PROCEDIMIENTOS OPERATIVOS BÁSICOS

The findings from this study revealed how the caring behaviours demonstrated by nurse lecturers and student nurses formed their identities, which evolved from the need to care for others. It is important to note here that although student nurses and nurse lecturers

referred to themselves as ‘caring’, in reality this may not be entirely accurate. The data

obtained from the participants served as the participants’ accounts of their behaviours,

attitudes, opinions and actions which may contrast with reality. Nevertheless, I discuss how the participants presented themselves to me, as the researcher throughout the interviews. As outlined in chapter five, many student nurses spent a significant proportion of DST engaged with caring roles in the home which included caring for children, grandchildren and/or partners. Such roles became blurred with their professional caring roles in clinical practice and ultimately prevented student nurses from developing a student identity.

At the time of writing, there is no available evidence which has specifically explored how caring roles of student nurses affects their student identity. However, there is extensive evidence which demonstrates that non-nursing students who have a clear student identity have been found to perform successfully and succeed in later life (Cameron, 1999b; Martin et al, 2012). Whilst evidence promotes the need for students to develop a clear sense of identity, the research undertaken by McInnis and James (1995) and Scanlon et al. (2007) demonstrated how reduced contact time with lecturers in classrooms resulted in traditional students sensing a loss of student identity. The fact that nursing students spend a significant proportion of their time away from campus within DST or in clinical practice

169 resonates with McInnis and James’ and Scanlon's work. The division of time spent by student nurses between clinical practice and academia could further reduce their success at finding a student identity; which in turn has a negative impact on their level of engagement with learning and particularly SDL as they struggle to identify themselves as university students. The lack of student identity made it difficult for students to develop as adult

learners, therefore Knowles’ (1980) theory of andragogy became more of an ideal than a

reality.

The identity of ‘carers’ was also demonstrated by lecturers in this study. Within chapter six I discussed how nurse lecturers adopted mothering roles towards students, as evidenced through their language. The ways in which they described their interactions with students

included terms such as ‘molly coddling’ and ‘spoon feeding’ distinguished them from university lecturers who taught within other subject disciplines. Whilst some nurse lecturers described how they resisted the temptation to adopt such mothering behaviours, they were generally accepted by other lecturers to be the norm and it was apparent that other lecturers felt an obligation to assume this responsibility. Such mothering of students was considered to encourage pedagogical learning as opposed to andragogical, student centred learning. By mothering students, lecturers were increasing the dependency of

students which contradicts Knowles’ (1980) theory of adult learning and reduces the

impetus for students to take responsibility for their own learning.

Burnard et al. (2007) and Timmins et al. (2011) emphasised the need for student nurses to be well supported by lecturers due to the high levels of stress associated with the academic and practical components of nursing courses, although their work did not discuss

‘mothering’ behaviours. Hauver-James (2012) did consider the mothering behaviours of teachers, although this was within school education. At the time of writing, there is no evidence which has considered how the caring roles of university lecturers can result in mothering identities; or how such identities impact on students’ attitudes and behaviours towards learning or SDL. Therefore the ‘mothering’ identities of lecturers within higher

170 In addition to the lecturers’ identities as students’ mothers, the findings revealed how the caring behaviours of lecturers also pronounced their identities as nurses as they demonstrated nursing behaviours towards students. Although the nurse lecturers had worked within universities for a minimum of five years, the majority openly identified

themselves as ‘nurses’. Their ‘nurse’ identity significantly influenced their interactions with

student nurses, whereby the lecturer-student relationship resembled a nurse-patient relationship. I considered that the nursing of patients which lecturers had experienced during their previous roles had transgressed into the classroom environment.

In chapter six, I discussed how the majority of lecturers continued to practice as RNs clinically during their time off. Whilst many lecturers explained how such activities were undertaken in an attempt to increase their credibility with student nurses; it was considered that the obligation to continue to work clinically combined with the ‘nursing of students’

was an attempt by the nurse lecturers to reinforce their ‘nurse’ identity and at times to make a connection with the students. Previous research has explored the challenges experienced by nurse lecturers following the transitions from clinical practice into academia which have resulted in feelings of loss and isolation (Evers, 2000). There has been an extensive debate surrounding whether or not nurse lecturers should be expected to continue to work within clinical practice to maintain clinical competence (Maslin-Prothero and Owen, 2001; Fisher, 2005; Barrett, 2007; Elliot and Wall, 2008; Ousey and Gallagher, 2010). Morgan (2012) suggested that instead nurse lecturers need to be credible and can demonstrate credibility by applying theory to practice. Luntley (2011) also highlighted the importance of the capacity to generate new ways of thinking. Ousey and Gallagher (2010, p.662) described how the ‘soul searching’ of lecturers for clinical credibility was an

‘unnecessary distraction’ and called for closure on the debate. Whilst the debate exists, there is no empirical evidence that demonstrates the need for nurse lecturers to work in clinical practice. In terms of the caring identities of nurse lecturers, at the time of writing this thesis no research could be found which has explored potential links between the inherent need to care for others and the inabilities of nurse lecturers to relinquish their clinical nursing identity.

