NURSING

Nursing: Then and Now

Nursing: Then and Now

Introduction

Nursing is the ultimate academic discipline and practice profession, which has shaped leadership displayed by women throughout the pace of time. Nursing was historically viewed as an extension of a woman's role in the home. Organized nursing had its roots in religious orders of women and men, such as the Knights Templar, dating back centuries before the era of Florence Nightingale, considered the mother of professional nursing. Nightingale was a leader not only in nursing but in her country. She set the stage for leadership for the thousands of women across the world that would come behind her to lead nursing into the next two centuries.

Nursing in the 1970's

Shortages from the 1970s into the early 1990s resulted in waiting lists of students seeking admission to nursing programs, but in the mid-1990s nursing programs began to experience massive enrollment declines. Schools of nursing watched as enrollments plummeted from the mid-1990s into 2001. This drop in enrollment was attributed to many factors, including (a) the availability of other professions, including medicine, to women; (b) the turmoil in the health care system that was reported in the media, including the lay-offs of nurses and the failure of new nurse graduates to find jobs; and (c) the perception of nursing as a low-paying career. Then suddenly another nursing shortage began at the dawn of the new century. The mass media began to carry stories of the new and unprecedented demand for nurses. Johnson & Johnson launched a Web site to educate the public about careers in nursing.

The professional and lay literature began to speak about the new demand for nurses resulting from a growing population of elderly persons, a growing incidence of chronic illnesses, new roles for nurses, and the emergence of new health care services and new employers who needed nurses, requiring more nurses than schools could produce. The tight grip of managed care had been loosened, the explosion of technology and scientific knowledge were creating new treatments and cures, new venues for health care delivery were opening, and old venues were again expanding.

In the late 1980s an acute shortage of nurses resulted in a conflict between the leadership of major nursing organizations (predominantly women) and the leadership of the American Medical Association (AMA) (predominantly men). The AMA proposed the creation of a new category of health care workers, registered care technologists (RCTs), to address this nursing shortage. The AMA proposed that these health care workers would be educated in 9-month training programs designed by physicians because of what the AMA leadership perceived to be an overemphasis on formal, academic education by nursing. Basic RCTs were proposed to provide the same care as existing nursing assistants but could also carry out selected nursing activities under the supervision of RNs, who would be held accountable for the care provided by these RCTs. Advanced RCTs would receive an additional 9 months of training and were proposed to be able to carry out other nursing tasks, again ...