I recently read some passages from Etienne Wenger’s “Communities of Practice”. I found Wenger’s writing and social theory of learning very thought provoking. I find I can easily relate to and identify with Wegner’s ideas. Perhaps one of the reasons behind this easy familiarity is that I am a perpetual student. I have literally been participating in formal education for over 28 years, 12 of which have been undergraduate studies. I feel that my last four years of undergraduate nursing school has transformed me as a person. Nursing has changed my way of thinking. As a result, it is through a nurse’s lens that I examine Wenger’s theories.
A lens can be understood as “One’s own culture provides the “lens” through which we view the world; the “logic”… by which we order it; the “grammar” … by which it makes sense. In other words, culture is central to what we see, how we make sense of what we see, and how we express ourselves.”(PBS,1997)
A nurse’s lens is how I see and understand my role and experiences as a health care provider. My nurse’s lens helps me comprehend the station of a nurse from the perspective of a female in a traditionally male dominated environment. Furthermore, this viewpoint impacts how I view my rights as an employee of an institution; how I interact with my patients, their families, my co-workers and superiors.
I found Wenger’s ideas about the two main axes of intellectual traditions fascinating. It reminded me of the two vastly different ways nursing has been taught over the years, and the tension that still exist between them. Wenger states that “theories of social structure” give an acknowledged importance to institutions, accepted norms and rules. As a result, our culture places greater value on knowledge that has been attained in a formal setting. For example, a degree or certificate from a recognized institution would carry more value than knowledge that has been acquired though the experience of an individual. Whereas, the “theories of situational experience” places the greatest value on the “dynamic of everyday existence, improvisation, coordination and interactional choreography…They mostly address the interactive relations of people with their environment” (Wenger p. 12) In this theory, personal experience is viewed as valuable learning.
As Wenger describes these two theories, I feel he is describing oil and water and their inability to mix. Sadly, this has been my experience in regards to learning in the nursing world. Not too long ago nursing evolved from a two year program to a four year bachelor’s degree. The profession of nursing used to be taught exclusively in the hospital. Becoming a certified registered nurse required two years of hands-on clinical training as well as examinations for certification. The classes were small, predominantly made up of female students, and taught by female registered nurses. It was not uncommon for these teachers to be nuns. During this two year program the students were continuously learning and practicing nursing skills, while simultaneously caring for sick patients.
In today’s world, to become a registered nurse, one needs four years of undergraduate nursing education. Unfortunately, the majority of this learning is theory, with very little patient interaction. Only a small percentage of the degree is dedicated to in-hospital, hands-on patient care. From my personal experience, this theory-centered higher learning leaves a novice nurse feeling overwhelmed and completely uneducated in regards to patient care. This may seem like an exaggerated situation, but this sentiment is common among novice RN’s. So much so, that there are hundreds, if not thousands, of scientific journals and laymans’ blogs discussing it. This has made me question why nursing school was taken out of the hospital?
I also wonder where the shame attached to being hospital educated came from? Many nurses who have participated in the two year registered nurse certification program, regard it as a thing of embarrassment. I have often overheard seasoned nurses commenting, that they “only have their RN’s”. Yet, in my experience, these coworkers are some of the best nurses I have come across. Their knowledge in regards to wound care, intravenous management and critical thinking is vast and rich, yet their education is trivialized. This is reflected in their lower salary allotment in comparison to university educated nurses. Furthermore, nurses who are hospital educated are not employed in preceptor roles for nursing students. I feel that this is a reflection of our society’s educational elitism. It is this kind of elitism that is causing shortages for student nurses looking for crucial in-hospital training preceptors. In fact, this crisis is not just a national problem, but a global one.
“Educating the next generation of qualified nurses in sufficient numbers is paramount to addressing the current nursing shortage. However, the current educational infrastructure in nursing schools inhibits workforce growth. While schools are struggling with such barriers as limited classroom space, insufficient clinical sites, and overall budget constraints, it is the shortage of nurse faculty that is the major obstacle to increasing student capacity. If not addressed, the shortage of nurse educators will continue to hinder further progress in reversing the national nursing shortage.” (Guillen, 2010, pg 3.)
To use Wenger’s words, university BSCN programs are denying “agency or knowledgeability to individual actors”, by placing little or no value on RN certified educators (Wenger p. 12). Could we as a society be cutting off our nose to spite our face?