Achieving partnership: the contribution of nursing education to the production of a flexible workforce.
OBJECTIVE
This paper examines education's contribution to labour force reform in the nursing profession within the United Kingdom.


BACKGROUND
In a globalized society there is increasing demand for more flexible forms of working. Nursing faces radical change in its employment characteristics if it is to continue to meet the health care needs of the population in the new century. ORIGINS OF INFORMATION AND DATA ANALYSIS: Key sociological texts and contemporary analysis of nursing skill have been analysed and synthesized to identify the dynamic of change in nursing and nursing education's contribution to these changes.


RESULTS
Patterns of upskilling and multiskilling are leading to the breakdown of professional role boundaries in the broader workforce. These patterns can also be seen in nursing. Upskilling is associated with increased stress and 'risk' for the individual, therefore achievement of flexibility is not without cost. Changes in the skill level in nursing lead many to conclude that the profession will become divided into a core and periphery distinction. This simplistic analysis does not account for the complexities of nursing and nursing skill although there is clearly a growing need for a 'knowledge and technical elite'.


CONCLUSIONS
The core-periphery distinction is too simplistic to analyse nursing skills and the dynamic of change in the workforce. A radical perspective of nursing characterized by workers with a range of skills and competencies is less likely to lead to rigid professional boundaries. There is a clear need for multiskilled and knowledgeable workers; the 'technical and knowledge elite'. These nurses may be recognized as advanced practice nurses. High quality education is required to prepare these practitioners. Adaptation of nursing to the postmodern world needs to be facilitated by changes in current educational policy and practice.
Flanagan
J
J
University of Leeds, School of Health Care Studies, Highroyds Hospital, Menston, Ilkley, UK.
D002983:Clinical Competence / Q000592:standards*; D004508:Education, Nursing, Baccalaureate / Q000458:organization & administration*; D004651:Employment / Q000458:organization & administration*; D005544:Forecasting; D006801:Humans; D007587:Job Description; D008008:Licensure, Nursing / Q000639:trends; D008389:Marketing of Health Services; D020380:Needs Assessment; D009740:Nursing Staff / Q000193:education* / Q000600:supply & distribution*; D009936:Organizational Innovation; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D013222:State Medicine / Q000639:trends; D006113:United Kingdom