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A century ago, nursing education was often exploitative because

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students staffed hospital wards as part of their training, only to be without work at the end of their training. \"Schools of nursing took women and turned them into girls.\" Nursing education was transformational, but not in a way that served nursing's—or society's—best interests.

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In 2009, Patricia Benner, PhD, RN, FAAN and her team at the Carnegie Foundation for the Advancement of Teaching published a study, Educating Nurses: A Call for Radical Transformation which suggested that

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a bachelor of science in nursing (BSN) be the entry level for registered nurse (RN) practice, and that all RNs be required to earn a master of science in nursing (MSN) within 10 years of licensure.

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the Carnegie Foundation study, in October, 2010, the Institute of Medicine (IOM) published a report, The Future of Nursing: Leading Change, Advancing Health (IOM, 2010). This report was compiled as the result of a 2-year initiative by the Robert Wood Johnson Foundation (RWJF) and the IOM to address the need to transform the profession of nursing. Four key messages were at the center of the Future of Nursing report:

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1. Nurses must practice to the fullest extent of their education and training. 2. Nurses should attain higher education levels through a system of improved education with seamless progression across degrees. 3. As health care in the United States is being transformed, nurses should be full partners with other health care professionals in this effort. 4. Improved data collection and information infrastructure can result in more effective workforce planning and policy development.

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Nightingale revolutionized and professionalized nursing by stressing that nursing was not a domestic, charitable service but a respected occupation requiring advanced education. In 1860, she opened a school of nursing at St. Thomas' Hospital in London and established the following principles, which were considered highly innovative at the time:

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1. The nurse should be trained in an educational institution supported by public funds and associated with a medical school. 2. The nursing school should be affiliated with a teaching hospital but also should be independent of it. 3. The curriculum should include both theory and practical experience. 4. Professional nurses should be in charge of administration and instruction and should be paid for their instruction. 5. Students should be carefully selected and should reside in \"nurses' houses\" that form discipline and character. (Nightingale envisioned nursing as a profession only for women.) 6. Students should be required to attend lectures, take quizzes, write papers, and keep diaries. Student records should be maintained

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The first training schools for nurses in the United States were established in______ . Located at

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1872 Bellevue Hospital in New York; the New England Hospital for Women and Children in New Haven, Connecticut; and Massachusetts General Hospital in Boston, the course of study was 1 year in length. These schools became known as the \"famous trio\" of nursing schools.

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In October 1873, Melinda Anne \"Linda\" Richards became the first

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\"trained nurse\" educated in the United States.

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October 1899 marked the culmination of some 4 years of work by the American Society of Superintendents of Training Schools for Nurses. Isabel Hampton Robb chaired a Society-selected committee to investigate a means to

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prepare nurses better for leadership in schools of nursing.

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Teachers College in New York was the location for the first leadership training of nurses. A program, originally designed to prepare administrators of nursing service and nursing education, began as

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an 8-month course in hospital economics

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Mary Adelaide Nutting came to Teachers College in 1907 as the first

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nursing professor the world had ever known. Under her direction, the department progressed and became a pioneer in nursing education. The school became known as the \"Mother House\" of collegiate education because it fostered the initial movements toward undergraduate and graduate degrees for nurses

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In 1912, Mary Adelaide Nutting conducted a nationwide investigation of nursing education, The Educational Status of Nursing, that focused on

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the living conditions of students, the material being taught, and the teaching methods being used

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The Study of Nursing and Nursing Education in the United States, a major study of nursing education was published in 1923 and was referred to as the Goldmark Report. The study focused on

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the clinical learning experiences of students, hospital control of the schools, the desirability of establishing university schools of nursing, the lack of funds specifically for nursing education, and the lack of prepared teachers

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When the Yale School of Nursing was opened in 1924, it was the first

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nursing school to be established as a separate university department with an independent budget and its own dean, Annie W. Goodrich. The school demonstrated its effectiveness so well that in 1929 the Rockefeller Foundation ensured the permanency of the school by awarding it an endowment of $1 million

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The 1934 study Nursing Schools Today and Tomorrow and the 1937 publication Curriculum Guide for Schools of Nursing outlined a 3-year curriculum and influenced the structure of diploma schools for decades. Consistently made five similar recommendations:

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1. Nursing education programs should be established within the system of higher education. 2. Nurses should be highly educated. 3. Students should not be used as the means to staff hospitals. 4. Standards should be established for nursing practice. 5. All students should meet certain minimum qualifications on graduation.

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Most diploma programs today have established agreements with colleges and universities that allow students to

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earn college credit in courses such as English, psychology, and the sciences, thereby enabling them to attain advanced standing in a bachelor's degree program on completion of the diploma program.

