Course Name Forces Influencing the Development of the Nursing Profession: 3 of 27Introduction

Topic Name Topic Introduction Here is a transcript of Dr. Smiths conversation. You can now begin your exploration. The Timeline will provide you an overview of the evolution of nursing from 3000 B C to the present. You will learn about the early history of nursing, military influences on nursing, as well as the nursing leaders, organizations, and reports that have impacted the nursing profession. You will also learn about the evolution of nursing education. In the Hall of Fame, you will discover more details about some of the leaders, organizations, and reports that are on the Timeline. They have earned a place in the Hall of Fame because of their profound and far-reaching impact on the profession of nursing. Memorabilia will acquaint you with some of the traditions and ceremonies associated with nursing. Once you have gathered all of the information, you will proceed to the Game Room, where you will be presented with activities based on the knowledge you have gathered. I wish you the best in your efforts to learn and hope you will continue to use this knowledge to better your nursing practice.

Course Name Forces Influencing the Development of the Nursing Profession: 4 of 27Timeline

Topic Name 3000 B C476 A D Early History 3000 B C EGYPT Medical records were written on paper scrolls (papyri). Imhotep, the God of Medicine, was the first physician. Egyptians established public hygiene and sanitation, along with many other rules, such as those for food and drink. Women had considerable freedom and dignity. Nursing care was mainly carried out by mothers and daughters in the home. 2100 B C BABYLONIA The belief was that disease was a punishment by the gods for sins. The Code of Hammurabi, the greatest legal document of ancient times, was created. The nurse was most likely a servant or slave, either male or female. 1900 B C ANCIENT ISRAEL During this time, the belief was that man is a body-mind-spirit unity. The Mosaic Code addressed disease prevention through clearly defined rules. It was formed to govern ethical human relationships, mental health, and disease control. Contagious diseases were handled by isolating the individual. 5001500 A D Early History 5001500 A D MEDIEVAL PERIOD During this time, care of the sick was an important component of monasteries. One monastic order which still exists today was the Order of Benedictines. In this early Christian period, nursing began to have a formal and more clearly defined role. Women called deaconesses and Monks, who were men, made the first organized visits to sick people and buried the dead. Hospitals were built for enormous number of pilgrims needing health care. Nursing was provided by individuals with high intellect and social standing. It was a respected vocation with a purpose and a direction.

Course Name Forces Influencing the Development of the Nursing Profession: 6 of 27Timeline

Topic Name 15011850 A D Early History 15011850 A D THE DARK AGE OF NURSING With the close of many monasteries and convents, a tremendous shortage of people to care for the sick resulted. One solution was to recruit women prisoners and prostitutes to provide this care. They received low pay, worked very long hours in most unfavorable conditions, which is why this time period is called the Dark Age of Nursing. In addition, other examples of early providers of nursing care in the 16th19th centuries were: Catholic Religious Orders in Mexico and South America: The first hospital was built in Mexico City in 1524; the first medical school was founded at the University of Mexico in 1578. Sisters of Charity: In 1633, educated women from parish churches were recruited to care for abandoned children. In 1809, a nursing school was founded in the United States. Sisters of the Holy Cross: Founded in 1844 in the United States. This group cared for the sick in hospitals and orphanages. Deaconesses at Kaiserwerth: In 1836, Dr. Fliedner reestablished a training school in Germany. In 1849, the Motherhouse of Kaiserwerth in Pittsburgh, Pennsylvania was established. Once again, deaconesses were called upon to care for the sick, make visits to the home and also teach nursing.18511900 A D Leaders FLORENCE NIGHTINGALE (18201910) The birth of modern nursing is attributed to Florence Nightingale since she was able to differentiate nursing as a profession separate from medicine. DOROTHEA DIX (18021881) Dorothea Dix pioneered reforms in the treatment of mental illness. CLARA BARTON (18211912) Clara Barton known as the little lone lady in black silk, was the founder of the American Red Cross. LINDA ANNE JUDSON RICHARDS (18411930) Linda Richards was the first trained nurse in the United States. MARY ELIZABETH MAHONEY (18451926) Mary Mahoney was the first African-American registered nurse in the United States. ISABEL HAMPTON ROBB (18601910) Isabel Hampton Robb was a leader in nursing and nursing education. This was identified by her organization of a nursing school at Johns Hopkins Hospital in 1889. LILLIAN WALD (18671940) Lillian Wald was the founder of public health nursing. In 1893, she opened the Henry Street Settlement House in New York City. Nurses from this establishment provided care to the poor in their homes. This organization eventually became the Visiting Nurses Association of America (V N A A). 19011940 A D Leaders MARGARET SANGER (18791966) Margaret Sanger founded the Birth Control League of New York, which later became Planned Parenthood Federation of America (P P F A). Military Influences WORLD WAR I (19141918) In 1901, the Army Nurse Corp was founded and seven years later, the Navy Nurse Corp was established in an effort to organize nursing care delivered to injured soldiers. During World War I, the Army Nurse Corp and the Navy Nurse Corp provided the majority of care for wounded soldiers. However, the lack of qualified nurses continued to be identified. Nursing Organizations SIGMA THETA TAU INTERNATIONAL (1922) Sigma Theta Tau International (S T T I) (1922) was founded. This organization recognizes superior ability and leadership in nursing. (Excelsior College is proud to be a part of this honor society. Its chapter name is Tau Kappa.) Significant Reports

Course Name Forces Influencing the Development of the Nursing Profession: 9 of 27Timeline

Topic Name 19411960 A D Leaders MILDRED MONTAG (19082004) Mildred Montag established the Adelphi School of Nursing and was its director from 194248. Military Influences WORLD WAR II (19391945) The United States Cadet Nurse Corp was established between the years of 1940 and 1943 graduating large numbers of nurses who would serve in the military. These nurses who served were commissioned as officers and given a military rank. Programs in Flight Nursing were established as an answer to caring for the wounded who needed to be evacuated via air to nearby hospitals. Nurses also began to find employment in manufacturing plants due to the industrial boom, This created a nursing shortage in civilian and military hospitals. With advances in medicine and technology, the role of nurses increased, also creating a need for more education. Nurses who returned from the War were eligible to receive money for advancing their nursing education under the G I Bill. This led to more nursing students in baccalaureate and masters programs. KOREAN WAR (19501953) The Mobile Army Surgical Hospital (MASH) was established to provide treatment to the wounded soldiers on19612011 A D Military Influences GULF WAR (199091) Nurses were deployed to areas of battle to establish MASH units. Conditions were quite different in this war, as there was an increase in chemical warfare and the environmental conditions were very dry and dusty. AMERICAN ORGANIZATION OF NURSE EXECUTIVES (A O N E) (1967) This is a national organization for nurses who design, facilitate, and manage care. This organization is the voice of nursing leadership and shapes public policy for health care in all types of settings. Membership in the organization represents nurse leaders across the country and internationally from all levels throughout an organization. AMERICAN ASSOCIATION OF COLLEGES OF NURSING (A A C N) (1969) Membership in this organization is represented by baccalaureate and graduate degree nursing programs. This organization focuses on promoting the quality of baccalaureate and graduate nursing programs through support to the deans of these programs. It is a member of the Tri-Council for Nursing. Its autonomous