Defending The Status Quo

Once upon a time, nurses were on the bottom of the ladder among the medical professions.  Not treated with respect, self-trained or facility-apprenticed, sometimes paying for their own supplies, and not expected to question how things were done.  Eventually pushing for a standardized curriculum and state registration.  As an Activity Professional, does all this sound familiar?

But then history stepped in and nursing took a different path.

In 1923, following some serious lobbying by nurse leaders, the Rockefeller Foundation (RF) published the Goldmark Report.  It called for university-based education and national accreditation to replace the hospital training programs. Then the RF put their money where their mouth was and financially supported nursing students and nursing-related projects. Those who researched the Foundation claimed:

“Financial support from the RF trained better nurses, who proved vitally important to RF health initiatives. This investment in nursing education also led to an increased amount of respect for the profession. Once considered a career only for underprivileged women, nursing gained real status as a respectable profession…” (emphasis mine)

Status.  Toby Stuart, in his book, “Anointed,” describes the dynamics behind status in the typical human hierarchy.  Apparently having status levels is kind of a universal thing with people, on a social level, political level, economic level, professional level, you name it.  Every culture around the world has them.  Pre-schoolers have them.  Some folks are recognized as being at the top of the stack, while others are seen as being at the bottom.  What he calls “the anointed” could be the movie stars, the mega-rich, the high-ranking politicians, the Nobel prize winners, the CEOs, the media influencers with the most “likes,” the stylish clothing brand, or the elite university or private foundation.

What roles do “the anointed” play?  One role Stuart describes reminds me of Hawaii’s famous double entendre song, Princess Pupule, who “has plenty papaya” and “likes to give it away.”  Some people, or in this case, institutions like the Rockefeller Foundation, have enough status that they can share it with others.  Nurses could raise their own status just so much.  It took outside validation and money to get them out of hospital housing and into specialized university programs and a professional path.

LPN, ADN, RN, BSN, MSN, DPN, NP, CRNA…  You get the picture.  So where is Activity Professional training on this continuum?  We’re 100 years behind nursing.  Other than the Activity Director Associate of Applied Science (AAS) degree program at Ridgewater College?  We’re not even on the chart.

What would a specialized college program for Activity Professionals look like?  I admit that I’m thinking of more than general studies with MEPAP tacked on.  The boomer cohort includes more college-educated people than the age group that went before.  “Meaningful” activities look different for people with higher education in the sciences, history, arts, and literature.  Some activities transfer over okay, but there will be unmet needs if the Activity Professionals don’t have the background to speak to those needs. We need to know about cognitive science as it informs our practice.  We need to know how to adapt more varied activities to residents with limited cognitive or physical assets.  Just as nurses need specialized training, Activity Professionals do, too.  It will take the extra education to step up our game.

I like what Seth Godin had to say, “Either you defend the status quo, or you invent the future.”

© Donna Stuart, ADC, MT      May 23, 2026

https://resource.rockarch.org/story/the-women-pioneers-of-global-nursing-education-who-built-the-rockefeller-foundation-program/

Stuart, T. (2025). Anointed. New York: Simon & Schuster.