Distribution, Not Lack, Nurse Puzzle

              2-C Sunday, Nov. 18, 1973 THE SHREVEPORT TIMES
Distribution, Not Lack, Nurse Puzzle
By Margaret Martin
Times Medical Writer
Dr. Peggy Ledbetter says that though
there may be a maldistribution of nurses in
Louisiana, there is no shortage.
Not only that, but she thinks there are
too many nursing schools in the state
turning out nurses.
And she prefaces both remarks with
the comment that she knows they are
controversial topics.
The soft spoken Dr. Ledbetter became
dean of the Northwestern State Univer-sity
College of Nursing at age 29.
More recently she was elected to a
two-year term as president of the 2,000-
member Louisiana State Nurses As-sociation.
State Board Member
Dr. Ledbetter has been involved with
nursing on a statewide level as president
of the State Board of Nurse Examiners,
the legally constituted board governing
nursing in the state. She resigned as
board president when she ran for head of
the state association. She is still a board
member.
In an Interview in the NSU College of
Nursing Headquarters, 1800 Warrington
Place, Dr. Ledbetter discussed what is
ahead for nurses, and problems facing
nurses both on the state and national
level.
She says that the top priority for the
state association this year is a statewide
nursing plan.
Pulling a faded blue book out of a
file, Dr. Ledbetter pointed out that the
last such survey was made in 1956.
The governor has appointed a com-mittee
to make such a study.
One of the big hassles, she said, is,
"Is there a shortage of nurses?"
"Some of our critics say that nurses
say there is no shortage because we try
to find security in scarcity," she said.
She thinks such criticism is highly un-professional,
especially since it even
comes from nurses. She predicts the
study will show a maldistribution of
members of the nursing profession.
Another problem is the sudden
proliferation of foreign nurses into the
state, although the dean points out that
this is also a problem nationwide.
The State Board of Nurse Examiners
voted last spring to discontinue granting
a temporary permit to foreign nurse
Dr. Peggy Ledbetter
graduates. The action was effective Sept.
1.
The Board of "Nurse Examiners'
decision to discontinue the issuance of
temporary permits is based on the fact
that the passing percentage for foreign
nurse graduates has been below 20 per
cent, according to a memo release by
the board.
The memo said that the board
established the policy of granting tem-porary
permits to foreign nurse
graduates in 1968. Between the years
1968 and 1972 the number of these per-mits
issued averaged less than 12 a year.
However, in mid-1971, due to efforts of
recruitment agencies, the number of
foreign nurse graduates greatly in-creased.
In 1972, a total of 72 foreign nurse
graduates wrote the examination for the
first time and 23 repeated the
examination. In 1973, the number expec-ted
to take the test was 250.
Passing rate for foreign nurse
graduates was approximately 40 per cent
in 1971. In 1972 the passing rate for first-time
candidates was 15.1 per cent and
for repeat candidates, 28.6 per cent. For
graduates of Louisiana schools of nur-sing
the overall passing rate for the last
six years has been between 81 and 86 per
cent. ' •
Another burning issue in the state
today, she continued, is the moratorium
declared by the state board on new nur-sing
programs.
Pointing out that there are seven bac-calaureate
programs in Louisiana, in-cluding
two which .are not even
nationally accredited, Dr. Ledbetter said
she thinks that is too many for a state
the size of Louisiana.
Pointing out, also, that several as-sociate
degree programs were approved
earlier this year, the nursing official said
that she feels the moratorium was im-posed
a year too late.
She has several reasons for these
opinions.
Number one, she said, is that some
clinical facilities are so overridden with
students that one patient might have one
student from one school in the morning
and one from another in the afternoon.
"There just aren't enough clinical
facilities for the extent of proliferation,"
Dr. Ledbetter said.
Urges Higher Degrees
She also said that over half of the in-structors
in the state schools of nursing
have only the baccalaureate degree,
"and the master's is the minimum they
should have for teaching."
The future will bring an expanded or
extended role for the nursing profession,
Dr. Ledbetter predicts.
She explains that the very strong New
York Nursing Association has even
redefined the nursing role and
established nursing as an independent
profession.
She emphasized that she isn't ad-vocating
that approach for Louisiana
right now — nor is she sure that
Louisiana is ready to go in that direc-tion.
But she said there is a possibility, for
instance, that a nurse could have stan-ding
orders in an outpatient clinic, for
instance. Within these orders, she might
act independently to decide whether to
send a patient home with medicine, or
let them see a doctor.
The nursing profession is also going
to have to face the question of peer
review, she said.
She feels the issue is going to be tied
in with continuing education.
But, she added, the whole issue of
continuing education is a problem for it
has not been accredited on the national
level.
The Professional Practices Committee
will be looking at peer review as a way
to move in the direction of continuing
education, she said.
Nurses are also looking at salary dif-ferentials
and maternity leaves, which
they have not been granted in the past.
Nurses tend not to question the
system. They try to maintain the status
quo.
Why?
She shrugged, "Maybe it's the nurse's
temperament. They do not want to be
seen as aggressive."
The newer breed nurses will perhaps
feel freer to question, she predicted.
Dr. Ledbetter is a low key liberal and
a liberated woman who is not a feminist.
She depended on scholarships or
worked her way through college for four
degrees and a nursing diploma.
She is no administrator in an ivory
tower, for Dr. Ledbetter has worked as a
staff nurse on a rotating basis; as a
teacher; and for the Alabama State
-Health Department, where she developed
a manual of standards for health care
for nursing homes.
When she came to NSU in 1968, with a
brand new doctoral diploma in hand, she
was one of the youngest deans in the
country.
She had had no administrative ex-perience,
but succumbed to promises
from the NSU administration that "we'll
grow together."
NSU now has 700 students in three
nursing programs, two of which — the
associate degree and the graduate —
started after she arrived.
One of the big changes Dr. Ledbetter
made was to integrate the special
program for registered nurses into the
regular nursing curriculum.
Under her direction, the NSU College
of Nursing has relocated under one roof
in Shreveport. All clinical aspects of the
program are also concentrated here.
The only teaching Dr. Ijedbetter does
now is an occasional guest lectureship.
She misses teaching, she said in the hour
and a half interview.
"I miss the exchange you get in the
classroom," she explained. "There is no
way to fill the void . . . "