Shaping nursing profession regulation through history - a systematic review.

AIM: The aim of this systematic review was to provide a critical synthesis of the factors that historically shaped the advancements of nursing regulators worldwide. BACKGROUND: An in-depth examination of the different factors that moulded regulatory changes over time is pivotal to comprehend current issues in nursing. INTRODUCTION: In the light of global health scenarios, the researchers explored the factors that historically influenced the socio-contextual circumstances upon which governments made regulatory changes. METHODS: A systematic search was performed on the following databases: PubMed, CINAHL, Scopus, OpenGrey and ScienceDirect. The review included papers from January 2000 to October 2016 published in English. The authors used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and an inductive thematic approach for synthesis. RESULTS: Two main themes were identified: factors underpinning current challenges and historical and contextual triggers of regulation. The first theme was composed of three aspects: education, migration and internationalization, and policy and regulation; the second theme consisted of four attributes: demographics, economics, history of registration and wars, and historical changes in nursing practice. DISCUSSION: Factors that shaped nursing regulation were linked to changing demographics and economics, education, history of nursing registration, shifting patterns of migration and internationalization, nursing practice, policy and regulation and significant societal turns often prompted by wars. CONCLUSION: A deeper understanding of the developments of the nursing regulatory institutions provides the foundation for portable standards that can be applied across an array of jurisdictions to guarantee a better public safety. IMPLICATION FOR NURSING AND HEALTH POLICY: Understanding factors that socially, legislatively and politically have influenced the development of regulatory bodies over time helps to mould local, national and international policies that have a stronger impact on health worldwide. To achieve this, there must be effective cooperation among systems of nursing regulations globally.

A game of snakes and ladders: negotiating the 'ups and downs' of endorsement as a nurse practitioner in Australia.

BACKGROUND: Australian legislation supporting the nurse practitioner (NP) role was enacted in 1998. Since then, NPs have played an important advanced practice role within the interdisciplinary healthcare team. However, the literature suggests that transition to the NP role can be challenging. AIM: This paper highlights the complex transition experiences of ten recently endorsed Australian NPs. The convoluted legislative and regulatory requirements that were negotiated by the NPs are presented as narratives. METHODS: Informed by an ethnographic approach, participants were interviewed several times during their first year. Interview transcripts were thematically analysed and aggregated into three narratives representative of key findings. KEY FINDINGS: The findings exemplify the complexity of navigating through a labyrinth of bureaucracy and the extensive negotiations required to appease those who yielded power over their future practice. CONCLUSION: This study raises awareness of the transition experiences of Australian NPs and their challenges and barriers during this time.

Spanish nurses' credentialing in the 20th century.

BACKGROUND: Nurses credentialing as healthcare professionals commenced in Western Europe and in the USA by the end of the 19th and the beginning of the 20th century, boosted by the protestant reform movement. In Spain, it started in 1915, during the kingdom of Alfonso XIII (1902-1931). This historical period was marked by great political instability and big flaws in the healthcare delivery system. AIM: To describe the regulatory pathway that gave rise to the nursing profession in Spain, through official credentialing and regulation during the first third of the 20th century. METHOD: Documental, historical and regulatory documental research describing and analysing the national legislative sources used to regulate the professional development, as well as the education, training and competencies of the nursing practice in Spain, as compared with the developments in the European and American context. CONCLUSIONS: Professional development of the nursing profession in Western Europe and in the USA is consolidated during the 20th century as resulting in educational and training enhancement and the establishment of national and international professional bodies. In Spain, the regulatory and legal recognition of the nursing profession come into being in 1915 in response to a request from a female religious congregation.

The making and transnationalization of an ethnic niche: Vietnamese manicurists.

The article addresses how Vietnamese immigrant women developed an urban employment niche in the beauty industry, in manicuring. They are shown to have done so by creating a market for professional nail care, through the transformation of nailwork into what might be called McNails, entailing inexpensive, walk-in, impersonal service, in stand-alone salons, nationwide, and by making manicures and pedicures de riguer across class and racial strata. Vietnamese are shown to have simultaneously gained access to institutional means to surmount professional manicure credentializing barriers, and to have developed formal and informal ethnic networks that fueled their growing monopolization of jobs in the sector, to the exclusion of non-Vietnamese. The article also elucidates conditions contributing to the Vietnamese build-up and transformation of the niche, to the nation-wide formation of the niche and, most recently, to the transnationalization of the niche. It also extrapolates from the Vietnamese manicure experience propositions concerning the development, expansion, maintenance, and transnationalization of immigrant-formed labor market niches.

Education, Ethics, and History: The Peer Review Process in the US.

