Essay wha? Is there any point whatsoever in nursing students writing essays? Do they really serve their supposed purpose of developing critical thinking skills and ascertaining how students are processing information? A former educator has his doubts.

It's not surprising Padraigh O'Luanaigh's career in New Zealand nursing education was brief (Something is rotten in the state of education, Kai Tiaki Nursing New Zealand, June 2005; 10-11). An Irish male midwife? Innovative, imaginative, charismatic? Articulate and critical? It's a wonder he lasted as long as he did.

O'Luanaigh left us with a perceptive and insightful commentary on New Zealand nursing education systems. This will be totally ignored by the educational sector. It didn't get where it is today by being responsive and self analytical However, one observation struck me. O'Luanaigh said: ".. many [students] are starting a degree struggling with the fundamentals of essay writing" This may be true.

In a former life as a teacher in a new graduate programme, I found that not only did students start, but many graduates finished a degree still struggling with the fundamentals of essay writing. Much of my work involved post traumatic therapies as new graduates recovered from the abuses and bizarre contradictions of their previous three years. The other major work involved remediation of written expression. Whether this focused on persuading nurses to leaven strings of safe, empty cliches citing nursing theorists, (uniform in their depersonalised passivity and fear of individual opinion) with passion and personality; or whether it was persuading nurses that objects were a good thing to put into sentences. Oh, and predicates and apostrophes, commas and the various ephemera of English grammar--air these I tried to explain--were worthy of inclusion in their written work.

It also struck me, as I was waging this rather lonely and thankless crusade, that a great transformation had occurred. Nurses had, through the elevating energies of tertiary education, left behind those empty rituals like making beds with crease[ass sheets or ensuring patients were dean and got their right dentures back. In place of these meaningless and demeaning symbols of patriarchal oppression, there were now more mature and sophisticated obligations. The idea of writing in the third person was (is?) such a wonder that academia has wrought. Whether or not to indent the second line of a reference? There is a controversy that can now more fruitfully occupy the nursing imagination. Putting a student number rather than a name on written work? Now that tails us more about the trust we put in academics' objectivity and the nursing pursuit of humanity and "personhood" than I think we want to know.

But I digress. The central question here is why do nursing students have to write essays? I asked a friend this recently (the only bit of research I did for this piece). He's a lecturer, so I sort of knew what to expect, which was: "Essays test critical thinking skills. They let us know how students are processing information and produce critiques".

Which is fair enough. However, when I asked him exactly how the connection between critical thinking ski[Is and essay writing were established and quantified, and what evidence was at hand to investigate and establish such a connection, no answer came. If I had been more on the bail, I would have asked him what research had connected essay writing and good nursing practice, but we were drinking beer at the time and while bonhomie and repartee were present, the intense and penetrating logic required for such debate was not.

'Not a skerrick of evidence'

There is not a skerrick of evidential connection between good essay writing and good nursing (or even intelligence, come to that!). The creation of the essay and the judgements upon it are hugely subjective. The idea of writing one while comatose and assessing it by flinging a pile of essays down the stairs and grading them, depending upon the position of the tread on which they fail, is quite reasonable given the context in which they are produced. And that's not to mention the lack of evidence-based arguments for any other strategies.

Nurses write essays because their preparation for nursing occurs in tertiary educational settings. If essays were now as they evolved--as discursive expositions of thoughts, imaginings and entertainment (remember English essayist Charles Lamb telling us how roast pork was discovered?) (1) --that might be OK. But they're not. People become nurses, or not, depending upon their ability [or not] to produce the jolly things. Just as nursing educators are now subject to oppressive and systemic violence from their masters, they visit this same oppression and academic bullying upon the very people who should be at the apex of their endeavours. Not content with robbing nursing students of experience and financial wellness (I make no apology for comparisons with the pre-tertiary era nursing training), nursing education imposes a set of regimented de-intellectualised exercises [ie essays] on this same deprived population. The only reason nursing students have to write essays is that they are no longer nursing students: they are now 'students of nursing' in courses provided by polytechnics and universities. For a reformation that sought to empower nurses, this signifies a major and unacceptable failure.

You may ask why such a seemingly minor aspect of nursing education arouses such a splenetic response. The answer is because the emphasis on essay writing (and the failure to succeed even in that) is highly symbolic of the mess in which nursing education finds itself. Nurses are now prepared for practice in institutions which are impervious and imperious organisations, populated by the ethically timid, under-performing intellectually and fairing in the basic objectives of preparing sufficient nurses, sufficiently prepared. A splenetic response is fairly restrained given those circumstances.

(1)The Works of Charles Lamb 1775-1834. A Dissertation Upon Roast Pig. Essays of Elia, published 1823.

* Footnote: Pedants may detect some grammatical errors in this piece. There is difference between writing for effect and writing for grammatical perfection.