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Nursing education: a descriptive examination of the effects of moving from hospitals to colleges
NURSE EDUCATION TODAY \,‘mLongman Group Ltd 1985
(1985) 5, 3-10
Nursing education: a descriptive examination of the effects of moving from hospitals to colleges Vivian Wood
Twenty years of change. That has been the experience of nurse educators in Ontario. Those years saw programmes shortened by a third, curricula revised significantly, bases moved from hospitals to colleges, faculty unionised and organisational relationshops altered. In Ontario the changes climaxed in the move, in 1973, of the diploma schools of nursing from their hospital bases to postsecondary education system, specifically to the Colleges of Applied Arts and Technology (CAAT) . This article examines the developments leading to this move and some of its effects on nursing education and nurse educators. In general the findings indicate that the move brought major pressures on the nursing curriculum, the faculty themselves and the department chairmen.
The
pressures
early
years
nursing
for
change
originated
after
World
War
II.
education
had
been
embedded
in
the
Traditionally,
proved
educational
dificult
from
and
scientific
fessional process
were
day-to-day time,
were
not
however. involved
bases Change
change
took
wholly
systematic
As in most
changes
were
agencies
place.
complex
made
in an
of
the
nursing
or submerged was needed These or
changes
In
each
instance
to the problems
following sketch
nation
of
changes
took
budgets,
the
discussion and
environment
place.
The
curriculum,
promotion
and
begins
and
assessed.
leading
to the move.
effects faculty,
teaching
scribed
with
is followed in
which
the
of the move
on
appointments,
assignments
We start
a brief
by an exami-
with
are the
de-
events
coordinated,
situations, and
in and,
depth. was given
of the administrator. The
pro-
in
attention
historical
priorities The
as agreement
was reached
became available. The results underlying of a larger study of Ontario nology.
service to time.
confused
activities.
over
ific
often
and time
examined
particular
apprentice philosophy where students performed much of the work in the hospital. Consequently, maintaining
were
specamong
as resources
this discourse are part nursing education at
Colleges of Applied Arts and TechA total of 12 situations in five colleges
V Wood BScN MM, Professor of Nursing, University of Western Ontario, London, Ontario
BRIEF HISTORICAL SKETCH NURSING EDUCATION IN ONTARIO Before the September 1973 move to the Colleges of Applied Arts and Technology, there was a variety of programmes in Ontario awarding the Registered Nurse diploma. The distinguishing
elements
among
programmes
were the length of programme and the length and quality of time spent in clinical facilities. In the early 196Os, the typical nursing edu3
NURSE
4
cation
EDUCATION
programme
TODAY
was based
three-year
medical
model.
‘training’
and
shift-work.
and
living
Ontario
on
were
was
usually
pital,
and
the
reported
to
director
director
the
of nursing. responsibility
the
(Murray
of
in the early commissioned
Report,
which
report
confirmed was,
shortage. Service
hospital
board
would
subsequent
the
Working
the
report,
detailed
plan
schools
and
nursing. plus
the
one’
a two-year
commendations
concerned
about
EduThis
the
responsi-
for the expanfor
in
1965,
a
of regional schools an
to be replaced This
interim in 1975
proposal
between profession
of
re-
the demands and the reHospital
Meanwhile, becoming health
Associ-
the proincreasingly care
system.
on the Heal-
in 1966 by an Order
in Council. In 1970, this committee recommended that nursing education should be moved to the postsecondary institutions (CAAT). This change came
into
of nursing
education
coincided
move
to
the
effect
the
colleges
(after
colleges chairmen
colleges).
the
many of
on nursing
of
were
the
to
the
directors
departments the
effects
education?
First,
experienced
working
and
with
move these
nursing
What
administrators
in September
1973.
In
the
the
in of
the
all faculty
many
changes
environments.
Fifty-six
system,
reported
to
administrator.
directly
responsible
students
teaching
planning
and
week
and
with
those
[Murray view
of
the teachers
programme. and
community
became
responsible
Services
who
College’s
in
a was
Vice-President
With
setting, to
turn
with
experirnres. the
atmosphere
more was hospital-based
the
health agencies One chairman
school
success,
the
were to
chairman
Dean
of
responsible
Academic.
within ‘egalitarian’
the
the move
Health to
There
a nursing coordinator for each year year programme. Each coordinator liaison
or
passed
on the wards,
specified.
college
but,
whether
or
for student
and
re-
the director
failed
classroom
nurses grade
determined
had
tightly
head
Student
with
Requirements
in the
explicit
held
a 37-hour
approximating
hospital’s 1977).
were
student
a
both
the
for
course
worked
salaries
Lenz
were
director
supervision,
They
of
senior
members
school’s
and paid
director
hospitals’
Faculty
delivery.
1970,
the
the
to the
were
meetings
not
the
ENVIRONMENT
hospital-based
school
in general,
provided
proposed
the ‘Committee
to
qualified
of existing
the whole
was established
com-
demands
of the Ontario
As a consequence ing Arts’
directors
in curriculum
changes
nurse
Nursing
with
programme.
(Murray 1970). government was
needs.
of nursing
also
presented a compromise made by the nursing
an
Hospital
development
system,
56
that
of schools
the expansion report
existing
of Health.
details
delivered for
The
For many
the
THE WORKING
Hospital
future
on
was charged
anticipated
two-year
of Colleges
indeed
led to another
forward
fit
of Health
in their
Ontario
Party
establishment
nurses. Their
meet
the
by the Minister
Party
to
Ministry
to be, a nursing of the
study
curricula
schools
Ministry
1965. that
their
Thus
of the
Ontario
transfer
This
many
and
and
indicated
to
and
‘Working
govern-
time
Universities
community
of
short
revise
schools
22 CAATs.
(Ontario
Committee
Ontario
needed
of bringing and
in
continue Survey
Commission created
Ewart
of nursing
Report
mittee,
a shortage
utterings
A
cation’,
ation vincial
was
about
public
was
Service
‘two
financing
completed
and
Ewart
meet
school’s
the
was
schools
expansion
sion
the
the
to
within
programmes 1973).
through
1960s the provincial
Commission
hospital
bility
education
a very
had
plus two independent
departments
became
ment
The
nursing
hos-
board
to concerns
nurses
there
the
nursing
of the
of nursing
became within
1970).
In response
by
The
by of
part
of
hospital
in
education
school
to and
schools
were
subsidised
The
adjacent
students Their
heavily
government.
on the traditional
The
the was
of the twoacted as
for the clinical commented that community
college
than that of which preceded it.
the
BUDGETS Before
the move,
when
a school
of’ nursing
was
NURSE EDUCATION
affiliated
with the hospital,
running
all monies
for the
of the school were administered
by the
per week were limited
would
contact
days per year to 190. These
for a given
budget
constraints
hospital. outline year
The
director
her budgetary
within
and submit
administrative
hospital.
Although
was
urged
the school’s
always
functioned
them
department
she
the budget’,
were almost
school
80 per cent of which was
salaries)
appropriate
the
requirements
(approximately
for teachers’
get
of
second
the Ministry
‘stay needs
The than
revision perience
funds were provided ment,
through
system. The tration.
in Ontario,
by the provincial
a relatively
actual
the college
colleges complex
distribution
was decided substantially
ning department. the college
on a budget
Each
a lump
annum
for part-time
timing
of
usually
and plan-
year the province
sum. Within
this sum, the college based upon divisional
and
gave
the limits
distributed
the
of
funds
departmental
re-
the
experience, increased $75000 approved certain
that
full-
to
her
sub-
departmental
mission
to
‘budget
and
salaries
were considered
college
automatically
ment
the
approved
faculty bases.
planning’.
