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The oldest and most traditional nursing education type in the U.S. is the diploma program. This is a two or three-year program that is primarily accomplished in a medical setting. Diploma program graduates receive just a diploma and not a college degree. Majority of diploma programs are now college or university affiliated, meaning, college credits are granted for certain courses.
Many hospitals now collaborate with nursing schools to provide science and basic humanities courses; with the graduates receiving credits to be applied towards an Associate or a Baccalaureate of Science degree. In a few cases, a student can earn dual credentials, an associate degree and a hospital diploma. An example is the Mount Olive College and Watts School of Nursing articulation agreement.
Diploma graduates can take the same state licensing exam for RNs as students that graduate with an associate or baccalaureate degrees.
Since the 1870s, diploma nursing programs in the country have been set up in hospitals located in cities such as Boston, New York, Chicago, Hartford and Philadelphia. The catalyst for many diploma programs is the Nightingale School of Nursing. This was founded by Florence Nightingale in 1860.
The first nursing school models quickly spread throughout the nation and as the number of hospitals grew, these became the chief source of nurses.
The curriculum was not standardized back then and there was very little classroom experience. Nursing students often provided free labor for hospitals, with many of them working for 12-18 hours each day, at 6-7 days each week. In essence, students were learning everything hands-on.
Diploma programs soon evolved into courses that took longer to complete. By the late 1900s, majority of the programs took three years to finish. The early graduates started writing nursing textbooks and which then paved the way for specialty training.
Till the 1960s, the diploma programs were the major providers of RN graduates. The programs were at their peak during the ‘50s and ‘60s with around 1,300 diploma schools all over the country.
These days, however, the number of such programs are slowly dwindling. It is now less than 10-percent of every entrance RN program. The decline started all the way back in the late ‘70s when nursing education shifted from apprentice-type learning to instruction type at colleges and universities.
Diploma programs, these days, give a sturdy foundation in social science and biology with emphasis on clinical experiences as well as direct patient care. These also provide more clinical instruction as compared to any type of entry-level program. To many students, learning through experience is an effective way of studying nursing and those who enroll in such a program understand this concept.
The diploma program curriculum is similar to the ADN or Associate Degree in Nursing program, with the difference seen at additional clinical hours for the former. Graduates become adept with their clinical skills, hence, they can easily find employment in long-term care, acute care and community health care settings.
Many of the remaining U.S. diploma schools are located in the East and in Midwest; with the programs concentrated in New Jersey and Pennsylvania.
After training, many are hired by hospitals, which is the type of nursing care these students are groomed for. Today, there are less than 100 programs.