Journey To The Masters' Degree In Nursing Education
Concept of Post Graduate Nursing Education
“When one turns to the other he [sic] finds a distinct possibility
that a fresh and conspicuously enlarged contribution may soon come from many more
nurses who find places of great social and professional usefulness in
consultation, planning, research, writing, and the promotion of health
services. . .” (Brown, 1948, p. 98).
The quote above by Esther Lucille Brown was a prelude to the formation of nursing education programs that granted nurses master's degrees. At the time of her statement few nurses had master's degrees (known at that time as “specialties”), and many who had preparation beyond basic nursing education had postgraduate education.
Postgraduate education was training nurses received through internships in areas such as pediatrics and infection control, practicum experiences in midwifery and anesthesia, or theoretical preparation in public health and nursing education (Bullough, Bullough, & Soukup, 1983).
It also included additional training for nursing supervision and
administration (Brown, 1948). Prior to the 1950s, if nurses wanted to obtain a
master's degree rather than postgraduate education, they had to seek an
advanced degree in another field such as sociology or psychology (Bullough
& Bullough, 1984).
The History of Master's Preparation in Nursing Education
During the 1950s nurses first had the opportunity to obtain a master's degree in nursing when Rutgers University in New Jersey offered a master's degree in psychiatric nursing. This first master's degree prompted additional programs, which interestingly reflected specializations of the early postgraduate education in nursing (eg, teaching, pediatrics, administration). As masters in nursing programs grew, support for them also increased.
Advance Concept of Nursing Education
In 1969 and 1978 the ANA advocated for nurses' advanced preparation in theory to improve practice and in specialty nursing roles to offer high levels of competence in particular areas of nursing practice. By the 1970s societal trends encouraged an even greater demand for masters in nursing programs (Murphy, 1981). For instance, healthcare environments needed nurses with advanced preparation in areas such as research, teaching, administration, and clinical areas of nursing practice.
The Council of Baccalaureate and Higher
Degree Programs (1985) provided further support for master's preparation by
stating that the nation needed nurses prepared with master's degrees in nursing
to meet society's nursing needs.
Reforming Master's Preparation in Nursing Education
Despite support for master's education for nurses, Starck (1987) argued that by the 1980s there were far too many master's preparation programs, which served only to confuse the public. She pointed out that by the later 1980s there were 257 master's degrees in nursing programs. She provided recommendations for reforming master's degree programs where by all master's prepared nurses would receive core preparation in leadership, management, teaching, intellectual curiosity, creative inquiry, collaborative and consultative skills, and professionalism (p. 20).
This preparation would
provide the public with a clear understanding of a master's prepared nurse. It
would also prepare nurses to work in settings where autonomy and fiscal
management were needed. For instance, she projected trends in healthcare costs
would lead to the need for master's-prepared nurses to manage community based
nursing centers and to oversee companies providing services to hospitals.
Understanding Master's Preparation in Nursing Education Today
Starck (1987) was correct in projecting the need for master's-prepared nurses to function within a greater scope (eg, there are now community-based clinics managed by nurse practitioners). Today there are a variety of master's degree programs, and according to the Bureau of Labor Statistics (2006b) there will continue to be a great demand for clinical nurse specialists, nurse practitioners, midwives, and anesthetists, especially in medically under served areas.
For a nurse wishing to seek graduate preparation,
the continuing variety of specializations from which to choose is appealing and
personally satisfying. Nonetheless, in today's healthcare environment, it has
become important to “think outside the box.” Will the master's prepared nurse
of today be able to meet the needs of society in the future?
New Model of Nursing Graduate
Recent trends include a movement towards a
new model of graduate education called the Clinical Nurse Leader (CNL). The CNL
focuses on generalist preparation, rather than specialist preparation (AACN,
2007b). The reason for developing such a role comes from evidence suggesting a
need for nurses with master's education to develop methods for improving
patient outcomes, coordinate evidence based practice, and promote client self
care and client decision making.
Clinical Nurse Leader and Masters' In Nursing
The AACN does not suggest that the CNL replace other master's prepared nurses; however, it contends this role will provide the public with nurses who have a comprehensive understanding of the broader healthcare system. Despite the movement to develop the CNL, it is controversial. There are those who contend that the CNL only adds confusion to the multiple existing graduate education pathways, that its development undermines the roles of other nursing specialists (eg, nurse practitioners and clinical nurse specialists), and that it minimizes the leadership role of every professional nurse (Erickson & Ditomassi, 2005).
The AACN has attempted to
address such concerns by describing the differences between these roles and the
importance of the CNL (AACN, 2005). These conflicts highlight the need for
continued dialogue about the CNL, the need for research on its effectiveness,
and the overall impact of this role in nursing practice specifically, and in
healthcare systems generally.
It is clear, however, that there is an
ever increasing need in the United States for nurses prepared at the
master's-degree level. The complexity of the healthcare system, the critical
shortage of nurse educators, and the need for advanced practice nurses to
deliver cost-effective, evidence-based patient care are just three of the
driving forces that require nurses be prepared beyond the baccalaureate level
to provide leadership in nursing administration, education, and practice.
Give your opinion if have any.