‘fixed monies’
allocated
required
situation
and the
started.
to each depart-
amounts
based
upon
Eighty
to 90 per
required who
The
were budget
resources was not cases the chairman
an
nursing budget consisted
for part-time paid
and
on hourly
request
for
sessional faculty
always approved. In such either made necessary ad-
justments or submitted to the administration a list of possible ‘consequences’ to the nursing programme
should
the requested
funds not be
forthcoming. Subsequently the administration made a final decision on the department’s budget. The budget was affected by two major factors which were not present before the transfer. The first was a limit on faculty teaching hours which was specified in the collective bargaining agreement between the academic employees
would
increase
of $75000 Because
requirement had
was
for
agreed
per
of the clinical to fund
specifically rules).
submitted The
The
to,
and
chairman
was
the funds had been forwarded
downward
faculty the
Thus
within
in August, the
college
requirements
arrangements
funds
budget
revisions,
budgets
arose
increased
to
had
other
just
before
did
not
as ‘special’.
This classes
treat
nursing’s
the
Part-time
had yet to be made
requested
submission
as
the college.
but
supplementary
had not been approved
by
the college.
or weekly
these
three
Faculty
faculty complement.
cent of the ‘non-fixed’ of funds
budgetary
to im-
the college, but so far her budget requests, which included the increase, had been subject
did not include
in
that time
by, the Ministry.
time
salaries
calculated
Ministry
requirement
ex-
In one
in clinical
requirements general funding
the
clin-
clinical
of 14 weeks.
staffing
(outside
diploma
This programme
salaries.
new
the
quests and needs. The nursing chairman faculty
increase
allocation adminis-
1978 when
the pregraduate
an approximate
In the process the administration
depended
this
of The
the student
by 425 hours.
require
of funds within
hiring area.
until
to increase
the chairman
plement
limits and
the
clinical
did not evolve
govern-
by its central
the
of a minimum
situation,
At all the community
for
increased
hours
to 21 and the maximum
issued an edict requiring
ical experience
bud-
constraint.
factor
teaching
necessitated
schools of nursing
as
a
The maximum
teachers
to the
money
as a guide
part-time
in the to
accommodated.
more
and the college.
5
TODAY
During to
the
community
nursing Instead, budget
the first two years after the transfer college,
experienced she found about
perienced
the same
at the hospital
then the situation
one
chairman
of
no budget difftculties. the tasks related to the as those
she had
school of nursing.
changed.
Tighter
exBut
budgeting
increased the time spent on planning and calculating required part-time and full-time faculty on the one hand, and clinical and classroom hours for student nurses on the other. For this director,
as at the other colleges, most of the
budget was set automatically by the approved number of full-time faculty. Constraints on the balance required the director to spend long
6
NURSE
EDUCATION
TODAY
hours trying to fullil arbitrarily set limit. Nursing
was just
commitments
within
one of the many
budget
The
chairmen
the
nursing
‘privileged
school
argue const+ntly college,
scenario
had and
enjoyed she
hour
faculty
as well
have
to
funds. At the
many
extra
days
for funds to meet
to
The
all
the
above
situations
studied. For changed sulted
budget in
and
pendence
and
activities.
in
The
increased brought
areas,
deabout
made
more
of high quality
in clinical
re-
educational
constraints
the achievement
the
and practices
faculty
union
ing particularly
chairman,
changes
on part-time
by budget difficult
assumptions
significant
approaches
as the
Committee
teach-
as a succeed-
Regents
for
bureaucratic visibility
In the hospital-based
is
the
extent
evaluated
curriculum vidual the
changes
advisory
Lombard
been
School
disguised), with
nurses Lombard informal
were
boards.
(all
The
by
names
members
backgrounds
atmosphere.
The approval
approval,
the curriculum
the Board
of Governors
After
to
process was
were
then
in their sent
to
After the move to the colleges the process at Lombard became more formalised and detailed.
For
riculum
example,
revision
after
an exhaustive
had been completed
cur-
and ap-
proved by the faculty, the programme was submitted to the nursing school’s advisory committee. From there it was sent to the curriculum committee of the college, who then forwarded
the
proposal
to
the
the
public
demands
for Nursing
for
1981).
to
which
to the community
its
colleges,
school In
by individual
schools
addition
can also be dictated When such changes all
visibility increased
to change
Regents.
to
has
(as described)
is
the move
the public
changes
apply
Since
programmes
substantially.
ally
performance
referees.
initiated
curriculum
by the Council occur,
nursing
of
they norm-
programmes
in
Ontario. This
change
was illustrated
in another
situ-
ation. When the Council of Regents moved to extend the students’ clinical experience by 425 hours,
the school
curriculum the
the
was already
revision.
‘pregraduate’
to
place
take
shift-work
announced revision
the required
ing. Thus,
because
there
called ex-
continuous
patient the
load. As
Council
of
of the nursing
to be reworked
additional
clinical
to
teach-
of the move and subsequent
was
a more
pensive process of evaluating curriculum
a
much
had
plan clinical
and it was to be
by
were mandatory,
programme’s
events,
over
by an increasing
changes
include
in the midst of
school’s
required to include
Regents
The
extended
and
ex-
and providing
for
changes.
board
were sent to
(of the hospital
area) and, once approved, the College of Nurses.
the in an
advisory
changes
have were
business was conducted
not seen as mandatory.
indi-
was the case in
school
board
similar
faculty,
approved
This
and
of
Although the evaluation pro-
League
by ‘outside’
of nursing
period, programme
with
Council
approval.
and extended,
characterised
system,
final
(National
perience
THE CURRICULUM
of Governors.
One measure of a school’s public accountability
for
ing section illustrates.
of the Board
it was sent to the provincial
cess is in tune
relatively
not
requirements.
common
structured
a
did
she spent
was
in
while in the hospital,
and repetitioning
programme
units
department.
for the necessary
however,
petitioning
and planning
felt that,
status’
Review Then
the college where funds were largely by a central
an
Curriculum
FACULTY Before
the move
the clinical
units of the hos-
pital where the schools had been based were ‘training grounds’ for the nursing students. If necessary, nursing faculty taught overtime in the units. While supervising clinical experience they
worked
Faculty student
alongside
hospital
staff
nurses.
working hours were adjusted to suit and hospital needs. After the move to
the colleges the instructors and students had much less flexibility. At Lombard College students were sent to three large medical agencies
NURSE
for clinical clauses
experience.
limited
Because
the
faculty member’s
union
maximum
weekly clinical
to 21 and the annual
number
contract
number
of a
teaching
hours
of contact
had to be assigned
to
Part-time
were
clinical
used,
course.
to comply
Typically,
with
a part-time
these
faculty
faculty
constraints.
member
and clinical
would
APPOINTMENTS In
the
Colleges
other two or three days. Consequently,
conform
contact
further
days, student
times reduced This the
nursing
limits
clinical
on
hours
and
days were some-
was occasionally teacher
when
by the student
their teaching
frustrating
the
needed
care than the time permitted. This
two different Also, to ac-
to six hours from the usual eight.
limitation
nursed
the
hospital
patient more
Often,
for
being
extensive to achieve
goals they would stay ‘overtime’.
