Orwgltudfla! fm 0 m6 s \ 3’ PHASE I { a? ' U,S. DEPARTMENY OF HEALTH, EDUCATION, AND WELFARE PUHHL HEALTH SERVICE I HEAUH RESOURCES ADM‘NISYRAHON Longitudinal AUG 9 WU C _ MW DUKES PHASE I HARRY A.‘$ULTZ,‘D.D.S., M.P.H., Professor MARIA ZIELEZ , h. 0., Assistant Professor Department of Social and Preventive Medicine School of Medicine State University of New York at Buffalo and LOUIS KINYON, B.A. Proiect Supervisor March 1976 Health Manpower References DHEW Publication No. (HRA) 76:43 luff/l] 7 3 \1117 U.$. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE I HEALTH RESOURCES ADMINISTRATION BUREAU OF HEALTH MANPOWER I DIVISION OF NURSING BETHESDA, MARYLAND 200‘4 DISCRIMINATION PROHIBITED—Title VI of the Civil Rights Act of 1964 states: “No person in the United States shall, on the ground of race, color, or national origin, be excluded from par- ticipation in, be denied the benefits of, or be sub- jected to discrimination under any program or activity receiving Federal financial assistance.” Therefore, the nursing distribution analysis pro- gram, like every program or activity receiving financial assistance from the Department of Health, Education, and Welfare, must be oper- ated in compliance with this law. The research reported in this publication was per- formed under Public Health Service Contract Number N01 NU 34064 from the Division of Nursing, Bureau of Health Manpower, Health Resources Administration. Division of Nursing project officers are Marie Henry, R.N., D.N.Sc., Nurse Consultant, and Har- riet D. Carroll, R.N., M.N., Public Health Nurse, Nursing Practice Branch. For sale by the Superintendent of Documents. US. Government Printing Office Washington, DC. 20402 - Price $1.75 Stock No. 017—041-00111—4 II RT FOREWORD 8% The expanded roles for nurses into areas of care traditionally dependent on physician supply has been a growing trend for many 3, years. In recent years educational preparation of nurse practition- PUBL ers and their utilization in the provision of health care, especially , ' in the areas of pediatrics, adult and family health, have increased rapidly. Current emphasis on delivery of preventive health services, which increases the need for nurse practioners as providers of primary health care, indicates the trend will continue. Central to the concerns of the Division of Nursing to support programs of nursing care to advance the health status of the Nation, has been the Division’s support, since the mid-1960’s, of education of nurses to function in expanded roles. The study re- ported in this publication is an outgrowth of the Division’s recog- nition of a lack of reliable national data on which to base evalu- ation of its past efforts in nurse practitioner education and to plan effectively for the future. This report presents findings from Phase I of the longitudinal study to obtain baseline data which describe the current national nurse practitioner educational efforts. Phase I describes the pro- grams and the students in them; later phases will delineate nurse practitioner functions in the practice setting and explore the re- lationship between those functions and the ones for which they were educationally prepared. f“ ~ M . OW Jessie M. Scott Assistant Surgeon General Director Division of Nursing III 7325 PREFACE In order to understand the motivation and need for this project, it must be viewed in a broader perspective of current trends in health manpower. The problem of physician maldistribution has been repeatedly documented. One response to this situation has been the preparation of other types of personnel, particularly in those areas in which there is a shortage, to assist with some of the traditional physician functions, i.e., history taking, physical exami- nation and assessment, limited supervision of care regimes, and health maintenance supervision either by telephone or by office, hospital, and home visits. The personnel trained to carry out these needed services are often referred to as “physician extenders” with- out differentiation by educational requirements or previous discipli- nary preparation. Since the 1930’s midwives have been trained to carry out func- tions which would otherwise increase the demand for OB—GYN specialists and other physicians. In the 1960’s the more recent im- petus began for educational programs to expand nursing func- tions into areas of care more traditionally dependent on physician supply, e.g., pediatrics, adult and family health. During the last several years, training programs for nurses in expanded roles have proliferated across the United States with considerable variation in curriculum, faculty, duration of training, and employment set- tings. A review of the literature has yielded a large number of publications which reflect interest in various aspects of the intro— duction of expanded roles for nurses in the provision of health care. The Division of Nursing has been supporting the education of nurses to function in expanded roles for some time: The Nurse Training Act of 1964 and Title II of the Health Manpower Act of 1968 authorized Special Project Grants which could be used for the development of programs for training specialized nurse practi- tioners (NPs). More recently, the Nurse Training Act of 1971 added two mechanisms specifically aimed at increasing the number of nurse practitioners: contract funds earmarked for aiding nurse practitioner training programs and incentive increases in Capita- tion funds to nursing schools with “discrete programs directed to- ward preparing nurses for expanded functions.” Although it is well known that the innovative deveopment of nurse practitioner programs has produced considerable variation in NP programs, there are no data to document the extent of the variability and to examine its ramifications for differences in NP functioning Within health care systems. Moreover, there are no sound national data in existence to quantify NP educational activ- IV ities and to serve as a baseline against which to compare future data. Nor is there any information from which to identify or esti- mate the need for support to NP programs. These are important questions which urgently require answers in order to plan intelli- gently for the future. Since it is the intent of the Division of Nursing to evaluate past efforts in NP education and plan optimally for the future, it is necessary to obtain sound baseline data which describe the current national NP educational efforts. To answer some of the most im- portant questions for planning, it is also necessary to undertake longitudinal followup of a cohort of graduates. Being able to link the educational information with the prospective data will provide the first opportunity to date to examine the variation in training programs and its relationship to employment functioning. The initial planning of the Longitudinal Study of Nurse Practi— tioners was undertaken with the consultation and cooperation of Division of Nursing staff, as well as representatives of other Fed- eral agencies and faculty of several schools of nursing. Dr. Sandra Eyres was the original project officer, and Dr. Doris Roberts was Chief, Nursing Practice Branch, for the planning phase and during the early conduct of the study. We hope that the successful comple- tion of the effort and the value of it findings justify their consider- able effort and enthusiasm for its initiation. Others involved at the very outset of the project were Mr. Earl Bryant, Deputy Director, Office of Statistical Methods, National Center for Health Statistics, and Mr. Stanley Siege], Assistant Chief, Manpower Evaluation and Planning Branch, DN. Other active participants from the Divi- sion of Nursing, practically from the inception of the project, were Mrs. Harriet Carroll (who subsequently became coproject officer) and Mrs. Margaret Sheehan, Supervising Consulting Nurse, Office of the Chief, Nursing Education Branch. The many early decisions that were required to shape the form and content of the study were expedited and facilitated by the most constructive advice from these participants. The resignation of Dr. Eyres and Dr. Roberts from the Division of Nursing during the first phase of this project could have occa- sioned serious problems of communication and direction. It is to their credit and our good fortune that Dr. Marie Henry and Mrs. Harriet Carrol assumed the roles of coproj ect officers and provided uninterrupted and highly constructive guidance to the project. Dr. Carolyn Williams from the School of Public Health of the University of North Carolina, Dr. Alice Hosack from the Depart- ment of Nursing, Simmons College, Dr. Judy Sullivan from the School of Nursing, University of Rochester, and Dr. Jeannette Spero from the School of Nursing, State University of New York at Buffalo, have provided invaluable consultation. Dr. Arnold Bel- V linger from Wayne State University has also consulted with project staff and was the source for the analysis of job satisfaction. We wish to express a special word of appreciation to Miss Jessie M. Scott, Assistant Surgeon General, Director, Division of Nurs- ing, whose support, encouragement, and advice contributed so much to the success of this endeavor. A project such as this requires the harmonious interplay of a number of special skills in order to maintain continuous productiv- ity. We recognize these persons, therefore, whose daily efforts con- tributed significantly to the conduct of the study: Patricia Milkow- ski (statistician), Frank Rens, Don McGreevy, and Joan Craft (data preparation and computer processing), Frances Sherwin (technical editor), and Kathleen Nagel, Debbie Love, and Marcia Wopperer (secretaries). HARRY A. SULTZ MARIA ZIELEZNY LOUIS KINYON Bufialo, New York March 1976 Contents Foreword ___________________________________________ Preface ________________________ V _____________________ List of Tables ________________________________________ List of Figures ______________________________________ I. Introduction ___________________________________ Explanatory Notes ____________________________ II. Study Design Enumeration of Educational Programs for the Preparation of Nurse Practitioners ____________ Student Data _________________________________ Survey Response _____________________________ III. Study Findings Nurse Practitioner Programs ___________________ Geographic Distribution of Programs and Students _________________________________ Program Characteristics ____________________ Admission Characteristics ____________________ Financial Support for Programs and Students and Tuition Charges _______________________ Characteristics of Faculty ____________________ Features of Curricula: Program Length _______ Features of Curricula: Curriculum Content ____ Nurse Practitioner Students ____________________ Characteristics _____________________________ Financial Problems and Sources of Support ____ Factors Influencing Students to Enter NP Programs ________________________________ Professional Expectations ____________________ APPENDIXES Appendix A. Nurse Practitioner Certificate Programs Appendix B. Nurse Practitioner Master’s Programs__ Appendix C. Program Questionnaire ______________ Appendix D. Student Questionnaire _______________ VII Page iii iv viii xiii 9 16 32 34 40 53 63 74 74 80 83 87 99 111 119 137 5090.49 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Tables NP program respondents and nonrespondents, by spe- cialty and type of program ________________________ NP student respondents and nonrespondents, by spe- cialty and type of program ________________________ Geographic distribution of responding NP programs, by region, specialty, and type of program ____________ Geographic distribution of responding NP students, by region, specialty, and type of program ______________ Geographic distribution of nonresponding NP students, by region, specialty, and type of program ____________ States, by number of NP programs ________________ NP programs, by State, specialty, and type of program NP programs, by specialty and type of program ______ NP programs, by class size, specialty, and type of program ________________________________________ Average number of students in those NP programs reporting applicants not in excess and in excess of class capacity and average number of applicants in excess, by specialty and type of program _____________________ Response of NP program directors to the question: “Does demand for graduates exceed supply ?” by speci- alty and type of program __________________________ NP programs, by sponsoring institution and type of program ________________________________________ NP programs, by sponsoring institution, specialty, and type of program _________________________________ NP students admitted and graduated per year, 1970— 1974, by type of program _________________________ NP programs, by number of beginning classes per year and type of program ______________________________ NP programs, by year initiated and type of program __ NP programs, by year initiated, specialty, and type of program ________________________________________ NP programs, by year initiated, length, and type of program ________________________________________ Average length of NP programs, by year initiated, availability of preceptorship, and type of program ___ NP programs, by availability of inner-city and/ or rural practice setting and type of program _______________ VIII Page 10 11 12 13 14 17 18 19 20 20 21 24 24 25 26 27 28 29 Tables—Continued Page 21. Number of credits awarded for certificate NP pro- grams, by type of credit ___________________________ 29 22. Master’s NP programs, by number of credits awarded _ 29 23. NP programs, by title most commonly used to designate graduates and type of program ____________________ 3O 24. NP programs, by provision of job placement services and type of program _____________________________ 30 25. NP programs, by provision of continuing education to graduates and type of program ____________________ 30 26. NP programs, by characteristic evaluated and type of program ____________________________ _ ___________ 31 27. Certificate NP programs, by minimum nursing edu- cation accepted for admission ______________________ 33 28. NP programs requiring and not requiring for admission guaranteed employment upon program completion, by type of program _________________________________ 33 29. NP programs, by test used for student evaluation and type of program _________________________________ 33 30. NP programs, by source of funding for programs and students, year (1970—1974), and type of program ____ 35 31. NP programs, by amount of tuition charged to students and type of program _____________________________ 37 32. NP programs, by amount of tuition charged to students and specialty ____________________________________ 37 33. NP programs, by amount of tuition charged to students, program length, and type of program _______________ 38 34. Average amount of tuition charged to NP students (in, dollars), by program length and type of program ____ 38 35. NP programs, by amount of tuition charged to stu- dents, sponsoring institution, and type of program __- 39 36. NP programs, by program support available to students and type of program _____________________________ 39 37. NP programs, by discipline of program director and codirectors and type of program __________________ 41 38. NP programs, by discipline of program director and codirectors, sponsoring institution, and type of program 41 39. Average number of NP program staff teaching person- nel in selected disciplines, by specialty and type of program ________________________________________ 42 40. Number of NP program staff teaching personnel in selected disciplines, by specialty, and type of program _ 43 IX Tables—Continued Page 41. Ratio of students to NP program staff teaching person- nel in selected disciplines, by specialty and type of program ________________________________________ 44 42. NP programs, by comparison of nursing versus phy- sician faculty as staff teaching personnel, specialty, and type of program _____________________________ 45 43. NP programs, by type of discipline of staff teaching personnel not utilized, specialty, and type of program _ 46 44. NP programs with and Without nurses carrying a caseload and providing patient care in addition to teaching, by specialty and type of program __________ 47 45. Nurses carrying caseloads and providing patient care in addition to teaching, by specialty and type of pro- gram ___________________________________________ 48 46. Contributed faculty in NP programs, by discipline and type of program _________________________________ 49 47. Average number of contributed faculty, by discipline, specialty, and type of program ____________________ 50 48. Guest lecturers in NP programs, by discipline, specialty, and type of program _______________ , ______________ 51 49. NP programs, by discipline of students’ supervisor during perceptorship and type of program __________ 52 50. NP programs, by availability of practicing NPs for clinical consultation during clinical didactic and pre- ceptorship components and type of program _________ 52 51. NP programs, by length, specialty, and type of program 54 52. Average length and range in months of NP programs, by specialty and type of program __________________ 54 53. Average length of NP programs, by sponsoring institu- tion, specialty, and type of program ________________ 55 54. Average length of each curricular component in NP programs, by specialty and type of program _______ 56 55. Average number of months of didactic components of NP programs, by availability of preceptorship and type of program _____________________________________ 57 56. NP programs, by length of didactic component and type of program _____________________________________ 57 57. NP programs, by length of didactic component, speci- alty, and type of program _________________________ 58 58. NP programs, by length of classroom didactic compon- ent and type of program __________________________ 59 X Tables—Continued Pa e 59. NP programs, by length of clinical didactic component 9 and type of program ______________________________ 59 60. NP programs, by length of preceptorship and type of program ________________________________________ 59 61. NP programs, by length of preceptorship, specialty, and type of program _____________________________ 60 62. Range of months NP programs spend on specific functions Within the didactic component, by specialty and type of program ____________________________ 64 63. Average number of months NP programs spend on specific functions within the didactic component, by specialty and type of program _____________________ 65 64. Average percent of time NP programs spend on specific functions within the didactic component, by specialty and type of program ____________________________ 66 65. Percent of NP programs preparing students in infant and child health care to perform selected functions for specific patient populations, by type of program ______ 67 66. Average percent of physician consultation students prepared in infant and child health care are expected to require when performing selected functions for specific patient characteristics, by type of program _________ 68 67. Percent of NP programs preparing students in adult health care to perform selected functions for specific patient populations, by type of program _____________ 69 68. Average percent of physician consultation students prepared in adult health care are expected to require when performing selected functions for specific patient characteristics, by type of program ________________ 70 69. Percent of NP programs preparing students in matern- ity care/ family planning to perform selected functions for specific patient populations, by type of program -__ 71 70. Average percent of physician consultation students prepared in maternity care/ family planning are ex- pected to require when performing functions for specific patient characteristics, by type of program __________ 72 71. Percent of NP programs preparing students to perform specific functions and average percent of expected phy- sician consultation, by type of program _____________ 73 72. NP students, by specialty and type of program ______ 74 73. NP students, by selected demographic characteristics and type of program ________________-_____f ______ 75 XI Tables—Continued Page 74. NP students, by ethnic self description, specialty, and type of program ________________________________ 76 75. NP students, by selected professional characteristics and type of program _____________________________ 77 76. Average number of years NP students have spent in professional nursing, by specialty and type of program 78 77. NP students, by number of years in job just prior to entering NP program, and type of program __________ 78 78. Percent of NP students, by previous employment setting, specialty, and type of program _____________ 79 79. NP students with financial problems, by years in pro- fessional nursing and type of program ______________ 81 80. NP students with financial problems, by source of sup- port and type of program _________________________ 82 81. NP students by the most important factor influencing them to become NPs, by type of program ___________ 84 82. Percent of NPs citing the most important factor in influencing them to become NPs, by previous employ- ment setting and type of program __________________ 85 83. NP students by most important factor influencing them to attend a particular program, by type of program ___ 86 84. NP students, by whether or not they have knowledge of future employment, specialty, and type of program _ 88 85. Percent of NP students, by anticipated employment setting, previous setting, and type of program _______ 89 86. Percent of NP students, by anticipated patient popula- tion, specialty, and type of program ________________ 91 87. NP students, by approximate, annual salary just prior to entering NP program and type of program ________ 91 88. Percent of NP students, by anticipated salary change, previous annual salary, and type of program _________ 93 89. Average, annual, expected increase in salary, by speci- alty and type of program __________________________ 94 90. Average, annual, expected increase in salary, by prior nursing preparation and type of program ____________ 94 91. Average response of students to selected job character- istics in terms of attainment and aspiration in prior nursing position, importance to the student, and expec- tation in the NP role, by type of program ___________ 95 XII FWN!" 9°71?” Figures Census regions of the United States __________________ NP graduates per year, by specialty ________________ NP graduates per year, by specialty and type of program Average length of certificate NP programs with and without preceptorship, by specialty ________________ Average length of master’s NP programs with and with— out preceptorship, by specialty ____________________ NP certificate students, by anticipated salary as an NP NP master’s students, by anticipated salary as an NP __ NP students’ job dissatisfaction and expected improve ment, by type of program __________________________ NP students’ job dissatisfaction and expected improve- ment, by previous nursing education and type of pro- gram ______________________ , ____________________ XIII Page 3 22 23 61 62 92 92 96 97 I. INTRODUCTION This project originated with the Division of Nursing in an effort ' to obtain the data necessary to evaluate program efforts related to nurse practitioners in expanded roles and to obtain baseline infor- mation for the further development and support for nurse practi- tioner education and practice. The term nurse practitioner (NP) as used in this study describes the nurse whose education extends beyond the basic requirements for licensure as a registered nurse. NP education is formally planned to prepare students for expanded functions in diagnostic and treatment needs of patients. Educa- tional programs were accepted into this study only after review of their activities indicated that they met the following criteria: 0 They must offer a formal curriculum as opposed to inservice training for their own employees. 0 They must have started instruction with enrolled students by January 1, 1974. 