Is academic nursing being sabotaged by its own killer elite? A rejoinder
We thank Bryar et al. (2013), Cross and Williams (2013), Gallagher (2013), Ralph (2013), Rolley (2013) and White (2013) for responding to our editorial (Thompson & Darbyshire 2013), which has certainly fulfilled its aim of stimulating debate. Before we address some of the points and issues raised in this JAN Forum, we should mention that our piece has, to date, elicited over 50 emails from the UK, Australia, and Canada. Approximately half are from current and past professors of nursing, while professors of sociology and psychiatry and various junior faculty have also weighed in. Intriguingly, we have also received commentary from faculty in the departments of our critics. Our correspondents were, without exception, encouragingly supportive of our stance, with many confirming the authenticity of our account and relating the range of damaging and negative experiences they too had suffered or witnessed at the hands of some of the ‘killer elite’ we alluded to. We are currently considering a follow-up editorial highlighting some of these creatively malevolent and decidedly un-scholarly professional practices that our correspondents shared. Should any readers wish to email us with their examples or experiences, we would value their contribution and of course respect their confidentiality.
In response to Bryar et al., who complain that our apples are not oranges, we wrote an editorial, a viewpoint – not a systematic review. It was intended to convey an opinion and, yes, our considered ‘judgement’ of a particular situation. It was never intended as an academic treatise or a ‘scholarly critique of a university culture’. We are well aware of the history of academic nursing, having been immersed in it ourselves for over 30 years and like to maintain the view, in the face of the ageing process, that there were indeed some halcyon days of academic nursing and university life. We well remember leading professors who were strong individuals who cherished and maintained academic and scholarly principles with drive, passion and vision, and who were unafraid of challenging the status quo, but with the same integrity that they brought to all aspects of their professorship. Our own careers and those of many others owe much to these inspirational colleagues. If these days have vanished into a ‘Poppletonian’ (Taylor 1994) miasma of mediocrity, or worse (Readings 1996, Hil 2012), then we are all the poorer for it.
Bryar et al. claim that only a small minority of nurses ‘may have been promoted beyond their abilities’. We beg to differ but, of course, we could always have been persuaded by some compelling evidence. We question also the claim that many of faculty in the ‘new world’ of university nursing education were forced to ‘sink or swim’. While many took to the water and swam strongly, we recall very little ‘sinking’. We wonder whether a great many more simply bobbed along happily and continue to do so, especially given the ‘protracted and difficult processes’ rightly noted by Cross and Williams (2013), that exist to address ‘under-performing staff’.
Bryar et al. are positive about the value of collaborative approaches to research across both disciplines and universities, hailing this ‘response to cuts’ as a ‘strategic approach’. Thank heavens they did not tout this as an ‘exciting new innovation’. Has it really taken drastic funding cuts and an economic climate of ‘austerity’ to lead academic nursing to the point where we think that it may be a good idea to seriously ‘play nice’ with other disciplines, departments, organizations and institutions? If academic nursing has not been pursuing such approaches for the past few decades, no wonder Bryar et al. see the comparable performance of nursing in the academy as being a 30- to 50-year project. Contrast this plodding prediction with the remarkable ‘research culture’ progress that some service sectors have made in the face of possibly even greater stringencies. See for example: http://www.guardian.co.uk/healthcare-network-nihr-clinical-research-zone/interview-with-pennine-acute-hospitals-nhs-trust; http://www.guardian.co.uk/healthcare-network-nihr-clinical-research-zone/southampton-hospital-wins-national-award-research; and http://www.guardian.co.uk/healthcare-network-nihr-clinical-research-zone/interview-with-nottingham-citycare-partnership?INTCMP=ILCNETTXT3487 (all accessed 21 February 2013).
We can only shake our heads as we imagine what junior faculty or emerging new researchers will make of such a glacial time-frame. What should we advise them we wonder? Perhaps, as Gallagher argues, this also ‘just goes with the territory’. So, if you could please manage to hang on in this academic nursing world for just another few decades…
Nurses often seem to lapse into an unseemly default position of blaming others for their woes and, while we accept that swingeing financial cuts have hindered research, nursing could, should and has to be more resilient and entrepreneurial. When it is clear that the quasi-instinctive demands for ‘more resources’ no longer work, perhaps it is time for ‘more resourcefulness’ (Darbyshire 2011).
As a sidebar to Bryar et al.'s comments regarding ‘self-publicists’ and ‘celebrity culture’, we suggest that rather than being the kind of metaphorical ‘bad smell’ that traditional academia imagines, an understanding of the importance of ‘marketing’ is an essential attribute for any nursing academic or researcher. Where self-promotion falls down among the ‘killer elite’ is when there is nothing to promote. If, on the other hand, your academic work, research and ideas are of value to nursing, education or society, or if you have the ability to inform, challenge and inspire students, colleagues or wider audiences, then the ‘self-promotion’, marketing and sharing of this ‘value’ are not dirty words, but a professional and ethical imperative. Being the best-kept secret in the nursing academy is not an achievement, it is a failing.
We could not agree more that: ‘To profess nursing is not simply to accumulate orthodox academic metrics such as authorship on numerous papers, highly cited research outputs and impressive h-indices but also to take the profession of nursing forward’. For exactly this reason, in our work, we write, speak, challenge and contribute across the broadest church, from blogs to the BMJ and from tweets to broadsheets. We also appreciate the rapidly changing dynamics of concepts such as influence and impact and wonder whether one day an academic's Klout score (www.klout.com) will be as important as their ‘h’ or any other index; interesting times indeed.
