Nurse education consists of the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. This education is provided to nursing students by experienced nurses and other medical professionals who have qualified or experienced for educational tasks. Most countries offer nurse education courses that can be relevant to general nursing or to specialized areas including mental health nursing, pediatric nursing and post-operatory nursing. Courses leading to autonomous registration as a nurse last four years. Nurse education provides post-qualification courses in specialist subjects within nursing. During past decades, the changes in education have replaced the more focused, but ritualistic, training structure of conventional preparation. Nurse education integrates today a broader awareness of other disciplines allied to medicine involving inter-professional education, the utilization of research when making clinical and managerial decisions.
Orthodox training can be argued to have offered a more intense practical skills base, but emphasized the handmaiden relationship with the physician. This is now outmoded, the impact of nurse education is to develop a confident, inquiring graduate who contributes to the care team as an equal. In some countries, not all qualification courses have graduate status. Traditionally, from the times prior to Florence Nightingale, nursing was seen as an apprenticeship undertaken in religious institutes such as convents by young women, although there has always been a proportion of male nurses in mental health services. In 1860 Nightingale set up the first nurse training school at London. Nightingale's curriculum was base around nursing practice, with instruction focused upon the need for hygiene and task competence, her methods are reflected in her Notes on Nursing. Some other nurses at that time, notably Ethel Gordon Fenwick, were in favor of formalized nursing registration and curricula that were formally based in higher education and not within the confines of hospitals.
Nurse education in the United States is conducted within university schools, although it is unclear who offered the first degree level program. So far as known Yale School of Nursing became the first autonomous school of nursing in the United States in 1923. In November 1955, a World Health Organization study group on the education of nurses met in Brussels and made several recommendations, including that "At least one experimental school of nursing be set up in each country." In the UK, the first department of Nursing Studies at the University of Edinburgh was established in 1956, with a five-year integrated degree programme introduced in 1960. Several other universities across the UK during the 1960s. In 1974 La Trobe University commenced the first nursing course in Australia. There are multiple entry levels into nursing; this has led to confusion for the public, as well as other healthcare professionals. The earliest schools of nursing offered a Diploma in not an actual academic degree. Community colleges began offering an Associate of Science in Nursing degree, some diploma programs switched to this model.
Universities began to offer Bachelor of Science in Nursing and Bachelor of Nursing degrees, followed by Master of Science in Nursing degrees, Doctor of Nursing Practice degrees. Pre-registration nurse training and education in the UK is now via a bachelor's degree following the phasing-out of the Diploma of Higher Education in Nursing, offered at universities and colleges. To become a student nurse, individuals must apply through the University and Colleges Admissions Service to their nursing degree choices, choosing from one of the four nursing fields: Adult, Mental Health and Learning Disabilities. Requirements for entry to a pre-reg nursing degree are five GCSEs at Grade C or above, along with three A-Level subjects at Grade C or above, although the majority of universities will seek higher grades due to the competition for places. Key Skills courses are no-longer accepted as an alternative to GCSEs, however science or healthcare-based BTEC Level 3 Extended Diplomas and Access courses are most oftem accepted in lieu of A-Level qualifications.
If successful following interview, the student will study a "core" first year, learning basic nursing competencies essential to all four of the above fields. It is from second year and onwards that the degree will begin to focus on the student's chosen field. Following completion of the degree, the applicant will be registered with the Nursing and Midwifery Council as a Registered Nurse in their field of practice, using the post-nominal RNA, RNC, RNMH or RNLD as appropriate to their degree qualification. There are two specific pathways individuals can take if they wish to become a nurse in Western Australia, they can decide to study at university to become a registered nurse, alternatively they can study at Technical and Further Education to become an enrolled nurse. Both pathways require a variety of entry requirements whether it be passing year 12 Maths and Human Biology along with receiving a specific Australian Tertiary Admission Rank known as a score for university or providing prior learning experiences and legal clearances for TAFE.
Either way individuals need to be aware these requirements can vary year to year and, why they are recommended to contact each university or institute to find out entry requirement
Nursing is a profession within the health care sector focused on the care of individuals and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health care providers by their approach to patient care and scope of practice. Nurses practice in many specialties with differing levels of prescription authority. Many nurses provide care within the ordering scope of physicians, this traditional role has shaped the public image of nurses as care providers. However, nurse practitioners are permitted by most jurisdictions to practice independently in a variety of settings. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, many of the traditional regulations and provider roles are changing. Nurses develop a plan of care, working collaboratively with physicians, the patient, the patient's family and other team members, that focuses on treating illness to improve quality of life.
