Commentary: Lessons from history still used in nursing today
Dec. 7, 1941, is a date that lives in infamy for nearly every American. Movies have been made about it, memorials created, and history has established it as the date that moved the United States into World War II. What is not often recognized is the impact the Pearl Harbor attack had on nursing and the need for trained nurses.
At the time, the American Army Corps had less than 1,000 nurses and the Navy Nurse Corps a little over 800. By the end of the war, over 70,000 nurses had served in either the Army or Navy Corps, present in every theater of war and often very close to the front line. But this large number of nurses had an impact on the needs of hospitals back in the United States, which led to the development of an accelerated program, the Cadet Nurse Corps established in the summer of 1943. The program allowed women from all walks of life, who had at least a high school diploma, to become trained nurses.
Following the end of the war, Dr. Esther L. Brown prepared a report for the National Nursing Council that attempted to answer the question of who should be responsible for the organization, administration and financing of schools of nursing in the future. In the scathing introduction, Brown assessed a pre-world war nursing education structure that was unable to “produce the requisite amount of qualified general nursing care needed by expanding health services.”
Brown acknowledged it was possible to have, within one profession, two different kinds of preparation. In industries such as engineering, the professional or degree-trained practitioner and the practical or associate-trained practitioner were seen as effective measures already in place. Brown argued that nursing would benefit from this differentiation, allowing the professional/bachelor-trained nurse to have a broader scope of work and the technical/associate-trained nurse to function in a narrow scope, while still maintaining their own accountability.
Just five years after this report was published, a pilot program of seven nursing schools was established. Weber College, now Weber State University, and its association with the Dee Hospital School of Nursing was selected to participate, with 36 women graduating with the first associate degree of nursing. In 1965, the American Nurses Association recommended the elimination of hospital-based diploma programs and the practical nursing program, and recognized the license and title of the associate-degree nurse as Registered Associate Nurses.
It was this auspicious start, almost 70 years ago, that has led to the development of a school of nursing that continues to offer the associate degree. While there is debate surrounding the need for associate-level education, with the profession focused on bachelor-trained nurses, the associate program continues to provide a means of entry into the profession that offers a reasonable return on investment for students in time and money.
Recognizing the need to grow and ensure it meets the needs of both the community and health care, Weber State’s Annie Taylor Dee School of Nursing has constantly sought to develop itself. The school continues to be at the forefront of nursing education through partnerships with local technical colleges that provide a transition from practical nursing programs to registered nursing programs, the establishment of innovative simulation suites that provide a safe space where nursing students can practice theoretical and practical skills, and the development of hybrid and online options to better suit the changing environment of education. There is no better example of the school’s continued progress than the first Weber State students to graduate with the Doctorate of Nurse Practitioner degree in spring 2021.
Brown wrote, “[I hope] that nursing education will soon be established on a sounder and more substantial base; that nurse educators will be able to look back on these years of struggle and uncertainty with wonder that the road could have seemed so hard, and be able to look ahead … secure in the knowledge that theirs is a socially vital and a socially recognized profession.”
While registered nurses are still struggling to break free of the skill-based structure embraced by the public and organizations alike, the Annie Taylor Dee School of Nursing continues to provide a sound and substantial base in both theoretical and practical structures. It is these structures that set up the student, with stepping out points along the way, with a configuration by which they can successfully transition from layperson to registered nurse and beyond.
Dr. Rachel Ardern is an assistant professor of nursing at Weber State University’s Annie Taylor Dee School of Nursing, which will celebrate its 70th anniversary next year.