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Conclusion The tension between nursing's two cultures still underlies and informs nurses' efforts to define and control their work. Leaders have gradually won much of their program; yet as more and more nurses earn degrees, they are discovering the limits of credentials as a means to gain the prerogatives of professionals. On the job, the culture of apprenticeship continued to reproduce itselfand, in somewhat altered forms, the values of apprenticeship still flourish. The divisions introduced by the transition to baccalaureate requirements are not yet mended, and nurses confront the persistent limits oftheir work under the handicap ofinternal conflict and turmoil. But at the same, the traditions of professional ideology and apprenticeship culture each provide resources for moving forward nurses' claims to authority at work. After the 1948 Brown report, the transition to collegiate education proceeded slowly but inexorably. New programs began to form and to recruit growing numbers ofcandidates. In 1952, the first associate degree program opened, offering an intermediate credential intended to rank between the hospital diploma and the baccalaureate degree. Associate degree nurses attended two years ofjunior college and took some clinical training. By 1963, these programs claimed a modest 4 percent ofall new graduates. Baccalaureate programs increased slowly in number and influence, representing 14 percent of new nurses in 1962. In 1965, the professional associations took drastic action to speed the transition, setting a twenty-year deadline for the goal ofa college education for every nurse. A small group ofnurses passed the proposal without consulting 208 CONCLUSION the general membership, and inadequate provisions for diploma nurses provoked sharp antagonism and opposition. After the 1965 resolutions, nurses' education shifted decisively away from the hospital schools. More hospital schools closed each year, and by 1970 associate programs claimed over 26 percent of the new graduates, while another 20 percent held baccalaureate degrees. College-based programs were making headway in nurses' education and beginning to have an impact on their work lives: more and more supervisory or specialized nursing posts required the degree.! Equally striking, though, was the persistence ofapprenticeship culture in nurses' workplaces. Long after leaders proclaimed the superiority ofthe college-educated nurse, hospital school graduates often enforced another standard on the job. Schooled to appreciate firm control and practiced skills, diploma nurses scorned their uncertain and fumbling sisters, who came to their first jobs with degrees but also with less clinical experience. In the informal hierarchy among nurses, the degree nurse might have to humble herselfto the hospital graduate. Baccalaureate nurses defended themselves in language that suggests their precarious status in workplaces still dominated by the values ofapprenticeship. In 1969, for example , one college-educated nurse wrote RN to complain about the many letters that disparaged baccalaureate nurses. "A layman reading these letters would hesitate before allowing a BSN to trim his fingernails, " she exclaimed. pleading for a fair hearing from diploma nurses: "I'm tired of being judged as unqualified simply because a few other BSNs haven't measured up. Let each ofus bejudged individually. I don't believe in condemning a whole group because ofthe faults ofa few." As late as 1970, another college-educated nurse felt it necessary to remind intransigent supporters of hospital schools that "a degree nurse must pass the same state board exam as a diploma nurse.... our degree nurses need a boost instead of a boot."2 Hospital hiring practices sometimes enforced traditional standards of apprenticeship, for some nurse-employers treated the degree as a detriment rather than a credential. In CONCLUSION 209 one example, the American Nurses' Association demanded equal pay for associate degree nurses, who were being hired for lower wages than hospital school graduates in Minnesota hospitals in 1967. A 1976 state survey of 77 hospitals and 34 nursing homes in Kansas found that nurse-employers did not favor the nurse with a degree. Nurse-superintendents in hospitals of 100 or fewer beds frankly preferred the diploma nurse. In larger hospitals, nurses in charge ofhiring considered the diploma nurse to be the equal ofa baccalaureate nurse and superior to the nurse with an associate degree. The military concurred. The Army Nurse Corps refused associate degree nurses until 1971; the Air Force Nurse Corps did not relent until a year later.3 The vigor and resilience ofordinary nurses' work culture suggest a vision that might shape nursing's future. Apprenticeship culture has provided an alternative to professional ideology, a different structure within which nurses can affirm their skills and define their work. In their frequent opposition to leaders...


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