Patsy Maloney, EdD, MSN, RN-BC, CEN, NEA-BC is a Senior Lecturer of Nursing and Healthcare Leadership at University of Washington Tacoma.
"Let us never consider ourselves finished nurses...we must be learning all our lives." -Florence Nightingale
There has been much excitement about the release of the 2016 Nursing Professional Development (NPD) Scope and Standards. The workgroup of NPD experts did a great job. The workgroup stood on the shoulders of the nursing and NPD leaders that went before us. This blog entry will briefly describe what a scope and standards document is, the history of our current scope and standards, a brief overview of the major changes in our current scope and standards, and a call to implement the standards by advancing the NPD specialty.
What is a Scope and Standards document ? A nursing specialty scope of practice describes the specialty practice, its boundaries, and its practitioners (Anderson, 2011). The American Nurses Association (ANA) (2015) publishes a Nursing Scope and Standards that applies to all nurses, including all specialty nurses. The scope is an overview of nursing and answers the who, what, when, where, how, and why questions of nursing practice. The standards of professional practice have two parts, a description of each standard followed by a list of competencies (Strong, 2016). The second edition of Nursing Scope and Standards (ANA, 2010) is available online . The third edition (2015) can be purchased online .
History of the NPD Scope and Standards. The history of our scope and standards begins with the history of our specialty. The roots of our specialty go back to the founder of modern nursing, Florence Nightingale. Ms. Nightingale's belief that life-long learning was crucial influenced her opposition to registration (licensure ) of nurses. She believed that if nurses were licensed after completing their training program, they would consider themselves “finished nurses” and would not continue learning ( http://www.austincc.edu/adnlev1/rnsg1413online/mod_prof/history_notes.htm ).
Pfefferkorn stated “The improvement of the nurse in service, in its broadest implications is as old as nursing…but the improvement of the graduate nurse for professional or cultural growth, is yet in its infancy” (1928, p.700) . So the improvement of nursing practice “in service” of the patient is as old as nursing, but including the professional development of the nurse beyond the immediacy of care of the patient was in its infancy in 1928 (88 years ago). The word in-service and in-service education took hold and articles about in-service education started to appear in the nursing literature. As more nurses moved from independent practice to hospital employees and the need for nurses increased, in-service education to orient and refresh nurses became even more important. By 1953 the in-service education role began to separate from that of nursing administrator, and divisions of in-service education were established within departments of nursing service ( Abruzzese & Yoder-Wise, 1996).
Concurrent with the development of divisions of in-service education within hospitals, ANA started to develop the forerunners to scope and standards. These documents were called statements of functions. One of the earliest mentions of these was in the American Journal of Nursing in 1954 . These statements of functions were developed by ANA committees. The 1954 statements included education, but not in-service education. By 1956 the statements of functions had evolved to statements of functions, standards, and qualifications for practice . Over the next few years American Journal of Nursing published these statements for a variety of nursing areas. They did not use the term specialties. Although in-service education was not included in the first statements of functions, standards, and qualifications, the specialty was included in The Yearbook of Modern Nursing 1956. It was not until 1966 that the Nursing Service Administrators section of ANA developed a “statement of functions and qualifications for in-service educators (Abruzzese & Yoder-Wise, 1996). This document was the precursor of our scope and standards.
By 1970 in-service education was subsumed under continuing education, which had come to include all education that took place outside degree granting nursing school programs. The Journal of Continuing Education published the ANA's landmark statement on in-service education in 1970 and in 1972 published ANA's landmark statement on continuing education. The Council on Continuing Education was organized with members from both in-service education and college continuing education programs in 1973. In 1974 ANA published the first standards for continuing education and in 1976 published guidelines, not standards for staff development. (Abruzzese & Yoder-Wise, 1996). With the publication of these guidelines the term in-service education was replaced with the term nursing staff development. Instead of referring to an area of practice, in-service education came to mean education and training delivered in the practice setting to facilitate an individual's ability to function within a given agency (ANA, 2000).
