Overview and Summary: Cornerstone Documents in Healthcare: Our History, Our Future

Abstract

Primary healthcare serves as a curriculum thread at my institution. We base our definition of the term on the World Health Organization's (WHO) 1978 Declaration of the Alma Alta (WHO. 1978). This definition reflects a holistic view of nursing and healthcare that takes into account the determinants of health, shared decisionmaking, intersectorial collaboration, policy and politics, social justice, and access to population-based care. All of these are relevant terms for nurses who actualize the reform efforts found within the 2010 Patient Protection and Affordable Care Act (PPACA. 2010J. Nurses need to understand the primary healthcare philosophical framework in order to practice effectively and safely in any setting - whether in public health, primary care, or acute care settings. To do so, it is essential that they also know the history of nursing's engagement in primary healthcare like initiatives even before the Declaration of Alma Alta. For me, history helps shape the teaching/learning experience for our students. Primary healthcare from both a historical and contemporary perspective relies on the work of nurses to develop the standards and scope of practice.The articles in this Online Journal of Issues in Nursing (OJIN) topic resonate with my work as an educator and as a historian. I see the essence of primary healthcare fill these new OJIN articles. Within each article, we can see how nurses have practiced to the fullest extent of their education (Institute of Medicine [TOM1. 2010!. how nurses have responded to the changing legislation that defined practice, how nurses have determined their ethical framework in which they practice, and how shifts in nursing practice occurred in both the United States and Cambodia. To introduce the articles in this topic, I must first reflect on nursing's history and its evolution as a profession concerned about primary healthcare.From the beginning of the modern nursing movement in 1873, nurses advocated control of their practice and education. In 1893, nurses organized the National League for Nurses (NLN) (originally called the Society of Superintendents of Nursing) and by 1896 the American Nurses Association (ANA) (originally called the Nurses Alumnae Association). The purpose of both organizations included the development of standards of practice and education. The superintendents, like the deans of today, concerned themselves with educational standards and reforms. The ANA fought for state licensure and issues related to nursing practice. In 1912 the National Organization for Public Health Nursing formed and defined the meaning of public health nursing and created standards of practice in this growing specialty. The National Association of Colored Graduate Nurses started a few years earlier in 1908. It too concerned itself with the standards of practice and education, but also focused its goals on race inequality in nursing and healthcare. Each of the four organizations sought ways to address nursing legislation, ethical behavior, professional standards, and practice guidelines. By 1952, these four organizations restructured, and the NLN and the ANA became the two major organizations that would address nursing's scope of practice and specialty issues regardless of backgrounds (Lewenson & Nickitas. 2016: Roberts. 1954!.Fast-forward to 2015, and we find that nursing continues to develop documents in support of nursing practice and education. Authors Deborah S. Finnell, Elizabeth L. Thomas, Wendy M. Nehring, Kris McLoughlin, and Carol J. Bickford address in the article, "Best Practices in Developing Specialty Nursing Scope and Standards of Practice." how nurses today create, revise, and refine specialty nursing scope and standards of practice. But unlike nursing's earlier efforts, the authors provide the readers with a structure and process to help to "demystify" the very process of developing specialty nursing scope and standard documents. They ask the reader to consider the questions of "who, what, when, why, and how," as they undertake this important task. …