0 They must provide preparation in extended nursing roles, i.e., primary care skills such as history taking, physical exami- nation, ordering laboratory tests, and assuming responsibility for medical management of selected cases with emphasis on primary care. 0 They must require that students be registered nurses in order to enroll. The information obtained about both programs and students was intended to clarify the numbers and types of NP educational pro- grams, the entrance requirements, curricula lengths and contents, and the faculty participation in that preparation. Of particular im- portance were questions relating to the responsibilities and roles for which nurses were being prepared and their expectations re- garding future employment, income, and function. These data, as well as information regarding the subsequent employment of nurse practitioners and the relationship between nurse practitioner edu- cation and that employment (which will be obtained in the second and third phases of the study), are considered by the Division of Nursing to be essential to evaluate past efforts and plan optimally for the future. Since the findings of phase I are in themselves voluminous, the early dissemination of this report is offered in response to the Widespread interest among nurses and other health professionals in nurse practitioner education. The data are presented with a minimum of interpretation at this time to permit objective indi- vidual assessment of the findings and appropriate responses to this 1 2 CHAPTER I report. More detailed and interpretive analyses of specific sections of the data will subsequently be published to serve the interests of those concerned with particular aspects of nurse practitioner edu- cation. It may be helpful for those perusing these data to understand that although these findings may be of interest in themselves, their value will increase with the addition of the data obtained in subse- quent phases of this study. The national cohort of NP students, about which we are reporting, is being followed to determine the type and success of their subsequent employment, their impact on the health care delivered in the various settings, and many other aspects of their role and function. The data from phase I contained in this publication will also serve, therefore, as variables which may be identified as contributing to the outcomes determined in subse- quent phases of the study. The completion of all three phases of this project will provide a complete picture of the role and functioning of nurse practitioners throughout the country, the adequacy and appropriateness of their preparation, and their relative contribution to the provision of primary health care services particularly in medically disadvan- taged areas. The findings should provide clear direction for future planning with important implications for the Division of Nursing and the educational institutions either now involved or contemplat- ing participation in nurse practitioner preparation. Explanatory Notes Two very frequent variables in the phase I analysis are type of program and specialty. The term type indicates whether the pro- gram awards a certificate or a master’s degree upon completion. Specialty designates six areas: pediatric, midwifery, maternity, family, adult, and psychiatric. It should be noted that all percentage distributions have been rounded to achieve 100 percent. Most of the data presented in this report have been grouped after being collected, with the exception of questions pertaining to the percent of physician consultation. Estimated percentage of physician consultation was provided by respondents in terms of predesignated groupings. The symbol ___ in the tables indicates zero value (none) and —indicates not applicable. The four regions of the United States as designated by the Na- tional League for Nursing and the States in each region are illus- trated in figure 1. .INTRODUCTION Figure 1.—Census regions of the United States Northeast: Connecticut New Hampshire Pennsylvania Midwest: Illinois Kansas Missouri Ohio South: Alabama District of Columbia Kentucky Mississippi South Carolina Virginia West: Alaska Colorado Montana Oregon Wyoming NORTH DAKOiA SOUTH DAKOTA NEBRASKA KANSAS Maine New Jersey Rhode Island Indiana Michigan Nebraska South Dakota Arkansas Florida Louisiana North Carolina Tennessee West Virginia Arizona Hawaii Nevada Utah A w NOW" omuom ARKANSAS fl hnnflm A n s New Massachusetts New York Vermont Iowa Minnesota North Dakota Wisconsin Delaware Georgia Maryland Oklahoma Texas California Idaho New Mexico Washington ll. STUDY DESIGN‘ Enumeration of Educational Programs for the Preparation of NPs The first task of the study was to identify those programs meet- ing the predetermined criteria and offering education of nurses in expanded roles from lists prepared by the Division of Manpower Intelligence, Bureau of Health Manpower, and the American Nurses’ Association. Approximately 100 institutions sponsoring over 100 certificate and 180 master’s degree programs were queried by telephone to determine if they met the criteria. Program direc- tors were asked to indicate Whether their programs prepared stu- dents primarily for care in ambulatory care settings rather than institutional inpatient care settings, and whether the program em- phasized preparation in the primary care skills of history taking, physical examinations, ordering of laboratory tests, and assessing the medical management of uncomplicated cases. An affirmative response regarding these two criteria qualified the program tore- ceive a mailed self-administered questionnaire designed to elicit information on program history, entrance requirements, student selection, curriculum, faculty, and funding. A copy of the program questionnaire is included as Appendix C of this report. The re- turned questionnaires were carefully reviewed to verify the appro- priateness of each program’s inclusion in the study. These two screening procedures produced a revised listing of programs eli- gible for inclusion in the study. The study universe was thereby reduced to 87 programs which award a certificate and 46 programs which award a master’s degree. The study data presented for phase I do not include programs initiated after January 1974. Lists of the programs included in the study are presented in this report as Appendixes A and B. Student Data In a cover letter that accompanied the program questionnaire, program directors were requested to distribute to each student in the current class who would graduate between May 1974 and June 1975 a student questionnaire which was individually completed and returned. A copy of this questionnaire is included as Appendix D. Data on prior background and training, previous work experi- ence and income, previous functions in the nursing role, the degree of satisfaction in previous roles, the stimuli to enter nurse practi- tioner programs, and expectations of the program and subsequent 5 6 CHAPTER II employment were obtained. The students who completed and re- turned the initial questionnaire constitute the cohort of nurse prac- titioners who will be followed in phases II and III of the study. Subsequent data collection will involve information about job choice, the problems in employability, the functions in the new role, satisfaction, degree of independence and autonomy, and the relationship of education to job functions. Those phases of the study will also involve the collection of similar types of data from employers. Survey Response The following tables (1 and 2) indicate the response rates for phase I of this study. Since only one certificate and one master’s program did not participate, the overall response rate was 99 per- cent for certificate programs and 98 percent for master’s programs. The response for students was 85 percent for certificate programs and 84 percent for master’s programs. Although response rates for students varied by specialty and by type of program; in each case participation was more than adequate for this longitudinal study. All study findings as presented in subsequent tables will be based on the respondent populations. Table 1.—NP program respondents and nonrespondents, by specialy and type of program Type of program and program response Certificate Master’s Total Specialty Respond- Nonre- Respond- Nonre- Respond- Nonre- ents spondents Total ents spondents Total ents spondents Total No. Pct. No. Pct. ~ No. Pct.— No. Pct. No. Pct. No. Pct. No. Pct. ' No. Pct. No. Pct. Pediatric _________________ 42 98 1 2 43 100 8 100 ___ _2_ 8 100 50 98 1 2 51 100 Midwifery ________________ 5 100 ___ ___ 5 100 6 100 -__ -,_ 6 100 11 100 ___ _u 11 100 Maternity _________________ 7 100 __2 _,_ 7 100 7 100 -11 ___ 7 100 14 100 ___ ___ 14 100 Family ___________________ 17 100 ___ ___ 17 100 12 100 ___ ___ 12 100 29 100 _,_ ___ 29 100 Adult _____________________ 15 100 ___ -2 15 100 8 89 1 11 9 100 23 96 1 4 24 100 Psychiatric _______________ — — — —— — -— 4 100 _2_ _H 4 100 4 100 ___ ___ 4 100 Total ___________________ 86 99 1 1 87 100 45 98 1 2 46 100 131 98 2 2 133 100 Table 2.—NP student respondents and nonrespondents, by specialty and type of program Type of program and student response Certificate Master’s Total Specialty Respond- Nonre- Respond- Nonre- Respond- Nonre- ents spondents Total ents spondents Total ents spondents Total No. Pct. No. Pct. No. Pct. No. Pct. No. Pct. No. Pct. No. Pct. No. Pct. No. Pct. Pediatric _________________ 351 84 66 16 417 100 30 88 4 12 34 100 381 84 70 16 451 100 Midwifery ________________ 26 63 15 37 41 100 54 90 6 10 60 100 80 79 21 21 101 100 Maternity _________________ 60 97 2 3 62 100 30 64 17 36 47 100 90 83 19 17 109 100 Family ___________________ 185 86 30 14 215 100 100 94 6 6 106 100 285 89 36 11 321 100 Adult _____________________ 172 88 23 12 195 100 66 75 22 25 88 100 238 84 45 16 283 100 Psychiatric _______________ _ ._ _. _ __ _ 27 34 5 16 32 100 27 84 5 16 32 100 Total ___________________ 794 as 136 15 930 100 307 84 60 16 367 100 1.101 85 196 15 1.297 100 NDISEG mms Ill. STUDY FINDINGS NP Programs Geographic Distribution of Programs and Students The following tables (3—7) present data on the geographic dis- tribution of responding programs and students and nonrespond- ing students by type. These distributions are presented by region Within the United States. Regions have been designated by the National League for Nursing and are illustrated in figure 1. Also shown in this section are the number of programs Within each State and, in addition, this distribution by specialty and type. It should be recognized that a number of nurse practitioner programs presently exist that did not have enrolled students scheduled for graduation during the period stipulated for inclusion in this study. These programs are not reflected in any of the tables and figures presented hereafter. 10 CHAPTER 111 Table 3.—Geographic distribution of responding NP programs, by region,‘ specialty, and type of program Type of program Reglon and Certificate Master’s Total specralty No. Pct. No. Pct. No. Pct. West Pediatric _________ 9 11 1 2 10 8 Midwifery ________ 1 1 1 2 2 1 Maternity _________ 1 1 ___ -, _ 1 1 Family ___________ 5 6 2 5 7 5 Adult ____________ 3 3 1 2 4 3 Psychiatric _______ — — 2 4 2 2 Subtotal ________ 19 22 7 15 26 20 Midwest Pediatric _________ 11 12 3 7 14 11 Midwifery ________ ___ ___ 2 5 2 1 Maternity _________ 2 3 -1- ___ 2 2 Family ___________ 3 3 1 2 4 3 Adult ____________ 3 2 4 4 3 Psychiatric _______ — — ___ ___ _W ___ Subtotal ________ 18 21 8 18 26 20 Northeast Pediatric _________ 11 13 2 5 13 10 Midwifery ________ 1 1 2 4 3 2 Maternity _________ 1 1 4 9 5 4 Family ___________ 3 3 5 11 8 6 Adult _____________ 5 6 2 5 7 5 Psychiatric _______ — — 1 2 1 1 Subtotal ________ 21 24 16 36 37 28 South Pediatric ......... 11 13 2 4 13 10 Midwifery ________ 3 3 1 2 4 3 Maternity _________ 3 3 3 7 6 4 Family ___________ 6 8 4 9 10 8 Adult ____________ 5 6 3 7 8 6 Psychiatric _______ -— — 1 2 1 1 Subtotal ________ 28 33 14 31 42 32 Total _________ 86 100 45 100 131 100 1Regions are those designated by the National League for Nursing (see figure 1). STUDY FINDINGS: NP PROGRAMS Table 4.—Geographic distribution of responding NP students, by region,1 specialty, and type of program Type of program Reglorliarlitd Certificate Master’s Total pe a y No. Pct. No. Pct. No. Pct. West Pediatric _________ 79 10 7 2 86 8 Midwifery ________ -__ __a 11 3 11 1 Maternity eeeeeeeee 14 2 __‘ __2 14 1 Family ___________ 71 9 25 8 96 9 Adult _____________ 50 6 5 2 55 5 Psychiatric eeeeeee — — 12 4 12 1 Subtotal ________ 214 27 60 19 274 25 Midwest ‘ Pediatric _________ 91 12 3 1 94 8 Midwifery ________ _-_ -2- 22 7 22 2 Maternity ___________ 12 1 _-_ ..__ 12 1 Family ___________ 28 4 12 4 40 4 Adult ____________ 17 2 18 6 35 3 Psychiatric 2222222 — — ___ ___ _w _-_ Subtotal ________ 148 19 55 18 203 18 Northeast Pediatric __________ 86 10 12 4 98 9 Midwifery __________ 14 2 14 5 28 2 Maternity __________ 4 1 14 5 18 2 Family ___________ 39 5 37 12 76 7 Adult _____________ 68 8 17 5 85 8 Psychiatric _______ —- — 12 4 12 1 Subtotal __________ 211 26 106 35 317 29 South Pediatric __________ 95 12 8 3 103 9 Midwifery ________ 12 1 7 2 19 2 Maternity _________ 30 4 16 6 46 4 Family ___________ 47 6 26 8 73 6 Adult _____________ 37 5 26 8 63 6 Psychiatric _______ — —- 3 1 3 1 Subtotal ________ 221 28 86 28 307 28 Total _________ 794 100 307 100 1,101 100 1Regions are those designated by the National League for Nursing (see figure 1). 12 CHAPTER III Table 5.—Geographic distribution of nonresponding NP students, by region,1 specialty, and type of program Type of program Region and Certificate Master’s Total specralty No. Pct. No. Pct. No. Pct. West Pediatric _________ 18 13 1 _ ___ 18 9 Midwifery ________ 1__ ___ _-_ ___ ___ ___ Maternity _________ _H ___ ___ -__ -1, ___ Family ____________ 16 12 5 8 21 11 Adult _____________ 14 10 3 5 17 8 Psychiatric _______ — — 4 7 4 2 Subtotal ________ 48 35 12 20 60 30 Midwest Pediatric __________ . 15 11 2 3 17 8 Midwifery ________ _,_ -11 1 2 1 1 Maternity _________ 1 1 _- _-_ 1 1 Family ___________ 3 2 e_.,_ __1 3 1 Adult ______________ __1 ___ 6 10 6 3 Psychiatric _______ — — _H _-_ ___ ___ Subtotal ________ 19 14 9 15 28 14 Northeast Pediatric _________ 26 19 2 3 28 14 Midwifery 11111111 4 3 5 8 9 5 Maternity 111111111 __- ___ 8 13 8 4 Family ___________ 3 2 1 2 4 2 Adult _____________ 5 4 4 7 9 5 Psychiatric _______ — — 1 2 1 1 Subtotal ________ 38 28 21 35 59 31 South Pediatric _________ 7 5 .__ _h 7 4 Midwifery ________ 11 8 _,_ ___ 11 6 Maternity 111111111 1 1 9 15 10 5 Family ___________ 8 6 -11 ___ 8 4 Adult _____________ 4 3 9 15 13 6 Psychiatric _______ — — _1- ___ __- ___ Subtotal ________ 31 23 18 30 49 25 «Total _________ 136 100 60 100 196 100 1Regions are those designated by the National League for Nursing (see figure 1). STUDY FINDINGS: NP PROGRAMS 13 Table B.—States, by number of NP programs Number of programs per State States 0 __________ Alaska, Florida, Georgia, Idaho, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Vermont and Wyoming 1 __________ lowa, Kansas, Kentucky, Louisiana, Montana, Puerto Rico and West Virginia 2 __________ Arizona, Delaware, Hawaii, Maine, Mississippi, New Jersey, Ohio, Virginia and Washington 3 __________ Colorado, District of Columbia, lndiana, Missouri and North Carolina 4 __________ Illinois, Michigan, Minnesota and Wisconsin 5 __________ Arkansas, Connecticut, Maryland, Massachusetts, Pennsyl- vania and Utah 6 __________ Alabama and Texas 9 __________ Tennessee 11 __________ California 13 __________ New York Table 1.—NP programs, by State, specialty, and type of program State Certificate Mid- Matern- Fam- wifery ity ily Pedi- atric Type of program and specialty Mid- wifery Pedi- Total atri c Adult Matern- ity ily Master’s Fam- Total Alabama _________ Arizona __________ Arkansas California Colorado _________ Connecticut Delaware District of Columbia _______ Hawaii ____________ Illinois Indiana .......... Iowa Kansas __________ Kentucky ________ Louisiana ________ Maine ___________ Maryland ________ Massachusetts ___ Michigan ________ Minnesota ,,,,,,,, 1 ___ 1 -__ 1 ___ ___ 1 1 ___ _h 1 2 ___ ___ ___ 1 ___ _-_ --- 2 _-_ ___ ___ 2 ___ _,_ ___ l l l p—Ip—lp—Il—lw l l l | | I w wwapn | l l I l I 1 1 H III HELLJVHO Mississippi ______ 1 Missouri _________ 2 Montana _________ ___ New Jersey ______ 2 New York ________ 5 North Carolina ,fl 1 Ohio ______-_,A-,,_ 1 Pennsylvania _____ 1 Puerto Rico _____ ___ Tennessee _______ 2 Texas ___________ 2 Utah ____________ ___. Virginia __________ 1 Washington ______ 1 West Virginia “a 1 Wisconsin _______ 1 Total __________ 42 \ll-‘I-‘NOJ HMO-INN le—IHNNUJ SWVHDOHJ dN :somama AGflLS 91 16 CHAPTER 111 NP Programs—Continued Program Characteristics The next group of tables (8—26) and figures 2 and 3 present in- formation about the number of NP programs by specialty and type, the variation in class size, availability of places in NP classes for applicants, supply and demand for NP graduates, and the types of institutional sponsorship. Also presented are the number of NP students admitted and graduated per year, the number of begin- ning classes during the year for each program and their length, and the number of NP programs initiated each year by length, ‘ specialty, and the availability of a preceptorship. Other variables shown are the availability of inner-city and rural practice settings, the type and number of credits awarded, the commonly used titles for graduates of NP programs, whether job placement services and continuing education are provided, and finally, the character- istics NP programs evaluated. STUDY FINDINGS: NP PROGRAMS Table 8.—NP programs, by specialty and type of program 17 Type of program Specialty Certificate Master's Total No. Pct. No. Pct. No. Pct. Pediatric ________ 42 48.8 8 17.8 50 38.2 Midwifery ________ 5 5.8 6 13.3 11 8.4 Maternity ________ 7 8.1 7 15.5 14 10.7 Family __________ 17 19.8 12 26.7 29 22.1 Adult ___________ 15 17.5 8 17.8 23 17.6 Psychiatric ______ — —- 4 8.9 4 3.0 Total __________ 86 100.0 45 100.0 131 100.0 Table 9.--NP programs, by class size,l specialty, and type of program Specialty and type of program Class Pediatric Midwifery Maternity Family Adult Psychiatric Total size No. Pct.2 No. Pct. No. Pct. No. Pct. No. Pct. No. Pct. No. Pct. Certificate <2 ____________________ 1 2 _-- ___ ___ ___ ___ --- ___ --- — — 1 1 2—3 ____________________ 2 7 1 20 1 14 1 6 1 7 — — 6. 8 4—5 ____________________ 3 14 _-_ 20 2 43 1 12 1 13 — — 7 16 6-7 ____________________ 8 33 --- 20 1 57 4 35 2 27 — — 15 34 8—9 ____________________ 6 48 1 40 1 71 ___ 35 1 33 —- — 9 44 10—11 ___________________ 8 67 -__ 40 --_ 71 2 47 3 53 — — 13 59 12—13 ___________________ 6 81 -_- 40 ___ 71 5 76 _-_ 53 — —- 11 72 14—15 ___________________ 5 93 2 80 1 86 1 82 2 67 — — 11 85 16-17 ___________________ 2 98 --- 80 --_ 86 ___ 82 2 80 _ _ 4 90 18—19 ___________________ ___ 98 1 100 _-- 86 2 94 1 87 — — 4 94 >19 ___________________ 1 100 --_ 100 1 100 1 100 2 100 — -— 5 100 Total _________________ 42 5 7 17 15 — 86 Master's <2 ____________________ 2 25 -_- _2- --_ ___ ___ ___ ___ ___ ___ ___ 2 4 2—3 ____________________ 2 50 1 17 3 43 --- -_- _-- ___ 1 25 7 20 4-5 ____________________ 1 62 __- 17 __2 43 4 33 ___ _-2 _- 25 5 31 6-7 ____________________ 1 75 2 50 1 57 3 58 3 38 1 50 11 56 8—9 ____________________ 1 88 --_ 50 2 86 58 1 50 1 75 5 67 10—11 ___________________ 1 100 1 67 -_- 86 3 83 1 62 --_ 75 6 80 12—13 ___________________ ___ 100 --- 67 --_ 86 1 92 1 75 1 100 3 87 14—15 ___________________ ___ 100 _-- 67 --- 86 --- 92 1 88 --_ 100 1 89 16—17 ___________________ ___ 100 2 100 1 100 ___ 92 --_ 88 ___ 100 3 96 18—19 ___________________ --_ 100 --- 100 ___ 100 _-- 92 1 100 ___ 100 1 98 >19 ___________________ ___ 100 _-- 100 2-- 100 1 100 ___ 100 _-_ 100 1 100 Total _________________ 8 6 7 12 8 4 45 1 Class size is based upon the students identified for the cohort. ’ Percentages are cumulative. 81 III HELLJVHO STUDY FINDINGS: NP PROGRAMS 19 Table 10.—Average number of students in those NP programs reporting applicants not in excess and in excess of class capacity and average number of applicants in excess, by specialty and type of program Type of program NP programs NP programs reporting no excess reporting excess 8 . It Average pecra y No. of Average no. No. of Average no. no. of programs of students programs of students applicants in excess Certificate Pediatric ________ 8 8 29 10 13 Midwifery cccccccc 2 12 3 11 37 Maternity ________ 1 2 6 10 9 Family __________ 3 10 13 11 18 Adult ____________ 3 10 11 14 13 Total 1 _________ 17 8 62 11 15 Master's Pediatric ________ 7 3 1 10 4 Midwifery ________ 1 7 4 12 16 Maternity ________ 5 7 2 6 8 Family __________ 6 7 6 11 14 Adult ____________ 7 11 ___ _-- ___ Psychiatric ______ 4 8 ___ ___ ___ Total 1 _________ 30 7 13 10 13 1Five pediatric, one family and one adult certificate program reported applicants in excess of class capacity, but the number was not specified. One master’s program reported applicants in excess of class capacity, but the number was not specified. Another master’s program did not supply information on whether applicants exceeded class capacity. 20 CHAPTER III Table 11.—Response of NP program directors to the question: “Does demand for graduates exceed supply?” by specialty and type of program Response to question: “Does demand exceed supply?" and type of program Specialty Yes No Don’t know Total 1 No. Pct. No. Pct. No. Pct. No. Pct. Certificate Pediatric ___________ 23 56.1 10 24.4 8 19.5 41 100.0 Midwifery __________ 5 100.0 ___ ___ ___ -__ 5 100.0 Maternity ___________ 5 71.4 1 14.3 1 14.3 7 100.0 Family _____________ 14 82.3 2 11.8 1 5.9 17 100.0 Adult _______________ 8 53.4 2 13.3 5 33.3 15 100.0 Total _____________ 55 64.7 15 17.7 15 17.6 85 100.0 Master’s Pediatric ___________ 7 87.5 ___ ___ 1 12.5 8 100.0 Midwifery __________ 5 83.3 ___ ___ 1 16.7 6 100.0 Maternity ___________ 5 71.4 1 14.3 1 14.3 7 100.0 Family _____________ 10 83.3 2 16.7 ___ ___ 12 100.0 Adult _______________ 6 75.0 2 25.0 ___ ___ 8 100.0 Psychiatric _________ 4 100.0 ___ _-_ ___ __1 4 100.0 Total _____________ 37 822 5 11.1 3 6.7 45 100.0 1 One certificate pediatric program did not respond to the question. Table 12.—NP programs, by sponsoring institution and type of program . Type of program Sponsoring Certificate Master’s Total inStitUtiO" No. Pct. No. Pct. No. Pct. University/college _______ 71 82.5 45 100.0 116 88.5 Hospital _________________ 9 10.4 _,1 _ 9 6.9 Department of health “-1 3 3.5 __- A 3 2.2 Coordinated home health facility ________________ 1 1.2 _,1 _ 1 .8 Outpatient facility ______ 1 1.2 __A __ 1 .8 Regional medical program ______________ 1 1.2 ___ 1-- 1 8 Total _________________ 86 100.0 45 100.0 131 100.0 STUDY FINDINGS: NP PROGRAMS 21 Table 13.—NP programs, by sponsoring institution, specialty, and type of program Type of program and sponsoring institution Certificate Master’s Specialty University/ University/ college Hospital Other 1 college No. Pct. No. Pct. No. Pct. No. Pct. Pediatric ___________ 33 46.5 6 66.7 3 50.0 8 17.8 Midwifery __________ 4 5.6 ___ ___ 1 16.7 6 13.3 Maternity ___________ 6 8.5 1 11.1 ___ ___ 7 15.5 Family ______________ 15 21.1 ___ ___ 2 33.3 12 26.7 Adult _______________ 13 18.3 2 22.2 _s_ ___ 8 17.8 Psychiatric _________ — —- — —- — — 4 8.9 Total _____________ 71 100.0 9 100.0 6 100.0 45 100.0 lathe-r includes three programs sponsored by departments of health, one by a coordi- nated home health facility, one by an outpatient facility, and one by a regional medical program. 22 CHAPTER III Figure 2.—NP graduates per year, by specialty 1.503 m Family m Maternity m Midwifery m Pediatric ..... 1970 197] 1972 i973 1974 STUDY FINDINGS: NP PROGRAMS Figure 3.-—NP graduates per year, by specialty and type of program 1,192 CERTIFICATE I: Psychiatric M Adult Family m Maternity .‘V.'O'O'4 . A O O O Q Q 53.3.3.2,1 Mid w Ife ry % Pediatric 645 289 174 \ \\\ 1970 i971 i972 i973 1974 311 MASTER'S i970 i971 i972 i973 i974 24 CHAPTER m Table 14.——NP students admitted and graduated per year, 1970—74, by type of program Number of students and type of program Year 1:322:ng Total Average Total Average admitted admitted graduated graduated Certificate 1970 __________ 18 201 11 174 10 1971 __________ 29 363 13 289 10 1972 __________ 66 806 12 645 10 1973 __________ 86 1,369 16 1,134 13 1974 __________ 1 86 21,449 17 2 1,192 14 Total _______ — 4,188 — 3,434 - Master’s 1970 __________ 18 114 6 75 4 1971 __________ 24 195 8 117 5 1972 __________ 36 267 7 187 5 1973 __________ 45 360 8 239 5 1974 __________ 1 45 2 532 12 2 311 7 Total _______ — 1,468 — 929 ___ 1The number of programs is identical for 1973 and 1974, because study data do not include programs initiated after January 1974. 2Program directors may have estimated the number of admissions and graduates for 1974. Table 15.—NP programs, by number of beginning classes per year and‘type of program Type of program Number of beginning ' Certificate Master's c asses per year No. Pct. No. Pct. Fewer than 1 ___________ 1 1.2 ___ ___ 1 ______________________ 27 31.4 40 88.9 2 ______________________ 48 55.8 1 2.2 3 ______________________ 6 6.9 3 6.7 4 ______________________ 3 3.5 1 2.2 5 ______________________ 1 1.2 ___ ___ Total ________________ 86 100.0 45 100.0 STUDY FINDINGS: NP PROGRAMS 25 Table 16.—NP programs, by year initiated and type of program Type of program Year program Certificate Master’s initiated Cumulative Cumulative No. Pct. percent No. Pct. percent 1968 and before _____ 5 5.8 5.8 10 22.2 22.2 1969 ________________ 3 3.5 9.3 ' 2 4.5 26.7 1970 ________________ 10 11.6 20.9 6 13.3 40.0 1971 ________________ 11 12.8 33.7 6 13.3 53.3 1972 ________________ 37 43.0 76.7 12 26.7 80.0 1973 ________________ 20 23.3 100.0 9 20.0 100.0 Total 1 ____________ 86 100.0 45 100.0 1This presentation is limited to those programs initiated each year which are still in existence. Table 17.