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Seventh chart: Goals of 5-year practical nurse program

Goals of the 5-year program for practical nurses have been set. In 1954, five and a half thousand students completed their educational and training programs at schools and in hospitals. By the end of the 5-year period provided in the bill it is anticipated that 9,500 additional practical nurses would be graduated each year from State-sponsored programs. This would increase the rate to 15,000 practical nurse graduates per year by 1961.



This completes our presentation of the objectives and provisions of title III, Mr. Chairman. Before concluding this statement, however, I should like to mention very briefly two related proposals which round out our program for Federal participation in the alleviation of nursing shortages.

Earlier in this statement I pointed out the need for a twofold approach; (1) increasing the supply of nursing personnel and (2) utilizing the available supply more effectively. Title III is aimed at increasing the supply. The two related proposals are directed primarily toward better utilization.

The first proposal, which requires no additional legislative authorization, is for an intensive program of Federal aid and participation in the development of improved methods for the utilization of available nursing skills. Our proposed budget for 1956 includes additional funds: (1) For studies and technical services by the nursing resources staff of the Public Health Service, and (2) for research grants and fellowships to stimulate nurse utilization studies and demonstrations by non-Federal organizations and individuals. We believe that this investment of Federal dollars in the development of improved administrative techniques will pay substantial dividends in the utilization of available nursing personnel.

The second proposal, embodied in title IV of S. 886, would authorize Federal traineeships to permit more professional nurses to take advanced training for supervisory, administrative, and teaching positions. The real key to more effective utilization lies in better supervision and administration. The value of specialized training for such positions is becoming increasingly recognized. A number of schools are now offering programs directed toward this need. The principal obstacle to increasing the number of graduates of such programs is that coniparatively few professional nurses can afford to leave their jobs for a year of full-time advance training. The traineeships authorized in title IV will there. fore contribute substantially to increasing the number of nurses prepared for key administrative and training positions.

In summary, Mr. Chairman, we are faced with a serious imbalance between nurse supply and demand. There is no simple or easy solution to this problem. We believe, however, that the Federal Government can make an effective contribution: (1) Through special grants to extend training opportunities for practical purses; (2) through the development of improved utilization methods; and (3) through traineeships to increase the supply of administrative and supervisory personnel. We therefore recommend enactment of title III of S. 886 and early consideration by your committee of the related provisions of title IV.

Chairman HILL. Are there any other questions?

If not, these hearings will continue tomorrow morning at 10 o'clock. They will be held in room 318 in the Senate Office Building.

The committee will now stand in recess until 10 o'clock tomorrow morning in room 318.

(Whereupon, at 2:45 p. m., the subcommittee recessed, to reconvene at 10 a. m., Thursday, April 14, 1955.)




Washington, D.C. The subcommittee met, pursuant to adjournment, at 10:10 a. m., in the caucus room, Senate Office Building, Senator Lister Hill (chairman) presiding.

Present: Senators Hill and Lehman.

Also present: Stewart E. McClure, staff director; Roy E. James, minority staff director; and William G. Reidy, professional staff member.

Chairman Hill. The committee will kindly come to order.

We will proceed with the hearings on Senate 929 and title III of Senate 886, to provide for practical nursing through our vocational education program.

I will ask Dr. Lucius Wilson, chairman of the Council on Government Relations of the American Hospital Association, if he would come around, please.

Doctor, will you proceed in your own way, please, sir. STATEMENT OF DR. LUCIUS R. WILSON, ACCOMPANIED BY


Dr. Wilson. Thank you, Mr. Chairman. I am Dr. Lucius R. Wilson, director of the Episcopal Hospital of Philadelphia. I represent the American Hospital Association as chairman on its Council on Government Relations, and I have with me Mr. Kenneth Williamson, the associate director of the American Hospital Association.

The American Hospital Association welcomes the opportunity of presenting its views on Senate bill 929 and title III of Senate 886, which are receiving the attention and consideration of your committee.

These measures in the main seek to cope with many complex and diffuse problems confronting the nursing profession and the hospitals of the Nation, the specific proposals embodied in these measures, that we address this statement.

We have distributed before you our testimony, and since it is long, I would like to just hit the highlights, please, sir. Chairman Hill. We would be very happy to have you do

so, please, Doctor, and then your testimony in full will appear in the record. Dr. Wilson. Right.


With the tremendous advance which has been made by medical science in the last few decades, the complexity of developing the kind of higher quality medical care has substantially increased. Teamwork has become more important and more of a necessity. Out of the recognized need of patient care developed the concept of the nursing need in 1953. By this concept, the number of persons working as a group under the supervision of the professional nurse give a variety of patient needs. As head of the team, the professional nurse assigns duties to this team and other members commensurate with their abilities in the patient's requirements and care.

Today practical nurses are a very vital part of this nursing team. While the early courses emphasize training for duty and homes, practical nurses are now being increasingly used by hospitals.

In 1953, some 54,000 of them were working in hospitals. To a very considerable degree, they have appreciably helped in meeting patients' care and demand for services. They have been instrumental in helping to bridge over the gap of such personal needs as those arising from the demands for more professional nurses.

Other categories of auxiliary hospital personnel are important too, and part of the nursing team. Recognition of the value of their services is obtained from the fact that such workers are being increasingly employed by hospitals. To the degree that they relieve nurses from duties not requiring their highly skilled training, these workers are helping to relieve nursing shortages.

Mr. Chairman, there follows a description of the American Hospital Association and the work it renders, and I think all of you are acquainted with that so I will not take up your time by going into that.

Chairman Hill. May I interpose by saying it is very fine work, sir. Dr. Wilson. Thank you, sir.

Now, I shall not discuss all the provisions in both of the measures, but will confine my testimony to those which I think are most pertinent to and have the greatest impact upon the hospitals of this Nation.

The American Hospital Association supports Senate bill 929 and title 3 of Senate bill 886. We believe in the philosophy underlying these measures. They recognize the principle that the role of the Federal Government should be to stimulate and encourage the building up of the necessary health resources, not to control them. This should hold true whether such resources are physical facilities as in the Hospital Survey and Construction Act, or in programs for training more health personnel, as proposed in this legislation.

These measures deal with vocational education. Such programs are not untried and untested. They evolved from the fundamental idea that vocational education is a matter of national interest and essential to the national welfare. Experience has demonstrated time and again their value. Since 1917, with the passage of the SmithHughes Act, State and local public school systems with Federal funds matched with State or local funds, have conducted vocational education programs. Both measures make additional Federal funds available for such programs. Senate bill 929, however, earmarks them for training of practical nurses and auxiliary hospital personnel and in-service training for directors, teachers, and supervisors; Senate bill 886 for practical nurses, teachers, teacher-trainers, directors, and supervisors. The material difference of eligible persons who may

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