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The first BSN program was established in

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1909 at the University of Minnesota, was part of the University's School of Medicine and followed the 3-year diploma program structure. Most of the early BSN programs were 5 years in duration.

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Esther Lucille Brown's 1948 report Nursing for the Future, more commonly known as the Brown Report recommended that

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basic schools of nursing be placed in universities and colleges, with effort made to recruit men and minorities into nursing education programs

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In 1965, the ANA published a position paper entitled Educational Preparation for Nurse Practitioners and Assistants to Nurses. Although not all nursing historians agree, this paper, which subsequently created conflict and division within nursing, had a significant influence on the growth of baccalaureate education in nursing; concluded that baccalaureate education should become the foundation for professional practice. The ANA position paper made four major recommendations:

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1. Education for all those who are licensed to practice nursing should take place in institutions of higher learning. 2. Minimum preparation for beginning professional nursing practice should be the baccalaureate degree in nursing. 3. Minimum preparation for beginning professional nursing practice should be the baccalaureate degree in nursing. 4. Education for assistants in the health service occupations should consist of short, intensive preservice programs in vocational education institutions rather than on-the-job training programs.

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In 1979 the ANA further strengthened its resolve that BSN be the minimum entry requirement into the nursing profession by proposing three additional positions

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1. By 1985 the minimum preparation for entry into professional nursing practice should be the BSN. 2. Two levels of nursing practice should be identified (professional and technical) and a mechanism to devise competencies for the two categories established by 1980. 3. There should be increased accessibility to high-quality career mobility programs that use flexible approaches for individuals seeking academic degrees in nursing.

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In 1970, the National Commission for the Study of Nursing and Nursing Education published a report entitled An Abstract for Action (Lysaught). Also known as the Lysaught Report, it made recommendations concerning the

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supply and demand for nurses, nursing roles and functions, and nursing education. Among the priorities identified by this study were (1) the need for increased research into both the practice and the education of nurses and (2) enhanced educational systems and curricula.

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In the mid-1980s, the National Commission on Nursing suggested that

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the major block to the advancement of nursing was the ongoing conflict within the profession about educational preparation for nurses. The Commission recommended establishing a clear system of nursing education, including pathways for educational mobility and development of additional graduate education programs

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National League of Nursing (NLN) in 1982 approved the Position Statement on Nursing Roles: Scope and Preparation, which affirmed

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the BSN as the minimum educational level for professional nursing practice and the ADN or diploma as the preparation for technical nursing practice

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According to The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008), nurses who graduate from BSN programs are prepared to

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\"practice within complex healthcare systems and assume the roles: provider of care; designer/manager/coordinator of care; and member of a profession\" and also stressed the concepts of patient-centered care, interprofessional teams, evidence-based practice, quality improvement, patient safety, informatics, clinical reasoning/critical thinking, genetics and genomics, cultural sensitivity, professionalism, and practice across the lifespan in an ever-changing and complex health care environment

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The most US RN graduates of all the basic programs have educational level of

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ADN. Begun in 1952 as a result of a post-World War II nursing shortage, based on a model developed by Dr. Mildred Montag, and fueled by the post-World War II community college movement of the 1950s.

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The original ADN program, as outlined by Montag (1951), offered general education courses in the first year and nursing courses in the second year. Montag originally viewed the ADN as

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a final, end-point degree, not a stepping stone to the BSN

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Landmark in history of nursing 1860

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Florence Nightingale founded the first organized program to educate nurses at St. Thomas' Hospital in London.

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Landmark in history of nursing 1872

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The \"famous trio,\" the first year-long training schools for nurses, was established in the United States, founded at Bellevue Hospital, the New England Hospital for Women and Children, and Massachusetts General Hospital.

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Landmark in history of nursing 1873

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Melinda Anne \"Linda\" Richards became the first \"trained nurse\" to graduate in the United States.

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Landmark in history of nursing 1899

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Teachers College, Columbia University, offered the first postgraduate course in hospital economics for nurses.

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Landmark in history of nursing 1907

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Mary Adelaide Nutting became the first nursing professor at Teachers College, Columbia University.

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Landmark in history of nursing 1909

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The first BSN program was established at the University of Minnesota.

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Landmark in history of nursing 1923

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The Goldmark Report was published, the first such report focusing on hospital control of schools of nursing and lack of proper teacher preparation.

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Landmark in history of nursing 1924

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Yale University established the first nursing school as a separate university department with its own dean, Annie W. Goodrich.

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Landmark in history of nursing 1932

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The first EdD in nursing was granted by Teachers College.

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Landmark in history of nursing 1934

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The first PhD program in nursing was initiated by New York University.