Our substantive point remains, however, that the ‘killer elite’ we describe have been singularly poor in performing, not only by ‘orthodox academic metrics’ but by almost any conceivable others. We agree also that it is the impact (and reach) of research that matters and we await with interest the assessment of nursing's performance in the upcoming UK Research Excellence Framework as being but one yardstick.
Bryar et al. also chide us for insinuating that some clinical professors of nursing and those with joint health service appointments have performed poorly. Again, we disagree and had evidence been provided, we may have been convinced otherwise. There are examples of nursing professors who are contributing to the UK Collaboration for Leadership in Applied Health Research and Care initiative and to improvements in health care. We suggest, however, that the nursing contribution is often vague or unclear and comparatively low in priority and significance.
We are well aware that there are some stellar scholars in ‘joint chair’ positions whose work and contribution are rightly appreciated as invaluable by both university and service partners. If only they were the majority. Some of the ‘contextual issues’ around clinical and joint chairs and the emergence of the ‘ten-a-penny professoriate’ (Darbyshire 2010, p.2595) that Bryar et al. imagined were ‘ignored’, were and remain readily available in the editorial's Darbyshire (2010) reference provided.
At first blush, Gallagher's response seems a fairly standard ‘rent-seeking’ approach. No surprise perhaps that a director of an ethics unit will see predominantly ‘challenging ethical questions’. We were delighted to hear that her PhD student correspondent has had good experiences with their professoriate; would that everyone had. As for the ‘desired outcomes’ of the piece, we aimed to raise a contentious problem that many will only whisper in private and to open it up for discussion. What a pity that this student, and the colleagues to whom Gallagher refers, missed an opportunity to contribute their thoughts directly to this JAN Forum.
That a critic somewhere would raise the spectre of our editorial being ‘horizontal violence’ as Gallagher did was wearily predictable. This term, in our view, has become so diluted and misused that it has been almost leeched dry of any meaning and power. Let us be as clear as we can here: expressing a contrarian viewpoint, writing a forceful, even polemical editorial, having a spirited debate or directly calling someone to account for their performance is not any kind of ‘violence’.
Actions that may be more deserving of the term ‘violence’ have been part of the arsenal of the ‘killer elite’ for many years, and it is disingenuous if not naive for Gallagher to propose that junior faculty or other comparatively less powerful colleagues could simply gather under the ‘professional ethics’ flag and ‘do everything in their power to remove these nurses from their positions’. In exactly the same way, no doubt, that Lance Armstrong's many team mates should have done. How could we possibly have overlooked such an obvious solution? We suspect that the accounts of faculty who have ever tried such approaches would provide a salutary lesson here.
We also disagree that we have advanced a ‘myopic vision of ‘academic nursing’’ likely to demoralize. Indeed, two of the recurring points made in responses to our editorial is how rare and far-sighted our position may be and how such a discussion offers positive hope for the future of nursing in the academy. As a profession and as part of the academy, nursing must be mature enough to be open, honest, and self-critical about nursing. Self-congratulatory sops about how ‘committed’ everyone is or ‘how hard everyone is working’? Now that really is a ‘blind alley’. If we as nurses cannot challenge, question, and critique ourselves without this being perversely portrayed as some kind of ‘nursing disloyalty’, it is difficult to see who can. As is so often the case, nurses and academics who should know better retreat into defensiveness and faux indignation. In what other discipline, we wonder, would a self-critical view of it be so construed?
Turning to Ralph, Rolley and White, it is gratifying to hear from their perspective as both comparatively junior and very senior faculty members and to know that our editorial has resonance with their experiences and with those of many of their contemporaries who may feel restrained from describing them. We appreciate their having the courage to share their views, which we might suggest are a credible reflection of too much of contemporary nursing academe. That they are willing to engage in passionate critical debates such as this offers a refreshing dash of hope and optimism. Academic nursing needs to heed and encourage such voices.
Cross and Williams’ commentary is as informative as it is exemplary, adding both context and nuance and valuable challenges to our thinking. We could not agree more that a PhD alone should not be the golden key to a professorial position. This does indeed ‘set the bar low’. We too would prefer to see a professorial position as a high jump rather than a limbo contest. Cross and Williams’ points about the political and financial machinations within universities are well taken and show clearly how academic and professorial performance, whether poor or exemplary, has both a personal and a system dimension. Similarly, the tension between research and teaching seems as timeless as the competing demands on an academic's time, and the prospect of the creation of two tiers of ‘teaching only and ‘research’ universities is never far from the headlines.
Gallagher and Cross and Williams are absolutely correct in pointing out that the existence of a ‘killer elite’ is not the exclusive preserve of nursing. Indeed, the worst in some other disciplines would make our own seem like a basket of kittens. It would be heartening though to think that the ‘caring profession’ of nursing could rise above such excesses.
Despite the concerns that we raised in our editorial, we, like Cross and Williams, are optimistic for the future of nursing and for nursing within the academy. We know too many wonderful scholars, researchers, teachers, junior faculty, clinical colleagues, students and professorial peers to feel otherwise. The world is changing and the world of the academy with it. A ‘solution’ to the killer elite may be as simple as history itself. This worst of this particular ‘old guard’ will move aside. As the academy becomes increasingly demanding and as other career and professional advancement opportunities emerge to attract our brightest and best, we suspect and hope, that now and in the future, fewer people will tolerate or indulge a ‘killer elite’.