practice nurses who work in traditional settings such as hospitals and long-term-care facilities is also fundamental to their practice in these settings.

Accreditation and Regulation

The regulation of nursing education and practice is accomplished through a number of credentialing mechanisms. Each mechanism standardizes outcomes (competencies of graduates and practicing nurses) for the assurance of safe delivery of nursing care.

Higher education programs in nursing are accredited by regional accrediting bodies as part of the larger institutional accreditation process. Additionally, schools of nursing seek accreditation from the NLN at the associate degree, diploma, baccalaureate, and master's levels. Within each state, approval for education programs is usually conferred by the state's regulatory board of nursing education content. However, no accrediting body in nursing currently considers environmental health content to be required for the receipt of accreditation.

Official documents of professional nursing organizations endorse the presence of environmental health content in basic and graduate programs. However, accreditation mandates for schools of public health require education in environmental health sciences for graduates of public health programs. Currently, the roles of accrediting bodies and standards in mandating content ensure the visibility of environmental health in schools of public health. Such mechanisms of ensuring an environmental health content bear exploration for the accreditation process in schools of nursing.

NURSING EDUCATION PATHWAYS

Agreement on the common educational base required for entry into nursing has not yet been achieved (Fagin and Lynaugh, 1992; Oermann, 1994). Oermann argues that the explosion of knowledge, changing health care systems, and community-oriented care demand that nurses be prepared at the baccalaureate level. According to the U.S. Public Health Service (1992), 62 percent of the nurse workforce is prepared at the associate degree and diploma levels, whereas 30 percent of the nursing workforce is prepared at the baccalaureate level. Eight percent is prepared at the master's or doctoral level. When nurses, licensed by the profession, present themselves for employment unprepared for community-based, population-focused practice, the employer has three options:

  1. Do not hire, and let positions stay vacant, decreasing capacity for service;



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