NCM 100- Lecture (3 units) Foundation of Nursing

Course Description: The course provides the students with the overview of nursing as a profession, science, & as an art. It shall include a discussion on the different roles of a nurse emphasizing on health promotion, illness prevention & utilizing the nursing process as a basis for nursing practice. Three Main Topics

Nursing as a Profession Nursing as a Science Nursing as an Art

Nursing as a Profession Definition of Nursing: It is a caring profession. A unique profession, it is practiced with an earnest concern for the art of care & the science of health. The profession involves a humanistic blend of scientific knowledge, & holistic nursing practice. Definition of Nursing The art & science by which people are assisted in learning to care for themselves whenever possible & cared for by others when they are unable to meet their own needs. Florence Nightingale (1860).  The act of utilizing the environment of the patients to assist him in his recovery.

Definition of Nursing 

Virginia Henderson (1960).  The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or it s recovery ( or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge, & to do this in such a way as to help him gain independence as rapidly as possible. Virginia Henderson (1960).  The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or it s recovery ( or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge, & to do this in such a way as to help him gain independence as rapidly as possible. Orem  A helping or assisting service to persons who are wholly or partly dependent- infants, children, & adults- when they, their parents & guardians, or other adults responsible for their care are no longer able to give or supervise their care. American Nurses Association (ANA;1980)  The diagnosis and treatment of human responses to actual & potential health problems. Canadian Nurses Association (CAN;1984)  The identification & treatment of human responses to actual & potential health problems & includes the practice of & supervision of functions & services that directly or indirectly in collaboration with client or providers of health care other than nurses, have as their objectives the promotion of health, prevention of illness, alleviation of suffering, restoration of health & optimum development of health potential & includes all aspects of the nursing process.    


Is a profession that serves the need of society, in the area of health. The practice of nursing addresses a wide range of health problems, both actual & potential, requiring of its practitioners a special body of knowledge including skills to meet client needs & a value system that recognizes the client as autonomous human being with rights.

The Philippine Nursing Act
Professional Nursing as the performance for a fee, salary or other reward or compensation of professional nursing services to individuals, families, communities in various stages of development toward the promotion of illness, restoration of health, & alleviation of suffering through:  Professional Nursing as the performance for a fee, salary or other reward or compensation of professional nursing services to individuals, families, communities in various stages of development toward the promotion of illness, restoration of health, & alleviation of suffering through: communities & the like settings: Undertaking consultation services & engaging in such other activities that require the use of knowledge & decision-making skill of a registered nurse. 1. Utilization of the nursing process. 2. Establishment of connection with community resources & coordination of the heath team. 3. Motivation of individuals, families, & communities & coordination of services with other members of the health team. 4. Participation in teaching, guidance & supervision of students in nursing education programs as well as administering of nursing services in varied settings such as homes, hospitals, 5. Undertaking nursing & health manpower development training & research & soliciting finances, therefore, in cooperation with the appropriate government & private agencies. Concepts of Profession  Is a calling, an occupation that requires special knowledge, skill & preparation.  A profession is generally distinguished from other kinds of occupation by: a) its requirement of prolonged, especialized training to acquire a body of knowledge pertinent to the role to be performed; b) an orientation of the individual toward service, either to a community or team organization. 

EDUCATED: June 1860 when Nightingale School of Nursing opened in London. CONTEMPORARY: Began at the end of World War II.APPRENTICE: on-the-job training.INSTINCTIVE. . practicing midwifery and being wet nurse to a child without training or direction. without formal education. It dated from prehistoric times. INTUITIVE: Reference to nursing was mother role because pre-historic man was a nomad who had to search for food and shelter. Near East: A. designed doctors for each diseases.History of Nursing FOUR GREAT PERIODS IN NURSING: 1. was practiced among primitive tribes and lasted through the Christian era. It extends from the founding of religious nursing orders in the 6th century. Philosophy then was self-preservation Cause of illness was invasion of victim s body by an evil spirit Trephine is drilling a hole in the skull with a rock or stone to remove the evil spirit without the benefit of anesthesia Shaman or witch doctor had the power to heal by using white magic. through the Crusades which means bean in the 11th century. Babylonia   King Hammurabi codified Babylonian Laws Code of Hammurabi medical regulations established. Nurse s role: instinctive directed towards comforting. but he also had the ability to inflict greater harm through black magic.INTUITIVE:UNTAUGHT. 3. It was performed out of feeling of compassion for others. 4. 2. Forma education for nurses. Discouraged experimentation. and patients were given the choice between the use of charms and medicine or surgery and cure of his disease. out of desires to help and out of a wish to do good . to 1836.

