NURS 3000 – Issues and Trends in Nursing Assignment.

NURS 3000 – Issues and Trends in Nursing Assignment.

Improvement of healthcare delivery in the United States relies on many factors, such as effective nurse advocacy through politics, policy, and professional associations. But advocacy depends on the ability to fully understand current issues, systems, policies, and related contexts. NURS 3000 – Issues and Trends in Nursing Assignment.In this course, students engage in a systems-level analysis of the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery.

Through policy analysis assignments students apply legislative, regulatory, and financial processes relevant to their organization and provision of healthcare services in their community. Students consider the impact of these processes on quality and safety in nursing practice environment and disparities in the healthcare system. NURS 3000 – Issues and Trends in Nursing Assignment.Through this course, students gain the knowledge and skills needed to advocate for vulnerable populations and promote positive social change. (Prerequisites: NURS 3000) Note: Students must take this course first in their sequence.

N URSING education is undergoing,
drastic changes. History repeating herself through a new social expression has kept consistently in step
with the development and progress in
related fields of life activity. The demand today for a different preparation
for the nurse, general and professional,
is a demand not of the idealist but of
the times. NURS 3000 – Issues and Trends in Nursing Assignment.
It is hardly necessary to trace the evolution of nursing practice from an age-old emotional expression in response to human suffering to the present-day three-dimensional demand that adds to
succor the technics required for curative medicine and a program of health
education for nursing in relation to
preventive medicine-the third immeasurably extending the scope of activity and the social contribution of the profession.