—NP programs. by year initiated, specialty, and type of program 98 Year program Specialty and type of program initiated Pediatric Midwifery Maternity Family Adult Psychiatric Total Certificate 1968 and before ______________ 3 2 ___ 11- _,_ — 5 1969 _________________________ 3 ___ _,_ ___ _-_ — 3 1970 _________________________ 5 ___ 2 2 1 — 10 1971 _________________________ 6 1 -__ 4 ___ —— 11 1972 _________________________ 18 1 3 8 7 — 37 1973 _________________________ 7 1 2 3 7 — 20 Total ______________________ 42 5 7 17 15 — 86 Master’s 1968 and before ______________ 1 3 2 1 1 2 10 1969 _________________________ ___ “1 1 __c 1 ___ 2 1970 _________________________ 1 1 1 1 2 ___ 6 1971 _________________________ 2 ___ 2 ___ 1 1 6 1972 _________________________ 3 1 1 5 2 ___ 12 1973 _________________________ 1 1 ___ 5 1 1 9 Total ______________________ 8 6 7 12 8 4 45 III HELLdVI-IO Table 18. NP programs, by year initiated, length, and type of program STUDY FINDINGS: NP PROGRAMS 27 Year program Length (in months) and type of program initiated 3—5 6—8 9—11 12—14 15—17 18—20 >20 Total Certificate 1968 and before __ 2 1 1 1 -,7_ _-_ ___ 5 1969 _____________ 1 1 _a 1 _N _-_ _fl 3 1970 _____________ 3 4 2 ___ ___ 1 _H 10 1971 _____________ 3 1 3 3 n- 1 ___ 11 1972 _____________ 8 11 9 5 3 _H 1 37 1973 _____________ 6 4 3 7 W- ___ ___ 20 Total __________ 23 22 18 17 3 2 1 86 Master’s 1968 and before -- -4- _-, 2 1 3 4 ___ 10 1969 _____________ __ ___ ___ ___ _,_ 2 ___ 2 1970 _____________ __- ___ -9- 3 1 1 1 6 1971 _____________ __ _-_ _-_ 4 1 1 ___ 6 1972 _____________ ___ -__ ___ 5 1 6 -9- 12 1973 _____________ ___ ___ ___ 2 4 3 -.r_ 9 Total __________ __ ___ 2 15 10 17 1 45 Table ISL—Average length of NP programs, by year initiated, availability of preceptorship,1 and type of program Availability of preceptorship and type of program Not available Available Number Total aver- Number Average length in months of age length of programs in months programs Didactic Preceptorship Total Certificate 1968 and before ___________ 3 6.7 2 4.0 4.0 8.0 1969 ______________________ ___ — 3 3.3 4.7 8.0 1970 ______________________ 3 4.7 7 4.9 4.6 9.4 1971 ______________________ 4 6.5 7 5.1 5.9 11.0 1972 ______________________ 12 5.2 25 4.2 6.2 10.4 1973 ______________________ 9 5.0 11 3.8 6.9 10.7 Total ___________________ 31 5.4 55 4.3 5.9 10.2 Master’s 1968 and before ___________ 10 15.4 u- —- — ~— 1969 ______________________ 2 18.0 ___ — — — 1970 ______________________ 5 15.6 1 10.0 2.0 12.0 1971 ______________________ 1 16.0 5 10.0 3.2 13.2 1972 ______________________ 9 15.0 3 10.3 5.7 16.0 1973 ______________________ 6 17.0 3 11.3 2.7 14.0 Total ___________________ 33 15.8 12 10.4 2.7 13.1 1The internship or preceptorship portion ’is a specified period of supervised clinical practice in patient assessment and management and is 3 require- ment for completion of some programs. This is distinct from and follows the clinical experience offered concurrently With the didactic portion. 83 III HELLJVHO STUDY FINDINGS: NP PROGRAMS 29 Table 20.—NP programs, by availability of inner-city and [or rural practice setting and type of program Type of program Practice sbeltting Certificate Master’s avaI a e No. Pct. No. Pct. Inner city _____________________ 39 45.3 23 51.1 Rural ________________________ 5 5.8 3 6.7 Inner city and rural __________ 36 41.9 18 40.0 Neither ‘ _____________________ 6 7.0 1 2.2 Total ______________________ 86 100.0 45 100.0 1 Neither was not specified. Table 21 .—Number of credits awarded for certificate NP programs, by type of credit Number of credits Type of credit ‘ Range Median Average Academic 2 _______________________ 3—48 12 17 Continuing education 3 ___________ 8—64 26 31 1 Eight programs awarded both academic and continuing education credits. 2Of the 25 programs which awarded academic credits, two did not supply information on number of credits. 3Of the 30 programs which awarded continuing education credits, six did not supply information on number of credits. Table 22. Master's NP programs. by number of credits awarded. Numb‘." °f No. Pct. credits <36 _________________________ 1 2.2 36—40 ________________________ 19 42.3 41—45 ________________________ 3 6.7 46—50 ________________________ 11 24.4 >50 1 _________________________ 11 24.4 Total ______________________ 45 100.0 Range _______________________ 2 34—146 Median ______________________ 45 Average _____________________ ._ 50 1Programs awarding over 50 credit hours are between 15 and 21 months in length. 'The range of credits is very great because of one midwifery program which reported awarding 146 credits. 30 CHAPTER 111 Table 23.—NP programs, by title most commonly used to designate graduates and type of program Type of program Title most commonly s (11 Certificate Master’s u e No. Pct. No. Pct. Nurse practitioner ____________ 51 64.6 5 13.2 Nurse clinician ______________ 4 5.0 11 28.9 Nurse associate _____________ 17 21.5 ___ ___ Clinical nurse specialist ______ 1 1.3 17 44.7 Nurse midwife _______________ 4 5.0 5 132 Nurse generalist _____________ 2 2.6 ___ ___ Total ‘ _____________________ 79 100.0 38 100.0 1The titles listed below are frequently used with a term which reflects specialty (e.g.. family nurse associate, pediatric nurse practitioner, OB-GYN nurse clinician, medical/surgical clinical specialist). " aSeven certificate and seven master's programs did not supply information on title most commonly used. Table 24.-—NP programs, by provision of job placement services and type of program Type of program Job placement1 Certificate Master’s No. Pct. No. Pct. Provided _____________________ 7 23.3 10 24.4 Not provided _________________ 23 76.7 31 75.6 Total 2 _____________________ 30 100.0 41 100.0 1This variable was not applicable to the 52 certificate programs which required their applicants to have guaranteed employment at completion of the program. 2Four certificate programs and four master's programs did not supply information on job placement services. Table 25.—NP programs, by provision of continuing education to graduates and type of program Type of program Continuing education Certificate Master's Provided ......................... 53 62.4 7 15.6 Not provided __________________ 32 37.5 38 84.4 Total 1 _______________________ 85 100.0 45 100.0 10ne certificate program did not supply information on whether it sponsored continuing education. STUDY FINDINGS: NP PROGRAMS 31 Table 26.—NP programs, by characteristic evaluated and type of program Type of program Characteristic evaluated Certificate Master’s No. Pct1 No. Pct1 Effect of the graduates’ employment on the availability of health care ____ 22 34.9 4 20.0 Effect of the graduates’ employment on the cost of health care ___________ 8 12.7 1 5.0 Competence of the graduates _________ 40 63.5 13 65.0 Degree of independence with which the graduates function _______________ 50 79.4 10 50.0 Match of the graduates’ functions and responsibilities with thOSe for which they were trained _____________ 50 79.4 12 60.0 1This presentation is based on the 63 certificate programs and 20 master's programs which evaluated their programs. 32 CHAPTER III NP Programs—Continued Admission Characteristics One of the most difficult decisions in initiating new educational programs relates to the prior preparation and type of student con- sidered appropriate or desirable for admission. Some variations in these characteristics are presented in the following tables. Table 27 shows a distribution of programs which award certificates by the minimum prior nursing education accepted for admission. This kind of distribution is not shown for the programs which award master’s degrees because, as would be expected, these programs required a baccalaureate degree for admission. Table 28 indicates the proportion of programs which require that students have guaranteed employment upon graduation. Table 29 presents data on whether programs used tests to evaluate students, and if so, whether only aptitude tests were used, whether only personality tests were used, or whether both were used. STUDY FINDINGS: NP PROGRAMS 33 Table 27.—Certificate NP programs, by minimum nursing education accepted for admission Nursing education accepted for admission No. Pct. Less than a baccalaureate degree1 _________________________ 76 88.4 Baccalaureate degree or more ______-_____v_________» ________ 10 11.6 Total _____________ ___ __ ___ 86 100.0 1 Less than a baccalaureate includes diploma and associate degree. Table 28.—NP programs requiring and not requiring for admission guaranteed employment upon program completion, by type of program Type of program Guaranteedt Certificate Master’s Total emp oymen No. Pct. No. Pct. No. Pct. Required ___________ 52 60.5 __- __1 52 39.7 Not required _________ 34 39.5 45 100.0 79 60.3 Total ______________ 86 100.0 45 100.0 131 100.0 Table 29.—NP programs, by test 1 used for student evaluation and type of program Type of program Test Certificate Master’s No. Pct. No. Pct. Aptitude test only __________________________ 5 5.8 32 71.1 Personality test only ________________________ 19 22.1 2 4.4 Both aptitude and personality tests _________ 6 7.0 4 8.9 Neither aptitude nor personality test ________ 56 65.1 7 15.6 Total ______________________________________ 86 100.0 45 100.0 1This presentation does not distinguish between tests given prior to acceptance and those used after entrance into the program. 34 CHAPTER III NP Programs—Continued Financial Support for Programs and Students and Tuition Charges Various financial aspects of NP preparation are illustrated in the following tables (30—36) . Table 30 presents data on the sources of program/ student funding for the 5 years, 1970 through 1974. Tables 31—35 show the variation in the amount of tuition charged to students by type of program, specialty, program length, and sponsoring institution. Table 36 provides information on program support in the form of scholarships or stipends, loans, and wages available to students. Table 30.—NP programs, by source of funding for programs and students, year (1970—74), and type of program Program/ student funding, year, and type of program Source of funding 1970 1971 1972 1973 1974 Program Student Program Student Program Student Program Student Program Student Certificate Division of Nursing __________ 2 1 2 1 14 13 21 15 21 14 Capitation funds __________ 1 —— 1 — 1 —- 4 — 2 _— Contracts ______________________ _a _fi _fi 8 6 10 8 10 7 Special project grants _____ 1 _fi 1 ___ 5 2 8 4 11 4 Traineeships _______________ — 1 —- 1 — 5 — 4 — 3 Scholarships ______________ — _fl —. ___ — ,1- — 1 — — Loans _____________________ —— s“ —— ___ —_ 1 — 1 — 1 MCH 1 _______________________ 1 ___ 3 3 11 6 9 7 8 7 BHSR ' ______________________ 1 1 3 2 6 6 6 7 6 RMPa _______________________ 2 2 5 1 12 2 15 3 7 2 OEO‘ ________________________ 1 1 1 ___ 2 ,,_ 1 1 ___ ___ Other Federal funds __________ 1 2-- 1 u- 4 3 4 2 6 4 Sponsoring institution only ___ 6 7 11 15 18 28 24 34 29 44 Other non-Federal funds _____ 6 6 8 7 13 12 24 22 21 16 Total ' _____________________ 18 29 66 86 86 See footnotes at end of table. SWVHDOHJ JN :SDNIGNIJ ACID-LS 98 Table 30.—-NP programs. by source of funding for programs and students, year (1970—14), and type of program—continued Program/student funding, year, and type of program Source of funding 1970 1971 1972 1973 1974 Program Student Program Student Program Student Program Student Program Student Master’s Division of Nursing __________ 3 13 4 14 20 20 32 28 28 25 Capitation funds __________ 2 — 2 — 18 — 30 — 23 _— Contracts __________________ ___ _-_ c“ ,__ ___ h- 1 ___ 2 ___ Special project grants _____ 1 1 2 1 4 ___ 6 ___ 7 __- Traineeships _______________ — 10 — 12 — 19 — 21 — 24 Scholarships ______________ — 2 — 3 — 7 — 12 — 12 Loans _____________________ — 5 — 5 — 9 —- 15 — 13 MCH 1 _______________________ 3 2 5 3 6 6 7 8 7 8 BHSR 2 ______________________ ___ - _fi ___ ,__ ,__ ___ ___ ___ ___ _-_ RMP3 _______________________ 1-- _-_ 1__ ,__ ___ ___ ___ ___ ___ -__ OEO‘ ________________________ w. ___ -__ _u ___ ___ ___ ___ ___ ___ Other Federal funds __________ 3 5 3 5 3 5 3 6 2 5 Sponsoring institution only ___ 11 1 15 4 12 10 15 13 17 13 Other non-Federal funds _____ 1 1 3 3 8 4 10 7 10 8 Total 5 _____________________ 18 24 36 45 45 1 Maternal and Child Health Service, Health Services Administration, formerly HSMHA. ’ Bureau of Health Services Research, Health Resources Administration, formerly National Center for Health Services Research and Development. 3 Regional Medical Programs. ‘ Office of Economic Opportunity. fiTotal represents all the programs for a given year. Because the various sources of funding are not mutually exclusive, the totals are not a summa- tion of the columns. The number of programs is identical for 1973 and 1974. because study data do "01' include programs initiated atfer January 1974- 98 III HELLJVHD STUDY FINDINGS: NP PROGRAMS 37 Table 31.—NP programs. by amount of tuition charged to students and type of program Tuition charged Type of program to students Certificate Master’s Total (in dOHaI’S) No. Pct. No. Pct. No. Pct. 0 ____________ 32 39.5 _-_ ..__ 32 26.2 1—500 ___________ 28 34.6 7 17.1 35 28.7 501—1,000 ________ 16 19.7 7 17.1 23 18.9 1,001—2,000 ________ 5 6.2 12 29.2 17 13.9 2,001-3,000 ________ a- ..__ ___ _.._ ___ ___ 3,001—4,000 ________ ___ .._- 7 17.1 7 5.7 4,001—5,000 ________ ___ "-2 3 7.3 3 2.5 >5,000 ________ ___ -2" 5 12.2 5 4.1 Total 1 __________ 81 100.0 41 100.0 122 100.0 1Five certificate programs and four master’s programs did not supply information on tuition. Table 32.—NP programs, by amount of tuition charged to students and specialty Tuition charged Specialty to students Pedi- Mid- Mater- . Psychi- (in dollars) atric wifery nity Family AdUIt atric Total 0 ____________ 14 2 3 8 5 — 32 1—500 __________ 20 ___ 4 3 7 1 35 SUI—1,000 ________ 6 2 3 5 6 1 23 1,001—2,000 ________ 5 3 1 6 2 ___ 17 2,001—3,000 ________ ___ ___ ___ ___ ___ ___ ___ 3,001-4,000 ________ 1 3 1 1 ___ 1 7 4,001-5,000 ________ ___ ___ 1 1 1 ___ 3 >5,000 ________ 1 1 1 2 ___ ___ 5 Total 1 __________ 47 11 14 26 21 3 122 1Nine programs, three pediatric, three family. two adult, and one psychiatric did not supply information on tuition. 38 CHAPTER m Table 33.—NP programs, by amount of tuition charged to students, program length, and type of program Tuition charged Length (in months) and type of program to students Total (in dollars) 3—5 6—8 9—11 12—14 15—17 18—20 >20 —l\To.—PcT Certificate 0 __________ 8 9 3 7 3 1 1 32 39.5 1—500 ________ 12 5 7 4 ___ ___ ___ 28 34.6 SDI—1,000 _______ 2 3 5 6 1-- ___ ___ 16 19.7 1,001—2,000 _______ 1,- 4 1 ___ ___ ___ ___ 5 6.2 Total 1 _________ 22 21 16 17 3 1 1 81 100.0 Master’s 1—500 ________ ___ ___ ___ 7 __- ___ ___ 7 17.1 501-1,000 _______ ___ -__ ___ 5 ___ 2 ___ 7 17.1 LOCI—2,000 _______ ___ ___ _-_ ___ 2 10 ___ 12 29.2 2,001—3,000 _______ ___ _-_ ___ ___ ___ ___ ___ ___ ___ 3,001—4,000 _______ ___ ___ 2 ___ 4 1 ___ 7 17.1 4,001-5,000 _______ ___ ___ ___ 2 1 ___ ___ 3 7.3 >5,000 _______ ___ ___ ___ 1 1 2 1 5 122 Total 1 _________ ___ _-_ 2 15 8 15 1 41 100.0 1 Five certificate and four master’s programs did not supply information on tuition. Table 34.—Average amount of tuition charged to NP students (in dollars), by program length and type of program Length (in months) Type °fpr°gram 3—5 6-8 9—11 12—14 15-17 18—20 >20 Total Certificate 1 ______ 197 477 467 361 ___ -__ -1- 345 Master’s1 ________ — — 3,562 1,465 3,237 2,187 6,750 2,306 1 Five certificate and four master's programs did not supply information on tuition. STUDY FINDINGS: NP PROGRAMS 39 Table 35.—NP programs, by amount of tuition charged to students, sponsoring institution, and type of program Type of program and sponsoring institution Tuition charged Certificate Master's to students University/ . 1 University/ (in dollars) college HOSp'ta' Other college No. Pct. No. Pct. No. Pct. No. Pct. 0 _________ 23 34.8 5 55.6 4 66.6 ___ ___ 1—500 ______ 24 36.4 3 33.3 1 16.7 7 17.1 SUI—1,000 _____ 14 212 1 11.1 1 16.7 7 17.1 LOCI—2,000 _____ 5 7.6 ___ ___ ___ ___ 12 29.2 2001-3000 _____ ___ ___ ___ ___ ___ ___ ___ ___ 3,001—4,000 _____ ___ ___ ___ ___ ___ ___ 7 17.1 4,001—5,000 _____ ___ ___ ___ ___ ___ ___ 3 7.3 >5,000 _____ __- ___ ___ ___ ___ ___ 5 12.2 Total 9 _______ 66 100.0 9 100.0 6 100.0 41 100.0 1 Other includes three programs sponsored by departments of health; one by a coordinated home health facility; one by an outpatient facility; and one by a regional medical program. 2Five certificate programs and four master's programs did not supply information on tuition. Table 36.—NP programs, by program support available to students and type of program Type of program Program support available Certificate 1 Master's No. Pct. No. Pct. Scholarships or stipends Only _____________________________ 23 27.1 5 11.1 In combination with other support- 23 27.1 31 68.9 Loans Only ____________________________ 3 3.5 7 15.6 in combination with other support- 15 17.6 32 71.1 Wages Only ____________________________ 10 11.8 ___ ___ In combination with other support- 14 16.5 2 4.4 None ______________________________ 21 24.7 1 2.2 1 One certificate program did not supply information on available program support. 40 CHAPTER III NP Programs—Continued Characteristics of Faculty A great deal of variation occurs in the composition of faculty for NP programs. Tables 37-50 present data on several different as- pects of faculty makeup. Variables presented include discipline of program directors and codirectors by type of program and sponsor- ing institution, staff teaching personnel in selected disciplines, and the ratio of students to staff teaching personnel. Other presenta- tions show nursing versus physician faculty as staff teaching per- sonnel and types of staff disciplines not used in some programs. Table 44 enumerates the programs with and without nurses carry- ing caseloads and providing patient care in addition to teaching. Table 45 presents the number of nurses who have these extra re- sponsibilities in addition to teaching. The data on staff teaching personnel is presented in terms of full-time equivalents with the exception of that presented in table 45. Tables 46 and 47 present information on faculty, a category which includes staff teaching personnel as well as preceptors and guest lecturers. These tables present information on contributed faculty compared to all faculty (both salaried and contributed) as well as the discipline of con- tributed faculty, guest lecturers, and supervisors during precep- torship. The final table in the series provides information on the availability of practicing NPs for clinical consultation. STUDY FINDINGS: NP PROGRAMS 41 Table 37.—NP programs, by discipline of program director and codirectors and type of program Type of program Discipline of program , _ Certificate Master’s Total director and codirectors No. Pct. No. Pct. No. Pct. Nurse director with: Physician codirector _____________ 25 2 27 Nurse codirector ________________ 4 9 13 Nurse and physician codirectors-_ 2 -_- 2‘ No codirector ___________________ 21 32 53 Subtotal ________________________ 52 60.5 43 97.7 95 73.1 Physician director with: -- ,,-7- Nurse codirector ________________ 16 ___ 16 Physician codirector _____________ 1 -__ 1 No codirector ___________________ 4 -_- 4 Subtotal ________________________ 21 24.4 - -- --- 21 16.1 Nurse and physician codirectors Subtotal _______________________ 13 15.1 1 2.3 14 10.8 Total1 _________________________ 86 100.0 44 100.0 130 100.0 1 One master's program did not supply information on discipline of director and codirec- tors. Table 38.—NP programs, by discipline of program director and codirectors, sponsoring institution, and type of program Type of program and sponsoring institution Discipline of program Certificate Master‘s director and codirectors University / _ 1' University/ college Hospital Other college Nurse director with: Physician codirector ______________ 23 1 1 2 Nurse codirector __________________ 3 -_- 1 9 Nurse and physician codirectors _-- 2 --- __- --- No codirector _____________________ 20 ___ 1 32 Subtotal ________________________ 48 1 3 43 Physician director with: Nurse codirector __________________ 9 4 3 --- Physician codirector ______________ 1 --- -_- --- No codirector _____________________ 4 --- --- --_ Subtotal ------------------------ 14 4 3 __- Nurse and physician codirectors Subtotal ------------------------ 9 4 -.-- 1 Total ’ ---------------------------- 71 9 6 44 1Other includes three programs sponsored by departments of health, one by a coordi- nated home health facility, one by an outpatient facility, and one by a regional medical program. 2One master's program did not supply information on discipline of director and codirec- tors. 42 CHAPTER m Table 39.—Average number of NP program staff teaching personnel 1 in selected disciplines, by specialty and type of program Number Discipline and type of program Specialty of programs NP Nurse Physician Other ’ Total Certificate Pediatric ______ - 42 1.4 .2 .6 .1 2.3 Midwifery _______ 5 4.9 ___ .9 -__ 5.8 Maternity ________ 7 1.3 .7 .4 .1 2.5 Family ___________ 17 2.3 .4 1.0 .4 4.0 Adult ____________ 15 1.3 .3 .7 .1 2.4 Total __________ 86 1.7 .3 .7 .1 2.9 Master's Pediatric ________ 8 1.1 1.2 .4 .1 2.8 Midwifery _______ 6 4.4 .1 -__ .1 4.6 Maternity ________ 7 1 5 .5 .3 .1 2.4 Family ___________ 11 1.7 .8 .8 .1 3.4 Adult ____________ 8 1.4 .7 .2 .1 2.4 Psychiatric ______ 4 2.7 .6 .4 .3 4.0 Total ’ _________ 44 2.0 .7 .4 .1 3.2 1Staff teaching personnel excluded those persons characterized as guest lecturers. Staff teaching personnel is presented in terms of full-time equivalents and was based on esti- mated percentage of total work time provided. 3 Other was not specified. 3‘One family master's program did not supply information on number of staff teaching personnel. Table 40.—Number of NP program staff teaching personnel1 in selected disciplines. by specialty, and type of program Estimated Discipline and type of program Specialty Nl:;"?::fl:f number of p g students NP Nurse Physician Other ’ Total Certificate Pediatric ____________________ 42 410 57.6 9.8 25.0 2.5 94.9 Midwifery ____________________ 5 57 24.3 ___ 4.7 ___ 29.0 Maternity ___________________ 7 62 9.0 4.6 3.1 .8 17.5 Family ______________________ 17 215 38.8 6.7 16.2 7.0 68.7 Adult ________________________ 15 195 20.0 4.2 10.2 1.4 35.8 Total ______________________ 86 939 149.7 25.3 59.2 11.7 245.9 Master’s Pediatric ____________________ 8 34 9.0 9.3 3.2 .6 22.1 Midwifery ____________________ 6 60 26.3 .6 __s .8 27.7 Maternity ___________________ 7 47 10.3 3.9 2 0 .4 16.6 Family ______________________ 11 100 19.2 8.8 8 9 .7 37.6 Adult ________________________ 8 84 11.5 5.7 1.9 .2 19.3 Psychiatric __________________ 4 32 10.8 2.3 1.8 1.3 16.2 Total 3 _____________________ 44 357 87.1 30.6 17.8 4.0 139.5 1 Staff teaching personnel excluded those persons characterized as guest lertcrers. Staff teaching personnel is presented in trms of full-time equivalents and was based on estimated percentage of total work time provided. 2 Other was not specified. BOne family master's program did not supply information on number of staff teaching personnel. SWVHDOHJ dN ISDNIGNIJ AGHLS 817 Table 41.—Ratio of students to NP program staff teaching personnel‘ in selected disciplines, by specialty and type of program _ Number of Discipline and type of program Specialty programs NP Nurse Physician Other 3 Total Certificate Pediatric ___________________________________ 42 7:1 42:1 15:1 164:]. 4:1 Midwifery __________________________________ 5 2:1 ___ 12:1 ___ 2:1 Maternity __________________________________ 7 7:1 13:1 20:1 78:1 4:1 Family _____________________________________ 17 6:1 32:1 13:1 31:1 3:1 Adult ________________________________________ 15 10:1 46:1 19:1 139:1 5:1 Total ______________________________________ 86 6:1 37:1 16:1 80:1 4:1 Master's Pediatric ___________________________________ 8 4:1 4:1 11:1 57:1 2:1 Midwifery ___________________________________ 6 2:1 100:1 _-_ 75:1 2:1 Maternity __________________________________ 7 5:1 12:1 24:1 118:1 3:1 Family ______________________________________ 11 5:1 11:1 11:1 143:1 3:1 Adult _______________________________________ 8 7:1 15:1 44:1 420:1 4:1 Psychiatric _________________________________ 4 3:1 14:1 18:1 25:1 2:1 Total 3 ____________________________________ 44 4:1 12:1 20:1 89:1 3:1 1 Staff teaching personnel excluded those persons characterized as guest lecturers. Staff taching personnel is presented in terms of full-time equivalents and was based on estimated percentage of total work time provided. 2 Other was not specified. , 3One family master's program did not supply information on number of staff teaching personnel. 1717 III SERVED Table 42.