Contents

• COMMITTEE ON NURSING AND NURSING EDUCATION
• INSTITUTE OF MEDICINE
• Preface
• Acknowledgments
• Summary and Recommendations
• Chapter I. Nursing Services and Nursing Education: An Overview
  • The Diversity of Registered Nurses' Responsibilities
  • Variety of Nursing Service Personnel
  • Variations in Nursing Service Staff Mix
  • Education for Registered and Practical Nurses
  • Relation of Type of Generalist Nurse Education to Licensure and Practice
  • Debate Over Appropriate Generalist Nurse Education
  • Responsibilities of Advanced Level Nurses
  • Education for Advanced Level Positions
  • Federal, State, and Private Financing of Nurse Education
• Chapter II. Meeting Current and Future Needs for Nurses
  • Current Supply and Demand
  • Future Supply and Demand
  • Supply of Registered Nurses Educated in the Three Types of Generalist Programs
  • State and Local Planning for Generalist Nurse Education
• Chapter III. The Effects of Education Financing on Generalist Nurse Supply
  • Student Decision Making
  • State and Institutional Decision Making
• Chapter IV. Education for Generalist Positions in Nursing
  • Attracting New Kinds of Students
  • Opportunities for Educational Advancement
  • Collaboration Between Education and Service
• Chapter V. Education for Advanced Positions in Nursing
  • Advanced Education for Nursing Administration
  • Advanced Education for Teaching and Research
  • Advanced Education for Nurse Specialists
  • Interrelationships Among Types of Advanced Education
  • The Need for More Nurses with Graduate Education
  • The Effect of Financing on Future Supply
  • Statement of Exception to Recommendation
• Chapter VI. Alleviating Nursing Shortages in Medically Underserved Areas and Among Underserved Populations
  • Some Reasons for Areas of Underservice
  • The Nature and Consequences of Underservice
  • Educational Outreach
  • Education Opportunities for Minority Students
  • Adequate Revenues for Inner-City Hospitals
  • Nursing Education for Care of the Elderly
  • Upgrading Existing Staff in Nursing Homes
  • Adequate Payment for Long-Term Care
  • Lowering Barriers to Expanded Nurse Practice
  • Financing Recommended Actions
• Chapter VII. Improving the Use of Nursing Resources
  • The Effects of Management Decisions on Supply and Demand
  • Job Turnover and Attrition in Nursing
  • Improving Career Opportunities and Working Conditions
  • Inactive and Part-Time Nurses
  • Accounting for Nursing Services
• Chapter VIII. Advancing Research in Nursing and Getting Facts for Manpower Planning
  • Improving the Nation's Nursing Research Capacity
  • Comparative Competencies of Registered Nurses With Different Educational Preparation
  • Evaluation of Promising Management Approaches
  • Information to Monitor Supply and Demand
• Appendix 1 Congressional Charge--Excerpts from Public Law 96-76
• Appendix 2 Appropriations Under the Nurse Training Act
• Appendix 3 Summary of Information on State Reports of Nursing Issues
• Appendix 4 Certificates for Specialist Registered Nurses
• Appendix 5 Projections of Registered Nurse Supply and Requirements
• Appendix 6 Doctoral Programs in Nursing: Illustrative Statements of Purpose From School Catalogs
• Appendix 7 Multivariate Analysis of Determination of Work Status and Wage Rates
• Appendix 8 Nursing Research: Definitions and Directions
• Appendix 9 Participants in the Study's Workshops and Advisory Panels
• Listing of Background Papers

This study was supported by U.S. Department of Health and Human Services Contract No. 282-80-0043, T.O. 7.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education.