Honoring the Foundation for Our Future
By Josh Cornwall
One hundred years. A century.
A celebration of innovation, excellence, and care for the School of Nursing at the University of Wisconsin–Madison is on the horizon in 2024.
It would have been hard to imagine the impressive growth of the School of Nursing 100 years ago when the Board of Regents successfully established the collegiate program in 1924. Based on the belief that better education was imperative for modern nursing practices, the school’s inception was groundbreaking in the state as its first collegiate nursing school and among the first public programs nationally.
Fast forward 100 years, and the School of Nursing consistently ranks among the best public nursing schools in the country, according to U.S. News and World Report’s Best Colleges. Annual enrollment in the School of over 1,000 students in five different programs and three certificate tracks is a far cry from the 11 students who were a part of the inaugural graduating class in 1927. It is known for its innovative programming and partnerships, students graduating with career readiness, and a commitment to a more diversified workforce to reflect the populations it serves. As the School has developed over the last century, it has grown and evolved to respond to a changing health care landscape.
The beginning and evolution of the degree
The timing could not have been more perfect.
Four years after an initial attempt to get a state-funded nursing school established, the University of Wisconsin–Madison achieved success under the direction of Helen Denne (Schulte) in September, 1924. It just so happened that Wisconsin General Hospital opened down the street the same month.
The two organizations opening simultaneously offered an easy symbiotic relationship, instantly providing students in the School with hands-on opportunities for learning as a part of their studies. The first graduating class, the class of 1927, had a choice between earning either a certificate or degree in nursing. The certificate program was a three-year course that included one semester of academic work followed by 32 months of instruction in nursing. Nursing degree candidates also selected a second major in either the College of Letters and Sciences or the School of Home Economics. The dual-major approach required three years of academic work, with 27 additional months of instruction in nursing. Both majors included a bachelor of science degree in hygiene.
By the time the School of Nursing reached its 15th year, the certificate program had undergone several structural changes, and the School offered the first nursing-specific major in public health as a way to remove the need for the aforementioned double-major.
In the early 1940s, the certificate program format changed to four full semesters of academic instruction and 27 months of clinical practice.
An increased demand for nurses came soon after as World War II raged across the globe. The School of Nursing was one of many that participated in the U.S. Cadet Corps program, allowing for a temporary accelerated program to get nurses into the queue for service. As a result, School of Nursing alums were sent all over the world for service, including to many of the battle hotspots in Europe and the Pacific.
Interest in the nursing field increased following the war as the number of registered nurses enrolling in the School increased with nurse veterans taking advantage of the G.I. Bill of Rights. The natural result was more changes to the degree makeup. The School revamped the public health major and created a second nursing major: Ward Management and Ward Teaching.
In the ten years following the end of World War II, the university established a Department of Nursing, which held continuing education classes for nurses looking to fine-tune their skills, and moved its undergraduate program to a four-year curriculum solely within the School of Nursing, changing the title of the degree from a BS in hygiene to a BS in nursing. It also dissolved its certificate program, putting all of its resources into the traditional degree program by the turn of the 1960s.
Progress continued into the ’60s when the School of Nursing was finally recognized as an independent entity, no longer sharing space under a different academic department. It was the final brick laid on an already solid foundation for excellence to come.
Meeting the Challenges of a Shifting Health Care Landscape
While the need for trauma-prepared nurses continued into the 1970s, the landscape of the health care industry at home was shifting drastically. The role of the nurse was changing, and the UW–Madison School of Nursing needed to adjust to meet the evolving needs of the profession.
Moving away from majors in public health and ward management was the first step in the early ’60s, giving aspiring nurses more modern looks at medicine and health care.
In 1964, the School introduced the UW System’s first graduate program in nursing. Under the direction of Florence Blake, the program enrolled students to earn a master of science degree in pediatric nursing.
Three years later, the School earned independent status from the Board of Regents, becoming an autonomous unit within the University of Wisconsin–Madison.
As the School of Nursing approached its 50th anniversary in 1974, enrollment soared to the highest in its history at nearly 1,300 students. Just years earlier, an in-depth curriculum study led to a forward-thinking redesign of its baccalaureate teachings, increasing overall interest. A school that, only years earlier, was more regional in attraction from prospective students nearly doubled in size from just over 700 enrolled nursing students.
