Ch. 7 education of nursing
Challenges in Nursing Education
Inability of nursing programs to produce enough nurses to meet society's need as a result of several causes, including: -Lack of capacity in nursing schools -Faculty shortages due to retirement and low salaries
Continuing Education in Nursing
Non-degree-seeking ways to maintain expertise in nursing; "life-long learning" The nationwide need is for mandatory CE as a prerequisite for license renewal.
ANCC is responsible for:
Standards of continuing education (CE) Accreditation of CE programs Transferability of CE from state to state Development of guidelines for states' recognition systems
Need to transform nursing education for complex U.S. health care needs (IOM, 2003) based on:
Students not educated to care for diverse patient types Students not educated to work in teams Students not educated to access and use scientific evidence in practice Students unprepared to identify and eliminate errors or problems Students not provided basic informatics training
The requirement for mandatory continuing education is a government's 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.
Programs for "second degree" students:
type of extern degree program that includes: *second bachelor's program *Generic master's degree programs: Accelerated MSN programs for individuals with bachelor's degrees in another field *Generic nursing doctorate (ND)
Articulated programs
-"Articulation": mobility; multiple entry/multiple exit programs -Move from licensed practical/vocational nurse (LPN/LVN) to ADN to BSN to MSN or higher -Can terminate at any degree level to take licensure exam
Accreditation of Educational Programs
-All nursing programs require approval by the state board of nursing. -Accreditation is a supplementary, voluntary review process. -Courses/programs are reviewed by professional nursing organizations.
Certification is possible at different education levels
-An advanced practice nurse: use the initials APRN, BC after their name -Bachelor's degree: RN, BC -Diploma and associate degree: RN,C
Educational Preparation for Nurse Practitioners and Assistants to Nurses (1965) "position paper": By the ANA
-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.
Certification Programs in Nursing
-Certification goes beyond licensure to validate a high level of knowledge and proficiency in a practice area. -American Nurses Credentialing Center (ANCC) is largest certification body in the United States.
Accrediting bodies include
-Commission on Collegiate Nursing Education (CCNE): Accreditation for BSN, MSN, and doctoral programs -National League for Nursing Accreditation Commission (NLNAC): Four councils for ADN, diploma, BSN, and MSN/doctoral programs
Accrediting agency
-Compares the educational quality of the program with established standards and criteria. -Derive their authority from the U.S. Department of Education.
Educational Pathways to Becoming a Professional Nurse
-Diploma program:Hospital-based 24-month program (registered nurse [RN] eligible) -4-year bachelor's of science in nursing (BSN) degree program -2-year associate degree in nursing (ADN) program
Diploma Programs
-Earliest type of nursing education *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 United States *Colleges and universities did not recognize the diploma as an academic credential, refusing college credit.
University of Minnesota (1909)
-First bachelor's degree program established was the start of the movement of brining busing education into the recognized system of higher education
Doctorate of nursing practice (DNP)
-For practice in advanced clinical roles, such as CNP or CNM -may prove a solution to shortage of primary care physicians
Master's Education
-Prepare for roles in administration, case management, informatics, health policy/health care systems, teacher education, clinical nurse specialist, certified nurse practitioner (CNP), certified nurse-midwife (CNM), certified registered nurse anesthetist (CRNA), and others -Emphasis on advanced practice through clinical specialization -Increased demand for CNPs has resulted in tripling the number of CNP programs in the United States.
Recommendations of Early Nursing Education Studies
-Programs should be established within the U.S. system of higher education. -Nurses should be highly educated. -Students should not be used to staff hospitals. -Standards for nursing practice should be established. -All students should meet minimum graduation requirements.
