The rise and fall of university-based nurse training

To consider the future of nurse education and the merits of a university-based course versus vocational training.

In the 1990s nurse training in the United Kingdom moved from an apprenticeship model to a university-based education. At about the same time, the two-tier structure of registered and enrolled nurses was abandoned, leading to an all-graduate profession.

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Nursing is primarily a humanistic endeavour, requiring interpersonal as well as academic knowledge and technical skills. We argue that the move into universities has not served recruits (and patients) as well as intended. Students today are financially worse off than their predecessors, have fewer practice opportunities, and often lack the sense of belonging that existed when training was hospital-based. The academic environment is a deterrent to some who cannot afford fees or who would struggle to attain a university degree. Branch-specific courses have produced an inflexible workforce.

The move from practice to universities was a bold approach, but it has failed. We urge a revised apprenticeship model, with university input and generic training.