Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Teaching & Learning

First Advisor

Dr. Kathleen Gershman


A case study approach was used to examine House Bill1245 (HB1245, 2003) introduced by the ND Nurses Association (NDNA) in the 2003 58th ND Legislative Session. The purpose of this study was to trace the events and debates that rescinded the nursing education for entry-into-practice that existed since 1987. The study was designed to answer the following questions: (a) What events prompted the introduction of House Bill1245? (b) Who were the key actors during the legislative process? (c) What was the understanding ofHB1245 by nurses? (d) What factors influenced the outcome of HB1245? and, (e) Why did NDNA introduce HB1245?

Data were drawn from relevant documents, including minutes of meetings, memos, e-mails, letters, legislative testimony, and interviews from key-informants representing the ND Nurses Association (NDNA), ND Long-term Care Association (NDLTCA), College and University Nursing Education Administrators (CUNEA), ND Board of Nursing (NDBON) and key legislators. John Kindgon's multiple streams model provided an organizational tool for the refinement of gathered data and a base for data analysis.

Three major themes emerged: (a) the NDNA members did not understand the rationale for HB1245 and felt disenfranchised after fighting for 17 years to maintain entry-into-practice, (b) tension and conflict occurred between the NDNA and NDBON resulting in the introduction of HB1245 by NDNA in response to the NDBON's action of changing the Nurse Practices Act (NPA) to allow a nurse licensed in another state without a baccalaureate degree to continue practicing in ND without ever obtaining a baccalaureate degree, and (c) the complexity and ever changing status of HB1245 making it very difficult for nurses and legislators to understand. The findings also revealed a lack of communication between NDNA Board of Directors and the NDNA membership.

Implications of this study demonstrates the need for the nursing profession to be aware of the political landscape before introducing legislation and to include the membership in major decision-making processes for any policy change to be effective.