● Describe your professional identity.

 ● Answer “What do nurses do?”

● Describe your professional socialization thus far.

● Discuss Basic Student Socialization as explained in Cohen’s Model and Benner’s Model.

● Why is socialization important?

 ● Which of the five nurses featured in The American Nurse film do you relate to the most and why?

● Which of the five nurses featured in the film do you relate to the most?

 ● Which scenario in the film spoke to you or made you feel especially connected?Write down or take note of a specific scene, dialogue, object, activity, visual cue, etc., that captured your attention and explain why.

Carolyn Jones – The American Nurse (Links to an external site.) To watch The American Nurse https://kinonow.com/account/videos Chapter 4

Nursing Education In An Evolving Health Care Environment

Future of Nursing:

 Leading Change and Advancing Health

❖ 2009: Patricia Benner – Educating Nurses: A Call for Radical Transformation

 ❖ 2011: Institute of Medicine – The Future of Nursing: Leading Change. Advancing Health. 4 Key Messages.

❖ 2009: Aiken and call for increased federal support ˜2010: Tri-Council for Nursing and Policy Statement

❖ ANA urged Congress to increase funding for Title VIII Nursing Workforce Development Programs (as contained in Public Health Service Act).

2011: IOM: The Future of Nursing: Leading Change. Advancing Health. 4 Key Messages.

● Nurses must practice to the fullest extent of their education and training.

● Nurses should attain higher education levels through a system of improved education with seamless progression across degrees.

● As health care in the United States is being transformed, nurses should be full partners with other health care professionals in this effort.

● Improved data collection and information infrastructure can result in more effective workforce planning and policy development.

Development of Nursing Education in the United States

Florence Nightingale and formal nursing preparation Ø1860: St. Thomas Hospital in London

Belief: Nursing schools should be financially and administratively separate from hospitals.

1873: Establishment of first US training schools

 1900: 432 hospital-owned and hospital-operated nursing programs NUR 3805 UCF Module 1 Professional Identity Socialization Questions Diploma programs – hospital based nursing education. Nursing students staffed the hospital.High-quality nursing education was not the priority Early Studies of the Quality of Nursing Education Oct 1899: American Society of Superintendents of Training Schools – Isabel Hampton Robb Investigate ways to prepare nurses for leadership ØTeachers College 1907: Mary Adelaide Nutting, first nursing professor in History School at Teachers College – Mother House of collegiate education

 The Educational Status of Nursing” focused on students’ living conditions, nursing education curricula, and teaching methods.Early Studies of the Quality of Nursing Education 1923: The Study of Nursing and Nursing Education in the United States (Goldmark Report) focused on:Clinical learning experiences of students, Hospital control of the schools,Desirability of establishing university schools of nursing, Lack of funds specifically for nursing education Lack of prepared teachers (Kalisch and Kalisch, 1995) Early Studies of the Quality of Nursing Education

★ 1924: Yale University opened the school of nursing*. NUR 3805 UCF Module 1 Professional Identity Socialization Questions

★ 1934 – Nursing Schools Today and Tomorrow – reported the number of existing schools (NLNE, 1934)

★ 1937 – A Curriculum Guide for Schools of Nursing – outlined 3-year curriculum (NLNE, 1937)

Recommendations of Early Studies of Nursing Education

● Nursing education programs should be established within the system of higher education.

● Nurses should be highly educated. 

● Students should not be used to staff hospitals.

Standards should be established for nursing practice.

● All students should meet certain minimum qualifications on graduation.

Educational Paths to Become a Registered Nurse

1. Diploma Programs

2. Baccalaureate Programs

 3. Associate Degree Programs Diploma Nursing Program

Peak: 1920–1930 – ~200 programs in almost any status

Mid 1960s – dramatic decline caused by: Growth of ADN and BSN programs, a move to the mainstream of higher education

1. Inability of hospitals to continue to finance nursing education

2. Accreditation standards have made it difficult for diploma programs to attract qualified faculty

3. Increasing complexity of health care has required nurses to have greater academic preparation.

Diploma Nursing Programs

1800-early 1900s – Diploma programs provided formal education and jobs to women.

➢ Modified apprenticeship model ØDemanding schedule

➢ Duration: 3 years (current programs: 24 months)

 ○ Most colleges and universities did not recognize diploma programs.

