PREPARED STATEMENT OF MRS. ETTA B. SCHMIDT, EXECUTIVE DIRECTOR, Mr. Chairman and members of the Subcommittee on Veterans' Affairs, my name is Etta B. Schmidt. I am Executive Director of the National Federation of Licensed Practical Nurses (NFLPN). The National Federation of Licensed Practical Nurses (NFLPN) is the national association of licensed practical nurses. The association has 40 constituent state associations with individual members in each of the remaining states. Its current membership is approximately 29,000. NFLPN was organized in 1949. Its primary purpose is to foster high standards of nursing practice through sound practical nurse training programs and through upgrading of the LPN practitioner to the end that the people of this country will have the best possible nursing care. By way of personal background, I am a licensed practical Nurse (LPN). I received my license to practice in Illinois in 1953. I obtained my Master in Education degree in 1960 from Colorado State University with a major in Administration and Supervision of Vocational Education. For three years I served on the Advisory Committee for Health Occupations Education of the U.S. Office of Education. We appreciate this opportunity to present our views to the Committee on H.R. 16025 which would amend chapter 35 of title 38 United States Code to make educational benefits available to War Widows as defined. In the course of my service with the Licensed Practical Nurse Association of Illinois (1950-60) and my responsibilities with the national group going back to 1957, I have had the opportunity to observe the rapid increase in the demand for the services of the LPN and the general acceptance of her service as an integral part of caring for the sick and disabled in this country. Also, I am particularly aware of the skilled services of the Licensed Practical Nurse (LPN) which have been made possible by the Federal funds authorized by the 1956 amendments (P.L. 84-911) to the Vocational Education Act of 1946 (GeorgeBarden Act) and specifically extended in Sections 10 and 11 of the Vocational Education Act of 1963 (P.L. 88-210). Thus it is with enthusiasm that we endorse and support H.R. 16025 because it will offer educational opportunity to a number of deserving women whereby they can become self-supporting members of society. It will also offer access to a field of nursing where tremendous shortages exist. Thirty years ago the practical nurse was an untrained auxiliary worker. She had no legal status. Her function was debatable. Today she is recognized as a skilled practitioner and an essential component in the health services. Every state provides a legal definition in the Nurse Practice Act. In California and Texas the legal title is Licensed Vocational Nurse. In 1965 there were 338,000 licenses issued. It is estimated 250,000 are actively engaged in nursing. The LPN remains on the job longer than any other member of the nursing team. She is the Bedside Nurse of today. Her role has been defined as a nurse prepared to give direct patient care under supervision of a registered nurse, physician or dentist. The LPN is prepared to work independently in nursing situations relatively free of scientific complexities. She can assist the RN and the MD in giving bedside patient care in more complex nursing situations. The skilled supportive service of the LPN enables the registered nurse and the physician to further extend their services in meeting the health needs of the people. The LPN is employed in every kind of health facility. Major areas of employ. ment are private and government hospitals, extended care facilities, nursing homes, doctor's offices, public health service, the military and private duty in the home and hospital. In the past 25 years the demand for the service of the LPN has far exceeded the supply in spite of the rapid growth in numbers. The hospital is the employer of the greatest number of LPN's. A 1967 report of the Bureau of Health Manpower of the United States Public Health Service states "The annual output of practical nurses should be increased from the present 25,000 to not less than 40,000." In 1966 a health Manpower survey was conducted by the United States Public Health Service and the American Hospital Association. The Report, Manpower Resources in Hospitals1966 (See Table 1) indicated urgent current needs for 41,400 LPN's in the hospitals reporting. The Report estimates a total of 245.000 LPN's needed by 1975 in these hospitals alone. Similar needs exist in Extended Care Facilities where it is reported a shortage of 9400 LPN's in 1966 (see Table 2). The American Medical Association's policy making House of Delegates, at its 1967 biannual session in Atlantic City adopted a statement reaffirming its continued support of all nursing education programs. The statement is: "Resolved, That the American Medical Association reaffirms its support of all forms of nursing education including baccalaureate, diploma, associate, and practical nurse education programs ***" (emphasis added). Practical Nursing was first recognized by the Federal Government as a component of Vocational Education through the Public Health Amendments Act of 1956. The Vocational Education Act of 1963 gave additional impetus by identifying funds for practical nursing education in Sec. 11(a) of