Norrie, C., and Goodson, I. (Eds.). (2005).

Ethical and Professional issues in Nursing: Perspectives from Europe (Tadd,
2004) explores issues in European Nursing. It covers the development of EU
minimum standards for the education of professional nurses since 1977, making
freedom of movement a reality. Another issue raised is the WHO conference in
Vienna in 1989, where a decision was reached to pursue the development of the
generic nurse. This has proved to be a fundamental threat to the maintenance of
the pre-registration branch education programmes in mental health, learning
disabilities and paediatric nursing. Other chapters cover current issues in
nursing, such as the emphasis of evidence-based practice and increase in multidisciplinary
team working. They also note there is a North/South divide in
Europe with regards to the concept of ‘nurse advocacy’. This trend (starting in
the US civil rights movement and moving onto institutionalised patients for
example those in mental institutes) can be seen as an impetus to nurse autonomy.
But the Northern European idea of nurses ‘protecting’ patients from doctors does
not seem to be shared in Southern Europe. In Spain the idea of patient advocacy
seems to have been taken on jointly by doctors and nurses, in a less
confrontational manner. Another chapter of this book notes the current trends in
nursing of homecare and primary care expansion, increase in unqualified staff,
use of IT and concern over costs, delivery and quality of care as well as the
increased involvement of patient and consumer groups. It also describes the
various nursing research organisations in Europe and notes there are about
twenty nursing groups active across Europe.
The Workgroup of European Nurse Researchers (WENR) who network for the
advancement of nurses, have recently published a position paper (Perala and
Pelkonen, 2004) and are one of the oldest groups having been established in the
1970’s.
The WHO published a report on the role and functions of nurses and midwives
within the health systems of European countries including countries of central
and eastern Europe (CCEE) in response to the paucity of reliable data on nursing
practices in Europe (Salvage and Heijnen, 1997).
In Health, migration is an issue with England and Ireland in particular
experiencing staff shortages and recruiting nurses from Spain and Finland while
an OECD report (Simoens et al., 2005) concludes that nurse shortages are an
issue across developed countries. To cope with the ethical issues of creating
brain drains in developing countries, international recruitment policy documents
have been introduced at national and supra-national levels (Commonwealth
Secretariat, 2003, International Council of Nurses, 2005, Aiken et al., 2004).
The Professions and Restructuring
Representations of professions in the literature will now be examined and the
implications of restructuring on them. The concept of profession can have
different connotations across languages for example, in Finnish‘profession’
(professio) is a new word and is not used in everyday communication.
“The essential properties of professions must not be decided by how the
concept is used in English. It is argued that essential properties must
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A Literature Review of Welfare State Restructuring in Education and Health in European
Contexts: Implications for the Professions and Professional Knowledge