Nursing education: the marriage of two normative worlds — creating a sustainable relationship?

Abstract

Nursing has had a presence in Australian higher education since 1975 however, during the past 19 years this area of endeavour has seen a number of significant changes. The most significant change being that of relocating all pre-registration nursing education from its traditional hospital base into the higher education sector, This transfer however, has not been without problems, some of which relate to the lack of nursing's effective adjustment to higher education and the changes in higher education itself. Antecedent to these factors are other elements which include fundamental changes to western ways o f life and thought and the lack o f adequate preparation o f nurses for the experiences and roles they would encounter in the higher education sector as a result of their occupational experiences as nurses and women. These antecedent factors require nurses therefore, to not only understand the significance o f the changes occurring in the western world but also the need on the part o f nurse academics to work in, understand and acknowledge two normative organisations and the impact these organisations are experiencing as the result of the social and cultural changes occurring in the western world. A normative organisation is one in which the exercise o f power is undertaken in such a way so as to gain the commitment to and personal involvement in the organisation's goals by the individuals working in the organisation. The two organisations associated with nursing education, universities and health care organisations, are as such normative organisations. These organisations however, while being normative, differ markedly in a number o f ways. This includes their historical origins, goals, organisational structures and processes established to achieve their goals and the expectations they have o f the individuals who work in them. In this sense, nurse academics work between two normative organisations that generate, as a consequence o f their differences, a number of significant difficulties. Additionally, changes in the health care structures, increasing cost containment and the historically generated values o f nursing itself combine to create a range of difficulties that will potentially have a deleterious effect on nursing and which are impossible to overcome unless nursing acknowledges its current difficulties and takes specific steps toward their resolution. Changes being experienced in these normative organisations are however not occurring by chance but as the result of a much wider set o f circumstances. Rather, I suggest that these changes have their genesis in history with the rise o f science and the subsequent advances in knowledge and technology. These innovations gave rise to the industrial revolution and the modern age. In turn, advances in science, knowledge and technology generated a range o f circumstances that has led to a weakening of the traditions and social structures associated with the modern age and a resultant lack of social and cultural stability. This lack of social and cultural stability, the emergence ofmultiplicities and the associated trends o f internationalisation; increasing technologisation; privatisation; commodification and vocationalisation o f education has resulted, in turn, in greater cultural fragmentation, pluralism, diversity and change that collectively is referred to as postmodernity (Lyotard 1986). The forces generated by postmodernity are currently placing pressures on both universities and hospitals and in turn impact on the nature o f and processes associated with nursing education. These are clearly evident in the role and function o f nurse academics and the problems they currently experience. This paper offers some beginning thoughts about these issues and in so doing hopes to stimulate discussion between all persons involved in nursing education. Throughout this paper I use the word hospital to refer to all health care organisations. While in terms of structure and broad philosophical orientation a difference has been made between hospitals and community agencies, in terms of their normative function and associated expectation of the individuals who work in them there is minimal difference.