171 The findings from this study could suggest that the nursing behaviours demonstrated by lecturers and the need to retain their nursing identity may be due to the altruistic tendencies of nurses. Mimura et al. (2009) and Haigh (2010) discovered that nursing

students’ primary motivation to select nursing as a career choice was due to altruism and

the need to help others. According to Schϋtz (1998) and Mimura (2005) altruistic

behaviours result from an individual’s low self-esteem; Mimura (2005) proposed that in an

attempt to improve their self-esteem, RNs craved gratitude from patients. In a later paper, Mimura et al. (2009) described how altruistically motivated nurses become frustrated when they do not receive gratification from patients. Whilst there is no available research which has explored potential links between altruism and the student-lecturer relationship; the evidence from my study could suggest that nurse lecturers continued to identify themselves as nurses (by continuing to work in clinical practice and demonstrating nursing behaviours towards students) in an attempt to fulfil their cravings for gratitude from both patients and students to develop their level of self-esteem.

The need for nurse lecturers to ‘mother’, and ‘nurse’ nursing students could be due to the

fact that nursing has traditionally been, and continues to be a female dominated profession and females have historically been considered to be naturally caring (Culkin et al, 1987; Meadus, 2000; Stott, 2004). Whilst there has been an increase in the number of males entering the nursing profession, records demonstrate how nursing continues to be dominated by women with eighty nine per cent of nurses in the UK being female (NMC, 2008c). Although there is no evidence to suggest that males are not caring, the fact that nursing is a female dominated profession could explain why nurse lecturers take on parenting and nursing roles when supporting students. However, if we consider other healthcare professions, which are female dominated for example midwifery (NMC, 2008c) there is no evidence which suggests that midwifery lecturers ‘mother’ midwifery students. Whilst the importance of student retention cannot be underestimated, particularly with the rising costs of education; my study revealed that extreme levels of caring demonstrated by

nurse lecturers, recognised as the ‘nursing’ of students led to student dependency on lecturers in relation to their learning. Nevertheless we cannot deny that student support is essential, but this extreme level of care demonstrated by lecturers risks students becoming

172 disempowered learners. I discussed in chapter two how Darbyshire (1993) accused nurse education of adopting the principles of adult learning in the late 1980s, without full consideration. Whilst the findings from my study support Darbyshire’s (1993) point, they also indicate that the ‘nurse’ identity of nurse lecturers prevents student nurses from becoming autonomous learners, thus suggesting that nurse education remains ill prepared to fully adopt the humanistic learning principles advocated by Knowles (1980); Rogers (1983) and Candy (1991).

7.1.2 “Misted” Academic Identity

I use the term “misted” to describe how nurse lecturers identified themselves through a

misted lens. The behaviours and attitudes of nurse lecturers demonstrated how they

predominantly identified themselves as ‘nurses’, but also identified themselves as ‘teachers’

rather than academics. This was exemplified by the use of terminology such as “classroom”; they discussed how they “taught” students in “classrooms” and described the activities they

carried out when in “class”. These terms implied they viewed nursing students as pupils or school children as opposed to adult learners. The ways in which nurse lecturers identified

themselves as ‘teachers’ and perceived their job as a teaching job supports the previous findings of Findlow (2012) and Smith and Boyd (2012). Findlow’s (2012) ethnographic study

which explored the professional and academic identity of twenty one nurse lecturers within one pre 1992 English university, revealed how the identity of nurse lecturers was problematic. By gaining accounts of individuals’ experiences of lecturing over a three year period, Findlow described how nurse lecturers did not consider themselves to be ‘proper

academics’. Similarly Findlow noted that although nurse lecturers shared similar problems of other lecturers, they lacked confidence in their “ability to hold their own” (Findlow, 2012, p. 122) when in the company of lecturers from other academic disciplines. A lack of academic authority was also reported by Findlow who argued that nurse lecturers lacked authority due to their practice origins and were sensitive towards the non-degree status within nursing, which Watson (2006) suggested was due to nurse education remaining on the periphery of higher education.

173 The introduction of the Project 2000 curriculum (UKCC, 1986) and the move of nurse education into higher education throughout the late 1980s and early 1990s resulted in significant changes for both nurse education and the role of the nurse lecturer. Prior to the move, nurse education within England was predominantly based within hospital schools of nursing and nursing students followed an apprenticeship style of training; being taught by nurse tutors, as reported in chapter one. During the move nurse tutors, employed by the NHS were transferred into universities to take on the role of lecturer. The lecturers were still required to teach nursing students but were also expected to embrace the lecturer role and to extend their remit to encompass research and scholarly activity. The impact of the change of role for nurse tutors at the time cannot be underestimated, many of the nurse tutors successfully embraced the lecturer role but others found the transition difficult wanting to remain as a nurse tutor whose main aim was to teach and support students.

Considering that nurse education is now established within universities, the ‘misted’ identity

of lecturers that was identified during data analysis was alarming considering their experience within a lecturing position. In addition, the majority began teaching in universities after nurse education had moved from hospital based training. Concerns regarding the knowledge, confidence and status of nurse lecturers have been previously highlighted as problematic (Murray, 2007; Boyd and Lawley, 2009; Hurst, 2010; Duffy, 2012). There is an array of literature to support the notion that the move from practice roles to lecturer roles creates challenges (Diekelmann, 2004; Lombardo, 2006; Hurst, 2010; Findlow, 2012).

The lack of clarity regarding the position of nurse lecturers could be further complicated by the professional body for nursing, the NMC. I question how nurse lecturers can be expected to gain a clear sense of identity when the NMC (2010) continue to label nurse lecturers as

‘teacher’ and define the role of the ‘teacher’ throughout their publications; no reference is made to the term ‘lecturer’. One example of this is the “Standards to support learning and

assessment in practice” publication (NMC, 2010) which provides an overview of different roles relating to nurse education and describes the role of the ‘nurse teacher’and ‘teacher’.

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