➢ Current practice: Diploma programs establish agreements with colleges and universities.

Baccalaureate Programs

➢ Nurses need a bachelor’s degree to qualify nursing as a recognized profession and to provide leadership in administration, teaching, and public health.

➢ 1909: First BSN program in University of Minnesota

➢ 1919: Seven BSN programs. Most BSN programs were 5 years in duration.

➢ Growth of BSN was slow because of:

○ The reluctance of universities to accept nursing as an academic discipline

○ The power of the hospital-based diploma programs Baccalaureate Programs

➢ The theoretical, scientific orientation of the BSN program was in sharp contrast to the “hands-on” skill and service orientation that was the hallmark of

hospital-based diploma education.

○ Influences on the Growth of Baccalaureate Education

➢ 1948: Lucille Brown. Nursing for the Future. (The Brown Report). Sponsor: Carnegie Foundation.

○ Recommendation: Basic schools of nursing must be placed in universities and colleges with an effort to recruit men and minorities.

1965: ANA Position Paper. Educational preparation for Nurse Practitioners and Assistants to Nurses. It did not refer to Medicare and Medicaid.

○ It concluded that baccalaureate education should become the foundation for professional practice.Influences on the Growth of Baccalaureate Education ˜1970: National Commission for the Study of Nursing and Nursing Education published An Abstract for Action (Lysaught Report)

It made recommendations concerning supply and demand for nurses, nursing roles and functions, and nursing education.

Priorities identified by the study:

■ The need for increased research into both practice and education of nurses

 ■ Enhanced educational systems and curricula Influences on the Growth of Baccalaureate Education˜1980: National Commission on Nursing

 The major block to the advancement of nursing was the ongoing conflict about educational preparation for nurses.


 ■ Establish a clear system of nursing education including pathways for educational mobility and development of additional graduate education programs (DeBlack, 1991)

Influences on the Growth of Baccalaureate Education−1982 National League for Nursing Position Statement on Nursing Roles: Scope and Preparation – affirmed BSN as the minimum educational level for professional nursing practice and ADN or diploma as the preparation for technical nursing practice.˜1996: AACN Position Statement. The baccalaureate Degree in Nursing as the Minimal Preparation for Professional Practice.It supports articulated programs which enable ADN nurses to attain BSN. Characteristics of Pre-licensure Baccalaureate Programs

˜4-year program. General education + nursing courses. Faculty qualifications – minimum of master’s degree −BSN graduates are eligible to take licensure exams, prepared to move into graduate programs and advanced practice certification programs.˜2008 AACN. The Essentials of Baccalaureate Education for Professional Nursing Practice

―Rhode Island Nurses Institute Middle College Charter High School in Providence Associate Degree Program ―It Began in 1952. It is based on a model developed by Mildred Montag.

˜Popularity of ADN is due to ØAccessibility of community colleges ØLow tuition costs Part-time and evening study opportunities ØShorter duration of programs ØGraduates’ eligibility to take the RN licensure exam

Associate Degree Programs

 ˜Mildred Montag’s ADN program

Short duration to prepare nurse technicians

 Nurse technicians function under supervision of professional nurses ØRoutine care in acute and long-term settings

Intended for end-point degree and not an incremental step to BSN

˜Current trends in ADN programs External Degree Programs

˜Students attend no classes.

 ˜Excelsior College (formerly: NY Regents External Degree Nursing Program)

 It does not offer clinical experiences to those seeking a basic nursing education and as such they are encouraged to seek basic education that includes clinical instruction.

1981: California State University Consortium offered a statewide external BSN program.

 Articulated Programs

 ˜Definition: Mobility between programs

 ˜Purpose: Facilitate opportunities to move up the educational ladder.

˜Multiple-entry and multiple exit programs

Articulation agreements facilitate student movement between programs and accept transfer credit between institutions. These result in acceleration or advanced placement.

Alternate Paths in Nursing Education: Baccalaureate Programs for Registered Nurses RN-to-BSN Education

˜Diploma and ADN nurses are given credits to meet certain BSN requirements.

 ˜Transfer of general education courses ˜Options for advanced placement Programs for Second-degree Students

 ˜Accelerated or fast-track sequence to award a second bachelor’s degree or in some cases MSN

 Alternate Paths in Nursing Education: Baccalaureate Programs for Registered Nurses Online and Distance Learning Programs ˜Intended to improve access for nurses from rural areas ˜Online education provides flexibility.

