Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 179

Mary Adelaide Nutting, a renowned nurse educator and activist, declared in 1908, “There is no place in its (the hospital) strenuous scheme of life for the machinery of a school. All the space, the effort, the means which the hospital can provide are needed to carry out its immediate purpose, which is the care of the sick, and any scheme of education must, of necessity, take a secondary and insignificant place” (Nutting cited in Grace, 1978, p. 20). In other words, nursing education had to get out from under hospital control. But, until the mid‐1950s, most nursing programs continued in the 3‐year diploma, hospital‐based training model.

University programs for nurses had been around since 1909, but their development was accelerated by a study, commissioned in 1948 by the National Nursing Council, to examine who should organize, administer, and finance schools of nursing. The National Nursing Council was composed of multiple constituent nursing organizations. The study's Director, Esther Lucille Brown, an anthropologist, strongly recommended that nursing education move out of hospitals and into colleges and universities (Brown, 1948). Starting in the mid‐1950s, the number of 3‐year diploma, hospital‐based nurse training schools went down and the number of baccalaureate and associate degree programs increased.

In the early 1950s, after World War II, there occurred, as has happened quite regularly over the years, a nursing shortage. Nurses leaving the profession, many of whom wanted to get married or to start a family after the war, exacerbated this shortage. Other nurses, who had served in the armed forces, didn't want to return to the constraints and rules of civilian nursing and, possibly, wanted to utilize the G.I. Bill of Rights to gain a college education. In addition, the Hill‐Burton Act of 1946 supported extensive new hospital construction, which required more nurses. Mildred Montag, a nurse who was pursuing a doctorate in education at Teachers College, Columbia University, in New York, proposed a novel educational solution. Her dissertation, titled “Education for Nursing Technicians,” proposed a 2‐year Community College program for nurses. Nursing technicians could, as conceived by Montag, perform the technical rather than the professional components of nursing (Montag, 1963). A later grant enabled Montag to put her proposal into action in seven Community Colleges in six states, New York, New Jersey, Michigan, Utah, California, and Virginia (Montag, 1959). Montag's study showed that the 2‐year nursing program, and at this time it was just 2 years, with 1 year of general studies and 1 year of nursing, attracted non‐traditional students. Furthermore, graduates of the 2‐year program compared favorably with 3‐year diploma graduates in terms of test scores and satisfaction from all parties. Montag's plan was for the 2‐year associate degree program to develop a technical nurse—not a “professional” one (Montag, 1963). She thought that associate degree and baccalaureate degree programs should not blend with each other because they were just too different (Orsolini‐Hain & Waters, 2009). Supported by the Nurse Training Act of 1964, associate degree nursing programs grew exponentially. By 1980, approximately 80% of new graduates were from associate degree programs (Orsolini‐Hain & Waters, 2009).

Meanwhile, back in 1899, Teacher's College at Columbia University in New York had established the first graduate education program for nurses in the fields of hospital economics and educational administration (Grace, 1978). However, the bulk of nursing graduate education was developed in the 1950s and 1960s, as the need for nurse educators in the college programs expanded (Gerard, Kazer, Babington, & Quell, 2014). The early nursing graduate programs focused mainly on education and administration. Later, in the 1960s, graduate degrees for clinical nursing roles came to the forefront (Gerard et al., 2014).