problem
illustrated
was
at
Graham
where teachers exceeded the maxiCollege, mum allowed for contact hours in order to achieve complete clinical experiences for their students but refrained from reporting the fact. Not only did the contact
and clinical
hours
restrict the teaching faculty, but also, the use of part-time faculty required extensive orientation programmes bilities
to prepare
them for their responsi-
(Bower et al 1980).
efforts were necessary
Similarly,
to coordinate
ties of the part- and full-time time faculty that tended
the
coordination
was
the clinical
Teachers
now had
to college
time pressures preparation changes
reaching
appropriate
judging
an
often
decisions
were
studied.
the
four situations ably
clinical
area
countered Other
the chairman
to report
all of
by students
and administration and had to cope with a more complex ‘arms-length’ relationship with hospital staff. In addition they had to integrate
lacked the
about
In
the Their
were made.
full-time
necessary difficulty.
the
specified
area.
chairman
assisted
Hiring
qualifications In one instance
BScN
when unable
faculty faculty
etc. or to assist
in the clinical the
in
were en-
arose when part-time sick time,
re-
in the
Nevertheless,
problems
for
hirother
were all favour-
applicants.
had to hire a part-time
several occasions, help,
the
performance
a continuing
experience
in six of the
their prior experiences
with
proved
indicators.
examined
to substitute
They
in
is that of
performance.
after the appointments
make
evaluated
by
with the teaching
who
future inadequate
in question.
problems
individuals
These
problems
encountered
were very good.
every situation
to
same
Of these six, in only two did
ferences regarding
situation,
salaries of new
particular
the interviewers
impressed
new
the
have any hesitation
applicants
effective.
faculty.
At
hiring decisions
are
the interviewers ing
the
the levels of academic
applicant’s
Credentials
for vacation,
certain
For
at the colleges studied. One of the major difftculties
situations
Tech-
were required
procedures.
in some
either
The full-
college.
to raise
resulted
Hiring
and
of nursing faculty developed.
the activi-
faculty.
such as increased security, variations, and benefits, it also brought a set their time, were formally
each
used
Thus, although the move brought many advantages for teachers and administration
problems.
to
were
themselves available to answer questions and, when necessary, informally rearrange assignments of students and part-time
system
Arts
were made within a com-
nursing faculties some changes
particular
were the ones who made
to monitor
of Applied
nology appointments mon
commodate
with part-time
faculty assistants.
cover one day a week of course clinical requirements and a full-time member would cover the staff had to adjust to at least teachers for each clinical unit.
experience
7
TODAY
days
to 190, two or more teachers each
courses
EDUCATION
teacher
degree.
On
to get qualified with
the
clinical
herself.
At one particular college, most of the faculty transferred from the hospital-based school to the community college when the move occurred. Of those who transferred,
only 17 per cent had
a BScN degree. The other 83 per cent did not. This situation - a large percentage of ‘unqualified’ faculty - still presents a problem for some schools. The Canadian Nurses Association has
NURSE
8
gone
EDUCATION
on record
ing practice
future
1982).
Thus
(Canadian will
position. nursing
courage
their usually
or
such
academic
increasingly
departments
given
quired
clinical
faculty
with
evaluations
en-
qualifiIn
largely
plicated
the chairman’s Thus given
the
were
was
systematic for
faculty
munity and
relatively
of her
thought
ought
positions.
most
using
trial
of
The for
situcareful
evolved
com-
obsolete new
hiring
and error.
much
nator
lowering
employee
hired
for a period ment.
was
of two
During
the
classified years
as probationary
continuous
probationary
but
be released must
calendar
during
have
at least
days
after
requirements
had
the
both
the first 30 days’
employ-
period
ployee had to be informed in writing progress at six month intervals. An could
full-time
an emof his/her employee
five months, notice,
five
months.
positive
and
in
left insulli-
how
to the
formal
evaluation
and
became
after
is, of course, but
puts
a
problem
of
more
important.
who
process
strain
on
of both
‘precedence’ The
abstains
from
also coordi-
recording
relationships
encounters
deficiencies
advan-
the
awkward
completion
prove
or
difficulties
dysfunctional
of the probationary
procedures
be
or
process
of these
procedures
man
from
tend
to become
(Doyle
taking
from
complicates
tends
those
doing
to
the
the
administrative
chairfaculty
The
who
a
existence
problem
fixtures.
divides
those
The
to inhibit and
permanent
the perma-
recourse
1976).
action
evaluation
assessed
has
if
a faculty
employment
to resign,
member
grievance
that
that
If asked
period,
followed
convinced
is so unacceptable faculty
formal
must
became
be severed.
nent any
the
illustrates
of morale,
if these
After
must contract,
with
deadlines
unsatisfactory.
member
to the union
The
to respond
to avoid
the chairman
According
contained
critical
employee
teacher,
or chairman
deficiencies
specific
PROMOTION
as-
chairman
chairman
evaluation
becomes
later
the
became
change
the
The
to
practice
This for
continual
The
move
the
In this case the
status.
faculty
parties.
the
past
example
move.
of candidates
administrators
procedures
Each
tageous
qualifi-
for the
documented
assessment
made
time
two-year
evaluation
later
had satis-
apparent
that
to be improved. that
in
problem.
the
subsequent
need
cient
the
were
the use of a probationary
Needless supply
there
of ‘permanent’
quantity
when
inadequate. the
and
colleges
constant
of
throughout
reported
inaccuracies
difficulty
the coordinator faculty member
performance
coordinator
quali-
at a time
however,
often
for com-
and
Even
suggest
review
came
quality
arose.
studied
pressures training
simultaneously.
acceptable,
performance ations
in re-
task of obtaining
both
problems
cations
and
pressures
to be increased
faculty,
increases
academic
These
expansion. to say,
pects
had
response.
probationary Nevertheless,
was
rules,
experience higher
fied faculty. were
a
advent working
the chairman
period.
ineffective. In summary,
effect
factory
education.
encouragement
into
unten-
their
further
came
forming an appropriate At another college,
directors often
to upgrade
through
nurs-
Association the
circumstances,
faculty
instance
into
in the not too
Nurses
be in an
schools
entry
without
In these
cations, this
that a degree
faculty
background of
as saying
will require
distant
able
TODAY
use of
are
being
assessment
and
relationships.
or 90
Consider
These
teaching ineftctiveness when circumstances argue for dismissal. Such documentation can
negative
consequences. At one college, a new faculty member had been given a two-year probationary contract. Over the next one and a half years she received satisfactory clinical evaluations. Then two complaints were received from the agency. With only six months until ‘permanent’ status
take years ineffective.
the
problems
of trying
to document
and if casually done may still prove On the one hand, the chairman has
the Standards of Nursing Practice and the agencies to contend with and the problems of acquiring and keeping qualified faculty on the other. The problems inherent in balancing these pressures can lead to ‘no-win’ situations.
NURSE
For the nursing
TEACHING ASSIGNMENTS At the colleges, following
teaching
assignments
year were required
by the end of June. schedules,
lems
to be completed
Course
descriptions,
laboratory
classroom,
for the
and
time clinical
hours had all to be spelled
out in detail.
restrictions
days and
hours
on the contact
made
the
task
of developing
ceptable schedule of teaching within the time limits a formidable
The
teaching an
ac-
assignments one (Halli-
became
chairman
taxing.
