Nina Elisabeth Blegen
Head of Department, Department of Nursing and Health Sciences, University of Southeast Norway (USN)
We want to train nurses who are able to practice their profession in a responsible manner. At the same time, we want to be brave and innovative. Then we need help.
This is a chronicle. Opinions in the text are at the writer’s expense.
Dear Prime Minister Jonas Gahr Støre.
We are affected by a pandemic that has major and serious consequences for society, and you and the government are taking measures to curb infection and prevent serious disease development.
Much is good and right, but these measures do not solve the acute and critical staffing situation at the hospitals and in the municipal health and care services around the country.
The Norwegian Nurses’ Association has called for necessary crisis packages that can ensure predictability for the health service, nurses and other health personnel in this extreme situation. These are measures that can ease the acute and dramatic situation we are experiencing now, but in the long run we need more nurses.
We are ready to contribute
We need nurses both for hospitals and for the health and care services in the municipalities. We need them, not least because it is these nurses who later specialize in, among other things, intensive care.
In order to educate more people, more study places are required. Adjusting the number of study places is relatively easy if there is the political will to do so, but appropriations for internships are also required.
Even if you and the government were to do this, we are still tied to the hands and feet of an EU directive that tells us exactly how many hours students should be in practice, and how the practice can be.
This makes it harder to think new and different. And that prevents us from finding new and innovative ways to educate nurses, which are perhaps more geared to what we see as needs in the future.
At universities and colleges, we are ready to help educate more nurses. But we unfortunately experience more obstacles than opportunities, as laws and regulations work today:
Bottleneck 1: Bound by the EU
A nursing student is out in an EU-regulated practice in working life for 50 percent of the study time. At the University of Southeast Norway, we have state-of-the-art simulation departments with advanced equipment. Here, students can practice, train and learn through simulation, not least in demanding intensive situations.
However, our specially designed simulation departments are not approved as practical studies by the EU. So even though we have several ideas for how practical studies can be solved alternatively, we are bound by rules that were adopted at a time when the societal changes we are facing today were not foreseen.
We are bound by rules that were adopted at a time when the societal changes we are facing today were not foreseen.
Bottleneck 2: Lack of internships
One solution is more study places. The way the system works today is not sufficient, because we do not have enough internships. As an educational institution, we are subordinate to the Ministry of Education and Research, while half of the nursing study is in the clinical reality which is subordinate to the Ministry of Health and Care Services.
As we experience it, there is no or little cooperation between the Ministry of Health and Care Services and the Ministry of Education.
The health and care services were under pressure even before the pandemic and are not funded to be able to contribute to the education of nurses.
The health services must be equipped to receive far more students and contribute to the development of other forms of practical studies. Practice supervisors must be given the opportunity to take the necessary continuing education in supervision. Here the government must take action.
As we experience it, there is no or little cooperation between the Ministry of Health and Care Services and the Ministry of Education
Bottleneck No. 3: Teacher capacity
The third bottleneck is teacher capacity. For who will train tomorrow’s nurses? Strong forces in society want us to focus on getting nurses to work quickly via a bachelor’s education, and that we prioritize the master’s education of nurses.
However, it will have an effect on tomorrow’s teachers in nursing education. Being a nurse is not enough for someone who is going to train new nurses.
The knowledge and guidance must be research-based. It requires teachers with research skills. Building educational and research skills requires time and long-term planning.
We need educational courses where nurses can study pedagogy and didactics towards their own subject. New and alternative teaching methods require knowledge and competence beyond a clinical master’s degree. A doctoral degree and educational competence are needed.
Building educational and research skills requires time and long-term planning
We have to think new and different
The University of Southeast Norway (USN) is well on its way to developing a decentralized nursing education that will start in the autumn of 2022.
Here we get to try out alternative teaching and tutoring methods. It may point forward to a new and more future-oriented nursing education.
However, it is expensive to educate less coal in the districts, so here political will is also required.
In our seemingly controlled world, the pandemic came as a surprise, and nothing was prepared. This is perhaps the clearest sign that we must seek to think new and different in order to solve the underlying problems in today’s staffing crisis.
At USN, we want to train nurses who are able to practice their profession in a responsible manner, and at the same time be brave and innovative when it comes to solving unpredictable challenges.
Then we need the government’s help to remove the bottlenecks.