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Landmark in history of nursing 1948

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Esther Lucille Brown's report Nursing for the Future was published, recommending that basic nursing programs be situated in colleges and universities rather than in hospitals.

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Landmark in history of nursing 1952

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The first ADN program, based on Dr. Mildred Montag's model, was established to prepare nurse technicians.

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Landmark in history of nursing 1965

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The ANA issued a position paper advocating the BSN degree as the minimum educational preparation for entry into nursing practice.

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With broad preparation in clinical, scientific, community health, and patient education skills, the baccalaureate nurse is well positioned to

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move across community-based settings such as home health care, outpatient centers, and neighborhood clinics, where opportunities are fast expanding.

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There have been reports of fraudulent online programs in which large fees are charged for \"mail-order degrees.\" Other programs look good at the outset, but enrolled students find serious flaws in the delivery and evaluation processes. Students contemplating taking courses toward entry-level or advanced nursing degrees should be educated consumers and consider several factors when evaluating options such as:

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1. Does the program have legitimate accreditation from a regional accrediting body and from one of the two legitimate nursing accreditation bodies? 2. What is the pass rate on the licensing exam? 3. How are clinical experiences planned and supervised? Does your state board of nursing approve of the type of experiences offered? 4. What is the reputation of the program and its faculty? 5. Do you have the self-discipline needed to keep up with assignments outside a traditional classroom setting? 6. Do you learn best when you can interact with other learners and faculty? As a distance learner, how much access will you have to faculty members? 7. Do distance students have access to student support services just as if they were students-in-residence on campus?

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Two agencies responsible for accrediting nursing educational programs today are

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the NLNAC, now called ACEN Accreditation Commission for Education in Nursing and the Commission on Collegiate Nursing Education (CCNE), ,

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Accrediting bodies establish standards by which a program's effectiveness is measured. For a program to be accredited, the process steps are

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Programs under review prepare reports, known as self-studies, that show how the school meets each standard. The self-study is reviewed by a volunteer team composed of nursing educators from the type of program being reviewed, and an on-site program review is conducted by the same team. After the site visit, the visitors' report and the program's self-study are reviewed by the accrediting organization, and a decision is made about the accreditation status of each nursing program.

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Once a program is accredited and in good standing, continuing accreditation reviews take place every

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8 to 10 years.

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LPN/LVN programs, diploma programs, and ADN programs continue to be accredited by

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NLNAC, now called ACEN, and bachelor's and higher degree programs may choose which of the two accrediting bodies they wish to use.

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The purpose of master's education is to

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prepare people with advanced nursing knowledge and clinical practice skills in a specialized area of practic

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Entrance requirements to master's programs in nursing usually include the following:

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a BSN degree from an accredited program, licensure as an RN, completion of the Graduate Record Examination or other standard aptitude test, a minimum undergraduate grade point average of 3.0, recent work experience as an RN in an area related to the desired area of specialization, and specific goals for graduate study.

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master's traditional program length is

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18 to 24 months of full-time study

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Master's students generally select both

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an area of clinical specialization, such as adult health or gerontology, and an area of role preparation, such as informatics, administration, or teaching. Students may be required to write a comprehensive examination and/or to complete a thesis or research project.

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Major areas of nurse role preparation include

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administration, case management, informatics, health policy/health care systems, teacher education, clinical nurse specialist, NP, nurse-midwifery, nurse anesthesia,

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The two most common graduate degrees offered for nurses are

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the master of science (MS) and the MSN

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MSN/MBA and MSN/JD are

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master of science in nursing/master of business administration (MSN/MBA) for nurse administrators or the master of science in nursing/juris doctor (MSN/JD) for nurse attorneys.

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Doctoral programs in nursing offer several degree titles. These can be divided into two categories:

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a research-focused degree—doctor of philosophy (PhD)—and a practice-focused degree—DNP.

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Formal doctoral education for nurses began at

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Columbia University's Teachers College in 1910 with the creation of the Department of Nursing and Health. The first student completed work for the doctor of education (EdD) in nursing education and was awarded the doctorate in 1932. Seventy-seven years later, in 2009, Teachers College was still granting EdDs in nursing education.

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In 1934, New York University initiated the first

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PhD program for nurses. The programs at Teachers College and New York University

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In 1954 the University of Pittsburgh opened the first

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PhD program in clinical nursing and clinical research in the United State

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As the 1950s drew to a close, a total of only ____ doctoral degrees had been awarded in nursing

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36

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Most nurses in the 1950s and 1960s earned doctorates in non-nursing fields, such as education, sociology, and physiology. Doctoral education for nurses moved into a new phase when the federal government initiated

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nurse scientist programs in 1962. These programs were created to increase the research skills of nurses and provide faculty for the development of doctoral programs in nursing. The nurse scientist programs were discontinued in 1975 after more universities began offering doctoral programs in nursing.