Consider
the
situation
which
developed
at
ber of teachers keeping
required
she had made and the faculty process
had
academic faculty
teachers
most
students
in
clinical
units.
in
as
The
usual
the affiliation
employees
within
number
(ie. clinical with
of hours For
nursing
‘contact’
time
is stipulated
per
week,
hours
or
are
‘There
190
time
a teacher
might
weeks
long
was
equally
weeks. per idual
exceed
plus
six
course
assigned much
to of
two
each
the
manding
courses.
‘contact’
time,
faculty
the
schools
at
following: curriculum consultation.
Apart
number
six
teachers
faculty planning,
in
the
of time be
the indiv-
the The
submitted
were received
weekly
time
sheets.
by the chairman,
ment. The
These
who reviewed
sheets were checked bargaining
available
committee advising
the collective
ing faculty ministering
the
for
contract
for the nursone should
hours
involved
The
necessary
the process.
reduces
administer
bargaining
advantages
and the administration,
underestimate
work’
had not been
was also required
faculty.
Although
not
depart-
to see that the
agreement
This monitoring
everyone’s
ability
to
in ad‘paper
teach
or
effectively.
faculty
do
more
deas
generally for
be the
meetings, students
DEALING WITH THE PROBLEMS OF FACULTY We had seen that the move to colleges resulted in an increase the
in workload
and
and in problems
for
administration.
changed
Faculty responsibilities also, particularly with respect to fail-
ing students.
Any
academic
issue
involve student dismissals had proached carefully and judiciously Wejman required
1976).
their clinical part-time
The
student
evaluations.
faculty involved,
achieve. Another problem agencies complain
With
that
might
to be ap(Ghilardi &
appeals
that the faculty carefully
and use of such appraisals be
is stipulated
and and
two
might
can
are
or
of students,
members
meetings,
whereby
cannot
Part-time what
of
time.
number
upon
and
from
hour
clinical
hours
teaching
All
subsequently
same
Depending to
an
or one
the
course.
clinical
is,
of clinical
20 hours
requirements from
year.
averages’
classroom
by one teacher.
anywhere
found
for
spend
21 hours
workload
requiring
can
in
to exceed
21 hours
diminished
week
all academic they’
hour
his/her
to
schools,
for ‘rolling
as
A course
taught
the entire
1: 10.
are limited
that
an
stu-
academic
equal;
equals
is a provision as
per
the
classroom
in diploma
not
days
considered
classroom
week
teachers
both
integrated
was
colleges
per
teaching.
ratio
OPSEU,
provincial
mind
of an from
the
faculty
providing
teacher
with on
among in
aim
For
spent or
divided
the
same
was
keeping
approach the
unit).
Since
were
and
week.
laboratory
possible,
correlated with
time
the
Courses
expertise
clinical
the
of that
class,
equitably
and
to them,
year in order to avoid violations.
provides some definite
each
Once
in June,
throughout
personnel
dents
always
calculations
had agreed
part-time
35 to 40 hours
situ-
constraints.
to be monitored
Before the move to the College, the hospitalbased school of nursing teachers and hospital worked
prob-
the num-
by each course,
the initial
9
particular
carefully
in mind the contract
violated.
personal
the staffing
one
ation she had to determine
collective
one college:
as
In
TODAY
them and passed them to the personnel
man 1977).
the
EDUCATION
process
document
all
the number
uniform became
of
preparation difficult
to
arises if head nurses in the about students or faculty
(Nagle 1976). At one college a letter was sent to the chairman by the agency complaining about an inadequate ‘level of supervision provided by the nursing instructor’. At another, a head nurse complained to the chairman that
10
NURSE
EDUCATION
an instructor the
TODAY
was demonstrating
student
nurses
a procedure
that
was
not
to
in
the
curriculum. Similar
illustrations
be given. trate
However,
the
problems First
from these
other
are stiffkient
to illus-
educating
there
operational
delicate
nature
chairman
must
the agency
of the clinical
nursing
Young
blems
faculty
(De
Then
she
must
see
that
dents
are
given
due
process.
the
her
particulars
could
result
or in grievance
address.
faculty
and
Finally,
of the
in hours
stu-
she must
contract.
spent
Devi-
at meetings
on
may to
flexibility
in
often
impacted
to deliver most
contracts,
staffing more
they
Indeed
to studies
provide for
in
addressed,
time,
union
modified
Nevertheless
procedures.
In
(is
Changes
not
ability
be resolved. that
be
needed
or capacity
were
seen,
the
education.
we provid-
of nurses?).
as we have
indication are
nurses?)
environments
although,
(are
environment
today’s
significantly
1976).
of principle
multidisciplinary
a shortage/surplus
and
of her
the
for
the satisfy
of
the
range
competence
ations
could
on problems
ing
which
she must
observe
colleges
focus
there for
these
pro-
is some example,
some
clinical into
quality
of the
needed teaching.
topics
are
needed. $‘I 1,
SUMMARY The
move
to the
Technology
brought
teachers
and
Some
Colleges
of
to
the
many
the changes
obtained
more
salaries.
Students
had
man
academic For
the
used
faculty
proposed from
higher
of a more
The
department
chair-
of
larger
the
focused
in the
A much
rules
effects.
and
resources
chairman The
practice time
directors.
the advantage
the
nurse
positive
security
and
the
institution.
multiplied. sible.
to
school
had job
environment.
obtained
Arts
changes
nursing
Faculty academic
of Applied
past
increased
resulted. for
about
problems
of stafling
teaching
of
was
no
longer
pos-
dependence
on
part-
Increases
nursing
in qualifications
faculty
probation
coincided
discouraged to temporarily
leaving
clinical
that
with faculty upgrade
themselves. The
required
methods
stafIing tended lems. Although creased
there
was
would
be increased
desired
full-time
The
of
budgeting
and
to accentuate the above probclinical requirements were in-
discussion
lems in the past,
no
guarantee
that
suffkiently
budgets
to acquire
thr
faculty. of nursing and
even
education
today,
prob-
has tended
to
References
C.
The announcement of the transfer was made by the /Ontario Ministry of Colleges and Universities and tht :,, Ontario Ministry of Health in a joint release in January __I 1973. The transfer took place in September 1973. Bower D, Fairchild N, Hawkins J, et al 1980 Part time faculty, responsibilities, opportunities and terms. Nursing Outlook 1: 43-45 Canadian Nurses Association 1982 Entry to the practice of nursing. ‘I‘hc Canadian Nurses Association, Ottawa De Young L 1976 The administrator’s role: accountability to the process. In: Accountability: accepting the challenge. National League for Nursing, New York, 23 -33 Doyle A 1976 Establishment and implementation of a gricvancc procedure for faculty in a school of nursing. In: Today’s issues: tomorrow’s achievements. National League for Nursing, New York Ghilardi M, Wejman B 1976 Dewloping guidelines for resolving student-faculty problems. In: Today’s issues: tomorrow’s achievements. National League for Nursing, NW York Halliman J 1977 Analysing faculty workload. Nursing Outlook 9: 721-723 Lenz E R 1977 Surveying faculty salaries. Nursing Outlook 11: 705-777 Murray V V 1970 Nursing in Ontario. Queen’s Printer, Toronto, p. 171-181, 19&192, 179-197, 60 Naglr M R 1976 Administrative accountability, In: Accountability: accepting the challenge. National League for Nursing, New York, p 15.-21 National League for hTursing 198 1 The faculty’s role in policy development. National League for Nursing, New York
:\ 1 ’
(1985) 5, 3-10
Nursing education: a descriptive examination of the effects of moving from hospitals to colleges Vivian Wood
Twenty years of change. That has been the experience of nurse educators in Ontario. Those years saw programmes shortened by a third, curricula revised significantly, bases moved from hospitals to colleges, faculty unionised and organisational relationshops altered. In Ontario the changes climaxed in the move, in 1973, of the diploma schools of nursing from their hospital bases to postsecondary education system, specifically to the Colleges of Applied Arts and Technology (CAAT) . This article examines the developments leading to this move and some of its effects on nursing education and nurse educators. In general the findings indicate that the move brought major pressures on the nursing curriculum, the faculty themselves and the department chairmen.