arm is the Commission on Collegiate Nursing Education (C C N E), which is responsible for the accreditation of baccalaureate and graduate programs in nursing. AMERICAN ACADEMY OF NURSING (A A N) (1973) This organization was established as an honorary association whose members are elected to the Academy as Fellows because of their significant contributions to nursing. Members are eligible to use the initials, F A A N. Florence Nightingale (18201910) Florence Nightingales work was centered on the belief that nursing was a respectable profession different from medicine; and that the nurses role was patient care as opposed to ancillary tasks like cleaning. She emphasized discipline, professionalism, and continuing education for nurses. Beginnings Florence Nightingale was the second daughter of a wealthy family. The economic and social position of her family gave her the benefits of extensive travel and a good education. Her ambition was to become a nurse. She met Sidney Herbert and his wife, who were interested in hospital reform. She began gathering information about public health and hospital conditions in England, where reforms were much needed and were being intensely debated. Gradually, she began to be considered an expert in these areas and was often consulted by reformers and physicians. Also during this time she learned about Kaiserwerth, a hospital that also trained nurses, run by Pastor Fliedner. She studied at the institute for three months in 1851. Career The turning point in her career came in 1854 with the Crimean War. When she learned about the terrible conditions under which care was provided to the wounded British Army soldiers, she consulted Sir Sidney Herbert, Secretary of War and her old friend. Florence Nightingale led a team of nurses to Crimea. It was due to her hard work and efforts that the wartime mortality rates for ill and injured soldiers were reduced. Florence Nightingales efforts in the war won her acclaim nationally, and after the war ended, she began instituting public health reforms for British soldiers. These included simple measures like ensuring hygiene, as well as activities such as constructing hospitals. She continued to work tirelessly on public health, hospitals, and nursing reform. Throughout her lifetime she wrote on these subjects as well. Her most famousClara Barton (18211912) Clara Barton is best known for establishing the American Red Cross in 1881. This, however, was by no means her only achievement. Throughout her lifetime, the little lone lady in black silk blazed many new paths. Beginnings Clara Barton was a schoolteacher, when teaching was dominated by men. Similarly, she was one of the first women to be employed by the federal government, opening federal government appointments to women. Career It was during the Civil War that her courage, compassion, and determination came to the forefront. She volunteered to help care for soldiers in the field by bringing in supplies, often endangering her own life. She provided nursing care to the soldiers, paying no attention to if they were white or black, or from the North or South. After the War, she also helped in efforts to trace missing prisoners of war. Contribution After founding the American Red Cross, she was president of it for 23 years, in which time she supported several disaster relief activities and various other humanitarian causes. By example, she paved the way for the field of volunteer service.Dorothea Dix (18021887) Dorothea Lynde Dix was a woman who accomplished much in her life. She was firstly a teacher and then a social reformer for the treatment of the mentally ill. Beginnings Dorothea Dix was not a trained nurse, but a schoolteacher. However, she did seminal work in reforming treatment of the mentally ill, especially those who were poor. Career Her career as a teacher began when she opened a school in Boston, for young girls from well-to-do families. Soon afterwards she began teaching poor and neglected children at home. In addition to teaching, she wrote storybooks for children. During this time she went to England, where she met men and women who believed that social welfare should be a responsibility of the government. She was also inspired by the British lunacy reform movement. The movement would investigate conditions in madhouses and asylums in detail, in order to involve the government in reform. During the Civil War, Dix worked as the Superintendent of Army Nurses for the Union Army. After the war, she went back to her mission of bringing about reform in the care provided to prisoners, and those with disabilities or mental illnesses. Contribution Dorothea Dix has been described as "the most effective advocate of humanitarian reform in American mental institutions during the nineteenth century.Linda Richards (18411930) Linda Richards was one of the pioneers in the profession of nursing. She was Americas first trained nurse. She organized and was administrator of several nursing schools in the United States. She was also known for her missionary work in Japan. Beginnings Linda Richards was trained at the New England Hospital for Women and Children in Boston, Massachusetts, where she graduated in 1873. Career Her first position after graduation was as night superintendent at Bellevue Hospital, New York City. She then became Superintendent of Nurses at Boston Training School (Massachusetts General Hospital). Richards used these positions to bring about innovations in the nursing profession and nursing education. Contribution Among her contributions was the concept of nurses wearing uniforms. In addition she was responsible for the writing of patient records, including nurses notes and doctors orders instead of only verbal reports. She was instrumental in developing the training program for nurses at Boston Training School and for effectively proving that the quality of care provided by trained nurses was superior to care provided by nurses with no formal training. Linda Richards was also the first stockholder in the American Journal of Nursing.Isabel Hampton Robb (18601910) Isabel Hampton Robbs major contributions were in the areas of nursing education and nursing organizations. Beginnings Isabel Robb trained as a nurse at the Bellevue Hospital Training School for Nurses, graduating in 1883. Career She began her career in nursing education when she became the Superintendent of Nurses at Illinois Training School in Chicago. Several years later she was appointed as the Principal of the John Hopkins Hospital Training School for Nurses. Contribution She brought about many innovations in nursing education. Some of her initiatives were the implementation of a grading system, terminating the practice of students doing private duty nursing, using clinical affiliations when a learning experience was not available in the parent hospital, reducing the length of the workday for students, and organizing the curriculum into specialty areas. She was instrumental in organizing the American Society of Superintendents of Training Schools for Nurses in 1893. The membership was restricted to individuals that were directors of training schools. Their responsibilities were education reform. She was also the founder and first president of the Nurses Associated Alumnae of the United States and Mildred Montag (19082004) The evolution of nursing education from hospital programs to community colleges is credited to Mildred Montag. The proposal she made in her now-famous doctoral dissertation, The Education of Nursing Technicians (1951) was to provide an alternative method of educating nurses by having programs offered in two year community colleges. Beginnings Mildred Montag obtained a bachelors degree in nursing from the University of Minnesota School of Nursing in 1933. She then received a masters degree in nursing education from Columbia University Teachers College in 1938. She also did her doctoral studies at Teachers College. Career In 1942, Mildred Montag established a nursing education program at Adelphi University on Long Island, New York. As the founder and director of the program from 194248, Montag initiated many changes in the traditional format of nursing education. She limited the number of clinical hours that students spend in the hospital; she ensured that the program had a strong theoretical component with most classes being conducted on campus; and she encouraged nursing students to participate in college activities much like students in other programs. Dr. Montag was associated with nursing education