BALANCING PROFESSIONAL AUTONOMY AND STATE REGULATION: THE NEW YORK STATE BOARD OF NURSE EXAMINERS, 1903-1940.
Contributors: State University of New York at Albany.
Published: 1989
Number of pages: 354
Subjects: Education, Higher.; Health Sciences, Nursing.; History, United States.
Description: Current dilemmas in the field of nursing, state regulation and higher education have raised questions about proper balances between professional autonomy and accountability to the public. This historical case study focuses on the pivotal position of the New York State Board of Nurse Examiners as it sought a balance between professional and public interests in the precedent-setting years between 1903 and 1940 in which the structure and process of state regulation of nursing were established.

A conceptual framework operationalizing professional autonomy in terms of prerogatives to educate and control entry to practice and consideration of the evolving characteristics of professionalization guided examination of primary and secondary sources. It became evident that an oligarchy within the trained nurse group in the state was empowered to set standards, but that once the alliance with the state was achieved, the self-determination of the group was severely compromised within the political arena of the legislature and the regulatory agency. Several factors indigenous to the field of nursing, such as heterogeneity, minimal economic resources and lack of a distinctly defined knowledge base and scope of practice, were shown to adversely affect the impact the professionalizing leaders hoped to have on recruitment and education standards. Such factors prompted questions about the appropriate timing for a state nurse practice law and the inclusion of all levels of nursing within one regulatory law.

The Board of Nurse Examiners evolved from a board synonymous with the ruling oligarchy of the professional association to a more broadly representative board and one increasingly directed toward public accountability as a legal mandate. The early nurse examiner boards sought to establish the professional autonomy of nursing; succeeding boards learned that autonomy is relative and diminished by expressions of public and competing professional interests in the complex and often difficult implementation of regulation. The nature and evolution of the state regulatory agency itself (The Board of Regents and its administrative arm, the Education Department), had a direct effect on the degree of professional autonomy that would be possible.

Professional autonomy and state regulation are concepts which need to be re-evaluated in terms of their adequacy to represent the intent of the professionalizing occupation and the role of the state in protecting public welfare.
Notes: Source: Dissertation Abstracts International, Volume: 50-04, Section: A, page: 0883.

Thesis (ED.D.)--STATE UNIVERSITY OF NEW YORK AT ALBANY, 1989.

School code: 0668.