The Nursing Profession and Graduate Status in England: Perspectives from Student Nurses and Health Professional Educators

This study investigates all graduate entry to nursing in England, focusing on the
perceptions and experiences of nursing students and health professional educators at
one English university. It presents a history of nurse education, debates the cases for
and against the move to an all graduate entry, and introduces a conceptual framework
based on the influences on, and expected outcomes of, the undergraduate nursing
student. The study adopts a single-embedded case study design. Data was collected
between October 2012 and September 2014 using questionnaires and focus groups.
Statistical analysis and thematic analysis (using the framework devised by Braun and
Clarke, 2006) were undertaken on the quantitative and qualitative data respectively.
The undergraduate student nurses reflected a positive attitude towards nursing,
seeing a therapeutic relationship and the values underpinning ‘compassion in practice’
as fundamental to the role of Registered Nurse (RN). They also demonstrated
motivations that reflected these principles and, to some extent, recognised them in
themselves. The importance of developing and demonstrating graduate attributes was
acknowledged, but these were not seen to be as significant as the fundamental
principles of what it means to be a nurse. The majority of health professional
educators supported the move to an all graduate entry to nursing, with nurse educators
being more in favour that their Allied Health Professional colleagues. There was also
clear recognition that the role of the RN had changed and that RNs needed graduate
attributes in order to manage the complexities of twenty-first century healthcare.
Participants in this study saw the move to all graduate entry as welcome and
necessary, although this view was not universal. Reasons students gave for pursuing
a career in nursing reflected those identified in earlier studies. The students’
experiences in clinical practice were affected by the standards of care they observed,
the quality of mentorship and by issues related to ‘belongingness’. The study
highlights and contributes to the on-going debate surrounding the development of
nursing as a profession, confirming that the ideals of altruism have not been lost in the
development of academic processes and identity.