Higher Education in Nursing: Three Major Historical

¶ … Higher Education in Nursing: Three Major Historical Events

"Advanced practice nursing has evolved over the years to become recognized today as an important and growing trend among healthcare systems worldwide;" the evolution of advanced nursing is directly linked to the evolution of higher education within the nursing field (Kaasalainen et al. 2010 p 35). The structure of higher education in nursing today is nothing like it was even fifty years ago. Many major events in out distant past helped push the context of higher education and gave it a more theoretical and educational standard that has allowed for advanced nursing to thrive within the context of the contemporary health care environment. First, there was Florence Nightingale's push towards embracing theoretical foundations in nursing education, then Mary Adelaide Nutting's push for some of the earliest advanced nursing education programs, and finally there was the event of the Nurse Training Act of 1964, which required nursing educators to receive their own forms of advanced degrees within specified areas.

Early Models of Nursing Education

In antiquity, nursing educational was minimal and quite frankly scary, by today's standards. Here, the research suggests that "because no formal education in the care of the sick was available, the earliest nurses learned their art through oral traditions passed from generation to generation, from observations of others caring for the sick, and many times, through a process of trial and error," (Egenes 2010 p 2). Most nurses were trained through learning within only a clinical context, with little or no educational foundation to help train them of underlying theoretical structures. Apprentice systems to facilitate the early teaching of nurses. However, this was widely criticized by academics in the healthcare industry and other genres because of its "lack of intellectual rigor and its exploitation of student labor" (Egenes 2010 p 19). These early education strategies produced nurses with extremely limited abilities and the complete inability to progress their understanding of health care practice beyond what they could see right in front of them in clinical practice.

Establishment of a Theoretical Framework in Nursing Education

Florence Nightingale began to open up for new opportunities of advanced education in nursing. She is most well-known for the founding of the Nursing St. Thomas' Hospital in London, where "nurses received classes in theory coupled with clinical experience on hospital wards" (Egenes 2010 p 5). Her efforts began to create specialization within nursing practice that would later facilitate the need for higher education practices. This essentially created a model for other educational facilities to follow that incorporated more formal educational training within the certification of nurses. Such models "offered a high standard of nursing education that served as a model for nurse training schools" (Egenes 2010 p 17). Many subsequent universities followed the Nightingale model, like the first American nursing university, the Women's Hospital of Philadelphia in 1872 (Egenes 2010). This model first presented by Nightingale continued to develop more and more formalized standards for the education of nurses around the world. In 1923, the Goldmark Report was published, which focused on setting and maintaining more educational standards within nursing education. This report also moved education to actual universities and required teachers within nursing programs receive advanced nursing training and accreditation (Egenes 2010). This was the earliest beginnings of a push towards more specified roles for advanced educational programs catering to nursing educators and nurses practicing in more specialized areas that required higher education. Often times, modern advanced nursing programs focus tremendously on application of theory, either within an educational or clinical context. The much earlier event created the push to create more advanced roles in nursing practice, "those roles being the nurse practitioner and the clinical nurse specialist" (Kaasalainen et al. 2010 p 37). This is what makes Nightingale's push for a more theoretical foundation in nursing education so long ago so crucial to the evolution of advanced nursing practice today.

Programs for Advanced Nursing

The next event took place during the Industrialization era, during the period where modern nursing practices were just taking shape. Mary Adelaide Nutting began making progress in terms of creating opportunities for providing nurses with more advanced educations beyond bachelorette training and degrees. Nutting is "well-known as an advocate of higher education for nurses" (Klainberg 2011 p 27). After initially graduating from John Hopkins University in 1891, she became one of the most influential superintendents the facility had ever seen in terms of its improvement on higher education programs for nursing students. Before Nutting, many of the hospitals nursing students worked for demanded long hours, which essentially kept them out of the context of the classroom. At John Hopkins, she contributed to the larger field of nursing education by "expanding the program for two to three years, allowing for greater time in the classroom, and by decreasing the number of hours the students were required to work in the hospital" (Klainberg 2011 p 27). Nutting knew that nursing students needed more time learning their practice in order to be more effective and efficient nurses. Here, the theoretical assumption was that nurses needed a good wealth of time learning in a more educational environment, than through the erratic environment of pure practice alone. This has continued to shape the education of nurses, both in bachelorette programs and higher education contexts. Later, at the turn of the 20th century, Nutting was crucial in the creation of the first higher education program available to nurses. She helped found the Department of Nursing and Health, Teachers College at Colombia University (Klainberg 2011). She also was a major figure in the beginning years of the scholarly journal for nursing, the American Journal of Nursing, were new research findings and practices could be shared with nurses and nursing educators alike (Klainberg 2011).