英国首位护理教授聘请50周年

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This year marks the 50th anniversary of the establishment of the first Chair for nursing in the UK at The University of Edinburgh in 1972. Its first incumbent was Margaret Scott Wright.

This was the first professorship for nursing outside of North America. There, way back in 1907, Mary Adelaide Nutting (1858–1948) became the world's first nursing professor in the Department of Nursing and Health at the progressive Teacher's College at New York's Columbia University. Prior to this, she was a supervisor of nurse training at the John Hopkins Hospital in the city. On her retirement in 1925, Nutting was described as one of ‘the small band of brilliant women of her generation … who laid the foundations upon which the towering and spreading structure of American nursing rests’ (TCCU, 2012).

Margaret Scott Wright (1923–2008) also held senior positions in the nursing service before moving in—back to—academe. She already had been to university before entering nursing, having graduated in 1946 with an MA in history from Edinburgh University. That led to a job as an analyst for a political scientist in a large industrial organization. However, recognizing the difficulties for a woman to forge a successful career in a male-dominated occupation, she decided instead to follow her sister into nursing. This was despite knowing, through her, that the profession was struggling with recruitment and retention in the UK's recently established and rapidly expanding National Health Service. Perhaps her academic background and her work in the sphere of politics and industry allowed her to think that maybe she could play a part in the post-war modernization of British nursing.

Indeed, Margaret Scott Wright rose quickly through the ranks at St George's Hospital in London, her training school, and while Ward Sister of its medical professorial unit she became aware of the importance of research. So, when an opportunity arose to return to her alma mater to undergo research training, she seized on it. Under the supervision of an eminent Professor of Public Health, and supported by a Boots Fellowship, Margaret Scott Wright undertook a research evaluation of experimental nurse training schemes in Scotland, and in 1961 she graduated with a PhD. One of the first nurses in the UK to gain a doctoral degree. She returned to London, first back to St. George's as Deputy Matron and a year later she moved to the nearby Middlesex Hospital to take over as Matron.

There could have been no one better qualified than Margaret Scott Wright—a Matron with a PhD—when, in 1968, the University of Edinburgh needed to appoint a new Head for its fledgling Department of Nursing Studies. The post had fallen vacant the previous year after the untimely death of Elsie Stephenson, the founding Director of the original Nursing Studies Unit that was established in 1956 with funding support from the Rockefeller Foundation. Its early courses for nurse tutors and administrators had by then been superseded by Diploma programmes and, in 1960, the first programme in the UK leading to a degree coupled with nursing registration had been introduced. Two of us (AJT and AMR) are proud graduates of The University of Edinburgh's pioneering degree nursing programme and both of us were touched by Margaret Scott Wright's influence early on in our respective careers. Her influence in and beyond the department so impressed the university that, in 1972, it decided to create a Chair of Nursing Studies. And so Margaret Scott Wright became the UK's first nursing professor.

That landmark event occurred in the same year as another: namely, the publication of the Report of the Committee on Nursing (HMSO, 1972). Chaired by the eminent historian, Asa Briggs, Margaret Scott Wright was one of its members. This report recommended formally for the first time that the UK nursing profession should strengthen its links with the university sector to widen educational opportunities and help equip the profession for its expanding role in the country's fast-developing healthcare system. The declared ambitions with regard to university developments were modest. The report stated ‘that the number of graduates is likely to remain small’ (2%–5% of the profession: para 259, p. 82). And although ‘Briggs’ argued that ‘nursing should become a research-based profession’ (para 370, p. 108) it proposed that only a small number of nurses should be research-trained.

Were those ambitions so restrained because it could not be envisaged that the UK university system could (or would) support nursing education on a larger scale or be willing to take in a discipline with virtually no research tradition? Or was it awareness of the lingering opposition in the profession—and in the public at large—that tempered the aspirations? As it turned out, several decades would pass before the government announced in 2009 that by 2013 all UK-educated nurses joining the register would require to be graduates.

Margaret Scott Wright made no secret of her frustration with the slow progress and the lack of resources being invested in university education and research for nursing in the wake of ‘Briggs’. Aware that she might have more opportunity to advance these agendas more quickly ‘on the other side of the pond’, Margaret Scott Wright left Edinburgh in 1976 for Canada. First to Nova Scotia to become Director of the School of Nursing at Dalhousie University and then to Alberta where, as Dean of Nursing at The University of Calgary, she worked with colleagues to introduce Canada's first doctoral programme in nursing. Margaret Scott Wright retired in 1985 and moved back to Norwich in England, her birthplace, and there she died in 2008, aged 84. Her obituary in The Times noted that the University of Calgary had described her as ‘one of the greatest nursing leaders of our time’ (The Times, 2008).