In the United States and the United Kingdom, advanced practice nurses, such as clinical nurse specialists and nurse practitioners, diagnose health problems and prescribe medications and other therapies, depending on individual state regulations. Nurses may help coordinate the patient care performed by other members of a multidisciplinary health care team such as therapists, medical practitioners and dietitians. Nurses provide care both interdependently, for example, with physicians, independently as nursing professionals. Nursing historians face the challenge of determining whether care provided to the sick or injured in antiquity was nursing care. In the fifth century BC, for example, the Hippocratic Collection in places describes skilled care and observation of patients by male "attendants," who may have been early nurses. Around 600 BC in India, it is recorded in Sushruta Samhita, Book 3, Chapter V about the role of the nurse as "the different parts or members of the body as mentioned before including the skin, cannot be described by one, not well versed in anatomy.
Hence, any one desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and observe, by dissecting it, examine its different parts." Before the foundation of modern nursing, members of religious orders such as nuns and monks provided nursing-like care. Examples exist in Christian and Buddhist traditions amongst others. Phoebe, mentioned in Romans 16 has been described in many sources as "the first visiting nurse"; these traditions were influential in the development of the ethos of modern nursing. The religious roots of modern nursing remain in evidence today in many countries. One example in the United Kingdom is the use of the historical title "sister" to refer to a senior nurse in the past. During the Reformation of the 16th century, Protestant reformers shut down the monasteries and convents, allowing a few hundred municipal hospices to remain in operation in northern Europe; those nuns, serving as nurses were given pensions or told to get married and stay home. Nursing care went to the inexperienced as traditional caretakers, rooted in the Roman Catholic Church, were removed from their positions.
The nursing profession suffered a major setback for 200 years. Florence Nightingale laid the foundations of professional nursing after the Crimean War, her Notes on Nursing became popular. The Nightingale model of professional education, having set up the first school of nursing, connected to a continuously operating hospital and medical school, spread in Europe and North America after 1870. Nightingale was a pioneer of the graphical presentation of statistical data. Other important nurses in the development of the profession include: Agnes Hunt from Shropshire was the first orthopedic nurse and was pivotal in the emergence of the orthopedic hospital The Robert Jones & Agnes Hunt Hospital in Oswestry, Shropshire. Agnes Jones, who established a nurse training regime at the Brownlow Hill infirmary, Liverpool, in 1865. Linda Richards, who established quality nursing schools in the United States and Japan, was the first professionally trained nurse in the US, graduating in 1873 from the New England Hospital for Women and Children in Boston.
Clarissa Harlowe "Clara" Barton, a pioneer American teacher, patent clerk and humanitarian, the founder of the American Red Cross. Saint Marianne Cope, a Sister of St. Francis who opened and operated some of the first general hospitals in the United States, instituting cleanliness standards which influenced the development of America's modern hospital system. Catholic orders such as Little Sisters of the Poor, Sisters of Mercy, Sisters of St. Mary, St. Francis Health Services, Inc. and Sisters of Charity built hospitals and provided nursing services during this period. In turn, the modern deaconess movement began in Germany in 1836. Within a half century, there were over 5,000 deaconesses in Europe. Formal use of nurses in the modern military began in the latter half of the nineteenth century. Nurses saw active duty in the First Boer War, the Egyptian Campaign, the Sudan Campaign. Hospital-based training came to the fore in the early 1900s, with an emphasis on practical experience; the Nightingale-style school began to disappear.
Hospitals and physicians saw women in nursing as a source of inexpensive labor. Exploitation of nurses was not uncommon by employers and educational providers. Many nurses saw active duty in World War I, but the profession was transformed during the second World War. British nurses of the Army Nursing Service were part of every overseas campaign. More nurses volunteered for service in the US Army and Navy than any other occupat
Naturopathy or naturopathic medicine is a form of alternative medicine that employs an array of pseudoscientific practices branded as "natural", "non-invasive", as promoting "self-healing". The ideology and methods of naturopathy are based on vitalism and folk medicine, rather than evidence-based medicine. Naturopathic practitioners recommend against following modern medical practices, including but not limited to medical testing, drugs and surgery. Instead, naturopathic study and practice rely on unscientific notions leading naturopaths to diagnoses and treatments that have no factual merit. Naturopathy is considered by the medical profession to be ineffective and harmful, raising ethical issues about its practice. In addition to accusations from the medical community, such as the American Cancer Society, naturopaths have been accused of being charlatans and practicing quackery. Over the years, many practitioners of naturopathy have been found criminally liable in the courts of law around the world.
