Competence and British nursing: a view from history

In the light of current political and professional debate in the United Kingdom concerning preparing nurses for competence, this paper takes an historical perspective, and considers how nursing competence was defined historically through an analysis of statutory syllabuses and nursing textbooks 1874-1977. Competence was perceived by nursing textbook writers to have four facets. Firstly, it involved the moral character of the nurse; secondly, it required technical knowledge, practical skill and procedure; thirdly, it depended on the role of the ward sister; and fourthly, it relied on the professional etiquette of right relationships. The analysis shows that the traditional system of nursing competence presumed a clearly defined purpose: the production of the bedside nurse, whose function was to care for the sick person. This raises a fundamental question for nursing today: what is the purpose of the modern nurse?