BEF 644: Philosophy of Science and its Relation to Education Chineda Hill and Curt Spires

 Licensure laws  Overproduction of nurses and low standards  Physicians create unified profession  Nurses sought to define professional nursing

 Supplementary voluntary aide system  Mobilization of “Leisure class” women  Army School of Nursing  War and pandemic years

 American Hospital Association call for “hospital helpers”  “Sub-nurses”  Chicago Training School for Home and Public Health Nursing

 Study on public health nursing  Goldmark Report  Nursing divided

 National League of Nursing Education’s Committee on Grading  Reviewed results of Goldmark report  Organized “independent” study including representatives from major nursing, hospital, public-health & medical associations  AMA NOT happy because study NOT AMA controlled

 Survey comprehensively nursing’s ills & propose necessary changes  Study supply & demand for nursing services  Job analysis of nursing work  Grading of nursing schools  Prove quantitatively & objectively problems nursing faced

 First published in 1928 as Nurses, Patients and Pocketbooks  Oversupply of nurses & increasing unemployment  Undersupply of nurses able to provide skilled & complex care at reasonable costs

 One out of every 590 people in US is an active graduate nurse  2296 schools of nursing in the US – numbers seem to be increasing  This year (1928) 20,000 new graduates entering profession  Average professional life of the nurse is little more than 17 years

 Of the 20,000 new graduates, nearly half are women who have never finished high school – academic education is less than that of stenographers, typists or file clerks  Under educated women coming not only from small hospitals, but from larger ones as well  Only 3 out of 10 graduate nurses belong to the American Nurses’ Association

Best Summarized as Why Not Improved Training for Fewer Nurses

 Class distinction – “Working class” vs. “High- grade”  Wanted to exclude certain “classes” “Somehow these undereducated women, in inadequate social and academic backgrounds must be kept out of the profession. Fortunately there is no longer any need for them….Therefore our first problem … how can women be kept out of nursing who manifestly have not the proper background to enter”

 Majority of “trained nurses” employed in the home setting  “Trained Nurses” competed with cheaper services of the “untrained nurse” & charitable services of the public-health nurses  Well-to-do patients began utilizing hospitals & private duty nurses began to “special” them in the hospital as compared to the home

 Expensive Service – less utilization  Private duty nurses can’t find employment in the home because patients admitted to hospital – can’t find employment in the hospital because of hospitals use of undergraduate (student) nurses  Sixty (60) percent of ALL nurses unemployed

 Depression era had significant impact on use of Private Duty  Many nurses left profession entirely due to inability to obtain work  Various “remedies” attempted – group practice, community health nursing partnerships, etc.

 Grading Committee’s final report (1932)  “Too many, yet too few trained nurses”  Too many ill-prepared  Too few “broadly-experienced, professionally- minded”

 Physician’s increasing power & professional autonomy impacted nursing profession  Ill-trained and subordinate ranks of nurses impacted profession  Nursing administration unable & unwilling to make bold moves to transform nursing education waited as change swirled around them