It is said that the Americans have no plan. This I question. Consciously and unconsciously, Americans are adhering to the slow but sound democratic
principle of social growth and development, namely, education of the entire population as the sine qua non of efficient citizenship, the cornerstone of which is physical fitness. NURS 3000 – Issues and Trends in Nursing Assignment.
In no country are there greater opportunities for the realization of the “American dream-that belief in the
right and possibility of a better life for
all.” Institutions of higher education open wide doors through which, in ever increasing numbers, the youth of the country seek fullest preparation for their chosen life activity, and throughout the country highly equipped health and social organizations and institutions offer almost unlimited opportunities,
and enough graduates of the varied types of social worker to provide the personnel demanded for adequate care and direction of the people, and for the instruction and practical experience of students in their related fields.
The opportunity of the nurse in the field of health education is now generally conceded, and for such function, emphasis has been laid on the preparation of a special group designated as public health nurses. Financial provision, however, for the practice of this group, either by private philanthropy or
governmental appropriation, is entirely inadequate to meet the needs of the population, whether rural, urban, or suburban. Approximately 20,000 public health nurses are now engaged in a field that 100,000 would not adequately cover. A tragedy of the day is the
inadequate employment in the medical
and nursing professions, the uncared-for
sick, and the unattended births in the
community-the latter deplorable in a
century so informed on the importance of the birth episode through its influence on the mother and child and.n ipso facto, the future generations.
Fortunately there is today an awakening appreciation of the contribution
[ 764]
that might be made in the field of preventive medicine by this numerically
strongest division of health workers,
through a curriculum shaped not for a
selected group but for the entire profession.
That courses in the newer sciences,
sociology, psychology, psychiatrv, as
well as in the physical sciences, are
essential for this wider interpretation of
practice, either as prerequisites or in the professional curriculum, is not open to question. The content of such courses in their application to the particular field requires much study and experimentation. The same may be said of the various branches of clinical medicine, some experience in each of which
is of utmost importance if the practice
of the nurse is to extend through the field of curative medicine into that of preventive medicine, as it obviously should, since the opportunity of this practitioner for health education through
her intimate and sometimes prolonged association with the patient and the family equals, may even exceed, that of the public health nurse. NURS 3000 – Issues and Trends in Nursing Assignment.
This expansion of function in half a century of organized existence presents a problem of curriculum readjustment greatly complicated by the conditions governing schools of nursing.
The first schools in this country, established on the Nightingale plan, were conceived as separate units, though closely allied to the institutions providing a practice field. The profession,
however, early lost its integrity and educational freedom by the establishment
throughout the country of these schools as integral departments of the hospitals-with the asset of assured support, but the predictable result, in large measure, and in many cases entirely, of the subordination of the educational program to the needs of the nursing service rendered by the student body.
The values accruing, despite the palpable defects of the educational program, are recognized, but the insistent
and increasing demands from the rapidly developing field of public health for nurses equipped to meet the health as well as the sickness needs of the community could not be disregarded.
The League of Nursing Education, therefore obtained a grant from the Rockefeller Foundation that made possible the first study ever undertaken, which was directed by Josephine Goldmark, in cooperation with a representative committee of which C.-E. A. NURS 3000 – Issues and Trends in Nursing Assignment.
Winslow, Dr.P.H., was chairman. The
findings were published in 1921 under
the title ” Nursing and Nursing Education in the United States.” Originally
conceived as a study of the supplemental
subject matter required for public health
nursing, a superficial survey of the
undergraduate courses left no question
as to the need of a searching investigation of the basic professional preparation. It was determined to extend the
study to include the courses offered in
15 selected schools.
This study, a classic that will stand
the test of time, was shortly followed
by a more comprehensive undertaking,
the purpose of which was indicated by
the designation of the advisory body as
the Grading Committee. Again the
problems involved deflected the original
intent into other channels. NURS 3000 – Issues and Trends in Nursing Assignment.The first
report, prepared by Dr. Burgess, a
highly qualified statistician, was entitled ” Nurses, Patients, and Pocketbooks.” This presented to an astonished public a yearly outpouring from 2,000 schools of nursing of a graduating body that had already brought the ratio of nurses to population in some states as high as 1 to 300, and that would multiply by compound interest to an astounding figure in a comparatively few years. NURS 3000 – Issues and Trends in Nursing Assignment.The report further presented the low level of general education; inadequate teaching facilities as
expressed in the number and preparation of instructors; theoretical and
‘Vol. 26 765
clinical content of curriculum and
teaching equipment; and other factors
bearing directly or indirectly on the
preparation of workers for a field of
acknowledged social importance.
Under the caption ” Nursing Schools
Today and Tomorrow,” the Grading
Committee published in 1934 a report on its further findings, but did not feel it possible to fulfil the complex task.
for which it was created. It is a reasonable question whether, without changes acknowledged as essential but
far from achieved, grading or accrediting of the schools on so unstable a basis as now exists is advisable, despite the obvious need of reliable information for candidates. The National League
of Nursing Education, through its Standards Committee and in conference with experts in education, medicine, and nursing, is studying the problem and will undoubtedly develop a plan which will clarify the situation through some form of classification. NURS 3000 – Issues and Trends in Nursing Assignment.
The influence of these reports was evidenced by a steady decrease in the number of schools, and the advancement of the educational requirement for admission to completion of high school,
reported as 90 per cent in the second and last publication of the Grading Committee.
Concurrently with the studies of the Grading Committee in this country,
studies of nursing and nursing education were conducted in England by the
Lancet Committee, and in Canada,
under the supervision of the Canadian
Medical Association and the Canadian
Nurses Association, by G. M. XVeir,
Professor of Education in the University of British Columbia. The latter brought out the most comprehensive, sympathetic, and constructive discussion of the subject that has yet appeared.
It is not necessary to discuss in detail the defects revealed in the present
system of nursing education. The number of schools still existing, approximately 1,500, is suggestive of the
situation, without the very definite evidence of inadequate instruction, inadequate clinical experience, and hours of physical and mental output generally conceded as detrimental to health-in short, an educational interpretation
out of step with present-day social conditions, educational methods, and scientific conclusions.
Through these several studies the profession now has a foundation of
facts and analyses upon which to base future plans and programs, and through which the values intrinsic in the traditional type of nursing education may not be lost, but deepened and broadened by the vitalizing current of scientific findings bearing on the human organism. To these studies also must be attributed the very definite tendency to effect connections between schools of nursing and institutions of higher
education. NURS 3000 – Issues and Trends in Nursing Assignment.
This trend in the United States
toward a higher level of general education and a more comprehensive professional preparation, supported by the unequivocal pronouncement of the
Canadian Survey of Nursing Education, and the trends in several countries on
the European Continent, leave little question as to the ultimate release of the hospitals from a burden that should never have been imposed.



