Comment

Tony Butterworth: Stop the assault on undergraduate nurse education

New pathways into nursing, such as apprenticeships and associate roles, pose a huge risk to the profession. Yet there is no strong opposition from senior nurse leaders, says Foundation of Nursing Studies chair Tony Butterworth.
undergraduate nursing_tile_iStock.jpg

New pathways into nursing, such as apprenticeships and associate roles, pose a huge risk to the profession. Yet there is no strong opposition from senior nurse leaders, says Foundation of Nursing Studies chair Tony Butterworth.

Earlier in my career I had the great privilege of working alongside Baroness Jean McFarlane at the University of Manchester. The leader of the first undergraduate nursing programme at an English university, she was a fierce proponent and defender of nurses being educated in universities. I cannot imagine her response to the persistent offensive on nursing in higher education.

People who should know better have all but closed their eyes and ears, and are standing by quietly as new plans that dramatically affect the nursing workforce are eased into place in the name of staff shortages.

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New pathways into nursing, such as apprenticeships and associate roles, pose a huge risk to the profession. Yet there is no strong opposition from senior nurse leaders, says Foundation of Nursing Studies chair Tony Butterworth.


Support for vocational routes into nursing could leave undergraduates feeling insecure. Picture: iStock

Earlier in my career I had the great privilege of working alongside Baroness Jean McFarlane at the University of Manchester. The leader of the first undergraduate nursing programme at an English university, she was a fierce proponent and defender of nurses being educated in universities. I cannot imagine her response to the persistent offensive on nursing in higher education.

People who should know better have all but closed their eyes and ears, and are standing by quietly as new plans that dramatically affect the nursing workforce are eased into place in the name of staff shortages.

In one stroke, HM Treasury has abolished nursing bursaries, but workforce planners can still find sufficient resources to offer bursary support to other groups. Can it be that nursing is a soft touch? Or is a clever, graduate and largely female profession viewed as some kind of threat?

Equal support

Arguments against the perceived wisdom of the day are unwelcome. 'If you are not with us, you are against us' is the worst kind of response, designed to stifle debate and push through change without critical feedback. I fear for my profession and its future; I might be reassured if proper debate was encouraged.

One of the issues here is with leadership. It is hard to imagine doctors' leaders being quiet about such an assault on their profession, but I do not hear strong opposition from our most senior leaders. Indeed, senior staff in the government and non-statutory organisations are actively working to support changes to the nursing workforce, but are strangely silent when it comes to supporting undergraduates, who must be feeling insecure.

We must support undergraduates with as much purpose as appears to be there for the proposed new workforce. Undergraduate nursing students are a clever and critical audience: make them feel unloved at your peril.

Lessons from history 

Another issue is access and continuing professional development (CPD). Many have said that the new workforce pathways will assist nursing associates in entering the graduate workforce and that apprenticeships will offer an answer to the loss of bursary support.

This is guesswork of the worst kind, and lessons from recent history give little cause for optimism: consider the demise of graduate mental health workers in primary care as they lost their champions.

Interestingly, the regulators and champions of the new workforce are at risk of being reorganised out of existence as the NHS struggles through new organisational models. The secretary of state could take against how the professions are regulated - organisational lives are short in health care and the professions. The Nursing and Midwifery Council and Health Education England should take note.  

CPD is badly funded and getting worse, and so responsiveness to necessary workforce change is unsupported. We are supposed to just get on with it. All the considerable evidence from organisational development processes and practice development theory would caution against 'just getting on with it', but evidence now clearly gets in the way of a good plan.

These changes would seem like nonsense to the pioneers who developed undergraduate nurse education. Those pioneers would, I'm sure, see this as an assault on intelligent, thoughtful nursing, and be angry that nursing brains are going down the drain.


About the author

 

 

 

Tony Butterworth CBE is emeritus professor at the University of Lincoln, chair of the Foundation of Nursing Studies, and vice-chair of the RCN Foundation

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