—NP programs, by comparison of nursing versus physician faculty as staff teaching personnel,‘ specialty, and type of program Nursing versus ' Specialty and type of program physician faculty Pediatric Midwifery Maternity Family Adult Psychiatric Total Certificate NP and nurse combined more than physician 2 _____________________ 34 5 7 14 13 — 73 More physician than NP and nurse combined3 ___________________ 7 _-_ _-_ 2 2 — 11 Physician equal to NP and nurse . combined ___________________________ 1 ___ ___ 1 ___ — 2 Master’s ‘ NP and nurse combined 2 more than physician ______________________ 8 6 7 10 7 4 42 More physician than NP and nurse combined ____________________ u- ___ ___ 1 1 ___ 2 Physician equal to NP and nurse combined __________________________ ___ ___ ___ ___ ___ ___ __c 1 Staff teaching personnel excluded those persons characterized as guest lecturers. Staff teaching personnel is presented in terms of full-time equivalents and was based on estimated percentage of total work time provided. 2There were three certificate programs operating with NPs only as staff teaching personnel, one a midwifery program and two family programs. There were eight master's programs operating with NPs only as staff teaching personnel, four midwifery. one maternity, one family. and two adult programs. 3There was one certificate program operating with physicians only as staff teaching personnel, a pediatric program. ‘One family master’s program did not supply information on number of staff teaching personnel by discipline. SDNIGNIJ ACIDLS SWWDOHJ JN 9T7 Table 43.—NP programs, by type of discipline of staff teaching personnel 1 not utilized, specialty, and type of program 917 Discipline of staff not utilized and type of program Specialty Number Of Nurse . . , Programs Nurse NP and NP Physxman Other Certificate Pediatric 42 27 5 1 ___ 29 Midwifery _ __- 5 5 ___ ,__ 1 5 Maternity __ 7 1 ___ ___ ___ 2 Family 17 10 1 1a- 3 9 Adult 15 5 1 ___ 1 11 Total 86 48 7 1 5 56 Master's Pediatric ___ 1-_ 1 8 1 2 ___ ___ 4 Midwifery _______ 6 4 _-_ 1a 6 4 Maternity _____ 7 3 1 -1- 1 4 Family _____ 11 3 1 ___ 2 5 Adult 8 3 1 -1- 3 6 Psychiatric 4 1 __- ___ 1 2 Total ___ 1___ ”44 15 5 ___ 13 25 III HELLJVHO 1 Staff teaching personnel excluded those persons characterized as guest lecturers. 2 Other was not specified. 30ne family master's program did not supply information on number of staff teaching personnel by discipline. Table 44.—NP programs with and without nurses carrying a caseload and providing patient care in addition to teaching, by specialty and type of program Type of program Programs with no Programs with Specialty nurses carrying nurses carrying Total a caseload a caseload No. Pct. No. Pct. No. Pct. Certificate Pediatric ________________________________ 32 78.0 9 22.0 41 100.0 Midwifery ________________________________ 4 80.0 1 20.0 5 100.0 Maternity ________________________________ 6 85.7 1 14.3 7 100.0 Family ___ 15 88.2 2 11.8 17 100.0 Adult __u ____ 13 92.9 1 7.1 14 100.0 Total 1 _________________________________ 70 83.3 14 16.7 84 100.0 Master’s Pediatric 7 87.5 1 12.5 8 100.0 Midwifery ________________________________ 5 100.0 W- V..- 5 100.0 Maternity ________________________________ 3 42.9 4 57.1 7 100.0 Family 7 63.6 4 36.4 11 100.0 Adult _____________________________________ 4 50.0 4 50.0 8 100.0 Psychiatric ______________________________ 4 100.0 a“ _,_ 4 100.0 Total 1 ___ 30 69.8 13 30.2 43 100.0 1One pediatric and one adult certificate program and one midwifery and one family master’s program did not supply information on nurses carrying a caseload and providing patient care in addition to teaching. SWVHDOHJ JN ISDNIGNIJ Adams [.17 Table 45.—-Nurses carrying caseloads and providing patient care in addition to teaching, by specialty and type of program Type of program 1 Nurses not carrying Nurses carrying Specialty a caseload a caseload Total No. Pct. No. Pct. No. Pct. Certificate Pediatric _________________________________ 39 31.5 85 68.5 124 100.0 Midwifery _______________________________ 16 48.5 17 51.5 33 100.0 Maternity ________________________________ 15 46.9 17 53.1 32 100.0 Family __________________________________ 13 17.1 63 82.9 76 100.0 Adult ____________________________________ 3 5.5 52 94.5 55 100.0 Total __________________________________ 86 26.9 234 73.1 320 100.0 Master’s Pediatric _________________________________ 23 52.3 21 47.7 44 100.0 Midwifery ______ 20 41.7 28 58.3 48 100.0 Maternity ___ 27 81.8 6 18.2 33 100.0 Family __________________________________ 32 58.2 23 41.8 55 100.0 Adult __ 31 79.5 8 20.5 39 100.0 Psychiatric ______________________________ 5 17.2 24 82.8 29 100.0 Total ___ 138 55.6 110 44.4 248 100.0 1This presentation is based on the 14 certificate and 13 master’s programs which reported having some nurses carrying caseloads and providing patient care in addition to teaching in their programs. 817 III HELLJVHO Table Ila—Contributed faculty’ in NP programs, by discipline and type of program Discipline and type of program Number Ph sicians Other All disci lines Programs of Nurses per program peryprogram pgfcplrjogrzm per program 9.2:; s Contributed Contributed Contributed Contributed Total ‘ No. Pct. Total‘ No. Pct. Total ‘ No. Pct. Total‘ No. Pct. Certificate No contributed staff ____ 12 2.28 —— -— 1.42 — — .06 — — 3.76 — —— Contributed staff ________ 49 2.98 .82 27.5 3.41 2.30 67.4 .37 .17 45.9 6.76 3.29 48.7 Master’s No contributed staff ____ 14 3.24 — — 1.61 -— — .13 -— — 4.98 — — Contributed staff 111111111 21 4.90 .89 18.2 1.31 .82 62.6 .08 .03 37.5 6.29 1.74 27.7 1 In this presentation, faculty includes staff teaching personnel as well as preceptors and guest lecturers and is presented in terms of full-time equiv- alents. 2Other faculty includes disciplines such as pathology, physiotherapy, public health, nutrition, pharmacy, psychology, economics, sociology, social work, speech, dentistry, and law. 3Twenty-five certificate programs and ten master’s programs did not supply information on contributed faCUItY- ‘Total includes both salaried and contributed faculty in programs that have both. SWWDOHJ JN :somama AGQLS 6V 50 CHAPTER III Table 47.—Average number of contributed faculty,‘ by discipline, specialty, and type of program Discipline and type of program ' Specialty Nurse Physician Other2 Total Certificate 3 Pediatric ______________ .85 1.90 .21 2.96 Midwifery _______________ 1.50 _-.. , ._ 1.50 Maternity _______________ 1.08 .98 .02 2.08 Family ___________________ .78 3.88 .23 4.89 Adult __________________ .37 1.92 .07 2.36 Total ________________ .82 2.30 .17 3.29 Master’s “ Pediatric _______________ .92 1.00 .02 1.94 Midwifery ______________ 2.07 .97 -,,- 3.04 Maternity ______________ .43 .40 _ ._1 .83 Family _________________ .08 .84 .06 .98 Adult __________________ .10 .75 .10 .95 Psychiatric _____________ 2.50 .75 .05 3.30 Total ________________ .89 .82 .03 1.74 1 Faculty includes staff teaching personnel as well as preceptors and guest lecturers and is presented in terms of full-time equivalents. This presentation is limited to contributed faculty and excludes salaried faculty. ‘-‘Other includes disciplines such as pathology, physiotherapy, public health, nutrition, pharmacy, psychology, economics, sociology. social work, speech, dentistry. and law. “This presentation is based on the 49 certificate and 21 master's programs which re- ported having some contributed faculty. Table 48.—Guest lecturers 1 in NP programs, by discipline, specialty, and type of program Discipline and type of program Nurse Physician Other 3 Total Specialty Average Average Average Average No. no. per No. no. per No. no. per No. no. per program program program program Certificate Pediatric ____________________ 209 5.2 588 14.7 233 5.8 1,030 25.7 Midwifery ____________________ 12 2.4 33 6.6 22 4.4 67 13.4 Maternity ____________________ 17 2.4 48 6.9 31 4.4 96 13.7 Family ______________________ 136 8.0 462 27.2 85 5.0 683 402 Adult ________________________ 89 5.9 254 16.9 34 2.3 377 25.1 Total 3 _____________________ 463 5.5 1,385 16.5 405 4.8 2,253 26.8 Master’s Pediatric ____________________ 19 2.4 37 4.6 15 1.9 71 8.9 Midwifery ____________________ 28 4.7 38 6.3 10 1.7 76 12.7 Maternity ____________________ 7 1.0 6 .9 5 .7 18 2.6 Family ______________________ 37 3.7 124 12.4 42 4.2 203 20.3 Adult ________________________ 33 4.1 49 6.1 11 1.4 93 11.6 Psychiatric __________________ 5 1.7 10 3.3 4 1.3 19 6.3 Total 3 _____________________ 129 3.1 264 6.3 87 2.1 480 11.4 1 Guest lecturers were not considered to be staff teaching personnel. 2 Other was not specified. aTwo pediatric certificate programs. two family master’s programs. and one psychiatric master's program did not supply information 0" EUBSt lecturers. SWVHDOHJ (IN: :SDNIGNIJ AGflLS 19 52 CHAPTER m Table 49.—NP programs, by discipline of students' supervisor during preceptorship1 and type of program Discipline of students’ TYPE 0f program supervisor during Certificate Master’s preceptorship “Wm—T No. Pct. NP and/or physician ____ 14 26.0 9 75.0 NP only _________________ 1 1.9 1 8.3 Physician only __________ 38 71.7 2 ' 16.7 Total 3 ________________ 53 100.0 12 100.0 1The internship or preceptorship portion is a specified period of supervised clinical prac- tice in patient assessment and management and is a requirement for completion of some programs. This is distinct from and follows the clinical experience offered concurrently with the didactic portion. There are 31 certificate and 33 master's programs which do not in- clude a preceptorship, therefore the question related to internship/preceptorship did not apply. 2Two certificate programs did not supply information on discipline of supervisor during preceptorship. Table 50.—NP programs, by availability of practicing NPs for clinical consultation during clinical didactic ‘ and preceptorship 2 components and type of program Curricular component and type of program Availability of Clinical didactic preceptorship practicing NPs Certificate Master's Certificate Master’s No. Pct. No. Pct. No. Pct. No. Pct. Always _________ 53 61.6 22 48.9 14 26.9 6 50.0 Usually ________ 28 32.6 15 33.3 21 40.4 2 16.7 Seldom ________ 4 4.6 6 13.3 16 30.8 4 33.3 Never __________ 1 1.2 2 4.5 1 1.9 ___ ___ Total 3 _______ 86 100.0 45 100.0 52 100.0 12 100.0 1The clinical didactic component includes relevant clinical observations and experiences and operates concurrently with such activities as lectures and self-instruction. 2The internship or preceptorship portion is a specified period of supervised clinical prac- tice in patient assessment and management and is a requirement for completion of some programs. This is distinct from and follows the clinical experience offered concurrently with the didactic portion. There are 31 certificate and 33 master's programs which do not include a preceptorship, therefore the question related to internship/preceptorship did not apply. 3Three certificate programs did not supply information on availability of NPs during pre- ceptorship. STUDY FINDINGS: NP PROGRAMS 53 NP Programs-Continued Features of Curricula: Program Length Since the inception of nurse practitioner preparation, questions have been raised as to the appropriateness of various program lengths. Tables 51—61 and figures 4 and 5 illustrate the findings as they relate to both didactic and clinical aspects of NP preparation. Those variables presented in this series include program length by type, specialty and sponsoring institution, the average length of each curricular component, and the length of the entire program' and of the didactic component if the program includes or does not include a preceptorship. Also shown is the length (in months) of the didactic component, the length of the classroom only, the clini- cal only, and the length of the preceptorship, and finally the length (in months) of the preceptorship by specialty and type of pro- gram. 54 CHAPTER m Table 51.—NP programs, by length, specialty, and type of program Length (in months) and type of program spec'a'ty 3—5 6—8 9—11 12—14 15—17 18—20 >20 Total Certificate Pediatric ________ 13 13 9 5 1 ___ 1 42 Midwifery ________ ___ 2 2 1 ___ ___ ___ 5 Maternity ________ 4 1 2 ___ ___ _-_ ___ 7 Family __________ 1 3 3 7 1 2 ___ 17 Adult ____________ 5 3 2 4 1 -__ ___ 15 Total __________ 23 22 18 17 3 2 1 86 Master’s Pediatric ___________ ___ ___ 2 1 5 ___ 8 Midwifery ________ ___ ___ 1 ___ 1 3 1 6 Maternity __________ ___ 1 3 1 2 _-_ 7 Family __________ ___ ___ __- 5 4 3 ___ 12 Adult _______________ ___ 1-- 4 1 3 ___ 8 Psychiatric _________ ___ ___ 1 2 1 ___ 4 Total __________ ___ ___ 2 15 10 17 1 45 Table 52.-—Average length and range in months of NP programs, by specialty and type of program Type of program Specialty Average length Range (in months) (in months) Certificate Pediatric ___________ 7.9 4—24 Midwifery ___________ 9.0 7—12 Maternity ___________ 5.9 3—10 Family _______________ 11.1 3—18 Adult ______________ 8.3 3—16 Total _____________ 8.5 3—24 Master’s Pediatric ___________ 16.4 12—20 Midwifery ___________ 17.0 10—21 Maternity ___________ 14.1 11—18 Family ______________ 14.7 12—18 Adult ______________ 14.8 12—18 Psychiatric __________ 15 8 12-20 Total ______________ 1523 10—21 Table Sit—Average length of NP programs, by sponsoring institution. specialty, and type of program Type of program and sponsoring institution Certificate Master’s University/ . 1 University/ Specialty college Hospital Other college Number Average Number Average Number Average Number Average of length of length of length of length programs in months programs in months programs in months programs in months Pediatric ____________________ 33 7.5 6 11.7 3 4.7 8 16.4 Midwifery _____________________ 4 9.5 ___ ___ 1 7.0 6 17.0 Maternity ____________________ 6 6.3 1 3.0 ___ _-_ 7 14.1 Family ______________________ 15 10.9 ___ ___ 2 13.0 12 14.7 Adult ________________________ 13 8.8 2 5.0 ___ -1- 8 14.8 Psychiatric __________________ — — — —— — — 4 15.8 Total ______________________ 71 8.5 9 92 6 7.8 45 15.3 SWVHDOHJ (IN ZSDNIGNIJ AGflLS lOther includes three programs sponsored by departments of health. one by a coordinated home health facility, one by an outpatient facility. and one by a regional medical program. 99 Table 54.—Average length of each curricular component in NP programs. by specialty and type of program Curricular component and type of program Didactic 1 Preceptorship 2 Total Average length in months Specralty No. of Classroom No. of ’12:??? No. of Alzirgatie / programs Classroom ClInical cliriiial programs in months programs in months / , Certificate Pediatric ____________________ 42 2.3 2.1 4.4 25 53 42 7.9 Midwifery ____________________ 5 3.8 5.2 9.0 _-_ — 5 9.0 Maternity ____________________ 7 1.9 2.1 4.0 3 4.3 7 5.9 Family _______________________ 17 2.8 2.5 5.3 16 62 17 11.1 Adult ________________________ 15 2.4 1.3 3.7 11 6.3 15 8.3 Total ______________________ 86 2.4 2.2 4.7 55 5.9 86 8.5 Master’s Pediatric ____________________ 8 9.3 4.9 14.2 4 4.2 8 16.4 Midwifery _____________________ 6 9.5 7.5 17.0 ___ — 6 17.0 Maternity ____________________ 7 10.3 3.4 13.7 1 3.0 7 14.1 Family ______________________ 12 6.9 6.3 132 5 3.4 12 14.7 Adult ________________________ 8 8.2 62 14.4 1 3.0 8 14.8 Psychiatric __________________ 4 9.4 5.6 15.0 1 3.0 4 15.8 Total ______________________ 45 8.7 5.7 14.4 12 3.6 45 15.3 1The didactic portion includes a classroom and a clinical component. The classroom component includes such activities as lectures and self-instruc- tion. The clinical component includes relevant clinical observations and experiences and operates concurrently with the classroom component. ’The internship or preceptorship portion is a specified period of supervised clinical practice in patient assessment and management and is 3 require- ment for completion of some programs. This is distinct from and follows the clinical experience offered concurrently with the didactic portion. There are 31 certificate and 33 master’s programs which do not include a preceptorship, In which case this presentation related to internship/preceptorship did not apply. 99 III SERVED STUDY FINDINGS: NP PROGRAMS 57 Table 55.—Average number of months of didactic components of NP programs, by availability of preceptorship and type of program Didactic componenta Preceptorship 1 and type of program Classroom Clinical Total Certificate Available ___________ 2.4 1.9 4.3“ Not available _______ 2.5 2.9 5.4 Master’s Available ___________ 6.2 4.2 10.4 Not available _______ 9.6 6.2 15.8 1The internship or preceptorship portion is a specified period of supervised clinical prac- tice in patient assessment and management and is a requirement for completion of some programs. This is distinct from and follows the clinical experience offered concurrently with the didactic portion. There are 31 certificate and 33 master's programs which do not include a preceptorship. IThe didactic portion includes a classroom and a clinical component. The classroom com- ponent includes such activities as lectures and self-instruction. The clinical component in- cludes relevant clinical observations and experiences and operates concurrently with the classroom component. Table 56.—NP programs, by length of didactic component and type of program Length of didactic Type of program component 1 Certificate Master’s (in months) No. Pct. No. Pct. 1—3 ______________ 17 19.8 ___ ___ 4—6 ______________ 59 68.6 1 2.2 7-9 _______________ 7 8.1 ‘ 5 11.1 10—12 ______________ 3 3.5 12 26.7 13—15 ______________ ___ ___ 9 20.0 16—18 ______________ ___ ,__ 14 31.1 19—21 ______________ ___ ___ 4 8.9 Total _____________ 86 100.0 45 100.0 1The didactic portion includes a classroom and a clinical component. The classroom com- ponent includes such activities as lectures and self-instruction. The clinical component in. cludes relevant clinical observations and experiences and operates concurrently with the classroom component. Table 51.—-NP programs. by length of didactic component, specialty. and type of program Length of didactic Specialty and type of program co t1 Total 0:513:35) Pediatric Midwifery Maternity Family Adult Psychiatric No Pct Certificate 1—3 _____________ 7 ___ 1 3 6 —— 17 19.8 4—6 _____________ 33 H- 6 11 9 — 59 68.6 7—9 _____________ 2 4 ___ 1 N. — 7 8.1 10—12 _____________ __- 1 ___ 2 ___ — 3 35 Total ___________ 42 5 7 17 15 — 86 100.0 Master's 4-6 _____________ 1 ___ ___ --_ ___ ___ 1 2.2 7-9 _____________ 1 __- 1 1 1 1 5 11.1 10—12 _____________ ___ 1 3 5 3 ___ 12 26.7 13—15 _____________ 3 1 ___ 4 __- 1 9 20.0 16—18 _____________ 2 2 3 2 4 1 14 31.1 19—21 _____________ 1 2 ___ ___ ___ 1 4 8.9 Total ___________ 8 6 7 12 8 4 45 100.0 1The didactic portion includes a classroom and a clinical component. The classroom component includes such activities as lectures and self-instruction. The clinical component includes relevant clinical observations and experiences and operates concurrently with the classroom component. 89 III HSMVHO STUDY FINDINGS: NP PROGRAMS 59 Table 58.—NP programs, by length of classroom didactic component and type of program Length of classroom Type of program didactic component 1 Certificate Master’s (in months) No. Pct. No. Pct. <2 _______________ 29 33.7 ___ ___ 2-3 _______________ 47 54.7 3 6.6 4—5 _______________ 8 9.3 10 22.2 6—7 _______________ 2 2.3 9 20.0 8—9 _______________ __- _-_ 7 15.6 10—11 _______________ ___ ___ 7 15.6 >11 _______________ ___ ___ 9 20.0 Total _____________ 86 100.0 45 100.0 1The classroom didactic component includes such activities as lectures and self-instruction. Table 59.—NP programs, by length of clinical didactic component and type of program Length of clinical Type of program didactic component 1 Certificate Master's (in months) No. Pct. No. Pct. <1 _______________ 15 17.4 3 6.7 1—2 ________________ 49 57.0 4 8.9 3—4 ________________ 16 18.6 15 33.3 5-6 ________________ 3 3.5 5 11.1 7—8 ________________ 3 3.5 11 24.4 9—10 _______________ 2-- ___ 4 8.9 >10 ______________ ___ __- 3 6.7 Total _____________ 86 100.0 45 100.0 1The clinical didactic component includes relevant clinical observations and experiences and operates concurrently with the classroom didactic component. Table BIL—NP programs, by length of preceptorship and type of program Length of Type of program preceptorship 1 Certificate Master’s (in months) No. Pct. No. Pct. 1—2 ________________ 7 12.7 2 16.7 3—4 ________________ 15 27.3 8 66.7 5—6 ________________ 14 25.4 1 8.3 7—8 _________________ 10 182 1 8.3 9—10 _______________ 4 7.3 --_ ___ 11—12 _______________ 4 7.3 ___ ___ >12 ______________ 1 1.8 ___ ___ Total _____________ 55 100.0 12 100.0 1The internship or preceptorship portion is a specified period of supervised clinical prac- tice in patient assessment and management and is a requirement for completion of some programs. This is distinct from and follows the clinical experience offered concurrently with the didactic portion. There are 31 certificate and 33 master's programs which do not include a preceptorship, in which case this presentation related to internship/preceptorship did not apply. Table lib—NP programs. by length of preceptorship, specialty, and type of program Length of ' Specialty and type of program preceptorship 1 _ , _ _ _ _ _ . Total (in months) Pedlatnc MIdWIfery Matemlty Family Adult Psychiatric T—T’EE" Certificate 1—2 _____________ 3 __- 1 1 2 — 7 12.7 3—4 _____________ 9 ___ ___ 4 2 — 15 27.3 5—6 _____________ 5 ___ 2 5 2 —— 14 25.4 7—8 _____________ 5 ___ __- 4 1 — 10 18.2 9—10 ____________ 1 ___ ___ 1 2 — 4 7.3 11—12 ____________ 1 ___ -__ 1 2 — 4 7.3 >12 ___________ 1 ___ ___ ___ ___ — 1 1.8 Total __________ 25 ___ 3 16 11 — 55 100.0 Master’s 1—2 _____________ ___ ___ ___ 2 ___ ___ 2 16.7 3—4 _____________ 3 ___ 1 2 1 1 8 66.7 5—6 _____________ 1 ___ _-- ___ ___ ___ 1 8.3 7—8 _____________ ___ __- ___ 1 1-- ___ 1 8.3 9—10 ____________ ___ ___ ___ ___ ___ ___ ___ ___ 11—12 ____________ ___ ___ -__ ___ ___ ___ ___ ___ >12 ___________ ___ ___ ___ ___ ___ ___ ___ __- Total __________ 4 ___ 1 5 1 1 12 100.0 1The internship or preceptorship portion is a specified period of supervised clinical practice in patient assessment and management and is a require- ment for completion of some programs. This is distinct from and follows the clinical experience offered concurrently with the didactic portion. There are 31 certificate and 33 master's programs which do not include a preceptorship, in which this presentation related to internship/preceptorship did not apply. 09 III HELLJVHO STUDY FINDINGS: NP PROGRAMS 61 Figure 4.—Average length of certificate NP programs with and without preceptorship, by specialty Month 5 ‘2 E Preceplorshipl/ ‘Ciinicol DidacticJ m Classroom DidacticJ 0 Pediatric Midwifery Malernily Family Ad uit 1The internship or preceptorship portion is a specified period of supervised clinical prac- tice in patient assessment and management and is a requirement for completion of some programs. This is distinct from and follows the clinical experience offered con- currently with the didactic portion. There are 31 certificate and 33 master's programs which do not include a preceptorship. 2The didactic portion includes a classroom and a clinical component. The classroom com- ponent includes such activities as lectures and self instruction. The clinical component includes relevant clinical observations and experiences and operates concurrently with the classroom component. 62 CHAPTER III Figure 5.—Average length of master's NP programs with and without preceptorship. by specialty Months 18 I: Preceptorshipy V/A Clinical Didacticy m Classroom Didacticy 10 Pediatric Midwifery Maternity Family Adult Psychiatric l See footnote 1, figure 4. 9 See footnote 2, figure 4. STUDY FINDINGS: NP PROGRAMS 63 NP Programs—Continued Features of Curricula: Curriculum Content The variability in the duration of nurse practitioner preparation among programs must necessarily result in corresponding vari- ability in the amount of time spent in the teaching of various nurse practitioner functions. The next series of tables (62—71) illustrate this variation in a number of ways to permit comparisons among programs of the same type and programs of different types. The content areas are necessarily broad and may actually involve quite diiferent instructional specifics. Nevertheless, they appear to form the most useful basis for interprogram comparisons. Tables 62, 63 and 64 quantify in different ways the amount of attention NP pro- grams devote to the same series of functions, first, by presenting the range of months, second, the average number of months, and third, the average percent of time spent on these functions. The next series of tables (65-70) presents data in terms of three spe- cialty areas—infant and child health care, adult health care, and maternity care/family planning. In tables 65, 67, and 69, the func- tions NP programs prepare their students to perform are presented for specific patient characteristics. These three tables have com- panion tables (66, 68, and 70) which present the percent of physi- cian consultation students in each of the three specialty areas are expected to require. Each pair of tables presents the same variables. Table 71 presents a different set of functions and the percent of programs preparing students to perform those functions as well as the average percent of expected physician consultation when they are being performed. Table 62.