N490 Module 1 Assignment: Evolution of Nursing Paper

Building a Profession: How Four Education Reforms Turned Nursing From Apprenticeship Into a Discipline

Student Name

RN to BSN Program, Aspen University

N490: Issues and Trends in Professional Nursing

Instructor Name

Month Day, Year

What this page is doingThe title makes a claim instead of naming a topic. "The Evolution of Nursing" tells a grader nothing about what the paper will argue; "four education reforms" promises a structure the grader can check off as the sections arrive. The title page itself is plain APA 7 student format, with the program line placing the writer as an RN-to-BSN student, which matters later when the paper turns to the writer's own practice.

Building a Profession: How Four Education Reforms Turned Nursing From Apprenticeship Into a Discipline

Nursing did not become a profession by being needed. People were nursed at home, in almshouses, and in religious orders for centuries before anyone called the work a profession. What changed in the last 160 years was the way nurses were prepared, and each change in preparation was fought for by a small number of people who could show, with the evidence of their day, that better educated nurses produced better outcomes. This paper traces four of those turning points: the Nightingale training school, the reports that moved nursing toward the university, the split between technical and professional preparation, and the outcome research that finally tied education to patient survival. It closes with what that history means for a registered nurse returning to school for a baccalaureate degree.

What this page is doingAn introduction for this kind of paper has one job: announce the thesis and the map. This one does both in five sentences. The opening line is a small provocation, that need alone never made nursing a profession, and the paper spends the rest of its length proving it. Graders in an issues and trends course read for an argument about history, not a timeline, and the map sentence tells them where each rubric item will be answered.

The Nightingale Model and the First American Schools

Florence Nightingale's lasting contribution was not the lamp in Scutari but the idea that nursing could be taught. In Notes on Nursing she argued that the knowledge of how to put a patient in the best condition for nature to act was distinct from medical knowledge and could be learned by observation and discipline (Nightingale, 1860). The school she founded at St. Thomas' Hospital in 1860 made that idea institutional: students were selected, taught by nurses, and supervised in practice rather than simply hired as ward labor.

The model crossed the Atlantic within a generation. In 1873 three training schools modeled on Nightingale's principles opened in the United States, at Bellevue Hospital in New York, in New Haven, and at Massachusetts General Hospital in Boston. Linda Richards, often called the first professionally trained American nurse, finished her training that same year. The weakness of the American version was built in from the start: the schools belonged to hospitals, and hospitals quickly learned that students were cheap staff. By the early twentieth century hundreds of hospital schools existed, many of them teaching little beyond the routines of the ward that owned them.

What this page is doingThis section earns the "key events and individuals" row with precision instead of volume: a year, three places, two named people, and one idea per person. The highlighted sentence is the move that separates a strong history paper from a list. It names a structural flaw the rest of the paper has to resolve, so the history now has a plot. Primary sources are cited where they exist, Nightingale's own book rather than a summary of it.

Moving the Education Into the University

The first serious challenge to the hospital school came from outside nursing's workforce and inside its leadership. The Committee for the Study of Nursing Education, funded by the Rockefeller Foundation and staffed by Josephine Goldmark, surveyed schools across the country and concluded that nurses were being trained for the convenience of hospitals rather than educated for their work; it recommended that nursing education be separated from hospital service and placed in universities (Committee for the Study of Nursing Education, 1923). The Yale School of Nursing opened the same year as an independent school within a university, a demonstration of what the report proposed.

Public health nursing supplied the practical case. Lillian Wald had founded the Henry Street Settlement in New York in 1893, sending nurses into tenement homes and coining the term public health nurse for work that required judgment no ward routine could teach. Her nurses assessed families, taught hygiene, and reported conditions to authorities, which is to say they practiced independently decades before the education system prepared anyone to do so.

A quarter century later, Esther Lucile Brown's Nursing for the Future repeated the argument with a postwar workforce in view, recommending that professional nursing education be based in colleges and universities and that the nation stop relying on students for hospital labor (Brown, 1948). The reports did not close the hospital schools, but they changed the question. After Brown, the debate was no longer whether nursing belonged in higher education but how quickly it could get there.

