The first position paper issued by the American Nurses Association Committee on Education recommends that all nurses licensed to practice nursing should be prepared in institutions of higher education. The Committee also suggests that minimum preparation for beginning technical nursing practice at the present time should be an associate degree nursing education. It may seem unbelievable to some members of the nursing profession that a program thirteen years old could be identified as the program which should be producing the majority of the licensed nursing practitioners. As startling as this may seem, it is undoubtedly the course upon which we have embarked.
The Committee also states that the minimum preparation for beginning professional nursing practice at the present time should be baccalaureate education in nursing and that the education for assistants in health service occupations should be the responsibility of the vocational school rather than of the employing agency. For the first time the nursing profession has spelled out succinct levels oí preparation for practice in the nursing field. In so doing, two specific goals toward which the profession must proceed are clearly identified: (1) realignment of existing educational patterns; and (2) restructuring of nursing care patterns.
Movement toward these goals in a manner which will benefit the profession and the public is necessary and calls for the knowledgeable, positive contribution of each member of the profession. It requires our national organizations, the American Nurses Association and the National League for Nursing, to work together in a productive and perhaps unprecedented way to bring about the gradual realignment of existing educational programs, and with this realignment the gradual restructuring of nursing care patterns.
Changes in educational patterns will have to be made slowly. All programs now providing competent nursing education should be continued until the nursing needs in a particular community and state can be met effectively through programs of the types described in the position paper. All existing programs must be assisted to feel worthy and needed in the contribution they are making during this transitional period. The National League for Nursing has a responsibility to actively assist these educational programs during the transitional period so that the nursing needs of communities will be met. The ability of the NLN to move forward to provide this assistance as constructively and as rapidly as possible may be a mark of its stature.
The second step that must be taken will be even more difficult Nursing practice is currently in the hands of a variety of practitioners and assistants. Activities performed by a competent professional nurse during one portion of a twenty-four-hour period may be performed by an unskilled assistant with little or no supervision during another portion of the same twenty-four-hour period. The activity being performed is not necessarily the crucial factor. The crucial factor is a lack of registered professional and technical nurses to perform the needed activities.
We must find the will and the means to prepare the registered professional nurses and registered technical nurses in the numbers needed and to utilize them as they are able to function. Lulu Wolf Hassenplug in her recent article, "Preparation of the Nurse Practitioner," states: "Nurse educators and nursing service administrators must join forces and find ways to restructure our nursing services so that nurses can nurse and patients can be nursed . . . whatever needs to be done to make it possible for baccalaureate graduates to serve in a role for which they are being prepared, we must do, and the time to do this is now."* With this restructuring will come the effective use of the registered technical nurse and the health service assistant. The end result will be nursing care of a much higher caliber than we are providing at the present time.
The mood and the rapidity with which these changes take place will be an indication of the stature of the nursing profession, for the professional nurses in this country must move both national organizations toward their respective goals. We are at a crossroad in the nursing profession. We have the opportunity to come of age. In fact the health professions are faced with the need to translate the knowledge available to man into methodology whereby mankind may have access to this knowledge in health practice. Each of the health professions is faced with the task of identifying the types of practitioners it will need to bring its particular service to individuals. We should be pleased the nursing profession has identified and enunciated the hierarchy of persons needed at this time to provide quality nursing care to the population of this country.
The associate degree nursing program, when viewed from the vantage point of history, may well have made its greatest contribution by serving as a catalytic agent to the nursing profession in its identification of levels of preparation for nursing practice. Certainly, this was one of the intentions of the farsighted leaders of the early 1950s who envisioned its potentiality. They were wise enough to know that nursing could not continue on a horizontal plane and that both nursing education and nursing practice must establish themselves on a vertical plane, with theory and practice at each level carefully defined.
In this issue of The Journal of Nursing Education, we have brought together several articles which will add to the literature on the associate degree program and serve to interpret further the philosophy, purpose, and methodology of the program. We are pleased to include two articles that focus on the use of the nursing laboratory for this is one, if not the most significant, way in which this program is different. A third article discusses the introduction of teaching by television to a nursing faculty. Two of the articles deal with the utilization of the graduate: one from the viewpoint of the director of nursing, and one from the viewpoint of the nurse educator. Both present timely and important interpretations of the role, ability, and potential of the graduate of the associate degree nursing program.