Another look at entry into practice

From the President

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American

Academy

of

Nursing

ANOTHER LOOK AT ENTRY INTO PRACTICE

V

ery shortly, we will have a major study added to the healthcare literature that demonstrates the impact nursing education makes on the quality of care the American public receives. Conducted by one of our most esteemed fellows of the academy, this study shows there is a relationship between the educational preparation of nurses and the outcomes of patients in acute care hospitals. Of course, those of us in practice will not be surprised by these findings. Many nurse administrators and clinicians have long held that increasing the number of nurses prepared in baccalaureate and higher degree programs has a positive impact on the care that is delivered in a variety of settings. The point is, however, that we will now have data to support our experience. And in this era of increasing emphasis on quality, the issue of educational preparation may finally become as important as the issue of quantity (ie, there will be recognition that knowledge and competency matter at least as much as the number of nurses available to patients and their families). For the profession, the forthcoming publication promises to be a landmark contribution, perhaps creating the “tipping point” that will serve to move the matter of entry into practice forward. The dangerous shortage of nurses that we are facing nationally has stimulated many public and private entities to address the workforce problems that confront the field. Inevitably, the question of basic preparation for RN licensure arises. This is the point when the opportunity for a discussion of quality occurs. However, because the subject of educational preparation is so highly charged politically, such discussions rarely take place. It is therefore a real pleasure to call to your attention the announcement that many of you have already received via the listserve: Dr. Brenda Cleary, the Executive Director of the North Carolina Center for Nursing will be convening a “special interest” group at our annual meeting NURSING OUTLOOK

JULY/AUGUST 2003

Margaret L. McClure, EdD, RN, FAAN

in San Diego this fall to discuss basic nursing education. The session is open to any and all fellows who want to participate and explore ideas and/or actions that the academy might take regarding this issue. In my own opinion, there is no question with a more important impact on the areas of both workforce and quality. The dimensions of this impact are enormous and affect such vital areas of concern as: ● The image of nursing and our ability to attract able students to our programs ● The breadth and depth of the knowledge base that underlies our practice, most often noted in our responsibility for monitoring patients’ progress (and frequently resulting in the dimension labeled “failure to rescue” in the error literature) ● The ability of nurses to achieve truly collegial relationships with other members of the healthcare team ● The attitudes that practicing nurses have toward their careers ● The availability of nurses to fill leadership positions, creating vacancies in such critical areas as faculty and administrative posts. ● The availability of nurses for other positions in the larger healthcare context (eg, in information system development, government/policy positions, etc). There are a number of important considerations that are pertinent to any dis-

cussion about entry into practice. These include, but are not limited to: ● Attrition rates among the various types of educational programs ● Actual lengths of the various types of educational programs (ie, the mean length of time that students spend in the programs) ● The numbers of qualified applicants that are turned away from programs due to a lack of faculty or other resources. ● The extent to which the graduates of the various types of programs continue in the profession. For virtually all of the above, we have large data sets that can serve to guide our deliberations. The work that remains is essentially the analyzing and synthesizing of the existing information, capturing the entire picture, and bringing it into sharper focus. I believe that the American Academy of Nursing is in a unique position to lead the dialogue regarding the entry issue. As stated in our bylaws, the purpose of the AAN is to “. . .provide visionary leadership to the nursing profession and the public in shaping future health care policy and practice that optimizes the well being of the American people through synthesis of scientific and philosophical knowledge as the basis for effective health care policy and practice.” This statement creates for us the responsibility to examine the profession’s most important questions objectively and to take positions that are data based. Further, the fact that the fellowship is comprised of the broadest possible representation of American nursing and its leaders imbues our efforts with a degree of objectivity and balance that other nursing organizations cannot readily achieve. The message, therefore, is threefold. The time has come for the nursing profession to put its educational house in order. We have the ability and the commitment to confront this difficult problem and to solve it. The American Academy of Nursing can and should provide the needed leadership that will ultimately benefit the health care of our nation. 䡲 McClure

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