The
pressures
early
years
nursing
for
change
originated
after
World
War
II.
education
had
been
embedded
in
the
Traditionally,
proved
educational
dificult
from
and
scientific
fessional process
were
day-to-day time,
were
not
however. involved
bases Change
change
took
wholly
systematic
As in most
changes
were
agencies
place.
complex
made
in an
of
the
nursing
or submerged was needed These or
changes
In
each
instance
to the problems
following sketch
nation
of
changes
took
budgets,
the
discussion and
environment
place.
The
curriculum,
promotion
and
begins
and
assessed.
leading
to the move.
effects faculty,
teaching
scribed
with
is followed in
which
the
of the move
on
appointments,
assignments
We start
a brief
by an exami-
with
are the
de-
events
coordinated,
situations, and
in and,
depth. was given
of the administrator. The
pro-
in
attention
historical
priorities The
as agreement
was reached
became available. The results underlying of a larger study of Ontario nology.
service to time.
confused
activities.
over
ific
often
and time
examined
particular
apprentice philosophy where students performed much of the work in the hospital. Consequently, maintaining
were
specamong
as resources
this discourse are part nursing education at
Colleges of Applied Arts and TechA total of 12 situations in five colleges
V Wood BScN MM, Professor of Nursing, University of Western Ontario, London, Ontario
BRIEF HISTORICAL SKETCH NURSING EDUCATION IN ONTARIO Before the September 1973 move to the Colleges of Applied Arts and Technology, there was a variety of programmes in Ontario awarding the Registered Nurse diploma. The distinguishing
elements
among
programmes
were the length of programme and the length and quality of time spent in clinical facilities. In the early 196Os, the typical nursing edu3
NURSE
4
cation
EDUCATION
programme
TODAY
was based
three-year
medical
model.
‘training’
and
shift-work.
and
living
Ontario
on
were
was
usually
pital,
and
the
reported
to
director
director
the
of nursing. responsibility
the
(Murray
of
in the early commissioned
Report,
which
report
confirmed was,
shortage. Service
hospital
board
would
subsequent
the
Working
the
report,
detailed
plan
schools
and
nursing. plus
the
one’
a two-year
commendations
concerned
about
EduThis
the
responsi-
for the expanfor
in
1965,
a
of regional schools an
to be replaced This
interim in 1975
proposal
between profession
of
re-
the demands and the reHospital
Meanwhile, becoming health
Associ-
the proincreasingly care
system.
on the Heal-
in 1966 by an Order
in Council. In 1970, this committee recommended that nursing education should be moved to the postsecondary institutions (CAAT). This change came
into
of nursing
education
coincided
move
to
the
effect
the
colleges
(after
colleges chairmen
colleges).
the
many of
on nursing
of
were
the
to
the
directors
departments the
effects
education?
First,
experienced
working
and
with
move these
nursing
What
administrators
in September
1973.
In
the
the
in of
the
all faculty
many
changes
environments.
Fifty-six
system,
reported
to
administrator.
directly
responsible
students
teaching
planning
and
week
and
with
those
[Murray view
of
the teachers
programme. and
community
became
responsible
Services
who
College’s
in
a was
Vice-President
With
setting, to
turn
with
experirnres. the
atmosphere
more was hospital-based
the
health agencies One chairman
school
success,
the
were to
chairman
Dean
of
responsible
Academic.
within ‘egalitarian’
the
the move
Health to
There
a nursing coordinator for each year year programme. Each coordinator liaison
or
passed
on the wards,
specified.
college
but,
whether
or
for student
and
re-
the director
failed
classroom
nurses grade
determined
had
tightly
head
Student
with
Requirements
in the
explicit
held
a 37-hour
approximating
hospital’s 1977).
were
student
a
both
the
for
course
worked
salaries
Lenz
were
director
supervision,
They
of
senior
members
school’s
and paid
director
hospitals’
Faculty
delivery.
1970,
the
the
to the
were
meetings
not
the
ENVIRONMENT
hospital-based
school
in general,
provided
proposed
the ‘Committee
to
qualified
of existing
the whole
was established
com-
demands
of the Ontario
As a consequence ing Arts’
directors
in curriculum
changes
nurse
Nursing
with
programme.
(Murray 1970). government was
needs.
of nursing
also
presented a compromise made by the nursing
an
Hospital
development
system,
56
that
of schools
the expansion report
existing
of Health.
details
delivered for
The
For many
the
THE WORKING
Hospital
future
on
was charged
anticipated
two-year
of Colleges
indeed
led to another
forward
fit
of Health
in their
Ontario
Party
establishment
nurses. Their
meet
the
by the Minister
Party
to
Ministry
to be, a nursing of the
study
curricula
schools
Ministry
1965. that
their
Thus
of the
Ontario
transfer
This
many
and
and
indicated
to
and
‘Working
govern-
time
Universities
community
of
short
revise
schools
22 CAATs.
(Ontario
Committee
Ontario
needed
of bringing and
in
continue Survey
Commission created
Ewart
of nursing
Report
mittee,
a shortage
utterings
A
cation’,
ation vincial
was
about
public
was
Service
‘two
financing
completed
and
Ewart
meet
school’s
the
was
schools
expansion
sion
the
the
to
within
programmes 1973).
through
1960s the provincial
Commission
hospital
bility
education
a very
had
plus two independent
departments
became
ment
The
nursing
hos-
board
to concerns
nurses
there
the
nursing
of the
of nursing
became within
1970).
In response
by
The
by of
part
of
hospital
in
education
school
to and
schools
were
subsidised
The
adjacent
students Their
heavily
government.
on the traditional
The
the was
of the twoacted as
for the clinical commented that community
college
than that of which preceded it.
the
BUDGETS Before
the move,
when
a school
of’ nursing
was
NURSE EDUCATION
affiliated
with the hospital,
running
all monies
for the
of the school were administered
by the
per week were limited
would
contact
days per year to 190. These
for a given
budget
constraints
hospital. outline year
The
director
her budgetary
within
and submit
administrative
hospital.
Although
was
urged
the school’s
always
functioned
them
department
she
the budget’,
were almost
school
80 per cent of which was
salaries)
appropriate
the
requirements
(approximately
for teachers’
get
of
second
the Ministry
‘stay needs
The than
revision perience
funds were provided ment,
through
system. The tration.
in Ontario,
by the provincial
a relatively
actual
the college
colleges complex
distribution
was decided substantially
ning department. the college
on a budget
Each
a lump
annum
for part-time
timing
of
usually
and plan-
year the province
sum. Within
this sum, the college based upon divisional
and
gave
the limits
distributed
the
of
funds
departmental
re-
the
experience, increased $75000 approved certain
that
full-
to
her
sub-
departmental
mission
to
‘budget
and
salaries
were considered
college
automatically
ment
the
approved
faculty bases.
planning’.
