Academic journal article Journal of Character Education

WHAT PART DOES UNIVERSITY PLAY IN THE DEVELOPMENT OF A CARING CHARACTER DISPOSITION FOR NURSES? Some Theoretical, Historical, and Empirical Considerations

Academic journal article Journal of Character Education

WHAT PART DOES UNIVERSITY PLAY IN THE DEVELOPMENT OF A CARING CHARACTER DISPOSITION FOR NURSES? Some Theoretical, Historical, and Empirical Considerations

Article excerpt

LEARNING TO CARE AT UNIVERSITY

This article explores how nurses learn to care and in particular, what higher education adds to that learning. Does it leave nursing graduates resentful of the more menial aspects of nursing, or ?too posh to wash? (Beer, 2013; Hall, 2004) and if so, does that matter? The article begins with discussion of what it takes to be a ?good? nurse, drawing upon a theoretical framework linking Tronto's ethic of care (1998), Eraut's typology of knowledge (1994, 2007), and an Aristotelian understanding of phronesis. In seeking to understand how nurses learn to care, I examine the context of nurse education, suggesting that the drive for higher (professional) status led nursing to move toward university-based education, with an associated shift in emphasis toward technical, scientific knowledge. Drawing upon narratives from four student nurses who form a small case study of student experiences in the early 21st century, I report their descriptions of their motivation to nurse, their understanding of how education prepares them for the caring aspects of nursing and how they viewed university as a site for learning in their profession. I conclude that though nursing is an intensely practical activity, it requires a highly knowledgeable, reflective, virtuous practitioner to be able to care well, and higher education, though ideally placed to nurture those capacities, has yet to convince the nursing profession of the importance of phronetic virtue in nurse education.

CURRENT CONCERNS: A LACK OF CARE?

Recent reports into poor care in United Kingdom hospitals and care homes (Department of Health, 2012a; Francis, 2010) have caused something of a moral panic amongst the public and popular press about the quality of nursing care. Yet it is unclear to what extent such failings relate to institutional factors such as staffing levels and time pressure, so-called ?missed care? (Ball et al., 2013), highlighted in the Francis report (2010), or to a lack of care in the virtue of the individual nurse. Some have argued that nurses are now unwilling to provide basic care because they have been led to believe their role requires more clinical expertise than mundane tasks (Hall, 2004) and this is portrayed as a lack of care by nurses. In its response to the Francis report, the Royal College of Nursing argued ?the National Health Service often sets up good people to do bad things, through constant change, chronic understaffing and unrelenting pressure staff have kindness and compassion eroded from them? before concurring with Francis on the need to recruit student nurses who ?exhibit the right values, display a desire to deliver compassionate care and learn the technical skills essential to modern day nursing? (2013, pp. 5- 6).

Established amid concerns that nurse education needed to change, the Willis Commission on Nursing Education in England found no obvious shortcomings in that education and reiterated the importance of moving to university-based education. It argued that although ?some critics blame the problems explicitly on the move to degree-level nursing education,? with its emphasis on technical and clinical expertise, nurses required both intellectual abilities and compassion. It went on to suggest strengthening higher education's engagement with nurse education, including promoting research and scholarship in practice and lifelong learning for nurses (Willis Commission on Nursing Commission, 2012, p. 8).

Therefore, we are left with confusion about how nurses can best be educated to meet the demands of the modern health service, what part compassion and care play in nursing and specifically how nurses learn to care. To address this confusion, I discuss what it takes to be a ?good? nurse before tracing the development of nurse education, highlighting crucial influences that shape how nurses are prepared for practice.

WHAT DOES IT TAKE TO BE A ?GOOD? NURSE?

A nurse in the 21st century needs to have practical competency, and propositional knowledge (Muller & Young, 2014), but these alone do not suffice. …

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