at Adelphi University, until her death in 2004. Funded by the W.K. Kellogg Foundation, Dr. Montag directed the five-year research project, the Cooperative Research Project in Junior and Community College Education for Nursing at Teachers College, Columbia University, which included seven junior and community colleges and one hospital school, located in six regions of the United States. This research project was later published in 1959 as a significant nursing report titled, Community College Education for Nursing. This report was significant to the development of more associate degree nursing programs. Mary Elizabeth Mahoney (18451926) Mary Mahoney became the first African-American registered nurse in the U S A, opening the profession of nursing to people of various races. Beginnings The path to becoming a nurse was not easy for Mary Mahoney. Born in 1845 to southern free African- Americans who had migrated to the north before the Civil War, she was interested in nursing from a very young age. In 1863, she found employment at the New England Hospital for Women and Children in Roxbury, Massachusetts, where she worked as an untrained nurses assistant. The hospital conducted a nursing program, to which she was admitted in 1878. At the end of 16 months, on August 1, 1879, Mahoney was one of four, and the only African-American, to complete the course. Career Following graduation, Mary Mahoney worked as a private nurse for the next thirty years Her last position was as director of an orphanage on Long Island, New York. Contribution In 1908, Mahoney co-founded the National Association of Colored Graduate Nurses (N A C G N). She gave the welcoming address at the Associations first convention, and also served as its national chaplain. In 1936, a decade after Mahoneys death, N A C G N instituted the Mary Mahoney Medal in her honor. The award was given to women who worked toward racial integration in nursing. After the dissolution of the N A C G N in 1951, the American Nurses Association (A N A) continued the award, honoring women who Organizations The following organizations are significant for their contributions to the growth and evolution of the profession of nursing. American Nurses Association(A N A) The American Nurses Association (A N A) (http://nursingworld.org/) is the professional organization for registered nurses in the United States. The forerunner of the A N A was the Nurses Associated Alumnae of the United States and Canada, an organization founded by Isabel Hampton Robb in 1896. Membership in the A N A consists of state nurses associations and three territorial constituent units. Individual nurses can belong to the A N A as members of their state organization or by joining A N A directly. Since its inception in 1911, A N A has worked to promote the nursing profession and the welfare of nurses. This includes being responsible for nursing scope of practice, public policy, ethics, and elevating nursing education. A N A also works with state and federal lawmakers for these purposes. ANA produces several publications for nurses, including Code of Ethics for Nurses, American Nurse Today (A N As official publication), and The Online Journal of Issues in Nursing (O J I N). It also organizes conferences and events, and provides credentialing and continuing professional development for nurses. National League for Nursing (N L N) The National League for Nursing (http://www.nln.org/) promotes excellence in nursing education. The American Society of Superintendents of Training Schools for Nurses became the National League for Nursing Education, and today is the National League for Nursing. Studies and Reports Various studies and reports have acted as guideposts in the development of the nursing profession. Here are some of the important ones. Winslow-Goldmark Report on Nursing and Nursing Education in the United States (1923) The report analyzed nursing education in hospital training schools and stated that there were fundamental weaknesses in these programs. The study focused on the preparation of students to become future nurses, public health practitioners, teachers or supervisors and the qualifications necessary for these roles. Based on the recommendations of the report, the Yale University School of Nursing was established. This was the first nursing school to be recognized as a separate department within a university. Community College Education for Nursing (1959) This landmark study by Mildred Montag paved the way for the creation of associate degree nursing programs in community colleges. The report was based on a five-year study of eight nursing programs, seven community colleges, and one hospital-based program from across the United States. Dr. Montag used the findings to establish the need for two-year nursing education programs for technical nurses offered in community colleges. Dr. Montags vision was that the associate degree would be a final degree, and not a stepping stone to the baccalaureate degree. Today, the associate degree in nursing is not a final degree. However, it is the most common basic nursing program in the United States. A Position Paper on Educational Preparation for Nurse Practitioners and Assistants to Nurses (1965; Reaffirmed 2000) Memorabilia Here are some of the traditions and ceremonies associated with nursing. Nursing Pin The tradition of the nursing pin was probably started by Florence Nightingale, as students graduating from her first nursing school were given pins shaped as Maltese crosses. The Maltese cross itself has religious and philanthropic connotations, as a white Maltese cross badge was part of the uniform of the Knights Hospitaller of St. John of Jerusalem during the Crusades. Each of the eight points of the cross represented the eight beatitudes. In the U.S., the Bellevue Hospital training school for nurses is attributed with awarding the first nursing pin. The custom of wearing badges or buttons to symbolize values such as faith and courage probably goes back to the 16th century. It began with the coat of arms that the king bestowed to deserving noblemen for their loyalty and service, and spread to craft guilds and schools. Nightingale was likely influenced by this custom when she introduced the nursing pin. The custom spread to other nursing schools as well, each designing a unique pin that was given to students to symbolize the accomplishments of the graduate. Since many nursing schools were part of hospitals that were in turn supported by religious groups, the Maltese cross was frequently incorporated into the design of the nursing pins. Nursing Cap In the early days of nursing education, the nursing cap and the nursing pin were unique symbols for each nursing school. The cap could have been part of the fashion of those times, which considered it appropriate for women to

Game Room You have now gathered all of the knowledge and will go through the activities based on this information. These activities are divided into five categoriesLeaders, Organizations, Studies and Reports, Education, and Traditionsand will be presented by experts in the nursing profession. Here is a transcript of Dr. Sharon Smiths conversation. You now have the requisite knowledge about the leaders, events, organizations, and studies that have acted as guideposts in the evolution of nursing, and some of the traditions in nursing. Here is a transcript of the experts introduction. Joanne Thomas, M S, R N, Assistant Professor and an Expert on Nursing Leaders I have been part of the ECHO College of Nursing faculty for the past five years. I am also working on my doctorate at the College. My dissertation, which I have recently submitted, is on the impact of the pioneer nurses on modern nursing. John Elbert, Ph D, R N, F A A N, Associate Professor and an Expert on Nursing Organizations Along with teaching and research at the ECHO College of Nursing, I have been part of the board of directors of several nursing organizations. In these roles, I have worked closely with the U.S. government for advancement in nursing education and service. Susanna Abbot, Ph D, R N, Associate Professor and an Expert on Studies and Reports I am currently an adjunct faculty member at ECHO College and have published several papers in peer-reviewed nursing journals. I have also been part of two committees, one of which was set up to prepare a blueprint of future directions in nursing and the other analyzed and suggested ways of improving nursing education. Reports of both these committees have been published recently.