C. they learn nothing in physiology. fruits. Mosaic Code Physical purity is equivalent to moral purity Reference to nurses are midwives and wet nurses Music Therapy: David played the harp for King Saul when depressed Aaron The High Priest as physician of the people Moses father of sanitation . beliefs about the cause of disease were embedded in superstitions & magic. In 200 BC . caused by angry spirit(demons) Treatment : exorcism.  Greeks believed in life after death  Developed the ability to make clinical observation  Healthiest of all countries because of Hygiene principles  Exhibited careful planning to meet certain community needs and avert public health problems. contributions in architecture. C.     Ancient Civilization: The evolution dated back to 400 BC to primitive societies in which mother nurse worked with the priest.  Art of Embalming for human anatomy but since done on dead. care of the sick and formulated wise proverbs..  Imhotep Chief physician and advisor to Pharaoh. drugs obtained from plants. Egypt: Herodotus Time: 485 425 B. neurosurgery was advanced. the use of wet nurses is recorded in Babylonia. During this time. B. animals. Hebrew:        Leviticus: Laws controlling the spread of communicable diseases Judaic Covenant with God directing the ritual of circumcision of the male child on the 8th day.

. India:       Built hospitals. China:  Belief in spirits and demons  Practice of ancestor worship prohibiting dissection of human body  Materia Medica (Pharmacology) 52 volumes of Chinese Medicine  Huae To exponent of acupuncture  Emperor Shen Nung father of Chinese Medicine  Diagnosis was made on the basis of the Pulse Theory  Yang and Yin Theory established some scientific basis for disease  Yang (Male principle) positive. dark. an lifeless B. fiery and full of life  Yin (Female Principle) negative. practiced asepsis Proficient in medicine and surgery First reference to nurses taking care of the sick Writings of Sushurutu found a list of functions and qualifications of the nurses Medical practice declined with the fall of Buddhism Diet was according to patient s condition   India Early hospitals were staffed by male nurses who were required to meet 4 qualifications:  Knowledge of drugs  Cleverness  Devotedness to patient  Purity of mind & body. cold.Far East A. active. weak.

physiotherapy fresh air. Fabiola her home was the first hospital in the Christian World .goddes of health. Greece:     Nursing was the task of untrained slave.directed by physicians. Religious institutions-governed by priests. pain Christianity value life and equality a. Secular. D. 2. sunshine Greek medicine  Two kinds of refuges for the sick: 1. Prietesses attended to patients who were housed in the temple. Phoebe first visiting nurse b. wholesome food. Rome( early Christian church & hospital)        Illness was a sign of weakness Sick was left to care of slaves Evidence of specialization Translation of Greek medical terms to Latin Celsius his concept of cardinal signs of inflammation: redness. Caduceus insignia of the medical profession. Which corresponds roughly to our spas or health resorts of today. swelling. Aesculapius god of healing  Hygeia.of health. associated with Aesculapius father of Medicine in Greek Myth Hippocrates Father of Medicine Practices that brought about cure were rest.C.  Apollo. heat.  They were known for their practice of gods & goddesses.

Secular Orders the work of these nurses was complicated by religious taboos and the social restrictions of their cultures and education  Augustinian Sisters  Third Order of St. Vincent de Paul  Ladies of Charity  Benedictines Order nuns prayed with and took care of patient. B. Crusades: (began before 1100-1300  Military religious orders founded during the Crusades.APPRENTICE: Medicine in Europe was under two influences lay medicine and ecclesiastical medicine During the middle ages. John established organization of rank and the principles of complete and unquestioned devotion of duty  Teutonic Knights German equivalent of St. C. Military Orders (Knight Hospitaliers)  Knights of St. younger ones washed soiled linens . Lazarus for lepers  Alexian Brothers one of the largest school of nursing under religious auspices operated exclusively for men in the US. Established hospitals and staffed them with men who served as nurses. regular vows (with vows) and the secular orders (without vows) Nursing care performed by people who are directed by more experienced nurses Europe: A. John  Knight of St. Francis  Order of St. thousands of years after the death of Christ. three organizations were developed military orders.

 Forerunners of the great development during this period were:  Leonardo da Vinci. universities were established. but no formal nursing schools were founded. Women continued to fullfill the traditional role of nurturer & caregiver in the home. Religious upheaval of the 16th century which destroyed the unity of Christian faith in Europe  Transition from medieval to modern civilization which left the world with the following: a.  William Harvey. Economic changes b. Renaissance : 14-15-17th century the period of great revival of learning. cultural changes . Hildegarde prescribed cures and was supposed to have performed miracles 3. Catherine of Siena Original Lady with a Lamp 2. described muscle & arteries. St. developed principles of surgery.surgeon. nursing reached a high level of organization & efficiency with religious & military orders. St. Because of renewed interest in science.described human anatomy.D.discovered how blood circulates. Reformation (1600) religious movement that aimed in reforming the Roman catholic church & resulted in establishing the Protestant Churches.  Andreas Vesalius.anatomical studies. Elizabeth of Hungary Patroness of Nurses  Care of the sick were performed mainly by volunteers who devoted themselves to nursing. St.  Ambroise Pare.  During this period. political changes c. Regular Orders: These religious orders gave rise to nursing saints: 1.

