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Look how far nursing education has come
We have a rich history and a bright future
By Eileen P. Williamson
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The history of nursing’s growth into the largest and one of the most important professions in healthcare is one nurses can be very proud of.
Fueled by change and the educational advances nursing made in response to it is a vital part of our history. In this Digital Resource Guide, we look at higher education today and the many and varied academic opportunities still ahead for us.
It all began with Nightingale
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Eileen Williamson, MSN, RN, is a writer for and serves in an advisory role.
Nightingale’s school wrote the first page in nursing education’s history book. Similar models arose after that in England and the U.S. By the turn of the century more than 400 schools were open here, and before long the
first university-based nursing baccalaureate program
opened at the University of Michigan. From there, up through the mid-20th century, healthcare changed each decade, and nursing changed with it. The 1950s brought Mildred Montag’s
proposal for a technical nurse program leading to an associate's degree
from a community college. In the 1960s, dialogue began on a proposal to make the baccalaureate degree minimum preparation for RN licensure and entry into practice, and was followed by proposals to phase out diploma programs and require associate degree nurses to hold separate technical nurse licenses. By the late ‘60s and ‘70s diploma program numbers were declining and being replaced by associate degree programs. Nursing graduation numbers increased; more nurses pursued BSNs; the number of master’s-prepared nurses grew; and many new nursing programs opened. Nurses were working on advanced degrees at the post-master’s and doctoral levels and getting involved in research.

The number of advanced practice degrees started to rise, and new roles like clinical nurse specialists, NPs, and DNPs appeared. The only slowdown in education of any kind came in the early 1990s when the great nursing shortage and fear of more shortages hit, and moves to make the BSN mandatory for entry into practice were put on hold.
Move to another century
As the 21st century began, the change underway in healthcare was again the impetus for nursing education to move ahead. In 2010, The Institute of Medicine
Report on the Future of Nursing
called for higher levels of educational preparation for nurses to meet healthcare needs; the legislative proposal known as the
"BSN in 10" passed in NY
; and employers began looking to hire only BSN nurses and created incentives for their nurses to get BSNs. Technology was on the rise with smart phones and tablets at work, and just about everything was becoming computerized. Forecasts of patient care moving to the community created new roles for nurses and patient care models were being re-engineered to meet patient care needs.

Nursing curricula added topics like Evidence Based Practice, Informatics, Interprofessional education and practice, simulation, and a whole new lexicon of acronyms and terms.
Research findings,
including Aiken’s well-known work, was demonstrating outcomes improved when nurses were BSN-prepared, All of these trends and movements were changing nursing education.
Future is brighter than ever
The face of nursing education has changed over the past 150 years, as nursing moved through three centuries and made academic advances too numerous to count. We earned diplomas and associate degrees; bachelors, masters and doctoral degrees; professional certifications, and countless continuing education credits, and continually grew nursing’s body of research and advanced our clinical skills.

We took on new roles, responsibilities and titles in a variety of specialties and work settings — and the value we’ve always placed on education and educators has been at the heart of it all.
The strides we’ve made required determination, foresight, strategic and critical thinking, collaboration, problem-solving, and leadership and teaching skills. And we’re not done yet. We will continue to move ahead academically and acquire new knowledge to apply to our practice in ways that will do more for patients and healthcare than we could ever have dreamed possible a century and half ago.
New century brings new models
To appreciate how far we’ve come, we need look only to Nightingale. It was she who took us from, “Notes on Nursing” to nursing care plans; dressings to doctorates; bedpans to board rooms.”
Eileen Williamson, RN
A little more than 150 years ago, formal nursing education began with Florence Nightingale’s establishment of the first hospital-based nursing school. Before then, patients were cared for at home by “nurse” relatives who carried out tasks given them by physicians. To appreciate how far we’ve come, we need look only to Nightingale. It was she who took us from, “Notes on Nursing” to nursing care plans; dressings to doctorates; bedpans to board rooms. Seeing nursing as her God-given calling, she defied the norms of the day and her station in life to pursue her call. Fueled by strong desire and prepared by the education her wealthy family gave her, she schooled herself in how nurses should be educated and began her work ministering to soldiers during the Crimean War of the 1850s. With her leadership skills, teaching abilities and interest in careers with opportunities for women, she established the
St. Thomas Hospital Nightingale Nurses Training School
in London in the 1860s, the first in-hospital nursing school.