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PARADIGM SHIFT IN NURSING CURRICULUM AND ADMINISTRATION
I.PRE-WAR TO 1945
1.
Concept of a hospital:
The Hospital has a morbid image to the people at this period. When someone is brought to the hospital, people feel the patient is dying.
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The hospital is for the sick and the dying2.organizational structure and facilities
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Highly centralized/ absence of electronic devices3.Nursing service
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No participation in operational planning
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No managerial knowledge, managerial practice was gained byexperience
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Task-oriented, but ensures high quality and excellent bedside care
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Multi-dimensional scope of responsibilities, e.g. Incharge of linen,housekeeping and dietary at times
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Nurses were highly disciplined but very few takes up Nursing
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Nurses lack theoretical knowledge to back-up their skills
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Nursing administrator holds a very demanding job; she must be strongand clever.4.Nursing education
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A three-year Graduate Nursing program solely existed.
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Conceptualization of BSN program and implementation in 1947 withthe first graduate from UP College of Nursing in 1952
II.Professionalization Period of Nursing (1946-70s)
1.Hospital – the Hospital image gradual changed
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It maintained curative and rehabilitative function; however, thepreventive function was not emphasized
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Electronic age started, e.g. chemotherapy for Tb and cancer, andradiation became available
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The hospital was still highly centralized in terms of control2.Nursing Service
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Chief Nurses had no voice in Operation Planning; no emphasis onqualification, tenure was the basis of succession
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Many registered nurses enrolled in supplemental programs
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Maintained highly appreciated bed care
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Exodus of nurses started in the 50s
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In late 70s, Standards for Nursing Practice were formulated
 
3.Nursing Education
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Nursing began to be recognized as a profession due to birth of theBSN Program. However, two (2) types of programs existed (GN andBSN) for some time
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Abolition of GN Program came in the late 70s4.Health Delivery System Came in Three LevelsThree Levels are:
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Primary
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Secondary
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TertiaryThis concept is premised on self-sufficiency at the primary level with thedevelopment of Barangay Health Workers. It aimed to promote proper utilizationof the secondary and tertiary facilities.5.Technology
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Computerization made some job easy
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Electronic gadgets at the bedside became a necessity (e.g. cardiacmonitors)
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Faster communication system was a great support in the Health careinstitutionIII.ERA OF CARE FRAGMENTATION (80's to 90's)It is worthwhile to quote Dhorter Edwards, "While medical knowledge hasrapidly expanded in recent years, but medical and nursing care has in certainways deteriorated." This is highly evident in the Philippine setting.A.The Hospital
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For the sick and the well – many people come to the hospital for executive check-up. There is awareness of the public for heathmaintenance and health promotion
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Emphasis on diagnostic programs
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Decentralization – departments were well-organized and hadautonomy in running their departments
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Facilities are high tech! hospitals competed in their facilities
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Highly specialized services came into reality (i.e. intensive careunits)
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B.Nursing Service
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Exodus increased as USA, Canada, Australia, Middle East are all open
 
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Understaffing was felt and became a big headache for Nursing Admin.
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Public demand for quality care both in government and privatehospitals are echoed
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Nursing care activities delegated to non-nursing personnel due tounderstaffing – thus contributing to poor quality of care rendered.
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Continuing education Units, a prerequisite to licensure, a requirementwhich had never proven its worth
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Birth of "manager" title with unclear job description is a fashion. Almostall hospitals changed the title of supervisor/head nurse to manager.Nevertheless, there was no corresponding change in the content of their job description
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Scarce local employment (in spite of the unemployment of nurses)
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Proliferation of health care workers/providers
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Specialization in nursing care with sophisticated equipment to supportthe nurses in their skills. To quote, Simon and Schuster: "fancydevices, new fangled diagnostic procedures, esoteric jargonmachinery, buzzers and beepers, play an important role in the medicaland nursing practice. These technological tools, innovations, and evenmiracles, while producing new hope for diagnosis and cure, tend todistance the caregiver from the patient."
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At this point in time Nursing Service became complicated to manageand thus;
Demand for better management of nursing service
Change in role expectations heightened calling for:
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Business Management
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Clinically oriented
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Labor relation which demands for strong orientation tolegal aspects of Nursing Administration
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Educator of patients and staff 
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Nursing Management Systems that respects the major administrative principles of Planning, Organizing,Directing and Controlling.
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Service coordinator with other departments
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Operational planning was felt needed by some nursingadministrators.
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Budgetary planning is a must but barely done due toinadequacy in the technical know-how.C.Environmental Factors affecting patient care and the Role of the NursingAdministrators
Socio-economic condition – Poor health condition in the midst of risinghealth care cost
Corporatization of Health care by the year 2000 is shaping up. Manyhospitals are now run by corporations thus the profit orientation.
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vanjlovely

"Paradigm Shift in Nursing Curriculum and Admini..."

reply01 / 30 / 2010
tlcnarreto

may i know who authored the paradigm shift of nursing curriculm and the administrators. i owuld like to commnend as very sustantial and i would like to include some informations in my study. please. or how will i know. thank you .. anyone,

reply01 / 18 / 2010
Gail Violenta

girl, i just would like to know your reference on this output. i would want to do some personally reading myself. thank you. by the way this document was really helpful for me.

reply11 / 21 / 2009
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