P.L. 88-210. The availability of these funds was instrumental in bringing about the rapid growth and development of practical nursing programs. In 1960 the programs had increased to 693 and they graduated 16,635. (See Table 3.) Today there are 1150 programs in operation graduating more than 27,000 annually. The need is still not met. The practical nursing curricula includes instruction in basic concepts in the biological and behavioral sciences and direct bedside nursing care of patients of all age groups. Every practical nursing program is approved by the State Department of Nursing and we encourage accreditation by the National League For Nursing. Every program gives basic instruction and clinical practice in at least four basic areas; medical nursing, surgical nursing, nursing of children and care of the mother and the newborn infant. Many schools are adding a fifth area; care of the emotionally disturbed patient. An increasing number of affiliations with nursing homes provides for clinical practice in the care of the geriatric patient. By 1970, it is estimated that there will be 20 million of our citizens age 65 or over. A large portion of these persons will have chronic or disabling illness requiring medical and nursing service. It is known that 90% of all patients are not acutely ill, but rather chronically ill or psychiatric patients. The practical nursing programs prepare a bedside practitioner that is particularly well qualified to administer nursing care to these people. These facts alone identify the real need for continuation and expansion of practical nursing training programs. As never before we need assurance that funds will be available for training of practical nurses. Therefore, we feel it is in the public interest to oppose the elimination of the practical nurse category of vocational education which is proposed by Section 215 of H.R. 15066. Practical nursing is a dignified vocation available to qualified candidates from all economic levels of our society and with a variety of academic backgrounds, ranging from two years of high school to college degrees. It attracts the high school drop out, the high school graduate as well as the mature person who wishes to be trained in nursing skills so greatly needed in every community. The practical nurse training programs accept both male and female students in the age range from 17 to 55 years. It is one of the few status vocations to which the culturally disadvantaged have ready access and reasonable possibility of attainment in minimum time. CONCLUSION We respectfully urge this committee to favorably recommend H.R. 16025. The expansion of the War Orphans Educational Assistance Act to include War Widows is a fully justified step that a grateful nation should take on behalf of these women. Further it will provide a partial answer to the proven shortage of Licensed Practical Nurses by making access to these training programs available. BIBLIOGRAPHY Facts About Nursing, 1967, Chapter IV, Section B. TABLE 2.-NURSING PERSONNEL NEEDS IN EXTENDED CARE FACILITIES, 1966 The information below is taken from Facts About Nursing, 1967, Chapter IV. The Research and Statistics Unit of the National League For Nursing reports 1150 practical nursing programs in operation in March, 1968. TABLE 3.-ADMISSIONS, ENROLLMENTS, AND GRADUATIONS FROM 1960 TO 19661 As of Octboer 15, 1966, there were 1,081 programs in 1,043 schools. Between 1960 and 1966 these programs have increased: The following is a list of practical nursing programs and administrative control for 1963-66: Hon. EDWARD M. KENNEDY, AMERICAN VETERANS OF WORLD WAR II, July 10, 1968. Chairman, Subcommittee on Veterans' Affairs, Committee on Labor and Public Welfare, Senate Office Building, Washington, D.C. DEAR SENATOR KENNEDY: In response to telephone call to Mr. Ralph E. Hall, the following is intended to provide the AMVET position on certain legislation : AMVETS is now on record as being in favor of : H.R. 7481: (To Authorize Payment of a Higher Portion of Hospital Costs in H.R. 14954: (To Improve Vocational Rehabilitation Training for ServiceConnected Veterans by Authorizing Pursuit of Such Training on a Parttime Basis.) H.R. 16025, S. 2985: (AMVETS favors the passage of H.R. 16025 with the proposed revisions.) AMVETS supports the following Senate measures: S. 995: (To Provide for a Contract with Private Hospitals in Alaska and Hawaii.) S. 3349: (ÁMVETS supports the one and one-half month-for-service formula in this measure, and the on-the-farm training aspect.) S. 3477: (AMVETS is highly in favor of this loan fund measure.) RALPH J. ROSSIGNUOLO, National Director of Programs. (Thereupon, at 3:30 p.m., the subcommittee adjourned, subject to call of the Chair.) O HEARING BEFORE THE SUBCOMMITTEE ON VETERANS' AFFAIRS OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE NINETIETH CONGRESS SECOND SESSION ON S. 2910 TO PROVIDE SPECIAL ENCOURAGEMENT TO VETERANS TO PURSUE A PUBLIC SERVICE CAREER IN DEPRIVED AREAS S. 2911 TO AMEND TITLE 38 OF THE UNITED STATES CODE TO IMPROVE VOCATIONAL REHABILITATION TRAINING FOR SERVICE-CONNECTED VETERANS BY AUTHORIZING PURSUIT OF SUCH TRAINING ON A PART-TIME BASIS S. 2937 TO AMEND TITLE 38 OF THE UNITED STATES CODE TO INCREASE THE AMOUNT OF HOME LOAN GUARANTY ENTITLEMENT FROM $7,500 TO $10,000, AND FOR OTHER PURPOSES |