 ˜Distance Learning and issues of adequate and properly supervised clinical experiences

˜Fraudulent programs

˜Before committing to an online program… Accreditation: Ensuring Quality Education

Accreditation – voluntary educational programs by review process of a professional organization

˜The accrediting agency compares the educational quality of the program with established standards and criteria.

˜It derives authority from the US Department of Education.

˜Two agencies:

 Accreditation Commission for Education in Nursing (ACEN) ØCommission on Collegiate Nursing Education (CCNE)

Accreditation of Nursing Schools 

˜An accredited program voluntarily adheres to standards that protect the quality of education, safety, and the profession itself.

 ˜Accrediting agencies establish standards by which program effectiveness is measured. Self-study and site visits ØContinued accreditation ØDeficiencies

˜Implications on prospective students and graduates Accrediting Agencies

-Commission on Collegiate Nursing Education (CCNE) – national agency for accreditation of bachelor’s and graduate nursing education programs. 

̃Accreditation Commission for Education in Nursing (ACEN) – accredited LPN/LVN, diploma, and ADN programs.

 It has a close relationship with the National League for Nursing.

Advanced Degrees in Nursing: Master’s Education

 ˜What is the purpose of master’s education? ˜1899: Teachers College and graduate education

−1950–1960s: Master’s degree as a terminal degree.

˜1970s: Development of doctoral degrees ØMaster’s degrees were shortened and emphasized on clinical specialization.

 Master’s programs sought voluntary accreditation from either ANEC or CCNE. Advanced Degrees in Nursing: Master’s Education˜Entrance requirements ˜Duration of the program ˜Curriculum NUR 3805 UCF Module 1 Professional Identity Socialization Questions ˜Major areas of role preparation Administration, case management, informatics, health policy/health care systems, teacher education, clinical nurse specialist, NP, nurse-midwifery, nurse anesthesia, and other clinical and nonclinical areas of study

˜Common graduate degrees

Advanced Degrees: Doctoral Education

Doctoral programs prepare nurses to become faculty members in universities, administrators in schools of nursing or large medical centers, researchers, theorists, and advanced practitioners.

Research-focused degree—doctor of philosophy (PhD) ØPractice-focused degree—doctor of nursing practice (DNP) Advanced Degrees: History of Doctoral Education˜1910: Columbia University’s Teachers College – creation of the Department of Nursing and Health˜1934: New York University initiated the first PhD program for nurses.

˜1934–1953: No new nursing doctoral programs were opened.

 -1954: University of Pittsburgh opened the first PhD program in clinical nursing and clinical research.

 ˜1962: The federal government initiated nurse scientist programs. NUR 3805 UCF Module 1 Professional Identity Socialization Questions

˜1975: Nurse scientist programs were discontinued. Current Status of Doctoral Education in Nursing ˜PhD – research-focused doctorate and DNS or DNSc – doctor of nursing science

˜Oct 2004: AACN called a new doctorate, DNP ØProponents ØDetractors

˜ DNP and the shortage of primary care physicians

Becoming Certified: Validating Knowledge & Proficiency

˜Licensure ˜Certification

 Benefits of being a certified nurse ØANCC and standardized certification ØRequirements

Continuing Education: Maintaining Expertise and Staying Current

● Lifelong learning ˜Versus: Staff development ˜Role of ANCC

● Contact hours

 ● Mandatory continuing education Challenges

➢ Faculty and other resources shortages

○ Average age of professors: 59 years

 ○ Average age of associate professors: 52 years

○ Trends

 ➢ Quality and safety education for nurses (QSEN)

 ➢ IOM (2003) identified five problems in professional health education.

Continuing the Evolution of Nursing Education

➢ 2005: NLN Position Statement: Transforming Nursing Education – emphasis on evidence-based education

➢ 2008: NLN Position Statement: Preparing the Next Generation of Nurses to Practice in a Technology-rich Environment: An Informatics Agenda – call on nursing programs to prepare graduates to use of electronic health records

What is an accurate statement regarding nurse certification?

● Certification is required at the entry point to practice.

 ● Certification is the government’s way of ensuring currency in practice.

 ● Certification refers to agency efforts to maintain competence.

 ● Certification validates knowledge, skills, and abilities.