Module 1: Nursing Education In Texas

Module 1: Nursing Education in Texas Subtopic 1: Yesterday

Professional Nursing Education

Professional nursing education in Texas has come a long way since the first formal nursing program was established in 1890 with two students. A group of forward thinking ladies gave birth to the concept and arranged for the two year training program to be housed at John Sealy Hospital in Galveston as an independent educational entity. This program became part of the University of Texas in 1896. In 1907, the training period was extended to a third year with a diploma awarded for successful completion. Other programs subsequently opened in hospitals throughout the state as administrators realized the value of staffing wards with nursing students who brought cleanliness, order, and respectability to the hospital. The state had eighty-five accredited training schools by 1923. Conditions in most schools were poor, and the standard of education was low as it was secondary to other required duties. Regulations were strict and ward nurses worked twelve-hour shifts. Students were forbidden to marry while enrolled in a training program. (Crowder, 2002)

During the early 1900s, a group of concerned nurses from the Texas Graduate Nurses Association-TGNA (forerunner to the Texas Nurses Association-TNA), worked diligently to convince the Texas legislature that nurses should oversee nursing education. As a result of these efforts, the first nurse practice act was passed and the Board of Nurse Examiners was established in March of 1909. (Crowder, 2002) At the first meeting on July 20, 1909 at the Driskill Hotel in Austin, the Board drew up Bylaws and Rules for Training:

Applicants should not be less than 21 years of age.

The period of instruction in training schools shall not be less than two full years.

Training schools giving a three year course and wishing to continue the practice of utilizing their pupils to earn money for the hospital, may send them out to private cases or for district work among the poor, for a period not exceeding three months in the third year of their course.

Practical experience:

1. Each pupil should have the care of not less than eight cases of typhoid fever, and five of pneumonia, and other medical cases in proportion. 2. She should have 6 weeks operating room experience, as well as the preparation for, and after care of, major and minor operations. 3. Her Obstetrical experience should consist of attendance upon not less than 6 labor cases, with after care of mother and child for one week or more.

4. Dietetics should be taught by theory and practice in not less than 20 lectures. (Rowland, 1985) The first licensing examination was administered on October 15, 1912 in San Antonio, Waco, Temple, Fort Worth and Houston for five candidates. In 1915, the Board passed a motion that “each member of the Examiners Board shall examine the training schools in her district at least once each year. Look into the course of study and make suggestions to the managers.” In 1916, the Board appointed a training school Inspector, however, the appointment was discontinued in 1917. (Rowland, 1985)

In 1923, legislation mandated that the Board appoint an educational secretary “who shall be at least thirty years old, and shall have had at least five years’ experience in educational work among nurses…” (Texas Legislature, 1923) The Board hired Louise Dietrich, to inspect and evaluate nursing schools. As a strong advocate of better education in nursing, she helped pass the Nurses Compulsory Registration Bill in 1923. (Crowder, 2002)

The following year, the Board published educational criteria for training schools. Over time, requirements for approval from the Board of Nurse Examiners became more stringent. (Crowder, 2002; BNE, 1924)

The John Sealy College of Nursing, the first collegiate program for nurses in Texas, was established as a five-year program in 1923, although at the time the majority of students were still enrolled in the diploma program. (Crowder, 2002) In February of 1942, the Johan Sealy College of Nursing requested permission to accept students over 30 years of age. The Board denied the request. In May of the same year, the Board sent a letter to all schools of nursing informing them that schools could admit students from 17-35 years of age for the duration of the war. (BNE, 1924)

In 1943, the Bachelor of Science in Nursing (BSN) was first offered in addition to the diploma program. BSN programs at Incarnate Word College and Harris College of Nursing followed in 1930 and 1946, respectively. However, the number of nurses earning college degrees did not begin to increase significantly until after World War II. (Crowder, 2002)

In the early 1950s, in an effort to relieve the shortage of nurses, Mildred Montag undertook a research project at Teachers College, Columbia University, to educate nurses in junior colleges in two years instead of the three years required in a hospital-based diploma program. Each graduate would receive an associate degree. (Crowder, 2002) On November 19, 1959, the Board granted temporary accreditation to Texarkana Junior College under the new curriculum plan. (Rowland, 1985)

From late 1960 through 1980, the number of diploma programs decreased as the number of baccalaureate and associate-degree programs increased. (Crowder, 2002)

Vocational Nursing Education

The first training for practical/vocational nurses was offered in 1892 at the Young Women's Christian Association in New York City. The first official school for LVN/LPN education was established in 1893 at the Ballard School in New York: the program was 3 months long. The curriculum consisted of homemaking skills, in addition to techniques for caring for the sick. Students were sought who "had a special way with the sick" (Anderson, 2001, p. 17). After the turn of the century, LPN education and licensure became more formalized. The National League for Nursing developed a system for standardization of requirements for the LPN. Not all states passed LPN licensure laws until 1955. World War II brought with it the need for additional nurses, which focused attention on the contributions of the LPN/LVN. The National Association for Practical Nurse Education and Service (NAPNES) was formed in 1941 and accredited LPN educational programs from 1945- 1984. At that time, the NLN established the Council for Practical Nursing Programs in 1961, which assumed the responsibility for promoting LPN interests within the NLN (Anderson, 2001).

The Board of Vocational Nurse Examiners (BVNE) was created in 1951; licensure was granted by waiver based on experience and affidavits from physicians. In 1952, the State Board Test Pool Examination (National) became a requirement for licensure. The period for licensure by waiver was closed (BVNE, 2002). In 1952, hospital-based apprenticeship programs were the primary site for vocational nurse education. Today, 96 of the 114 vocational nursing programs in Texas are college based. The length of the programs is usually 12 to 18 months

In 1961, the BVNE adopted Minimum Standards for vocational nurse education programs. In 1975, the NCLEX-PN was administered and required for licensure.

The BVNE became a member of the National Council of State Boards of Nursing in 1978. In 1991, the BVNE/BNE impaneled the Nursing Education Advisory Councel (NEAC) to develop essential competencies for graduates of program in Texas.

References

 Anderson, M. (2001). Nursing leadership, management, and professional practice for the LPN/LVN. Philadelphia: F.A. Davis.  Crowder, E.L.M. (2002) .The Handbook of Texas Online: Nursing education. (Available Online: http://www.tsha.utexas.edu/handbook/online/articles/view/NN/shn1.html  Rowland, M.L. (1985). Excerpts from the Minutes of the Board of Nurse Examiners, 1909 - 1983  Texas Legislature. (1923). S.B. Creating a Board of Nurse Examiners, Etc. S.B. No 40. Chapter 183. Approved April 3, 1923.  BNE. (1924). Requirements for Accredited Schools of Nursing, 1924. The Board of Nurse Examiners for the State of Texas.  Board of Vocational Nurse Examiners. (2002). Agency Strategic Plan. Retrieved February 2, 2003 from http://www.bvne.state.tx.us/Final%202003-2007%20Strategic %20Plan.doc

Continue to Subtopic 2: Nursing Education - Today Nurse Practice Act of 1909 NURSING—DEFINING AND REGULATING PRACTICE OF.