The boom in enrollment, combined with a slew of well-timed grants, led to exciting new opportunities for the School of Nursing. Between 1975-77, the school added three nurse practitioner programs — geriatric, pediatric, and adult — and received an entitlement to plan its first doctoral program in nursing, which became officially established in 1984.
The nurse practitioner programs, many of which were innovative and first-of-their-kind, became an area of distinction for the School as it opened a new Clinical Science Center in November 1977. The location, 600 Highland Ave., bolstered the School of Nursing’s range of resources dedicated to research and teaching with all the latest medical technology.
At the Cutting Edge of Technology
Much like the University at large, the School of Nursing was a trailblazer in the technology that was changing the health care industry.
The School started with two-way telecommunication educational opportunities, and ultimately ended up with its first course, “Call Nursing 1966,” in the late spring of 1966. It was the School’s first foray into long-distance learning, which gave nurses a chance to listen to non-credit lectures of varying lengths on various nursing topics.
The program evolved over its 25-year tenure, gaining national notoriety for its extended learning in the process.
While still a relative novelty in the classroom in the 1960s, the School began to use television to teach in 1963. Thanks to the efforts of May Hornback, assistant professor of nursing, the School launched its first televised course, “Fundamentals in Nursing.” The series was eventually released beyond the University of Wisconsin network of schools, reaching a wider audience with primary nursing skills education.
Hornback, along with Bruce Westley, a UW–Madison faculty member at the time who specialized in research methods and theory in the study of social and mass communications, eventually published their findings and successes of the television initiative. It was the first faculty research publication to come out of the School of Nursing, and a signifier for what was to come.
By the early 1980s, the School of Nursing had been at the forefront of emerging learning technologies for nearly two decades. However, signs of the digital age were becoming abundantly clear with the development of computers.
As the School continued its television course outreach to its external constituents in the late ’80s, the School saw the formation of the Computer and Instructional Resource Center to support the increasing need for instructional and research support involving computers. Within the next few years, the use of computers utilized in the School grew immensely, from instructional use to simulated research assistance.
With technology quickly evolving, so did the need for the nursing profession to stay ahead of the times. The School recognized that they were already living in the future they had anticipated some 30 years before. In an effort to adapt to the quickly evolving technological landscape, the School of Nursing created its official home on the world wide web in 1995. The website opened a whole new set of doors to limitless opportunities.
The introduction of the internet revolutionized the way many institutions thought of instructional technology, which was no different for the
University of Wisconsin–Madison. Its use allowed the School of Nursing to expand its reach through an online collaborative program between the five universities within the UW System that had nursing programs at the time. First referred to as the Collaborative Nursing Program, it is now known as the BSN@Home program, a RN-BSN completion program.
Soon after, in 1997, the School saw its first ever internet course offered to students — a class on Primary Health Care in the School Setting offered by Patricia “Pat” Lasky, MS’68, PhD, RN.
Just four years removed from publishing its first web page–ushering in a new era of digital reach–the School of Nursing was poised for the challenges ahead. The early foundation of investing in technology prepared the School for the turn of the millennium.
Innovating to Better Serve A Growing and Diversifying Population
With a focus on resources, programming, and education, the innovations that have resulted from keeping the community at the forefront of the School’s efforts to grow and advance nursing in the state of Wisconsin and beyond have led to greater impacts on the populations Badger nurses serve.
Since its inception, the School has kept nurses on top of ongoing changes in health care through offering continuing education programming. Early courses, such as refresher courses for nurses returning to the workforce, were created to help address needs like nursing shortages and changes in health care practice.
Over the decades, the School of Nursing has remained dedicated to delivering new and innovative resources, education, and programming. One such program, introduced in the early 2000s, was Nurse Education for Tomorrow (NET), offering nurses the opportunity to enroll in a master’s program online or gain post-master’s credits while remaining in their home communities. NET broadened the online programming being offered to those continuing their education in rural areas, and the initiative planted a seed about the importance of providing care to underserved communities. Since then, the core tenets of community, accessability, and outreach remain central to the School’s efforts.