‘fixed monies’
allocated
required
situation
and the
started.
to each depart-
amounts
based
upon
Eighty
to 90 per
required who
The
were budget
resources was not cases the chairman
an
nursing budget consisted
for part-time paid
and
on hourly
request
for
sessional faculty
always approved. In such either made necessary ad-
justments or submitted to the administration a list of possible ‘consequences’ to the nursing programme
should
the requested
funds not be
forthcoming. Subsequently the administration made a final decision on the department’s budget. The budget was affected by two major factors which were not present before the transfer. The first was a limit on faculty teaching hours which was specified in the collective bargaining agreement between the academic employees
would
increase
of $75000 Because
requirement had
was
for
agreed
per
of the clinical to fund
specifically rules).
submitted The
The
to,
and
chairman
was
the funds had been forwarded
downward
faculty the
Thus
within
in August, the
college
requirements
arrangements
funds
budget
revisions,
budgets
arose
increased
to
had
other
just
before
did
not
as ‘special’.
This classes
treat
nursing’s
the
Part-time
had yet to be made
requested
submission
as
the college.
but
supplementary
had not been approved
by
the college.
or weekly
these
three
Faculty
faculty complement.
cent of the ‘non-fixed’ of funds
budgetary
to im-
the college, but so far her budget requests, which included the increase, had been subject
did not include
in
that time
by, the Ministry.
time
salaries
calculated
Ministry
requirement
ex-
In one
in clinical
requirements general funding
the
clin-
clinical
of 14 weeks.
staffing
(outside
diploma
This programme
salaries.
new
the
quests and needs. The nursing chairman faculty
increase
allocation adminis-
1978 when
the pregraduate
an approximate
In the process the administration
depended
this
of The
the student
by 425 hours.
require
of funds within
hiring area.
until
to increase
the chairman
plement
limits and
the
clinical
did not evolve
govern-
by its central
the
of a minimum
situation,
At all the community
for
increased
hours
to 21 and the maximum
issued an edict requiring
ical experience
bud-
constraint.
factor
teaching
necessitated
schools of nursing
as
a
The maximum
teachers
to the
money
as a guide
part-time
in the to
accommodated.
more
and the college.
5
TODAY
During to
the
community
nursing Instead, budget
the first two years after the transfer college,
experienced she found about
perienced
the same
at the hospital
then the situation
one
chairman
of
no budget difftculties. the tasks related to the as those
she had
school of nursing.
changed.
Tighter
exBut
budgeting
increased the time spent on planning and calculating required part-time and full-time faculty on the one hand, and clinical and classroom hours for student nurses on the other. For this director,
as at the other colleges, most of the
budget was set automatically by the approved number of full-time faculty. Constraints on the balance required the director to spend long
6
NURSE
EDUCATION
TODAY
hours trying to fullil arbitrarily set limit. Nursing
was just
commitments
within
one of the many
budget
The
chairmen
the
nursing
‘privileged
school
argue const+ntly college,
scenario
had and
enjoyed she
hour
faculty
as well
have
to
funds. At the
many
extra
days
for funds to meet
to
The
all
the
above
situations
studied. For changed sulted
budget in
and
pendence
and
activities.
in
The
increased brought
areas,
deabout
made
more
of high quality
in clinical
re-
educational
constraints
the achievement
the
and practices
faculty
union
ing particularly
chairman,
changes
on part-time
by budget difficult
assumptions
significant
approaches
as the
Committee
teach-
as a succeed-
Regents
for
bureaucratic visibility
In the hospital-based
is
the
extent
evaluated
curriculum vidual the
changes
advisory
Lombard
been
School
disguised), with
nurses Lombard informal
were
boards.
(all
The
by
names
members
backgrounds
atmosphere.
The approval
approval,
the curriculum
the Board
of Governors
After
to
process was
were
then
in their sent
to
After the move to the colleges the process at Lombard became more formalised and detailed.
For
riculum
example,
revision
after
an exhaustive
had been completed
cur-
and ap-
proved by the faculty, the programme was submitted to the nursing school’s advisory committee. From there it was sent to the curriculum committee of the college, who then forwarded
the
proposal
to
the
the
public
demands
for Nursing
for
1981).
to
which
to the community
its
colleges,
school In
by individual
schools
addition
can also be dictated When such changes all
visibility increased
to change
Regents.
to
has
(as described)
is
the move
the public
changes
apply
Since
programmes
substantially.
ally
performance
referees.
initiated
curriculum
by the Council occur,
nursing
of
they norm-
programmes
in
Ontario. This
change
was illustrated
in another
situ-
ation. When the Council of Regents moved to extend the students’ clinical experience by 425 hours,
the school
curriculum the
the
was already
revision.
‘pregraduate’
to
place
take
shift-work
announced revision
the required
ing. Thus,
because
there
called ex-
continuous
patient the
load. As
Council
of
of the nursing
to be reworked
additional
clinical
to
teach-
of the move and subsequent
was
a more
pensive process of evaluating curriculum
a
much
had
plan clinical
and it was to be
by
were mandatory,
programme’s
events,
over
by an increasing
changes
include
in the midst of
school’s
required to include
Regents
The
extended
and
ex-
and providing
for
changes.
board
were sent to
(of the hospital
area) and, once approved, the College of Nurses.
the in an
advisory
changes
have were
business was conducted
not seen as mandatory.
indi-
was the case in
school
board
similar
faculty,
approved
This
and
of
Although the evaluation pro-
League
by ‘outside’
of nursing
period, programme
with
Council
approval.
and extended,
characterised
system,
final
(National
perience
THE CURRICULUM
of Governors.
One measure of a school’s public accountability
for
ing section illustrates.
of the Board
it was sent to the provincial
cess is in tune
relatively
not
requirements.
common
structured
a
did
she spent
was
in
while in the hospital,
and repetitioning
programme
units
department.
for the necessary
however,
petitioning
and planning
felt that,
status’
Review Then
the college where funds were largely by a central
an
Curriculum
FACULTY Before
the move
the clinical
units of the hos-
pital where the schools had been based were ‘training grounds’ for the nursing students. If necessary, nursing faculty taught overtime in the units. While supervising clinical experience they
worked
Faculty student
alongside
hospital
staff
nurses.
working hours were adjusted to suit and hospital needs. After the move to
the colleges the instructors and students had much less flexibility. At Lombard College students were sent to three large medical agencies
NURSE
for clinical clauses
experience.
limited
Because
the
faculty member’s
union
maximum
weekly clinical
to 21 and the annual
number
contract
number
of a
teaching
hours
of contact
had to be assigned
to
Part-time
were
clinical
used,
course.
to comply
Typically,
with
a part-time
these
faculty
faculty
constraints.
member
and clinical
would
APPOINTMENTS In
the
Colleges
other two or three days. Consequently,
conform
contact
further
days, student
times reduced This the
nursing
limits
clinical
on
hours
and
days were some-
was occasionally teacher
when
by the student
their teaching
frustrating
the
needed
care than the time permitted. This
two different Also, to ac-
to six hours from the usual eight.
limitation
nursed
the
hospital
patient more
Often,
for
being
extensive to achieve
goals they would stay ‘overtime’.
