenous Nursing Education Working Group. This Group worked for five years on a wide range of methods that included consultation within the profession, information dissemination and longitudinal surveying of university schools of nursing and Indigenous support units. RESULTS: Findings show that collaborative efforts between key stakeholders in nursing education appear to be succeeding to increase the numbers of Indigenous students of nursing. Around two-thirds of schools of nursing now include Indigenous content in their undergraduate curricula, but the majority is yet to provide Indigenous cultural awareness/cultural safety training for faculty.     

Snakes and ladders: the immediate future of nurse education?

This paper considers the recent increase in proposals to merge colleges of nursing and midwifery with higher education institutions. It reviews the differing natures of proposed mergers. It considers some major challenges posed by such mergers: the academic, the cultural, the professional, personal and identity, and the epistomological. It reflects on some ways in which these challenges might be met by the application of management theory, and enlightened practice. It concludes by suggesting that the opportunities afforded colleges by individual mergers are so divergent as to risk fragmenting nurse education within the higher education sector, rather than uniting it into a coherent whole, and compromising the development of nursing, midwifery and health visiting as learned practice professions.     

Preparing the nursing workforce for the next era: Re-classifying and reframing enrolled nursing knowledge

Health systems are being transformed and redesigned in Australia to better respond to changing health needs, technological advances, and new capabilities needed for safe and quality care. A capable and responsive nursing workforce, at both enrolled and registered nurse levels, is one of the mechanisms required for achieving effective health care reform.This paper situates a critical discussion of enrolled nurse education within a symbiotic relationship model to consider how nursing knowledge can enhance workforce performance and contribute to improved function of health systems. Discussion focusses on classification, or what constitutes nursing knowledge, and how that knowledge can be presented, or framed, in nursing education.It is contended that different nurse education systems in Australia mean the construction of professional enrolled nurse knowledge differs in form and structure from registered nurse professional knowledge. While different courses are needed for enrolled and registered nurses to reflect their different scope of nursing practice, it is important enrolled nurse education classified and frames nursing knowledge in ways that prepare graduates for complex nursing practice to safeguard the public.     

The problem of motivating teaching staff in a complex amalgamation

This paper addresses some of the problems brought about by the merger of a number of schools of nursing into a new complex amalgamation A very real concern in the new colleges of nursing and midwifery in the United Kingdom is the effect of amalgamation on management systems and staff morale The main focus of this paper is the motivation of staff during this time of change There is currently a lack of security amongst staff and in many instances the personal job satisfaction of nurse teachers and managers of nurse education has been reduced, which has made the task of motivating staff difficult Hence, two major theories of motivation and the implications of these theories for managers of nurse education are discussed The criteria used for the selection of managers within the new colleges, leadership styles and organizational structures are reviewed The amalgamations have brought about affiliation with higher-education institutions Some problems associated with these mergers and the effects on the motivation of staff both within the higher-education institutions and the nursing colleges are outlined Strategies for overcoming some of the problems are proposed including job enlargement, job enrichment, potential achievement rewards and the use of individual performance reviews which may be useful for assessing the ability of all staff, including managers, in the new amalgamations     

The ENB pilot schemes. How plans have become reality

After inviting schools of nursing to submit proposals for innovative nurse education programmes incorporating some of the elements of Project 2000, the English National board approved six as pilot schemes. This paper reports on a three-year research project which looked at how the schools tackled the brief and introduced changes to their curriculums. Two of the courses enable students to gain registration and a diploma in nursing studies or nursing science, and one offers a certificate from a university granting exemption from one year of an undergraduate course. Further developments on accreditation, and course units, together with the possible reduction of multiple student intakes to once annually, are issues to be explored further in Project 2000 courses.     

Graduate education in geropsychiatric nursing: findings from a national survey

By 2030, the numbers of older adults with mental illness will strain our health care system. Sufficient advanced practice nurses (APNs) with specialized knowledge to provide care will be critical. All 339 graduate nursing programs in the US were surveyed regarding the extent and nature of geropsychiatric nursing (GPN) content in their curricula. Of 206 schools responding, 15 reported having a GPN subspecialty. Regarding the 60 schools with a psychiatric/mental health nursing (PMHN) graduate program, only one third (n = 23) included some GPN content, while more than half (n = 116) of all schools reported integration of GPN content in a non-psychiatric nurse practitioner program. Thus, currently, the greatest numbers of APNs receiving education on mental health needs of older adults are prepared in non-psychiatric nurse practitioner programs. This article discusses the implications for nursing education and practice.     

