I read Professor Watson’s interesting memory of Penny Prophit, and his comparison of her to Jason Arday. I too have a memory of Penny Prophit, whom I met when she examined my nursing doctoral thesis. This originated in my own scepticism of the newly academicised UK nursing. In order to question the rigour of this supposed ‘body of nursing knowledge’ I had to become academically familiar with it. This led me into publishing several books and numerous articles on my concern that much of this new nursing scholarship was based not on medical sciences (which would make sense) but on social sciences. And it was not being subjected to proper scrutiny.
UK ‘academic’ nursing found its way into the universities via education departments, just as Jason Arday did. It adopted social science methodologies, such as ethnography, phenomenology, lived experience, reflective practice, grounded theory and action research. These were used as justification for funding nursing university departments, nursing doctoral theses, nursing professorships and hence nursing’s political activism for the past four decades, keeping out any critical scrutiny as disloyalty.
Indeed I found UK nursing journals rejected my articles, so I published in the Lancet, the British Medical Journal, Social Science and Medicine, Journal of Medical Ethics and North American nursing journals instead. I may have been a lonely sceptic in the academy, but I was not with my practical nursing colleagues on the wards who also questioned the value of this new academic nursing for care of patients. A few years ago, just before I retired, I replied to an editorial in Journal of Advanced Nursing (edited by Professor Watson), which, to my surprise, admitted that academic nursing was being hampered, even sabotaged, by a mediocre ‘killer elite’. My submission was rejected (by Professor Watson as he later told me) so I published it in the Times Higher Education instead.
As for Penny Prophit, she defended herself against what she described as distorted claims. She was praised by the Scottish Office, and sued the BBC for defamation in what became a seminal case. The BBC settled out of court. She died in 2021, so cannot defend herself against Professor Watson’s claims.
It seems to me that the Jason Arday scenario helpfully exposes the psychodynamic pablum of much social science research. And it is that so-called scholarship, which nursing has adopted, that should be under the spotlight. Social science research, even carried out conscientiously, has major flaws: researcher bias, subjectivity, low generalisability, lack of validity and reliability, too much variability, and indeed what Richard Dawkins calls “gobbledygook”. And it is very questionable, as the Francis Report in 2013 highlights, whether nursing research has actually contributed to higher levels of nurse recruitment and staffing or improved the quality of patient care. But then moving nurse training out of hospital apprenticeship into polytechnics and then universities was never really about improving patient care. It was always about power: improving the status of nursing by creating an academic elite.
Dr Ann Bradshaw SRN is a retired Senior Lecturer in Adult Nursing at Oxford Brookes University. Her previous books include The Nurse Apprentice and The Project 2000 Nurse.
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Enshittification comes to everything, given enough time, and some attention from those who like to ‘fix’ what is not broken.
On a related theme, many NHS staff (non clinical as well as nursing) have to do a masters degree to get on the next rung of the ladder, often to get a Band 7 post, which is equivalent to being a ward sister, but includes admin staff. They are paid by a hospital to be at university one day a week for two years, the hospital pays the university tuition fees, the university makes money and the student learns how to make a meaningless word salad. It’s a gravy train for the universities, at a significant cost to the hospitals. From what I’ve seen of the content of these courses, there is nothing of actual meaning or substance that they learn.
Nursing and policing being made graduate entry – two more ways in which the working class have been stuffed. And nursing and policing ruined.
Bring back cottage hospitals, Technical Colleges and nurses trained on the job. NOW please.
and the hospital Matron.
I previously had no idea that ‘pablum’ was a recognised variant of ‘pabulum’. The OED gives it as an alternative. You learn something new every day.
Nobody needs a university degree to empty bedpans, and nobody with a university degree wants to empty bedpans. Hence the state of nursing.
I have a nursing degree (mental health) and if the need arises I have no problem with emptying a bedpan or clearing up sick or (with elderly patients) changing their incontinence pads.
Yes… mental health.
? What do you mean?
But is the term ‘killer’ justified? Perhaps. There must be a suspicion that the Arday case is at the tip of a dangerous iceberg, one that needs attention before a Titanic happens.
The subject of nurses is a truly bizarre, but not unique story of the ridiculous over qualification of the work place. I have no connection to the NHS other than as an occasional patient but my mother was a nurse. She left school around 1950, having matriculated and went to become a student nurse at the London Hospital. She then joined the Princess Mary’s RAFNS achieving the equivalent rank of Flight Lieutenant. Back in civilian life she was a nursing sister and then matron of a small group of hospitals when she retired. She was an excellent nurse. She didn’t need a university education and, I firmly believe, nor do the majority of nurses in the NHS. They should be employed and trained in teaching hospitals and if moving on to a specialism should seek advanced, degree level qualifications.
What we seem to have achieved by insisting on graduate level nurses is to push away competent caring men and women in their teens who would be amazing on the wards to bringing in thousands of migrant nurses, who may or may not be as skilled as a home grown person, denying the career to, admittedly, less qualified UK kids and… Read more »
Quite right.
I had a friend who qualified as a nurse in Poland and moved here. He was horrified by the lack of practical skills among nurses in the UK (ironically he moved away to pursue a doctorate in nursing….I suppose now he will have responsibility for training the next generation at university)
Do we really need research to figure out how to train nurses. Their roles develop but not in ways that exceed the ability of normally sensible senior staff to handle
Was not the political drive to get every school pupil into “uni”, and to force workers to take an academic qualification, for the benefit not of the students or workers but of the predominantly socialist class who teach, manage, and administer the academies?
“ moving nurse training out of hospital apprenticeship into polytechnics and then universities was never really about improving patient care. It was always about power: improving the status of nursing by creating an academic elite “.
BIngo! As a London Teaching Hospital – trained SRN, I was still nursing when the push for nurse training to be centred on universities occurred. Those pushing this seemed to be of the opinion that such a move would gain more respect for nursing. Instead, there proliferated many accounts citing nurses who were “ too posh to wash “. I certainly encountered more than a few students who were not interested in providing basic, or what I would call fundamental nursing care, but who only wanted to observe “interesting” procedures. Of course, the apprenticeship system under which I trained was not perfect, but I believe that it equipped me very well for the job that I had for 40 years. I remember one gentleman who said to me, “ but you, Sister, are a proper nurse “. A proper nurse was exactly what I aspired to be.