Leaders Here are the questions presented by Joanne Thomas, M S, R N, Assistant Professor and an Expert on Nursing Leaders Question: Who created a school of nursing in London and stated that a nursing schools curriculum would include two components: theory and clinical? a.Clara Barton b.Dorothea Dix c.Florence Nightingale d.Isabel Hampton Robb Correct Answer: Florence Nightingale Feedback: Florence Nightingale created a nursing school, in which the curriculum had both theoretical and clinical components. Question: Who is known as the little lone lady in black silk? a.Clara Barton b.Dorothea Dix c.Mildred Montag d.Isabel Hampton Robb Correct Answer: Clara Barton Feedback: Clara Barton is known as the little lone lady in black silk. Organizations Here are the questions presented by John Elbert, Ph D, R N, F A A N, Associate Professor and an Expert on Nursing Organizations Question: Which organization is established as the professional organization for registered nurses? a.A N A b.N L N c.N- O A D N d.N C S B N Correct Answer: A N A Feedback: The American Nurses Association (A N A) is the professional organization for registered nurses. Question: Identify the organization whose purpose is to improve the quality of associate degree education. a.A A C N b.N L N c.N- O A D N d.N C S B N Correct Answer: N- O A D N Feedback: The National Organization for Associate Degree Nursing (N- O A D N) works to improve the quality of associate degree education.

Studies and Reports Here are the questions presented by Susanna Abbot, Ph D, R N, Associate Professor and an Expert on Studies and Reports Question: What was conceived as a result of the study titled Community College Education for Nursing? a.Baccalaureate degree education nursing programs in community colleges b.Associate degree nursing education programs c.Separate nursing education departments within the community college d.Continuing Education for nursing in community colleges Correct Answer: Associate degree nursing education programs Feedback: As a result of Mildred Montags doctoral dissertation, Community College Education for Nursing, associate degree nursing education programs were conceived. Question: What Report stated a recommendation for the need to increase baccalaureate prepared nurses to 80% by 2020? a.Health Professions Education: A Bridge to Quality b.Winslow-Goldmark Report c.The Future of Nursing: Leading Change, Advancing Health d.ANA Position Paper Correct Answer: The Future of Nursing: Leading Change, Advancing Health Feedback: The report, The Future of Nursing: Leading Change, Advancing Health, recommended that Education Here are the questions presented by Claudia Jade, Ph D, R N, Associate Professor and an Expert on Nursing Education Question: What is the significance of The New England Hospital for Women and Children in nursing education? a.It was the first hospital to establish a formal one-year training program for nursing. b.It was established by Florence Nightingale, the founder of modern nursing. c.It was the first hospital to emphasize theoretical education more than clinical experience. d.Nurses graduated from this hospital were the first to get R N licenses. Correct Answer: It was the first hospital to establish a formal one-year training program for nursing. Feedback: The New England Hospital for Women and Children was the first hospital to establish a formal one- year training program for nursing. Question: What is common between the associate degree, baccalaureate, and hospital based diploma nursing programs? a.All of the three are educational pathways to become a technical nurse. b.They were created as a result of the proposals in Mildred Montags doctoral dissertation. c.They are three educational pathways to become a registered nurse. d.Each of the three programs offers a two-year nursing curriculum. Correct Answer: They are three educational pathways to become a registered nurse. Traditions Here are the questions presented by George Hadley, M S, R N, Assistant Professor and an Expert on the History of Nursing Question: Which hospital school of nursing is attributed with awarding the first school pin? a.New England Hospital for Women and Children b.Connecticut Training School c.Bellevue Hospital d.Boston Training School Correct Answer: Bellevue Hospital Feedback: The Bellevue Hospital training school in New York City is attributed with awarding the first nursing pin. Question: Which traditional ceremony associated with nursing is no longer carried out today? a.Pinning ceremony b.Capping ceremony c.Passing of the lamp d.College commencement Correct Answer: Capping ceremony Feedback: The capping ceremony is no longer carried out today.

Summary You have completed the interactive tutorial for this module which included the key concepts listed below. You can now exit the tutorial to return to the table of contents and complete the remaining learning and assessment activities for this module. Various people, events, organizations, and studies have influenced the development of the nursing profession and nursing education. In prehistoric civilizations, nurses were either servants or slaves. This role gradually changed to that of a childrens nurse. In the medieval period (5001500 A D), care of the sick was provided by monks and nuns in monastic orders, who were individuals with high intellect and social standing. Between 1500 and 1850 A D, nursing care was often provided by women who were prisoners or prostitutes. Deaconesses and nuns also continued to provide nursing care. Florence Nightingale (18201910) was the founder of modern nursing, who defined nursing as a separate profession from medicine. She also established a school of nursing at St. Thomas Hospital, London. Other nursing leaders who had a deep and lasting impact on the profession include Dorothea Dix, Clara Barton, Isabel Hampton Robb, Lillian Wald, Lavinia Dock, Linda Richards, Mary Elizabeth Mahoney, and Mildred Montag. Montags dissertation led to the establishment of the associate degree in nursing. Wars have had a profound impact on the development of the nursing profession. With the Civil War (186165), the grave need for trained nurses was identified. World War I led to the establishment of the Army Nurse Corp (1901) and the Navy Nurse Corps (1908). As nursing evolved into a distinct profession, various organizations were founded to serve the interests of the profession. These include the American Nurses Association (A N A), National League for Nursing (N L N), American Association of Colleges of Nursing (A A C N), National Council of State Boards of Nursing (N C S B N), National Organization for Associate Degree Nursing (N- O A D N), and the International Council of Nurses (I C N). Nursing education began with short-term courses offered by hospitals and courses in practical nursing. The New England Hospital for Women and Children was the first hospital to establish a formal one-year diploma program to train nurses (1872). Baccalaureate nursing programs were introduced in 1909. Associate degree nursing, a two-year program was introduced as a result of Mildred Montags research, In the 1980s, masters and doctoral degrees in nursing were introduced

