The Euro‐nurse: theory or reality

An international approach to master's‐level preparation for clinical nurse specialists*

“…and practice of nurses in these countries thus encounter extra difficulty m developing the kind of continuing and The mam aim of this paper IS to discuss the development of higher education for nurses that other countries are higher education for nurses in Europe and to offer a model beginning to achieve showing one way m which this development might be For some time now it has been WHO policy in the enhanced European Region that there should be a system of For many years nurse education in Europe has been generalist nurses and specialist level nurses Stussi (1990) subject to European directives for a common core of pre-has descnbed the specialist nurse as 'a state registered registration studies, as reported by Collins (1982) How-nurse authonsed to practice as a speaalist with adever, the EEC Directives also include a commitment to vanced expertise m a branch of the nursmg field Speaality contmumg education for nurses As Collms argued, this is practice', she argued, 'mcludes dmical teaching, admmisone of the ways in which the implementation of the World tration, research and consultant roles Post-basic education Health Organization (WHO) call for health care for all by for speciality practice is a formally recognized programme year 2(K)0 might be facibtated m Europe of study built upon the general education of the nurse Altschul (1987), however, descnbed the situation m and providing the content and expenence to ensure many European countnes where nursmg remams very competency in the speaality practice much under the influence or control of the medical profession In many countnes, doctors undertake the kmds of mterventions that m other countnes nurses do, as descnbed Collaboration by Butterworth (1991) Attempts to improve the education in a most useful review of the European scene m nursing ._ ^, , , , __^, ,"", , mvolvme the work of the WHO and the Intemational…”

“…Concems can be expressed of the value of higher education for nurses and studies attempting to evaluate the outcome have run into difficulty m demonstrating suitable cntena by which to make judgement However, in terms of contnbution to practice, evidence seems to indicate that graduate nurses tend to stay in clinical practice, not moving excessively into senior posts although a proportion do enter the academic and research worlds (e g Sinclair 1987) Many authonhes have attempted to delineate the potential advantages of higher education for nurses Clark (1987), for example, argued that higher education can instil the discplines of systematic enquiry and cntical reflection, enabling the practitioner to have the attnbutes of good practice as well as being able to eontnbute to the development of professional knowledge Institutions of higher education also have the potential to prepare the teachers and role models for nurse learners A feature of the pre-registration of nurses m many countnes, and particularly in the UK where most of this author's expenence lies, is that innovations in practice are mtroduced through new pre-registration cumcula There might seem to be nothmg wrong with this, but the record mdicates that these changes are introduced before or alongside their mtroduction for registered and practising nurses However, this means that there are no expenenced, skilled practitioners to act as role models skilled in the innovation for the learners It also means that registered nurses themselves feel threatened by the learners commg to them with new approaches with which they themselves are not famihar The result is difhculty or even failure m mtroducmg the innovation An example of this is the recent mtroduction of Project 2000 in the UK where a new kind of nurse is being prepared to meet the demands of approaches to health care in the years 2000 -I-It is smce the introduction of this new programme that efforts are bemg made to enhance the practice, knowledge and understandmg of nurses who will act as role models, mentors for the new leamers and neophyte practitioners coming out of the new programmes Collins (1982), reporting on the work of the Advisory Committee on Training m Nursmg for the EEC, identified the following aims for continuing education up-datmg practice m the light of new techniques, developing high levels of stall in nursmg speaalisms, developing supervisory and teachmg roles, and formal and mformal teachmg sblls Clark (1987) also emphasized the importance of education and practice at different levels, and this is also a feature of the programmes of contmumg education bemg developed m Scotland and Wales, for example The identification of advanced levels of practice and the lmtang of these with levels of academic endeavour is an important challenge facmg the profession today and an attempt to meet this challenge has recently been made by the author and a colleague (Davis & Bumard 1992) Evidence from the UK, The Netherlands (Utrecht) and the USA was used to demonstrate that, as a profession, nursing is almost ready to identify clearly expectations of expert practice in vanous clmical and other fields m relation to educational, academic levels Increasingly, descnptions of advanced nursmg practice utilize termmology from the academic world, such as analysis, critical thmtang, syn- Table 1 Some advantages of a modular scheme* Greater freedom of choice of topics by students Improved quality/economy of teaching and learning Clearer structure for both students and lecturers More accountability for lecturers Flexibility of topics and teaching across a vanety of centres ...…”