www.advanceweb.com | 2018 | FOCUS ON EDUCATION 23 already in practice. So this action begs the dilemma question that has plagued the nurs- ing profession: Is it really such a bad idea to have a BSN as the minimum entry level? PROFESSIONAL NURSING HISTORY SNAPSHOT Professional nursing has grown significantly over the past 150 plus years. Many of the foundation members of the discipline would derive significant pleasure to see the progres- sive accomplishments that have transformed the practice. That being said, the single com- ponent of what is recommend as entry-level practice still perplexes us with disagreement and controversy. In 1965, an American Nurses Association’s (ANA) position paper called for nurses to have a baccalaureate education before entering practice (American Nurses Association, 1965). Until that time, hospi- tal-based nurse training programs were the standard for most of the country. Nurses func- tioned to a greater degree with minimal inde- pendence under the guidance of physicians. Even though hospital-based nurse training programs were common post-World War II, community college and junior college nurs- ing programs began to dot the academic landscape during the 1950s and 1960s. The two-year nursing programs were generated in response to nursing shortages, which seemed to vacillate to a degree in the two decades following World War II. This age of intellec- tual and academic enlightenment became very appealing to students pursuing a career in nursing. Compounding the attraction was the fact that a nursing student could obtain an associate’s degree in applied science (AAS). If desired, the graduate could then explore the possibilities for further higher degree educa- tional opportunities, such as a BSN (Taylor, 2008). CONTROVERSY AND OPINION DILEMMA Early in 1964, significant changes were devel- oping to drive momentum for nursing educa- tionreform.TheFederalNurseTrainingActof 1964 provided funding opportunities for col- legiate nursing education systems to expand (Miller, 1985). These actions saw increases in nursing programs that offered baccalaureate, master’s, doctorate, and advanced practice nursing programs. In 1965, the ANA provided thoughtful insight and delivered a position paper on higher education for nurses (American Nurses Association, 1965). The ANA discussed a number of forward-thinking concepts for professionals to consider. Recognizing that techniques, complexity, and technol- ogy advancements were quickly entering health care, the ANA responded with rec- ommendations of higher education. The ANA Committee on Education studied and reviewed the issues relative to nursing at that time. The committee submitted to the ANA Board of Directors a summary of changes in entry-level nursing requirements that would speak to changes in the health care industry (American Nurses Association, 1965). These included the following: • A BSN would be the minimum standard for a registered nurse (RN) license. • A new license and title would be created for nurses with an associate’s degree des- ignating these members as registered associate nurses (RAN). • Hospital-based nursing education pro- grams and practical nursing programs would be eliminated. At that time, supporting discussion was also considered that identified numerous other related professions that had developed a gap between entry-level training and higher education. The disciplines of genetic coun- cilor, audiologist, speech and language pathol- ogist, and physical therapist had taken steps to increase the educational requirements for entry level to practice (Smith, 2009). Similar to the supporting nursing research of today, these other disciplines recognized the need to provide higher educational requirement stan- dards as the related technologies progressed through the 1960s. This consideration still is valid today and is discussed below. As the next two decades progressed, strong political divides between state nursing associ- ations and the ANA evolved. Recommended professional title changes (technical nurse) for nurses with an associate’s degree and hospi- tal-based diploma nurses were debated during the 1980s. This action only further strength- ened the determination and stalled any signifi- cantprogressinmovingforwardbaccalaureate education as the minimum entry level to prac- tice (Jacobs, DiMattio, Bishop, & Fields, 1998). As difficult as this period was for nursing, other bright spots did emerge. Colleges and universities recognized there were groups of nurses that desired continued higher educa- tion. Consequentially, graduate-level master’s programs and doctoral-level programs real- ized their beginnings. As the nursing disci- pline matured, nursing began to realize the benefits of moving contemporary issues and agendas forward. ATTEMPTS AT POLITICAL, LEGISLATIVE, AND REFORM MANDATES With the ANA’s position paper close to 20 years old and the growth of college and uni- versity programs glaringly obvious, four Early in 1964, significant changes were developing to drive momentum for nursing education reform. The Federal Nurse Training Act of 1964 provided funding opportunities for collegiate nursing education systems to expand (Miller, 1985). These actions saw increases in nursing programs that offered baccalaureate, master’s, doctorate, and advanced practice nursing programs. FOCUS ON EDUCATION  |  CONTINUING EDUCATION