A Policy Perspective on the Entry into Practice Issue

It has been forty four years since the American Nurses Association (ANA) published its first position paper on entry into practice advocating that the baccalaureate degree be the minimum degree for entry into registered nurse practice. During that time period, only one state, North Dakota, was successful at getting the entry into practice proposal fully implemented, and even there it was rescinded in 2003. Although there has been much general discussion as to why the proposal initially failed, little has been written on this topic strictly from a policy perspective. This article begins with a brief history of nursing education leading up to the 1965 entry into practice paper (ANA 1965a). This is followed by a look at recent discussions and developments concerning the entry into practice proposal, an examination of the events surrounding the failure of the proposal in the original four focus states identified by the ANA for early implementation, and a discussion identifying possible reasons for the proposal’s initial failures. Encouragement and suggestions for present and future entry into practice supporters are provided.