NNF's key issues

Three-year education, state authorization and advanced education.

The Nordic Nurses’ Federation (NNF) was initially a joint forum in the struggle for state authorization of a three-year nursing education, which the International Council of Nurses (ICN) also worked for. In 1920 at the NNF's foundation several of the Nordic associations already demanded a documented three-year education in order to obtain membership. This requirement became an important political tool in the countries to pursue state authorization on the same terms.  

Despite the ambitious educational requirements for membership of the individual Nordic Nurses associations, they sadly shared the fact that no one had a heterogeneous education in length and content. The quality of the education was solely depending on the program the individual hospitals offered. Therefore the NNF easily agreed to struggle for a three-year education in theory and practice and importantly authorization by the state. In the NNF founding year 1920, the Swedish parliament already had passed state authorization in 1919 for a two-year education. But it was a compromise! The criticism was harsh from the other NNF members. The Norwegian president Bergliot Larsson said: “What we do not like is that they surrendered. We must all have an education of three years” (Wingender 1995: 13). The NNF did not easily accept the Swedish model though it can be added that although the Swedish authorization remained unchanged, the Swedish nursing education in 1933 was three years all over the country. As for the theory and practice of the education, it was emphasized that the theory should support the practical work, however not too much theory. Danish Charlotte Munck warned sharply about the academic tendencies as observed in America. There was an agreement to work for the matron system, meaning a matron in leadership of the schools of nursing and hospitals – and employment of nurse instructors.

SSN kongres 1954 Helsingfors Finland Arbejdskomiteerne for öppen vård og undervisning
NNF Congress 1954 in Helsinki, Finland. The working committees for outpatient care and teaching meet. On the left side of the table are representatives from Iceland, Denmark, Finland and on the left side representatives from Norway and Sweden

Another important discussion was which qualification to agree on in the admission of women to the nursing education. Personal qualities were highly valued, as nursing was seen as a vocation and Christian values as mercy and sacrifice of great importance. Such qualities were in accordance with a bourgeois educational ideal, in the same way as spoken for at the Nightingale School. Between the lines, everyone knew that the educated daughters would support the recognition of the profession, and to secure this educational level it was recommended to establish pre-nursing-schools as already done in Finland. There was not an agreement to require qualifications at secondary school level as in Finland. It was - as Danish Charlotte Munck said - sufficient to ask for a primary school of approximately seven years, as it was not necessarily the girls with academic knowledge that became the best nurses. Higher education contradicted or even destroyed the desired qualities in nursing viewed as a Christian vocation.

An important exception from this rule was that a minor part of the trained/graduated nurses should have access to advanced education. This was due to that an improved basic training program of nurses demanded a qualified teaching staff. On top of that, it was not sufficient that nurses only could take advanced education outside the Nordic countries. It was of great importance nurses could be educated to influence their own profession and have the opportunity to create careers Finnish Hjördis Eklund suggested that all the NNF members worked for establishing nursing faculties at the universities and in areas as teaching, administration, and public health care. This was followed by an NNF idea to establish a joint Nordic folk high school for advanced education and this idea was taken in by everyone and therefore from the start an important topic for the NNF. The Nordic School of Public Health (Nordiska Hälsovårdshögskolan) was established in 1953 in Gothenburg. It was established by the Nordic Council of Ministers and jointly funded by the Nordic countries. The problem for the Nordic nursing associations was that the school was primarily for medical doctors. The NNF requested repeatedly the school to admit nurses however the first were not admitted before 1957. (The Nordic School of Public Health will be presented further in a separate thematic section)

It took decades to fulfill the NNF's strategy of state authorization of a three-year education and the establishment of national institutions for advanced education. The individual national politics influenced how the strategy was met in the individual country. It took three decades before everyone had obtained state authorization (the period stretched from 1919 to 1948). When it concerned the goal of establishing institutions for advanced education, e.g. in public health nursing and nurse instructors, the individual association worked strongly for this cause and inspired each other very much in this process. In several countries, the association established the country's first school of advanced nursing education, which then eventually was taken over by the public (see table). By 1938, everyone except Iceland had advanced nursing education. In 1953, the NNF's education committee published a report comparing the Nordic countries' advanced education for nurses. As stressed by the authors it was a difficult task to compare as they schools curricula and organization differed a lot. However, the report stands today as an important historical document of a joint effort toward including nurses education at all levels in the countries university programs. This goal was not fulfilled before 2003.

 

 

Denmark

Norway

Sweden

Finland

Iceland

Faroe Islands

Association  /

Foundation year

The Danish Nurses’ Organization  / 1899

The Norwegian Nurses’ Organisation / 1912

The Swedish Nurses’ Association / 1910

The Finnish Nurses’ Organisation / 1898

The Icelandic Nurses’ Association / 1919

The Faroese Nurses’ Association / 1988

Member of NNF

1920

1920

1920

1920

1923

1998

State authorisation

of three year education

1933

1948

1919 (2-year education)

Despite that in 1933 three year education in all schools

1929

1932

1933 via Denmark

Otte timers arbejdsdag

1946

1937

1939

1946

1942

1946 via Denmark

Advanced Nursing Education

Public1938

Association 1925

Association1938

Public 1958

Association 1924

Public 1945

 

1938 via Denmark

University education / high school all levels

2001

1985

1977

1979

1973

2003

The table shows when the NNF's objectives regarding basic education and advanced education were met in the individual countries.

References
  1. 1946 års kommitté för sjuksköterske-utbildningen, Stockholm 1951
  2. Dansk Sygeplejeråds arkiv, SSN 28-3 beretninger fra kongresser
  3. Dansk Sygeplejeråds arkiv, SSN 28-108: ”En sammenlignende undersøkelse av videreutdannelse for sygepleiersker i Norden”, 1953.
  4. Melby, Kari. Kall og Kamp. Norsk Sykepleiersforbunds historie, Oslo 1900
  5. Sjuksköterskors samarbete i Norden. Kongressberättelser från 25 år, red. Olga Lackström, 1947.