I am probably not quoting Star Trek correctly, but you get the idea. When do the needs of one person outweigh the needs of the community? It’s a question I struggled with throughout my career as a nurse educator. What to do with the poor student?

In the days when nurses were trained in hospitals, the poor students were washed out of the program with no qualms. Why? Because nursing students were being trained to work in that hospital and they only wanted the best. So, the poor and mediocre students were dismissed if they were judged to be irredeemable. In this case, the “good of the one” (meaning the achievement of the student’s goals), was outweighed by “the good of the many” or the hospital.

When I lived in California, the educational mandate of the time (I have no idea if it is still true) was to keep a child in his or her age grade no matter how they performed. The experts were certain a child’s personality would be warped if they did not remain with their class – despite not being able to keep up academically. There were “confessions” in the newspaper from professional football players who publicly admitted they could not read, yet they had graduated from college and had bachelor’s degrees.  In these cases, was it the “good of the individual that outweighed the good of the many?” Or was it instead, the fact that these young men had athletic ability others did not have and their skills were wanted for the world of professional football and their fans? Instead of helping these men, when they were boys, to learn to read – a skill for a lifetime – they were ‘moved on up’ because they had a skill desired by a group. These boys were deprived of learning skills they would use for their entire lives and not just for their limited careers in pro-ball. Whose needs were being met?

I faced this issue in nursing education. Failing a university student meant the loss of revenue to the university in the form of tuition and fees. Failing the nursing student in the university was unusual. For the most part, nursing faculty “felt sorry” for the student and did their best to help the student achieve her goals, no matter how poor they were academically.  Two examples were of foreign nationals, one was a First Nations student. (These examples stand out in my memory because the problems were so clear. There were others who were not minority students or international students.)

One was working on her master’s degree, having achieved her RN and bachelor’s degrees in her home country. Both she and her husband had applied for graduate work at the university and were accepted. I was her thesis supervisor – at least for the writing of her thesis. She was a concrete thinker rather than a conceptual thinker. We would go over her data together and discuss ways of presenting the findings. If I suggested that one of the findings was particularly interesting, If I made a suggeston to her that she might begin the paragraph with, “It was interesting to note . . , “ then every other  paragraph was introduced that way. I could not figure out a way to explain to her the difference. One of the other graduate students felt sorry for her and wrote her thesis for her. She did finish her thesis and graduated. In the meanwhile, she was taking the licensing exam to practice nursing. She failed the exam four times before passing with the help of tutoring by another graduate student. When she applied for a clinical nursing job, the Director of Nursing at the hospital hired her as a nurse’s aide rather than as a registered nurse because she was not trusted to dispense medications without error. In this example, the school of nursing was bending over backwards to help this student graduate. But what of the wider community? An RN with a master’s degree is expected to have a certain level of knowledge and skills that this woman did not possess. Was the school doing her, or the community, any favors by graduating her?

The other international student was very bright and charming, and she did have the academic qualifications to apply for and receive admission into the PhD program. I was her teacher for one of her research courses. She decided to take a vacation during my course and missed one third of the course. When she submitted her final paper, it was obvious that she had no idea what she was talking about. I gave her a failing grade for the paper and the course. She appealed my decision and her paper was given to another faculty member to review. The other faculty person wrote ten pages of critique of the paper but gave the student a passing grade. The student did receive her PhD, doing her research under that faculty person. Once again, someone “felt sorry” for the student and passed her along rather than having her repeat the course. Now she has a PhD and is academically qualified to teach at the PhD level – including teaching research courses. I can only hope she learned something about research methods during her dissertation research.

The First Nations student was in her first year of undergraduate nursing education. She had been adopted and raised by an Anglo family but was fiercely “First Nations.” I assumed that, since she had gone to school off-reservation, that she would have the academic skills required of a high school graduate in order to be admitted to a baccalaureate program in nursing. I was wrong. Like many first nations peoples, she distrusted books. Whenever she had a question, she would go to the reservation and ask her grandmother (who was not a nurse) rather than go to the library to look up the answer. She rarely read her assigned textbooks but relied totally on the internet for information. When I brought her up at the curriculum committee meeting, my colleagues had no suggestions to offer on how to deal with her. They saw no reason why she should not pass the course despite her poor academic performance. Again, the nursing faculty “felt sorry” for the student and bent over backwards to help her graduate. I assume she applied to work on reservation but wonder if we did the reservation any favors.

These were my conundrums. Does the “good of the one outweigh the good of the many?”

When I was in graduate school for my nursing master’s degree, I learned years later, the faculty “felt sorry” for me and kept me in the graduate program. I don’t know if it was because they thought I was remediable or because they would have lost the money from the government grant that supported me. I tried to make up for my lack of training and skills post graduation, but always felt insecure.

I wonder to this day whether passing me and letting me graduate, was an example of “the good of the one out weighing the good of the many.”