—Range of months NP programs spend on specific functions within the didactic component,1 by specialty and type of program Type of program ’ and specialty Certificate Master's Function Pedi- Mid- . Pedi- Mid- . Psychi- atric wifery Maternal Family Adult atric wifery Maternal Family Adult atric Taking health and social history; performing physical examination __ .4—4.4 1.2—2.3 .7-1.6 .4-2.4 3—2.5 .9—5.2 1.5—5.0 9—3.0 1.5—5.0 3—7.1 .9— 7.1 Surveillance of essen- tially well individuals and management of care of the ill ______________ .2—2.4 .2—82 .7-1.8 .4—4.8 3—2.4 1.3—4.1 2.1—9.3 .0-4.1 1.8—4.4 1.7—5.3 1.2— 3.0 Teaching, counseling and support of patients/families ______ .2—2.4 1.2—2.2 .5—1.4 3-2.1 3—1.2 .6—4.0 1.6-4.0 3—4.0 .6—3.8 3—5.3 .9— 3.2 Planning, developing and implementing group educational programs ______________ .0— .6 .4—1.1 .0— .4 .0—1.0 .0— .8 .4—22 3—2.4 .4—1.8 3—2.9 3—23 .6- 2.0 Assessment of quality and effectiveness of nursing practice; use of demographic, social and health data regarding community and popu- lation groups to identify high-risk subgroups ____ .0—1.2 .4—1.0 .0— .4 .0—2.0 .0—12 5—2.6 5—2.5 .6-l.4 .4-4.9 .8—23 .8— 1.5 Other8 ________________ .0—1.5 .2—2.1 .1—1.6 .1—1.9 .0— .4 1.8—8.4 1.8—8.6 2.4—8.0 3—9.0 3—4.0 .3—12.0 1The didactic component is the formal portion of an NP program in which a specified curriculum is taught using lectures, self-instruction materials and concurrent relevant clinical observations and experiences. 2Two pediatric, one midwifery and one family certificate program did not supply infOrmation on specific functions. One maternity and one adult mas- ter's program did not supply information on specific functions. 30ther, for certificate programs, included role reorientation, understanding the legal aspects of extended roles, and developing cultural sensitivity; and for master's programs, research and scholarly efforts, teaching, supervision, and social, psychological, and philosophical issues. 179 III HELLJVHD Table Bit—Average number of months NP programs spend on specific functions within the didactic component, by specialty and type of program Type of program and specialty Certificate Master's Function Pedl- Mld- PedI- Mld- Maternity Family Adult . . Psychi- atric wifery Maternity Famlly Adult atric wifery atric Taking health and social his- tory; performing physical examination ___________________ 1.4 1.6 1.1 1.4 12 2.4 2.8 2.0 2.3 3.8 2.9 Surveillance of essentially well individuals and management of care of the ill ________________ 1.1 3.8 1.1 1.7 1.1 2.5 4.6 1.9 2.7 32 2.4 Teaching, counseling and support of patients/families -_ 1.0 1.5 .8 .9 .7 2.5 2.5 2.5 1.7 2.5 2.2 Planning, developing and implementing group educa- tional programs _______________ .2 .8 .2 .2 .3 1.1 1.6 1.2 1.1 1.3 1.3 Assessment of quality and effectiveness of nursing prac- tice; use of demographic, social and health data regarding community and population groups to identify high-risk subgroups _____________________ .3 .6 2 .4 .3 1.3 1.3 1.0 1.4 12 1.1 Other ’ ________________________ .4 .7 .6 .6 2 4.5 4.3 4.4 4.0 1.9 5.1 Total 3 _______________________ 4.4 9.0 4.0 5.2 3.8 14.3 17.1 13.0 13.2 13.9 15.0 lThe didactic component is the formal portion of an NP program in which a specfied curriculum is taught using lectures, self-instruction materials and concurrent relevant clinical observations and experiences. 2Other, for certificate programs, included role reorientation. understanding the legal aspects of extended roles, and developing cultural sensitivity; and for master’s programs, research and scholarly efforts, teaching, supervision, and social, psychological, and philosophical issues. 3Two pediatric, one midwifery and one family certificate program did not supply information on specific functions. One maternity and one adult mas- ter's program did not supply information on specific functions. SWVHDOHJ JN :SDNIGNIJ ACRES 99 Table 64.—Average percent of time NP programs spend on specific functions within the didactic component,1 by specialty and type of program as Type of program and specialty c» . Certificate Master’s Fundmn P d' M'd P d' M'd P h' afrig wiflery Maternity Family Adult afritlz- wit‘lery Maternity Family Adult Emel- Taking health and social history; performing physical examination __________________ 30.8 18.5 27.2 27.0 31.9 16.5 16.8 14.8 18.1 25.1 18.9 Surveillance of essentially well individuals and management of care of the ill _________________ 25.6 37.4 26.1 30.0 30.3 18.1 26.6 13.5 21.4 23.2 17.3 Teaching, counseling and a support of patients/families ___ 22.4 17.7 20.8 16.7 18.2 16.9 14.8 18.6 12.7 17.0 14.5 E Planning, developing and 3 implementing group educa- g tional programs _______________ 4.6 9.5 6.2 5.2 8.0 7.9 9.2 9.5 7.9 10.2 8.6 5 Assessment of quality and effectiveness of nursing prac- tice; use of demographic, social and health data regarding community and population groups to identify high-risk subgroups _____________________ 6.4 7.1 4.4 8.1 7.2 9.1 7.6 8.1 10.0 9.4 7.7 Other 2 ________________________ 10.2 9.8 15.3 13.0 4.4 31.5 25.0 35.5 29.9 15.1 33.0 Total 3 _______________________ 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 lThe didactic component is the formal portion of an NP program in which a specfied curriculum is taught using lectures. self-instruction materials and concurrent relevant clinical observations and experiences. aOther, for certificate programs, included role reorientation. understanding the legal aspects of extended roleS. and developing cultural sensitivity: and for master's programs, research and scholarly efforts, teaching, supervision, and social. psychological. and philosophical issues. 3Two pediatric, one midwifery and one family certificate program did not supply information on specific functions. One maternity and one adult mas- ter's program did not supply information on specific functions. Table 65.—Percent of NP programs preparing students in infant and child health care to perform selected functions for specific patient populations, by type of program Function and type of program1 Obtain or . Order lab Decide to Initiate Obtain or Perform Assume update . tests/other manage health . update physrcal . . . health care . soaal/ health histo exam diagnostic patient or maria ement teaching and family history ry procedures refer to MD g counseling Patient Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif— Mas- Certif- Mas- Certjf- Mas- population icate ter’s icate ter's icate ter’s icate ter's icate ter's icate ter's icate ter’s For essentially well infants and children- 98 97 98 97 88 75 94 84 — — — — 97 100 If potential problem is identified ________ — — 95 91 85 85 82 70 94 78 91 78 — —— For 1-year.o|d children with low- grade fever rhinorrhea __________ — — 89 69 89 69 85 61 88 64 86 70 — — For children with bronchial asthma (mild attack) _______ — — 91 70 91 70 77 61 75 64 52 53 — — Overall average _____ 98 97 93 82 91 75 87 69 86 69 76 67 97 100 1This presentation is based on the 66 certificate programs and 33 master's programs which prepare students in infant and child care. SWVHDOZIJ JN ZSDNIGNIJ LflfliLS L9 Table 66.—Average percent of physician consultation students prepared in infant and child health care are expected to require when performing selected functions for specific patient characteristics, by type of program Function and type of program 1 Obtain or . Order lab Decide to Initiate update Obtain or Perform tests/other manage Assume health . update physrcal . . . health care . social/ health histo exam diagnostic patient or mana ement teaching and family history ry procedures refer to MD g counseling Patient Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- characteristics icate ter's icate ter's icate ter's icate ter's icate ter's icate ter's icate ter's For essentially well infants and children- 9 4 10 4 16 15 16 5 — — 7 7 8 4 If potential problem is identified ________ — —— 17 13 21 25 34 27 42 29 36 29 — — For 1-year—old children with low- grade fever rhinorrhea __________ — — 10 5 12 12 20 14 21 18 18 6 — —- For children with bronchial asthma (mild attack) _______ — — 14 12 21 18 36 22 42 32 54 35 — -— Overall average _____ 9 4 13 8 17 17 26 17 35 26 29 19 8 4 1Sixty-six certificate programs and 33 master's programs prepare students in infant and child health care. However. all of these programs do not teach each of the functions listed. Some of the programs which do teach the functions listed could not estimate the amount of physician consultation. Other programs did not supply information on some functions. This presentation is therefore based on a different number of programs responding for each function. 89 III KEMVHO Table ISL—Percent of NP programs preparing students in adult health care to peI'fOI'm 88'9““ functions for SPECific patient populations, by type of program Function and type of program 1 Obtain or Obtain or Order lab Decide to Assume initiate update Perform tests/ manage health health ' update ' h t' t ar t ach'n Alte di t Alter (2) soclal/ health physrcal . ot er . pa Ien c e e I g r e dosage family history exam dlagnostlc or refer manage- and history procedures to MD ment counseling Certif- Mas- Certif— Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas~ Certif- Mas- icate ter's icate ter's icate ter's icate ter's icate ter's icate ter's icate ter's icate ter's icate ter's 1 ...... 100 100 100 100 98 80 97 87 —— — — — 100 100 —- — — — 2 ...... — -— 100 100 100 96 100 77 100 96 97 88 100 100 — — —— — 3 ...... —- — 100 96 100 96 100 74 100 91 100 87 — — — —— — —— 4 ...... — — 100 96 100 96 100 74 100 83 97 78 — -— —. __ _ _. 5 ...... — — 100 96 100 96 97 74 100 78 85 71 100 96 88 91 78 50 6 ...... — —— 97 96 97 96 97 70 94 70 83 68 97 96 84 87 78 48 7 ...... — — 100 96 100 95 100 83 100 87 81 54 100 96 84 65 78 43 8 ...... — — 100 96 100 96 100 83 100 87 74 52 —— — 84 74 75 52 9 ...... 100 100 100 97 99 96 99 78 99 85 88 71 99 98 85 79 77 48 lThis presentation is based on the 32 certificate and 24 master's programs which prepare students in adult health care. 2 Patient population: lzessentially well 6:5ymptomatic with hypertension 2:if potential problem identified 7:diabetic stabilized on insulin therapy 3:primary complaints of nasal congestion and rhinorrhea 8:0n oral hypoglycemic agents 4:primary complaint of chest pain 9:0verall average 5:.asymptomatic with hypertension SDNIGNIJ AGHLS SWWDOHJ dN 69 Table 68.—Average percent of physician consultation students prepared in adult health care are expected to require when performing selected functions for specific patient characteristics, by type of program Function and type of program 1 Obtain or Obtain or Order lab Decide to Assume Initiate update update Perform tests/ manage health health Alter social/ physical other patient care teaching Alter diet (2) f . health d' . f ‘ dosage amily history exam iagnostlc or re er manage and history procedures to MD ment counseling Certif- Mas- Certif- Mas‘ Certif- Mas- Certif- Mas— Certif- Mas- Certif- Mas- Certifv Mas- Certif- Mas- Certif- Mas- icate ter's icate ter's icate ter's icate ter’s icate ter’s icate ter's icate ter's icate ter's icate ter's 1 ...... 6 4 6 3 14 7 6 3 — — — —— 8 3 — — — .— 2 ...... — —— 6 20 16 8 17 21 23 24 23 19 8 9 — -——- — —- 3 ..... — — 6 8 9 3 7 11 9 11 13 20 -— -— __ __ _ _ 4 llllll — — 13 10 22 8 27 27 48 38 16 21 —— —— __ _ _ _ 5 ...... — — 8 6 12 6 14 23 39 35 38 33 11 11 11 25 50 37 6 ...... -—— -— 14 10 15 11 29 23 47 41 44 41 16 13 9 40 55 46 7 ...... — -— 8 4 10 8 16 18 37 15 38 26 9 10 21 17 55 34 8 ...... — — 8 4 11 6 13 14 32 18 49 41 — -— 13 23 53 35 9 ,,,,,, 6 4 8 8 14 7 16 13 34 26 32 29 10 9 14 26 53 38 1Thirty-two certificate programs and 24 master’s programs prepare students in adult health care. However, all of these programs do not teach each of the functions listed. Some of the programs which do teach the function could not estimate the amount of physician consultation. Other programs did not supply information on some functions. 2 Patient population: 1=essentially well 6:‘symptomatic with hypertension 2:if potential problem identified 7:diabetic stabilized on insulin therapy 3:primary complaints of nasal congestion and rhinorrhea 8:on oral hypoglycemic agents 4:primary complaint of chest pain 9:0verall average 5:asymptomatic with hypertension 01. III. HEMVHD Table 69.—Percent of NP programs preparing students in maternity care/family planning to perform selected functions for specific patient populations. by type of program Function and type of program 1 Obtain or . 4 Order lab . . Decide to Assume Place update Obtain or Perform Perform work at Initiate manage health patient I rt social/ update physical pelvic the health patient or care on oral nse (2) . health . teachlng & IUD family history exam exam appropnate counseling refer to manage- contra- history intervals MD ment ceptives Certif- Mas- Certif- Mas- Certif~ Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas’ icate ter's icate ter’s icate ter's icate ter's icate ter's icate ter's icate ter's icate ter's icate ter's icate ter’s 1 . 79 96 79 96 65 84 54 67 7O 81 85 96 ~—- — —- — — — — —- 2 . — — — ~ 72 92 54 69 — — — — — ——- -— — — — —— — 3 . — — —— — 64 81 56 65 — -— -— — — — —— — — — — -— 4 _ — — —- — 56 77 49 65 — — — —— —— — — — —- — — — 5 . — —— — — 67 85 59 69 —- — — — —- —- — -- — — — — 6 . — —- —— — — — — — —- — — — 74 92 74 88 — -- — — 7 . — — — — — — — — -— —- —— — 54 69 26 50 — — —- — 8 ..97 100 95 100 87 85 90 85 — — 97 96 —— — — — 77 73 41 35 9 .88 98 87 98 76 84 72 76 70 81 91 96 64 81 50 69 77 73 41 35 1This presentation is based on the 40 certificate programs and 26 master's 2 Patient population: programs which prepare students in maternity care/family planning. 1 : maternity 2 : maternity, 3 = maternity, 4 = maternity. 5 = maternity, initial examination second trimester third trimester postpartum 6=symptomatic complaints 7:severe symptomatic complaints Bzfamily planning service 9:0verall average SDNIGNIJ AGILLS SWVHDOIM JN IL Table TIL—Average percent of physician consultation students prepared in maternity care/family planning are expected to require when performing functions for specific patient characteristics, by type of program Function and type of program 1 Obtain or Obtain or Order lab Initiate Decide to Assume Place update update Perform Perform work at health manage health patient Insert (2) social/ health physical pelvic the teaching patient or care on oral lUD family . exam exam appropriate and refer to manage- contra- , history . . . history intervals counseling MD ment ceptnves Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas‘ Certif- Ws- Certif- Mas- Certif- Mas- Certif- Mas- Certif- Mas- icate ter's icate ter's icate ter's icate ter’s icate ter's icate ter's icate ter's icate ter's icate ter's icate ter's 1 . . 16 6 18 6 23 17 23 23 22 14 18 3 — —-—- ._ _. _ _ _. _ 2 ,.— — — —- 19 26 34 32 — —- — — — — — — — — — .— 3 ,,—— — — — 24 15 20 15 —— — — — — — — — — — — .— 4 ,.—— —— — — 29 13 2O 19 -— — — — —— — — — — — — .— 5 ,.—- — — — 21 15 19 25 — — — — —— — -—— — -— — —— — 6 ..—— — — — — —— — — — — — — 26 20 29 21 —- — — _ 7 ..—— —- — — — — — — — -- —- — 66 56 63 50 — — — .— 8 ..13 5 13 6 11 12 21 15 — -— 13 4 — — — — 34 21 27 25 9 .,14 5 15 6 17 14 22 19 22 14 15 3 46 38 46 36 34 21 27 25 lForty certificate programs and 26 master's programs prepare students in maternity care/family planning. However, all of these programs do not teach each of the functions listed. Some of the programs which do teach the function listed could not estimate the amount of physician consultation. Other programs did not supply information on some functions. This presentation is therefore based on a different number of programs responding for each function. 2 Patient population: 1 :maternity ' 6:symptomatic complaints szaternity, initial examination 7=severe symptomatic complaints 3:maternity, second trimester 8:family planning service 4:maternity, third trimester 9:0verall average 5 : maternity, postpartum ZL III. HHJKIVHO Table 11.—Percent of NP programs preparing students'to perform specific functions and average percent of expected physician consultation, by type of program Type of program F . Percent preparing students Average percent of expected unctlon . . . . . . for specrflc functions 1 phySICIan consultation 1 Certificate Master’s Certificate Master’s Immunizations 94 69 7 7 Place patient on oral contraceptives __________________________ 77 73 34 21 Insert IUD __ 41 35 27 25 Apply sutures 45 17 38 33 Alter dosage of antihypertensive drugs ________________________ 78 49 52 42 Add/delete antihypertensive drugs ____________________________ 75 44 65 48 Alter insulin dosage for diabetes patients _____________________ 78 43 55 34 Change from oral drugs to insulin _____________________________ 52 30 82 64 Decide to manage patient or refer to MD. _ ____________________ 83 78 38 30 SWV‘H‘DOHJ JN ZSDNIGNIJ moms 1 Percents are based on the number of programs which prepare students to perform the specific function. 8L 74 CHAPTER 111 NP Students Characteristics The number, and personal and professional characteristics of the nurse practitioner students constituting the study cohort are pre- sented in the following tables (72-78). These students will be fol- lowed at intervals through their employment experience and subse- quent phases of the study and the information obtained will be re- lated both to these student characteristics and the variables of the programs in which they were prepared. Tables 72—75 present dis- tributions of NP students by specialty, type of program, demo- graphic characteristics, ethnicity, and professional characteristics. Shown in tables 7 6—7 8 are the average number of years NP students have spent in professional nursing, the number of years in the job just prior to entering an NP program, and previous employment setting. Table 72.—NP students, by specialty and type of program Type of program Specialty Certificate Master’s Total No. Pct. No. Pct. No. Pct. Pediatric ________ 351 44.2 30 9.8 381 34.6 Midwifery _______ 26 3.3 54 17.6 80 7.3 Maternity ________ 60 7.6 30 9.8 90 8.2 Family __________ 185 23.2 100 32.6 285 25.8 Adult ____________ 172 21.7 66 21.4 238 21.6 Psychiatric ______ — — 27 8 8 27 2 5 Total __________ 794 100.0 307 100.0 1,101 100.0 STUDY FINDINGS: NP STUDENTS Table 73.—-NP students, by selected demographic characteristics and type of program 75 Type of program Dhemogtrapllic Certificate Master’s Total c arac ens w No. Pct. No. Pct. No. Pct. Sex Male _____________ 16 2.0 6 2.0 22 2.0 Female ___________ 778 98.0 301 98.0 1,079 98.0 Total ___________ 794 100.0 307 100.0 1.101 100.0 Race White ____________ 695 88.4 286 93.8 981 89.9 Black ____________ 65 8.3 10 33 75 6.9 Other ‘ ___________ 26 3.3 9 2.9 35 3.2 Total ’ __________ 786 100.0 305 100.0 1,091 100.0 Marital Status Unmarried ________ 337 43.0 148 49.2 485 44.7 Married __________ 446 57.0 153 50.8 599 55.3 Total 3 __________ 783 100.0 301 100.0 1,084 100.0 Age (in years) <25 ____________ 29 4.0 4 1.5 33 3.3 25—34 ____________ 355 49.5 174 63.7 529 53.4 35-44 ____________ 176 24.5 83 30.4 259 262 45—54 ____________ 128 17.8 11 4.0 139 14.0 >54 ______________ 30 4.2 1 .4 31 3.1 Total ‘ __________ 718 100.0 273 100.0 991 100.0 Average ________ 362 32.5 35.2 Median _________ 33 31 33 1Other includes oriental, American Indian. Mexican American, American. 9 Eight certificate and two master's students did not supply information on race. aEleven certificate and six master's students did not supply information on marital status. ISeventy-six certificate and thirty-four master's students did not supply information on age. Puerto Rican, and Latin 76 CHAPTER m Table 74.—NP students, by ethnic self-description, specialty. and type of program Specialty and type of program Ethnic self- Pedi- Mid- Mater— . Psychi- 1 description atric wifery nity Family Adult atric Total Certificate Caucasian ___________ 303 19 53 169 151 —- 695 Black American ______ 31 6 6 9 13 — 65 Oriental ______________ 7 ___ 1 2 2 — 12 American lndian _____ 1 ___ ___ 1 ___ — 2 Mexican American ___ 3 ___ __- 2 3 — 8 Puerto Rican ________ ___ ___ ___ 1 ___ — 1 Latin American ______ 2 __- -__ __- 1 — 3 Total ______________ 347 25 60 184 170 — 786 Master’s Caucasian ___________ 30 50 28 93 61 24 286 Black American ______ ___ 3 2 4 ___ 1 10 Oriental ______________ -__ 1 ___ ___ 5 1 7 American Indian _____ ___ ___ ___ 1 ___ ___ 1 Mexican American ___ ___ ___ ___ 1 ___ --_ 1 Puerto Rican ________ _-_ ___ __- ___ ___ ___ ___ Latin American ______ ___ ___ -__ ___ -__ ___ _-_ Total ______________ 30 54 30 99 66 26 305 Total Caucasian ___________ 333 69 81 262 212 24 981 Black American ______ 31 9 8 13 13 1 75 Oriental ______________ 7 1 1 2 7 1 19 American Indian _____ 1 ___ ___ 2 ___ ___ 3 Mexican American ___ 3 ___ ___ 3 3 ___ 9 Puerto Rican ________ ___ -_- _-_ 1 ___ ___ 1 Latin American ______ 2 ___ ___ ___ 1 ___ 3 Total ______________ 377 79 90 283 236 26 1,091 1Eight certificate and two master's students did not supply information on ethnic self- description. STUDY FINDINGS: NP STUDENTS 77 Table 75.—NP students, by selected professional characteristics and type of program Type of program Professronal Certificate Master's Total characteristlcs No. Pct. No. Pct. No. Pct. ANA membership Member ___________________ 309 39.1 189 61.8 498 45.4 Nonmember _______________ 481 60.9 117 38.2 598 54.6 Total 1 __________________ 790 100.0 306 100.0 1,096 100.0 Years in professional nursing 0 _______________________ 23 2.9 4 1.3 27 2.5 1—5 ______________________ 233 29.7 159 ' 51.8 392 35.9 6—10 _____________________ 228 29.1 72 23.4 300 27.5 11—15 _____________________ 118 15.1 48 15.6 166 15.2 16-20 ______________________ 96 12.2 18 5.9 114 10.5 >20 _____________________ 86 11.0 6 2.0 92 8.4 Total 2 ___________________ 784 100.0 307 100.0 1,091 100.0 Average _________________ 10.3 7.0 9.4 Median __________________ 8 5 7 Prior nursing preparation Hospital diploma __________ 370 46.7 11 3.6 381 34.7 Associate degree __________ 70 8.8 2 .6 72 6.5 Baccalaureate degree _____ 299 37.7 287 93.8 586 53.3 Master's degree ___________ 54 6.8 6 2.0 60 5.5 Total 3 ___________________ 793 100.0 306 100.0 1,099 100.0 Previous employment setting‘ Hospital outpatient service- 92 12.0 19 6.3 111 10.4 Hospital inpatient service -_ 215 28.0 172 57.1 387 36.2 Health center _____________ 133 17.3 16 5.3 149 13.9 Extended care facility _____ 16 2.1 2 7 18 17 Fee-for-service physician __ 54 7.0 1 3 55 52 Prepaid group practice ____ 12 1.6 ___ 12 11 Community/home health agency __________________ 148 19.3 40 13.3 188 17.6 School ____________________ 53 6.9 8 2.7 61 5.7 Teaching __________________ 25 3.2 35 11.6 60 5.6 Other5 ____________________ 20 2.6 8 2.7 28 2.6 Total ° ___________________ 768 100.0 301 100.0 1,069 100.0 1Four certificate and one master’s student did not supply information on ANA member- ship. 5Ten certificate students did not supply information on the number of years in profes- sional nursing. aOne certificate and one master's student did not supply information on prior nursing preparation. ‘Twenty-three certificate and four master's students had not been previously employed. “Other includes settings within State and Federal agencies, including the armed services, inservice education, and social agencies, as well as combined inpatient/outpatient settings. °Three certificate and two master’s students did not supply information on previous em- ployment setting. 78 CHAPTER III Table 76.—Average number of years NP students have spent in professional nursing, by specialty and type of program Type of program Certificate 1 Master's Specialty Number of Years in Number of Years in students professional students professional nursing nursing Pediatric ________ 344 9.6 30 4.6 Midwifery _______ 26 10.5 54 6.7 Maternity _______ 60 8.3 30 5.8 Family __________ 185 9.8 100 7.3 Adult ____________ 169 12.9 66 9.3 Psychiatric ______ — —— 27 4.6 Total ___________ 784 10.3 307 7.0 1Ten certificate students did not supply information on the number of years in professional nursing. Table 71.—NP students, by number of years in job just prior to entering NP program, and type of program Number of years in Type of program job just prior to Certificate Master’s Total entering NP program No. Pct. No. Pct. No. Pct. <2 ______________ 179 23.7 107 36.4 286 272 2 ______________ 190 25.2 94 32.0 284 27.0 3—5 _____________ 182 24.1 53 18.0 235 22.4 6—10 ____________ 125 16.5 29 9.9 154 14.7 11—15 ____________ 57 7.5 9 3.0 66 6.3 16—20 ____________ 13 1.7 2 .7 15 1.4 >20 _____________ 10 1.3 —— — 10 1.0 Total 1 __________ 756 100.0 294 100.0 1,050 100.0 Average ________ 4.5 3.0 4.1 Median, _________ 3 2 2 1Twenty-eight certificate and nine master's students were not employed just prior to enter- ing an NP program. Ten certificate and four master's students did not supply information on the number of years in job just prior to entering NP program. Table 78.