Shifting grounds: A historical review of the dynamic tension between acute care and public health nursing

Background Advanced practice nursing education experienced a seismic shift when the American Association of Colleges of Nursing (AACN) changed graduate nursing education by creating the Doctorate in Nursing Practice (DNP). In 2006, the AACN deemed entry into advanced practice by 2015 would require a DNP. Additionally, to be accredited through AACN, nursing programs must meet the new essentials for baccalaureate/ graduate degree programs. What are the ramifications of these changes for community/public health nursing education, for addressing the public's health, as well as for ensuring social justice and equity for vulnerable populations?

Description: A review of historical patterns which have shaped the profession of public health nursing, as well as how the praxis of nursing has shifted from populations to the individual will be presented. The 1923 Goldmark, The 1948 Future of Nursing, and the 1983 National Commission on Nursing all critiqued nursing education and called for nursing schools to strive for autonomy and improve the quality of nursing education preparing students to practice in acute care and public health.

Lessons Learned: History has seen tension between clinical praxis and curricular learning mandated to prepare nurses for public health as well as hospital nursing. How to balance biological and clinical content with broader, more comprehensive critical thinking skills of population based health continues to be an issue today.

Recommendations: These competing priorities must be examined within a social justice framework with particular attention on the significance for care of vulnerable populations and health disparities in nursing curriculums today.