Despite the near-universal acceptance of the benefits of a sound peer review process (PRP), the topic of peer review remains a source of controversy among surgeons. The current PRP is plagued by heterogeneity across different hospital and institutional systems. These inconsistencies, combined with a perceived lack of fairness inherent to the PRP in some institutions, led to concerns among practicing surgeons. In this review of the relevant literature on the PRP, we attempted to provide some context and insight into the history of the PRP, its role, its shortcomings, its potential abuses, and some key requirements for its successful execution.

Translating the family medicine vision into educational programmes in Singapore.

The core of the Family Medicine (FM) vision is patient-centred care, requiring specific education and vocational training. We traced how FM education started and what have been achieved. FM training began in 1971 with the formation of the College of General Practitioners Singapore. Previously, training consisted of self-directed learning, lunchtime talks and examination preparation courses run by hospital specialists. Formal FM vocational training programmes in the United Kingdom and Australia provided the model for a 3-year programme in 1988. The tripartite relationship between the local university, College of Family Physicians and Ministry of Health, together with a structured training programme, contributed to its success. To date, more than 240 Family Physicians in Singapore have been awarded the Masters in Medicine (FM) degree. The Graduate Diploma in Family Medicine programme (GDFM) was introduced in 2000 for Family Physicians who wished to practice at an enhanced level. This programme has trained 194 doctors since then. Behind the scenes, the following were important developments: counterculture with a difference, tripartite stake-holding, training the trainers and learning from others. For the FM undergraduate programme, our aim is to develop the knowledge base, core values and roles of the Family Physician. Sustaining the value of Family Medicine as a career choice is the enduring vision.

The Doctor of Nursing Practice degree: lessons from the history of the professional doctorate in other health disciplines.

Despite the American Association of Colleges of Nursing's adoption of the Doctor of Nursing Practice (DNP) degree as the appropriate level of education for advanced practice, a number of controversies have persisted, including questions of timing, academic support, grandfathering, diffusion of nursing research, and economics. This article discusses the path to the professional doctorate in optometry, osteopathy, public health, pharmacy, physical therapy, audiology, chiropractic, and naturopathy. It reveals similar struggles to professionalism and the consensus drawn from doctoral development in these fields. It concludes with lessons for a path forward for the DNP.

Surgical nurse practitioners as registered nurse first assists: the role, historical perspectives, and educational training.

Advanced practice nurses (APN) who practice in the surgical subspecialty areas may have the opportunity to expand their scope of practice to include first assistant at surgery. Surgical APNs who practice as registered nurse first assistants (RNFA) should seek credentialing and apply for institutional privileges to assure the consumer of competent providers. Credentialing as an RNFA documents the educational learning process and skills acquired, and recognizes this area of expertise. The role of the APN as an RNFA at surgery is practiced within the specialty area of perioperative nursing which includes preoperative, intraoperative, and postoperative care. In this study, the nurse practitioners describe the role of the RNFA, its historical evolution over wartime, the required educational training, and the benefits of the role for patient care. The surgical nurse practitioner who undertakes training and education as a surgical RNFA is in an excellent position to provide patient care across the surgical continuum.

Moving the Nursing Profession Forward.

One nurse has traveled the world to advocate higher standards in nursing.

[Strategies of medical self-authorization in early modern medicine: the example of Volcher Coiter (1534-1576)]. / Strategien ärztlicher Selbstautorisierung in der frühneuzeitlichen Medizin: Das Beispiel Volcher Coiters (1534-1576).

Based on the example of Volcher Coiter--a town physician at Nuremberg and one of the leading anatomists in early modern medicine--, this essay points out that the authoritative status of contemporary physicians mainly was predicated on an interplay of self-fashioning and outside perception. It provides ample evidence that Coiter made use of several characteristic rhetorical and discourse-related strategies of self-authorisation such as the participation in social networks, a highly convincing technique of self-fashioning by emphasizing particular erudition, the presentation of academic medicine as a science authorised by god and the concurrent devaluation of non-academic healers. Furthermore, graphic and visual strategies of self-authorisation could be ascertained: Coiter took care for a premium typography of his books. He also used his talent as a graphic artist in his books to visualise his medical concepts. Moreover, the so-called 'Nuremberg Portrait' of Coiter served to illustrate his outstanding authority.

The medical profession and alternative medicine in The Netherlands: its history and recent developments.

