Description
Imagine that you could restructure nursing education for an ideal world. Where would you begin? How many levels of nursing education would you incorporate into your model? Would each level be terminal or articulated with others? Where would general education fit into your model? How would you see the graduate of each program functioning on the healthcare team? How would you see each level reimbursed for services?
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Chapter 2
Educational Preparation for
Nursing
Copyright © 2023 Wolters Kluwer Health | Lippincott Williams & Wilkins
The Educational Route
❖Different options available to reach goal
❖Presents more opportunities for prospective
students to reach career goal
❖Is viewed by some as one of nursing’s strengths
❖Is confusing for healthcare consumers and
employers
❖Involves more than just nurses, as an individual can
work up through the programs to achieve their
ultimate goal
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The Nursing Assistant
❖ Certified Nursing Assistant (CNA)
o Minimum of 75 hours of theory and practice and pass state
examination; required to work in nursing homes
❖ A.K.A.: nursing assistant, unlicensed assistive personnel (UAP),
client care assistant
❖ Functions under direction of RN or LPN/LVN
❖ Home health aide
❖ Advance specialty training available for certain skills
❖ Training occurs in many settings
❖ Often first step in career ladder
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Practical Nurse Education
❖Licensed practical/vocational nurse (LPN/LVN)
education varies among states
❖Typically takes 1 year to complete
❖Stress clinical experience with basic therapeutic
knowledge and introductory content from biologic
and behavioral sciences
❖Stackable credentials allowed in some states
❖Graduates take NCLEX-PN exam
❖Receive direction from RN or licensed physician
❖Nursing shortage has resulted in LPN/LVNs filling RN
positions in certain areas
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Programs That Prepare Graduates for RN
Licensure #1
❖Diploma programs
o Originally hospital-based; today most are
affiliated with a college or university due to
requirements; vary from 27 to 36 months
❖Associate degree (ADN) programs
o 2-year program; 40% of credits are general
education; clinical experience corresponds with
classroom lectures
o Challenges: Selective Admission Process
o Various misunderstandings about AD education:
entry into practice
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Programs That Prepare Graduates for RN
Licensure #2
❖Baccalaureate programs (RN-BSN)
o 4-year college or university program offering
basic or generic program
o Eligible to take NCLEX-RN exam
o Some programs designed for advancement from
LPN
o Learn basic nursing skills, health promotion and
disease prevention, supervisory and leadership
roles
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Master’s Prelicensure Programs
❖Offers generic master’s degree in nursing.
❖Students with baccalaureate degree in another
discipline can earn master degree after 2-year
program in nursing.
❖Some nursing leaders feel master’s degree should
be minimum preparation for professional nursing.
❖Provides path of career change when have
baccalaureate degree in another field of study.
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Question #1
❖Is the following statement true or false?
❖Two major avenues to preparation for licensure as a
registered nurse exist in the United States: the
college-based baccalaureate degree and the
associate degree usually offered in community
colleges.
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Answer to Question #1
❖False
❖Rationale: Three major avenues to preparation for
licensure as a registered nurse exist in the United
States: the diploma and associate degree (usually
offered in community colleges) and the collegebased baccalaureate degree.
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Nontraditional Prelicensure Programs
❖ Accelerated Programs
o Prepare students at both baccalaureate and master’s level
o Builds on previous learning experience
o Fast paced program
❖ External Degree Programs
o Uses assessment approach, designed for those with some
experience in nursing
o Student must demonstrate specific skills have been
learned
o Limitations to use
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Similarities Among Traditional Entry-Level
Prelicensure Programs #1
❖Academic similarities
o All must meet criteria by state board of nursing.
o Graduates must be prepared to pass NCLEX
exam.
❖Administrative similarities
o Adequate financial support
o Appropriate learning experiences
o Proper preparation for current practices
o Recruitment and retention of qualified faculty
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Similarities Among Traditional Entry-Level
Prelicensure Programs #2
❖Similarities Relating to Students
o Recruitment and selection of students
o Increased legal concerns regarding choice of
student
o Various challenges due to diversity of student
body
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Nursing Education at the Graduate Level
#1
❖Master’s Preparation
o Various routes available to complete
o Recommended for leadership positions in
nursing, clinical specialization, teach nursing
o Clinical nurse leader (CNL)
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Nursing Education at the Graduate Level
#2
❖Doctoral Studies
o Doctor of Nursing Science (DNS)
o Doctor of Science in Nursing (DSN)
o Doctor of Nursing Education (DEd)
o Doctor of Philosophy in Nursing (PhD)
o Doctor of Education (EdD)
o Doctor of Public Health (DPH)
o Doctor of Nursing Practice (DNP)
o Advanced Practice Nurse (APN)
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Other Forms of Nursing Education
❖ Changing role of nurse has created need for more education
❖ Push to make nursing more professional and prepare nurses to
complete research
❖ Increased need for leadership
❖ Distance Education
o Achieving advance learning more accessible
o Moderate technology
o Mentor or preceptor relationships
o Requires commitment of all parties involved to accomplish
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Question #2
❖Is the following statement true or false?