What this page is doingThree sources, three different kinds of pressure: a survey report, a practitioner who proved the need in the field, and a second report with a new workforce in view. That variety is what the rubric means by analysis of influences. Each paragraph also ends with a consequence sentence, so a grader can see what each event changed instead of inferring it.

Technical and Professional Preparation

The answer to that question arrived in two forms that still shape the workforce. Mildred Montag proposed in 1951 that a shorter program in community colleges could prepare nurses for technical, bedside functions, with the baccalaureate reserved for broader professional practice (Montag, 1951). Her associate degree model spread faster than anyone expected, because it was affordable, local, and quick, and within a few decades associate degree programs were preparing a large share of new registered nurses.

The American Nurses Association responded in 1965 with a position paper stating that the minimum preparation for beginning professional nursing practice should be the baccalaureate degree and that technical practice should be prepared in associate degree programs (American Nurses Association, 1965). The paper was controversial because it seemed to demote working nurses who had qualified through diploma and associate programs, and its central recommendation was never written into licensure. The result was a single license resting on three different educational paths, an arrangement unusual among the professions and one that still frames the RN-to-BSN student's decision to return to school.

What this page is doingHere the paper handles a genuinely contested moment without taking cheap sides. Montag is presented on her own terms, as a solution to a shortage, and the ANA position is presented with the reason it angered working nurses. A reader who holds an associate degree is not insulted, and the highlighted sentence states the unresolved fact the next section will test against evidence.

Evidence Joins the Argument

For most of the twentieth century the case for university education rested on principle. That changed with outcome research. In a study of surgical patients in 168 Pennsylvania hospitals, Aiken et al. (2003) found that each 10 percent increase in the proportion of nurses holding a baccalaureate or higher degree was associated with a 5 percent decrease in the likelihood of death within 30 days of admission and of failure to rescue. A later study of 300 hospitals in nine European countries found that each 10 percent increase in bachelor's degree nurses was associated with a 7 percent decrease in the likelihood of inpatient death after common surgery (Aiken et al., 2014). Both studies are observational, and association is not proof of cause, but the finding held after adjustment for patient and hospital characteristics and was repeated across different health systems.

Policy followed the data. A landmark national report recommended increasing the proportion of nurses with a baccalaureate degree to 80 percent by 2020 and doubling the number of nurses with doctorates (Institute of Medicine, 2011). Its successor report shifted the emphasis from the size of the workforce to what nurses do with their education, calling on the profession to address social determinants of health and advance health equity (National Academies of Sciences, Engineering, and Medicine [NASEM], 2021). The history had come full circle: the argument Nightingale and Wald made from observation was now being made from mortality data and population health.

What this page is doingThe strongest paragraph in the paper, and the one most drafts get wrong. The findings are stated with their denominators (168 hospitals, 300 hospitals, per 10 percent), the study design is named, and the limit is conceded in one sentence: observational, so association rather than cause. Stating the limit costs nothing and buys credibility with a graduate-minded grader. The last sentence ties the evidence back to the historical thread.

What the History Means for a Returning RN

For a nurse who qualified through an associate degree and has practiced for years, this history can read as an accusation. It is more useful read as a description of what the baccalaureate adds. The reforms that moved nursing into universities were never about bedside skill, which diploma and associate graduates demonstrably have. They were about the capacities Wald's nurses needed in the tenements: assessing a population rather than a single patient, reading and weighing evidence, and acting on the conditions that make people sick before they arrive at the hospital (NASEM, 2021).

Consider a medical surgical nurse on a busy unit who notices that patients discharged on new anticoagulants keep returning with bleeding complications. Skilled practice produces careful discharge teaching for each patient. Baccalaureate practice asks further questions: how many readmissions, over what period, what the literature says about teach-back and follow-up calls, and who on the unit could change the process. That shift from the individual case to the pattern is exactly what the Goldmark and Brown reports were asking universities to teach, and it is the reason the evidence in Aiken et al. (2003) points where it does.

