Question

The mid- to late 20th century was filled with amazing changes and events in professional nursing.

Select one of these changes or events, describe it, and explain how that change or event has impacted quality of nursing practice today.

Answer 1

The "registered" part of registered nurse comes from the registries or lists of trained nurses in the late 19th and early 20th century. Families or patients hired nurses to care for patients in their home and nurses were paid directly so that there was an economic relationship between a nurse and patient. Nursing was very entrepreneurial during that time. When acute care transitioned to hospitals in the mid 20th century, nurses became employees of hospitals. In turn, hospitals billed the care provided by nurses as room and board just like hotels. That is the crux of nursing's dilemma. While nursing is one of the largest components of the resources used by hospitals and contributes substantially to the overall cost of care, nurses are invisible in the health care financial system and essentially have no economic value because we don't pay for nursing care outright like it was once done. This leads to a number of inequities such as higher nursing workload because patient acuity is rising, but the room rate does not reflect the necessary additional nursing care.