| Summary: | The purposes of this study were: to investigate the practice and education of associate degree nurses in Massachusetts; to determine the relevance of the program to present as well as the future practice environment; and to determine if the program prepares its graduates to function within the limited scope of registered nursing practice proposed by Mildred Montag. Changes in the nursing curriculum are suggested based on the outcomes of this study. Competencies of the associate degree nurse, standards of nursing practice, licensure requirements, and job descriptions are used as a frame of reference to examine the current practice. A telephone survey was conducted to obtain information, about job description and responsibilities of registered nurses at acute care hospitals. The hospitals selected were general medical/surgical facilities with at least 100 beds. The curricula of the associate degree nursing programs in Massachusetts were reviewed to determine if they reflect the guiding principles of the original program developed by Mildred Montag in 1951. A comparison is made of: length of programs; total number credits, including non-nursing as well as nursing; and the prevalence of the term technical nurse. Evidence presented in this study indicate that nursing practice will change. Nursing practice in the future and specifically in Massachusetts will be shaped by: government intervention in cost containment; increased proportion of the older population; increased complexity of patient needs and severity of patient conditions; and shift in delivery of patient care away from hospitals. The areas that need to be addressed in the present associate degree nursing curriculum are community health, home care and gerontology. A greater percentage of the curriculum should be geared toward the geriatric patient in non-hospital settings. A outline of program changes is suggested based on predicted trends in health care delivery. In conjunction with the changes in the curriculum, nursing service and education need to come to consensus on the differences in practice based on the educational preparation of the nursing graduates.
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