In some countries, it is a criminal offense for naturopaths to label themselves as medical professionals. Naturopaths are campaigning for more recognition in the United States; the term "naturopathy" originates from "natura" and "pathos" to suggest "natural healing". Naturopaths claim the ancient Greek "Father of Medicine", Hippocrates, as the first advocate of naturopathic medicine, before the term existed. Naturopathy has its roots in the 19th-century Natural Cure movement of Europe. In Scotland, Thomas Allinson started advocating his "Hygienic Medicine" in the 1880s, promoting a natural diet and exercise with avoidance of tobacco and overwork; the term naturopathy was coined in 1895 by John Scheel, purchased by Benedict Lust, whom naturopaths consider to be the "Father of U. S. Naturopathy". Lust had been schooled in hydrotherapy and other natural health practices in Germany by Father Sebastian Kneipp. Lust defined naturopathy as a broad discipline rather than a particular method, included such techniques as hydrotherapy, herbal medicine, homeopathy, as well as eliminating overeating, tea and alcohol.
He described the body in spiritual and vitalistic terms with "absolute reliance upon the cosmic forces of man's nature". According to the Merriam-Webster Dictionary, the first known use of "naturopathy" in print is from 1901. From 1901, Lust founded the American School of Naturopathy in New York. In 1902, the original North American Kneipp Societies were discontinued and renamed "Naturopathic Societies". In September 1919, the Naturopathic Society of America was dissolved and Benedict Lust founded the American Naturopathic Association to supplant it. Naturopaths became licensed under naturopathic or drugless practitioner laws in 25 states in the first three decades of the twentieth century. Naturopathy was adopted by many chiropractors, several schools offered both Doctor of Naturopathy and Doctor of Chiropractic degrees. Estimates of the number of naturopathic schools active in the United States during this period vary from about one to two dozen. After a period of rapid growth, naturopathy went into decline for several decades after the 1930s.
In 1910, the Carnegie Foundation for the Advancement of Teaching published the Flexner Report, which criticized many aspects of medical education quality and lack of scientific rigour. The advent of penicillin and other "miracle drugs" and the consequent popularity of modern medicine contributed to naturopathy's decline. In the 1940s and 1950s, a broadening in scope of practice laws led many chiropractic schools to drop their ND degrees, though many chiropractors continued to practice naturopathy. From 1940 to 1963, the American Medical Association campaigned against heterodox medical systems. By 1958, practice of naturopathy was licensed in only five states. In 1968, the United States Department of Health and Welfare issued a report on naturopathy concluding that naturopathy was not grounded in medical science and that naturopathic education was inadequate to prepare graduates to make appropriate diagnosis and provide treatment. In 1977 an Australian committee of inquiry reached similar conclusions.
Beginning in the 1970s, there was a revival of interest in the United States and Canada, in conjunction with the "holistic health" movement. As of 2009, fifteen U. S. states, Puerto Rico, the US Virgin Islands and the District of Columbia licensed naturopathic doctors, the State of Washington requires insurance companies to offer reimbursement for services provided by naturopathic physicians. On the other hand, some states such as South Carolina and Tennessee prohibit the practice of naturopathy. In 2015, a former naturopathic doctor, Britt Marie Hermes, began writing critically about her experience being trained in and practicing naturopathic medicine; the practice of naturopathy is based on a belief in the body's ability to heal itself through a special vital energy or force guiding bodily processes internally. Diagnosis and treatment concern alternative therapies and "natural" methods that naturopaths claim promote the body's natural ability to heal. Naturopaths focus on a holistic approach avoiding the use of surgery and conventional medicines.