Beyond Canada—and Edinburgh—Margaret Scott Wright's name may not be well known but her role and legacy as the UK's first nursing professor should not be forgotten. Two years later, in 1974, Jean McFarlane was appointed to the first Chair for nursing in England at The University of Manchester and there has been a steady expansion of the UK's nursing professoriate ever since. The register maintained by the Royal College of Nursing (UK) currently lists 311 names of nurses and midwives who hold substantive chairs (i.e. not including honorary professorial appointments, of which there are many) in 79 HEIs across the four countries (Royal College of Nursing, 2022).

That register was used in 2015 for an analysis of the research performance of UK nursing professors as measured by the h-index (Watson, McDonagh, & Thompson, 2016). Similar analyses have been undertaken of Canadian and Australian professors. Results show that nursing does have some impactful well-published professors but also some who perform poorly by this measure. ‘It is simply not possible’ the authors contend (p. 999) ‘to display academic professorial leadership without publishing peer reviewed scholarly work and, in turn, having that work cited by others’.

Margaret Scott Wright most definitely would have failed miserably on an h-index assessment! She published little over the course of her career. She and our other early professors certainly did not lack academic capability—quite the contrary—but necessarily their focus was on building and heading up new university-based schools of nursing; on the design and accreditation of new programmes and degrees; and on acquiring funds and resources to nurture the development of research in nursing. These pioneers may not have published prolifically, but they were powerful orators and transformational leaders.

‘Leadership’, ‘vision’, ‘risk-taking’ and ‘inspirational mentoring’ are qualities highlighted in a JAN Editorial titled ‘The lost heroes of nursing’ in which Thompson (2019) pays tribute to those who have shaped the modernization of nursing over the past 50 years. Many of those named are professors. But Thompson also has contributed to criticisms levied at the nursing professoriate in terms of weakness of leadership as well as inadequacies of research performance, even questioning whether the nursing faculty is slowly drowning under the business model now driving policy in universities (Timmins, Thompson, & Watson, 2022). This, they argue, is not conducive to nursing as a practice discipline and that traditional benchmarking for appointments and promotions disadvantages nurse academics.

It certainly is the case that the number of professors is disproportionately small relative to the huge number of nursing students now in the university system. Furthermore, the steady improvement in the discipline's performance in the Research Excellence Framework (formerly the RAE) arguably is not fully reflected in levels of investment for education and research for what is the largest workforce in one of the largest sectors of the UK economy. Margaret Scott Wright would be despondent to know that nursing is still struggling to find its optimal place in the university system and to know that the profession is still grappling with the seemingly intractable problems of recruitment and retention.

On the other hand, she would be gratified by the expansion and success of university education and research for nursing, notably including the introduction of clinical–academic career pathways, and most of all to know that there now is a proven association between better-educated nurses and better outcomes for patients (Rafferty, 2020). However, despite the importance of this evidence, there is still no attempt to track this trajectory over time so that policy and workforce planning can take account of the quantum of graduates in the skill mix rather than focus only on overall numbers. We have the evidence, let us put it to good use. Margaret Scott Wright would have insisted on it!

The current incumbent of the 50-year-old Chair of Nursing Studies at The University of Edinburgh, Professor Aisha Holloway, is too young to have known Margaret Scott Wright but she wears the mantel as a tireless campaigner for the betterment of nursing (Rafferty & Holloway, 2022). This editorial provides an opportunity for her to acknowledge the privilege of holding this historic Chair and also to express appreciation of the contribution from the Margaret Scott Wright Endowment Fund towards the award of a Florence Nightingale Leadership Scholarship in 2018. This enabled time to be spent in the USA to study health policy and political leadership in nursing. Evidence—and inspiration—from that work contributed directly to the agendas that drove the global ‘Nursing Now Campaign’ and to subsequent participation in its leadership (Holloway et al., 2021).

Fifty years ago, a global initiative on this scale and with worldwide impact simply would not have been possible. In this globally connected age of the 21st century, a professor of nursing is no longer a lone voice in a wilderness as was the case for Margaret Scott Wright and other early modernizers of nursing. We now have many hundreds of nursing professors across the world who have the opportunity to exercise leadership, both nationally and internationally, in the common cause of improving nursing for the benefit of patients and society at large. Although we have focused this Editorial on the UK context by highlighting a particular historical landmark, we hope it will encourage JAN readers around the world to reflect on their own country's history of the connection between nursing and universities; on the role of the nursing professoriate and the importance of inspirational leadership; and on how the profession can rise to meet the enormous challenges that lie ahead in the coming decades.

