Submission of the Tertiary Education Union on the NZNO draft vision statement “2020 and beyond; a vision for nursing”
1 February 2011
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“2020 and beyond: a vision for nursing”
The Tertiary Education Union Te Hautū Kahurangi o Aotearoa (TEU) welcomes this opportunity to respond to the NZNO’s draft vision statement “2020 and beyond: a vision for nursing”. As the largest union and professional association representing staff in the tertiary education sector (in universities, institutes if technology/polytechnics, wānanga, private training establishments, OTEPs and REAPs), we have a significant number of members who work as nurse educators, and who therefore have an interest in the content of this document. Additionally, we are a professional association as well as an industrial union, so seek to contribute to discussion and strategy that relate to our members’ professional interests.
Because of our particular interest in nurse education, we will limit our comments to the section in the document that deals with education (Part 4: Education pg. 65 – 81) by responding to the questions posed on NZNO’s web-page.
Will current undergraduate and postgraduate educational structures meet the future demand for highly clinical and academically skilled nurses? If not, why not? If so, in what way?
The TEU believes the tertiary sector as a whole lacks a coherent vision and strategy for meeting the educational and skills needs of our population in the short, medium and long-term. Whilst we may disagree with some of the specific details of NZNO’s vision for nursing as it relates to nurse education, we are pleased that this work has been undertaken, and that in it, consideration has been given to development and support of nurse educators.
As with the tertiary sector generally, an overall vision and plan for nurse education is needed. The piecemeal ‘cuts’ and ‘rationalisations’ that many tertiary education institutions have been forced to make as a result of government funding cuts makes this even more imperative, so that we are not faced with serious staffing shortages in the tertiary sector and skills shortages amongst the health workforce. Such a plan needs to align with a national vision and strategy for the nursing profession. Part of the planning process should be an analysis of projected health workforce need, which can be integrated into planning for programme provision. This would then give a reasonable indication of the amount of provision required and to what extent current provision will be able to meet that demand.
In terms of current undergraduate and post-graduate structures, further investigation and research needs to take place to establish the extent that these structures are able to meet demands for ‘highly clinical and academically skilled nurses’. Two key areas of tension are:
- The view that university-based courses focus too much on theoretical learning at the expense of clinical practice, and;
- The view that programmes based in ITPs provide excellent clinical practice, but more limited opportunities for research-informed learning.
These two viewpoints need to be closely examined, and if they are supported by evidence, then each provider needs to work to ensure they are providing balance programmes that meet the needs of the profession. It is not satisfactory for these assertions to continue to be aired without more in-depth analysis; until this occurs, such assumptions only serve to negatively impact on public and employer perceptions of the quality of graduates, and do nothing to ensure that undergraduate and post-graduate structures and provision are meeting the current and future needs of the nursing profession.
Greater collaboration between providers (universities, ITPS and wānanga), as part of a national strategy for nurse education will also contribute to ensuring programmes are structured to meet future need and the expectations of the profession. The national strategy needs to emphasise regional collaboration that is clearly linked to agreed national and regional goals – so that each provider has a well-understood role in programme provision in their region, and that learners have a range of options available for completing undergraduate and post-graduate qualifications.
What do you think of the suggestion that the Nurse Entry to Practice (Net-P) programme be structured as a compulsory provisional registration year?
The TEU would support a compulsory provisional registration year for new graduates into the workplace. Better support for these graduates may assist with workplace retention issues and provide a structured framework to transition new graduates into the profession. Before such an approach was adopted however, more work would need to be done to evaluate the effectiveness of the programme, to confirm that it meets standards for educational quality, and that appropriate support systems are in place for both preceptors (in particular support /advice from nurse educators regarding their teaching role) and new graduates. Additionally (as the report notes) the integration of the programme with the undergraduate programmes offered by TEIs will be important to ensure a smooth transition from study to the workplace.
What is your opinion on establishing a national undergraduate nursing curriculum – what would be the advantages or disadvantages of this?
The TEU has previously supported rationalisation and nationalisation of curriculum, as long as the flexibility to provide specific ‘local’ content is retained. For a population of our size, the number of qualifications available and the variety in curriculum content makes it difficult for students to make course choices and for employers to have confidence in a new graduate’s knowledge and skills. There is also unnecessary duplication of effort and resources associated with a non-standardised curriculum.
The challenges facing the nursing profession now and into the future are generally well understood (e.g. the ability to respond to changing demographics and increasingly diverse communities, rapid technological changes, globalisation etc.). All nurses graduating from our nursing programmes need to have a comprehensive understanding of these issues and be able to integrate their understanding of them and myriad other skills/knowledge into their daily practice. A national curriculum would ensure that all programmes address these and other crucial subjects necessary for entry into this complex and ever-changing profession.
What would be the advantages or disadvantages of basing future nursing education in universities? What would be gained, what would be lost?
The TEU does not support moving nurse education into universities. We recognise that the ITP sector faces challenges in terms of developing institutional and staff capacity to undertake research and in addressing what are largely perceptual issues in relation to the quality of teaching and learning that takes place in these institutions – there is a perception that a university nursing degree is a ‘better’ degree than one obtained from ITPs, presumably because such degrees are delivered in a more established research environment.
The ITP sector has proven expertise in providing high-quality vocational education in learner-focused settings that are more able to provide smaller class sizes and individualised learning support. The sector also has an emergent applied research culture, which is particularly relevant to nursing, and which needs to be fostered. To propose moving nurse education into the university sector primarily on the basis of perceived status advantages and because this sector has a longer-established research culture does not acknowledge the unique opportunities that ITPs can provide for learners. A far better approach would be to address the (primarily workload) issues facing some ITPs (and indeed some universities) thus ensuring that a network of provision in a range of educational settings is maintained.
Our nurse educator members’ experiences of moving from the ITP sector to the university sector have often been reported to us as overwhelmingly negative. Comments have included clinical curriculums being re-developed with no input from clinically experienced nurse educator staff, a re-focus onto the theoretical elements of a programme, with a loss of clinical-based teaching, and a downgrading of the teaching expertise of staff, particularly those who are not currently research active. This indicates to us that such a move would be unnecessarily disruptive to the sector, and may have an adverse effect on the quality of programmes, especially in terms of maintaining a balance between theoretical understanding and practical application.
What are the priority curriculum options for nursing education in the future?
The draft vision statement outlines the key changes and issues that nursing facing into the future, including rapid scientific and technological advances, changing population demographics and increased population diversity, and the shift to primary healthcare settings. Additionally, as the draft vision statement notes, nurses need to work in a globalised context, with interdisciplinary teams, and be able to participate in opportunities for on-going learning and professional development throughout their careers.
In order for these requirements to be met, curriculum development needs to have a national framework, with a standard set of requirements at undergraduate level. Amongst these should be the requirement to learn in inter-disciplinary settings. Post-registration and post-graduate learning opportunities must meet both the clinical requirements of nurses ‘in the field’ and the need to develop professional leadership and interest in nurse education as an academic career.