S. B. No. 111. CHAPTER 117.

An Act to define and regulate the practice of professional nursing; create a Board of Nurse Examiners for the examination and licensing of nurses, and to prescribe their qualifications, to provide for their proper registration and for the revocation of certificates and to fix suitable penalties for the violation of this Act and declaring an emergency.

Be it enacted by the Legislature of the State of Texas: SECTION 1. That a board to be known as the Board of Nurse Examiners for the State of Texas is herby established. Said board shall be composed of five members who shall be trained nurses of at least twenty-three (23) years of age, of good moral character, and graduates of a training school connected with a general hospital or sanitarium of good standing, presided over by a graduate nurse where a two years training with a systematic course of instruction is given in the wards. Said board shall be appointed by the Governor of this State, within sixty days after this Act shall go into effect and biennially thereafter, within sixty days after his inauguration, and the term of office shall be two years or until their successors shall and qualified. Vacancies occurring in the board shall be filled by the Governor. SEC. 2. That the members of the said board shall as soon as organized, annually in the month of April, elect from their members a president and secretary who shall also be the treasurer. Three members of this board shall constitute a quorum and special meetings of said board shall be called by the secretary upon the written request of any two members. The board is authorized to make such by-laws and rules as shall be necessary to govern its proceedings, and to carry into effect the purpose of this Act. Provided, that said board shall adopt Roberts Rules of Order to guide it in the transaction of its business. The secretary shall be required to keep a record of all the meetings of said board, including a register of the names of all nurses duly registered under this Act, which shall at all seasonable time be open to public scrutiny, and said board shall cause the prosecution of all person violating any of the provisions of this Act, and may incur necessary expenses on that behalf. That the president and secretary shall make biennial report to the Governor on or before the first day of January immediately preceding the convening of the Legislature, together with a statement of the receipts and disbursements of said board. SEC. 3. That after organization it shall be the duty of said board to meet regularly once in every six (6) months, notice of which meeting shall be given to the public press and in one nursing journal one month previous to the meeting. At every regular meeting namely, every six months it shall be the duty of the board to examine all applicants for registration under this Act. Upon filing application for examination, each applicant shall pay an examination fee of ten dollars, which shall in no case be returned to the applicant whether the examination be passed or not, but in case the applicant passes the examination then no further fee shall be required for registration. The examination shall be of such a character as to determine the fitness of the applicant to practice professional nursing as contemplated by this Act; provided, said board shall prepare questions for examinations and shall examine applicants on the following subjects: practical nursing, surgical nursing, obstetrical nursing, materia medica, anatomy, physiology, hygiene, dietetics, and gynecology. If the result of the examination shall be satisfactory to the majority of the board shall sign and issue a certificate to the applicant to that effect which certificate shall be attested by the secretary; whereupon the person named in the certificate shall be duly qualified to practice professional nursing in this State. Any registered nurse from any other state where the laws with reference to professional nursing are up to the standard of the laws of the State of Texas, who shall show to the satisfaction of the beard that he or she is a trained, graduate nurse of a hospital or sanitarium, the standard of instruction and training of which shall meet the requirements of the rules prescribed by said board, and who shall be otherwise properly qualified, may receive a certificate and be registered as a nurse of this State without examination. SEC. 4. That all nurses who are engaged in nursing at the time of the passage of this Act and who shall show to the satisfaction of the said board that they are of good moral character and were graduated prior to April, 1906, from a training school, connected with a hospital or sanitarium giving a two years general training, or prior to the year, 1901, having given 18 months general training and who [which] maintains in other respects proper standards, shall be entitled to registration without examination. All persons who are in training in the wards of a general hospital or sanitarium in this State where a two years training with a systematic course of instruction is given at the time of the passage of this Act, and shall graduate hereafter, and possess the above qualification shall be entitled to registration without examination, provided such application be made to this board before the fist regular meeting. All nurses who have served in the army or navy of the United States and have been honorably discharged shall be entitled without examination. It shall be unlawful hereafter for any person to practice nursing as a trained graduate or registered nurse without a certificate form the State Board of Nurse Examiners. A nurse who has received his or her certificate according to the provisions of this Act shall be styled and known as a “registered Nurse.” No other personnel shall assume such title or use the abbreviation “R.N.” or any other letters to indicate that he or she is a trained, graduate or registered nurse. The board in each instance shall require a registration fee of ten ($10) dollars. SEC. 5. The State Board of Nurse Examiners shall have the power to revoke any certificate issued in accordance with this Act by a unanimous vote of said board, for gross incompetency, dishonesty, habitual intemperance, or any act derogatory to the morals or standing of the profession of nursing as may be determined by the board, but before any certificate shall be revoked, the holder thereof shall be entitled to at least thirty days notice in writing of the charge against him or her at least thirty days notice in writing of the charge against him or her and of the time and place of hearing and determining of such charges, at which time and place he or she shall be entitled to be heard and in the event said certificate shall be revoked by said board, the holder of such certificate shall have right of action within thirty days hereafter in the district court of the county of the residence of any member of the board to strike the name of the holder thereof from the roll of registered nurses. SEC. 6. All fees received by the State Board of Nurse Examiners, under this Act shall be paid to the treasurer of said board, who shall pay the same out on vouchers issued and signed by the president and secretary of said board upon warrants drawn by the president of the State Board of Examiners. All money so received and placed in said fund may be used by the State Board of Nurse Examiners in defraying its expenses in carrying out the provisions of this Act. SEC. 7. This Act shall not be construed to effect [affect] or apply to the gratuitous nursing of the sick by friends or members of the family, or to any person nursing the sick for hire who does not in any way assume the practice as a trained, graduate or registered nurse. SEC. 8. That any person violating the provisions of the Act or who shall make any false representations to said board in applying for a certificate, shall be guilty of a misdemeanor, and upon conviction be punished by a fine of not more than three hundred dollars. SEC. 9. The fact that there is no previous legislation providing for the examination by a State board of trained nurses creates an emergency and imperative public necessity that the Constitutional rule requiring bills to be read on three several days be suspended, and the same is hereby suspended and that this [Act] shall take effect and be in force from and after its passage and it is so enacted.

Approved March 25, 1909 Takes effect ninety days after adjournment

Members

The Texas State Board of Nurse

Examiners

MRS. HELEN H. LEHMANN, R. N…………………………………..President 3910 Shenandoah St., Dallas, Texas.

MISS MARY B. GRIGSBY, R.N…………………..Secretary and Treasurer. Box 1567, Waco, Texas.