3000 B C476 A D Early History 3000 B C EGYPT Medical records were written on paper scrolls (papyri). Imhotep, the God of Medicine, was the first physician. Egyptians established public hygiene and sanitation, along with many other rules, such as those for food and drink. Women had considerable freedom and dignity. Nursing care was mainly carried out by mothers and daughters in the home. 2100 B C BABYLONIA The belief was that disease was a punishment by the gods for sins. The Code of Hammurabi, the greatest legal document of ancient times, was created. The nurse was most likely a servant or slave, either male or female. 1900 B C ANCIENT ISRAEL During this time, the belief was that man is a body-mind-spirit unity. The Mosaic Code addressed disease prevention through clearly defined rules. It was formed to govern ethical human relationships, mental health, and disease control. Contagious diseases were handled by isolating the individual. 5001500 A D Early History 5001500 A D MEDIEVAL PERIOD During this time, care of the sick was an important component of monasteries. One monastic order which still exists today was the Order of Benedictines. In this early Christian period, nursing began to have a formal and more clearly defined role. Women called deaconesses and Monks, who were men, made the first organized visits to sick people and buried the dead. Hospitals were built for enormous number of pilgrims needing health care. Nursing was provided by individuals with high intellect and social standing. It was a respected vocation with a purpose and a direction.15011850 A D Early History 15011850 A D THE DARK AGE OF NURSING With the close of many monasteries and convents, a tremendous shortage of people to care for the sick resulted. One solution was to recruit women prisoners and prostitutes to provide this care. They received low pay, worked very long hours in most unfavorable conditions, which is why this time period is called the Dark Age of Nursing. In addition, other examples of early providers of nursing care in the 16th19th centuries were: Catholic Religious Orders in Mexico and South America: The first hospital was built in Mexico City in 1524; the first medical school was founded at the University of Mexico in 1578. Sisters of Charity: In 1633, educated women from parish churches were recruited to care for abandoned children. In 1809, a nursing school was founded in the United States. Sisters of the Holy Cross: Founded in 1844 in the United States. This group cared for the sick in hospitals and orphanages. Deaconesses at Kaiserwerth: In 1836, Dr. Fliedner reestablished a training school in Germany. In 1849, the Motherhouse of Kaiserwerth in Pittsburgh, Pennsylvania was established. Once again, deaconesses were called upon to care for the sick, make visits to the home and also teach nursing.18511900 A D Leaders FLORENCE NIGHTINGALE (18201910) The birth of modern nursing is attributed to Florence Nightingale since she was able to differentiate nursing as a profession separate from medicine. DOROTHEA DIX (18021881) Dorothea Dix pioneered reforms in the treatment of mental illness. CLARA BARTON (18211912) Clara Barton known as the little lone lady in black silk, was the founder of the American Red Cross. LINDA ANNE JUDSON RICHARDS (18411930) Linda Richards was the first trained nurse in the United States. MARY ELIZABETH MAHONEY (18451926) Mary Mahoney was the first African-American registered nurse in the United States. ISABEL HAMPTON ROBB (18601910) Isabel Hampton Robb was a leader in nursing and nursing education. This was identified by her organization of a nursing school at Johns Hopkins Hospital in 1889. LILLIAN WALD (18671940) Lillian Wald was the founder of public health nursing. In 1893, she opened the Henry Street Settlement House in New York City. Nurses from this establishment provided care to the poor in their homes. This organization eventually became the Visiting Nurses Association of America (V N A A). 19011940 A D Leaders MARGARET SANGER (18791966) Margaret Sanger founded the Birth Control League of New York, which later became Planned Parenthood Federation of America (P P F A). Military Influences WORLD WAR I (19141918) In 1901, the Army Nurse Corp was founded and seven years later, the Navy Nurse Corp was established in an effort to organize nursing care delivered to injured soldiers. During World War I, the Army Nurse Corp and the Navy Nurse Corp provided the majority of care for wounded soldiers. However, the lack of qualified nurses continued to be identified. Nursing Organizations SIGMA THETA TAU INTERNATIONAL (1922) Sigma Theta Tau International (S T T I) (1922) was founded. This organization recognizes superior ability and leadership in nursing. (Excelsior College is proud to be a part of this honor society. Its chapter name is Tau Kappa.) Significant Reports WINSLOW-GOLDMARK REPORT ON NURSING AND NURSING EDUCATION (1923) This report investigated the educational preparation of nurses and identified basic concerns in diploma/hospital training programs. Yale University School of Nursing was established as a result of this Report. It is the first school of nursing to be a separate department within a university. Types of Education BACCALAUREATE DEGREE NURSING (B S N) PROGRAMS (1909) The first university school of nursing was established at the University of Minnesota as a branch of the medical school. Education was still primarily in the form of an apprenticeship with nursing students providing service to the hospital in exchange for their education. These programs were five years long. Three years were devoted to nursing education and two years spent in the liberal arts. However, the curriculum emphasized the performance of skills rather than liberal education and scholarship. Todays B S N programs focus on integrating theory into practice and its graduates are prepared to work mainly in administrative, managerial and community health positions. Many are now four years in length.19411960 A D Leaders MILDRED MONTAG (19082004) Mildred Montag established the Adelphi School of Nursing and was its director from 194248. Military Influences WORLD WAR II (19391945) The United States Cadet Nurse Corp was established between the years of 1940 and 1943 graduating large numbers of nurses who would serve in the military. These nurses who served were commissioned as officers and given a military rank. Programs in Flight Nursing were established as an answer to caring for the wounded who needed to be evacuated via air to nearby hospitals. Nurses also began to find employment in manufacturing plants due to the industrial boom, This created a nursing shortage in civilian and military hospitals. With advances in medicine and technology, the role of nurses increased, also creating a need for more education. Nurses who returned from the War were eligible to receive money for advancing their nursing education under the G I Bill. This led to more nursing students in baccalaureate and masters programs. KOREAN WAR (19501953) The Mobile Army Surgical Hospital (MASH) was established to provide treatment to the wounded soldiers on19612011 A D Military Influences GULF WAR (199091) Nurses were deployed to areas of battle to establish MASH units. Conditions were quite different in this war, as there was an increase in chemical warfare and the environmental conditions were very dry and dusty. AMERICAN ORGANIZATION OF NURSE EXECUTIVES (A O N E) (1967) This is a national organization for nurses who design, facilitate, and manage care. This organization is the voice of nursing leadership and shapes public policy for health care in all types of settings. Membership in the organization represents nurse leaders across the country and internationally from all levels throughout an organization. AMERICAN ASSOCIATION OF COLLEGES OF NURSING (A A C N) (1969) Membership in this organization is represented by baccalaureate and graduate degree nursing programs. This organization focuses on promoting the quality of baccalaureate and graduate nursing programs through support to the deans of these programs. It is a member of the Tri-Council for Nursing. Its autonomous arm is the Commission on Collegiate Nursing Education (C C N E), which is responsible for the accreditation of baccalaureate and graduate programs in nursing. AMERICAN ACADEMY OF NURSING (A A N) (1973) This organization was established as an honorary association whose members are elected to the Academy as Fellows because of their significant contributions to nursing. Members are eligible to use the initials, F A A N. Florence Nightingale (18201910) Florence Nightingales work was centered on the belief that nursing was a respectable profession different from medicine; and that the nurses role was patient care as opposed to ancillary tasks like cleaning. She emphasized discipline, professionalism, and continuing education for nurses. Beginnings Florence Nightingale was the second daughter of a wealthy family. The economic and social position of her family gave her the benefits of extensive travel and a good education. Her ambition was to become a nurse. She met Sidney Herbert and his wife, who were interested in hospital reform. She began gathering information about public health and hospital conditions in England, where reforms were much needed and were being