Academic journal article Nursing History Review

"Coming to Grips with the Nursing Question": The Politics of Nursing Education Reform in 1960s America

Academic journal article Nursing History Review

"Coming to Grips with the Nursing Question": The Politics of Nursing Education Reform in 1960s America

Article excerpt

Abstract. The 1950s and 1960s were decades of change for the American nursing profession. A new generation of nurse educators sought to create greater professional autonomy for the nurse by introducing new models of education that emphasized science-based learning over technical skills and bedside care, and creating new clinical roles for the nurse, based on advanced graduate education. They confronted resistance from an older generation of nurses who feared becoming "second-class citizens" in increasingly academic nursing schools, and from academic health care institutions all too comfortable with the gendered hierarchy on which the traditional model of nursing education and practice was predicated. Using the University of Minnesota and University of California-Los Angeles (UCLA) as case studies, and based on institutional records and more than 40 oral histories with nursing and medical faculty, this article describes the generational conflicts this new cadre of nurse educators confronted within schools of nursing, and the institutional politics they struggled with as they sought to secure greater institutional status for the schools among the universities' other health science units.

In February 1963, the dean of the University of California-Los Angeles (UCLA) medical school wrote to UCLA's chancellor:

It would be best to abandon a Nursing School at UCLA, except as a Hospital Diploma School .... If a 'School of Nursing' is to be retained at UCLA it would require a great effort to reform it, and the 'School' should, in effect, become a Department of the School of Medicine.1

Five years later at the University of Minnesota, 22 members resigned from the School of Nursing, citing their dissatisfaction with the director of the school, Edna Fritz. One resigning faculty member wrote to Fritz that

At one time a competent and creative faculty was free to develop a nursing pro- gram to which it was committed. When I joined the faculty there was an excitement of dialogue, intellectual initiative, constructive criticism, and the push for inquiry .... This is no longer the case. The faculty is now fragmented and non-functioning. The curriculum is deteriorating .... Faculty and student morale has been seriously dam- aged .... You have encouraged fragmentation of faculty by supporting obstruction and rewarding non-productivity.2

A few months later, Fritz was fired as director of the School of Nursing.

Although separated geographically, these two scenes reflect the contested politics of nursing education reform in the United States during the 1960s. Through the mid-20th century, most American nurses were trained in hospi- tal training schools (or diploma programs) in which training and practice was, as Julie Fairman describes, "rule based, activity oriented, and relied heavily on the repetition of procedures rather than scientific or social theory-based deci- sion making."3 Across the United States during the 1950s and 1960s, however, a new generation of nurse educators sought to create greater professional autonomy for the nurse by introducing models of education that emphasized science-based learning over technical skills and bedside care. They also sought to create new clinical roles for the nurse based on advanced graduate educa- tion. As these educational reforms were gradually implemented throughout the country, the primary site of nursing education shifted from hospital-based diploma schools to colleges and universities.4

The introduction of education reform at nursing schools did not pass uncontested. Indeed, within a few years of being implemented, curriculum reforms introduced at UCLA School of Nursing in the 1950s and at the University of Minnesota School of Nursing in the early 1960s were causing problems for faculty, students, and administrators alike. The introduction of reform was also not a uniform process. Rather, the character and politics of education reform at an institution depended on the personalities involved and the local culture and politics of the specific institution. …

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