Nigeria: the land, its people, and health care

The unique health care needs in developing countries and the responsibilities of the nursing profession in such countries place a heavy responsibility on schools of nursing involved in the education of foreign nursing students. The students in this study indicated that it was frustrating to repeat course content that was already familiar to them knowing that there are many courses that would better meet their needs. In developing countries, like Nigeria, it has been suggested that there is a need to prepare a "comprehensive nurse"--a combination bedside nurse, public health nurse, and midwife who can provide preventive and curative services in multiple settings. Such a task is awesome and illustrates the need for schools of nursing to provide an academic counselor who has some knowledge of the culture and health needs of the students' native land. When asked: "How could the school of nursing have helped you cope with your academic problems?" 43% of the students suggested a foreign student advisor or counselor. "To have a foreign student advisor who has been overseas and who will relate to the student at their level," replied one student. Only when education is relevant to the specific needs of a given country, will there be an improvement in the health of the people of that country. To educate registered nurses abroad is very costly for countries with low G.N.P. If we accept students from developing countries into our nursing programs, we have a responsibility to prepare them to be effective practitioners when they return to their homeland. The special needs of nursing students and the health care needs of the community for which they are trained must therefore be integrated into their training.     

Nursing and higher education

Gladys Carter, an eminent Canadian nurse holding a "Boots" fellowship at the University of Edinburgh, in 1954 set out lucidly the ways in which the nursing profession would benefit from an increase of university graduates among its members. Since then the University of Edinburgh has been playing a prominent part in conducting courses at undergraduate and intermediate degree levels and a considerable number of nurses have obtained M.Phil. and Ph.D. degrees by research. There are now many other institutions of tertiary education which provide the opportunity for nurses to study for degrees and an increasing number of graduates enter colleges of nursing for nurse training. Using the Edinburgh experience as a starting point, the article discusses the value of degree courses to individual students and the potential value of graduates to the nursing profession. It is distressing, however, that graduates themselves do not appear to have career aspirations commensurate with their qualifications and that the profession in the United Kingdom still fails to find graduates to fill senior posts. Those who studied for university degrees after having established themselves in nursing appear more likely to be promoted to senior positions than those who have taken degree courses in nursing. The contribution of graduates to the establishment of a body of nursing knowledge and the role that the universities play in the research endeavour is discussed.     

Nursing in Taiwan

Although 10 years ago there was a crucial nursing shortage, Taiwan is currently experiencing an oversupply due to recent education reforms. Many new junior colleges have now been approved to take nursing courses. Taiwanese nurses are graduating at greater numbers than are leaving the profession, causing an ever increasing surplus.     

New structures for nurse education.

There are major changes taking place in the structure and organisation of nurse education. These include the amalgamation of schools and colleges of nursing, the development and formalisation of links with higher education, changes in funding arrangements introduced in April 1991, and the effects of Working Paper 10 (1), which requires schools and colleges of nursing to function in the purchaser/provider environment. As a result of these factors, particular attention is being focused on the organisational structures which are emerging in nurse education institutions. The author considers briefly the concept of organisational structure, including factors to be addressed in choosing and developing appropriate structures for specific organisations. The traditional bureaucratic structure common in nurse education establishments is discussed and evaluated and consideration is given to the development of more appropriate structures for these newly emerging nurse education institutions.     

The Financial Distress of Higher Education: Impact on Nursing

Until recently, serious financial problems were of limited concern to nursing education. With generous program and student aid from government sources, nursing education has not felt the same kind of severe financial distress that has afflicted the rest of higher education (Gonyea,1978). Unfortunately this state of affairs is changing. Funding of such programs is an expensive proposition for colleges and universities, and some institutions of higher education have begun to question the feasibility of continuing to fund their nursing programs (Allen & Gray,1975). Additionally, as supply and demand gaps in nursing manpower have narrowed, there is less incentive for the government to underwrite the costs of nursing education.
It is expected that tuition costs to nursing students will continue to escalate. Job opportunities for graduates will be less attractive and fewer in number than previously. Fewer women in the future are likely to select nursing as their career field. Small nursing education programs will be unable to sustain the very high costs of educating students and will likely cease to exist. Nursing education programs within colleges and universities will very likely compete less successfully with other institutional programs than they have in the past for the limited dollars.
As in all of higher education, nursing education will increasingly be held accountable for its costs, costs that will only increase in the coming decade. It will be asked to do more with far fewer resources, in terms of dollars, numbers of students, and numbers of programs. Should this trend continue, the profession may well be confronted in 20 to 30 years with another critical shortage of nurses across the nation.     

Nursing education in Sweden: development from vocational training to higher level education

Recent decades have seen several changes within Swedish nursing education. The length of Swedish nursing education was previously 2 years; today, however, it has been adapted to the rules laid down by the European Union, which means that it covers 3 years. Swedish nursing education was raised to university college level as early as 1977; however, it is only in recent years that the education can be said to meet the requirements placed on it. The requirement that the education should be scientifically based entails that the teaching staff should include teachers not only with nursing experience but also with a doctor's degree in nursing. The county councils are the authorities responsible for nursing education with the exception of three university colleges of nursing education which are independent. During the past year, however, seven nursing programmes have gone over to State control, and several more are discussing co-operation. A central evaluation made of Swedish university colleges of nursing education shows that 10 colleges provided education which could not be considered to correspond to the required level of higher education. No university college of nursing education has yet been accorded the right to provide education for the bachelor's degree. The future of the Swedish nurse is uncertain due to a large extent to the reorganization that has taken place within the health services.     