全文翻译（仅供参考）

今年是1972年爱丁堡大学（the University of Edinburgh）在英国设立第一任护理主席50周年。第一任主席是玛格丽特·斯科特·赖特（Margaret Scott Wright）。

这是北美以外的第一位护理教授。早在1907年，玛丽·阿德莱德·纳丁（1858-1948）就在纽约哥伦比亚大学进步教师学院护理与健康系成为世界上第一位护理教授。在此之前，她是该市约翰·霍普金斯医院的护士培训主管。1925年退休时，纳丁被描述为“她这一代的一小群杰出女性之一……奠定了美国护理业高耸入云的基础”（TCCU，2012年）。

玛格丽特·斯科特·赖特（Margaret Scott Wright，1923–2008）在重返学术界之前，也曾在护理部门担任过高级职位。1946年，她毕业于爱丁堡大学，获得历史学硕士学位。这导致了一份在一家大型工业组织担任政治科学家分析师的工作。然而，她意识到女性在男性主导的职业生涯中很难取得成功，于是决定跟随姐姐进入护理行业。尽管通过她知道，在英国最近成立并迅速扩大的国家卫生服务机构中，该行业正在努力招聘和留住人才。也许她的学术背景和她在政治和工业领域的工作让她认为，也许她可以在战后英国护理现代化中发挥作用。

事实上，玛格丽特·斯科特·赖特（Margaret Scott Wright）在伦敦圣乔治医院（St George‘s Hospital）的培训学校迅速晋升，而在其医学教授部门的病房护士（Ward Sister）期间，她意识到了研究的重要性。因此，当有机会回到母校接受研究训练时，她抓住了机会。玛格丽特·斯科特·赖特（Margaret Scott Wright）在一位著名公共卫生教授的监督下，在布茨奖学金（Boots Fellowship）的支持下，对苏格兰的实验性护士培训计划进行了研究评估，并于1961年获得博士学位。英国首批获得博士学位的护士之一。她回到了伦敦，先是回到圣乔治医院担任副主妇，一年后她搬到附近的米德尔塞克斯医院担任主妇。

1968年，爱丁堡大学（University of Edinburgh）需要任命一位新的护理研究系主任，当时，没有人比玛格丽特·斯科特·怀特（Margaret Scott Wright）更称职了，她是一位拥有博士学位的女教师。该职位在前一年因埃尔西·斯蒂芬森（Elsie Stephenson）早逝而空缺。埃尔西·史蒂芬森是1956年在洛克菲勒基金会的资助下成立的护理研究股的创始董事。它早期为护士导师和管理人员开设的课程已被文凭课程取代，1960年，英国引入了第一个与护理注册相结合的学位课程。我们中的两人（AJT和AMR）是爱丁堡大学开创性护理学位课程的骄傲毕业生，我们都被玛格丽特·斯科特·赖特在各自职业生涯早期的影响所感动。她在该系内外的影响力给该校留下了深刻的印象，以至于在1972年，该校决定设立护理研究主席。于是玛格丽特·斯科特·赖特成为英国第一位护理教授。

这一具有里程碑意义的事件与另一事件发生在同一年：即《护理委员会报告》（HMSO，1972年）的出版。由著名历史学家阿萨·布里格斯（Asa Briggs）担任主席的玛格丽特·斯科特·赖特（Margaret Scott Wright）是其成员之一。该报告首次正式建议，英国护理专业应加强与大学部门的联系，以扩大教育机会，帮助该专业在该国快速发展的医疗体系中发挥越来越大的作用。在大学发展方面所宣称的雄心不大。报告指出，“毕业生人数可能仍然很小”（占专业的2%至5%：第259段，第82页）。尽管“布里格斯”认为“护理应该成为一种以研究为基础的职业”（第370段，第108页），但它建议只有少数护士应该接受研究培训。

这些雄心壮志是否受到了限制，因为无法想象英国大学系统能够（或将）支持更大规模的护理教育，或愿意接受几乎没有研究传统的学科？抑或是意识到行业和广大公众中挥之不去的反对，才缓和了这种愿望？事实证明，政府在2009年宣布，到2013年，所有在英国接受教育的护士都必须是毕业生，这需要几十年的时间。

玛格丽特·斯科特·赖特（Margaret Scott Wright）毫不掩饰自己对《布里格斯》（Briggs）之后的进展缓慢以及缺乏用于大学教育和护理研究的资源感到失望。玛格丽特·斯科特·赖特（Margaret Scott Wright）意识到她可能有更多的机会“在池塘的另一边”更快地推进这些议程，于1976年离开爱丁堡前往加拿大。她首先来到新斯科舍省，成为达尔豪西大学护理学院院长，然后又来到阿尔伯塔省，作为卡尔加里大学护理学院的院长，她与同事们一起介绍了加拿大第一个护理博士课程。玛格丽特·斯科特·赖特（Margaret Scott Wright）于1985年退休，搬回她的出生地英国诺维奇（Norwich），2008年去世，享年84岁。她在《泰晤士报》（The Times）上的讣告称，卡尔加里大学（University of Calgary）将她描述为“我们这个时代最伟大的护理领袖之一”（《泰晤士报》，2008年）。

