The tradition of formal training for nurses is only about 150 years old. Prior to the 1870s, most people were cared for at home by family members, largely because nursing was not a respected profession. That perception began to change as more and more medical advances were made during the last part of the 19th century and beginning of the 20th century. Here’s our timeline of the highlights in nursing education, from bedpans to the BSN and beyond.
Early to mid-1800s: Physicians begin scattered efforts to “train” low-status women to assist them with menial tasks.
1854-1856: Florence Nightingale demonstrates the value of military nurses during the Crimean War. She begins to organize her thoughts on how nurses should be trained.
1859: Florence Nightingale publishes “Notes on Nursing,” the first instruction manual of any kind for nurses.
1860: The Nightingale Training School for nurses opens in England and is quickly deemed a success. This leads to a new public image of nurses as professionals and is widely seen as the invention of modern nursing as we know it today.
1873-1889: The Bellevue Hospital School of Nursing is founded in New York City, as the first nursing school in the U.S. to be founded on the principles set forth by Florence Nightingale—it features a one-year program. Soon afterward, the New England Hospital for Women (Connecticut) and Massachusetts General Hospital (Boston) open nurse training programs.
1889-1900: By the turn of the century, there are over 400 hospital-based nursing schools in the U.S. There is no standardization: programs range from six months to two years in length and each hospital sets its own curriculum and requirements. These schools exist primarily to staff the hospitals that operate them.
1909: The University of Minnesota School for Nurses becomes the first university-based nurse training program. It awards a baccalaureate degree to students that complete a three-year program.
1923: A study known as the Goldman Report concludes that nurses should ideally be educated in a university setting, according to academic standards.
1948: The Carnegie Foundations studies nursing education and publishes the Brown Report, again recommending that nursing schools be placed in academic settings rather than hospitals. Regardless, hospital-based diploma programs continue to be the norm, training the vast majority of American nurses and focusing on filling open nursing positions.
1952: A project at Columbia University introduces the concept of two-year, associate degree nursing programs as a research-based plan to test this new education model. The curriculum is composed of half nursing classes and half general-education classes, with clinical experiences gained in the community.
1960-1975: Diploma programs decline rapidly as they are replaced by associate’s degree programs at community colleges.
1982: Even as the ADN remains the most common degree held by working RNs, the National League in Nursing (NLN) releases the first position statement to affirm the BSN is most desirable as the minimum educational level for entry-level nurses. Over the next three decades, many other organizations adopt the same position.
1990: The Department of Health and Human Services creates a commission to address the national nursing shortage. Fears of worsening shortages put a damper on efforts to require the BSN as entry to professional practice.
2003-2008: Several studies demonstrate that patient outcomes improve when a higher percentage of nurses on staff hold a BSN.
2010: The Institute of Medicine issues a landmark report called The Future of Nursing, which compiles extensive research to back its recommendations for all nurses to attain higher levels of education. It calls for 80 percent of the nursing workforce to hold a BSN degree by 2020.
2012: New York and New Jersey consider controversial legislation known colloquially as the “BSN in 10” law. It would require ADN-prepared nurses to obtain a bachelor’s degree within ten years of entering nursing practice. Again, fears of a looming nursing shortage prevent the BSN from becoming a national standard for entry level practice. By this time, however, many employers are stating a preference for BSN-holding nurses and creating incentives for nurses to go back to school.
2016: What’s YOUR career and educational path? While a nursing diploma or ADN provides the basic technical skills necessary for safe and effective patient care, a good RN to BSN program will build on those skills in a way that encourages critical thinking. A BSN program helps nurses to develop critical thinking skills and improve existing communication skills. It can open minds to new ideas and new models of care – resulting in the highest possible standard of patient care that you’re able to provide. Likewise, an MSN program can be your passport to a specialty nursing field, like case management, informatics, or infection control. These areas require strategizing, collaborative relationships, and a multi-dimensional approach to tackling a problem Specialized knowledge forms the foundation of these nursing fields. When you acquire new knowledge, you can apply it to nursing practice in ways that enhance patient care and improve outcomes.