VIEWPOINT
By Susan LaRocco, PhD, RN
Where Are the Visionary Nursing Leaders of 1965? We need a coherent approach to entry into practice more than ever.
I
n 1969, when I began my nursing training, eva baccalaureate education. Students need more than eryone “knew” that the best nurses came from two years to prepare to take their place as members hospital-based diploma programs. At the hosof an interprofessional health care team in a variety pital, we believed that the students who attended a of complex health care settings. baccalaureate program had book learning but lacked Countries large (Brazil, South Korea, China) and practical skills and common sense. small (Portugal, Ireland, Sweden) have implemented But lurking in the background was the “Ameria baccalaureate requirement or a near equivalent can Nurses Association’s [ANA’s] First Position on for entry into professional nursing practice. For 10 Education for Nursing,” published in AJN in 1965, years, New York State has flirted with a proposal which asserted that “the educapopularly known as the “BSN tion for all those who are liin 10” initiative. If enacted, all censed to practice nursing new nurses would need to obLet’s make the should take place in institutain a baccalaureate within 10 tions of higher education” and years to maintain their license baccalaureate that “minimum preparation (currently licensed RNs and the de facto for beginning professional nurs current nursing students are exing practice at the present time empt). However, this bill has requirement. should be baccalaureate degree languished in the legislature. education in nursing.” In the Other states, such as Oregon, same paper, the ANA proposed have also developed initiatives that the “minimum preparation for beginning techto promote baccalaureate education. But encouragnical nursing practice” should be an associate’s deing education is not the same as passing legislation gree education. that makes it a requirement, and North Dakota, the As a student, I was concerned. What would my one state that had successfully established the requirediploma education mean in the future? We were asment of a baccalaureate for entry into practice, resured by our nursing instructors that we would be scinded it in 2003. grandmothered in and that our license as a profesWhile state boards of nursing and legislatures fail to sional nurse, an RN, would be secure. It is now more act to change the entry requirements for professional than 40 years since I graduated from my hospitalnursing, in many areas of the country the baccalaurebased diploma program and almost 50 years since ate is becoming the de facto requirement. Major medithe ANA position paper was published. Rather than cal centers in the Boston area no longer hire nurses worrying about the status of my nursing license, I am with associate’s degrees. At least one large, for-profit worried about the profession of nursing. hospital chain has decreed that their nurses must obIn 1965, the ANA argued that the knowledge tain a baccalaureate within a stipulated period of needed by the nurse practicing today “differs greatly time, typically three to five years. Nurses with associfrom that needed 20 or even 10 years ago. She is now ate’s degrees are limited in both their initial employbeing required to master a complex, growing body ment opportunities and their long-term options. of knowledge and to make critical, independent judgWhile the leaders of 1965 were visionary in their ments about patients and their care.” At the time of proposal of baccalaureate education as the entry to my prelicensure education, though, there was far less professional nursing, they were less effective in cretechnology to master on the usual hospital unit. Even ating the change that they proposed. Will our curin ICUs and dialysis units, the technology was basic. rent nursing leaders be successful in completing this But after four decades as a direct care provider, as an unfinished business? ▼ administrator, and in faculty positions in associate’s Susan LaRocco is a professor of nursing at Curry College, degree and baccalaureate programs, I believe that the Milton, MA. Contact author: [email protected]. The increased complexity of the work and the explosion author has disclosed no potential conflicts of interest, finanof knowledge require nurses who have a minimum of cial or otherwise. [email protected]
AJN ▼ April 2014
▼
Vol. 114, No. 4
11
By Susan LaRocco, PhD, RN
Where Are the Visionary Nursing Leaders of 1965? We need a coherent approach to entry into practice more than ever.
I
n 1969, when I began my nursing training, eva baccalaureate education. Students need more than eryone “knew” that the best nurses came from two years to prepare to take their place as members hospital-based diploma programs. At the hosof an interprofessional health care team in a variety pital, we believed that the students who attended a of complex health care settings. baccalaureate program had book learning but lacked Countries large (Brazil, South Korea, China) and practical skills and common sense. small (Portugal, Ireland, Sweden) have implemented But lurking in the background was the “Ameria baccalaureate requirement or a near equivalent can Nurses Association’s [ANA’s] First Position on for entry into professional nursing practice. For 10 Education for Nursing,” published in AJN in 1965, years, New York State has flirted with a proposal which asserted that “the educapopularly known as the “BSN tion for all those who are liin 10” initiative. If enacted, all censed to practice nursing new nurses would need to obLet’s make the should take place in institutain a baccalaureate within 10 tions of higher education” and years to maintain their license baccalaureate that “minimum preparation (currently licensed RNs and the de facto for beginning professional nurs current nursing students are exing practice at the present time empt). However, this bill has requirement. should be baccalaureate degree languished in the legislature. education in nursing.” In the Other states, such as Oregon, same paper, the ANA proposed have also developed initiatives that the “minimum preparation for beginning techto promote baccalaureate education. But encouragnical nursing practice” should be an associate’s deing education is not the same as passing legislation gree education. that makes it a requirement, and North Dakota, the As a student, I was concerned. What would my one state that had successfully established the requirediploma education mean in the future? We were asment of a baccalaureate for entry into practice, resured by our nursing instructors that we would be scinded it in 2003. grandmothered in and that our license as a profesWhile state boards of nursing and legislatures fail to sional nurse, an RN, would be secure. It is now more act to change the entry requirements for professional than 40 years since I graduated from my hospitalnursing, in many areas of the country the baccalaurebased diploma program and almost 50 years since ate is becoming the de facto requirement. Major medithe ANA position paper was published. Rather than cal centers in the Boston area no longer hire nurses worrying about the status of my nursing license, I am with associate’s degrees. At least one large, for-profit worried about the profession of nursing. hospital chain has decreed that their nurses must obIn 1965, the ANA argued that the knowledge tain a baccalaureate within a stipulated period of needed by the nurse practicing today “differs greatly time, typically three to five years. Nurses with associfrom that needed 20 or even 10 years ago. She is now ate’s degrees are limited in both their initial employbeing required to master a complex, growing body ment opportunities and their long-term options. of knowledge and to make critical, independent judgWhile the leaders of 1965 were visionary in their ments about patients and their care.” At the time of proposal of baccalaureate education as the entry to my prelicensure education, though, there was far less professional nursing, they were less effective in cretechnology to master on the usual hospital unit. Even ating the change that they proposed. Will our curin ICUs and dialysis units, the technology was basic. rent nursing leaders be successful in completing this But after four decades as a direct care provider, as an unfinished business? ▼ administrator, and in faculty positions in associate’s Susan LaRocco is a professor of nursing at Curry College, degree and baccalaureate programs, I believe that the Milton, MA. Contact author: [email protected]. The increased complexity of the work and the explosion author has disclosed no potential conflicts of interest, finanof knowledge require nurses who have a minimum of cial or otherwise. [email protected]
AJN ▼ April 2014
▼
Vol. 114, No. 4
11