Associate Degree Programs
-Provide basic education for licensure -Popularity the result of accessibility, 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 in nursing (MSN) -Graduate the most RN candidates of all basic programs
Bachelor's Degree Programs Today
-Provide college education and preparation for licensure after passing NCLEX-RN®, as well as advanced college education for established RNs -Faculty qualifications usually high -Equips graduates to practice within complex health care systems and to assume multiple nursing roles
External Degree Programs
-Students attend classes infrequently or not at all. -Learning is independent via online study ("virtual university"). -They can include BSN, MSN, or doctoral programs. -Bachelor's degree program for RNs -Online and distance learning programs
Doctorate of philosophy (PhD)
-prepares nurse scholars for research and development of theory -focus work on the development of the science of nursing.
in 1979 the ANA further strengthened its resolve by proposing three additional positions (ANA, 1979):
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.
ANA position paper major recommendations
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.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.
Brown Report (1948)
: by the Carnegie Foundation, recommended that basic schools of nursing be placed in universities and colleges
Which of the following is the most common type of basic nursing education program in the United States and graduates the most RN candidates of all the basic programs?
ADN programs: Education is the newest form of basic preparation for registered nurse practice. Begun in 1952 as a result of a post-World War II nursing shortage, based upon a model developed by Dr. Mildred Montag, and fueled by the post-WWII community college movement of the 1950s, associate degree programs are now the most common type of basic nursing education program in the United States and graduate the most registered nurse candidates of all the basic programs. (p. 15)
Accreditation promotes
Adherence to standards that: Protect quality of education, Protect public safety, Protect the nursing profession
ADN 24-month or longer curriculum
Focus on:Nursing science and clinical nursing skills, Decision making, Leadership
The Study of Nursing and Nursing Education "Goldmark Report" (1923)
Focused on clinical learning experiences, hospital control of education, desirability of university-based schools, funding, and lack of prepared teachers
Nursing Schools Today and Tomorrow (1934) by National League of Nursing Education (NLNE)
Focused on schools, curricula, professional collegiate education
The Educational Status of Nursing (1912) by Mary Adelaide Nutting
Focused on teaching methods, material being taught, and living conditions of students
BSN 4-year curriculum
General and Nursing focus on:Liberal arts, Nursing science and clinical nursing skills, Communication, Decision making , Leadership, Care to all patients in a variety of settings
The inability of nursing programs to produce enough nurses to meet society's need is a result of...
Lack of capacity in nursing schools Faculty retirement levels Low salaries for nursing professors
A Curriculum Guide for Schools of Nursing (1937)
Outlined 3-year curriculum and influenced school structure
National League for Nursing (NLN; 1982)
Position Statement on Nursing Roles: Scope and Preparation, which affirmed the BSN as the minimum educational level for professional nursing practice and the ADN or diploma as the preparation for technical nursing practice
Doctoral Education
Prepare for teaching as faculty in universities, administrators in nursing schools or large medical centers, researchers, theorists, and advanced practitioners
In the early days of diploma and hospital-based nursing programs, what was one of their primary contributions for women in society?
Provide an avenue for formal education and jobs. In the early days of formal nurses' training in the United States, nursing diploma (hospital-based) programs provided one of the few avenues for women to obtain formal education and jobs. (Chaper 7, "Diploma Programs")
Multiple U.S. certifying organizations
cause lack of uniformity and can create confusion among nurses.
National Commission for the Study of Nursing and Nursing Education published An Abstract for Action (Lysaught). Also known as the Lysaught Report,
made recommendations concerning the 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. (Black 136) Black, Beth P. Professional Nursing: Concepts & Challenges, 7th Edition. W.B. Saunders Company, 2014. VitalBook file.
The growth in the numbers of BSN programs was slow because...
of the reluctance of universities to accept nursing as an academic discipline and because of the power of the hospital-based diploma programs.
Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education
sets forth a uniform model of regulation of advanced practice registered nurse (APRN) practice across the nation.
AACN approved The Baccalaureate Degree in Nursing as Minimal Preparation for Professional Practice.
supports articulated programs, which enable associate degree nurses to attain a BSN