❖Master’s and doctoral programs that prepare nurses
for leadership positions in the profession continue to
grow, with more emphasis on the master’s degree
for advanced practice.
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Answer to Question #2
❖True
❖Rationale: Master’s and doctoral programs that
prepare nurses for leadership positions in the
profession continue to grow, with more emphasis on
the master’s degree for advanced practice. The
actual degree awarded at the end of doctoral studies
varies. A variety of new educational approaches to
higher degrees in nursing has evolved.
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Other Postlicensure Educational
Opportunities #1
❖Residencies and structured orientation for the new
graduate
o Graduates need time to adapt to new career.
o Internships and residencies allow new graduates
to transition from student to nurse.
o Many facilities now offer orientation time to
assist new graduate to gain necessary skills,
often rotating to various units.
o Major disadvantage: costs of operating.
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Other Postlicensure Educational
Opportunities #2
❖Continuing Education
o Planned learning experience beyond basic
nursing educational program
o Many options available
o Continuing education unit (CEU)
o Mandatory continuing education affects licensure
o Voluntary continuing education
o State board of nursing has information on
specific requirements to maintain licensure
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Other Postlicensure Educational
Opportunities #3
❖ Advanced Practice Preparation
o APN umbrella term for nurse practitioners, clinical nurse
specialist, certified nurse–midwives (CNM), certified
registered nurse anesthetists (CRNA)
o Specialty areas: pediatrics, gerontology, family health,
genetics, women’s healthcare
o Most programs require bachelor’s degree in some field and
current RN license to enter and receive master’s degree on
completion
o ANCC currently requires master’s degree for initial nurse
practitioner certification
o Push for all MSN nurse practitioner programs to become
DNP programs
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Factors That Bring About Changes in
Nursing Education #1
❖The Brown Report
o Encouraged move from apprenticeship toward
planned program of education
o NLNE recommended control of education move
from hospitals to educational institutions
❖Development of a National Examination Standard
o All states now require same examination
o Interstate endorsement of licenses
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Factors That Bring About Changes in
Nursing Education #2
❖National Accreditation of Nursing Programs
o Set standards for all schools
o Enhanced quality of education
❖Changes in Nursing Service
o Move from home to hospitals
o Clients in more serious or critical conditions
o Nurses assumed responsibilities of others
o Spending more time managing personnel,
delegating responsibilities, and carrying out
other administrative duties
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Factors That Bring About Changes in
Nursing Education #3
❖ The Report of the Surgeon General’s Consultant Group
o Identified lack of adequate nurses, lack of adequate
financial resources for nursing education
o The Nurse Training Act of 1964
❖ The American Nurses Association Position Paper
o Created various issues
o Many have been unwilling to compromise or make
changes based on recommendations
o Main problems: titling, scope of practice, grandfathering,
interstate endorsement
o Still pushes for all nurses to be educated at baccalaureate
level
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Forces for Change in Nursing Education #1
❖Incorporating Computer Technology in Nursing
Education
o PowerPoint presentations, response “clickers”
o Distance learning opportunities
o Testing, licensing examinations
o Use of mannequins
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Forces for Change in Nursing Education #2
❖Increasing Community-Based Practice Experiences
o Still being developed
o Clients are being discharged from hospitals
earlier and may still need quality nursing care in
a community environment
❖Increasing Emphasis on Research
o Various nursing theorists, providing various
categories
o Nursing theories usually classified according to
the structure or approach around which they
were developed
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Forces for Change in Nursing Education #3
❖Education That supports Evidence-Based Practice
o Variety of definitions and interpretations
o Generally refers to integration of the best
evidence available into expert nursing care
o Requires access to latest research, expert
opinion, and understandings of cultural and
personal values as basis for planning and
delivering nursing care
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Question #3
❖Is the following statement true or false?
❖No change has affected nursing education as greatly
as has the computer age.
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Answer to Question #3
❖True
❖Rationale: No change has affected nursing education
as greatly as has the computer age. Entire programs
can be completed online. Computer technology has
changed the structure of the typical nursing
classroom, and instructors prepare graduates who
will be able to function in a healthcare environment
that makes heavy use of computerized services.
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