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.

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.

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.

Children's nursing and future directions: learning from 'memorable events'.

At present, the UK provides pre-registration education in four distinct branches, including child, but this is under threat with calls for a single generalist register in line with most of the developed world. Debate about this may be understood by placing 'memorable events' associated with this in their historical context. Analysis of quantitative data, obtained from the Nursing and Midwifery Council identifies a clear correlation between the numbers of registered children's nurses and changes in child health and welfare policies as well as nurse education over the last century. This interpretation of 'memorable events,' showing the growth and influence of this branch of the profession, should enable present day reformers of nurse education to make a rational and informed decision as they debate and decide upon the future of children's (and young people's) nursing in the UK.

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.

Brief history of inclusion of content on culture in nursing education.

Nursing has a long history of focusing on the cultural dimension of care, dating back to Florence Nightingale and the early days of public health nursing. Nursing education studies advocated for including social science concepts in nursing curricula well before the founding of the first university school of nursing in the United States in 1910. A brief review of the highlights of major nursing curriculum, licensing, funding, accreditation studies, and initiatives reveals that culture competence in nursing education continues to receive increasing emphasis and support.

Appreciating the importance of history: a brief historical overview of mental health, mental health nursing and education in Australia.

History is consistently acknowledged as crucial to the identity of a profession. In the case of mental health nursing this is perhaps more so, as published accounts of the history of nursing rarely pays attention to the specialty of mental health. The aim of this paper is to provide a brief overview of the history of mental health nursing in Australia. It is concluded that an understanding of history is essential in understanding and interpreting contemporary mental health service delivery and seeking to overcome the professional distance between mental health and other branches of nursing.

A brief history of the Commission on Graduates of Foreign Nursing Schools: shaping policy through collaboration.

In the late 1960s many foreign nurses arriving in New York City were unable to pass the New York State Board licensing examination. In this article, the author explains how a group of leaders and organizations proceeded systematically to address this problem through effective policy development. The process is presented from the establishment of a local program to meet the needs of this group of nurses to the creation of a national commission to oversee issues encountered by professionals seeking employment in the United States. Today, the Commission on Graduates of Foreign Nursing Schools is recognized worldwide as an authority on the education, registration, and licensure of nurses and other healthcare professionals.

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.

The life and trial of Dagmar Nelson--Part 1.

During the more desperate years of the Great Depression, a group of physicians brought an injunction proceeding against Dagmar Nelson and her employing hospital for illegally practicing medicine without a license. She administered general anesthesia and her employer knew it and supported her. It was a bizarre trial in that the arguments presented by both sides seem incongruous to our way of thinking today. The evidence presented at the trial echoed the predominant view at the time--the undisputed dominance of the male physician over the female nurse, who was portrayed, even by the defense, as only an extension of the surgeon who "has the power and therefore the responsibility" to control the surgery. Had she lost, anesthesia as a specialty of nursing would not exist. The method by which she won, however, has haunted us to this day. Part 2 of this 2-part column on "The life and trial of Dagmar Nelson" is scheduled for publication in the August 2006 AANA Journal.

The life and trial of Dagmar Nelson--part 2.

During the more desperate years of the Great Depression a group of physicians brought an injunction proceeding against Dagmar Nelson and her employing hospital for illegally practicing medicine without a license. She administered general anesthesia and her employer knew it and supported her. It was a bizarre trial in that the arguments presented by both sides seem incongruous to our way of thinking today. The evidence presented at the trial echoed the predominant view at the time--the undisputed dominance of the male physician over the female nurse, who was portrayed, even by the defense, as only an extension of the surgeon who "has the power and therefore the responsibility" to control the surgery. Had she lost, anesthesia as a specialty of nursing would not exist. The method by which she won, however, has haunted us to this day. Part 1 of this 2-part column was published in the June 2006 AANA Journal.

The nurse registration movement in Great Britain.

This historical investigation focuses on the early nurse registration movement in Great Britain and the problems encountered by British nurses involved in the movement. Events in Great Britain enlightened American nurse leaders and guided their struggle for registration and licensure. Although the registration movement in the United States began 16 years after the British movement, American nurses were successful in achieving their goals well in advance of their British counterparts.