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The research-focused doctorate for students with prior degrees in nursing is the PhD. The PhD is considered

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an academic degree and prepares nurse scholars for research and the development of theory. Nurses with PhDs focus their work on the development of the science of nursing.

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In October 2004, the members of the AACN debated and passed a resolution calling for

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a new doctorate, the DNP

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Proponents of national health care reform see DNPs as

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a solution to the shortage of primary care physicians that will add to the profession's credibility

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The uniform model of regulation of advanced practice registered nurse (APRN) practice across the nation is the

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Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education

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A SAMPLE OF CERTIFYING ORGANIZATIONS IN NURSING*

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• American Association of Colleges of Nursing Certification Corporation (critical care) • American Association of Diabetes Educators • American Association of Spinal Cord Injury Nurses • American Board for Occupational Health Nurses, Inc. • American College of Nurse-Midwives • American Nurses Credentialing Center (40 areas of certification) • American Organization of Nurse Executives • American Psychiatric Nurses Association • Board of Certification for Emergency Nursing • Council on Recertification of Nurse Anesthetists • National Association of Neonatal Nurses • National Association of Nurse Practitioners • National Board for Certification of School Nurses • National Certification Corporation for Obstetric, Gynecologic, and Neonatal Specialties • Pediatric Nursing Certification Board • Rehabilitation Nursing Certification Board

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Licensure is

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required of individuals at the entry point to practice and must be renewed periodically. It is a legal designation that ensures public safety by assessing basic and continuing competence.

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Certification is a process which

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goes beyond licensure by validating a high level of knowledge and proficiency in a particular practice area. Certification has professional but not legal status.

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For the nurse to become certified

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A comprehensive examination is required as well as documentation of experience, letters of reference, and other documents. Currently, 48 organizations offer certification

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Clinical nurse specialist (CNS) certification areas

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• Adult Health CNS • Adult Psychiatric and Mental Health CNS • Child/Adolescent Psychiatric and Mental Health CNS • Diabetes Management—Advanced • Gerontological CNS • Pediatric CNS • Public/Community Health CNS

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Advanced-level certification areas other than clinical specialty

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• Nurse Executive—Advanced • Public Health Nursing—Advanced

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Specialty certifications

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• Ambulatory Care Nursing • Cardiac Rehabilitation Nursing • Cardiac Vascular Nursing • Case Management Nursing • College Health Nursing • Community Health Nursing • Gerontological Nursing • High-Risk Perinatal Nursing • Informatics Nursing • Maternal-Child Nursing • Medical-Surgical Nursing • Nurse Executive • Nursing Professional Development • Pain Management • Pediatric Nursing • Perinatal Nursing • Psychiatric and Mental Health Nursing • School Nursing

question

The requirement for mandatory continuing education is

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a way of ensuring that nurses remain up-to-date in their profession and is required in most professions including medicine, law, pharmacy, and accounting, among others. You should know your state's requirements related to CE when you become licensed. A major nationwide need is for mandatory CE as a prerequisite for license renewal. Before renewing their licenses in states and territories with mandatory CE, nurses must provide evidence that they have met contact hour requirements.

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As many as ____% of current nursing faculty are expected to retire by 2019

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75%

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The Transforming Nursing Education statement promoted

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evidence-based education; educational practices based on research into best educational practices rather than \"tradition, past practices, and good intentions\"

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The important thing for students of nursing to recognize about all nursing education reports

answer

is that nursing organizations and leaders are constantly analyzing the changes in the health care system and working to set standards by which high-quality education nursing programs can be designed, implemented, and evaluated.

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In Phases 1 and 2 of the QSEN project, Drs. Linda Cronenwett and Gwen Sherwood of the University of North Carolina at Chapel Hill School of Nursing and their team developed and pilot-tested approaches to curricula that would ensure that

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future nursing graduates had competencies in patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, and informatics

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In Phase 3 of the QSEN project, Drs. Linda Cronenwett and Gwen Sherwood of the University of North Carolina at Chapel Hill School of Nursing and their team focused on 3 goals:

answer

(1) promoting continuing innovation in the QSEN competencies and dissemination of these innovations (2) developing faculty expertise required for students to achieve quality and safety competencies (3) create mechanisms to sustain the will to change among nursing programs through nursing textbooks, accreditation and certification standards, licensure exams, and continued competence requirements.

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QSEN will be partnering with the Veterans Affairs Quality Scholars Program to support

answer

pre- and post-doctoral students in interprofessional training in quality improvement and safety

6 – 5 Educational patterns

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