MISS A. LOUISE DIETRICH, R. N………………….Educational Secretary. 1001 E. Nevada St., El Paso, Texas.

MISS EMILY D. GREENE, R. N. El Paso, Texas.

MISS L. JANE DUFFY, R. N. Austin, Texas.

MISS EULA WHITEHOUSE, R. N. Waco, Texas. Requirements of Registration _____

METHODS OF REGISTRATION Nurses may be registered in Texas by:

(a) RECIPROCITY WITHOUT EXAMINATION. Nurses who have registered in other States, whose laws are equivalent to those of Texas, may in the sound judgment of the Board, be granted a license to practice nursing. The fee is fifteen dollars ($15.00).

(b) EXAMINATION. Applicants must have had two years continuous training under a registered nurse in an accredited school approved by the Board of Nurse Examiners, and whose course shall cover two or more years. Applicants from a school connected with a special hospital must have had one year’s additional training in an accredited school connected with a general hospital.

2 CERTIFICATES (a) The certificate issued by the Board must be recorded with the County Clerk within thirty days after date of issue.

(b) Only Texas Certificates should be recorded in Texas.

(c) Registration in other states does not entitle the holder to use the “R.N.” title in Texas.

(d) Annual registration with the Secretary of the Board of Nurse Examiners on or before April 1st is compulsory. The fee is fifty cents ($.50).

3 PERMITS (a) Nurses registered in other states who do not expect to be in Texas more than three months may receive from the Board a permit to nurse during this time. The fee is two dollars ($2.00). (b) Nurses who have failed to pass their examinations must obtain a permit to practice, and take the next examinations.

4 EXAMINATIONS (a) Examinations are held twice each year,-- the latter part of April in Dallas, San Antonio, Galveston, Waco and El Paso.

In the latter part of October they are held in Dallas, Houston, Temple, Austin and El Paso. Examinations will also be held in some city of West Texas if needed. A notice of the time of the examination will be mailed to the superintendents of all accredited schools. (b) The examination fee if fifteen dollars ($15.00), and will be returned if the applicant is not accepted. (c) Examinations will be given in Medical Nursing, Surgical Nursing, Obstetrics, Gyanaecology, Anatomy, Physiology, Hygiene, Dietetics, Materia Medica, Ethics, History of Nursing and Pediatrics. (Genito-Urinary for male nurses instead of Obstetrics and Gynaecology (d) Applicants must make a passing mark of 70%. If she fails to make 70% in any subject, she has the right within a year to take a second or third examination. If more than three examinations are necessary, an additional fee of two dollars ($2.00) will be charged for each examination. (e) Applications for examinations must be in the hands of the Secretary fifteen days prior to the date of the examination. (f) A student who will have finished her course within three months of the time of the examinations, will be allowed to take the examinations, provided she has completed all her theoretical training, and has passed all examinations required by her school of nursing. A diploma issued by the school shall bear the actual date of the completion of the course, and the superintendent shall notify the Secretary of the Board, whereupon the certificate of registration shall be issued, bearing a date after the actual date of completion of the course. (g) Nurses who have completed their courses, or nurses coming to the State between examinations, must take the next examinations, and obtain permits to practice until that time. (h) Spelling, grammar, penmanship, as well as technical knowledge, will be considered in the marking of all papers. (i) Each applicant will be sent a card of admittance. This card must be presented on the first day of the examinations, with a recent photograph, post card size.

2 ACCREDITED SCHOOLS Method of Accrediting

The Educational Secretary appointed by the Board will visit all schools of nursing in the State at least once a year to confer with the Superintendents of Hospitals and Superintendents of Nursing Schools as to the system of instruction given, and as to the accommodations and rules governing the said schools in reference to the students. The Secretary after visiting the school must make a report to the Board of Nurse Examiners, and if this school meets the requirements made by the Board, and agrees to follow recommendations, the school shall be accredited for one year for the first time. Subsequent accrediting is given for an undetermined period, or during the proper conduct of the school. Schools must report immediately any changes of superintendent to the Board of Nurse Examiners.

1 REQUIREMENTS An accredited school of nursing must be connected with a general hospital having not less than 25 beds, and a daily average of 15 patients. The hospital must provide for adequate teaching and experience in Surgical and Medical Nursing of both men and women, in Diseases of Children, and Obstetrics. Each nurse must have the care of at least six obstetrical cases, including labor, deliver, and ten days aftercare of mother and infant. Hospitals not providing a separate children’s ward, must affiliate for such training. Schools connected with hospitals which do not provide opportunities for experience in all these departments, must affiliate with accredited schools giving such experience. All affiliations must be approved by the Board of Nurse Examiners. Affiliations approved by the Board may be used in tuberculosis and mental nursing.

FACILITIES FOR CLASS INSTRUCTION

The schools must provide for proper and adequate facilities for class instruction, including: (a) A class room well lighted and ventilated, provided with students chairs, black boards, a skeleton and a manikin. If this room is used for demonstration purposes in nursing procedures, it must also contain the necessary equipment.

(b) Laboratories equipped for the teaching of chemistry, cookery, bacteriology, analysis of urine, and drugs and solutions. Schools unable to provide for the teaching of theses subjects must arrange for course with a high school, college, or another accredited school.

(c) A library containing modern nursing reference books, periodicals, good general literature, current magazines, and a daily newspaper. 3 STUDENTS’ RESIDENCE (a) Living Quarters. Proper living conditions must be provided. These must include a building erected for the purpose, or where this is not possible, on with suitable and adequate accommodations.

(b) Dining Room. This room should be clean, well lighted, and suitably furnished. The service should be prompt and efficient during the meals. These should be at least one waiter or waitress to every twenty students, except when Cafeteria Plan is used.

4 FACULTY A sufficient teaching force must be maintained to conduct the instruction and guarantee properly supervised care of the patients, and to maintain this the minimum number should be:

(a) SUPERINTENDENT OF NURSES AND PRINCIPAL OF THE SCHOOL, who if she is also superintendent of the hospital, must have a fulltime instructor, and must also be competent to maintain a high standard of educational and moral efficiency. Qualifications of a Superintendent when she is an instructor (or for an instructor) should be: at least a high school education, some experience as an assistant, and some experience or education as a teacher.

(b) A GRADUATE NIGHT SUPERVISOR who is capable of assuming the responsibilities of the hospital and nursing force at night, and of teaching and supervising the pupils during this period of service.

(c) A GRADUATE SURGICAL SUPERVIS0R who is directly responsible for directing the operating room, and for the instruction of the students in surgical technique.

5 STUDENTS (a) All students entering after September 1, 1924, must have completed one year of high school, or be able to prove an adequate equivalent. Schools are required to have the educational credentials of each student on file. These credentials must be made out and signed by the principal of the school or schools where these credits were obtained. Educational equivalents must be plainly stated and proof offered. (An examination given by a high school principal, and a statement from him may be accepted.)