The curriculum. in preparation for nursing in
the new- field of preventive medicine demands that these schools find their place in the educational system of the country, and that as definite a relation to the institutions of higher education is imperative as obtains for the allied branches of medicine, nutrition,
pharmacy, dentistry, and social service.
No less than for the education of the
community should the State assume responsibility for its health. Privately
endowed or supported schools or departments would still continue but, as in the
case of other professional and voca766 Aug., 1936
tional courses in these institutions,
tuition fees would be required, while
working scholarships, as in other
branches of the arts and sciences, could
and should be made available for desirable candidates during their clinical
and field experience. NURS 3000 – Issues and Trends in Nursing Assignment.
Though as early as 1910 the University of Minnesota had authorized the
establishment of a school of nursing as
a department of the School of Medicine,
this control, unfortunately, hardly less
than that of the hospital, subordinated
the students’ program of study to the
demands of the affiliated hospitals for
nursing service. Had the principles and
provisions clearly defined by Richard
Olding Beard, M.D., to whose vision this step was attributable, been adhered to, the university relationship would have had even greater significance, for it would have established as essential for sound practice the right of schools of nursing to the academic freedom accorded other professions in the development of their program of study, and through the provision of an adequate graduate nurse staff for the affiliated hospitals, insured the student the educational value of the clinical experience. NURS 3000 – Issues and Trends in Nursing Assignment.
In 1934 the League of Nursing Education published a list of 136 schools
connected with universities. It is understood that 165 of the 400 Catholic
schools of nursing are affiliated with Catholic colleges. In many cases, both from the academic and professional standpoints, the connection is but in ‘name. While a number of schools
have been accepted as integral units of universities or colleges, the variations in the entrance requirements and the professional curriculum are great.
For instance, 2 university schools
George Peabody College for Teachers, Department of Nursing Educaticn, Nashville,
St. Louis University School of Nursing, St.
Louis, Mo.
Syracuse University, Department of Public
Health Nursing, Syracuse, N. Y.
Teachers College, Columbia University, Department of Nursing Education, New York,
N. Y.
University of Oregon, Department of Nursing Education, Portland, Ore.
University of Virginia, School of Nursing
Education, Charlottesville, Va.
Washington University School of Nursing,
St. Louis, Mo.
Simmons College School of Nursing, Boston,
University of California School of Nursing,
Berkeley, Calif.
University of Washington School of Nursing, Seattle, Wash.
Vanderbilt University School of Nursing,
Nashville, Tenn. NURS 3000 – Issues and Trends in Nursing Assignment.
Western Reserve University School of
Nursing, Cleveland, Ohio
Duke University School of Nursing, Durham, N. C.
Rochester University School of Nursing,
Rochester, N. Y.
St. Louis University School of Nursing, St.
Louis, Mo.
University of Michigan School of Nursing,
Ann Arbor, Mich.
University of Oregon, Department of Nursing Education, Portland, Ore.
Washington University School of Nursing,
St. Louis, Mo.
Be the selected field of her practice
where or what it may, every nurse
needs, as an individual, as a citizen,
and as a practitioner of vital social importance, a liberal education in the
fullest interpretation of the term. It
is frequently asserted that so prolonged and comprehensive a preparation is not justified by the rewards in
nursing as expressed in financial returns,
satisfactions accruing through the services rendered, and the hours of physical
output. NURS 3000 – Issues and Trends in Nursing Assignment.To all these arguments the
reply, based on any study of human
responses, should be that the higher
educational level, through the stimulation of the social and physical sciences,
brings an inquiring and resourceful
mind to the task-a type of mind that
” seeing that which is invisible ” overlooks-often too greatly overlooksconditions that early become unbearable to the arid mind of the mechanized
product of a program of education that
limits knowledge to the required technics. The stultifying influences of the sometimes unpleasant procedures, repetitive almost to the point of revolt,
can only be overcome by an interest and purpose that holds the attention above the drudgery of the means through which the desired end must
be achieved. NURS 3000 – Issues and Trends in Nursing Assignment.
But is there any life activity of which
this is not the case? Furthermore, in
any activity in which science is concerned-and there are few in which it
is not-these very procedures often assume undreamed of significance. The
failure to admit the desirability of a
scientifically oriented individual for the
part assigned the nurse-this connecting
link between the investigator and the
organism with which they are mutually
concerned-is difficult to understand in
the light of present-day scientific knowledge and social conditions.
In view of the unemployment of the
country’s greatest asset, her youth,
now expressed in millions; the unemployed qualified teachers; the unemployed graduate nurses; and the
ever shortening span of working years; there is little excuse for the failure to require for all workers a program of education through which the country may be better served, and their own lives enriched. In the field of nursing itself there is a wealth of dormant interest awaiting the specialists who will soon supplant the outmoded classification of private duty, institutional, and
public health nurse. I refer to the
specialists in nursing in surgery, medicine, nervous and mental diseases, obstetrics, and pediatrics, branches which
768 Aug., 1936,
again fall into sub-divisions requiring
for the nurse, no less than the physician, a highly specialized body of knowledge and skills.
The syntheses demanded for efficient result in the field of health can be
achieved only through the intelligent, collective will of the army of health
workers, specialists in their own field, but all versed in scientific concepts,
scientific methods, and scientific terminology, motivated by a unified objective. That such coordinated, cooperative programs be developed was the pronouncement of the Committee on Medical Care for the American people. NURS 3000 – Issues and Trends in Nursing Assignment.