除了加拿大和爱丁堡之外，玛格丽特·斯科特·赖特的名字可能并不广为人知，但她作为英国第一位护理教授的角色和遗产不应被遗忘。两年后，1974年，让·麦克法兰（Jean McFarlane）被任命为曼彻斯特大学（the University of Manchester）英国护理学第一任主席，此后，英国护理学教授人数稳步增加。由英国皇家护理学院（Royal College of Nursing，UK）维护的登记册目前列出了311名护士和助产士的姓名，他们在四个国家的79所高等教育机构（皇家护理学院，2022年）担任实职主席（即不包括荣誉教授职位，其中有很多）。

2015年，该登记册被用于分析英国护理教授的研究绩效，该绩效由h指数衡量（Watson，McDonagh，&Thompson，2016）。加拿大和澳大利亚的教授也进行了类似的分析。结果表明，护理学确实有一些有影响力的优秀教授，但也有一些在这方面表现不佳的教授作者们辩称（第999页），“如果不发表同行评议的学术作品，并反过来让其他人引用这些作品，就不可能展示学术教授的领导力”。

玛格丽特·斯科特·赖特（Margaret Scott Wright）肯定会在h指数评估中惨败！在她的职业生涯中，她几乎没有发表过什么文章。她和我们的其他早期教授当然并不缺乏学术能力，恰恰相反，但他们的重点必然是建立和领导新的大学护理学院；新课程和学位的设计和认证；以及获得资金和资源以促进护理研究的发展。这些先驱们可能发表的文章不多，但他们是强有力的演说家和变革领袖。

“领导力”、“远见”、“冒险”和“励志指导”是JAN社论《护理的失落英雄》中强调的品质，汤普森（2019）在该社论中向那些在过去50年中塑造了护理现代化的人致敬 年。许多被点名的人都是教授。但汤普森也引发了对这位护理专业教授的批评，指责其领导能力薄弱以及研究绩效不足，甚至质疑护理学院是否正在慢慢淹没在目前推动大学政策的商业模式下（Timmins，Thompson，&Watson，2022）。他们认为，这不利于将护理作为一门实践学科，传统的任命和晋升基准对护士学术不利。

当然，教授的数量与大学系统中的护理专业学生数量相比，少得不成比例。此外，该学科在卓越研究框架（以前称为RAE）中的表现稳步改善，可以说并没有充分反映在英国经济最大部门之一的最大劳动力的教育和研究投资水平上。玛格丽特·斯科特·赖特（Margaret Scott Wright）如果知道护理业仍在努力在大学系统中找到最佳位置，如果知道护理行业仍在努力解决招聘和留任这一看似棘手的问题，会感到沮丧。

另一方面，她会对本科护理教育和研究的扩展和成功感到欣慰，尤其是包括引入临床和学术职业道路，最重要的是，她知道，现在受过良好教育的护士与患者的更好结果之间存在着经证实的联系（Rafferty，2020）。然而，尽管这一证据很重要，但仍没有人试图随着时间的推移跟踪这一轨迹，以便政策和劳动力规划能够考虑到毕业生在技能组合中的数量，而不是只关注总体数量。我们有证据，让我们好好利用它。玛格丽特·斯科特·赖特会坚持的！

现年50岁的爱丁堡大学护理研究主席艾莎·霍洛韦教授（Aisha Holloway）目前还太年轻，还不认识玛格丽特·斯科特·赖特（Margaret Scott Wright），但她是一位不知疲倦的护理改善运动者（拉弗蒂和霍洛韦，2022年）。这篇社论为她提供了一个机会，让她承认担任这一历史性主席的荣幸，并对玛格丽特·斯科特·赖特捐赠基金对2018年佛罗伦萨·南丁格尔领导力奖学金（Florence Nightingale Leadership Scholarship）的贡献表示感谢。这使得她有时间在美国学习护理领域的卫生政策和政治领导力。这项工作的证据和灵感直接推动了全球“立即护理运动”的议程，并随后参与了其领导（Holloway等人，2021）。

50年前，一项如此规模、具有全球影响力的全球倡议根本不可能实现。在21世纪这个全球互联的时代，护理学教授不再像玛格丽特·斯科特·赖特和其他早期护理现代化者那样是荒野中的孤独声音。我们现在在世界各地有数百名护理教授，他们有机会在国家和国际上发挥领导作用，共同改善护理，造福患者和整个社会。尽管我们通过强调一个特定的历史里程碑，将这篇社论聚焦于英国背景，但我们希望它将鼓励世界各地的JAN读者反思自己国家护理与大学之间的联系历史；护理教授的角色和激励性领导的重要性；以及该行业如何崛起以应对未来几十年面临的巨大挑战。

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