POSTER - Barriers Preventing Resolution of the Entry-Level RN Debate
Presentation
Overview
Overview
Description
Purpose: The purpose of this research is to understand the socio-cultural-political context surrounding the decisions to develop the diploma, BSN, and ADN educational pathways; the resurfacing historical debate regarding the role and functions, educational pathway, and professional identity of the entry-level RN; and the relationship between the educational pathway developments and the resurfacing historical debate.
Significance: The 2007 “BSN in 10” legislative proposals and the 2010 IOM Future of Nursing report implicitly resurface the historical debate. Both urge for an increase in BSN nurses, yet neither reject the continuation of the diploma and ADN educational pathways nor differentiate the practice of diploma or ADN nurses from the practice of the BSN nurse. The legislative proposals and the IOM report have the potential to change the historical relationship between entry-level education and practice. An enhanced understanding of the historical context of the entry-level educational pathway developments and historical debate may broaden the personal experiences of today’s evidence-based nurse leaders and provide a new lens to guide decisions and responses to the “BSN in 10” proposals and the IOM report.
Methodology: Historical case study research served as the method. Decision points in history when individuals decided to initially develop the three educational pathways served as the case studies: diploma - Bellevue Training School for Nurses in New York, 1873; BSN - University of Cincinnati School for Nursing and Health in Ohio, 1916; and ADN - Orange County Community College nursing program in Middletown, New York, 1952. Biddle’s role theory, an adaptation of King’s Interacting Systems Framework, and the framework of feminist theory guided the study of the socio-cultural-political context of the developments and resurfacing of the debate. Significance, authenticity, and genuineness of the data were determined through careful collection and inspection of both primary and secondary source data. Bias was controlled with journaling, disclosure, and frequent review of the research questions and purpose. Synthesis of the data is displayed through the creation of a narrative account of both the descriptive and interpretative elements of the research study.
Major primary and secondary sources: Research of primary documents from the following archives was completed: Foundation of the New York State Nurses Association, Bellevue Alumnae Center for Nursing History; Blegen Library, Henry Winkler Center, and Wedbush Centre of the University of Cincinnati; and Gottesman Libraries of Columbia University. Research of secondary sources included research studies, reports on nursing, books, journal and newspaper articles, and dissertations.
Findings and conclusions: Each case study revealed divisions of gender and paternalistic control over nursing, and divisions of class within nursing. The triangulated analysis of these themes within the three case studies also revealed a consistent undefined division of nursing labor and lack of a distinct professional practice role for the BSN nurse throughout the history presented in this research. The identified themes continue to exist as barriers to resolve the historical debate and to clearly define a division of nursing labor.
