Nursing Practice
and Education
in the United States Today

Nursing in the United States has undergone tremendous changes in recent years. Those providing care and teaching in schools of nursing are better prepared educationally than ever before, the science that underlies our practice is increasingly being built through scholarly efforts of nurses, and collaborative partnerships between nurses and other health care workers continue to evolve. In addition, the opportunities for nurses to influence the health of people through their roles as nurse practitioners, nurse midwives, home care clinicians, managers and administrators, health educators, acute and long term care clinicians, and faculty are growing dramatically.

In order to prepare nurses for beginning and advanced levels of practice, educational programs also have undergone tremendous changes in recent years. Many curricula are creative and interactive, rather than rigid and proscriptive. Education is more learner-focused than teacher-centered. Clinical experiences for students reflect a greater emphasis on community-based care, health promotion, disease prevention, family involvement, and self-care. And the integration of technology and the use of distance learning strategies are more evident in nursing education programs.

In educational programs there is an increased emphasis on documenting program outcomes and demonstrating that graduates do, indeed, have the patient care, thinking, and communication abilities needed to function in our complex, constantly-changing, ambiguous, unpredictable, chaotic health care arena. Finally, nurse educators are realizing that there is an art and a science to teaching nursing - just as there is an art and a science to practicing nursing - and they are seeking preparation in curriculum development and evaluation, creative teaching/learning strategies, student and program evaluation, and other areas that complement their clinical specialization and expertise.

What to Expect
In light of these changes, students coming to the United States to study nursing should expect to find graduate and undergraduate programs that are challenging, innovative, and designed to meet their individual needs as learners. You should expect state-of-the-art practice laboratories that will help you learn and enhance comprehensive assessment skills, as well as home care and technological skills. You should expect to find library and computer resources that will allow you to access unlimited resources, be creative in teaching patients about managing their own health, communicate with experts in the field, and continually develop your own knowledge base and scholarly abilities.

Students who study in the U.S. will be exposed to patients/families from a vast array of cultural, ethnic, religious, socioeconomic, and educational backgrounds: homeless men who live on the streets of Detroit or New York, the 12-year-old single mother of Hispanic descent, the 6-year-old Hmong child suffering from asthma, the Chinese scholar, and the migrant worker with less than a high school education, among others. Nursing students - under the guidance of well-qualified faculty -- have many opportunities to touch and be touched by the lives of others who may be vastly different from themselves. Such experiences with diverse populations contribute to the students' understanding of human beings, as well as to their ability to provide culturally-sensitive care.

Factors to Consider in Program Selection
As you consider coming to the United States to study nursing at the undergraduate, master's, or doctoral level, you need to look carefully at a number of factors. Although this is not intended to be a complete list, the following things are important to consider when selecting a program:

• What courses in and outside nursing are required of students in the program? Will they help you build the knowledge base you need to pursue your professional career?
• How much flexibility is there in the program? Are there opportunities to select courses that are of interest to you? Are there opportunities to design individualized learning experiences (e.g., clinical experiences, the topic of a course paper, the case studies you develop) that will meet your own needs?
• What kinds of clinical experiences are available for students? Will you be able to work with diverse populations and in a variety of settings (e.g., acute care hospitals, home care agencies, hospice settings, clinics, community health centers, etc.)? What role do students have in selecting their clinical experiences?
• What are the qualifications of the faculty? Are they all prepared at the master's or doctoral level in nursing (or in the nursing-related specialty they teach, such as Pharmacology)? Are they clinically competent? Are they scholars in their areas of teaching? Are they leaders in the field?
• What resources are available to support students in the program? Are the library, practice laboratories, and computer centers comprehensive and current, offering state-of-the-art technology and adequate technological support?
• What resources are available to support international students in the program? Are there special advisors for international students … advisors who are sensitive to the needs of students studying abroad and able to help those students become a part of the life of the program?
• What are the relationships like among students and between students and faculty? Is there a "spirit" of learning together? Do students have the opportunity to work collaboratively on projects? Are master's students able to work with faculty on the faculty member's research? Do faculty see themselves as learners as well as teachers?
• What is the accreditation status of the program? Has the program undergone a comprehensive review by peers outside the institution and been judged to meet standards for academic programs that have been set by the profession?