Chapter 3: Nursing Education

Continuing Education

● "life-long learning" ● Mandatory continuing education ● Contact hour- measure of CE credit. 1 CE = 50-60 minutes in a CE course ● Staff development: refers to how an agency or institution assists its employees in maintaining competence

Baccalaureate Programs

● 1909 (University of Minnesota): first bachelor's degree program established ● Brown Report (1948): by the Carnegie Foundation, recommended that basic schools of nursing be placed in universities and college s ● ANA (1965) published Educational Preparation for Nurse Practitioners and Assistants to Nurses -BSN should become the basic foundation for professional practice -This was controversial and fostered conflict and division within nursing -Practicing nurses vehemently protested its recommendations ●National League for Nursing (NLN; 1982): Affirmed BSN as minimal educational level ●The Baccalaureate Degree in Nursing as Minimal Preparation for Professional Practice (1996): By AACN

Programs for Second-degree students

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

Accreditation of Educational Programs

● Accreditation goes beyond minimum state approval ● The accrediting agency compares the quality of the program with established standards and criteria ● Accreditation promotes adherence to standards that protect quality of education, safety, and the nursing profession ● Commission on Collegiate Nursing Education (CCNE) -Accreditation for BSN, MSN, and doctoral program ● National League for Nursing Accreditation Commission (NLNAC) - Four councils for ADN, diploma, BSN, and MSN/doctoral program ● All programs require approval by the State Board of Nursing

Master's Education

● BSN, standardized test, 3.0 GPA, experience for entry ● MS, MSN most common ● Emphasis on advanced practice through clinical specialization ● Prepare for roles in administration, case management, informatics, health policy/health care systems, teacher education, clinical nurse specialist, certified nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist, and others

Articulated Programs

● Def: 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

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

Challenges in Nursing Education

● Inability of nursing programs to produce enough nurses to meet society's need as a result of several causes: -Lack of capacity in nursing schools (1/3 of applicants denied) -Faculty shortages (retiring, low salaries, demands)

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 ● Requires discipline

Validating Knowledge & Proficiency

● Licensure -Required to practice -Must be renewed -Legal designation to ensure public safety ● Certification - Validates a high level of knowledge/proficiency -Usually practice area-specific -Professional but not legal status

What was education like prior to Nightingale?

● Nurses had no formal preparation ● No organized programs to educate nurses ● Nursing care was administered by relatives, self-trained persons, and military or religious affiliates ● Nursing seen as a domestic, charitable service

Main 3 Educational Paths (RN):

1. Diploma Program -Earliest from & currently declining -Hospital-based 24-month program 2. Baccalaureate Programs -3 to 5 years 3. Associate degree in nursing (ADN) program -2 to 3 years

Recommendations of Early Studies of Nursing Education

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 to staff hospitals 4. Standards should be established for nursing practice 5. All students should meet certain minimum qualifications on graduation

Accreditation

Voluntary review process of educational programs by a professional organization

Associate Degree Programs

● Originally proposed as a solution to a nursing shortage ● Provide basic education for licensure ● Newest form/most common type of preparation for RN practice ● Focus on beside nursing skills ● Popular due to: low cost, part-time and evening study options, shorter duration of education, eligibility for licensure ● Often used as a step in progression toward BSN or master's of science of nursing (MSN) ● Graduate the most RN candidates of all basic programs

Doctoral Education

● Prepare for teaching as faculty in universities, administrators in nursing schools or large medical centers, researchers, theorists, and advanced practitioners ● Doctorate of philosophy (PhD): for a research or theory development focus ● Doctorate of nursing practice (DNP): for practice in advanced clinical roles, such as CNP or CNM ● May provide a solution to shortage of primary care physicians

Baccalaureate Programs Today

● Provide college education and preparation for licensure after passing NCLEX-RN as well as advanced college education for established RNs ● 4 year curriculum with general and nursing focus on: liberal arts, nursing science, clinical nursing skills, decision making, leadership, care to patients in a variety of settings ● Faculty qualifications usually high ● Equips graduates to practice within complex health care systems and to assume multiple nursing roles ● Prepare graduates to move into advanced practice programs

Diploma Programs

● Provided avenue for women to obtain formal education and jobs ● 2000 programs at peak during 1920s through 1930s ● Eventually faced problem of being outside the higher education system in the US -colleges and universities did not recognize the diploma as an academic credential, refusing college credit ● Today's diploma programs usually have established agreements with colleges and universities to allow college credit for courses

What hospital was started in 1860 by Nightingale and formal nursing preparation?

● St Thomas Hospital in London

Concerns about the poor quality of nurse training programs led to....

● The Educational Status of Nursing (1912) -by Mary Adelaide Nutting-first nursing professor ●The Study of Nursing and Nursing Education, also called "Goldmark Report" (1923) ●Nursing Schools Today and Tomorrow (1934) by National League of Nursing Education (NLNE) ● A Curriculum Guide for Schools of Nursing (1937)

Development of Nursing Education

●Belief: Nursing schools should be financially and administratively separate from hospitals ● 1873: Establishment of 1st US training schools ● 1900: 432 hospital-owned and hospital-operated nursing programs ●Diploma programs: hospital based nursing education -Nursing students staffed the hospital -High-quality nursing education was not the priority