—Percent of NP students, by previous employment setting. specialty, and type of program Specialty and type of program PreVIous employment settmg‘ Pediatric Midwifery Maternity Family Adult Psychiatric Pct Total No Certificate Hospital outpatient service __________________ 11 4 7 12 18 — 12 92 Hospital inpatient service __________________ 25 61 31 35 21 —- 28 215 Health center ______________________________ 9 8 19 18 33 — 17 133 Extended care facility ______________________ 1 __- 3 1 6 — 2 16 Fee-for-service physician practice __________ 6 ___ 5 10 6 — 7 54 Prepaid group practice _____________________ 1 ___ 2 3 1 — 2 12 Community/home health agency ____________ 26 1 31 14 8 — 19 148 School 15 ___ -__ 1 1 — 7 53 Teaching 4 8 ___ 2 4 — 3 25 Other’ 2 8 2 4 2 -— 3 20 Total percent _____________________________ 100 100 100 100 100 — 100 Total number3 ___________________________ 332 26 58 181 171 — 768 Master's Hospital outpatient service _________________ 7 2 14 11 ___ 8 6 19 Hospital inpatient service __________________ 77 59 45 40 71 72 57 172 Health center ______________________________ 3 4 7 6 5 8 6 16 Extended care facility ______________________ 3 ___ ___ 1 __- ___ l 2 Fee-for-service physician practice ___________ ___ ___ __- 1 ___ ___ 3 1 Prepaid group practice _____________________ ___ ___ ___ ___ ___ ___ ___ ___ Community/home health agency ____________ ___ 21 10 25 1 4 13 40 School 7 ___ ___ 3 3 4 3 8 Teaching __- 3 7 24 10 19 4 12 35 Other 2 ______ ___ 7 ___ 3 1 __- 3 8 Total percent _____________________________ 100 100 100 100 100 100 100 Total number3 ___________________________ 30 53 29 97 66 26 301 1Twenty-three certificate and four master's students had not been previously employed. 2Other includes settings within State and Federal agencies, including the armed services, inservice education. and social agencies, as well as combined inpatient/outpatient settings. aThree certificate and two master's students did not supply information on their previous employment settings. smnaanms JNI :somanm Adams 6].. 80 CHAPTER 11] NP Students—Continued Financial Problems and Sources of Support The financial needs and suppport of students in educational pro- grams are matters of continuing importance. Table 79 presents a distribution of students with financial problems by years in profes- sional nursing, and table 80 presents a distribution of students with financial problems by source of support. Table 19.—NP students with financial problems, by years in professional nursing and type of program Type of program Certificate Master’s Total Years in Students with Students with Students with professional No. of financial No. of financial No. of financial nursing students problems students problems students problems 0 ________________ 23 5 21.7 4 2 50.0 27 7 25.9 1—5 _______________ 232 81 34.9 157 61 38.9 389 142 36.5 6—10 _______________ 228 73 32.0 72 30 41.7 300 103 34.3 11—15 _______________ 118 29 24.6 47 28 59.6 165 57 34.5 16—20 _______________ 96 24 25.0 18 12 66.7 114 36 31.6 >20 _______________ 85 24 28.2 6 6 100.0 91 30 33.0 Total 1 ____________ 782 236 30.2 304 139 45.7 1,086 375 34.5 1Ten certificate students did not supply information on the number of years in professional nursing. Three of these 10 students reported financial prob- lems. Two additional certificate students did not supply information on financial problems. Three master's students did not supply information on financial problems. someones JN SSDNIGNIJ AGDLS IS 82 CHAPTER m Table 80.—NP students with financial problems,1 by source of support and type of program Type of program Source of support Certificate Master's Total No. Pct. No. Pct. No. Pct. Stipend _______________ 60 25.1 5 3.6 65 17.2 Traineeship ____________ 3 1.3 42 30.2 45 11.9 Employer financial support _____________ 33 13.8 2 1.5 35 9.2 Loan __________________ 17 7.1 16 11.5 33 8.8 Wages for work related to NP training _______ 17 7.1 ___ -.__ 17 4.5 Scholarship ___________ 8 3.3 1 .7 9 2.4 GI bill ________________ 4 1.7 ___ ___ 4 1.0 Combination 2 _________ 43 18.0 47 33.8 90 23.8 Other 3 ________________ 54 22.6 26 18.7 80 21.2 Total ‘ _______________ 239 100.0 139 100.0 378 100.0 1Those students who reported having financial problems caused by participation in NP programs are the basis for this presentation. 2 Combination includes two or more of the sources listed above. 3 Other includes family support and part-time employment. ‘Two certificate and three master's students did not supply information on financial problems. STUDY FINDINGS: NP STUDENTS 83 NP Students—Continued Factors Influencing Students to Enter NP Programs The factors motivating nurses to modify career goals by enter- ing NP programs are presented in tables 81, 82, and 83. Table 81 shows a distribution of the students by the factor which they cited as most important in influencing them to become NPs. Table 82 presents essentially the same series of factors by previous employ- ment setting. Table 83 is a distribtuion of the NP students by the factor they cited as most important in influencing them to attend a particular program. 84 CHAPTER 111 Table 81.——NP students by the most important factor influencing them to become NPs, by type of program Type of program Factor Certificate Master’s No. Pct. No. Pct. Greater influence on patient care -__ 235 30.7 82 27.4 Additional learning opportunities ___ 199 26.0 72 24.0 Challenge of the work ______________ 163 21.3 , 38 12.7 Frustration of former work _________ 53 7.0 31 10.4 More independence ________________ 30 3.9 34 11.4 More responsibility ________________ 30 3.9 12 4.0 Collaboration with physicians _____ 7 .9 2 .7 Salary increase ____________________ 5 .6 5 1.7 Increased status ___________________ 2 .3 5 1.7 Other 1 _____________________________ 41 5.4 18 6.0 Total 2 ___________________________ 765 100.0 299 100.0 10ther includes to provide better patient care, for personal benefits such as time and pay, to prepare for a specific job, and because it was recommended by someone else. 2Twenty-nine certificate and eight master’s students did not supply sufficient information on factors influencing them to become NPs to be included in this distribution. Table 82.—Percent of NPs citing the most important factor in influencing them to become NPs, by previous employment setting and type of program Previous employment setting and type of program HOSpital Hospital Extended Fee-for- Prepaid mifi'iltly/ Factor p333: pa't'alm 5:32? f ear? p323; WP Mme Schw' "'22:" We" W service service acrlltres practice practice health agency Certificate Greater influence on patient care ___ 35 28 23 38 28 25 37 37 38 32 31 Additional learning opportunity ___- 21 19 32 12 26 17 37 21 46 10 26 Challenge of the work ______________ 26 27 20 12 17 25 15 18 4 32 21 More independence ________________ 6 5 3 ___ 4 ___ 1 2 4 11 4 More responsibility ________________ 2 4 4 ___ 15 ___ 2 6 ___ 5 4 Salary increase ____________________ ___ 1 1 __- 2 ___ __- 2 ___ ___ 1 Frustration of former work _________ 5 10 7 19 2 25 3 10 ___ ‘ 5 7 Other2 _____________________________ 5 6 10 19 6 8 5 4 8 5 6 Total percent ____________________ 100 100 100 100 100 100 100 100 100 100 100 Total number8 ___________________ 88 208 124 15 53 12 145 51 24 19 740 Master's Greater influence on patient care __- 22 29 40 __- ___ ___ 20 38 18 38 27 Additional learning opportunity ___- 17 21 13 50 ___ ~__ 28 37 46 12 24 Challenge of the work ______________ 6 11 20 _-_ ,__ ___ 28 M- 12 -__ 13 More independence ________________ 11 12 7 1-- ___ ___ 3 25 12 25 11 More responsibility ________________ 22 4 ___ ___ ___ ___ 3 ___ -__ 12 4 Salary increase ___________________ _ -_- 3 ___ __- _-_ ___ -__ ___ ___ ___ 2 Frustration of former work _________ 22 9 7 ___ -__ ___ 18 ___ 9 13 11 Other2 _____________________________ ___ 11 13 50 100 ___ e__ ___ 3 ___ 8 Total percent ____________________ 100 100 100 100 100 ___ 100 100 100 100 100 Total number‘ ___________________ 18 169 15 2 1 ___ 39 8 33 8 293 1Other (employment settings) includes settings within State and Federal agencies, including the armed services. inservice education, and social agencies. as well as combined inpatient/outpatient settings. 2Other (factors) includes to provide better patient care, for personal benefits such as time and pay, to prepare for a specific job, because it was recom- mended by someone else. to collaborate with physicians, and increased status. 3Twenty-three certificate and four master's students had not been previously employed. Thirty-one certificate and ten master's students did not supply sufficient information on factors influencing them to become NPs or previous employment setting or both to be included in this distribution. SLNHGfl-LS JN :SDNIGNIJ AGHLS 98 86 CHAPTER In Table ill—NP students by the most important factor influencing them to attend a particular program, by type of program Type of program Factor Certificate Master’s No. Pct. No. Pct. Clinical specialty offered __________ 232 29.8 108 35.8 Location of program _______________ 212 27.3 97 32.1 Availability of financial support ____ 72 9.3 20 6.6 institution in which located ________ 69 8.9 12 4.0 Quality of clinical facilities ________ 29 3.7 9 3.0 Placed by employer ________________ 29 3.7 1 .3 Schedule of program _______________ 27 3.5 3 1.0 Length of program _________________ 23 3.0 15 5.0 Wanted this type of clinically oriented program ________________ 16 2.0 10 3.3 Cost of program ___________________ 10 1.3 5 1.7 Nursing faculty _____________________ 9 1.2 8 2.6 Medical faculty ____________________ 6 .8 1 .3 Other 1 _____________________________ 43 5.5 13 4.3 Total 2 ____________________________ 777 100.0 302 100.0 1Other includes general appeal of the program, continuing education offered, opportunity to become a more attractive job candidate, to legitimize current practice, and factors such as convenience and eligibility for admission. 2Seventeen certificate and five master's students did not supply sufficient information on factors influencing choice of a particular program to be included in this distribution. STUDY FINDINGS: NP STUDENTS 87 NP Students—Continued Professional Expectations The reported expectations of the students prior to graduation are presented in tables 84—91 and figures 6—9. Of particular interest are the data relating to anticipated salaries and the students’ in- terpretation of various aspects of their previous employment and anticipated role. Table 84 presents a distribution of students by whether they have knowledge of their future employment; table 85 shows NP students’ anticipated employment setting by previous setting; and table 86 is is concerned with anticipated patient popu- lation. Table 87 is a presentation of NP students by approximate, annual salary just prior to entering the NP program. Figures 6 and 7 show distributions of certificate and master’s NP students by anticipated salary. Table 88 presents data on prior salary by anticipated salary change. Table 89 shows the average, annual, ex- pected increase in salary by specialty and table 90 by prior nursing preparation. Finally, table 91 reveals the average response of stu- dents to a series of eight job characteristics in terms of attainment and aspiration in prior nursing position, importance to» the student and expectation in the NP role. Figures 8 and 9 are graphic illus- trations of students’ job dissatisfaction and expected improvement by previous nursing education. 88 CHAPTER m Table 84.—NP students, by whether or not they have knowledge of future employment,1 specialty, and type of program Future employment and type of program Specialty Known Unknown Total No. Pct. No. Pct. No. Pct. Certificate Pediatric ___________ 91 62.8 54 37.2 145 100.0 Midwifery __________ 16 61.5 10 38.5 26 100.0 Maternity ___________ 13 50.0 13 50.0 26 100.0 Family _____________ 77 73.3 28 26.7 105 100.0 Adult ______________ ___ ___ ___ ___ ___ ___ Total _____________ 197 65.2 105 34.8 302 100.0 Master’s Pediatric ___________ 18 60.0 12 40.0 30 100.0 Midwifery __________ 33 62.3 20 37.7 53 100.0 Maternity ___________ 18 60.0 12 40.0 30 100.0 Family _____________ 44 44.0 56 56.0 100 100.0 Adult ______________ 41 62.1 25 37.9 66 100.0 Psychiatric _________ 15 55.6 12 44.4 27 100.0 Total 2 ____________ 169 55.2 137 44.8 306 100.0 1Those programs which do not require guaranteed employment are the basis for this we sentation. Thirty-four certificate and all 45 master's programs do not require guaranteed em- ployment. aOne master’s midwifery student did not supply information on whether she had knowl- edge of future employment. Table ass—Percent of NP students, by anticipated employment setting, previous setting. and type of program Com- Anticipated setting and type of program - Ex- Fee-for- . . Practi- Prevrous Out- In- . Prepaid munrty/ . . employment patient patient Health tended :erylce group home School hanger Uni- Other1 " setting only only center fat? p ysrclan practice health t al. versrty PCt' No. acrllty practice agency eac ing Certificate Hospital out- patient service_ 74 -_- 10 ___ 5 2 5 ___ ___ 2 2 100 89 Hospital in- patient service- 23 15 23 2 20 3 7 __- 1 l 5 100 209 Health center ___- 3 1 84 2 3 1 2 ___ 2 ___ 2 100 133 Extended care facility ________ ___ ___ 20 53 27 __- ___ ___ ___ ___ _~_ 100 15 Fee-for—service physician practice _______ ___ _-_ 6 ___ 83 6 3 _-_ 2-- __- 2 100 54 Prepaid group ‘ practice _______ 8 ___ __ ___ 17 75 ___ ___ ___ -__ ___ 100 12 Community/home health agency __ 5 _-_ 10 1 6 1 75 ___ ___ ___ 2 100 148 School __________ 4 -__ 2 ___ 7 ___ 2 79 ___ 2 4 100 53 Teaching ________ 16 _-_ 12 ___ 16 4 4 ___ 20 16 12 100 25 Other 2 __________ 35 -2- 10 ___ 10 5 5 ___ ___ ___ 35 100 20 Total 5 _________ 19 4 26 2 16 3 18 6 1 1 4 100 758 SLNEIGIILS (IN ZSDNIGNIJ Adams 68 Table Iii—Percent of NP students, by anticipated employment setting, previous setting, and type of program—Continued Anticipated setting and type of program Com- . ‘ Ex- Fee-for- . . Practi- Prevrous Out- 'F' Health tended service Prepaid munity/ tioner Uni- , Total employment patient patient . . group home School . Other ___—— . center care physrcran . and versuty Pct. No. setting only only f . . . practice health . acnlity practice teaching agency Master’s Hospital out- patient service- 27 5 27 --- 16 __- 5 1-- 10 5 5 100 19 Hospital in- patient service- 9 25 15 1 8 1 4 1 5 24 7 100 168 Health center ____ 13 7 46 13 7 __- 7 ___ -__ ___ 7 100 15 Extended care facility ________ ___ _c_ __- ___ 100 ___ -_- ___ ___ ___ ___ 100 1 Fee-for-service physician practice _______ __, ___ -1- ___ _,- H- 100 ___ ___ ___ N- 100 1 Prepaid group practice _______ ___ ___ ___ __e ___ ___ ___ ___ ___ ___ ___ _-- ___ Community/home health agency __ 8 10 16 3 10 5 31 3 3 5 6 100 38 School __________ 17 17 17 ..__ ___ ___ ___ 17 ___ ___ 32 100 6 Teaching ________ 3 14 12 __- 3 3 3 __- 12 50 ___ 100 34 Other2 __________ ___ 17 ___ ___ 17 ___ 17 ___ 17 ___ 33 100 6 Total 3 _________ 10 19 17 1 9 1 8 1 6 21 7 100 288 1Other (anticipated setting) includes settings within military, foreign, State. and Federal agencies, inservice education, fee-for-service private NP prac- tice. and special interest groups, as well as combined inpatient/outpatient settings. 20ther (previous employment) includes settings within State and Federal agencies, including the armed services, inservice education. and social agencies, as well as combined inpatient/outpatient settings. aTwenty-three certificate and four master's students had not been previously employed. Ten certificate students did not supply information on previous setting. Thirteen master's students did not supply information on anticipated setting, and two did not supply information on previous setting. 06 III HHMVHO STUDY FINDINGS: NP STUDENTS 91 Table 86,—Percent of NP students, by anticipated patient population, specialty, and type of program Anticipated patient population and type of program Inner . . Rural 1 Total SpeCIalty gr"? only Both Other W y Certificate Pediatric ___________ 56.2 22.6 15.1 6.0 100.0 345 Midwifery ___________ 53.8 19.2 19.2 7.7 100.0 26 Maternity __________ 43.3 23.3 25.0 8.3 100.0 60 Family _____________ 33.0 42.9 ‘ 18.1 6.0 100.0 182 Adult ______________ 49.4 22.0 12.2 16.4 100.0 154 Total ' ____________ 48.3 27.1 16.1 8.5 100.0 777 Master’s Pediatric ___________ 69.0 10.4 3.4 17.2 100.0 29 Midwifery __________ 63.5 11.5 15.4 9.6 100.0 52 Maternity __________ 65.5 20.7 3.5 10.3 100.0 29 Family _____________ 53.1 26.5 10.2 10.2 100.0 98 Adult ______________ 53.1 15.6 23.5 7.8 100.0 64 Psychiatric _________ 70.4 7.4 18.5 3.7 100.0 27 Total ' ____________ 59.2 17.7 13.4 9.7 100.0 299 1Other includes populations such as those in the military, suburban settings, nursing home for retired nuns, technical institute, school for deaf students. lSeventeen certificate and eight master's students did not supply information on antic- lpated patient population. Table Ill—NP students, by approximate, annual salary just prior to entering NP program and type of program Previous annual TYPe 0f program salary (in thousands Certificate Master's of dollars) No. Pct. No. Pct. <6 _______________ 10 1.4 5 1.7 6—10 _______________ 413 57.6 187 68.9 * 11—15 _______________ 266 37.1 75 26.2 E16 _______________ 28 3.9 9 3.2 Total 1 2 ___________ 717 100.0 286 100.0 1The 77 certificate and 21 master’s students are missing from this distribution either be- cause they were not previously employed, were not employed just prior to entering an NP program, were employed in atypical situations such as a foreign country, religious order, volunteer work, or did not supply information on previous salary. "The median previous annual salary for certificate students was $10,105 and for master’s students $9,845. CHAPTER III 92 Figure 6.—NP certificate students, by anticipated salary as an NP ,000 Increase d .w 1|. C e P S n U Increase Dec rea se 2 999 lncrea se $4 3 $2 . ¢ ¢ ¢ ¢¢¢¢¢¢¢¢¢ ¢¢¢¢o¢¢¢¢ .«......................... ceccetoo c t c cc. ‘ ‘ ‘ ‘ “OC . ,éwfifiooofie ‘ ‘G‘ <$2,000 Increase No Change Figure 7.——NP master’s students, by anticipated salary as an NP 000 Increase Unspecified Increase I Decrease 1.1% Z$4 \ “““ “ “ rafipamfiap? .. i / //// $26,999 Increa se < $2,000 Increase No Change Table BIL—Percent of NP students, by anticipated salary change, previous annual salary, and type of program Anticipated salary change and type of program PreVIous annual Increase (in thousands of dollars) salary1 2 f No Un Total 3 (in thousands o ' U k M douars) Decrease change .-\<2 2—3 a4 specified n "0w" Pct. No. amount Certificate <6 _______________________ -__ ___ 11.1 11.1 22.2 ___ 55.6 100.0 9 6—10 ,,,,,,,,,,,,,,,,,,,,,,,,,,, 0.5 19.8 18.6 19.4 11.6 4.4 25.7 100.0 413 11—15 ________________________ 5.7 35.4 19.0 10.6 1.9 3.8 23.6 100.0 263 516 ,,,,,,,,,,,,,,,,,,,,,,,,, 72 71.4 10.7 -__ ___ W- 10.7 100.0 28 Total ______________________ 2.7 27.3 18.4 15.3 7.7 3.9 24.7 100.0 713 Master's <6 - ______________________ _-_ ___ -__ ___ 33.3 66.7 ___ 100.0 3 6—10 _______________________ ___ 3.1 10.2 33.8 38.5 . 2.6 11.8 100.0 195 11—15 ______________________ 2.7 13.3 12.0 32.0 13.3 4.0 22.7 100.0 75 216 ________________________ 11.1 55.6 ___ 11.1 ___ ___ 22.2 100.0 9 Total _____________________ 1.1 7.4 10.3 32.3 30.5 3.5 14.9 100.0 282 1Twenty-three certificate and four master's students were not previously employed. An additional five certificate and five master's students were not employed just prior to entering an NP program. ‘-‘The median previous annual salary for certificate students was $10,105 and for master’s students $9,845. 3 Forty-two certificate and 16 master's students did not supply information on either previous salary or anticipated salary. Another 11 certificate students could not respond appropriately to the question of anticipated salary change because of situations such as employment in a foreign country. membership in a religious order, or volunteer work. SlNHGfl-LS dN iSDNIGNIJ AGILLS 86 94 CHAPTER m Table til—Average, annual, expected increase in salary, by specialty and type of program Type of program Certificate Master's Specialty Number of Salary Number of Salary 1 increase a 1 increase ' students (in dollars) students (in dollars) Pediatric _______________ 237 1,103 21 3,190 Midwifery _______________ 18 1,722 43 3,407 Maternity _______________ 37 851 23 3,435 Family __________________ 128 2,231 74 3,392 Adult ___________________ 110 1,004 56 3,134 Psychiatric _____________ — — 21 3,571 Total ‘ ________________ 530 1,358 238 3,336 1Twenty-three certificate and four master's students had not previously been employed. An additional five certificate and five master’s students had not been employed just prior to entering an NP program. Another 11 certificate students could not respond appropriately to the question of anticipated salary change because of situations such as employment in a foreign country, membership in a religious order, or volunteer work. Thirty-one certificate and 14 master's students expected salary increases but could not specify the amount, and 192 certificate and 45 master's students could not specify their salary expectations. 2Salary increase was based upon the individual’s report of decrease. increase, or no change in anticipated salary. 3Two certificate and one master's student did not supply information on salary increase. Table BIL—Average, annual, expected increase in salary, by prior nursing preparation and type of program Type of program . . Certificate Master’s PrIor nursmg preparation Number of . sa'a'y 2 Number of . 33'“ 2 students 1 increase students 1 increase (in dollars) (In dollars) Hospital diploma _______ 245 1,310 10 3,050 Associate degree ________ 49 2,296 1 2,500 Baccalaureate degree ___ 201 1,326 224 3,375 Master’s degree _________ 35 571 3 1,667 Total ' ________________ 530 1,358 238 3,336 lTwenty-three certificate and four master’s students had not previously been employed. An additional five certificate and five master‘s students had not been employed just prior to entering an NP program. Another 11 certificate students could not respond appropriately to the question of anticipated salary change because of situations such as employment in a foreign country, membership in a religious order, or volunteer work. Thirty-one certificate and 14 master's students expected salary increases but could not specify the amount, and 192 certificate and 45 master’s students could not specify their salary expectations. 2Salary increase was based upon the individual's report of decrease, increase, or no change in anticipated salary. 3Two certificate and one master's student did not supply information on salary increase. Table tit—Average response of students to selected job characteristics in terms of attainment and aspiration in prior nursing position, importance to the student, and expectation in the NP role, by type of program Job satisfaction variables “ and type of program Prior position Job characteristic 1 Attainment Aspiration Importance Expectation as NPs Certificate Opportunity for planning and organizing your own work routine ___________________ 4.91 5.81 6.20 6.02 Opportunity to use your own initiative ,1- 5.14 6.19 6.44 6.37 On-the-job freedom in your nursing position 4.82 5.77 6.17 6.01 Opportunity for independent thought and action 4.87 6.05 6.38 6.23 Opportunity for participating in the setting of goals _____________________________ 4.60 6.02 629 6.18 Opportunity to participate in the decision making process ________________________ 4.43 5.97 6.34 6.01 Opportunity for participating in determining methods and procedures ____________ 4.36 5.83 6.10 5.92 Authority connected with your position 4.47 5.52 5.78 5.72 Overall average _ 4.70 5.90 6.21 6.06 Standard deviation 1.36 .75 .64 .78 Master’s Opportunity for planning and organizing your own work routine ___________________ 4.46 5.64 6.33 6.08 Opportunity to use your own initiative 4.61 6.14 6.54 6.43 On-the-job freedom in your nursing position 4.22 5.61 6.32 6.00 Opportunity for independent thought and action 4.50 6.07 6.55 6.35 Opportunity for participating in the setting of goals ___-; ________________________ 4.23 6.08 6.47 6.25 Opportunity to participate in the decision making process ________________________ 3.96 5.92 6.43 6.22 Opportunity for participating in determining methods and procedures ____________ 3.92 5.72 6.07 5.96 Authority connected with your position 3.94 5.40 5.83 5.75 Overall average 4.22 5.80 6.32 6.13 Standard deviation 1.35 .81 .57 .73 1The job characteristics are taken from a questionnaire designed by Arnold C. Bellinger, Ph.D., Wayne State University. 2The scale used to measure these job satisfaction characteristics ranged from 1 (minimum) to 7 (maximum). ! Fifty-eight certificate and 14 master's students did not supply information on the selected job satisfaction characteristics, so that this presentation is based on responses from 736 certificate and 293 master’s students. SLNZICIDLS dN ISDNIGNIJ RUINS 96 96 CHAPTER III Figure 8.