intensely debated. Gradually, she began to be considered an expert in these areas and was often consulted by reformers and physicians. Also during this time she learned about Kaiserwerth, a hospital that also trained nurses, run by Pastor Fliedner. She studied at the institute for three months in 1851. Career The turning point in her career came in 1854 with the Crimean War. When she learned about the terrible conditions under which care was provided to the wounded British Army soldiers, she consulted Sir Sidney Herbert, Secretary of War and her old friend. Florence Nightingale led a team of nurses to Crimea. It was due to her hard work and efforts that the wartime mortality rates for ill and injured soldiers were reduced. Florence Nightingales efforts in the war won her acclaim nationally, and after the war ended, she began instituting public health reforms for British soldiers. These included simple measures like ensuring hygiene, as well as activities such as constructing hospitals. She continued to work tirelessly on public health, hospitals, and nursing reform. Throughout her lifetime she wrote on these subjects as well. Her most famousClara Barton (18211912) Clara Barton is best known for establishing the American Red Cross in 1881. This, however, was by no means her only achievement. Throughout her lifetime, the little lone lady in black silk blazed many new paths. Beginnings Clara Barton was a schoolteacher, when teaching was dominated by men. Similarly, she was one of the first women to be employed by the federal government, opening federal government appointments to women. Career It was during the Civil War that her courage, compassion, and determination came to the forefront. She volunteered to help care for soldiers in the field by bringing in supplies, often endangering her own life. She provided nursing care to the soldiers, paying no attention to if they were white or black, or from the North or South. After the War, she also helped in efforts to trace missing prisoners of war. Contribution After founding the American Red Cross, she was president of it for 23 years, in which time she supported several disaster relief activities and various other humanitarian causes. By example, she paved the way for the field of volunteer service.Dorothea Dix (18021887) Dorothea Lynde Dix was a woman who accomplished much in her life. She was firstly a teacher and then a social reformer for the treatment of the mentally ill. Beginnings Dorothea Dix was not a trained nurse, but a schoolteacher. However, she did seminal work in reforming treatment of the mentally ill, especially those who were poor. Career Her career as a teacher began when she opened a school in Boston, for young girls from well-to-do families. Soon afterwards she began teaching poor and neglected children at home. In addition to teaching, she wrote storybooks for children. During this time she went to England, where she met men and women who believed that social welfare should be a responsibility of the government. She was also inspired by the British lunacy reform movement. The movement would investigate conditions in madhouses and asylums in detail, in order to involve the government in reform. During the Civil War, Dix worked as the Superintendent of Army Nurses for the Union Army. After the war, she went back to her mission of bringing about reform in the care provided to prisoners, and those with disabilities or mental illnesses. Contribution Dorothea Dix has been described as "the most effective advocate of humanitarian reform in American mental institutions during the nineteenth century." Linda Richards (18411930) Linda Richards was one of the pioneers in the profession of nursing. She was Americas first trained nurse. She organized and was administrator of several nursing schools in the United States. She was also known for her missionary work in Japan. Beginnings Linda Richards was trained at the New England Hospital for Women and Children in Boston, Massachusetts, where she graduated in 1873. Career Her first position after graduation was as night superintendent at Bellevue Hospital, New York City. She then became Superintendent of Nurses at Boston Training School (Massachusetts General Hospital). Richards used these positions to bring about innovations in the nursing profession and nursing education. Contribution Among her contributions was the concept of nurses wearing uniforms. In addition she was responsible for the writing of patient records, including nurses notes and doctors orders instead of only verbal reports. She was instrumental in developing the training program for nurses at Boston Training School and for effectively proving that the quality of care provided by trained nurses was superior to care provided by nurses with no formal training. Linda Richards was also the first stockholder in the American Journal of Nursing.Isabel Hampton Robb (18601910) Isabel Hampton Robbs major contributions were in the areas of nursing education and nursing organizations. Beginnings Isabel Robb trained as a nurse at the Bellevue Hospital Training School for Nurses, graduating in 1883. Career She began her career in nursing education when she became the Superintendent of Nurses at Illinois Training School in Chicago. Several years later she was appointed as the Principal of the John Hopkins Hospital Training School for Nurses. Contribution She brought about many innovations in nursing education. Some of her initiatives were the implementation of a grading system, terminating the practice of students doing private duty nursing, using clinical affiliations when a learning experience was not available in the parent hospital, reducing the length of the workday for students, and organizing the curriculum into specialty areas. She was instrumental in organizing the American Society of Superintendents of Training Schools for Nurses in 1893. The membership was restricted to individuals that were directors of training schools. Their responsibilities were education reform. She was also the founder and first president of the Nurses Associated Alumnae of the United States and Mildred Montag (19082004) The evolution of nursing education from hospital programs to community colleges is credited to Mildred Montag. The proposal she made in her now-famous doctoral dissertation, The Education of Nursing Technicians (1951) was to provide an alternative method of educating nurses by having programs offered in two year community colleges. Beginnings Mildred Montag obtained a bachelors degree in nursing from the University of Minnesota School of Nursing in 1933. She then received a masters degree in nursing education from Columbia University Teachers College in 1938. She also did her doctoral studies at Teachers College. Career In 1942, Mildred Montag established a nursing education program at Adelphi University on Long Island, New York. As the founder and director of the program from 194248, Montag initiated many changes in the traditional format of nursing education. She limited the number of clinical hours that students spend in the hospital; she ensured that the program had a strong theoretical component with most classes being conducted on campus; and she encouraged nursing students to participate in college activities much like students in other programs. Dr. Montag was associated with nursing education at Adelphi University, until her death in 2004. Funded by the W.K. Kellogg Foundation, Dr. Montag directed the five-year research project, the Cooperative Research Project in Junior and Community College Education for Nursing at Teachers College, Columbia University, which included seven junior and community colleges and one hospital school, located in six regions of the United States. This research project was later published in 1959 as a significant nursing report titled, Community College Education for Nursing. This report was significant to the development of more associate degree nursing programs. Mary Elizabeth Mahoney (18451926) Mary Mahoney became the first African-American registered nurse in the U S A, opening the profession of nursing to people of various races. Beginnings The path to becoming a nurse was not easy for Mary Mahoney. Born in 1845 to southern free African- Americans