Nurse Education: Graduate Versus Diplomate: Does having a nursing degree make you a better nurse?


Bellefontaine, N (2019). Nurse Education: Graduate Versus Diplomate: Does having a nursing degree make you a better nurse? Thesis London South Bank University School of Law and Social Sciences
AuthorsBellefontaine, N

In 2013, nurse education in the United Kingdom (UK) moved to a graduate-only approach in the preparation of the future nursing workforce. This research study explores the key drivers for this historic change at a point of transition aiming to:
 Explore the impact that the introduction of an all-graduate nursing programme may have on the provision of nursing care from the perspectives of nurses in a particular setting.
Currently the NHS is operating within a liminal space in which nurses with degrees and nurses with diplomas work side by side. Interrogating the reality of this situation from the perspective of nurses who are directly impacted by the changes, is a central aspect of this study. It examines issues of power and influence from the inception of the NHS, and considers their impact on the current position of the nursing profession. Factors, which influence the preparation of nurses and implications for the provision of future health care are explored and give rise to the question of whether a degree is needed to be ‘a good nurse’. The thesis examines the various meanings attributed to the idea of ‘being a good nurse’. Drawing on the works of Husserl (1931) and Heidegger (1962), Interpretive Phenomenology is utilised to interrogate the lived experience of the participants and gain further understanding from their perspectives, with the objective of:
 Exploring graduate and diplomate nurses own perceptions of the impact that a graduate only qualification may have on nursing care delivery.
 Exploring nurses experiences of working with the graduate vs diplomate nurse, to ascertain ways in which they may perceive difference in ability
 Identifying the opinions of registered health care staff on the new entry criteria to nurse education, focussing on their inclusiveness or exclusivity
 Identifying any overall perceived differences in the nursing abilities of staff that hold a degree vs. diploma qualification in practice, from both nurses and other health care staff.
 Exploring participants perceptions of the ‘good nurse’
Data reveals a variety of understandings and experiences of both diplomate and graduate nurses. All participants discussed facing an increasingly challenging healthcare working environment, having to manage day-to-day care provision with diminished staffing levels and increasingly more complex patient requirements. These factors revealed tensions and left nurse participants questioning what sort of implications the introduction of the graduate only approach may have for the delivery of frontline care. The thesis concludes by recognising that there remain questions over the practical application of the graduate only approach to nurse education. Potential similarities and differences in expected performance and expectations of the new workforce were drawn from the research. Participants raised concerns in relation to possible changes to the qualitative nature of healthcare following the introduction of a graduate-only profession. Equity and access to nursing programmes was highlighted as an issue in relation to the supply of caring nurses and the possibility of missing out on potentially good nurses, who would be unable to undertake a graduate training programme for various reasons. Original contribution to knowledge is claimed in that that the nurses themselves provided their own insights which were analysed in detail. The investigation was limited to a specific context, but the approach was sufficiently rigorous to allow for the study to be replicated elsewhere and potentially further contribute to knowledge beyond the original setting.

PublisherLondon South Bank University
Digital Object Identifier (DOI)
Publication dates
Print01 Mar 2019
Publication process dates
Deposited13 May 2019
Publisher's version
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