The 2016 NPD Scope and Standards: Began with Florence
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).
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.
References
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 (3rd 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