who had migrated to the north before the Civil War, she was interested in nursing from a very young age. In 1863, she found employment at the New England Hospital for Women and Children in Roxbury, Massachusetts, where she worked as an untrained nurses assistant. The hospital conducted a nursing program, to which she was admitted in 1878. At the end of 16 months, on August 1, 1879, Mahoney was one of four, and the only African-American, to complete the course. Career Following graduation, Mary Mahoney worked as a private nurse for the next thirty years Her last position was as director of an orphanage on Long Island, New York. Contribution In 1908, Mahoney co-founded the National Association of Colored Graduate Nurses (N A C G N). She gave the welcoming address at the Associations first convention, and also served as its national chaplain. In 1936, a decade after Mahoneys death, N A C G N instituted the Mary Mahoney Medal in her honor. The award was given to women who worked toward racial integration in nursing. After the dissolution of the N A C G N in 1951, the American Nurses Association (A N A) continued the award, honoring women who Organizations The following organizations are significant for their contributions to the growth and evolution of the profession of nursing. American Nurses Association(A N A) The American Nurses Association (A N A) (http://nursingworld.org/) is the professional organization for registered nurses in the United States. The forerunner of the A N A was the Nurses Associated Alumnae of the United States and Canada, an organization founded by Isabel Hampton Robb in 1896. Membership in the A N A consists of state nurses associations and three territorial constituent units. Individual nurses can belong to the A N A as members of their state organization or by joining A N A directly. Since its inception in 1911, A N A has worked to promote the nursing profession and the welfare of nurses. This includes being responsible for nursing scope of practice, public policy, ethics, and elevating nursing education. A N A also works with state and federal lawmakers for these purposes. ANA produces several publications for nurses, including Code of Ethics for Nurses, American Nurse Today (A N As official publication), and The Online Journal of Issues in Nursing (O J I N). It also organizes conferences and events, and provides credentialing and continuing professional development for nurses. National League for Nursing (N L N) The National League for Nursing (http://www.nln.org/) promotes excellence in nursing education. The American Society of Superintendents of Training Schools for Nurses became the National League for Nursing Education, and today is the National League for Nursing. Studies and Reports Various studies and reports have acted as guideposts in the development of the nursing profession. Here are some of the important ones. Winslow-Goldmark Report on Nursing and Nursing Education in the United States (1923) The report analyzed nursing education in hospital training schools and stated that there were fundamental weaknesses in these programs. The study focused on the preparation of students to become future nurses, public health practitioners, teachers or supervisors and the qualifications necessary for these roles. Based on the recommendations of the report, the Yale University School of Nursing was established. This was the first nursing school to be recognized as a separate department within a university. Community College Education for Nursing (1959) This landmark study by Mildred Montag paved the way for the creation of associate degree nursing programs in community colleges. The report was based on a five-year study of eight nursing programs, seven community colleges, and one hospital-based program from across the United States. Dr. Montag used the findings to establish the need for two-year nursing education programs for technical nurses offered in community colleges. Dr. Montags vision was that the associate degree would be a final degree, and not a stepping stone to the baccalaureate degree. Today, the associate degree in nursing is not a final degree. However, it is the most common basic nursing program in the United States. A Position Paper on Educational Preparation for Nurse Practitioners and Assistants to Nurses (1965; Reaffirmed 2000) Memorabilia Here are some of the traditions and ceremonies associated with nursing. Nursing Pin The tradition of the nursing pin was probably started by Florence Nightingale, as students graduating from her first nursing school were given pins shaped as Maltese crosses. The Maltese cross itself has religious and philanthropic connotations, as a white Maltese cross badge was part of the uniform of the Knights Hospitaller of St. John of Jerusalem during the Crusades. Each of the eight points of the cross represented the eight beatitudes. In the U.S., the Bellevue Hospital training school for nurses is attributed with awarding the first nursing pin. The custom of wearing badges or buttons to symbolize values such as faith and courage probably goes back to the 16th century. It began with the coat of arms that the king bestowed to deserving noblemen for their loyalty and service, and spread to craft guilds and schools. Nightingale was likely influenced by this custom when she introduced the nursing pin. The custom spread to other nursing schools as well, each designing a unique pin that was given to students to symbolize the accomplishments of the graduate. Since many nursing schools were part of hospitals that were in turn supported by religious groups, the Maltese cross was frequently incorporated into the design of the nursing pins. Nursing Cap In the early days of nursing education, the nursing cap and the nursing pin were unique symbols for each nursing school. The cap could have been part of the fashion of those times, which considered it appropriate for women toGame Room You have now gathered all of the knowledge and will go through the activities based on this information. These activities are divided into five categoriesLeaders, Organizations, Studies and Reports, Education, and Traditionsand will be presented by experts in the nursing profession. Here is a transcript of Dr. Sharon Smiths conversation. You now have the requisite knowledge about the leaders, events, organizations, and studies that have acted as guideposts in the evolution of nursing, and some of the traditions in nursing. Here is a transcript of the experts introduction. Joanne Thomas, M S, R N, Assistant Professor and an Expert on Nursing Leaders I have been part of the ECHO College of Nursing faculty for the past five years. I am also working on my doctorate at the College. My dissertation, which I have recently submitted, is on the impact of the pioneer nurses on modern nursing. John Elbert, Ph D, R N, F A A N, Associate Professor and an Expert on Nursing Organizations Along with teaching and research at the ECHO College of Nursing, I have been part of the board of directors of several nursing organizations. In these roles, I have worked closely with the U.S. government for advancement in nursing education and service. Susanna Abbot, Ph D, R N, Associate Professor and an Expert on Studies and Reports I am currently an adjunct faculty member at ECHO College and have published several papers in peer-reviewed nursing journals. I have also been part of two committees, one of which was set up to prepare a blueprint of future directions in nursing and the other analyzed and suggested ways of improving nursing education. Reports of both these committees have been published recently. Leaders Here are the questions presented by Joanne Thomas, M S, R N, Assistant Professor and an Expert on Nursing Leaders Question: Who created a school of nursing in London and stated that a nursing schools curriculum would include two components: theory and clinical? a.Clara Barton b.Dorothea Dix c.Florence Nightingale d.Isabel Hampton Robb Correct Answer: Florence Nightingale Feedback: Florence Nightingale created a nursing school, in which the curriculum had both theoretical and clinical components. Question: Who is known as the little lone lady in black silk? a.Clara Barton b.Dorothea Dix c.Mildred Montag d.Isabel Hampton