Credentials are Good. Credentialism is a Serious Illness.

In 2005 a baccalaureate degree became the standard for entry to registered nursing practice in Ontario, and there was a scramble in the years preceding to set up collaborative programs between the CAATs (colleges of applied arts and technology) which had previously administered the three-year diploma programs and the universities who would be granting the new four-year degrees. During this process, one new university program I am familiar with rather haughtily decreed that no mere BScN (or, God forbid, a diploma RN) would sully the ranks of its clinical instructors, most of whom taught part-time in the CAAT system while working full-time clinical positions. You see, BScNs couldn’t possibly teach clinical: they didn’t have the proper credentials, despite having years of experience that collectively ran into centuries. The university nursing program then proudly hired MScNs and Ph.Ds to fill the very large holes left by the departure of the BScNs.

An excellent plan — until the program administrators realized all their new hires had little or no actual front line, bedside clinical experience. I suppose they had read about it somewhere. However, it quickly became evident they were not competent — and were even dangerous — acting as clinical instructors.

Unqualified.

I was thinking of this story when I read Terri Schmitt’s excellent post on her blog about the push for not just graduate degree holders in nursing programs, but nurses with the degree in the somewhat esoteric field of nursing education:

I think nurses with graduate degrees in nursing education are critical to the education process.  However, I recently was made aware of one nursing program that openly told its faculty that they will not get promoted if they do not have a degree in nursing education. This proclamation was made after they had hired nurses with degrees in clinical areas like CNSs or NPs.  Those faculty members, some who are the most clinically competent that I have ever met, were basically told that they were second class citizens.  To me, and this is purely my observation, it had the feel of lateral violence.

I am not clear, exactly, what exactly a degree in nursing education means, and why nursing (alone of any profession, or indeed any academic discipline) needs a speciality to teach itself. Is there some previously unknown aspect in the pedagogy of nurses which uniquely requires this degree? I’m doubting it. A quick online search reveals MScNs in “Nursing Education” from such places as Jacksonville University and Drexel University in online courses. The cynical portion of my brain — admittedly a large part — thinks that “nursing education” programs are less an academic discipline than a niche marketing position, to differentiate themselves from a “generic” MScN. “Nursing Education” may well be a credential too far, but yet it seems some nurses have bought into it.

Unqualifed.

Nurses are very quick to add letters of all shapes and sizes after their names. We see not only degrees, but certifications and specialities, and even degrees not yet awarded. (My personal favourite is the MScN (Cand.), which I have observed lingering after some nurses’ names like a bad smell for years.) I have often puzzled over this obsession with credentials in nursing. It worries me, a little, that in the push and requirement for ever more exotic credentials, nursing will lose a great deal of diversity and perspective, especially in its leadership. Think that Florence Nightingale, who despite prodigious accomplishments, would not be qualified to teach at the university program I mentioned above. Hildegarde Peplau, who revolutionized nursing education and the nursing profession, would be fired because she didn’t hold a degree in “Nursing Education.”

Unqualified.

Credentials are good, as far as they go. They are a public declaration of qualifications. Credentialism, where degrees are unthinkingly required for their own sake in the vain hope of producing some undesirable uniformity, is the result of some very unflattering pathology in the nursing profession. Nurses and nursing still tend to undervalue their degrees and education, especially vis-à-vis physicians. Wielding degrees has become an exercise in compensation. Having the “speciality” of nursing education is just another way to do it. In this context, Terri Schmitt is probably on the money when she suggests some nurses use their superior education as a weapon.  Personally, I do get a little tetchy at the inherent, unspoken assumption the granting of any graduate degrees confers some magical superiority as a nurse. I don’t see see the point of knocking down one part of the profession to build up another. We all need to go forward together. All nurses have a valuable contribution to make to our profession, not just the ones with long strings of letters following their names.

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  1. #1 by Raquel on Saturday 29 January 2011 - 0850

    That is very disheartening about the nursing education issue. Some of my best nursing professors had been clinical nurse specialists. That kind of experience is invaluable and irreplaceable.

  2. #2 by blogspot.de on Friday 14 February 2014 - 0500

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