NUR 6130 Module 3 Nursing Education History Paper: The Goldmark Report, Nursing for the Future and the Future of Nursing Example

From Apprentice Labor to the University: Three Reports That Reshaped Nursing Education

Student Name

M.S. in Nursing, Thomas Edison State University

NUR-6130: History of American Nursing

Mentor Name

Month Day, Year

From Apprentice Labor to the University: Three Reports That Reshaped Nursing Education

Introduction

I earned my first nursing credential from a hospital diploma school in 1998, one of the last in our region. My classmates and I spent long days on the wards and believed, with some pride, that no one graduated more ready for bedside work. When I enrolled in a bachelor's program years later, I learned that the question of where nurses should be educated had been argued for most of a century. This paper follows that argument through three reports that shaped it and considers what it means for nurses in graduate study today.

Hospital Schools and Their Problems

By the early twentieth century, hundreds of hospitals ran their own training schools. For many of them, students were the nursing staff: they worked long shifts on the wards, often with little supervision or formal teaching, and graduates left to work in private duty while a new class took their place. Critics within nursing argued that this system served hospitals' budgets better than it served students or patients.

The Goldmark Report

Goldmark (1923) reported the findings of a national committee on nursing schools, funded by the Rockefeller Foundation and began its work in 1919. The committee studied a sample of hospital training schools and public health nursing agencies. It found that in most schools the demands of hospital service came before education: students worked long hours, instruction was often given by tired staff after a full shift and clinical experience depended on whichever patients were in the hospital rather than on a planned curriculum. The report recommended that nursing schools have their own funding and governance separate from hospital service, that university schools be developed to prepare leaders, teachers and public health nurses and that a shorter course prepare subsidiary workers for simpler care. Its influence was most visible in new university schools, including the Yale School of Nursing, which opened in 1923 with Rockefeller support.

Nursing for the Future

A quarter century later, Brown (1948), a social scientist at the Russell Sage Foundation, studied nursing at the request of the National Nursing Council at the close of World War II. The war had exposed shortages and uneven preparation. Brown recommended that education for professional nursing be placed in colleges and universities, that schools be evaluated and accredited and that weak schools close. She distinguished professional nurses from practical nurses, who would be prepared in shorter programs for more limited roles, and she urged the profession to recruit more widely, including men and students of color. Her report met resistance from hospitals that depended on student labor and from nurses who valued the diploma tradition.

War and Federal Funding

World War II brought the first large federal investment in nursing education. The Bolton Act of 1943 created the U.S. Cadet Nurse Corps, which paid tuition and a stipend to students who promised to serve for the duration of the war. Participating schools had to meet standards for instruction and could shorten programs to 30 months. Some 124,000 nurses graduated through the program. The Cadet Nurse Corps showed that public money could raise standards, a lesson that shaped later federal support for nursing schools.

The Associate Degree and the 1965 Position

The decades after Brown brought two developments that shaped today's system. In 1952 Mildred Montag proposed a two-year associate degree, taught in community colleges, to prepare technical nurses; it spread rapidly because it was affordable and fast. In 1965 the American Nurses Association declared that the baccalaureate should be the minimum preparation for professional nursing. The result was not the single pathway reformers wanted but three entry routes, diploma, associate and baccalaureate, all leading to the same license.

The Future of Nursing

A report produced with the Robert Wood Johnson Foundation (Institute of Medicine, 2011) returned to the question in a new context of complex, aging patients and a changing health system. Its authors set a goal that by 2020, four in five registered nurses would hold a bachelor's degree, doubling the number of nurses with doctorates, creating smooth routes for nurses to continue their education and removing barriers that kept nurses from using everything they had been educated to do. Unlike earlier reports, it framed education as part of a broader argument about nurses' capacity to lead change in health care.

Continuity Across a Century

Read together, the three reports share a pattern. Each found nursing education shaped more by the immediate needs of hospitals than by what patients and the public would need from nurses in the future, and each urged a move toward colleges and universities. Each also met resistance rooted in cost, in hospitals' reliance on nursing labor and in pride in hands-on preparation. My own diploma class felt that pride, and it was not wrong; we were skilled. But the reports suggest that skill at the bedside was never the only question.

What the History Means Today

The growth of RN to BSN and graduate programs, including the one I am now in, is a direct result of this long debate. Knowing its history helps me answer colleagues who see degree requirements as credentialism: the argument has always been about preparing nurses for responsibilities that change faster than any hospital routine.

Limits

This paper relies on published reports and their summaries rather than archival research. It focuses on national reports and cannot capture regional differences. The narrator and her diploma school are invented.

Conclusion

Goldmark found that hospital schools put service before learning, Brown argued that professional nursing education belongs in colleges and universities and a national report set a target of four in five nurses with a bachelor's degree nearly a century after the first report. The path from apprentice labor to the university has been long and contested, and graduate students today stand at the end of it.

References

Brown, E. L. (1948). Nursing for the future. Russell Sage Foundation.

Goldmark, J. (1923). Nursing and nursing education in the United States. Macmillan.

Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. The National Academies Press. https://doi.org/10.17226/12956