Nursing Comes of Age

From Nursing Career

The End of World War II to the End of the Millennium

The decades after World War II saw massive change in America. The experiences of the population in the years after World War I led to a cautious yet optimistic approach by virtually every organization, from the government to Wall Street to farmers, which sought to capitalize on the boom in the economy while avoiding another severe recession. The 1960s would see huge advance in the area of civil rights, both for people of color and for women. The ‘70s were a decade in which a lot of the advances made during the ‘60s were codified and stated officially by the courts. The ‘80s would bring about several important days of recognition as far as calendar dates; and a whole new dimension was added to health crises worldwide. Finally, the spirit of the ‘90s was one of defeatism and cynicism. All of these attitudes, progresses, and setbacks, as well as the dangers, were reflected within the nursing profession.

In the years immediately following World War II, every national nursing organization began to set up planning committees at all levels. The purpose of these committees was to avoid the educational crisis that had befallen the profession in the years that World War I wound down and then ended. Several reports were commissioned. Prominent among these was that written by Dr. Esther Lucille Brown, known colloquially as The Brown Report. This report was to make several incredibly important recommendations when it came to the perception of the professional nurse and how the training of nurses should be handled. Among the most important highlights:

• Brown recommended that the term “professional” should only apply to nurses who had graduated from an accredited professional school. This recommendation would eventually lead to the combination of the National League for Nursing Education, the National Organization for Public Health Nursing, and the Association of Collegiate Schools of Nursing in 1952. The new organization known as the National League for Nursing, and took responsibility for the accreditation of nursing schools within the United States.
• Along with accreditation, the Brown Report also recommended that faculties within the recognized schools should have a national standard. This standard applied to the education and the practical experience of the faculties within the school, and was to be accepted in all schools.
• Finally, and perhaps most importantly as far as the profession is concerned, the schools for nurses were no longer to come under the purview of a hospital. Instead, their affiliation was to be through a university, with a budget separate from the running costs of the hospital.

The final recommendation of the Brown Report would set the groundwork for the nursing education of today. One of the biggest effects of this was that nursing students were recognized as training professionals, and not as an easily accessible, cheap (in many cases free) source of labor for the hospitals.

The 1950s would also see an important stride for male nurses in particular on the national scale. President Eisenhower would sign into law a proposal that granted male nurses within the army equal status with females, in that they too would now receive an officer’s commission. It was also during this decade that the idea of a National Nurses Day was first put out, although it was initially turned down by President Eisenhower.

The 1960s was a decade of national change that took place largely outside of professions, but was to lay incredibly important groundwork for changes within professions, especially those dominated by women (such as teaching and nursing). The civil rights movement was to have a great impact on the acceptance of black people within society. Also important to nursing was the women’s movement, stimulated by Betty Friedan’s The Feminine Mystique. Although this book was primarily directed at the full time homemaker, its application to the life of the nurse and other professional women was equally valid, as it laid a foundation for questioning the automatic placement of a wife’s career as secondary. In this way, the women’s movement gave a modern solidification of Florence Nightingale’s vision of the nurse as a full time career option for many women.

The 1970s were to see the efforts of nurses towards full professional status come to fruition at last. On March 15, 1972, New York State officially recognized nursing as a profession in a precedent setting decision. This decision designated the profession of nursing as separate from other health care professionals, with standards and theory of its own. In 1974, President Nixon would put the backing of the United States government behind the recognition of nurses as he declared National Nurses Week in the middle of May. Despite the progress of the ‘60s and the decisions of the ‘70s, however, nurses still struggled with the common perception of their role as subservient both to doctors and to their societal roles as wives and mothers.

The 1980s meant two very important developments in the role of nurses. The first was the beginning of the advancement of nursing theory. While these theories are even today still in their growing stages, all models continue to reflect the importance of assessment of the needs of a patient and the implementation of methods to achieve proper patient care. The 1980s also saw the rise of a major threat to the health of all health care professionals in the form of the HIV virus. Front line medical workers such as nurses have always been most at risk in the rise and spread of disease, and the threat posed by HIV meant that hospitals and training programs were revolutionized in the way bodily fluids were handled.

The continuing struggles of the nursing profession (failure to earn the respect deserved from doctors and sometimes patients, the difficulties of the work involved, sub-standard pay, and finally the submerged but still very real idea of the career of a woman being secondary to her role as mother and wife) meant that fewer people enrolled in nursing programs throughout the 1990s. Coupled with this was the perception that the career as nurse was a closed book, with too many nurses already in the field and no new positions opened for newcomers.

The new millennium, of course, belied the common perception towards nursing as an overflowing profession. Due to the failure of recruitment in the 1990s, a repetition of the recurring theme of a nursing shortage is now in full effect world wide. On the positive side, the shortage has meant society has been forced to recognize the vital role that nurses play in all aspects of health care. In addition, a new generation has meant that nursing is seen as a viable option for all genders, and that in itself the role of a nurse is a very worthy endeavor. Due to the intense competition for qualified staff, nurses’ pay is also beginning to reflect the amount of expertise and professionalism needed to carry out the job.