Nursing faculty, Pender stresses, "should determine how the concept of high risk environments may be given more attention in the curricula and which critical environmental assessment and intervention strategies are appropriate for inclusion" (Pender, 1992, p. 201).

Likewise, the American Association of Colleges of Nursing (AACN, 1991) endorses the necessity of curriculum revision to support nursing in the future. Nursing Education's Agenda for the 21st Century is not unlike the tenets called forth from the Pew Commission: broad content areas that are relevant to the development of healthy lifestyles and future health care solutions must be assembled. These content areas include health promotion and maintenance related to specific environmentally induced diseases (cancers, accidents and injuries, and trauma), as well as a particular emphasis on environmental and occupational health.

The traditional approach to basic nursing education represented by all three avenues—associate degree, diploma, and baccalaureate nursing programs—has been to emphasize curriculum for micro-level, individual situations rather than the macro-level of intervention. Recognizing that this individual focus will not suffice for the needs of the twenty-first century, the National League for Nursing (NLN) emphasized that "preparing all graduates of nursing education for community-based care, therefore becomes the responsibility of all programs and all faculty—perhaps in varying degrees, but a commonly shared responsibility" (NLN, 1992, p. 12).

The Association of Community Health Nursing Educators (ACHNE) published two documents describing the essentials of baccalaureate- and master's-level education for entry into community health nursing practice (ACHNE, 1992) and advanced practice nursing (ACHNE, 1991). Both documents build on reports from the American Nurses Association (ANA 1980, 1986), the World Health Organization (WHO, 1978), the American Association of Colleges of Nursing (AACN, 1986), the American Public Health Association (APHA, 1980), the U.S. Department of Health and Human Services (DHHS, 1988), and Jones et al. (1987). The community health content in the baccalaureate degree program specifies the inclusion of introductory environmental health and environmental hazards as essential to support the nurse generalist practice in the community (ACHNE, 1992). The content of the master's program to prepare advanced practice nurses in community and public health nursing specifies environmental health as a separate item linked more closely to the public health sciences than community and public health nursing (ACHNE, 1991). Thus, environmental health is considered essential to the education and practice of advanced practice nurses in community health and public health. It should be emphasized, however, that the development of competencies in environmental sciences for generalist and advanced



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement