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Nurses on the launch pad

Society and the healthcare sector are changing – and the nursing study programme is under pressure. Two researchers from Roskilde University are involved as Rigshospitalet (Denmark’s largest hospital) experiments with how to train future nurses. The expectations for what a newly educated nurse should be capable of are too high, and the traineeship programmes at clinics are under pressure, the researchers point out.
Sine Lehn-Christiansen & Mari Holen
Sine Lehn-Christiansen (left) and Mari Holen at Rigshospitalet, which is a partner in the research project. Press photo: Jón Bjarni.

It made headlines when the Social Democrats in October last year presented the party’s new proposed healthcare plan: 1,000 new nurses to look after us Danes when we become sick – or just old and infirm. Because we will be. The demographic data is clear, and the number of Danes requiring care will only increase in the years ahead. In other words, nurses will have plenty to do. So much, in fact, that many nurses choose another career when the pressure on them becomes too great. This can be seen already in the nursing study programmes, because the requirements are too high – even when one is studying to become a nurse.

“We are asking for a great deal from the nursing students,” says Sine Lehn-Christiansen, associate professor at the Department of People and Technology at Roskilde University.

“In three and a half years, they must become proficient in social analysis, scientific theory and methods, clinical practice and the latest technologies. If you read a description of what someone with a bachelor’s in nursing is expected to be capable of, it seems more like the CV of a highly experienced nurse,” she says.

Big words, few resources

Together with her colleague, Mari Holen, Sine Lehn-Christiansen is a researcher in the research project ACROSS at Rigshospitalet. The project was concluded in May 2019. The goal was to find out how to design the nursing study programme so that the nurses of the future will have the clinical competences that the citizens requiring care in the future welfare state will be in need of.

A particular area that the researchers wanted to explore is the increased focus on the so-called clinical competences and clinical practice. Today, about 40% of the entire study programme is practical studies, while the rest of the programme is taken at a university college. This division means that the question of the connection between theory and practice has been a major topic in the discussions surrounding the study programme. Perhaps even too much, the researchers say:

“The discussion surrounding learning in the clinical study programmes is highly disrupted by the discussion about the connection between theory and practice. It is just as important to take an isolated look at the quality of the practical part of the study programme,” Mari Holen argues.

“There is a lot of talk about being ready for the labour market. And about connection, especially between theory and practice, but also about the cohesion of patient treatment plans and between the healthcare sectors. Currently, the politicians overseeing the study programmes hope that the clinical part of the study programme can solve pretty much all challenges.”

This is a lot to ask, because in practice, the students encounter vastly different circumstances when they are studying at clinics. In some places, there is plenty of possibility for students to engage in patient care, while in other places, the needs of the patients are too complex to just allow a green student to get involved. It could also be that in some places the professional staff is simply too busy just trying to keep on top of things in the ward, and then the students and their learning become the lowest priority.

“Many students simple do not acquire the wide range of clinical skills that the description of the study programme covers. They know very well that people expect them to be ready to join the labour market on day one – but at the same time, it is to some extent a matter of random chance whether they actually acquire these competences. And we are, after all, talking about a clinic study programme that is immensely complex, immensely difficult and which asks a lot of the students – some of which often can’t be achieved in practice. What we are asking from the newly graduated nurses is unrealistic,” Mari Holen explains.


Sine Lehn-Christiansen & Mari Holen
Sine Lehn-Christiansen and Mari Holen. Press photo: Jón Bjarni.