(b) Applicants who have had four years of high school may be admitted after their seventeenth birthday, but other applicants must have passed their eighteenth birthday.

(c) It is advised that the schools of nursing stating the entrance requirements or more than the minimum (for example: two years of high school) do not admit students with less than that education.

(d) It is recommended that the schools of nursing give from eight months to one year’s credit to college graduates, provided they come from approved colleges, and have included in the course of study those subjects relating particularly to nursing education. 6

RATIO OF STUDENTS TO PATIENTS

Ratio of students to patients must depend on the size of the hospital, number and kinds of service, and affiliation required.

In starting a new school, or if there is an insufficient number of students, graduate nurses must be employed to fill out the required number or to care for the intermediate and senior services, as student nurses must not be over-worked or perform duties for which they are not adequately prepared, thereby rendering poor service to the patients.

TRANSFER OF STUDENTS

(a) No school of nursing shall accept a student who has been in training elsewhere without a written statement in regard to education, health and character, with a complete record of previous training, signed by her former superintendent. Only students from accredited schools may be accepted in this manner.

(b) No person shall be promised any definite amount of credit for time spent in previous training, until said person shall have served minimum probation of three months. Amount of credit given shall be governed in the judgment of the Superintendent of Nurses by the applicant’s skill and knowledge of practical nursing work as shown during probation, and by class and lecture work required, in order that upon graduation applicant will be assured of the number of hours in practice and theory, as set forth in the curriculum of accredited schools.

(c) No time will be allowed unless student can bring actual credit in hours of class work, with number and length of these class periods and standings obtained in tests, except she shall take an examination and make a mark in theory of 75% on studies already covered by the class she enters, and 80% on practical tests for same period. These credits or test papers, with markings, shall be kept as part of the student’s record in the second school, and be shown as proof of training before being admitted to state board examinations, with an exact statement of the time allowed.

(d) No credit shall be given for less than six months previous training.

GENERAL STATEMENTS

(a) Students should not be sent out for private duty during training.

(b) Students should not be put on special duty for more than three months, and this time should come only in their second or third year.

(c) No practical nurse shall be put on special duty in a hospital which conducts a school of nursing. Hospital helpers with definite duties may be employed.

(d) It is recommended that there be a training school committee of not less than five members, and it is suggested that it consist of the following: Superintendent of the hospital, superintendent of nurses, a physician, an educator, and a representative woman of the community. If the organization does not permit such a committee being a part of the hospital, under its incorporation, such a committee would be very valuable as an advisory committee. The Committee of Nursing Education recommends that the training school committee shall be used, also, as a court of appeals for students before dismissal. The functions of this committee should be advisory to the superintendent of nurses, to help her to obtain necessary instructors, equipment, and recreation for the school, to help recruit pupils, and to advise and support her. The committee should be instrumental in seeing that properly trained people hold the educational positions in the school of nursing.

(e) While the law permits a two-year school, it is not obligatory, but a minimum, and schools may have a three-year course if they desire and can show that the additional year can be used for the student’s advantage.

(f) The establishing of a two-year course in an already established school must start with a new class entering with an understanding that the course will be two years.

(g) No hospital shall be allowed to conduct both a three-year and a two-year school; the course must be definitely one or the other.

(h) Schools offering and giving post-graduate work must outline both theory and practice, and the same shall be true of schools giving affiliations, and they must give definite experience in each department to each pupil.

(i) Students must have had all the course planned for them, but may not be kept in the school (beyond the length of the course, two or three years) to get new courses added to the curriculum.

SPECIAL HOSPITALS

(a) Length of training should be two years in a school connected with a Special Hospital.

(b) An affiliation with an accredited school connected with a general hospital should be provided. This school must meet with the approval of the Board.

(c) Students must meet the requirements given under “General Hospitals.”

(d) A preliminary course of instruction should be given.

GRADING OF SCHOOLS

Schools of Nursing shall be graded A, B and C.

GRADE A

(a) A School of Nursing must be connected with a general hospital, having not less than 75 beds with a daily average of 50 patients (average to be taken at the same hour each day.) (b) Four registered nurses, one extra R.N. for every additional 25 beds over 75, or fraction thereof, including superintendent of nurses, night supervisor, instructor and surgical supervisor.

(c) Thirty students, one extra student for every additional 15 beds over 75, or fraction thereof.

(d) Graduate dietician

(e) Average number of operations daily, 4.

(f) Average number of obstetrical cases monthly, 10.

(g) Average number of obstetrical cases for each student, during training, 10.

(h) Separate home for nurses, with provisions for social and recreational features. (i) Adequate library, class room, laboratory equipment. GRADE B (a) School of Nursing must be connected with a general hospital, having not less than 50 beds, with a daily average of 30 patients, (average to be taken at the same hour each day.) (b) Three registered nurses, one extra R. N. for every additional 20 beds over 50, or fraction thereof, including superintendent of nurses, night supervisor and surgical supervisor.

(c) Part-time instructor. (d) Eighteen students, one extra student for every additional 15 beds over 50, or fraction thereof. (e) Average number of operations daily, 4. (j) Average number of obstetrical cases monthly, 5. (k) Average number of obstetrical cases for each student during training, 7. (l) Living quarters especially provided for nurses within hospital building. (m) Library, classroom and recreational accommodations. GRADE C. (a) School of Nursing must be connected with a general hospital, having not less than 25 beds, with a daily average of 15 beds over 25, or fraction thereof, including superintendent of nurses, night supervisor and surgical supervisor. (b) Three registered nurses, one extra R. N. for every additional 15 beds over 25, or fraction thereof.

(c) Ten students, one extra student for every additional 15 beds over 25, or fraction thereof.

(d) Average number of operations daily, 2.

(e) Average number of obstetrical cases monthly, 3. (f) Average number of obstetrical cases for each student during training, 6.

(g) Living quarters especially provided for nurses within hospital building.

(h) Library, classroom and recreational accommodations.

