Is nursing education a bursting bubble?

Bubbles are very real damaging things. Most people don’t see them until they’re too late. In-fact, it’s this sort of blindness that facilitates bubbles. There seems to be three ingredients. Firstly the new area is over-hyped, it is then perpetuated, and finally when it can no longer be sustained it collapses. To get a sense of this we can apply these concepts to a few famous examples.

The internet bubble released a new field of business. Companies like Napster and Google made huge success stories and everyone wanted in. The hype was so big that investors were chucking money at internet companies who didn’t have business plans or marketable products. When PayPal was in its infancy a South Korean firm wired them millions of Dollars without even negotiating a contract. When PayPal tried to wire the money back the firm wouldn’t tell them where to send it. The bubble was perpetuated by a strong belief system. If you questioned the value of an internet company you would be considered a crank. When a lot of these companies produced no value there became a landslide of bankruptcies. The same was in the housing bubble in the USA. The hype was government backed loans to subprime borrowers, no one questioned the value of a house and when they couldn’t pay back the loans the bubble burst. The last example of many is the green tech bubble. Al Gore’s Nobel Prize winning global warming video created a hype of green energy. This was perpetuated by companies claiming that if they had a small percentage of the energy market they would make billions. No one dared question as they would be labeled a crank or be branded as someone who doesn’t care about the future of the planet. Again a lot of them didn’t have business or distribution plans. They thought that if they built tech it would be adopted. This is naive which history has shown us before. When the American Civil war finished, slavery was outlawed, so the southern states made vague laws such as loitering. They then rounded up poor people and charged them with these laws resulting in massive fines. These “criminals” were then ordered to work in workhouses until the fine was paid off. Although it’s morally wrong their whole economic system was built on slave labour. It would have collapsed if they got rid of it over night. What this shows us is that idealism isn’t enough for the change you want. The green tech bubble shows us that idealism alone does not help stave off bubbles.

 

Now let’s look at nursing education. Nursing was hyped when it became a degree profession. The degree was paid for by government. Like we can argue that poor people deserve to own houses and that green tech should be the future, we can also argue that poor people shouldn’t be denied the opportunity of nurse training. However, there is some undesired consequences. When something is free people are less likely to be demanding or critical. Considering that you have to pay for most degrees this also introduces the student who chose this because they don’t like the idea of paying for a degree. Although this isn’t the same amount of hype as the internet bubble it does artificially inflate the desire to study nursing compared to other degrees.
The perpetuation is the type research and education offered to nursing students. Nursing academia is heavily bias towards idealism. Focuses on how patients and nurses feel about a subject or their perceptions is common in nurse training and research. Few people can argue that these subjects aren’t important, like few people can claim that the internet didn’t increase its impact since the 90s or that green tech isn’t an important investment for our future. However, questioning the practical value of nursing idealism will get you comments like “you just don’t understand nursing” or “you don’t care about your patients, you can’t boil them down to numbers”. The importance of a nursing degree is simply accepted with little checks. The figure below was taken from a paper that was accepted in the journal of advanced nursing:     

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However, there is an issue with selection bias. In qatar (where the data was collected) better-qualified nurses could simply get jobs at better hospitals. The professor took my comment and is going to check for this but we have to keep an eye on easy hype.

We are now coming into the crash stage. The government is no longer giving students bursaries. The politics of whether it’s right or wrong is neither here nor there. People are generally in agreement that this will affect nursing student recruitment. To simply blame the government for recruitment issues would be sweeping some uncomfortable truths under the rug. The reality is that the cotton mittens have come off and the nursing BSc has to compete on an even footing with most other degrees. Medicine is a more expensive degree yet people are clambering to get in. They employ admissions tests that have little correlation to success at medical school because they cannot interview all the applicants they have. Central London universities charge tens of thousands of pounds for a masters in financial engineering. If a nursing degree was worth it people would pay for it.
I don’t mean that society doesn’t need nursing degrees. Society needs green tech but their focus on the idealism of their product meant that their products were not compatible with many systems and thus worthless. Nursing doesn’t just need to offer practical clinical skills but practical academic skills that offer clear value.  Big data is upon us, computing is becoming more and more powerful and common. Statistics and data are more and more available at a quicker pace. Optional modules in computer programming and probability theory will not only give students an option of gaining a strong practical academic skill but it will also empower the profession. Combining the idealism with a set of nurses who can practically incorporate findings into systems, develop software, analyse big sets of data and develop data systems in hospitals that aid nursing decision making is a way to reduce a bubble effect. Engineering and physics grads code. They will not be able to compete with a computer science grad but they realise the importance of implementing their ideas and practically measuring outcomes. To avoid the fate of the green tech start ups some of our education has to be focused on packaging our idealism for the outside world.

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