Harmonising Nursing Education: Theory and Practice

Abstract

IntroductionNURSES ARE AN INTEGRAL PART OF a country's national development since they constitute the greatest part of any health care delivery system that helps to maintain productive human capital. They provide health care services for families across the life cycle, culminating with the last developmental stage of death. Primary, secondary and tertiary health care services are delivered by nurses who must be scientifically and clinically prepared to address the health needs of the community. The education of an adequate cadre of nurses should be of national importance because inadequate numbers of registered nurses lead to higher morbidity and mortality rates. A recent study concluded that hospitals with high pa tient-to-nurse ratios, surgical patients experience higher risk-adjusted three-day mortality rates and failure-to-rescue rates and that nurses are more likely to experience burnout and job dissatisfaction.1 The minimum standard of 18 nurses per 10,000 population is required to ensure that 80 percent of all childbirths are attended by a professional nurse.2 Belize is below acceptable standards with 15 nurses per 10,000, which should signal to all sectors that educating well-prepared nurses is a matter of high priority for inclusion in national development strategies.Nursing education has a major role to play in the development of graduates who can deliver high-quality nursing care, and in a manner that harmonises theory and practice. However, the gap between theory and practice continues to be a prevailing problem in nursing and midwifery. In addition to having to be adequately prepared for their future professional role, nursing students have to seamlessly fit into the nursing workforce. Despite much discussion and several efforts to implement various integration strategies, newly graduated nurses often confront an array of physical, technical and mental challenges in bridging the academic and clinical divide. Bridging the gap between theory and practice has implications for recruitment of students into the nursing programme, as well as retention of newly educated nurses. Reflectively, it is time for the nursing community and the University of Belize to utilise innovative strategies to expand and meet human resources in health requirements. A unified approach must be pursued to address existing challenges.The purpose of this article is to examine the issues and challenges related to student nurses' professional development, focusing on mechanisms to bridge the gap between theory and practice in general, and specifically in the University of Belize's Professional Nursing Education programme. Academic issues, including recruitment and selection of students, attrition and completion, and retention will be discussed; as well as methods used to facilitate students' acquisition of technical, clinical skills. Practice issues that will be explored include quality of care issues, and bridging mechanisms such as orientation, preceptoring, coaching and mentoring.Theoretical frameworkToday, nurses are confronted by new challenges within the health reform mandate to provide equitable, effective, affordable and quality health care services. The health care environment is constantly changing, and challenges abound to use computerised information systems, deliver evidence-based nursing care, and participate in quality improvement initiatives. There are certain characteristics which define how nurses perceive, comprehend and interpret health simations. Four perspectives are integrated into the curricula for nursing education: (i) the nature of nursing science as a human science; (2) practice aspects of nursing; (3) caring relationships that nurses and patients develop; and (4) a health and wellness perspective.3 A common complaint from nurses in clinical settings and the general public is that nurses seem to lack what is considered the essence of nursing - human caring. Patricia Cook and Janice Cullen propose that today the demonstration of caring is an exception rather than the rule. …