Additional programs and resources have been created since then to better serve the changing landscape of health care and the diverse communities nurses serve. These innovative academic programs and outreach initiatives, such as the Center for Aging Research and Education (CARE), or the New to Public Health Residency Program, improve quality of life by providing tools, resources, and education for nurses and other health care providers to stay on top of the continuous changes of the industry.
As health care has evolved, so has continuing education programming offered by the School of Nursing. The need for interprofessional collaboration and team-based care has become increasingly important when delivering optimal health care. As a result, the School transitioned in 2020 from what was then called Continuing Education in Nursing to a new format called Nursing Professional Development (NPD). The change in name marking a representation of the School’s commitment to life-long, self-directed learning.
Delivering educational opportunities designed by health care teams, for health care teams, NPD is built on a century of innovative technology, design, and delivery. Its reach expands beyond Wisconsin and the nursing profession to improve the health of patients and communities worldwide. Through NPD, the School partners with health science colleagues to deliver accredited continuing education, increasing the skills and strategies of nurses and interprofessional health care teams while preparing them for collaborative practice and the future of health care.
Through partnerships and collaborations, the School continues to expand nursing professional development, prepare health professions teams for the complexities of current and future health care systems, and improve the quality of life for residents of Wisconsin and beyond.
Addressing the Need for Diversity, Equity, and Inclusion
As the School entered into the 21st century, conversations in the workforce were shifting. Confidence in utilizing nurses as change makers was increasing, as were conversations around how nurses could positively impact those they serve by addressing inequities and diversity in health care.
In 2010, the National Academy of Medicine (NAM) — formerly known as the Institute of Medicine — published The Future of Nursing: Leading Change, Advancing Health, which offered recommendations to strengthen the education, capacity, and roles of the nursing workforce by empowering nurses to play a more central role in health care. Over the next few years, efforts increased within the School of Nursing to create a more diverse and inclusive nursing workforce.
The School was already ahead of the times. In 2007, it had formed the Equity and Diversity Committee, now known as the Equity, Diversity, and Inclusion Committee (EDIC). Since the committee’s inception, the EDIC has been dedicated to fostering an environment of inclusion that welcomes diversity among its students, faculty, and staff. Awareness of diversity and promotion of inclusivity has become central to the School’s efforts on multiple levels.
In 2018, the EDIC began the process of creating an inclusive excellence plan for the School. It also added inclusive excellence as a central pillar to the School’s 2019-2024 Strategic Framework, which was already supported by the foundational pillars of academic excellence, research expertise, faculty resources, and organizational effectiveness.
The inclusive excellence plan supports the School’s ongoing efforts to create safe, dynamic spaces in the workplace to ensure all members of the School understand their unique influence on the current nursing climate, and all nurses play a role in addressing the pervasive health inequities worldwide by expanding their own self-awareness, advocacy skills, and social engagement.
Beyond the academic setting, the impact of School of Nursing research on addressing the need for more equitable health care has had tremendous impact over the years. Recent initiatives, such as the work being done by the Nurses 4 Black Well-Being research team, advance the School’s mission and address the most recent call to action by the NAM, The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity, which calls on nurses to lead the way towards more equitable health care.
Led by Professor Linda Denise (LD) Oakley, PhD, RN, Louis J. and Phyllis Clark Jacobs Professor in Mental Health, the Nurses 4 Black Well-Being research team is using science to find health and well-being solutions to systemic hypertension present in Black communities.
Additional School initiatives to address diversity, equity, and inclusion center around the need for a more diverse nursing workforce that is more reflective of the populations nurses serve. In 2021, a gift from the Oscar Rennebohm Foundation created scholarships to support nursing students. The scholarships are intended for those who come from underrepresented groups or populations, those from socioeconomically disadvantaged backgrounds, or those who face additional barriers in pursuing further education in nursing. The goal being to address an immediate need to diversify the nursing workforce by first addressing the diversity of nursing students.