Robb Correct Answer: Clara Barton Feedback: Clara Barton is known as the little lone lady in black silk. Organizations Here are the questions presented by John Elbert, Ph D, R N, F A A N, Associate Professor and an Expert on Nursing Organizations Question: Which organization is established as the professional organization for registered nurses? a.A N A b.N L N c.N- O A D N d.N C S B N Correct Answer: A N A Feedback: The American Nurses Association (A N A) is the professional organization for registered nurses. Question: Identify the organization whose purpose is to improve the quality of associate degree education. a.A A C N b.N L N c.N- O A D N d.N C S B N Correct Answer: N- O A D N Feedback: The National Organization for Associate Degree Nursing (N- O A D N) works to improve the quality of associate degree education. Studies and Reports Here are the questions presented by Susanna Abbot, Ph D, R N, Associate Professor and an Expert on Studies and Reports Question: What was conceived as a result of the study titled Community College Education for Nursing? a.Baccalaureate degree education nursing programs in community colleges b.Associate degree nursing education programs c.Separate nursing education departments within the community college d.Continuing Education for nursing in community colleges Correct Answer: Associate degree nursing education programs Feedback: As a result of Mildred Montags doctoral dissertation, Community College Education for Nursing, associate degree nursing education programs were conceived. Question: What Report stated a recommendation for the need to increase baccalaureate prepared nurses to 80% by 2020? a.Health Professions Education: A Bridge to Quality b.Winslow-Goldmark Report c.The Future of Nursing: Leading Change, Advancing Health d.ANA Position Paper Correct Answer: The Future of Nursing: Leading Change, Advancing Health Feedback: The report, The Future of Nursing: Leading Change, Advancing Health, recommended that Education Here are the questions presented by Claudia Jade, Ph D, R N, Associate Professor and an Expert on Nursing Education Question: What is the significance of The New England Hospital for Women and Children in nursing education? a.It was the first hospital to establish a formal one-year training program for nursing. b.It was established by Florence Nightingale, the founder of modern nursing. c.It was the first hospital to emphasize theoretical education more than clinical experience. d.Nurses graduated from this hospital were the first to get R N licenses. Correct Answer: It was the first hospital to establish a formal one-year training program for nursing. Feedback: The New England Hospital for Women and Children was the first hospital to establish a formal one- year training program for nursing. Question: What is common between the associate degree, baccalaureate, and hospital based diploma nursing programs? a.All of the three are educational pathways to become a technical nurse. b.They were created as a result of the proposals in Mildred Montags doctoral dissertation. c.They are three educational pathways to become a registered nurse. d.Each of the three programs offers a two-year nursing curriculum. Correct Answer: They are three educational pathways to become a registered nurse. Traditions Here are the questions presented by George Hadley, M S, R N, Assistant Professor and an Expert on the History of Nursing Question: Which hospital school of nursing is attributed with awarding the first school pin? a.New England Hospital for Women and Children b.Connecticut Training School c.Bellevue Hospital d.Boston Training School Correct Answer: Bellevue Hospital Feedback: The Bellevue Hospital training school in New York City is attributed with awarding the first nursing pin. Question: Which traditional ceremony associated with nursing is no longer carried out today? a.Pinning ceremony b.Capping ceremony c.Passing of the lamp d.College commencement Correct Answer: Capping ceremony Feedback: The capping ceremony is no longer carried out today. Summary You have completed the interactive tutorial for this module which included the key concepts listed below. You can now exit the tutorial to return to the table of contents and complete the remaining learning and assessment activities for this module. Various people, events, organizations, and studies have influenced the development of the nursing profession and nursing education. In prehistoric civilizations, nurses were either servants or slaves. This role gradually changed to that of a childrens nurse. In the medieval period (5001500 A D), care of the sick was provided by monks and nuns in monastic orders, who were individuals with high intellect and social standing. Between 1500 and 1850 A D, nursing care was often provided by women who were prisoners or prostitutes. Deaconesses and nuns also continued to provide nursing care. Florence Nightingale (18201910) was the founder of modern nursing, who defined nursing as a separate profession from medicine. She also established a school of nursing at St. Thomas Hospital, London. Other nursing leaders who had a deep and lasting impact on the profession include Dorothea Dix, Clara Barton, Isabel Hampton Robb, Lillian Wald, Lavinia Dock, Linda Richards, Mary Elizabeth Mahoney, and Mildred Montag. Montags dissertation led to the establishment of the associate degree in nursing. Wars have had a profound impact on the development of the nursing profession. With the Civil War (186165), the grave need for trained nurses was identified. World War I led to the establishment of the Army Nurse Corp (1901) and the Navy Nurse Corps (1908). As nursing evolved into a distinct profession, various organizations were founded to serve the interests of the profession. These include the American Nurses Association (A N A), National League for Nursing (N L N), American Association of Colleges of Nursing (A A C N), National Council of State Boards of Nursing (N C S B N), National Organization for Associate Degree Nursing (N- O A D N), and the International Council of Nurses (I C N). Nursing education began with short-term courses offered by hospitals and courses in practical nursing. The New England Hospital for Women and Children was the first hospital to establish a formal one-year diploma program to train nurses (1872). Baccalaureate nursing programs were introduced in 1909. Associate degree nursing, a two-year program was introduced as a result of Mildred Montags research, In the 1980s, masters and doctoral degrees in nursing were introduced

Evolution of Nursing Education The three traditional educational avenues that prepare men and women for registered professional nursing are hospital-based diploma programs, associate degree programs (primarily found in junior and community colleges), and baccalaureate programs (offered at four-year colleges and universities). It is also possible for students to begin their nursing education in programs that culminate in a masters degree, and several programs now exist in which a student can earn a doctoral degree before being eligible to write the licensing examination for registered nursing. Nursing education has been inuenced by the American Nurses Association (A N A) position on nursing education that advocates the baccalaureate degree as the minimum educational preparation for professional practice. Many nurse educators, particularly those in diploma and associate degree programs, disagree with this position. Many changes are occurring in nursing education. These include more emphasis on articulation and career ladder programs, availability of distance education nursing programs, and in many programs, there is now a shift in clinical placement settings from acute care facilities to community-based experiences as well as the use of simulation for clinical learning. No change has affected nursing education as greatly as the computer age. Entire Registered Nurse (R N) to Bachelor of Science in Nursing (B S N) programs and masters degree programs can be completed on-line. Computer technology has changed the structure of the typical nursing classroom. Nursing faculty prepare graduates who will be able to function in a health care environment that makes heavy use of computerized services.