(Schools failing to meet the requirements of Grade C. will be recognized for one year in order that they may be given the opportunity of bringing their school up to standard). Curriculum Recommended for

Accredited Schools

Adopted October 13, 1923

Two Year Courses

FIRST YEAR Preliminary Term (4 months) Anatomy and Physiology 60 hours Practical Nursing* 60 hours Bandaging 8 hours Ethics of Nursing 6 hours Bacteriology 10 hours Drugs and Solutions 15 hours Hygiene, Personal, General, Sanita- 3 hours tion 6 hours History of Nursing 4 hours 172 hours Second Term (4 months) Materia Medica 20 hours Dietetics and Nutrition 20 hours Psychology 6 hours Urinalysis and Laboratory Technique 6 hours Advanced Nursing Procedures 16 hours 68 hours

SECOND YEAR First Term (4 months) Essentials of Medicine 14 hours Nursing in Medical Diseases 12 hours Nursing in Surgical Diseases 12 hours Gynecology 10 hours Nursing in Communicable Diseases including Tuberculosis 20 hours Orthopedics 6 hours 74 hours Second Term (4months) Obstetrics 20 hours Pediatrics and Infant Feeding 15 hours Eye, Ear, Nose and Throat 5 hours *Social Hygiene 4 hours **Contemporary Problems of Nursing Field 10 hours *Emergency Nursing and First Aid 10 hours *Mental and Nervous Diseases 6 hours Ethics 6 hours 76 hours Total for 2 years 390 hours *The subjects starred in the second term of the second year in the two year course may be transferred to the third year in a three year course as in the Standard Curriculum.

Some changes will have to be made if affiliation is given in Obstetrics, Children’s Diseases; then lectures on these should be given in the affiliation school. It is suggested that affiliation be given in the second term of the second year, o in the third year, also the special electives as follows:

Special Duty Administration (Training School, Hospital) Surgery Nursing of the Insane Public Health Children (Extra)

The Standard Curriculum can be obtained from:

The League of Nursing Education, 370-7th. Ave,. New York City, or from, The Chicago Medical Book Co., Honore St., Chicago, Ill.

Price……………………………………………….$1.50. (Postage Extra.)

In the teaching of Practical Nursing it is expected that the students shall have each procedure demonstrated to them in the class room, and that the first time the student carries it out o the wards, she does it under supervision, and this supervision is to be given each time until the instructor is sure of having gained the proper technique

It is suggested that doctors, lecturing should be given a typed copy of the teaching outlines, taken from the Standard Curriculum, and asked to adapt it, as far as possible, to the number of lectures given

**The course in Contemporary Problems of Nursing Field may include a Survey of Nursing Filed, a study of the Texas Law in regard to nursing, and nursing organizations, and a review of history or nursing. T H E

Board of Nurse Examiners

for the

State of Texas

CURRICULUM and REQUIREMENTS

Accredited Schools of Nursing _____

1924 Recommendations

Course of Study for a Two-year School

______

It is suggested that while the law allows for a two-year school that this course be supplemented by a four months’ preliminary course as provided for in a three-year course. The same outline of study is required for the first two years, although it is suggested that the three-hear school give an enriched program in the third year, as provided for in the Standard Curriculum.

The general schedule of hours suggested for the preliminary ferm is as follows:

4 hours daily in practical work. 3 hours daily in lecture, class and demonstration. 3 hours daily in study. 2 hours daily in recreation.

For the subsequent terms the schedule should be as follws:

8 hours daily in practical work 1 hour (average) daily in class work 1 hour daily for study 2 hours daily for recreation

(this means a total of 10 hours of actual required work, daily, during the academic year).

The Committee recommends that at no time in the course shall the student spend more that 8 hours per day in actual ward work, at the most 56 hours per week; and that where possible, should be given on afternoon a week off duty, and extra hours on Sunday, and that every effort be made to have lectures and class work before 7:00 P.M., that the hours of night duty be the same as for day duty, and not exceeding then hours a night, and that not more than two consecutive months of night duty be given at any one time.

These suggestions are the same for a three-year or a two-year school. It is required that each accredited school shall have a copy of the Standard Curriculum, and that it use the outlines as guides in so far as it is practicable, or unless a better outline is submitted to the Committee.

Students should be admitted in groups for the preliminary course, if possible, twice a year (in the spring and fall). A third class may be admitted the first of the year, though the difficulty of repeating the preliminary class makes it inadvisable to continue this, as it necessitates that carrying on of a heavy program of class work during the summer.

Students transferring from one accredited school to another should not be admitted except at the regular periods of admission. Such students must have completed the work of any given session before they may receive credit. Students withdrawing during any onne session, should not be accorded credit for the incomplete work of that session. Outlines for division of time for practical work for both a two and three-year course follows. It is suggested that a preliminary course be added to the time of a two-year school making the course 28 months in length.

SUGGESTED DIVISION FOR PRACTICAL WORK

(a) Two-Year Course

Four months, preliminary Five months, medical Four months, surgical Three months, Pediatric (including milk modification) Two months, operating room (and dispensary) Six to eight weeks, vacation One month, diet kitchen Three months, obstetrical Twenty-four months, (total)

Four of the above months may be given on night duty—two months a year and no night duty should be given until after the sixth month in the school. If patients are segregated, according to service the above schedule can be followed. If patients are not segregated students should keep case records, both in medicine and surgery, that a definite idea of the amount of surgery and its subdivisions and the amount of medicine may be had. Where there is no segregation of the patients, and where possible, a student should e assigned to medical cases for a definite period.

The records of this case work should be kept with student’s other records.

Where affiliation is necessary, it should not be given before the last term of the second year.

Students should not be given extensive work in laboratory, X-Ray, operating room, or pharmacy beyond that necessary for training. Students should not be used for office work, telephone operators, admission clerks, etc. X-Ray, pharmacy, anaesthesia and laboratory work should not be elective studies, but postgraduate and laboratory work.

(b) Three-Year Course

Four months, preliminary Five months, medical Three months, pediatrics Four months, surgical including gynecology, eye, ear, nose, throat, etc. Three months, obstetrical or delivery and care of 8 patients for 10 days. Three months, operating room and dispensary One month, diet kitchen Two months, vacation Four months, electives Two months, contagious One month, tuberculosis One month, laboratory (not more) Two months, for extras Thirty-six months, (total) Electives Public Health, four months Privat Duty, three months, (in hospitals) Administration, four months Extra (operating room), three months Teaching, three months Occupational, two months Mental and nervous, three months Three Year Course

In having a third year course, or in schools wishing to have more that a minimum, we advise increasing the number of hours in the first two years in the following subjects:

Hygiene Anatomy and Physiology Materia Medica Dietetics Practical Nursing Ethics Chemistry Follow the third year’s work, as outlined in the Standard Curriculum printed below.

SENIOR OR THIRD YEAR First Term

Nursing in Mental and Nervous Diseases 20 hours Nursing in Occupational, Venereal and Skin Diseases 10 hours Special Therapeutics (including Occu- Pational Therapy) 10 hours Public Sanitation 10 hours Survey of Nursing Field 10 hours 60 hours Second Term Modern Social Conditions 10 hours Professional Problems 10 hours Emergency Nursing and First Aid 10 hours *Introduction to Public Health Nurs- ing and Social Service 10 hours *Introduction to Private Nursing 10 hours *Home Problems of the Industrial Family 10 hours *Laboratory Technique 10 hours *Special Disease Problems (Advanced work in any of special forms of diseases studied above) 10 hours 60 hours ______Total for 3rd year 120 hours 390 hours As in Curriculum Total for 1st and ______2nd years Total number of hours for the three years—510 hours, which is 73 hours less than the minimum in the present Standard Curriculum. *The subjects starred in the second term of the senior or third year are all electives, to be selected according to the student’s future line of work. Each student would be expected to cover oat least three of these subjects, to make up a total of 60 hours for the last term.

