Evolution of RN Programs: Where Did All the Diploma Schools Go?

• Diploma school RN programs are the oldest and most traditional nursing curriculums in the United States, reportedly dating back to the 1870s. 
• A graduate of a nursing diploma school shares her experience and how it helped her career. 
• After a nearly 50-year career, she maintains that her schooling choice was the best one for her. 

Diploma nursing school programs are the oldest and most traditional nursing curriculums in the United States. They are reported to have gotten their start around the 1870s. These types of nursing programs have been purported to have been the inspiration of Florence Nightingale and her Nightingale School of Nursing in 1860. Back in those days, nursing students were used as unpaid labor for hospitals. The schedules usually consisted of 12-18 hours a day, six to seven days a week. As these programs advanced, the courses became more structured. The schools then advanced to requiring three years of study in the late 1900s.  

RN Programs and the Diploma School Curriculum 

RN diploma schools reached their peak of popularity in the 1950s and 1960s. There were an estimated 1,300 nationally. However, in the late 1970s, diploma schools seemed to slowly cease to exist as nursing schools were transitioning to a more academic setting within many colleges and universities, where it became a four-year undertaking. Scholarships were awarded to assist with the cost of these four-year programs. Today, there are said to be less than 100 diploma schools in the United States. Diploma school also allowed the student to apply for an LPN or Licensed Practical Nurse license after two years of study.  

Diploma school graduates received an Associate Degree in Nursing (ADN). This diploma degree allowed nursing students a more hands-on teaching practice role in various healthcare settings, such as clinics, hospitals, physician offices, and long-term healthcare facilities. 

My Journey Through a Diploma School  

I myself am a graduate of a diploma nursing school. I graduated from Flushing Hospital and Medical Center School of Nursing in 1975. At that time, it was a three-year nursing program. It is my conviction that the education I received was stellar. It combined book learning and hands-on training. The first year, we were in the hospital setting for one day for medical-surgical. I would get up the evening before, introduce myself, and greet my patients. The big question was whether my patient was to get a partial bath or the dreaded full bath! 

In the second year, we were on the floors two to three days per week. Our floor assignments were Pediatrics, Labor & Delivery, Nursery, Postpartum and Maternal Child Health. I actually got to assist in the delivery of twins! Talk about hands on! The second semesters were split and included the Operating Room and the Recovery Room. It was there I learned I was not OR nurse material. My glasses kept foggin up while wearing the mask! I was also not very prolific at opening suture packages in the sterile confines of the OR environment. 

Third year was an extremely critical year, as my classmates and I were considered one of the staff and given a patient to follow. Our assignment locations were the Emergency Department, Intensive Care Unit, Cardiac Care Unit, and Psych. We were on the units four days a week, collaborating closely with staff nurses. 

We had to perform many procedures in front of our instructors before we could go onto the floors, such as inserting foley catheters and nasal gastric tubes, administering sitz baths, and performing dressing changes. Intravenous insertion teaching took place while in the ICU and CCU rotations. 

Pros and Cons

There were a handful of favorable versus unfavorable issues attached to diploma school nursing. Unfavorable factors included that you did not receive college credits while attending a diploma program. You did not receive the BSN that many nurses today are trying to attain.

There may have also been a stigma about not having a four-year college degree. Another unfavorable factor may have also been the grade point average needed to get into a four-year school compared to a three-year diploma school. 

When I chose to continue my education after receiving my diploma, I contacted a college nearby who said that I could enroll with no issues. However, a few days before school started, I found out that the college would not accept my credits from a diploma nursing school, and I would have to start from scratch at their institution. Instead, I attended a nearby community college, which took most of my credits and after two-and-a-half years, I transferred to a four-year university and completed my education to receive my BSN. I continued my education journey online at another four-year school where I enrolled and completed my Master of Science in Education after three years. 

The Bottom Line

I still maintain that the positive advantages of the diploma school program were the hands-on education I received, instead of just book learning. To this day, my education choice was the best selection for me. And after my 49-year nursing career, I still believe I made the correct decision. I managed to reach my goal; it just took me a little longer. But I truly enjoyed the journey! 

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