problem
illustrated
was
at
Graham
where teachers exceeded the maxiCollege, mum allowed for contact hours in order to achieve complete clinical experiences for their students but refrained from reporting the fact. Not only did the contact
and clinical
hours
restrict the teaching faculty, but also, the use of part-time faculty required extensive orientation programmes bilities
to prepare
them for their responsi-
(Bower et al 1980).
efforts were necessary
Similarly,
to coordinate
ties of the part- and full-time time faculty that tended
the
coordination
was
the clinical
Teachers
now had
to college
time pressures preparation changes
reaching
appropriate
judging
an
often
decisions
were
studied.
the
four situations ably
clinical
area
countered Other
the chairman
to report
all of
by students
and administration and had to cope with a more complex ‘arms-length’ relationship with hospital staff. In addition they had to integrate
lacked the
about
In
the Their
were made.
full-time
necessary difficulty.
the
specified
area.
chairman
assisted
Hiring
qualifications In one instance
BScN
when unable
faculty faculty
etc. or to assist
in the clinical the
in
were en-
arose when part-time sick time,
re-
in the
Nevertheless,
problems
for
hirother
were all favour-
applicants.
had to hire a part-time
several occasions, help,
the
performance
a continuing
experience
in six of the
their prior experiences
with
proved
indicators.
examined
to substitute
They
in
is that of
performance.
after the appointments
make
evaluated
by
with the teaching
who
future inadequate
in question.
problems
individuals
These
problems
encountered
were very good.
every situation
to
same
Of these six, in only two did
ferences regarding
situation,
salaries of new
particular
the interviewers
impressed
new
the
have any hesitation
applicants
effective.
faculty.
At
hiring decisions
are
the interviewers ing
the
the levels of academic
applicant’s
Credentials
for vacation,
certain
For
at the colleges studied. One of the major difftculties
situations
Tech-
were required
procedures.
in some
either
The full-
college.
to raise
resulted
Hiring
and
of nursing faculty developed.
the activi-
faculty.
such as increased security, variations, and benefits, it also brought a set their time, were formally
each
used
Thus, although the move brought many advantages for teachers and administration
problems.
to
were
themselves available to answer questions and, when necessary, informally rearrange assignments of students and part-time
system
Arts
were made within a com-
nursing faculties some changes
particular
were the ones who made
to monitor
of Applied
nology appointments mon
commodate
with part-time
faculty assistants.
cover one day a week of course clinical requirements and a full-time member would cover the staff had to adjust to at least teachers for each clinical unit.
experience
7
TODAY
days
to 190, two or more teachers each
courses
EDUCATION
teacher
degree.
On
to get qualified with
the
clinical
herself.
At one particular college, most of the faculty transferred from the hospital-based school to the community college when the move occurred. Of those who transferred,
only 17 per cent had
a BScN degree. The other 83 per cent did not. This situation - a large percentage of ‘unqualified’ faculty - still presents a problem for some schools. The Canadian Nurses Association has
NURSE
8
gone
EDUCATION
on record
ing practice
future
1982).
Thus
(Canadian will
position. nursing
courage
their usually
or
such
academic
increasingly
departments
given
quired
clinical
faculty
with
evaluations
en-
qualifiIn
largely
plicated
the chairman’s Thus given
the
were
was
systematic for
faculty
munity and
relatively
of her
thought
ought
positions.
most
using
trial
of
The for
situcareful
evolved
com-
obsolete new
hiring
and error.
much
nator
lowering
employee
hired
for a period ment.
was
of two
During
the
classified years
as probationary
continuous
probationary
but
be released must
calendar
during
have
at least
days
after
requirements
had
the
both
the first 30 days’
employ-
period
ployee had to be informed in writing progress at six month intervals. An could
full-time
an emof his/her employee
five months, notice,
five
months.
positive
and
in
left insulli-
how
to the
formal
evaluation
and
became
after
is, of course, but
puts
a
problem
of
more
important.
who
process
strain
on
of both
‘precedence’ The
abstains
from
also coordi-
recording
relationships
encounters
deficiencies
advan-
the
awkward
completion
prove
or
difficulties
dysfunctional
of the probationary
procedures
be
or
process
of these
procedures
man
from
tend
to become
(Doyle
taking
from
complicates
tends
those
doing
to
the
the
administrative
chairfaculty
The
who
a
existence
problem
fixtures.
divides
those
The
to inhibit and
permanent
the perma-
recourse
1976).
action
evaluation
assessed
has
if
a faculty
employment
to resign,
member
grievance
that
that
If asked
period,
followed
convinced
is so unacceptable faculty
formal
must
became
be severed.
nent any
the
illustrates
of morale,
if these
After
must contract,
with
deadlines
unsatisfactory.
member
to the union
The
to respond
to avoid
the chairman
According
contained
critical
employee
teacher,
or chairman
deficiencies
specific
PROMOTION
as-
chairman
chairman
evaluation
becomes
later
the
became
change
the
The
to
practice
This for
continual
The
move
the
In this case the
status.
faculty
parties.
the
past
example
move.
of candidates
administrators
procedures
Each
tageous
qualifi-
for the
documented
assessment
made
time
two-year
evaluation
later
had satis-
apparent
that
to be improved. that
in
problem.
the
subsequent
need
cient
the
were
the use of a probationary
Needless supply
there
of ‘permanent’
quantity
when
inadequate. the
and
colleges
constant
of
throughout
reported
inaccuracies
difficulty
the coordinator faculty member
performance
coordinator
quali-
at a time
however,
often
for com-
and
Even
suggest
review
came
quality
arose.
studied
pressures training
simultaneously.
acceptable,
performance ations
in re-
task of obtaining
both
problems
cations
and
pressures
to be increased
faculty,
increases
academic
These
expansion. to say,
pects
had
response.
probationary Nevertheless,
was
rules,
experience higher
fied faculty. were
a
advent working
the chairman
period.
ineffective. In summary,
effect
factory
education.
encouragement
into
unten-
their
further
came
forming an appropriate At another college,
directors often
to upgrade
through
nurs-
Association the
circumstances,
faculty
instance
into
in the not too
Nurses
be in an
schools
entry
without
In these
cations, this
that a degree
faculty
background of
as saying
will require
distant
able
TODAY
use of
are
being
assessment
and
relationships.
or 90
Consider
These
teaching ineftctiveness when circumstances argue for dismissal. Such documentation can
negative
consequences. At one college, a new faculty member had been given a two-year probationary contract. Over the next one and a half years she received satisfactory clinical evaluations. Then two complaints were received from the agency. With only six months until ‘permanent’ status
take years ineffective.
the
problems
of trying
to document
and if casually done may still prove On the one hand, the chairman has
the Standards of Nursing Practice and the agencies to contend with and the problems of acquiring and keeping qualified faculty on the other. The problems inherent in balancing these pressures can lead to ‘no-win’ situations.
NURSE
For the nursing
TEACHING ASSIGNMENTS At the colleges, following
teaching
assignments
year were required
by the end of June. schedules,
lems
to be completed
Course
descriptions,
laboratory
classroom,
for the
and
time clinical
hours had all to be spelled
out in detail.
restrictions
days and
hours
on the contact
made
the
task
of developing
ceptable schedule of teaching within the time limits a formidable
The
teaching an
ac-
assignments one (Halli-
became
chairman
taxing.