Naturopaths aim to prevent illness through stress reduction and changes to diet and lifestyle rejecting the methods of evidence-based medicine. A consultation begins with a lengthy patient interview focusing on lifestyle, medical history, emotional tone, physical features, as well as physical e
Critical care nursing
Critical care nursing is the field of nursing with a focus on the utmost care of the critically ill or unstable patients following extensive injury, surgery or life threatening diseases. Critical care nurses can be found working in a wide variety of environments and specialties, such as general intensive care units, medical intensive care units, surgical intensive care units, trauma intensive care units, coronary care units, cardiothoracic intensive care units, burns unit and some trauma center emergency departments; these specialists take care of critically ill patients who require mechanical ventilation by way of endotracheal intubation and/or titratable vasoactive intravenous medications. Critical care nurses are known as ICU nurses, they treat patients who are acutely ill and unstable requiring more frequent nursing assessments and the utilization of life sustaining technology and drugs. Although many ICU patients have chronic health issues, patients are in the ICU for an acute pathology or an exacerbation of a chronic pathology.
ICU nurses apply their specialized knowledge base to care for and maintain the life support of critically ill patients who are on the verge of death. On a day-to-day basis a critical care nurse will "perform assessments of critical conditions, give intensive therapy and intervention, advocate for their patients, operate/maintain life support systems which include mechanical ventilation via endotracheal, tracheal, or nasotracheal intubation, titration of continuous vasoactive intravenous medications in order to maintain a " mean arterial pressure that ensures adequate organ and tissue perfusion. Critical care nurses in the U. S. are trained in advanced cardiac life support, many earn certification in acute and critical care nursing through the American Association of Critical–Care Nurses. Due to the unstable nature of the patient population, LPN/LVNs are utilized in a primary care role in the intensive care unit. However, with proper training and experience LPN/LVNs can play a significant role in providing exceptional bedside care for the critically ill patient.
To become a critical care nurse, one must first achieve an associate or bachelor's degree in nursing and pass the National Council Licensure Examination. Once the exam is passed someone can start working as a regular registered nurse. After getting hired into a critical care area, additional specialized training is given to the nurse. After 1750 hours of providing direct bedside care in a critical care area, a nurse can sit for the CCRN exam; the American Association of Critical Care Nurses advisory board sets and maintains standards for critical care nurses. The certification offered by this board is known as CCRN. Depending on the hospital and State, the RN will be required to take a certain amount of continuing education hours to stay up to date with the current technologies and changing techniques. Registration is a regulatory term for the process that occurs between the individual nurse and the state in which the nurse practices. All nurses in the US are registered as nurses without a specialty.
The CCRN is an example of a post registration specialty certification in critical care. There are variants of critical care certification test that the AACN offers to allow nurses to certify in progressive care, cardiac medicine and cardiac surgery. In addition, Clinical Nurse Specialists can certify in adult and pediatric acute and critical care. In November 2007, the AACN Certification Corporation launched the ACNPC, an advanced practice certification examination for Acute Care Nurse Practitioners. None of these certifications confer any additional practice privileges, as nursing practice is regulated by the individual's state board of nursing; these certifications are not required to work in an intensive care unit, but are encouraged by employers, as the tests for these certifications tend to be difficult to pass and require an extensive knowledge of both pathophysiology and critical care medical and nursing practices. The certification, while difficult to obtain, is looked upon by many in the field as demonstrating expertise in the field of critical care nursing, demonstrating the individual's nurse's desire to advance their knowledge base and skill set, thereby allowing them to better care for their patients.
Intensive care nurses are required to be comfortable with a wide variety of technology and its uses in the critical care setting. This technology includes such equipment as hemodynamic and cardiac monitoring systems, mechanical ventilator therapy, intra-aortic balloon pumps, ventricular assist devices, continuous renal replacement equipment, extracorporeal membrane oxygenation circuits and many other advanced life support devices; the training for the use of this equipment is provided through a network of in-hospital inservices, manufacturer training, many hours of education time with experienced operators. Annual continuing education is required by most states in the U. S. and by many employers to ensure that all skills are kept up to date. Many intensive care unit management teams will send their nurses to conferences to ensure that the staff is kept up to the current state of this changing technology. In Australia there is no compulsory prerequisite for critical care nurses to have postgraduate qualifications.