What this page is doingRubrics for this assignment usually include an application to the writer's own practice, and this section delivers it without confession or filler. The practice example is a composite pattern any medical surgical nurse will recognize, and it is used to show a specific capacity, moving from one patient to the pattern, rather than to say the writer has grown. It also closes the loop on Wald, so the history and the application read as one argument.

Conclusion

Nursing became a profession through its schools. Nightingale showed that nursing could be taught, the hospital school showed what happens when teaching is subordinated to staffing, and the reports of 1923 and 1948 argued for the university long before the evidence existed to prove them right. Montag and the ANA left the profession with one license and several paths, and outcome research has since given the baccalaureate argument the weight that principle alone never did. For the registered nurse returning to school, the degree is not a correction of past practice but the latest step in a reform that nurses themselves started.

What this page is doingA conclusion that recaps each section in one clause and then lands on a sentence the reader has not already seen. No new sources, no new claims, and the final line reframes the thesis for the actual reader of the paper, an RN-to-BSN student. That is the difference between a summary and a close.

References

Aiken, L. H., Clarke, S. P., Cheung, R. B., Sloane, D. M., & Silber, J. H. (2003). Educational levels of hospital nurses and surgical patient mortality. JAMA, 290(12), 1617-1623. https://doi.org/10.1001/jama.290.12.1617

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., Diomidous, M., Kinnunen, J., Kózka, M., Lesaffre, E., McHugh, M. D., Moreno-Casbas, M. T., Rafferty, A. M., Schwendimann, R., Scott, P. A., Tishelman, C., van Achterberg, T., & Sermeus, W. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824-1830. https://doi.org/10.1016/S0140-6736(13)62631-8

American Nurses Association. (1965). Educational preparation for nurse practitioners and assistants to nurses: A position paper. American Nurses Association.

Brown, E. L. (1948). Nursing for the future. Russell Sage Foundation.

Committee for the Study of Nursing Education. (1923). Nursing and nursing education in the United States. Macmillan.

Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. The National Academies Press. https://doi.org/10.17226/12956

Montag, M. L. (1951). The education of nursing technicians. G. P. Putnam's Sons.

National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. The National Academies Press. https://doi.org/10.17226/25982

Nightingale, F. (1860). Notes on nursing: What it is, and what it is not. D. Appleton and Company.

How this N 490 Module 1 example is structured

Module 1 of Issues and Trends in Professional Nursing opens the course on how the profession was built, and in many sections the written piece is a paper on the evolution of nursing: the events and the people that shaped it. Aspen does not publish module deliverables, so treat that as the usual shape and let your classroom's instructions decide the exact prompt, length and source count. This example is organized as an argument rather than a timeline. Each section covers one reform, names the people and documents behind it, and closes on what it changed. The evidence section states study sizes and concedes the limit of observational data. The practice section applies the history to a returning RN, which is where most N490 rubrics place their application row.

N490 Module 1 questions, answered

What does N490 Module 1 usually ask for?

The module is built around the history and professionalization of nursing, and the written assignment is commonly a paper on how the profession evolved: key events, key individuals, and how they shape practice now. Aspen does not publish module deliverables, so your classroom's instructions and rubric set the exact prompt, length and number of sources.

How do I keep a nursing history paper from reading like a timeline?

Give it a thesis and make each event serve it. The sample argues that nursing became a profession through changes in education, so every date appears because it moved that argument forward, and each section ends on what the event changed. A list of years with no claim tying them together is the most common reason these papers score in the middle.

Are sources from 1860 or 1948 acceptable in a current APA paper?

For history, yes, and they are usually the strongest choice, because citing Nightingale's own book or the Brown report shows you went to the source. Pair them with current evidence for any claim about today's practice, as the sample does with the 2003 and 2014 outcome studies and the 2021 National Academies report.

Write yours, or have the desk draft it

This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.

N490 Module 1 assignment: evolution of nursing paper, a full sample