The recent editorial by Professors Thompson and Darbyshire (2013) seems set to do what any effective opinion piece should do: provoke, divide, and stimulate debate. It also raises some challenging ethical questions. A PhD student commented to me by email: ‘I can't relate to these ‘killer elite’ – the professors of nursing in my old school seemed adequately qualified, pulled in grants, and were REF-returnable […]. It seems to me a callous method of trying to expose the ‘problem’ and I wonder what the authors anticipated the outcome of this editorial would be?’ Some other colleagues expressed less tempered views – this is ‘a rant’, ‘destructive’, and a kind of ‘horizontal violence’ to the profession.
My own reaction was primarily puzzlement. If these authors do have such serious concerns about the behaviour of specific senior nurse academics, is this the most effective response? If nurses in practice claimed that colleagues were ‘petty dictators’, bullies, and people guilty of horizontal violence, we would expect them to take action. We would expect them to raise concerns and, if necessary, do everything in their power to remove these nurses from their positions. Professional ethics requires no less.
These professor authors are disgruntled about a wide range of issues in ‘academic nursing’. Some of the issues referred to just go with the territory of higher education. We may yearn for some Utopia of harmonious collegiality, productive multidisciplinarity, and easy engagement with our practice and research colleagues. The reality is that we have to invest time and energy into working with different research paradigms, with different approaches to practice advancement, and we need to be creative in harnessing the different talents of practice and academic colleagues. These challenges are not restricted to nursing departments.
Some of their criticisms are nursing-specific and I, like the PhD student, cannot relate to them. In my experience, some of the most committed professors of nursing are those who have joint or clinical chairs and who effectively integrate the domains of practice, education and research. They are likely to be the people with the most credibility to practitioners and the most effective reach regarding their scholarship.
Crucially, we have to remember what it is all for – the advancement of nursing practice. So how do we do this? Do we focus on publications in high-impact journals or in writing that illuminates practice, enabling practitioners to negotiate ethical complexity? Do we conduct randomized controlled trials investigating technological and pharmacological interventions or employ creative ‘bottom-up’ practice development approaches with a view to sustaining caring practices? It is, of course, not either/or, and we should be wary of dismissing persons or approaches that seem not to accord with our view of what ‘academic nursing’ should look like.
Returning to the PhD student's question regarding the authors’ intention, it seems possible that they (and, we assume, the Editor-in-Chief) considered that this is a worthy opinion piece that would stimulate discussion. It has, most certainly, done this. But at what cost?
Advancing such a critical and myopic vision of ‘academic nursing’ seems more likely to demoralize and contribute to views, within and from other professions, that we are intent on self-destruction. Our problem, it seems, may not be lack of critique, but rather that we are overly and unnecessarily critical without appreciating the broader picture. There is an increasing awareness of nurse-to-nurse hostility and of their ‘eating their young’ (Bartholomew 2006). In this instance, it seems that a few unsavoury experiences have been chewed over and spat out without considering the necessary diversity of, and destructive impact on, our profession.
There is a missed opportunity here to discuss strategies to challenge unethical practices in nursing, to examine the potential of different approaches to practice improvement, and to role model a critical, ethical, and constructive mindset that does not inflict horizontal violence on the profession.