Thursday, May 06, 2010

Nursing Centennial: Diploma, Degree, Department, or School?

Today is National Nurses Day, and in honor of it and this year's centennial of the OHSU School of Nursing, we highlight a section from the history of the school written by emerita professor Barbara Gaines, in A history of the school, 1910-1996 (full text available online in PDF), in which the status of the nursing program within the University of Oregon Medical School is discussed:

Diploma, Degree, Department, or School?
The issue of explaining the differences between degree and diploma education on “The Hill” was more difficult. Although there had been a conscious decision to close the Multnomah Hospital diploma program, [Lois Albegore] Epeneter suggests that “no specific date marked the merger...” She accounts for the gradual disappearance of the hospital-administered program, noting that the department assumed more responsibility for the program and concludes that by 1945 the pin had been changed to read “University of Oregon Medical School Department of Nursing Education.” Yet we know the department initiated another diploma program at this time as a wartime measure. Given the proximity of the two actions it is unlikely that the general public could distinguish between the two diploma programs and understand that the “new” UOMS department diploma program would only exist as a wartime measure.

And indeed it is not clear that the diploma program served only as a wartime measure. The last class was admitted in 1950, suggesting that students still provided much-needed service to the hospital. This was certainly the case in much of the nation. According to Miss [Henrietta] Doltz and other sources, closure was considered in 1950 because the burden of operating a degree and diploma program was onerous, there was competition for diploma students from other programs in town, it was difficult to maintain the necessary quality of the degree program with parallel offerings, and an increase in graduate offerings was desirable necessitating a shift in faculty teaching responsibilities.

A confounding issue concerned the status of the program within the medical school. As a department, the programs in nursing were clearly part of the School of Medicine. And though Miss [Elnora] Thomson found this condition acceptable in 1932 when the state system was created, her position changed rapidly. As early as 1936, Miss Thomson began to argue to change the name from a department to a school of nursing. Her rationale was that graduates were having some difficulty with registration because the State Board for the Examination and Registration of Nurses recognized schools of nursing, and the Association of Collegiate Schools of Nursing recommended either the title college or school for degree programs. In her request to Dean Dillehunt, she acknowledged the need for approval by the State Board of Higher Education but posed her request in language that assumed the board would view the name change as a minor matter. Clearly this was not the case because the department would not officially become a school until 1960.

Miss Doltz reinitiated the conversations to change the status of the department to that of a school after World War II with the administration of the medical school. The department was now officially responsible for student learning even though much of the instruction and clinical supervision was still provided by medical school faculty and jointly appointed faculty/nursing service clinicians. Reflecting the sentiment in the Brown report and the continuing confusion expressed by prospective students, in 1948 Miss Doltz asked Mr. [William] Zimmerman, the business manager of the medical school, for an “official memo either from you or Dr. Baird relative to change of name of the Department of Nursing to the School of Nursing of the University of Oregon Medical School.” She iterated this request in 1949 with a one-page memorandum outlining reasons the change was necessary but assuring Dean Baird that changing the name would not be followed by a request for a change in administrative control.

When the 1948 and 1949 requests to change the name officially was denied, Miss Doltz used other strategies to convey an image of a school to prospective students and accreditors in an effort to mitigate the perceived problem that a department did not offer as strong a program as one administered by a school. She first attempted to change the symbols of the program.

Correspondence between Miss Doltz and the University Press in the spring of 1948 requested that the pin be changed to read University of Oregon Medical School of Nursing. In a handwritten note to Martha Hirsch, Miss Doltz’s administrative assistant and friend, she stated: "Mart–Ha!ha! They do have to get official sanction to change the name & have to bring it up at Board meeting on 4/26. But–Bill (Zimmerman) said to take a chance & get the cut of the pin made with School of Nursing so will."

The permission was denied, and the pin was not changed. On December 21, 1951, Miss Doltz sent Mr. Zimmerman another memo asking to change the name on the letterhead to School of Nursing–and the 1954 and 1955 Lamps identify the programs as part of a school.

The department-school issue would not go away and would be exacerbated by Miss Doltz’s resignation. The search committee appointed to find Miss Doltz’s successor spent 18 months looking for a new head for the programs. They believed the search was prolonged because of “difficulties [about] what appeared to others as confused academic and organic relationships between the nursing education program, the Medical School, other units of the State System of Higher Education and some independent colleges.”

The committee went on to say the necessary changes were simple– then provided 35 pages of rationale and appendices to justify the changes. The changes recommended were: (1) to change the name of the program from department to school, (2) to retitle the director’s position dean, (3) to change the degree granted by the University of Oregon to a Bachelor of Science in Nursing, and (4) to discontinue the practice of allowing other institutions to award the degree on the basis of the student’s pre-nursing course work. Once again assuring the dean of the medical school that the proposal did not mean that he would not remain the executive officer of the School of Nursing, the committee argued for the changes on the basis of the misunderstanding the current situation caused the public and the little cost associated with making them.

Although some of the changes would never be effected and the change to a school not effected until 1960, the Student Handbooks of 1957 and 1958 illustrate actions taken on campus to correct public perception. In 1957, a separate “Welcome” for nursing students was introduced for the first time and addressed the cooperative relationships between the programs. In 1958, newly-appointed director Jean Boyle provided the first written statement from the head of nursing program ever included in the handbook. Her message stressed the proud heritage of the School and progressive nature of its current programs.
Shown here is a sculpture by Claire Pasarow, donated by the Pasarow family, in recognition of Claire's deep appreciation for nursing. The family also contributed $1 million for nursing scholarships. The sculpture is currently located on the third floor of the school; it will be installed in the Pasarow courtyard when that space is completed.

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