Removing the barriers to nursing education: there are significant barriers to nurses gaining post-registration and post-graduate education. Only when these have been addressed will nurses' and nursing's contribution to patient health and well-being be fully realised.

For decades nurses have sacrificed personal time, personal energy and personal finances to gain advanced educational qualifications. They know if nurses are properly educated, they can help people with complex health problems most effectively. Well-educated nurses can find solutions to health problems more comprehensively, more promptly and more efficiently than others, thus patients are exposed to the best possible nursing interventions. There is a shortage of nurses with expert qualifications in the workforce and only a handful of nurse practitioners. The result is a patient population that becomes ill unnecessarily, takes longer to recover than necessary and is re-admitted for care more frequently than is desirable or cost-effective.

Currently, there is a mis-match between the commitment of employers and education providers and the commitment of individual nurses to post-registration and post-graduate nursing education. Currently, many employer practices indicate a dismissive and short-sighted attitude towards educating nurses. Staff can be granted a paltry two days' leave for professional development, as if that is sufficient preparation. Some members are even being refused the day's time to prepare their professional development recognition programme portfolios, agreed to in the district health boards' multi-employer collective agreement.

Annual leave to attend education sessions

Members report that, in a number of instances, nurses have had to take annual leave to attend post-graduate and other education sessions. Other members have had to pay the total costs of post-graduate student fees. In other cases, nurses enrolled in study programmes cannot attend because their employer has not provided sufficient staff to replace them in the workplace. Even when support systems are set up, unanticipated crises in the workplace can prevent nurses getting to education sessions. This is an indication of the desperate circumstances in which many nurses work. It also indicates that acute crises in the clinical setting often overrule the best Laid plans of both nurses and their employers.

Discouraging situation

This situation is discouraging to nurses. It also makes a mockery of nurses' professional aspirations and health care providers' goals and responsibilities. It explains nurses' eagerness to leave their jobs and their unwillingness to come back to work. Not even improved pay and conditions can overcome the disillusion of nurses who are desperately keen to become better nurses in order to better support patients. As things are, employers are currently operating with too few nurses and therefore putting their patient populations at risk. It is only when there is adequate staffing that first class nursing expertise can be fully used and exploited. In all other circumstances, nursing expertise is wasted. Managers may think they are saving on costs by employing fewer nurses, but the price is such things as greater rates of infection, more readmissions, ranger hospital stays because of complications, more complaints and more accidents.

In these circumstances it is perfectly reasonable for nurses to ask themselves: Why should I bother? What will it get me in the end? This attitude undermines the valuable contribution made by those who have engaged in education. The cost of education is a significant barrier to improving nursing education opportunities. Most post-graduate university papers cost around $1300. Students may also have to pay for accommodation and travel. Most nurses have to travel out of their region to access postgraduate education. This adds to the necessary leave from work.

The solutions to this problem must involve all sectors and be focused on both individual and collective gains. For example, Clinical Training Agency funding for nurses is currently inadequate. On the positive side, Ministry of Health scholarships have been granted to primary care nurses who wish to be endorsed as nurse practitioners. Such opportunities need to be available to nurses in secondary and tertiary areas of the hearth service. NZNO's nursing education policy standards incorporates the value of education for communities and the hearth sector. (1)

What else needs to occur? Educational opportunities have to be available to nurses in every part of the country. There needs to be increased access to professional development. There needs to be a campaign to increase the profile of the nursing education sector and identify its contribution to the health sector and to patient safety. Nurse leaders must embrace nursing education and deconstruct the workplace barriers. Training programmes for new graduates in the first year of practice is now a real opportunity for growth in nursing. Return to nursing programmes have to be affordable, accessible locally and linked to real job opportunities. There are two things that require urgent and significant reform. The first is the belief that post-registration and post-graduate nursing education is relevant to only a few. The second is the desperate need for an education framework that contributes to solutions of the issues faced by nurses in practice.

Reference

1) New Zealand Nurses Organisation (2003) Nursing education--policy and standards. Wellington: NZNO.

NZNO professional nursing adviser Suzanne Rolls