An important step, and one that further emphasizes the need of broadening the content of nursing education,
is the effort to persuade nurses, professionally so highly organized, to organize for service through local
community programs based on the needs
of and open to the entire population.
To this end the national nursing organizations have recently appointed a
committee that has outlined as basic
the following principles:
1. That a responsible group, representing the nursing profession, the medical profession, and such lay groups concerned with nursing as hospital boards, schools of nursitia committees, boards of public health nursing agencies, etc., work out plans in each community for a community nursing program.
2. Analyzing community nursing problems
a. How much nursing care is needed for different types of situations
b. What are the present facilities
c. What are the gaps and duplications as
shown by ” a ” and “b”
3. Meeting community nursing needs involves:
a. Reducing the number of agencies which distribute nursing service to as few agencies
as possible and providing one coordinating agency through which all types of nursing service may be obtained
b. An understood relationship and division
of responsibility between the various nursing
c. A concerted effort to fill in gaps and
eliminate duplication
d. The establishment in every community
of some type of machinery for supplying
nursing service
In the Canadian Survey of Nursing
Education will be found a comprehensive and suggestive consideration of
municipal support and administration
of community nursing service. NURS 3000 – Issues and Trends in Nursing Assignment.
Of wider significance than is at first
apparent are these 2 progressive stepsthe attainment for schools of nursing
of the rights and privileges of higher
education; and the integration, for local
community service, of the contributions
of the members of the nursing profession.
The national and international significance of the health movement, to the furtherance of which throughout the world American citizens have so greatly contributed, cannot be overestimated, and not only through the prevention of disease that takes no cognizance of national boundaries, but through the underlying emphasis on the value of
every human life- as such, provided
only that through heredity and environment the organism shall be well born.
Through an International Council of
Nurses, American nurses have long
since established professional relationships on all continents. Through the
Division of International Studies of the Rockefeller Foundation, nurses from
many countries have been enabled to
study-through undergraduate and graduate courses, and through visits
to American institutions and organizations-nursing education and nursing
service in the United States. It is
eminently fitting that the International Council of Nurses and the League of
Red Cross Societies should unite to
establish a Florence Nightingale VIemorial Foundation, and that this memorial
should take the form of courses for
international students under the auspices
of the University of London in cooperation with the hospitals and social orVol. 26 769
ganizations of the city in which was
offered the first and world renowned
professional program of nursing education. Never in the history of the world
was there a more timely moment to
further a project so consistently expressive of the potential value of every
human life. NURS 3000 – Issues and Trends in Nursing Assignment.
As in all professions, the responsibility
for the interpretation of function, and
the acquirement of the educational
content demanded for the fulfillment
of such function, rests upon nurses
themselves.NURS 3000 – Issues and Trends in Nursing Assignment. However obscured may be
the public’s understanding of the part
of nursing in social reconstruction,
nurses themselves, to whom the mental,
physical, and social crippling of humanity is an open book, cannot plead
ignorance, but, as an inalienable right,
should demand the educational content through which their most effective
service may be rendered and the means
through which such service may be
universally available. Not less than
for their educational needs should the
country assume responsibility for the
health of her children.
Weir, George M. The Survey of Nursing Education in Canada, University of Toronto Press, 1932,
chap. 2 5.
Committee on the Grading of Nursing Schools.
Nurses, Patients and Pocketbooks, Macmillan, 1928.
Dewey, John. The Public and Its Problems, Holt,
1927. NURS 3000 – Issues and Trends in Nursing Assignment.
Adams, James Truslow. Rugged Individualism
Analyzed, The New York Times, Mar. 18, 1934.
Committee on the Costs of Medical Care. Medical
Care for the American People, University of Chicago
Press, 1932.
Joint Committee on Community Nursing Service.
National League of Nursing Education Annual Report, 1935.
Committee for the Study of Nursing Education.
Nursing and Nursing Education its the United
States, Macmillan, 1923. NURS 3000 – Issues and Trends in Nursing Assignment.
The Medical Profession
I SAID our profession was a holy office on the same level as that of the priest if not higher, where surplus money-making should be forbidden by law. The doctors should be paid by the State and well paid like the judges in England. Those who did not like this arrangement should leave the profession and go on the Stock Exchange or open a shop. The doctors should walk about like sages, honoured and protected by all men. They should be welcome to take what they liked from their rich patients for their poor patients and for themselves, but they should not count their visits or write any bills.
What was to the heart of the mother the value in cash of the life of her child you had saved? What was the proper fee for taking the fear of death out of a pair of terror-stricken eyes by a comforting word or a mere stroke of your hand? How many francs were you to charge for every second of the death-struggle your morphia syringe had snatched from the executioner? How long were we to dump on suffering mankind all these expensive patent medicines and drugs with modern labels but with roots sprung from medieval superstition? We
well knew that our number of efficacious drugs could be counted on the ends of our fingers and were handed to us by
benevolent Mother Nature at a cheap price.-Axel Mlunthe, The Story of San
Mickele, 1930. NURS 3000 – Issues and Trends in Nursing Assignment.

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