The relationship between practitioners and academics – anti-academic discourse voiced by Finnish nurses

Abstract

Nursing in Western countries has become increasingly more theoretical, and nurse education has been integrated more often with the higher education system. Historically, nursing has been viewed as a non-academic domain. Establishing Nursing Science (NS) in Finland in the 1970s has meant that the new discipline is defined as the core of nurse education and as the basis for all nursing practice. However, research has highlighted tensions facing practitioners due to the theorisation and academisation of education. This article presents the findings from a study in which the educational accounts of Finnish nurses and nurse students were explored. Research orientation is underpinned by the sociology of education, and educational accounts were approached through discourse analysis. The data for research are composed of opinion writings and Internet platform discussion threads. Themes such as academic education, NS and theory–practice gap in nursing came up frequently in the data.These educational accounts can be characterised as critical, and therefore, the way of talking was labelled as an anti-academic discourse. We ask what this discourse is used for and discuss how to interpret it in the context of work arena and institutional education.

Keywords:

• discourse analysis
• educational accounts
• higher education
• nurse education
• theory–practice distinction

Notes

Authors contributed equally to this article

1. The system of polytechnics is still fairly new in Finland. Over 200 vocational institutions were amalgamated to form 32 polytechnics in the 1990’s. Polytechnics are multi-field regional institutions focusing on contacts with working life and on regional development. Currently, there are 25 polytechnics in the Ministry of Education and Culture sector. Polytechnics name themselves Universities of Applied Sciences while the Ministry of Education and Culture uses and recommends the term polytechnic. The naming policy of polytechnics can be seen as a manifestation of academic drift. (Kyvik 2007; Ministry of Education and Culture 2012; Välimaa and Neuvonen-Rauhala 2008, 77).

2. At the upper secondary level, vocational institutions (VET) offer initial vocational training. One of the fields is Health and Social Services. It is possible to specialise as a practical nurse in nine different study programmes. School-based training lasts three years or, alternatively, the practical nurse diploma can also be taken in the form of a competence-based qualification by combining training periods with an apprenticeship (Finnish National Board of Education 2005).

3. Although the UK had achieved the status of European forerunner in nursing research in the 1970’s, the development of nursing as an academic discipline has taken relatively long. NS was established in the university system mainly in the 1990’s, and was connected with the harmonisation of the higher education system when the polytechnics were awarded university status in 1992 (Burke 2006). Thompson (2009; see also Thompson and Watson 2005; Watson 2006) argues that nursing in the UK‘s universities is on shaky ground compared with nursing in the universities of USA, Canada, Australia and Scandinavia, for example.

4. E.g. nurses, midwives, public health nurses, physiotherapists, medical laboratory technologists, radiographers, dental hygienists, occupational therapists and also assistant health care professionals e.g. practical nurses.

5. The academic-professional discourse is characterised by the following dimensions: (1) emphasising theory and research, special knowledge and skills, (academic) expertise and professional boundaries as the foundations of nursing; (2) academic vocabulary in NS: ‘evidence-based’, ‘evaluation of care’ etc. ; (3) managerialist vocabulary: ‘efficiency’, ‘quality assurance’, ‘cost awareness’ etc.; (4) well-educated health professional is a competent, good and valued professional; and (5) strong faith in the power of education and strong willingness to train oneself. Correspondingly, the practical-‘calling’ discourse can be summed up to the following dimensions: (1) emphasising nursing as first of all practical work; (2) vocational vocabulary: ‘heart’, ‘calling’, personal characteristics etc.; (3) experienced and “proper” health professional is a competent, good and valued professional; and (4) “longing for recipes” from education.

6. The requirement for MA in polytechnics is a BA polytechnic degree and at least three years of work experience. The polytechnic MA is 60–90 study points and takes 1.5–2 years. (Ministry of Education and Culture 2012).

7. The clinical context of Finnish health professionals is still characterised by female-dominance. In 2009, 88 per cent of employees in the health field were women (Statistics Finland 2008). According to international comparisons, occupational segregation by gender is at very high level in Finland. One explanation for this may be the Nordic welfare state services for which women have traditionally been responsible.