Education for entry into nursing practice: revisited for the 21st century

Professions progress through an expected evolutionary process. This consists of expanding the scientific base, creating technical workers to share in the essential mission of the field, standardizing and up-grading education for entry into practice, and moving forward with specialization. Nursing s progression has been spotty and incomplete, largely because of the influence of external communities of interest, and the fact that nurses have resisted and personalized decisions that are necessary for future generations. For nursing, education for entry into practice has been the most contentious issue in this scheme of professional evolution. For almost 100 years, nurses have debated "entry", but moved to little planned change. Rather, nursing has been swept along by a host of social and educational circumstances that had little to do with nursing. The result has been a myriad of programs with graduates used interchangeably in the real world. This absence of consensus within the discipline of nursing causes consumer confusion, seriously compromises our ability to serve the public, and is intimately associated with the nursing shortage of 2002. What is adequate educational preparation for entry into professional practice for the 21st Century? Agreement on this issue is an essential step towards a preferred future. This paper is intended to raise issues, and to stimulate discussion around these issues, rather than to provide answers.