Mildred Montag designed the two-year associate degree in nursing. More American nurses have entered the profession through it than through any other route, and it did something close to the opposite of what she proposed.
The problem she was solving
Montag was born in Struble, Iowa on August 10, 1908. She took a bachelor's degree at Hamline University, a nursing degree at the University of Minnesota, and a master's and then a doctorate at Teachers College, Columbia. She was founding director of the nursing programme at Adelphi.
The postwar shortage was severe, and the existing routes into nursing were the hospital diploma school — three years of what was substantially unpaid labour, which Adelaide Nutting had documented as such fifty years earlier — and the four-year university degree, which produced too few graduates too slowly.
The proposal
Montag's 1952 doctoral dissertation, The Education of Nursing Technicians, proposed a third thing.
Her argument was that nursing contained two distinguishable kinds of work: the technical, carried out at the bedside under established protocols, and the professional, involving independent judgment, case management, teaching and supervision. A two-year programme in a community college could prepare a nursing technician for the first. The bachelor's degree would prepare the professional nurse for the second.
The technician was to be a distinct role with a distinct scope, working under the professional nurse.
What happened instead
The Cooperative Research Project in Junior and Community College Education for Nursing began at Teachers College in January 1952 with Montag as director, testing the model across seven colleges.
The results, published in 1959, were unambiguous: the graduates performed as well as diploma and baccalaureate nurses on the licensing examination and in practice.
That is where the design came apart. Because the graduates passed the same examination and practised competently, state boards licensed them as registered nurses — not as technicians. There was no separate licence, no separate scope and no separate title, and the profession never created one.
The community colleges took it up at enormous speed. Hospital diploma schools, which had defined American nursing for eighty years, closed almost entirely. Within two decades the associate degree was producing more registered nurses than any other route, and it still produces a very large share of them.
The consequence
This is why one licence in the United States is reachable by three educational paths of different lengths, and why the argument over entry into practice has run for sixty years without resolution. The American Nurses Association declared in 1965 that the bachelor's should be the minimum for professional practice; no state has ever made it a licensure requirement, and only New York requires the degree to be completed within ten years of licensure.
Montag herself said afterwards that the outcome was not what she intended, and objected to associate degree graduates being described as fully prepared professional nurses. She also defended the programmes, which had opened nursing to people — older students, parents, people who could not leave a job or a town for four years — whom the four-year route had excluded. Both things are true, and the profession has never settled the argument between them.
She died on June 29, 2010, aged 101. See levels of nursing.
Related
- Entry into practice and the BSN requirement
- Levels of nursing
- Adelaide Nutting
- Annie Goodrich
- The nursing shortage
- History of nursing
Sources
- The Relevance of Associate Degree Nursing Education: Past, Present, Future. Online Journal of Issues in Nursing. Accessed September 9, 2026.
- R. Louise McManus and Mildred Montag Create the Associate Degree Model for the Education of Nurses, 1947 to 1959. ERIC. Accessed September 9, 2026.
- "A New Program for Nursing in Community Colleges", Mildred L. Montag. Teachers College Record, 1953. Accessed September 9, 2026.
- History of Adelphi University nursing. Accessed September 9, 2026.