美国护理学硕士研究生课程设置的调查分析

[目的]调查分析美国部分护理院校护理学硕士研究生课程的设置,为我国护理学硕士研究生教育的课程设置改革提供依据。[方法]根据美国2011年护理院校排名选取排名前10位的院校,采用网络信息调查法调查分析其硕士研究生教育的课程设置。[结果]各院校按照美国学科专业目录（CIP2010）及美国护理学院协会（AACN）课程标准护理硕士教育基本要素,以核心课程、高级护理核心课程和专科课程为框架设置课程。[结论]美国护理学硕士研究生教育课程设置体现学科专业方向特色,具有规范性和专业性特点,我国护理教育工作者应借鉴美国的经验,结合中国国情,合理设置护理学二级学科及专业方向,制订课程设置总体要求和课程标准。     

The applicability of community of inquiry framework to online nursing education: A cross-sectional study

The Community of Inquiry (CoI) framework has the potential to contribute to online education by addressing the nexus of pedagogy, technology, and learners’ needs. However, there has been limited investigation of the application of CoI to Australian online tertiary education, with the awareness of CoI amongst Australian nurse educators being unknown. This paper reports on a project which used an online survey to investigate the level of awareness of the CoI framework and its applicability to the design of online and blended courses in Australian higher education nursing schools.Most respondents ranked the core concepts of the CoI framework as applicable for nursing education, but only 20% of the participants were familiar with the CoI framework before they participated in the survey. While nearly 90% of the participants viewed instructional design and a theoretical framework as essential for building an online course, 70% of respondents indicated that they did not use an explicit theoretical framework to guide the design or the evaluation of their nursing teaching and learning. These results provide the impetus for further investigation of factors influencing the development of online nurse education including the specific consideration of CoI frameworks.     

Nursing and nursing education in Iraq: challenges and opportunities

BACKGROUND: There has been extensive damage to nursing education and training in Iraq over the last two decades through three international wars, counterinsurgency struggles in the north and south, 13 years of economic sanctions, dictatorship and foreign occupation. Fortunately, there is wide agreement that nursing is a key area for further attention. Many nursing leaders have emigrated and the numbers of nurses working in professional roles in Iraq declined sharply after 1990. ISSUES: The number of nurses per population has always been low in Iraq, and fell off precipitously after foreign workers left. There is less than one nursing staff of any kind for physician today. Few of the nursing staff are qualified to what would be minimal standards of professional practice in many countries. There is a strong educational base for nursing education in three Iraqi universities, but it relates little to other schools or hospitals. Military nurses, now being integrated into the public system of hospital care, are considered to have far more technical skill levels than non-military nurses. ACTIONS: Iraq needs a new generation of well trained nurses to develop primary care and health education activities. Programmes in nursing administration and community health nursing need to be developed. The World Health Organization has supported the development of training centres and short courses for nursing leaders. The former six levels of entry to nursing practice have been streamlined to three. Nursing salaries since the 2003 invasion have been greatly increased. These are good beginnings, and much more remains to be done to restore nursing in Iraq.     

Nursing education: a descriptive examination of the effects of moving from hospitals to colleges

Twenty years of change. That has been the experience of nurse educators in Ontario. Those years saw programmes shortened by a third, curricula revised significantly, bases moved from hospitals to colleges, faculty unionised and organisational relationshops altered. In Ontario the changes climaxed in the move, in 1973, of the diploma schools of nursing from their hospital bases to post-secondary education system, specifically to the Colleges of Applied Arts and Technology (CAAT). This article examines the developments leading to this move and some of its effects on nursing education and nurse educators. In general the findings indicate that the move brought major pressures on the nursing curriculum, the faculty themselves and the department chairmen.     

The process of integration of schools of nursing into higher education

Before 1989, with the exception of a small number of nursing degree courses, most of nursing education within England was located within the NHS. Yet by 1995, all schools of nursing had been integrated into higher education institutions. Despite the significance of this change, there has been little discussion or empirical research within the nursing press about the way it happened or the experiences of the individuals involved. The aims of this paper are: The design was qualitative and the methods used were policy analysis and interviews. Interviews were conducted with a national, purposive sample of 30 senior individuals involved in healthcare education in the late 1990s selected from higher education institutions, national and regional offices of the Department of Health and professional bodies. A number of key lessons can be learned for contemporary nurse education. Notably: the need for clarity of policy aims; the value of sensitivity to the culture in which change is taking place; the importance of ensuring that the key individuals involved have the skills to make effective change and the need to share good practice in change management.     

238名护理毕业生择业心态调查

为了解护理毕业生的择业心态，以引导其成功就业，用自行设计的问卷调查表从理想的就业制度等6方面对238名护生进行调查。结果：护生群体择业心态有以下特点：择业中的专业思想、自主意识、勇于进取的精神较强，但也存在着不良心态，如盲目心态、功利心态、求全心态、依赖心态等。提示：医学院校要一如既往地对护生进行思想教育，加强择业指导，并尽力为其创造就业机会，并望得到全社会的支持。