Finally, in 1990 ANA published Standards for Nursing Staff Development (ANA, 1990). This was followed in 1994 by Standards for Nursing Professional Development: Continuing Education and Staff Development. Nursing professional development had become the umbrella term to encompass both continuing education and staff development. Embracing this new term, the Scope and Standards of Practice for Nursing Professional Development was published by ANA in 2000. The 2010 Nursing Professional Development: Scope and Standards of Practice was published jointly by ANA and National Nursing Staff Development Organization (NNSDO) (ANA & NNSDO, 2010). Our scope and standards led the way for the re-naming and re-branding of our specialty from NNSDO to the Association for Nursing Professional Development (ANPD) in 2012.
The nursing and NPD leaders on whose work the 2016 NPD Scope and Standards of Practice is built are too numerous to name. But I think it is really important to acknowledge Ms. Barb Brunt, who served with the 1994, 2000, and the 2016 standards work groups. Her contributions to our current scope and standards are immeasurable. Another NPD giant is Dr. Dora Bradley, who led the work group for the 2010 NPD Scope and Standards of Practice. This work group created the NPD Practice Model as a systems model that maintained much of its relevance and only required the 2016 workgroup. The 2010 Scope and Standards was an outstanding foundational document for the 2016 scope and standards work group.
Overview of the revisions in the 2016 NPD Scope and Standards. The significant revisions in the NPD Scope and Standards of Practice (ANPD, 2016) include expanding the settings in which the NPD specialty is practiced beyond acute care and even including virtual environments, replacement of the intertwined elements with seven NPD roles, identification of general (NPD Generalist) and advanced levels (NPD Specialist) of NPD practice. NPD practitioner became the umbrella term that incorporates both the NPD generalist and the NPD specialist (Harper & Shinners, 2016). Two standards of performance (Collegiality and Advocacy) were removed and integrated throughout the other standards. Change Management and Mentorship/Advancing the Profession were added in response to the NPD Role Delineation Study (Warren & Harper, 2015).
Conclusion. The seeds of the 2016 NPD Scope and Standards of Practice were planted by Florence Nightingale when she emphasized the need for life-long learning. These seeds started to take root when Blanche Pfefferkorn addressed the National League for Nursing Education's convention and discussed the deliberate pursuit of professional growth post-graduation from nursing school (Pfefferkorn, 1928). After the publication of Pfefferkorn's address articles on in-service education started to appear in the nursing literature. In the 1950's in-service education divisions started to appear in hospitals and by the 1960's the predecessor of the current scope and standards was developed. Our current 2016 Scope and Standards is the result of the work of well over 100 years of thought leaders. The last, but not least standard of performance, Standard 16: Mentoring and Advancing the Profession, calls us to advance our specialty. Our specialty is one of the oldest of nursing specialties. Be proud. Call your specialty by name, Nursing Professional Development.
Abruzzese, R. S., & Yoder-Wise, P. S. (1996). Staff development: Our visions. In R. S. Abruzzese (Ed.). Nursing staff development: Strategies for success (pp. 3-14). St. Louis, MO: Mosby Yearbook.
American Nurses Association. (2000). Scope and standards of practice for nursing professional development. Washington DC: Author.
American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author.
American Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author.
American Nurses Association and National Nursing Staff Development Organization. (2010). Nursing professional development: Scope and standards of practice. Silver Spring, MD: ANA.
ANA Statements of functions. (1954). The American Journal of Nursing, 56(10), 1305-1309.
ANA Statements of functions, standards, and qualifications. (1956). The American Journal of Nursing, 56(8), 1027-1030.
Anderson, T. (2011). Nursing professional development: Scope and standards of practice (2010). Nebraska Nurse, 44 (3), 8-9.
Harper, M. G. & Maloney, P. (2016). Nursing professional development: Scope and standards of practice (3 rd ed.). Chicago, IL: ANPD.
Harper, M.G. & Shinners, J. (2016). Overview of nursing professional development. Journal for Nurses in Professional Development, 32(4), 228-229.
History Notes. (n.d.). Nursing as a profession. Retrieved from http://www.austincc.edu/adnlev1/rnsg1413online/mod_prof/history_notes.htm
Pfefferkorn, B. (1928). Improvement of the nurse in service: An historical review. The American Journal of Nursing, 28 (7), 700-710.
Strong, M. (2016). Maintaining clinical competency is your responsibility. American Nurse Today, 11 (7), 46-47.
Warren, J. I., & Harper, M. G. (2015, July). Nursing professional development role delineation study . Presentation at the annual meeting of the Association for Nursing Professional Development, Las Vegas, NV