At the end of 1993, the Dutch parliament passed the Individual Health Care Professions Bill which replaced existing legislation. The new Act brings to an end the monopoly of the Dutch medical profession. The former prohibition on alternative practitioners to practice medicine was abolished. This article addresses the question of whether the Act affects the position of medical dominance in Dutch health care. It will be argued that the new Act preserves the present position of medical dominance to a large extent. Although alternative therapies have gained greater social recognition, there is little indication that the cultural and social authority of medicine is yet being challenged in the Netherlands. However, it could be argued that the Dutch health care system is moving in a more pluralistic direction.

Pride or prejudice--issues in the history of children's nurse education.

The history of the education of nurses to care for sick children is notable on two counts. First, that the advent of training for nurses in the care of children pre-dates that of nurses caring for adults. Second, that it is a history fraught with prejudice, threats and misapprehensions. Certain key issues recur throughout the 130 years that education of children's nurses has existed: most are as familiar to professionals in this arena today as they were at the turn of the 19th century. Central to these issues is the status of children's nurses within the profession. Often deemed second rate citizens in nursing spheres, relegated to a supplementary register in 1919, their skills and knowledge under-valued, the specialist needs of children's nurses have often gone unrecognised. Efforts to convince general adult nurses of the equity of their value and, in the light of the differences between children and adults, the importance of specialist pre-registration education, has at times been difficult to achieve. These factors have impacted upon, and been reflected in, the progress of education for children's nurses. It is these issues that this paper seeks to illuminate and explore, through an examination of the history and development of children's nurse education.

Looking back--Dean's address.

General dental practitioners have been part of The Royal College of Surgeons of England since the LDS RCS examinations in 1860. For 87 years, it was the general dentists who were part of the College. Later, the political necessity of introducing hospital dentists to the National Health Service changed the ethos for dentists with the formation of the Faculty of Dental Surgery in 1947. Secondary care dentists became entrenched within The College at the expense of the majority of those who practiced dentistry to the same level as secondary care dentists. It took a further 45 years before general practitioners could return to their home. The Faculty of General Dental Practitioners (UK), within a short space of time, has become the largest Faculty for dentists within any of the Royal Colleges. This article includes excerpts from the Dean's address at the Ceremony of Presentation of Diplomats held on 3rd March 2001 (see page 75). It unveils the accidents of history which formulated a Royal College, the perseverance of committed dentists which took them into the fold of The College. It describes the beginning of the Faculty of Dental Surgery and unravels the story of the Advisory Board in General Dental Practice which later became the Faculty of General Dental Practitioners (UK). The next article 'Looking Forwards' will describe a way forward for this Faculty, which has grown up all too quickly in a rapidly changing world.

Practice development credentialing in the United Kingdom - a unique framework for providing excellence, accountability and quality in nursing and healthcare.

This paper will describe the purpose, process and value of an international Practice Development Program by which clinical units can choose to be credentialed. It will describe how the fourteen criteria that a Unit is credentialed against takes them along a journey of practice, personal and professional development that equips them to not only positively respond to, but to proactively influence, the challenges and changes that healthcare is facing globally. It explains how The Program focuses on credentialing sustainable practice development that then contributes to the development of both the capability and capacity of healthcare services. As a result, it crosses professional and organisational boundaries and constraints and concentrates on their shared purpose, delivering excellent patient care.

[Jageillonian University medical students' relationship to awarding of the doctorate degree in all medical sciences in the period between wars]. / Studenci medycyny UJ wobec doktoratu wszech nauk lekarskich w okresie miedzywojennym.

The Academic Schools Act of 1920 and the Ordinance of 1924 pertaining to doctorates provided that one could earn the degree only having submitted a disseration. The Austrian Act which was in force up to that moment had allowed to receive the degree without writing a thesis. Protests voiced by medical students extended validity of the Act. The Jagiellonian University medicals played an important role in delaying the Ordinance coming into force. Protesting against the newest regulations they organized public meetings, wrote memorials and filled petitions. The Jagiellonian University Faculty of Medicine granted doctorates without dissertation up to the end of December 1932. However some doctorates were granted even after that term.

Circle of healing: traditional storytelling, part three.

Southcentral Foundation had to overcome several organizational and procedural hurdles when developing their Circle of Healing program. Among these hurdles was finding a way to credential Alaska Native healers so the Foundation could be reimbursed for their services and pay the healers, and so the healers could work in the hospital along with the staff delivering Western and alternative medical treatment. Southcentral Foundation chose to develop a process for certifying Alaska Native healers as tribal doctors. Rita Blumenstein is the first such person to be certified. Lisa Dolchok is the second. An important strength of Lisa's presentation is that she helps us broaden our understanding of healing from an Alaska Native perspective. So often we equate healing with curing, and while it can have this dimension, Lisa reminds us there is much more to it. She echoes LouAnn Benson's presentation in asserting that healing can address illness of the spirit or wounds to the soul.