Consider
the
situation
which
developed
at
ber of teachers keeping
required
she had made and the faculty process
had
academic faculty
teachers
most
students
in
clinical
units.
in
as
The
usual
the affiliation
employees
within
number
(ie. clinical with
of hours For
nursing
‘contact’
time
is stipulated
per
week,
hours
or
are
‘There
190
time
a teacher
might
weeks
long
was
equally
weeks. per idual
exceed
plus
six
course
assigned much
to of
two
each
the
manding
courses.
‘contact’
time,
faculty
the
schools
at
following: curriculum consultation.
Apart
number
six
teachers
faculty planning,
in
the
of time be
the indiv-
the The
submitted
were received
weekly
time
sheets.
by the chairman,
ment. The
These
who reviewed
sheets were checked bargaining
available
committee advising
the collective
ing faculty ministering
the
for
contract
for the nursone should
hours
involved
The
necessary
the process.
reduces
administer
bargaining
advantages
and the administration,
underestimate
work’
had not been
was also required
faculty.
Although
not
depart-
to see that the
agreement
This monitoring
everyone’s
ability
to
in ad‘paper
teach
or
effectively.
faculty
do
more
deas
generally for
be the
meetings, students
DEALING WITH THE PROBLEMS OF FACULTY We had seen that the move to colleges resulted in an increase the
in workload
and
and in problems
for
administration.
changed
Faculty responsibilities also, particularly with respect to fail-
ing students.
Any
academic
issue
involve student dismissals had proached carefully and judiciously Wejman required
1976).
their clinical part-time
The
student
evaluations.
faculty involved,
achieve. Another problem agencies complain
With
that
might
to be ap(Ghilardi &
appeals
that the faculty carefully
and use of such appraisals be
is stipulated
and and
two
might
can
are
or
of students,
members
meetings,
whereby
cannot
Part-time what
of
time.
number
upon
and
from
hour
clinical
hours
teaching
All
subsequently
same
Depending to
an
or one
the
course.
clinical
is,
of clinical
20 hours
requirements from
year.
averages’
classroom
by one teacher.
anywhere
found
for
spend
21 hours
workload
requiring
can
in
to exceed
21 hours
diminished
week
all academic they’
hour
his/her
to
schools,
for ‘rolling
as
A course
taught
the entire
1: 10.
are limited
that
an
stu-
academic
equal;
equals
is a provision as
per
the
classroom
in diploma
not
days
considered
classroom
week
teachers
both
integrated
was
colleges
per
teaching.
ratio
OPSEU,
provincial
mind
of an from
the
faculty
providing
teacher
with on
among in
aim
For
spent or
divided
the
same
was
keeping
approach the
unit).
Since
were
and
week.
laboratory
possible,
correlated with
time
the
Courses
expertise
clinical
the
of that
class,
equitably
and
to them,
year in order to avoid violations.
provides some definite
each
Once
in June,
throughout
personnel
dents
always
calculations
had agreed
part-time
35 to 40 hours
situ-
constraints.
to be monitored
Before the move to the College, the hospitalbased school of nursing teachers and hospital worked
prob-
the num-
by each course,
the initial
9
particular
carefully
in mind the contract
violated.
personal
the staffing
one
ation she had to determine
collective
one college:
as
In
TODAY
them and passed them to the personnel
man 1977).
the
EDUCATION
process
document
all
the number
uniform became
of
preparation difficult
to
arises if head nurses in the about students or faculty
(Nagle 1976). At one college a letter was sent to the chairman by the agency complaining about an inadequate ‘level of supervision provided by the nursing instructor’. At another, a head nurse complained to the chairman that
10
NURSE
EDUCATION
an instructor the
TODAY
was demonstrating
student
nurses
a procedure
that
was
not
to
in
the
curriculum. Similar
illustrations
be given. trate
However,
the
problems First
from these
other
are stiffkient
to illus-
educating
there
operational
delicate
nature
chairman
must
the agency
of the clinical
nursing
Young
blems
faculty
(De
Then
she
must
see
that
dents
are
given
due
process.
the
her
particulars
could
result
or in grievance
address.
faculty
and
Finally,
of the
in hours
stu-
she must
contract.
spent
Devi-
at meetings
on
may to
flexibility
in
often
impacted
to deliver most
contracts,
staffing more
they
Indeed
to studies
provide for
in
addressed,
time,
union
modified
Nevertheless
procedures.
In
(is
Changes
not
ability
be resolved. that
be
needed
or capacity
were
seen,
the
education.
we provid-
of nurses?).
as we have
indication are
nurses?)
environments
although,
(are
environment
today’s
significantly
1976).
of principle
multidisciplinary
a shortage/surplus
and
of her
the
for
the satisfy
of
the
range
competence
ations
could
on problems
ing
which
she must
observe
colleges
focus
there for
these
pro-
is some example,
some
clinical into
quality
of the
needed teaching.
topics
are
needed. $‘I 1,
SUMMARY The
move
to the
Technology
brought
teachers
and
Some
Colleges
of
to
the
many
the changes
obtained
more
salaries.
Students
had
man
academic For
the
used
faculty
proposed from
higher
of a more
The
department
chair-
of
larger
the
focused
in the
A much
rules
effects.
and
resources
chairman The
practice time
directors.
the advantage
the
nurse
positive
security
and
the
institution.
multiplied. sible.
to
school
had job
environment.
obtained
Arts
changes
nursing
Faculty academic
of Applied
past
increased
resulted. for
about
problems
of stafling
teaching
of
was
no
longer
pos-
dependence
on
part-
Increases
nursing
in qualifications
faculty
probation
coincided
discouraged to temporarily
leaving
clinical
that
with faculty upgrade
themselves. The
required
methods
stafIing tended lems. Although creased
there
was
would
be increased
desired
full-time
The
of
budgeting
and
to accentuate the above probclinical requirements were in-
discussion
lems in the past,
no
guarantee
that
suffkiently
budgets
to acquire
thr
faculty. of nursing and
even
education
today,
prob-
has tended
to
References
C.
The announcement of the transfer was made by the /Ontario Ministry of Colleges and Universities and tht :,, Ontario Ministry of Health in a joint release in January __I 1973. The transfer took place in September 1973. Bower D, Fairchild N, Hawkins J, et al 1980 Part time faculty, responsibilities, opportunities and terms. Nursing Outlook 1: 43-45 Canadian Nurses Association 1982 Entry to the practice of nursing. ‘I‘hc Canadian Nurses Association, Ottawa De Young L 1976 The administrator’s role: accountability to the process. In: Accountability: accepting the challenge. National League for Nursing, New York, 23 -33 Doyle A 1976 Establishment and implementation of a gricvancc procedure for faculty in a school of nursing. In: Today’s issues: tomorrow’s achievements. National League for Nursing, New York Ghilardi M, Wejman B 1976 Dewloping guidelines for resolving student-faculty problems. In: Today’s issues: tomorrow’s achievements. National League for Nursing, NW York Halliman J 1977 Analysing faculty workload. Nursing Outlook 9: 721-723 Lenz E R 1977 Surveying faculty salaries. Nursing Outlook 11: 705-777 Murray V V 1970 Nursing in Ontario. Queen’s Printer, Toronto, p. 171-181, 19&192, 179-197, 60 Naglr M R 1976 Administrative accountability, In: Accountability: accepting the challenge. National League for Nursing, New York, p 15.-21 National League for hTursing 198 1 The faculty’s role in policy development. National League for Nursing, New York
:\ 1 ’