It was just a suggestion, really. The post-World War II shortage of nurses was severe, so Mildred Montag set out to explore an alternative to hospital-based apprentice programs and four-year university plans. Little did she know she would unleash a firestorm. Almost nothing elicits controversy as easily as the proposal explored in her doctoral dissertation: “technical nurses” trained in two-year community colleges.

Her own education led to several successive degrees, like many nurses today. In 1930, she earned a bachelor’s degree with a concentration in history. By 1933, she earned her first nursing degree, followed in 1938 by an M.A in nursing education from Columbia University Teachers College.

During WW II, Montag developed a nursing program at Adelphi University. Many characteristics of traditional nurse education changed under her direction, and her leadership from 1942-48 resulted in a growing number of graduates. All classes occurred on campus, and only limited clinical experience took place at the hospital. Nursing students had to meet the admission and academic standards of the university and were encouraged to participate in general college activities.

But it was her doctoral dissertation, “The Education of Nursing Technicians,” published in 1951, which led to Montag’s renown. It suggested that one solution to the nursing shortage might be to educate technical nurses in community colleges. This would shorten the time needed to become a nurse; it would also make nursing education more available to men, older students, minorities and married persons. She envisioned these nurses as assistants to the professional nurses who, as Montag thought, would have a baccalaureate degree.

The W.K. Kellogg Foundation funded the initial experiments: seven pilot sites in four states, one of them Pasadena City College. Success was almost immediate; from the very beginning, the graduates had pass rates comparable to hospital and BSN graduates. 

From 1952-57, Montag directed the Cooperative Research Project in Junior and Community College Education for Nursing, a study that took five years and evaluated the new programs that were springing up. The pass rate was self-evident, but the evaluation of the job performance of AA graduates was something else. Nonetheless, as their teachers had anticipated, the associate degree graduates performed quite well as evaluated by their head nurses. Furthermore, the final report, “Community College Education for Nursing,” showed that students were attracted to the programs, that nursing became fully integrated into the colleges, and that schools were able to finance programs just like other academic departments. The ADN program remains the only nursing program that was research-proven over time.

Change was swift. By 1994, there were 868 associate degree programs in the country. The success of this radical shift in education led to significant changes. Hospital programs fell to the wayside. BSN programs continued to thrive, often incorporating the innovative changes first explored in community college programs: the use of learning objectives to shape clinical experiences and course content, pre- and post-case/clinical conferences, and programmed instruction that allowed self-pacing and the independent study essential to nursing education.

Montag did not wish to upset the apple cart. She always focused more on the service due the community rather than the status nursing enjoyed. After a long career at Columbia University Teachers College that included several texts and articles, she retired in the early ’70s. Her death came in 2004 at the age of 95. She knew that if nursing did not attend to the shortage, outsiders would, so Montag helped the nursing profession expand in unprecedented ways.  

Elizabeth Hanink RN, BSN, PHN is a freelance writer with extensive hospital and community-based nursing experience.