However, the Australian minimum standard recommends that critical care nurses should obtain postgraduate qualifications. Critical care nurses must have a bachelor of nursing, be registered with the Nursing and Midwifery Board of Australia, meet the NMBA’s standards in order to work as a critical care nurse in Australia. Critical care nurses work in a variety of differ
A nurse practitioner is an advanced practice registered nurse classified as a mid-level practitioner. A nurse practitioner is trained to assess patient needs and interpret diagnostic and laboratory tests, diagnose illness and disease, prescribe medication and formulate treatment plans. NP training covers basic disease prevention, coordination of care, health promotion, but does not provide the depth of expertise needed to recognize more complex cases in which multiple symptoms suggest more serious conditions. According to the American Association of Nurse Practitioners, a nurse practitioner is educated at the masters or doctoral level to provide "primary, acute and specialty care to patients of all ages and all walks of life"; the scope of practice for a nurse practitioner is defined by jurisdiction. Depending on jurisdiction, nurse practitioners may or may not be required to practice under the supervision of a physician. In United States, nurse practitioners have been lobbying for independent practice.
The opponents of independent practice have argued that nurse practitioner education is "flimsy," because it can consist of online coursework with few hours of actual patient contact. The number of patient contact hours in nurse practitioner training is less than or equal to 3% of physician training. Increased utilization of nurse practitioners is leading to increased cost of care through increased use of resources and unnecessary referrals; the advanced practice nursing role began to take shape in the mid-20th century United States. Nurse anesthetists and nurse midwives were established in the 1940s, followed by psychiatric nursing in 1954; the present day concept of the APRN as a primary care provider was created in the mid-1960s, spurred on by a national shortage of medical doctors. The first formal graduate certificate program for nurse practitioners was created by Henry Silver, a physician, Loretta Ford, a nurse, in 1965. In 1971, The U. S. Secretary of Health and Welfare, Elliot Richardson, made a formal recommendation in expanding the scope of the nursing practice and qualifying them to be able to serve as primary care providers.
During the mid 1970s to early 1980s, the completion of a master's degree became required in order to become a certified nurse practitioner. In 2012, discussions have risen between accreditation agencies, national certifying bodies, state boards of nursing about the possibility of making the DNP as the new minimum of education for NP certification and licensure by 2015. Given the quality and quantity of training, experts have questioned the quality of care delivered by nurse practitioners. Studies have shown multiple concerns associated with lack of training. Nurse practitioners are more to prescribe antibiotics when they are not indicated, it has been shown that “there is a tremendous need to enhance nurses’ skills." Nurse practitioners are more to make unnecessary referrals. They are more to order unnecessary tests and procedures such as skin biopsies and imaging studies. Although a few studies have shown that NPs provide similar quality care when compared physicians, these studies were found to have a medium to high potential for bias and had low to insufficient strength of evidence.
In the United States, because the profession is state-regulated, care provided by NPs varies and is limited to their education and credentials. Many NPs seek to work independently of other health professionals, while in some states a supervisory agreement with a physician is required for practice; the extent of this collaborative agreement, the role, responsibilities, nursing treatments, pharmacologic recommendations, etc. again varies amongst states of licensure/certification. Nurse practitioners can examine patients, diagnose illnesses, prescribe medication, provide treatments. Just under half of the country permits NPs the authority to practice on their own. In fact, 22 states give full practice authority to NPs. Thirty-eight states require NPs to have a written agreement with a physician in order to provide care. With the formal agreement between physician and NPs, their practice is restricted in at least one domain. Twelve of those states restrict NPs more. In order for NPs to provide care to patients, they are required to be supervised or delegated by a physician.
In Canada, an NP is a registered nurse with a graduate degree in nursing. Canada recognizes them in the following specialties: primary healthcare NPs and acute care NPs. NPs diagnose illnesses, prescribe pharmaceuticals and interpret diagnostic tests, perform procedures in their scope of practice. PHCNPs work in places like community healthcare centers, primary healthcare settings and long term care institutions; the main focus of PHCNPs includes health promotion, preventative care and diagnosis of acute illnesses and injuries, overseeing and managing chronic diseases. ANCNPs are specialized NPs, they administer care to individuals who are acutely, chronically ill patients. ANCNPs work in in-patient facilities that include neonatology and cardiology units; the path to becoming a nurse practitioner in the United States begins by earning a Bachelor of Science in Nursing or other undergraduate degree, requires licensure as a registered nurse and experience in the generalist RN role. One must graduate from an accredited graduate or doctoral program.
