Reforming nursing registration: Lessons from pandemics.

A nimble and flexible regulatory response regarding the nursing workforce is essential to a fully integrated public health approach to national crises and pandemics. The COVID-19 pandemic has drawn many comparisons to the 1918 Flu Pandemic. Some of them are well-reasoned and grounded in evidence. Other are not. This study provides a historically contextualized analysis of how the 1918 flu pandemic helped shape Pennsylvania nursing's current regulatory apparatus. We conclude that the state-based solutions that nursing registration represents are inadequate to deal with pandemics and crises with national, if not global, reach. We need to move immediately toward the national COMPACT system, while mindful of how regulatory processes and procedures can reinforce structural inequities.

The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

PURPOSE: The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. DESCRIPTION OF THE PROJECT: The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. OUTCOME: On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. CONCLUSIONS: Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

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.

"All who nurse for hire": nursing and the mixed legacy of legislative victories.

Sustained support of policy initiatives by nursing has resulted in significant legislative victories. One victory, the passage of the 1938 New York State Todd-Feld Act, which underwent legislative debate at a time when the nurse labor market was in disarray, during an economic depression, and before U.S. entry into World War II, reinforces our understanding that nursing must be a strong shepherd for policies beneficial for health care delivery. Designed to correct serious deficiencies in the nursing workforce, the act successfully required licensing for those working as registered and practical nurses. Yet, its provisions failed to stop all unlicensed nurse workers from practicing. Rapid changes occurring in the nurse labor market against the backdrop of growing hospital power over the employment of all nurse workers minimized the act's effectiveness. Policy implications include the need to focus on the complex nature of health care policy initiatives, flexibility in the face of changing circumstances, and acceptance of political realities.

Gender, politics, and regionalism: factors in the evolution of registered psychiatric nursing in Manitoba, 1920-1960.

In Canada, psychiatric nursing care is provided by two kinds of nurses. East of Manitoba, it is provided by registered nurses who may or may not have specialized psychiatric nursing education. In the four western provinces, a distinct professional group, registered psychiatric nurses, also provide care. Saskatchewan was the first province to achieve distinct legislation, in 1948, followed by British Columbia in 1951, Alberta in 1955, and Manitoba in 1960. Several factors coalesced to sway Manitoba to adopt the distinct profession model. First, there was little interest by the general nursing body in mental hospital nursing. Second, the other three western provinces had formed a Canadian Council of Psychiatric Nursing that encouraged mental hospital attendants and nurses in Manitoba. Third, a group of male attendants took on leadership roles supported by the mental hospital superintendents. Finally, Manitoba was culturally and geographically more aligned with western than eastern Canada.

The story of nurse licensure.

The evolution of nurse licensure is representative of the heroic efforts of nurses to enhance the value and impact of the nursing profession. This literature review presents a historical account of the advancement of nursing through the nurse licensure process.

Moving in circles: a brief history of reports and inquiries relating to mental health content in undergraduate nursing curricula.

Since the abolition of specialist, undergraduate education in mental health nursing, serious concerns have been raised about the inadequate amount of theory and clinical experience devoted to this specialty in most pre-registration nursing programs in Australia. A number of government initiated reports and inquiries have been undertaken to scope the problem and provide recommendations with the aim of overcoming the identified deficits. Most inquiries have agreed that mental health nursing is under-represented in undergraduate programs and this has serious consequences for establishing a sustainable mental health nursing workforce and for providing optimal care for people experiencing a mental illness. The recommendations tend to support the continuation of comprehensive nursing education, but emphasise the need for increased mental health content. Terms like significant and substantial are often used which are not easily quantifiable. The repetitive nature of the recommendations and findings of the reports suggests that real change is not likely to occur unless specific minimum standards for the mental health content of undergraduate nursing programs are set.

Reflections on a perioperative career: 1970-2008.

This paper is a personal journey through nurse training and perioperative practice. Nurse education is also explored alongside some of the social, academic and political changes that have influenced healthcare in the United Kingdom between 1966 and 2008. The views expressed are those of the author only, and the anecdotal descriptions are anonymous.

BJN 100 years ago. Nurses in the dock.

The BJN, even 100 years ago, published legal cases involving nurses or nursing situations. These were highlighted to illustrate the need for the State Registration of nurses. The following is a sample of some of the main points taken from such cases and helps us to compare some of our common professional issues with those of the past.

90 years strong.

The law on the registration of nurses is 90 years old this month. But the road for the regulatory bodies has not always been smooth.

The genesis of advanced nursing practice in New Zealand: policy, politics and education.

When New Zealand's first Nurse Practitioner was approved by the Nursing Council of New Zealand in December 2001, it was the centenary year of New Zealand nursing registration, but less than a decade after the commencement of New Zealand's first pre-registration nursing degrees. What were the conditions and forces in play that saw nursing achieve a new emphasis on advanced clinical education and practice, culminating in the development of an advanced, expanded scope of nursing practice? This contemporary historical study examines the professional and sectoral milieu of the 1990s and the turn of the 21st century, together with the policy initiatives undertaken to advance nursing in New Zealand during that period.