—NP students' job dissatisfaction and expected improvement,‘ by type of program (max.) 7 ~— 6 _ 5 — 4 _. C 3 - E c .9 E c .5 2 2 ‘a g .9 s .5 9 E .E E ‘5 s '9 a .2 EL 3 2 — < < U-ix < < .33 (min.) 1 CERTIFICATE MASTER'S %//// Job dissatisfaction: Aspiration in prior position minus Attainment in prior position W Expected improvement: Expectation as NP minus Attainment in prior position 1This figure is based on responses to selected job characteristics from a questionnaire designed by Arnold C. Bellinger, Ph.D., Wayne State University. STUDY FINDINGS: NP STUDENTS 97 Figure 9.—NP students' job dissatisfaction and expected improvement,1 by previous nursing education and type of program CERTIFICATE MASTER'S (max.) 7 5 3 Hospital diploma (min.) 1 (max.) 7 5 3 Associate degree (min.) 1 (max.) 7 5 Baccalaureate 3 degree (min.) 1 (max.) 7 5 3 Master's degree (min.) i ATT. ASP. EXP. ATT. ASP. EXP. % Job dissatisfaction ATT. — Attainment in prior position W Expected improvement ASP. — Aspiration in prior position EXP. — Expectation as NP xThis figure is based on responses to selected job characteristics from a questionnaire designed by Arnold C. Bellinger, Ph.D., Wayne State University. APPENDIX A NURSE PRACTITIONER CERTIFICATE PROGRAMS Abbreviations CNS —C|inical Nurse Specialist CS —Clinical Specialist NA —Nurse Associate NC —Nurse Clinician N'CP —-Nurse Clinical Practitioner NCS -Nurse Clinical Specialist NP —Nurse Practitioner 99 10. PROGRAMS THAT AWARD A CERTIFICATE Pediatric Nurse Practitioner Certificate Programs Program . Pediatric NP Pediatric NA Pediatric NA . Pediatric NP . School NP School NP Pediatric NA School NP Pediatric NP Pediatric NA Institution, City, State University of Alabama School of Nursing Birmingham, Alabama Good Samaritan Hospital Phoenix, Arizona Loma Linda University School of Nursing Loma Linda, California - University of California at Los Angeles University Extension Division of Nursing Los Angeles, California University of California at Los Angeles University Extension Division of Nursing Los Angeles, California San Diego State University School of Nursing San Diego, California University of California at San Francisco School of Nursing San Francisco, California University of Colorado School of Nursing Denver, Colorado University of Colorado School of Nursing Denver, Colorado University of Connecticut McCook Hospital Hartford, Connecticut 101 Nursing Director Medical Director Miss Isobel H. Thorp Dr. Daisy Lee Ms. Nancy Melvin Dr. Paul Bergeson Ms. Gladys Jacques Dr. Joseph W. St. Gene, Jr. Mrs. Florence Z. Binder Dr. Richard Schain Ms. Constance Salerno Dr. David L. Chadwick Ms. Doris E. Dunbar Dr. Donald L. Fink Ms. Vera M. Robinson Dr. Henry Silver Ms. Vera M. Robinson Ms. Ruth L. Burton Dr. Louis I. Hochheiser 102 APPENDIX A Pediatric Nurse Practitioner Certificate Programs (continued) Program 11. Pediatric NA 12. Pediatric NA 13. Pediatric NP 14. Pediatric NA 15. Pediatric NP 16. Pediatric NP 17. Pediatric NA 18. Pediatric NP 19. Pediatric NP 20. Pediatric NA 21. Pediatric NA Institution, City, State Rush-Presbyterian- St. Luke’s Medical Center Chicago, Illinois Indiana University School of Nursing Indianapolis, Indiana University of Iowa College of Nursing Iowa City, Iowa Maine Medical Center Portland, Maine Johns Hopkins University School of Health Services Baltimore, Maryland University of Maryland School of Nursing Baltimore, Maryland Northeastern University College of Nursing Boston, Massachusetts University of Michigan School of Nursing Ann Arbor, Michigan Children’s Hospital of Michigan Detroit, Michigan University of Minnesota School of Public Health Minneapolis, Minnesota Mayo Foundation- Mayo Clinic Rochester, Minnesota Nursing Director Medical Director Mrs. Iris Shannon Dr. Joseph R. Christian Mrs. Linda Oifutt Dr. Gabriel Rosenberg Ms. Jean Ann Lakin Ms. Marianne W. Rodgers Dr. George W. Hallett Ms. Maureen C. Maguire Dr. Kathleen C. Morton Ms. Frances P. Koonz Dr. Marvin Cornblath Miss Priscilla Andrews Dr. Alfred Yankauer Ms. Barbara Sachs Dr. Ruth H. Strang Ms. Mary Ann Krammin Dr. Leslie Pensler Miss Alma G. Sparrow Ms. Sue Zeman Dr. Thomas H. Williams CERTIFICATE PROGRAMS 103 Pediatric Nurse Practitioner Certificate Programs (continued) Program 22. Family Health NA (Pediatric component) 23. Pediatric NP 24. Pediatric NP 25. Pediatric NP 26. Pediatric NA 27. Pediatric NA 28. Pediatric NP 29. Pediatric NA 30. Pediatric NA 31. Pediatric NP Institution, City, State University of Mississippi School of Nursing Jackson, Mississippi Cardinal Glennon Memorial Hospital St. Louis, Missouri Washington University School of Medicine St. Louis, Missouri Rutgers University College of Nursing Piscataway, New Jersey Seton Hall University College of Nursing South Orange, New Jersey State University of New York at Buffalo School of Nursing Buffalo, New York Bronx Municipal Hospital Center Bronx, New York Cornell University— New York Hospital School of Nursing New York, New York Columbia-Presbyterian Hospital New York, New York University of Rochester School of Nursing Rochester, New York Nursing Director Medical Director Mrs. Linda C. Pearce Dr. Peter A. Boelens Dr. Fernando deCastro Mrs. Marcia Custer Dr. Lawrence Kahn Ms. Dorothy DeMaio Dr. Christian M. Hansen Professor Eileen Amy York Dr. Franklin Behrle Miss Mary Norma O’Hara Dr. James Markello Ms. Annette Milne Dr. Ruth Stein Dr. Eleanor C. Lambertsen Dr. Margaret C. Heagarty Dr. Catherine DeAngelis Ms. Harriet Kitzman Dr. Robert Hoekelman 104 APPENDIX A Pediatric Nurse Practitioner Certificate Programs (continued) 32. 33. 34. 35. 36. 37. 3 . (I) 3 . {D 40. 4 . H 42 Program Youth NP Pediatric NA Pediatric NP Pediatric NA Pediatric NP Pediatric NP ediatric NP ediatric NC ediatric NP ediatric NA . Nurse- Physician Team (Pediatric) Institution, City, State University of North Carolina at Greensboro School of Nursing Greensboro, North Carolina Good Samaritan Hospital Cincinnati, Ohio University of Pittsburgh School of Nursing Pittsburgh, Pennsylvania University of Tennessee College of Nursing Memphis, Tennessee Meharry Medical College Department of Nursing Education Nashville, Tennessee Texas Woman’s University College of Nursing Dallas, Texas University of Texas School of Nursing Galveston, Texas University of Virginia School of Nursing Charlottesville, Virginia University of Washington School of Nursing Seattle, Washington West Virginia University School of Nursing Morgantown, West Virginia University of Wisconsin Department of Family Medicine and Practice Madison, Wisconsin Nursing Director Medical Director Miss Shelley L. Jones Mrs. Patricia Chaney Dr. Donald J. Frank Mrs. Eileen Moult Ms. Brenda Mills Dr. David H. James, Jr. Ms. Mary 0. Pleas Ms. Judith M. Johnson Ms. Chloe Floyd Dr. Warren Dodge Dr. Barbara Brodie Dr. Jacob Lohr Dr. Jacqueline H. Vandeman Miss Elizabeth O’Connell Dr. Kenneth Wible Dr. Karen F. Pridham Dr. Marc F. Hansen 1. 10. CERTIFICATE PROGRAMS 105 Maternity’Nurse Practitioner Certificate Programs Program OB-GYN NP . Midwifery Maternity NA . OB-GYN NC Midwifery Midwifery . Family Planning NP Maternal and Child Health . Midwifery Midwifery Institution, City, State University of Alabama School of Medicine Birmingham, Alabama Loma Linda University School of Nursing Loma Linda, California University of California School of Nursing at San Francisco San Francisco, California Indiana University School of Medicine Indianapolis, Indiana University of Mississippi Medical Center Jackson, Mississippi State University of New York-Downstate Medical Center College of Health Related Professions Brooklyn, New York State University of New York at Buffalo School of Nursing Buffalo, New York University of North Carolina at Charlotte College of Nursing Charlotte, North Carolina University District Hospital Caparra Heights Station Puerto Rico Meharry Medical College Department of Nursing Education Nashville, Tennessee Nursing Director Medical Director Mrs. J uanzetta Flowers Dr. Hugh M. Shingleton Ms. Betty Highley Dr. Phillip J. Goldstein Mrs. Sharon Hammann Dr. Jack Pearson Mrs. Ruth Shiers Miss Laurette M. Beck Dr. James H. Nelson, Jr. Mrs. Eva Noles Dr. Norman G. Courey Mrs. Vera Smith Mrs. Eva Huertas de Grzuaga Ms. Pearline Gilpin 106 11. 12. APPENDIX A Maternity Nurse Practitioner Certificate Programs Program Maternal Child Health/ Family Planning NP Maternal Intensive Care NC (continued) Institution, City, State Meharry Medical College Department of Nursing Education Nashville, Tennessee University of Wisconsin School of Nursing Madison, Wisconsin Nursing Director Medical Director Ms. Ramona B. Young Ms. Erna Ziegel Dr. Jack M. Schneider Family Nurse Practitioner Certificate Programs . Family NP NP (Family emphasis) . Family NP . Primex Primex . Nurse Clinician (Family emphasis) Primex University of Arizona College of Nursing Tucson, Arizona University of Arkansas School of Nursing Little Rock, Arkansas University of California at Davis School of Medicine Davis, California University of California at Los Angeles University Extension Division of Nursing Los Angeles, California Indiana University School of Medicine Indianapolis, Indiana Wichita State University College of Health Related Professions Wichita, Kansas Frontier Nursing Service Hyden, Kentucky Ms. Josephine R. Gibson Dr. Daniel Levinson Dr. Lois Malkemes Dr. Len Hughes Andrus Dr. Rheba de Tornyay Dr. Charles Lewis Ms. Shirley Ross Dr. Robert Chevalier Mrs. Carla Lee Dr. Gertrude Isaacs Dr. W.B.R. Beasley CERTIFICATE PROGRAMS 107 Family Nurse Practitioner Certificate Programs (continued) 8. Family Nurse 10. 11. 12. 13. 14. 15. 16. 17. Program . Family NA Family Health NP Primary Care Nurse (Family emphasis) Family NP (Primex) Family NP Primex (Primary Health Practi- tioner) Primex Family NP Family NP Institution, City, State Tulane University School of Public Health and Tropical Medicine New Orleans, Louisiana University of Maine Portland-Gorham School of Nursing Portland, Maine Montana State University School of Nursing Bozeman, Montana Albany Medical College Department of Preventive and Community Medicine Albany, New York Cornell University- New York Hospital School of Nursing New York, New York University of North Carolina School of Nursing Chapel Hill, North Carolina Case-Western Reserve University School of Nursing Cleveland, Ohio Vanderbilt University School of Nursing Nashville, Tennessee University of Utah College of Nursing Salt Lake City, Utah University of Virginia Department of Internal Medicine Charlottesville, Virginia Nursing Director Medical Director Ms. Edna Treuting Ms. Mildred A. Roche Dr. Doris S. Pennoyer Miss Susan Dowell Dr. John Mest Ms. Nancy Barhydt Dr. Eleanor C. Lambertsen Dr. George G. Reader Ms. Julia D. Watkins Dr. C. Glen Pickard Dr. Virginia Boardman Mrs. Virginia George Ms. Ida Bickle Mrs. Susan S. Lynch Dr. Robert A. Reid 108 10. 11. APPENDIX A Adult Nurse Practitioner Certificate Programs Program . College Health NP (Adult emphasis) Adult Health NP Medical NA (Adult emphasis) Adult NP Primary Care NP (Adult emphasis) College Health NP (Adult emphasis) Adult NP Adult NP . Adult and Geriatric NA Adult NP Medical NP (Adult emphasis) Institution, City, State University of California at Los Angeles University Extension Division of Nursing Los Angeles, California University of Colorado School of Nursing Denver, Colorado Rush-Presbyterian- St. Luke’s Medical Center Chicago, Illinois Johns Hopkins University School of Health Services Baltimore, Maryland University of Maryland School of Nursing Baltimore, Maryland University of Massachusetts Health Services Amherst, Massachusetts Massachusetts General Hospital Boston, Massachusetts Peter Bent Brigham Hospital Boston, Massachusetts University of Minnesota School of Public Health Minneapolis, Minnesota Bronx Municipal Hospital Center Bronx, New York University of Rochester School of Nursing Rochester, New York Nursing Director Medical Director Ms. Gladys Jacques Dr. John Champion Ms. Vera M. Robinson Mrs. Iris Shannon . Dr. Barbara Noble Ms. Becky A. Winslow Dr. Malcolm L. Peterson Mrs. Rachel Z. Booth Dr. William S. Spicer, Jr. Dr. Katharine E. Reichert Mrs. Aina Apse Dr. Ann Baker Miss Helen Aikens Dr. Douglas Landwehr Miss Alma G. Sparrow Ms. Anne Bertrand Dr. Roger Platt Ms. Joan Lynaugh Dr. Barbara Bates CERTIFICATE PROGRAMS 109 Adult Nurse Practitioner Certificate Programs (continued) Nursing Director Program Institution, City, State Medical Director 12. Adult Health University of Tennessee Miss Patricia E. NP College of Nursing Brisley Memphis, Tennessee Dr. Iris Pearce 13. Adult Meharry Medical College Mrs. Evelyn K. Medicine Department of Nursing Tomes NP Education Nashville, Tennessee 14. Geriatric NP Texas Woman’s University Ms. Dolores College of Nursing ‘ Alford Denton, Texas 15. College Health Brigham Young University Ms. Marlyn NP (Adult Health Center Morris emphasis) Provo, Utah Dr. Cioyd C. Hofheins APPENDIX B NURSE PRACTITIONER MASTER'S PROGRAMS Abbreviations CNS —Clinical Nurse Specialist CS —Clinical Specialist NA —Nurse Associate NC —Nurse Clinician NCP —-Nurse Clinical Practitioner NCS —-Nurse Clinical Specialist NIP —Nurse Practitioner 111 PROGRAMS THAT AWARD A MASTER’S DEGREE Pediatric Nurse Practitioner Master’s Programs Program Institution, City, State 1. Pediatric NP University of Alabama School of Nursing Birmingham, Alabama 2. Pediatric CS University of Arkansas School of Nursing Little Rock, Arkansas Yale University School of Nursing New Haven, Connecticut 3. Pediatric CS 4. Child Health NC Wayne State University College of Nursing Detroit, Michigan 5. Pediatric NCS University of Pennsylvania School of Nursing Philadelphia, Pennsylvania University of Utah College of Nursing Salt Lake City, Utah University of Wisconsin School of Nursing Madison, Wisconsin 6. Child Nursing 7. Pediatric NC 8. High-Risk University of Wisconsin Neonatal School of Nursing CNS Madison, Wisconsin Nursing Director Medical Director Elwynn S. Hale Dr. Frances C. Dalme Dr. Katherine B. Nuckolls Ms. Suzanne L. Feetham Mrs. Lois A. Palmer Dr. Madeleine Leininger Ms. Patricia Hummel Ms. Dorothy Patteson Dr. Stanley Graven Maternity Nurse Practitioner Master’s Programs 1. Maternal and Infant NC University of Alabama School of Nursing Birmingham, Alabama 2. Maternity CS University of Arkansas School of Nursing Little Rock, Arkansas 113 Dr. Norma Mobley Dr. Frances C. Dalme 114 10. 11. 12. 13. APPENDIX B Maternity Nurse Practitioner Master’s Programs Program . Midwifery . Maternal- Child NC . Maternal- Infant NC Midwifery Midwifery Maternal- Child Health CS . Midwifery Midwifery Maternity NCP Maternal- Child NC Maternal Newborn (continued) Institution, City, State Yale University School of Nursing New Haven, Connecticut University of Delaware College of Nursing Newark, Delaware Catholic University of America School of Nursing Washington, DC. University of Illinois College of Nursing Chicago, Illinois Johns Hopkins University School of Hygiene and Public Health Baltimore, Maryland Boston College School of Nursing Chestnut Hill, Massachusetts St. Louis University Department of Nursing St. Louis, Missouri Columbia University Department of Nursing New York, New York University of Pennsylvania School of Nursing Philadelphia, Pennsylvania Texas Woman’s University College of Nursing Dallas, Texas University of Utah College of Nursing Nursing and Salt Lake City, Utah Midwifery Nursing Director Medical Director Ms. Joy Cohen Dr. Virginia Conley Dr. Lillian Runnerstrom Miss Gene S. Cranch Miss Teresa Chopoorian Dr. Howard Jacobson Sister Natalie Elder Dr. Mary I, Crawford Mrs. Clara H. Jordan Dr. Peggy Chinn Miss Joyce Cameron 10. 11. 12. MASTER’S PROGRAMS 115 Family Nurse Practitioner Master's Programs Program Community Health NP NP (Family emphasis) Family NP Community Health NC Family NP Family Health NC Family NC Family Health Specialist . Community Health Family NC Family NC Community Health/ Family NC Family and Community NC Institution, City, State University of Alabama School of Nursing Birmingham, Alabama University of California at Los Angeles School of Nursing Los Angeles, California Yale University School of Nursing New Haven, Connecticut Catholic University of America School of Nursing Washington, DC. University of Illinois College of Nursing Chicago, Illinois University of Rochester School of Nursing Rochester, New York University of Pennsylvania School of Nursing Philadelphia, Pennsylvania Pennsylvania State University Department of Nursing University Park, Pennsylvania University of Tennessee College of Nursing Memphis, Tennessee Vanderbilt University School of Nursing Nashville, Tennessee Texas Woman’s University College of Nursing Houston, Texas University of Washington School of Nursing Seattle, Washington Nursing Director Medical Director Dr. Charlotte Cumbie Ms. Doris Holm Ms. Charlotte J anuska Dr. Virginia Conley Dr. Virginia M. Ohlson Ms. Harriet Kitzman Ms. Martha M. Lamberton Mrs. Shirley Ettaro Dr. BeVerly H. Bowns Dr. Nel Getchel Ms. Edith Wright Dr. Carlos Vallbona Ms. Rosemary Pittman 116 Adult Nurse Practitioner Master’s Program 1. Medical/ Surgical NP (Adult emphasis) 2. Medical/ Surgical CS (Adult) 3. Medical/ Surgical NC (Adult) 4. Cardiovascular NC (Adult emphasis) 5. Medical/ Surgical NC (Adult) 6. Adult Health NC 7. Adult NP 8. Medical/ Surgical NC (Adult) APPENDIX B Institution, City, State University of Alabama School of Nursing Birmingham, Alabama University of Arkansas School of Nursing Little Rock, Arkansas University of Delaware College of Nursing Newark, Delaware Catholic University of America School of Nursing Washington, DC. University of Hawaii School of Nursing Honolulu, Hawaii Wayne State University College of Nursing Detroit, Michigan University of Minnesota School of Public Health Minneapolis, Minnesota Programs Nursing Director Medical Director Ms. Janet S. Awtrey Dr. Frances C. Dalme Dr. Virginia Conley Dr. Edith Anderson Ms. Dawn Zagornik Miss Alma G. Sparrow Texas Woman’s University Ms. Beth College of Nursing Dallas, Texas Vaughn-Wrobel Psychiatric Nurse Practitioner Master's Programs 1. Psychiatric CS 2. Psychiatric NOS 3. Mental Health- Psychiatric NC University of Arkansas School of Nursing Little Rock, Arkansas Yale University School of Nursing New Haven, Connecticut University of Hawaii School of Nursing Honolulu, Hawaii Dr. Frances C. Dalme Ms. Mimi Dye Dr. Edith Anderson MASTER’S mocmms 117 Psychiatric Nurse Practitioner Master's Programs (Continued) Nursing Director Program Institution, City, State Medical Director 4. Psychiatric University of Utah Miss Sumiko N CS College of Nursing Fujiki Salt Lake City, Utah APPENDIX C PROGRAM QUESTIONNAIRE 119 120 APPENDIX C O.M.B. No. 68673038 Approval Expires 9‘30-75 STUDY OF NURSES IN EXTENWL Supported by contract number N01 NU 34064 from the Division of Nursing, Bureau of Health Resources Development, Health Resources Administration, Public Health Service, U.S. Department of Health, Education, and Welfare. Institution Title of Nurse Practitioner program MASTER’S PROGRAMS 12] OMB No. 68-573038 Approval Expires 9-30-75 STUDY OF NURSES IN EXTENDED ROLES STUDENT QUESTIONNAIRE Credential awarded at completion of program: El certificate Cl Master's degree Cl other; specify E Date of graduation from NP program it 2, Name Last First MIdd/e or Maiden Present Address No, and Street City state Zip Telephone E Area Code Number l Permanent Address A /\ Na. and Street on y \/ Stare Zip Telephonem Area Code Number Sex: El Female El Male te of Birth How do you describe yourself? Please ch- -n|y on l3 White/Caucasian D -rto Rican American Indian l3 Black/Negro Cl J.anese/Chinese All other (please specify) D Mexican American Chic Marital status: (:1 Married Cl Not Married Please complete the following information regarding your education: Type of Program Year Graduated Maia! Field Hospital Diploma Associate Degree Raccalaureate Degree Master‘s Degree u Doctor's Degree Other (specify) Have you ever been employed in professional nursing? Cl Yes If yes, hbw many years have you been actively engaged in professional nursing? _ __ _ years Cl No If no. skip to question 12 122 APPENDIX c How many times per year does a new class begin your program? time(s) Are graduates of the following nursing education programs eligible for enrollment? Please check all that apply. 13 Diploma {3 Associate Degree [j Baccalaureate Degree I: Master's Degree Is an applicant required to have an employer who guarantees employment on completion of this program? [3 Yes D No If no, is job placement provided for graduates? E] Yes D No Are any aptitude tests used in the acceptance of applicants? D Yes Please specify the name(s) of the test(s): @ /\ W BM: 9) v ude s fthis program? Are any personality inventories or tests adminis - I: Yes Please specify the [Emma u m\i> Law E] No L/ At the time of admission of your last class did the number of qualified applicants exceed your class capacity? [3 Yes If yes, please estimate the number you were unable to admit for this reason: ______ qualified applicants D No What is the amount of tuition charged to a student for the entire program? Tuition per student State Resident $ Out-of-state Resident S What types of financial support are currently available to students? Please check (X) all that apply: scholarships or stipends loans wages for work related to NP training other (please specify) none DDDDD 18. 20. 21. 22. 23. PROGRAM QUESTIONNAIRE 123 What is the most common title used to designate graduates? For NON-DEGREE Programs For DEGREE Programs What credentialis) is awarded to all graduates of this What degree is awarded to graduates of this program? program? L—J Baccalaureate i: certificate C] Master’s i:i other (please specifyl__—_____ C] Other, please specify Are students who complete this program awarded aca- demic credit? Yes Ci No If yes, how many credits are awarded? Academic credits Are graduates of this program awarded continuing edu- cation credits? i:i Yes DNO If yes, how many credits are awarded? Continuing Education Units <\ /\ /\ Please indicate the number of students admitted A t r each calendar year specified, beginning with 1970 or the year this program was initiated if that was later. - ‘ a ‘ offered more than once per year, include the total number of 1.972 1973 1974 ‘ Number admitted Number graduated 'P/ease estimate the total number anticipated for 7974. What are the anticipated dates of graduation for the next two graduating classes and the corresponding number of graduates in each class? Man th Year Number of Gradua res b. Are there more requests for graduates of this program than can be supplied presently? E] Yes D No i:i Unknown Do you sponsor regularly scheduled continuing education sessions for your graduates? Ci Yes D No 124 APPENDIX c 24. 25s 26, 27s 28. 29. Have you conducted an evaluation study of this program? ‘3 Yes [I No If yes, did the evaluation study examine any or all of the following? Please check all that apply. El a. effect of the graduates' employment on the availability of health care? [:1 b. effect of the graduates' employment on the cost of health care? C] c. competence of the graduates? D d. degree of independence with which the graduates function? El e. match of the graduates’ functions and responsibilities with those for which they were trained? If you have completed an evaluation study, we would appreciate your sending a copy of the report to us. In the following questions dealing with program format we are distinguishing two components of many practitioner programs: A, The DIDACTIC or formal portion in which a specified curriculum is ta sing lectures. self-instruction materials, and concurrent relevant clinical observations and experiences. . The INTERNSHIP or PRECEPTORSHIP portion which is a s c'fied perio supervised clinical practice in patient assessment and management and is a requirement f o letio f program. This is distinct from and follows the clinical experience offered concurrently with tie di a , ortio e programs do not include a period such as this in which case the questions related to inte -. ship will not apply. m What is the total period of time req ’ s , of this program, including the DIDACTIC and INTERNSHIP/ PRECEPTORSHIP components and VAI ' w - rcable? Please specify calendar months. calendar months What is the total period of ti -- ired to complete the DIDACTlC component of the program (include both classroom and clinical experiences]? Do NOT include vacation time. For NON-DEGREE Programs For DEGREE Programs Please give CLOCK hours: Please give CREDIT hours: hours per week for _ credit hours 7 weeks, which equals Please check the credit hour system used: TOTAL clock hours {:1 Semester [:1 Quarter D Trimester Approximately what percent of the DlDACTlC component is spent in clinical experience? —__._.. percent Does this program include an INTERNSHIP/PRECEPTORSHIP (as defined above)? D Yes If yes, please complete questions 29 and 30‘ D No If no, please omit questions 29 and 30, and go to question 31. How many months are required to complete the INTERNSHlP/PRECEPTORSHIP? W— months 30. 31. 32. 33. 