RECORDS

The Committee recommends the Bell Records, as originally printed in the Modern Hospital (publication of July, 1917) and published and sold by the Physicians’ Record Company, 509 S. Dearborn Street, Chicago, Illinois. (If the school does not keep satisfactory records, it may be required to adopt these). Forms 14, 15,16, 17 and 18 are particularly valuable for showing the work of the school.

Educational Blanks should be used for high school credits, and Transfer Blanks are suggested.

All classwork should be recorded in hours or periods. The length of a class or lecture hour shall not be less than 45 minutes. A laboratory period, either in sciences, dietetics, or classroom practice should be reckoned on a basis of two hours, or 90 minutes to a period.

It is necessary, if the schools are to be standardized, that the same terms be used on all records, and if credit is given in colleges and universities for nursing education, these credits must be reckoned in the terms these institutions use.

COLLEGE AND UNIVERSITY AFFILIATION

Schools making college or university affiliation agreements must keep to the college entrance requirements. Schools must present the outline for such affiliation to the Board before entering into any agreements. A minimum of 90 semester hours or 135 quarter hours of academic work must be given in the college or university for a five-year course.

TEXT-BOOKS RECOMMENDED

Anatomy and physiology *Anatomy and Physiology for Nurses……………………………………...Kimber-Gray Anatomy for Nurses………………………………………………………………..…..Bundy Anatomy for Nurses………………………………………………………………….Williams

Hygiene Hygiene for Nurses…………………………………………………………………....McIsaac Personal Hygiene…………………………………………………………………………..Pyle Hygiene and Sanitation………………………………………………………………….Price *Home and Community Hygiene………………………………………………. Broadhurst *Personal Hygiene Applied.………………………………………………………...Williams

Bacterioloy Bacteriology for Nurses………………………………………………………………McIsaac *Applied Bacteriology and Pathology for Nurses……………………….Bolduan-Grund First Lessons in Bacteriology for Nurses…………………………………………….Morse Manual of Bacteriology and Pathology for Nurses………………………………..Roberts

Nursing *Modern Methods in Nursing………………………………………………………..Sanders *Practical Nursing..……………………………………………………………Maxwell-Pope *First Year Nursing………………………………………………………………….Goodnow Nursing Insane..……………………………………………………………………….Barrrus Practical Nursing.………………………………………………………………………Jamme Short History of Nursing.……………………………………………………..Stewart-Dock *Nursing Problems……………………………………………………………………Harmer History of Nursing……………………………………………………………………Goodnow

Medical Nursing *Essentials of Medicine……………………………………………………………..Emerson *Manual of the Practice of Medicine……………………………………………….Stevens Nurses Handbook of Drugs and Solutions……………………………………….Stimpson

Surgical Nursing Principle of Surgical Nursing…………………………………………………….Warnshuis Essentials of Surgery………………………………………………………………McDonald *Textbook of Surgical Nursing………………………………………………….Colp-Keller

Children’s Nursing Care of Baby…………………………………………………………………………….Griffith Diseases of Children…………………………………………………………………McComb Care and Feeding of Children………………………………………………………Ramsey *Diseases of Infancy and Childhood…………………………………………………..Holt *Practical Care of Children…………………………………………………………..Kerley

Urinalysis Practical Urinalysis for Nurses…………………………………………………Marquardt

Materia Medica Materia Medica for Nurses..…………………………………………………………….Dock Practical Meteria Medica………………………………………………………………Stoney Materia Medica Therapeutics…………………………………………………………..Foote *Materia Medica for Nurses…………………………………………………….Blumgarten *Materia Medica and Therapeutics…………………………………………………..Parker Materia Medica, Pharmacology and Therapeutics For Nurses…………………….Pope

Dietetics, Nutrition and Invalid Cookery Essentials for Dietetics……………………………………………………..Pope-Carpenter Foods, Cookery for the Sick Convalescent…………………………………………Farmer *Practical Dietetics……………………………………………………………………..Pattee *Dietetics for Nurses………………………………………………………………….Proudfit

Obstetrics and Gynecology A Nurses Handbook of Obstetrics…………………………………………………….Cooke *Obstetrics for Nurses…………………………………………………………………..DeLee Obstetrics and Gynecologic Nursing…………………………………………………..Davis Gynecology...……………………………………………………………………………..Graves *Reference and Handbook of Gynecology for Nurses…………………………..McFarlane *Obstetrical Nursing……………………………………………………………Van Blarcom

Ethics *Ethics of Nursing…………………………………………………………………………Robb *Ethics for Nurses………………………………………………………………………Aikens Nursing Problems and Obligations…………………………………………………Parsons

Chemistry Textbook of Chemistry for Nurses and Students of Home Economics……….MacLeod Textbook of Chemistry and Chemical Urinalysis for Nurses………………………Amos Chemistry for Nurses………………………………………………………………Ottenburg Chemistry and Toxicology for Nurses…………………………………………………Asher

Communicable Disease Nursing Nursing in Diseases of the Eye, Ear, Nose and Throat…………….Manhattan Eye, Ear, And Throat Hospital

Nursing in Mental and Nervous Diseases Nursing in Mental Diseases……………………………………………………………Bailey

Dictionary American Medical Dictionary………………………………………………………Dorland Medical Dictionary……………………………………………………………………..Gould

