Education for nursing has evolved from hospital based Diploma programs where students learned their discipline through hands-on experience while under the direct supervision of senior nurses to formal degree programs offered through colleges and universities. In the early 1900s, Congress empowered the Army Nurse Corps to train nurses in life-saving techniques for soldiers and the prevention of the spread of infection and disease. The hospital based diploma programs continued to serve Registered Nurse graduates through the 1970s when nursing education shifted from experiential apprentice based instruction to college and university based instruction.Columbia University began offering a Bachelor Degree program and Masters in Clinical Specialty in 1923 and 1956, respectively. Starting in 1925, Yale required applicants to complete two years of general education before entering the School of Nursing’s three-year program.
In 1988, the National League of Nursing lobbied nursing schools to revise their curriculums to meet the changing needs of the American’s society. New graduates needed to be leaders for health promotion and disease prevention, which required more critical thinking and a role expansion within the changing health care system.
Twenty years later, the National League of Nurses reported four notable changes regarding nursing. First, more nurses were employed in nonhospital positions as health care delivery shifted from inpatient to outpatient. Second, the need for evidenced based practice was increasing. Third, nursing team leadership roles were expanding, and fourth, that solely increasing the number of nurses working in the system would not solve the current and future nursing shortage.
In a 2010 report from the Institute of Medicine titled “The Future of Nursing: Leading Change,” it was noted that 50% of nursing graduates hold a university issued Bachelor degree. My experience has shown this to come from two areas, the first being that many students eager to gain employment enter nursing though the two-year community college based Associates Degree programs (60%) and many later in their careers, continue forward to earn various types of Bachelor’s degrees through university based degree completion programs such as a Bachelor of Health Care Services, Bachelor of Science in Nursing as well as various Business and Management degree completion programs. The second way that nurses obtain a Bachelor’s Degree has been through traditional university-based Schools of Nursing through 4 year tracks as well as transfers to University-based BSN programs from community-based colleges where student complete their general science and educational prerequisites courses prior to attending the University based curriculum.
Nurses are expanding their roles from the bedside to the C-suite in many healthcare organizations. They are building on their clinical knowledge with new dimensions. As examples, nurses are enrolling in graduate programs such as Health Informatics and Healthcare MBA as well as progressing in their discipline with Advanced Practice Registered Nurse (APRN), and Certified Registered Nurse Anesthetists (CRNA) degrees. Florida International University has experienced increased enrollments in these as well as the Doctorate of Nursing Practice (DNP) program. Nurses have become re-energized about their future roles as leaders in various clinical as well as management settings within complex integrated health care delivery systems.
This is good news! As noted in a 2010 NEJM article titled “Nurses for the Future,” as the level of education of nurses increase so do positive patient outcomes. Based on the increase of positive patient outcomes sufficient Federal funding should be made available to support educational initiatives for both university program development as well as support for student participation.