34. PROGRAM QUESTIONNAIRE 125 Is a particular nurse practitioner and/or physician designated as being responsible for the supervision of each student nurse practitioner during the INTERNSHIP/PRECEPTORSHlP? Nurse Practitioner El Yes D No Physician D Yes D No How many of the nurses who teach in the DIDACTlC component carry a caseload and provide patient care? Number of nurses Are nurse practitioners who are actively practicing the expanded role available to the student for consultation during the student's clinical practice period? During the DIDACTIC component? El Never a l: Seldom D Usually :1 Always ‘ During the lNTERNSHlP/PRECEPTORSHIP? Never Seldom Usually Always Does not apply DECIDE Are students given training experience in practic hic rimarily serve the following populations? Inner-city populations 1:] Yes No Rural populations 5 No To avoid the use of name : sig a number to each member of the staff who teaches in the DlDACTIC portion of the program and indicate in sect : the percent of total work time each spends on this program. Do not include guest lecturers who are not considered to be part of the program staff; give the number of such guest lecturers in section B. A. PROGRAM STAFF Nurse Practitioners Other Nurses Physicians Others 96 of full time 96 of full time % of full time 96 of full time at 1. a 1. a 1. a 1. at 2. ‘ at 2. a 2. a 2. a: 3. a: 3. a 3. t 3. at 4. as 4. n 4. x 4. e 5. a: 5. x 5. a: 5. as 6. # 6. e 6. e 6. at 7. at 7. a 7. a: 7. it 8. o 8. o 8. it 8. 1t 9. a 9. u 9. a 9. #10. v10. :10. #10. B. GUEST LECTURERS (NOT included above) Number Nurses Physicians Other 126 APPENDIX c 35. Please give the number of nurse, physician, and other instructors in FULL TIME EQUIVALENTS, indicating both salaried and contributed time, provided by the teaching staff (including those participating in the INTERNSHIP/PRECEPTORSHIP) In addition, please give the total estimated dollar value of the salaried time of the instructors. SALARIED TIME CONTRIBUTED TIME of instructors of instructors Number (lull-time Value (estimated Number equivalents) in dollars) (full-time equivalents) Nurses Physicians Others; specify: fl 36. For the years this program has been in existence from 1970 to 1974 ase indictv a chick (X) the sources of funds received, both for program and student support. SUP BY VEAR RECEIVED 1972 1973 FEDERAL FUNDS DIVISION OF NURSIN Capitation Funds Contracts Special Project Grants Traineeships Scholarships Loans MCH1 BHSR2 RMP3 0E04 Other, specify: NON-FEDERAL FUNDS Please specify: 1MCH: Nhternal and Child Health Serwce, Health Services Administration (formerly HSMHA) 23HSR’ Bureau of Health Services Research, Health Resources Administration (Iarmerly National Canter lor Health Services Research and Development) 33M»): Regional Medical Pregams 4CEO: Office cl Economic Opportunity 37. Following is a list of five selected curriculum content areas which may be included in nurse practitioner preparation. The list is not intended to be inclusive of all course content in the curriculum. Instead, it is an attempt to describe the degree of emphasis PROGRAM QUESTION NAIRE given to the following content areas when they are included in the curriculum. 1) Please indicate in Column A the emphasis given each CONTENT AREA in relation to the others by distributing a total of 100 points across those areas that apply to your program. Please read the entire list of content areas before scoring any. N Assign a Zero to any area that does not apply. Complete Column A before proceeding to Column 5. After assigning the relative values to all CONTENT AREAS, please consider the program aims for each area separately in relation to its FOCUS on (a) developing practitioner skills for practice and (b) enlarging the theoretical knowledge base of the practitioners. Indicate the relative emphasis placed on each of these units of FOCUS by distributing the total score assigned to each CONTENT AREA between (a) and (b) in Column 8 (total for (a) and (b) should equal CONTENT score given in Column A). 127 CONTENT AREAS AND FOCUS Column A CONTE N T Scores Column 8 FOC US Scares w a. N . Teaching, counseling a S" . Taking health and social history; performing physical examination ............... a To develop skill in the procedures and valid interpretation of the findings . a. To develop skills i a ting with patients and family members and assisting them with health care ......................................... b To deepen knowledge of social-psychological processes influencing behavior in relation to alternative care plans ..................................... . Planning, developing and implementing group educational programs ............... a. To develop skill in teaching patients and family members ................... b. To deepen knowledge of educational principals and of their application to curricular development .......................................................... Assessment of quality and effectiveness of nursing practice; use of demographic. social and health data regarding community and population groups to identify high risk subgroups ..................................................... a. To develop skills in planning, modifying and recording patient care ............. b. To deepen knowledge of administrative process and program planning evaluations and priority determination ......................................... 128 APPENDIX 0 3a. 39. Please estimate what proportion of your total curriculum content is represented by the five areas listed above: Estimated percent of total curriculum Content areas 1-5 above .................. Other maior areas ...................... Please give ,_ Following is a list of functions for which nurse practitioners are being prepared. It is not intended robe an exhaustive list of all practitioner functions; emphasis has been placed on those functions which are not traditionally included in basic nursing preparation. I) Please place a check (X) in the NP PREPARATION column to indicate whether or not your program is preparing its students to be able to carry out this function at the completion of the program. 2) If this preparation is provided, please place a check (X) in one of the boxes at the right to indicate the approximate percentage of patient contacts concerning the specific care or function which you exp r NP graduates, at the completion of the program, in general might need to consult with a physician. / A. IS INFANT AND CHILD HEALTH CARE INCLUDED IN THIS NP P RAM? CI Yes Please complete items 1-26 below E) No Please omit items I-26 and proceed to 'on NP CONSUL T WITH MD PREPARATION PERCENT OF PATIENT CONTACTS Yes No 05 6-25 26-50 51-75 76-100 1) Decide whether patient |. -. potential problem FOR ESSENTIALL Y WELL INFANTS AND CHILDREN 2) Obtain or update social/family history tially well or has a 3) Obtain or update health histOry 4) Obtain height, weight, head circumference 5) Order routine blood and urine samples 6) Perform physical exam at the following times: a. New-born exam (in hospital) b. Six weeks check-up c. 3 month check-up d. 18 months-10 years check-ups 7) Do systematic assessment of child's growth and development 8) Initiate prevention-oriented health teaching and counselling (e.g. care of infant, feeding, safety, sleep patterns) 9) Initiate routine immunizations (DPT, OPV) 39. PROGRAM QUESTIONNAIRE 129 (continued) IF POTENTIAL PROBLEM IS IDENTIFIED: 10) Refer patient automatically to MD 11) Obtain or update health history 12) Perform physical exam 13) Order specific lab tests or other diagnostic proce- dures (hematocrits, urine cultures, throat cultures, etc.) 14) Decide whether to manage patient or refer patient to MD for management 15) Assume health care management FOR I-YEAH-OLD CHILDREN WITH LOW-GRADE FEVER RHINORRHEA: 16) Obtain or update health history 17) Perform physical exam 18) Order appropriate lab tests and nostic di cedu res 5 19) Decide whether to ma nt refer patient to MD for management 20) Assume health care management of uncomplicated URI FOR CHILDREN WITH BRONCHIAL ASTHMA HA VING A MILD ASTHMA A TTACK: 21) Obtain or update health history 22) Perform physical exam 23) Order appropriate lab tests or diagnostic procedures 24) Decide whether to manage patient or refer patient to MD for management 25) Assume health care management if only oral bronchodilators were indicated 26) Assume health care management if epinephrine were indicated NP CONSUL TW/TH MD PREPARATION PERCENT OF PATIENT CONTACTS Yes No - 2660 51-75 76-100 ’r \ ’/ 130 APPENDIX c 39. (continued) B. IS ADULTHEAL TH CARE INCLUDED IN THIS NP PROGRAM? D Yes Please complete items 27-85 below. I] No Please omit items 27-85 and proceed to Section C, page 14 NP CONSUL T WITH MD PREPAR TI N PERCENT OF PATIENT CONTACTS Yes No 0-5 6-25 26-50 51-75 76-100 27) Decide whether patient is essentially well or has a potential problem FOR ESSENTIALL V WELL ADUL TS 28) Obtain or update Social/Family history 29) Obtain or update health history 30) Obtain routine blood and urine samples 31) Perform partial physical exam 32) Perform complete physical exam 33) Initiate prevention—oriented teaching and counselling IF POTENTIAL PROBLEM Is IDENTIFIED W 34) Refer patient automatically to M 35) Obtain or update heal ory 36) Perform physical exam 37) Order specific lab tests or diagnostic procedures 38) Decide whether to manage patient or refer patient to MD for management 39) Assume health care management 40) lnitiate problem-oriented teaching and counselling FOR PATIENTS WITH PRIMARY COMPLAINTOF NASAL CONGESTION AND RHINORRHEA.’ 41) Obtain or update health history 42) Perform physical exam 43) Order appropriate lab tests or diagnostic procedures 44) Decide whether to manage patient or refer patient to MD for management 45) Assume health care management (including ini- tiation of oral decongestants for uncomplicated URI) 39, PROGRAM QUESTIONNAIRE 131 MP CONSUL T WITH MD PREPARATION PERCENT OF PATIENT CONTACTS (continued) Ves No 0-5 6-25 26-50 51-75 76-100 FOR PA T/ENTS WITH PRIMARY COMPLAINT 0F CHEST PAIN: 46) Obtain or update health history 47) Perform physical exam 48) Order appropriate lab tests or diagnostic procedures 49) Decide whether to manage patient or refer patient to MD for management 50) Assume health care management for conditions such as musculoskeletal pain FOR PA TIENTS WI TH PRIMARY COMPLAINT 0F LACE RA TION: 51) Cleanse the wound 52) Assess whether there is tendon/nerve damage 53) Apply sutures when indicated FOR ASYMPTOMA TIC FA Tl WIT HYPERTENSION: 54) Obtain or update health 55) Perform physical exam 56) Order appropriate lab tests 57) Decide whether to manage patient or refer to MD for management 58) Assume health care management 59) initiate teaching and counselling (diet, medica- tions. exercise, rest, work) 60) Alter diet 61) Alter dosage of anti-hypertensive drugs 62) Add or delete anti-hypertensive drugs 132 39. APPENDIX 0 (continued) NP CONSUL T WI TH MD FOR SYMPTOMA TIC PATIENTS WITH HYPERTENSION: 63) 64) 65) 66) 67) 68) 69) 70) 71) FOR DIABETIC PA TIENTS STABILIZED 0N INSULIN THERAPY: 72) 73) 74) 75) 76) 77) 78) FOR PATIENTS 0N ORAL HYPOGL YCEMIC AGENTS: 79) 80) 81 ) 82) 83) 84) 85) PREPARATION PERCENT OF PATIENT CONTACTS Yes No 0-5 6-25 26-50 51-75 76-100 Obtain or update health history Perform physical exam Order appropriate lab tests Decide whether to manage patient or refer to MD for management Assume health care management Initiate teaching and counselling (diet, medications, exercise. rest, work) Alter diet Alter dosage of anti-hypertensive drugs Add or delete anti-hypertensive drugs Obtain or update health history Perform partial physical exam Order appropriatelabte - 'gno - -cedures Decide whether to mana- to MD for management -nt or refer patient Initiate teaching and counselling related to medi- cation Alter diet Alter dosage of insulin Obtain or update health history Perform physical exam Order appropriate lab tests Decide whether to manage patient or refer patient to MD for management Alter diet Alter dosage of oral hypoglycemic agent Change from oral drugs to insulin PROGRAM QUESTIONNAIRE 133 (continued) C. IS MA TERNITY CARE 0}? FAMIL Y PLANNING INCLUDED IN THIS NP PROGRAM? i:i Yes Please complete items 86409 below. Ci No Please omit items 86-109 and proceed to question 40, page 16 NP CONSULTWITH MD PREPARATION PERCENT OF PATIENT CONTACTS Yes No 0-5 6-25 26-50 51-75 76-100 86) Decide whether patient is pregnant FOR MA TERN/ TY PA T/ENTS: 87) Obtain or update Social/Family history 88) Obtain or update health history 89) Perform initial physical exam 3 90) Perform initial pelvic exam including measurements 91) Perform 2nd trimester check-up including fe heart sounds and measurement of fundus a /> \: 92) Perform 2nd trimester pelvic exam 2 93) Perform 3rd trimeste -up ing fetal heart sounds, measure undus, position of baby and engagement of ting part 94) Perform 3rd trimester pelvic exam 95) Perform postpartum check-up 96) Perform post-partum pelvic exam 97) Order laboratory work at the appropriate intervals (serology, antibody screening, hematocrit, urin- alysis) 98) Initiate health teaching and counselling 134 39‘ APPENDIX C (continued) NP CONSUL T WITH MD PREPARATION PERCENT OF PATIENT CONTACTS Yes No FOR PATIENTS WITH SYMPTOMA TIC COMPLAINTS: (e.g. nausea; constipation; dysuria, frequency; vaginal discharge with itching and/or burning; URI; headaches) 99) Decide whether to manage patient or refer patient to MD for management 100) Assume health care management FOR PA TIENTS WITH SEVERE SYMPTOMA TIC COMPLAINTS leg. bleeding; ecIampsia,‘ h yperemesisl 101) Decide whether to manage patient or refer patient to MD for management 102) Assume health care management FOR FAMIL Y PLANNING SERVICE: 103) Obtain or update social/family history 104) Obtain or update health history includi B history and past experience with c- ceptiv 105) Perform general physi 106) Perform pelvic and obta cimen for Pap smear IF NO ABNORMAL/TIES: 107) Initiate teaching and counselling regarding contra- caption 108) Place patient on oral contraceptives 109) Insert IUD ‘ A \Q \ \\\ PROGRAM QUESTIONNAIRE 135 40. Thank you very much for assisting with the study by completing this questionnaire. To facilitate later follow~up for study purposes we would appreciate your attaching to the questionnaire the names and addresses of all your currently enrolled students. Please list concurrent classes separately according to the anticipated datels) of graduation. For example: Class 1: Anticipated date of graduation: month year Name Address etc. ...................... Class 2: Anticipated date of graduation: month year Name Address ¢ \ \9 ..................... e \V THANK YOUAGAIN for making this 'onal su urse practitioner programs possible. A copy of the report of the findings will be 5- - you oon as it is available. Please return completed que ionnair in - envelope provided to: Study 0 urses in Extended Roles Dr, Harry A. Sultz Department of Social and Preventive Medicine 2211 Main Street Buffalo, New York 14214 APPENDIX D STUDENT QUESTIONNAIRE 137 1 3 8 APPENDIX D OMB. No. 68-573038 Approval Expires 9-30-75 STUDY OF NURSES IN EXTEN®L reventive Medicine Supported by contract number N01 NU 34064 from the Division of Nursing, Bureau of Health Resources Development, Health Resources Administration, Public Health Service, US. Department of Health, Education, and Welfare. 139 STUDENT QUESTIONNAIRE OMB. No, 65673038 Approval Expire: 9-30-75 STUDY OF NURSES IN EXTENDED ROLES Educational Program Survey PLEASE COMPLETE THIS QUESTIONNAIRE FOR THE NURSE PRACTITIONER PROGRAM INDICATED BELOW Title of this nurse practitioner (NPl Program: Please correct this title if it is incorrect Name of Director of this NP Program 3. Name of Codirector of this NP Program: Profession —__—_____ Profession Please list the namels) of the departmentlsl and organizations sponsoring this NP program. giving the department/organization with primary responsibility for curriculum planning and development. Address (\ b. Name 6) \b Address (W E To whom should future inquiries regar ‘ is NWm be directed? Name and title @ Institution 9 Address a. Name fl \v Number and Street City State Zip Tel ephon 9 Please check (X) the type of organization responsible for the administration of the department/organization listed in 4a above. L—J University/College El Outpatient Facility other than hospital l: Community/Junior College 12»Year) ‘3 Other, please specify Cl Hospital Is admission to this NP program restricted to registered nurses? CI Yes IF YES, PLEASE PROCEED TO NEXT QUESTION. D No IF NO, DO NOT COMPLETE QUESTIONNAIRE. BUT PLEASE RETURN THIS FIRST PAGE IN THE ENCLOSED ENVELOPE. ls enrollment in this NP program restricted to employees of a particular agency? CI Yes IF YES. DO NOT COMPLETE QUESTIONNAIRE, BUT PLEASE RETURN THIS FIRST PAGE IN THE ENCLOSED ENVELOPE. i: No IF NO, PLEASE PROCEED TO NEXT QUESTION. When was this program initiated? Date of entrance of first class If not now in operation, estimated date enrollment will begin IF ENROLLMENT HAD NOT BEGUN AS OF JANUARY 1, 1974, DO NOT COMPLETE QUESTIONNAIRE BUT PLEASE RETURN THIS FIRST PAGE IN THE ENCLOSED ENVELOPE. 2 140 APPENDIX D 10‘ Please provide the following information regarding the last nursing position you held prior to entering this educational program? a. in which field of nursing were you primarily employed? Please check only one area of primary employment. medical surgical maternity pediatric psychiatric rehabilitation community health other (specify) DDDUDDDD Cl' , In which of the following settings were you primarily employed? Please check only one setting. hospital outpatient service hospital inpatient service health center extended care facility fee-for-service physician practice (solo or a H‘ prepaid group practice community/home health agencmhealt other lspecnfy) B c Title of primary position: \/(\> staff nurse head nurse coordinator supervisor teacher clinical specialist administrator consultant researcher other (specityl DDDDDDDD DDDDDDDDDD d. Approximate annual salary before deductions: $ 11. How long had you worked for the employer you had just prior to entering this educational program? —_ years STUDENT QUESTIONNAIRE 141 12, Which of the following factors influenced your decision to become a nurse practitioner? Please rank the three most important reasons. (1=most important) salary increase challenge of the work increased status frustration of former work more independence greater influence on patient care collaboration with physicians additional learning opportunities assume more responsibility other (specify) 13‘ Which of the following factors influenced your decision to att cl (/7 most important reasons. (1=most important) ___. clinical specialty offered __ location of program __ particular institution in whi- t .ted __ nursing faculty ._____ medical faculty quality of clinical facilities @akner program? Please rank the three length of program schedule of program (days, time offered) cost of program availability of financial support continuing education offered following program other (specify) 14. Has your participation in this NP program caused any financial problems for you or your family? Cine :- :1 yes If yes, what are these problems? * 15. What type(s) of financial support are you receiving while attending this NP program? Please check (X) all that apply, E] scholarship El wages for work related to NP training El stipend D employer financial support (e.g.. tuition payment) (:3 loan [3 other (specify) El traineeship 1:] none 142 APPENDIX D In which of the following types of settings do you expect to work after completing this program? Please check only one. hospital outpatient service hospital inpatient service health center extended care facility fee-for-service physician practice (solo or group) prepaid group practice community/home health agency (e.g., health department, VNA) other (specify) DDDDDDDD Do you expect that the position you hold after completing this program will be in a practice setting which primarily serves the following populations? lnner~city populations El Yes El No Rural populations El Yes D No In comparison to the nursing position you held immediately prior to entering ' P program, how do you expect your salary will be affected upon completion of this NP program? Please check (X) the priate item and fill in the related blank estimating the amount. D an increase of $ — per year [3 no change <03 v " Cl a decrease of $ ____ per year 1: cannot specify expectation Q Are you a member of ANA? D Yes [:1 No Included here is a listing of several characteristics or qualities related to nursing positions. For each characteristic you are asked to provide three assessments. a. How much of the characteristic was there connected with the last nursing position you held prior to entering this NP program? b. How much of the characteristic do you think should be connected with the type of position you held? c. How important is this characteristic to you? For each of the following items please circle those numbers on the 3 scales which represent your assessments of each charac- teristic. Each rating scale contains numbers ranging from 1 to 7 with low numbers representing low or minimum amounts and high numbers representing high or maximum amounts. Thus. a typical item on the questionnaire might look like this. The authority connected with your position. a. How much was there in your last nursing position? (min.) 1 2 3 ® 5 6 7 (max) b. How much should there be in such a position? (min) 1 2 3 4 ® 6 7 (max) c. How important is this to you? (min.) 1 2 3 4 5 ® 7 (max.) STUDENT QUESTIONNAIRE 20. (continued) Please circle the appropriate responses for the following items: 1) The opportunity for planning and organizing your own work routine. a. How much was there in your last nursing position? (min.) 1 2 3 b. How much should there be in such a position? (min.) 1 2 3 c. How important is this to you? (min.) 1 2 3 2) The onAthe-iob freedom in your nursing position. a. How much was there in your last nursing position? (min.) 1 2 3 b. How much should there be in such a position? (min.) 1 2 3 c. How important is this to you? (min.) 1 2 3 3) The opportunity to use your own initiative. 3. How much was there in your last nursing position? (min. 1 b. How much should there be in such a position? min.) 1 2 c.' How important is this to you? in.) 2 3 (min.) 1 2 3 (min.) 1 2 3 (min.) 1 2 3 a. How much was there in your las b. How much should the c. How important is thi 5) The opportunity to participate in the decision making process. a. How much was there in your last nursing position? (min.) 1 2 3 b. How much should there be in such a position? (min.) 1 2 3 c. How important is this to you? (min.) 1 2 3 6) The opportunity for participating in determining methods and procedures. a. How much was there in your last nursing position? (min.) 1 2 3 b. How much should there be in such a position? (min.) 1 2 3 c. How important is this to you? (min.) 1 2 3 7) The opportunity for independent thought and action. a. How much was there in your last nursing position? (min.) 1 2 3 b. How much should there be in such a position? (min.) 1 2 3 c. How important is this to you? (min.) 1 2 3 8) The authority connected with your position. a. How much was there in your last nursing position? (min.) 1 2 3 b. How much should there be in such a position? (min.) 1 2 3 c. How important is this to you? (min.) 1 2 3 143 (max.) (max.) (max.) (max.) (max.) (maxi) (max‘) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) (max.) 144 APPENDIX D 21. Please rate by circling the following items in terms of how much of each characteristic you EXPECT in the position you will hold after completing this program. a. The opportunity for planning and organizing your own work routine. (min.) 1 2 3 4 5 6 7 (max.) P' The on-the-iob freedom in your nursing position. (min.) 1 2 3 4 , 5 6 7 (max.) c. The opportunity to use your own initiative. (min.) 1 2 3 4 5 6 7 (max.) F- The opportunity for participating in the setting of goals. (min.) 1 2 3 4 5 6 7 (max) e. The opportunity to participate in the decision making process. (min.) 1 . The opportunity for participating in determining methods n6)" cedur s. in.) 1 2 3 4 5 6 7 (maxJ g. The opportunity for independent th . . - t and a “ (min.) 1 2 3 4 5 6 7 N a U! 05 \l (max.) —. (maxJ h. The authority connected @r po tion. (min.) 1 2 3 4 5 6 7 (max.) 22. Do you know where you will be employed when you complete this educational program? D Yes El No Thank you very much for making this national survey of nurse practitioner students possible by completing this questionnaire. We hope that you will assist us further by completing another questionnaire a law months following your graduation. For this purpose we would appreciate your giving us the name and address of your future employer if you know it now. Name of luture ..' , Address Number and Street City State Zip Code Please return completed questionnaire in the envelope provided to: Study of Nurses in Extended Roles Dr. Harry A. Sultz Department of Social and Preventive Medicine 2211 Main Street Buffalo, New York 14214 fi' U.S. GOVERNMENT PRINTING OFFICE : 1976 O—2l6—113 CDB‘lEEE‘IB‘I