Evolving Academic Offerings to Meet Demand
The substantial growth and progress in both technology and community innovations helped usher the School of Nursing through the ’80s and ’90s, and into the early 2000s.
With substantial growth to both the School of Nursing and the profession, the School continued to evolve the academic offerings to meet new workforce demands. Academics were tailored to meet the challenges that were arising as the profession advanced and evolved, and research within the School was expanding into new territory thanks to heightened funding from grants and initiatives. As nursing research as a whole shifted its focus on patients and patient behavior, so did the focus on research efforts within the School of Nursing.
This focus on research led to more academic opportunities, including an early-entry PhD path. Established in 2003, the track makes it possible for undergraduate students interested in research careers to advance directly into the PhD program.
As the academic and research side of nursing expanded, there became a need for more advanced practice nurse leaders. The School of Nursing responded to the need, and in 2010 launched its doctor of nursing practice (DNP) program. With post-BSN and post-MS options, the program provides a customizable experience for each student to help them achieve career goals. Students were able to further develop critical thinking, and focused expertise in areas like health care systems, leadership, program development, informatics, and health policy.
While the School of Nursing was experiencing growth and success with its academic offerings, the profession was finding itself in progressively strained situations: the delicate balance between demand from health care sectors from an increasingly aging population, and the supply of nurses entering the workforce, were not matching up.
While the United States has experienced nursing shortages since before the School of Nursing opened, the strain on the profession typically resolved itself quickly. However, the turn of the century brought forth new challenges for the nursing profession. By 2012, the recognition of a significant nursing shortage had risen to the forefront of health care conversations. In addition, the Institute of Medicine recommended increasing the percentage of practicing nurses with a BSN to 80 percent by 2020.
To help address the needs of increased demands for more nurses in the workforce, the Board of Regents approved a new accelerated baccalaureate nursing program at UW–Madison in 2016.
The accelerated program, created to enable the School of Nursing to enroll more qualified students and contribute more BSN-prepared nurses to the workforce was designed for students who already hold a bachelor degree in a different discipline and have met nursing prerequisite classes. Students enrolled in the program would be able to graduate with their bachelor of science in nursing in just 12 months, preparing them for the workforce faster. The rigorous program kicked off with its first cohort of students in May of 2018, and upon graduation in May of 2019 and they were fully prepared to sit for licensure.
The School has continued to develop new pathways and access to nursing education in response to the persistent workforce needs. Most recently in 2022, the School helped secure a new transfer agreement between Madison College and the University of Wisconsin–Madison School of Nursing. The agreement addresses the need to create greater access to nursing education. In addition, it supports the need for more BSN-prepared nurses in health care, which will improve health in the state of Wisconsin and beyond.
Looking Ahead to the Next 100 Years
The School of Nursing’s first 100 years has seen incredible growth and progress. It has leaned into meeting the demands of societal and professional challenges. It has bounded over technological hurdles and strengthened its research enterprise. It has partnered with communities to create more inclusive health care. The curriculum has been refined, and the clinical skillsets enhanced. It has risen to the occasion of recognizing and addressing the challenges of its times over and over again.
But there is still work to be done. As 2024 and the UW–Madison School of Nursing’s centennial celebration quickly approaches, Badger nurses are asking, “Where do we go from here?”
Current affairs see the workforce facing ongoing challenges, including strain due to the nursing shortage. Aftershocks of the COVID-19 pandemic are still shaking the foundation of health care. There is a need for a more diverse nursing workforce to help care for an ever growing, aging, and diversifying population. Addressing disparities and building health equity is critical. The need for nurse leaders is greater than ever as health care evolves to a more collaborative, team-based approach to delivering optimal health care. And, like the clinician workforce shortage, the need for nurse educators and researchers is at an all-time high.
The decades ahead will test the nursing workforce in ways not yet imagined, but the School of Nursing is building on its strong history of leading and innovating to find solutions.
However, in order to move forward, the School must first look back and reflect on what has been. The challenges, changes, growth, and hurdles of the past are all key moments in time from which to learn. Each milestone is a rung in history that helps future Badger nurses do more to advance health for all.
Only by honoring the legacy of our past can we embrace the future and charge forward into a new century of changing lives.