Reference Library

Gray’s Anatomy and Physiology……………………………………………………Howells Massage and Swedish Movements…………………………………………………Ostrom Educational Standards for Nurses…………………………………………………….Robb Notes on Hospitals………………………………………………………………..Nightingale Life of Florence Nightingale…………………………………………………………..Pollard Practical Points in Nursing……………………………………………………………Stoney Dust and Its Dangers…………………………………………………………………Purdden Principles of Bacteriology………………………………………………………………Abbott A Nurse’s Guide for the Operating Room……………………………………………..Senn Principles of Practice of Bandaging……………………………………………………Davis Immediate Care of the Injured………………………………………………………Morrow Anatomy and Physiology and Hygiene of Infancy and Childhood………………Cotton Diseases of Infancy and Childhood……………………………………………………..Holt Infant Feeding………………………………………………………………………….Grulee Manual Obstetrics……………………………………………………………………….King History of Nursing……………………………………………………………..Nutting-Dock Consumption and Civilization………………………………………………………..Hubber Tuberculosis, A curable and Preventable Disease………………………………….Knopf Prevention of Infectious Diseases………………………………………………………Doty Elementary Chemistry………………………………………………………………Remsen Nursing in Eye, Ear, Nose and Throat……………………………………..Davis-Douglas Self-Control and How to Secure It………………………………………………….Doubois Invalid Occupations……………………………………………………………………..Tracy House on Henry Street………………………………………………………………….Wald Short History of Nursing……………………………………………………………Goodnow Nursing the Insane……………………………………………………………………Barrus Hygiene and Morality…………………………………………………………………..Dock Democracy and Social Ethics………………………………………………………..Addams Visiting Nurses in the United States………………………………………………Walters Private Duty Nursing…………………………………………………………………DeWitt State Registration and Nurses………………………………………………………..Boyd Medical Dictionary………………………………………………………………..Lippincott Bacteriology in a Nutshell……………………………………………………………….Reid Bacteriology and Surgical Technique………………………………………………..Stony Principles and Practice of Nursing……………………………………………………..Robb Primary Nursing Technique………………………………………………………MacIsaac Primary Studies for Nurses…………………………………………………………..Aiken Clinical Studies for Nurses……………………………………………………………Aiken History of Nursing, 4v………………………………………………………..Stewart-Dock Outlines of Internal Medicine…………………………………………………………..Farr Aseptic Surgical Technique……………………………………………………………..Robb Dietetics for Nurses………………………………………………….Friedenwald-Ruhrah Preventive Medicine…………………………………………………………………Rosenau How to Study…………………………………………………………………………Wheeler

(Excerpts) EDUCATIONAL PROGRAM

The New Curriculum

Effective September 1, 1959

General Plan of Instruction: The basic curriculum for Plan I or Plan II is divided into three phases, namely: Phase I is thirty-six weeks or one academic year which includes the basic science and other courses with their application to nursing care. Phase II is seventy-six weeks which included course related to nursing and the study of patient care involved in medical, surgical, maternal and child care, and psychiatric nursing. Phase III is twelve weeks which includes the Intensive Nursing Experience. This experience is flexible to enable the faculty to guide the student in select areas of clinical practice, which will supply a felt need for additional preparation in the practice of professional nursing. Throughout the entire state educational program emphasis is placed upon the related philosophy of the individual school of nursing which will not only clarify the relationships of the various bases of knowledge but will unify and correlate them in such a manner that the student is not exposed to an isolated and disconnected series of factual material. Various teaching methods are used, namely: lectures, classes, demonstrations, laboratory techniques, seminars, conferences, group teaching and discussions. As part of each basic clinical nursing course, assignments are made to the out-patient department in relation to planned lecture tous to the local health and welfare agencies. The rehabilitative therapies and the team approach to patient care are important to the professional competency consistent with the objectives of the basic curriculum. The recommended changes are optional. A school of nursing which deems it advisable to continue to adhere to the traditional curriculum pattern will be fully by the Board of Nurse Examiners. A school of nursing which decides to meet the recommended changes of the new design in its curriculum plan will be required to adopt the entire program with individual variations within the framework of Plan I or Plan II. A school of nursing which will conduct the new program will be required to complete the traditional program for the students who were admitted to the school of nursing prior to the organization and administration of the new curriculum plan. No school of nursing shall be accredited for the operation of both the traditional and the new programs. TRADITIONAL PROGRAM

The hospital-schools of nursing which are now conducting the traditional diploma program of three calendar years will continue to meet the requirements of the State Board Bulletin issued in 1951.

THE NEW CURRICULUM PLAN FOR PROFESSIONAL NURSE EDUCATION Academic *College Courses Semester Hours Psychology…………………………………………………………………………..3 Sociology……………………………………………………………………………. 3 Biology……………………………………………………………………………….4 to 6 Chemistry……………………………………………………………………………4 to 6 English……………………………………………………………………………….6 COURSES RELATED TO NURSING **Clock Hours of Instructions History of Nursing and Professional Relations…………………………48 *** Microbiology and Pathology (Demonstrations and Laboratory Techniques)………………….80 *** Elementary Materia Medica and Pharmacology………………………..80 *** Basic Nutrition and Diet Therapy (Demonstrations and Laboratory Techniques)…………………106 Human Anatomy and Physiology (Taught as correlated subject matter according to the designated clinical nursing courses in relation to the systems of the body)…………………………………………………………. 80 CLINICAL NURSING COURSES Fundamentals of Patient Care (Demonstrations and Laboratory Techniques)…………………106 Medical and Surgical Nursing…………………………………………….128 Maternal and Child Care……………………………………………………96 Psychiatry……………………………………………………………………..48 *** Community Aspects of Nursing Care……………………………………..80 ______*Plan I Admission of High School Graduates to a Diploma Program: The academic college courses will be supplied by course affiliation with colleges or universities, and a pre- clinical or freshman term (36 weeks) will be maintained by the hospital-school of nursing.

Plan II For Candidates Having College Preparation: The Admission Requirements of a Hospital- School of Nursing will provide for the Academic Courses by accepting candidates having specific preparation in the required academic courses. For these students, the fundamentals of Patient Care (12 weeks) will replace the pre-clinical or freshman term (36 weeks). ** The Hours of Instructions do not include nursing practice as clinical laboratory work. As yet, the Board of Nurse Examiners does not have a definite acceptable formula but approved experimentation being conducted by state accredited schools of nursing will determine the ratio of clock hours to clinical practice hours at which time a reliable ratio will validate a required formula. *** In part, and identifiable strands of correlated subject matter with the clinical nursing courses.

Time Assignments – Clinical Nursing Areas

Fundamentals of Patient Care.…………………………………………..12 weeks Medical Nursing…………………………………………………………….16 weeks Surgical Nursing…………………………………………………………….16 weeks Operating Room…………………………………………………………….. 8 weeks Maternal and Child Care…………………………………………………..16 weeks Psychiatry……………………………………………………………………. 8 weeks ______76 weeks Intensive Nursing Experience……………………………………………. 12 weeks Vacation……………………………………………………………………… 2 weeks ______90 weeks Academic Year………………………………………………………………. 36 weeks

Total Time Allotment for the Entire Curriculum Plan………….****126 weeks For the various clinical nursing areas the weekly time assignments shall be 40 hours which shall supply the educational requirements and provide for supervised practice under qualified supervision. The ratio for the weekly distribution of time: 24 hours to supply the educational requirement of theory and practice and 16 hours in nursing service under qualified supervision in the clinical division which conduct an organized in- service educational program to improve the students’ supervised practice for patient care. ______

**** For the Hospital-School of Nursing accepting high school graduates, Fundamentals of Patient Care (12 weeks) will be taught with other courses during the pre-clinical or freshman term (36 weeks); thereby reducing the time requirement for Plan I by 12 weeks.

Hospital-Schools of Nursing which are conveniently located should offer to interested students the opportunity of completing the requirements for an Associate Degree from a Junior or Community College.

