State of Nursing Science in Finland
6.2 Establishment and Development of the New Discipline of Nursing Science
The first sign of the new discipline of nursing science in Finland was the establish- ment of the Yearbook of Nursing (Sairaanhoidon vuosikirja) in 1958 and the Research Institute of Nursing (Sairaanhoidon tutkimuslaitos) in 1966. The Yearbook of Nursing was published by the Finnish Nursing Education Foundation (Sairaanhoitajien koulutussäätiö SHKS) which was established in 1944. At that time there was no academic nursing education in the country, and the Research Institute of Nursing did not have any educational duties, because it was set up for research purposes. In the late 1970s, for example, the Institute coordinated the Finnish part of the medium-term nursing research and developmental programme by the European Regional Office of WHO, which was the very first programme in the field of nursing research in Finland. Today, the Research Institute no longer exists; it was integrated into the Nursing Research Foundation in 2005. It was, however, an important first step in Finland, based on the collaborative work of many pioneers in those days [1–3]. The Finnish Nursing Education Foundation, which still exists today, is the main national foundation funding purely nursing research.
Academic university nursing education at Master’s level began in 1979 at the University of Kuopio. The planning of university education had, however, started years before; the first initiative to establish academic nursing education in Finland was made in the 1920s. Professional nursing education was established in Finland in the late 1800s, became state owned in the 1930s, and went through some reforms in the 1960s. In the 1970s, the time was finally right to launch formal academic nursing educational programmes, for several reasons. First, in the early 1970s, a new law on primary health care [4] was passed, broadening the perspective of health care and nursing, taking particularly into account primary health care and preven- tion. Second, the country was becoming economically stable after all the large reforms implemented after the Second World War, day-care institutions were estab- lished, and many other institutions facilitated women’s career development. Third, universities were stable, and other new educational programmes were also estab- lished, and fourth, international educational trends and collaboration between coun- tries increased. In nursing, this meant that pioneers in the field established connections with international partners. In Great Britain, university nursing educa- tion began already in the 1950s, with many good examples seen. Although many experts in health care expressed the need to establish a new discipline and research- based development of the nursing profession, there were, however, also sceptical voices to be heard in different parts of the country.
University-based Masters’ programmes spread quickly throughout the country, to all main universities: University of Helsinki (1981), Tampere (1981), Oulu (1986), Turku (1986), the Swedish-speaking university Åbo Akademi (1987) and University of Jyväskylä (1992). However, the educational programmes in Helsinki (1993) and Jyväskylä (2007) were later closed down, resulting in nursing science programmes at five universities today (Table. 6.1). In the first years, there was one
H. Leino-Kilpi and M. Stolt
academic professor chair in every university. However, the universities rapidly established more positions for professors and other academic staff. In 2018, a total of 19 full professorships have been established at five universities, in addition to other faculty members, researchers and tenure track posts. The Masters’ education was aimed at those already having professional qualification. Thus, the students were mainly nurses, public health nurses, midwives and professionals in all allied health fields. These entry requirements have been rather constant over the years;
only Åbo Akademi has admitted students without professional education after high school graduation. In the coming years, however, there will be a reform of admis- sion strategies to the universities in Finland.
In Finland, we currently have a formal dual model in education [5] consisting of universities and universities of applied sciences. The Ministry of Education and
Table 6.1 Academic nursing education in Finland (situation in 2018) University Faculty
Department/
Unit Master’s degree PhD degree
University of Eastern Finland
Faculty of Health Sciences
Department of Nursing Science
– Nursing leadership and management – Preventive nursing
science – Nurse teacher
education
PhD degree, health sciences (nursing science)
University of Oulu
Faculty of Medicine
The Research Unit of Nursing Science and Health Management
– Nursing Science – Teacher Education
in Health Sciences
PhD degree, health sciences (nursing science)
University of Tampere
Faculty of Social Sciences
Unit of Nursing science
– Nursing management – Teaching of nursing
PhD degree, health sciences (nursing science) University of
Turku
Faculty of Medicine
Department of Nursing Science
– Gerontological nursing science – Clinical nursing
science
– Mental health and psychiatric nursing science
– Health sciences teacher education
PhD degree, health sciences (nursing science)
Åbo Akademi (Swedish language)
Faculty of Education and Welfare Studies
Caring science
– Clinical caring science – Health care
administration and management – Didactics of health
sciences, health care education – Health technology
PhD degree, health sciences (caring science)
72
Culture is responsible for the planning and implementation of higher education and science policy. The mission of universities is to conduct scientific research and pro- vide education based on research evidence. Universities of applied sciences (UAS) provide practical education aiming to respond to the needs of the labour market.
Universities offering higher scientific and artistic education award Bachelor’s and Master’s degrees as well as postgraduate degrees, i.e. licentiate and doctoral degrees.
Universities of applied sciences award UAS Bachelor’s degrees and UAS Master’s degrees. In this chapter, however, we concentrate on the universities and the devel- opment of nursing science.
The academic education in the early years—like today—was public, strongly based on governmental funding and national juridical acts. At most of the universi- ties, the programmes in nursing science were established in the faculties of medi- cine or health sciences, whereas two of them still exist as independent units. These locations of the educational programmes also inform about the nature of education and research: they are oriented as health sciences, with health, human beings, nurs- ing and caring actions and environment as central concepts. In Åbo Akademi, which does not have a faculty of medicine or health sciences, the education has been more oriented to caring sciences [6], and it has engaged in Nordic collaboration more than the other universities. In the first years, the educational programmes led to a degree in health-care/nursing education and administration. In 1991, in the University of Turku, the first clinical nurse specialist master’s programme in older people care was established, followed by a programme in clinical nursing science in 1993 and in mental health and psychiatric care in 2014. There are also programmes in prevention and health promotion in the University of Eastern Finland (earlier Kuopio). All five universities have implemented Master’s programmes for nurse and health-care teachers and administrators. Academic nursing education had a good start in Finland: the programmes were popular; the students graduated and found high-level professional positions in Finnish society. In the beginning, the universi- ties admitted about 20 students per year, the current numbers being 45–50 per year/
university and around 40 graduations per year/university—thus approximately 200 new nurses graduate yearly with a Master’s degree from universities, and these nurses find new positions corresponding with their university education, based on the follow-ups of the universities [7].
In the early years, also other aspects/symbols of the early development of nurs- ing science as a discipline were established. For example, the Journal of Nursing Science (Hoitotiede) was founded in 1989 in collaboration with the Finnish Association of Nursing Research (Hoitotieteiden tutkimusseura)—both being strong symbols of the discipline. Furthermore, the Finnish Association of Nursing Research decided that Finnish National Conference will be held every second year.
Professors at the universities had regular national meetings, and they decided that every university would in turn assume responsibility for the management of the Association, the national conference and the Journal—this decision still holds in 2018. In national collaboration, a National Doctoral Education Network was also established in 1995, in addition to the already established PhD programmes of the universities. This network has been very important for the development of doctoral
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programmes but also for the development of research and nursing as a scientific discipline. The national collaboration has provided the opportunity to invite interna- tional experts to Finland, made research collaboration easier, and guaranteed high- level national education for PhD students. In summing up the establishment and the first steps in the development of nursing science in Finland, which was character- ized by strong enthusiastic attitude of the people working at the universities and in the field, it is important to note that the universities offering these programmes have been working together, have made collaborative decisions and have supported each other. This collaborative approach has been a characteristic of Finnish nursing aca- deme, in addition to the collaboration with other health sciences.