Overall, to become an NP requires 1.5 to 3 years of post-baccalaureate training, compared to physicians who are required to complete a minimum of 7 years of post-baccalaureate training. A new nurse practitioner has between 500 and 1,500 hours
A nursing school is a type of educational institution, or part thereof, providing education and training to become a qualified nurse. The nature of nursing education and nursing qualifications varies across the world. Since the mid 20th century nursing education in many countries has undergone many enhancements. Florence Nightingale was one of the pioneers in establishing the idea of nursing schools from her base at St Thomas' Hospital, London in 1860 when she opened the'Nightingale Training School for Nurses', now part of King's College London, her intention was to train nurses to a qualified and specialized level, with the key aim of learning to develop observation skills and sensitivity to patient needs allow them to work in hospital posts across the United Kingdom and abroad. Her influence flourished and nursing is now a course taught at a number of British universities. Apart from the nursing school of King's College London, the direct descendant of Nightingale's school, the University of Manchester was one of the first English institutions to offer the course at degree level.
A new building for the Manchester Medical School was opened in the early 1970s and degree courses in nursing were established about the same time. Nursing education at the university expanded in 1996 when a new School of Nursing and Midwifery was created by transferring the Manchester College of Midwifery and Nursing into the university's Faculty of Medicine and Nursing. Entry level courses, sought by most universities, are five Standard Grades/GCSEs, including English, maths and a science, two Highers/A-Levels. Mature students, over the age of twenty-one, have the option of entering upon completion of a college access course, experience in jobs such as being a health/nursing assistant are worthy for consideration into the course. Nursing is a three-year course in the UK, with students choosing the branch they want to study from day One e.g. adult, mental health, learning disability, or combinations of two. The course consists of a balance between course work in classes and practical placements in a health care setting.
The first year is foundation, where students learn basic health care. Newly qualified nurses have to register with the Nursing and Midwifery Council in order to apply for jobs and practice; the history of nursing education had a long and varied role in the United States. Before the late 1800s little formal education was available to train nursing students. Education was based on an apprenticeship with a senior nurse who taught bedside care within a hospital or clinic setting. Over time this model changed dramatically. A short chronology of Schools of Nursing in the United States is: In 1873, the Bellevue Hospital School of Nursing, of New York City, was founded, it was the first school of nursing in the United States to be founded on the principles of nursing established by Florence Nightingale. The School operated at Bellevue Hospital until its closure in 1969. 1883: The Medical University of South Carolina College of Nursing has been traced to its beginning in 1883 when the South Carolina Training School for Nurses was established at the request of Roper Hospital in Charleston, SC.
Due to an earthquake in 1886 which destroyed the City Hospital, the effort only lasted a few years. However, once the new hospital was built the nursing program was reestablished in 1895 as the Charleston Training School. In 1916, the Board of Commissioners of the Roper Hospital proposed the transfer of the training school to the Medical College of the State of South Carolina, whose school of medicine had been established in Charleston in 1824 and whose faculty was providing most of the nursing instruction; the proposal was accepted by both the hospital and the Medical College, in 1919 the Roper Hospital Training School for Nurses became the School of Nursing of the Medical College of the State of South Carolina. In 1969 when the Medical College was designated the Medical University of South Carolina, the School of Nursing became the College of Nursing. 1889: The Johns Hopkins School of Nursing was founded in conjunction with the creation of the Johns Hopkins Hospital. As one of the earliest hospital-based nursing schools in the United States school leaders consulted with Florence Nightingale on the program of education.
These same nurse leaders established what would be become the National League for Nursing Education and helped in establishing the American Nurses Association. In 1909, the University of Minnesota offered the first university based nursing program, it offered the first Bachelor of Science in Nursing degree and graduated the first bachelor's degree educated nurse. By 1916 13 universities and 3 colleges had developed bachelor's nursing degree programs. In 1923, the Yale School of Nursing was founded, it became the first School of Nursing to adopt the educational standards from the 1923 Goldmark Report, requested by the Rockefeller Foundation. The curriculum was based on an educational plan rather than on hospital service needs. In 1956, the Columbia University School of Nursing became the first in the United States to grant a master's degree in a clinical nursing specialty. Pre-requisites include math and other basic level courses. Basic courses in biology and physiology are required. Depending on the nursing school, credits can be taken elsewhere, transferred in, although limitations on time span between taking pre-requisites and applying to nursing programs exist around 5 years, although some schools set no parameters.
Core coursework includes anatomy, physiology and pharmacology. Additionally, a strong emphasis is placed on