Curriculum Components:

The development of the curriculum is the responsibility of the faculty and reflects the basic philosophy and objectives of the school. The curriculum should be flexible to meet both the present and the changing needs in professional nurse education. For the entire program, a curriculum chart shall show the plan for courses and related educational experiences. The curriculum plan shall be divided into areas showing the sequence in which the clinical courses are built upon foundation courses in order to provide for the progressive development of knowledge, understanding, attitudes, abilities, and skills. In addition to the specific requirements of the new curriculum plan, identifiable strands of progressive instruction in fundamentals of nursing , body mechanics and functions, historical data and professional relations, pharmacology and drug therapy, nutrition and diet therapy, mental health and psychotherapy, disease prevention and control, and the social, health, rehabilitative and occupational aspects should be emphasized as correlated subject matter in all of the appropriate nursing courses. Theoretical courses in clinical nursing subjects shall be taught concurrently with the clinical laboratory practice in the specific nursing area.

Instruction:

The faculty should be able to demonstrate that instruction is evaluated through performance of students while in the educational program and later as members of the nursing profession. Adequacy of instruction will be judged by performance of students on standardized and instructor-made tests and the State Board Test Pool Examinations. The evaluation and grading system should be realistic in terms of the objectives of the program and the intellectual capacity of the students admitted to the school of nursing. If grades are indicative of the individual abilities of students, an undue proportion of high grades will be inconsistent with good educational practices. The faculty should show evidence of methods of instruction appropriate to professional education, especially the problem solving methods of nursing education are used: such as lectures, class discussions, group teaching by resource instructors, laboratory practice, seminars, conferences, and filed trips. Use should be made of community resources and experts in related fields. A specific benefit would be seminars concurrent with the clinical laboratory practice in order that students may develop the ability to learn from experience. Special emphasis should be placed on development of ability in observation, oral and written expression.

Practices Relating to the Curriculum as A Whole: The year (school or calendar) should be divided into sessions, with dates set for the beginning and ending of each, and with learning experiences beginning and ending on the dates which are decided by the faculty. All students should begin the educational program and finish it on the same date. Schools of Nursing should not use “ill-time” concepts since such concepts apply to employed personnel rather than students. Instead they should have policies regarding the number of absences permitted per session. Absent students are expected to be responsible for supplying the deficiency of the content both for class and clinical laboratory work. If absences are so intensive that too much content has been missed, the student repeats the course during a subsequent session. Graduation should follow the finishing date. Students academic records and transcripts should not separate or give separate grades for class or clinical laboratory work, should not include vacation time or ill time, should not total days or weeks, should not list names or sizes of schools or agencies where some of the learning experiences are secured, should not separate the method of teaching for clinical laboratory courses and record separately such as lecture and “clinical teaching”.

Class Hours: For the new curriculum plan, the total number of hours in each course has been compiled on the basis of sixteen weeks per semester. A class hour is 50 minutes; a laboratory period consists of a minimum of two class hours or 100 minutes. For each hour of class, exclusive of laboratory, form one and one-half hours to two hours of study, or preparation for both the faculty and students should be a stated policy of the school of nursing. The evaluation of the semester or quarter hours depends upon the stated regulations of the individual college or university. BACCALAUREATE AND ASSOCIATE DEGREE PROGRAMS

A baccalaureate or and associate degree program offering professional preparation in nursing is conducted by an autonomous educational unit (or school of nursing) which is an integral part of a college or university. Institutions of higher education which control the programs in professional nurse education shall be approved by appropriate state, regional or national educational accrediting agencies. The school shall use hospitals and other related facilities which are approved by appropriate accrediting agencies. The educational unit in nursing must be accredited by the Board of Nurse Examiners. A degree in nursing shall be granted only to those registered in the educational institution who have completed the nursing program offered by the institution and have met the requirements for graduation as certified by the faculty. In the educational institution the nursing program should be comparable in length to other baccalaureate or associate degree programs and approximately one half of the program shall be in general education and one half in professional nurse education. The major in nursing shall meet the same requirements as a major in any other discipline. The quantity work rule of the nursing student shall be comparable to that of other students in the college or university. The curriculum should be concerned with the preventive, remedial, supportive, and rehabilitative aspects of nursing including the physical, emotional, and social components. It shall emphasize social sensitivity and responsibility for human understanding so as to develop coordinative ability, working with and through others in achieving patient care and shall include: The courses which are required for a baccalaureate or associate degree programs shall meet at least the requirements of the new curriculum plan for the state educational program For the clinical nursing course, the clinical laboratory work (or clinical practice) shall receive credit in accordance with the general policy of the college or university. In addition to the general policy of the college or university, the clinical nursing courses shall also include the balance of laboratory work, so that the total of sixteen hours of clinical laboratory work per week of the time allotment assigned to any one clinical nursing course for a semester shall be required by the school of nursing. Due to the different patterns in curriculum development for the degree programs, students will be required to complete the degree program in which they have matriculated before being eligible to write the State Board Licensing Examination. All other general requirements of the Board of Nurse Examiners which relate to accreditation shall be met by the baccalaureate and associate degree programs. Any college or university planning to establish an education unit in nursing should seek advice from the Board of Nurse Examiners. The Board will arrange conferences to assist the college or university in formulating plans to meet the requirements of the educational program. Before admitting students to the program, the educational institution shall submit the proposed curriculum to the Board for approval. For the evaluation of the baccalaureate program in nursing, the suggested guide by the Committee of Deans of the Texas Collegiate Schools of Nursing is recommended by the Board of Nurse Examiners. For the evaluation of the associate degree program, the Guiding Principles for Junior Colleges Participating in Nursing Education by a Committee of the American Associate of Junior Colleges is recommended by the Board of Nurse Examiners. DESCRIPTION OF COURSES

The required college courses are described in the catalogues of the respective colleges. The courses related to nursing which the school of nursing may teach are:

History of Nursing the and Professional Relations. …48 hours Microbiology and Pathology. …80 hours Human Anatomy and Physiology. …80 hours Elementary Materia Medica and Pharmacology. …80 hours Basic Nursing and Diet Therapy. …106 hours

CLINICAL NURSING COURSES

Fundamentals of Patient Care. …106 hours. 12 weeks entirely under the direct teaching and supervision of the full time nurse instructors. Medical and Surgical Nursing. …126 hours, 16 weeks for each phase of the course in clinical laboratory practice in addition to 8 weeks’ assignment to the operating room. Maternal and Child Care. … 96 hours. 16 weeks of clinical laboratory practice. Psychiatry. …48 hours in addition to 8 weeks of clinical laboratory practice conducted by in-service education. 16 hours Community Aspects of Patient Care. … 48 hours in addition to the equivalency of clinical laboratory practice of 32 hours. Intensive Nursing Experience. …24 hours. 12 weeks clinical laboratory practice and managerial experience.