Learned languages. believed that a clean environment played an important role in early recovery. she develop her self-appointed goal: To change the profile of Nursing . The development of nursing during this period was strongly influenced by:  Trends resulting from wars  From arousal of social consciousness  From the emancipation of women  From the increased educational opportunities offered to women. literature. Nursing during the Civil War: Early American Nursing  Miss Dorothy Dix. & social graces.        . and got together the first Nurse Corps of US Army  Clara Barton was president of the American Association of the Red Cross in the District of Colombia Period of Educated Nursing   This period began on June15.Reformation: 17th to 19th century. Thomas Hospital in London (St. Thomas School of Nursing). Born on May 12. as appointed Superintendent of Female Nurses. nursing sank to its lowest levels. Not contented with social custom imposed upon her as a Victorian Lady. FLORENCE NIGHTINGALE: Recognized as the Mother of Modern Nursing . mathematics. 1820 in Florence Italy Raised in England in an atmosphere of culture & affluence. Her education was rounded out by a continental tour. This is the DARK Period of Nursing. Crimean War: FLORENCE NIGHTINGALE took care of wounded soldiers. known as the Lady with the Lamp . 1860 when the Florence Nightingale School of Nursing opened at St. though not a nurse.

At the age of 31. Noted the need for preventive medicine & good nursing.    Compiled notes of her visits to hospitals. she believed that nurses should be formally educated & should function as client advocates. to pass my life in purity & to practice my profession faithfully. In 1853. Germany. 1860 establishment of the Nightingale Training School of Nurses. & worked as a superintendent of a charity hospital for ill governesses. As a result of her experiences . she overcame the family s resistance. her observation of the sanitary facilities & social problems of the places she visited.studied in Paris with the sister of Charity after which she returned to England. She entered the Deaconess School at Kaiserwerth . she forged the future of nursing education. and will not take or knowingly administer any harmful drugs.(1854-1856) She implemented her principles in the areas of nursing practice & environmental modification resulted in reduced morbidity & mortality during the war. I will abstain from whatever is deleterious and mischievous. Advocated for care of those afflicted with diseases caused by lack of hygienic practices. Disapproved of the restrictions on admission of patients & considered this as unchristian & incompatible with health care. Upgraded the practice of nursing & made nursing an honorable profession for gentlewomen.          The Nightingale Pledge I solemnly pledge myself before God. Led the nurses that took care the wounded during the Crimean War.where she received training for three months. and in the presence of this assembly. Put down her ideas in two published books: Notes in Nursing and Notes on Hospitals. .

Bellevue Training School of Nurses in NY. coming to my knowledge in the practice of my profession.   Nightingale Pledge was written in 1893 by: Canadian born Lystia Grette. Standard curriculum for nursing was prepared by the National League for Nursing Education between 1913 & 1937. Lilian Wald first President of the National Organization for Public Health Nursing 5. Maryland Leaders: 1. Linda Richards instituted the system of keeping records and orders. So help me GOD.principal of the Farrand Training School for Nurses in Detroit. Conn 3. and devote myself to the welfare of those committed to my care. Isabel Hampton Robb standardized nursing education programs and prepared teachers instruction in schools of nursing 3. Mary Adelaide Nutting had a unique collection of works on the history of nursing 4. Florence Nightingale stated that environment played an important role in man s health . The first graduate nurse in the US 2. 2. EDUCATED: Established of the Nightingale System of Nursing for improve nursing practice.I will do all in my power to maintain and elevate the standard of my profession. With loyalty. Connecticut Training School of New Haven. First decade of the 20th century: age of specialization. John Hopkins in Baltimore. and will hold in confidence all personal matters committed to my keeping and all family affairs. Early Schools: 1. Isabel Maitland Stewart first nurse to receive an MA degree 6. Mary Elizabeth Mahoney first professional black nurse in the US 7. It reflects Nightingale s philosophy & styles. Will I endeavor to work closely with the health team.

Use of atomic & nuclear energy for medical diagnosis & treatment. -The United Nations was created in 1945. created to fight diseases by providing health information and improving the living standards of all people . People found relief from pain or illness from herbs. Health is perceived as a fundamental human right . Disease and death were said to be god-given in a way of punishment. Utilization of computers for collecting data. The advent of space medicine also brought about the development of aerospace nursing. Under this was the World Health Organization.Period of contemporary Nursing This period covers the period after World War II to the present. Persons suffering from diseases without any identified cause were believed to be bewitched by the mangkukulam or mangagaway . living standards and environmental conditions for all people. Scientific & technological developments as well as social changes mark this period. ANCIENT TIME Care of the sick was based on mythical superstitions and mythical background. Development of the expanded role of nurses. teaching etc. History of Nursing in the Philippines Early Beliefs & Practices 1. Nursing involvement in community is greatly intensified. Herbmen were called herbicheros meaning the one who practiced witchcraft. roots and tubers without knowing the principles People were graced with amulates to subdue the spirits that caused illness Persons with powers to expel demons can drive away evil spirits (Herbolarios) Early care of the sick The early Filipinos subscribed to superstitious beliefs & practices in relation to health & sickness.WHO was formed to assist in fighting disease by providing health information and improving the nutrition.

night & day. Midwife assisted in childbirth. Earliest Hospitals Established: Hospital Real de Manila (1577). the mabuting hilot (good midwife) was called in. Josephine Bracken. San Lazaro Hospital (1578). San Juan de Dios Hospital (1596). support was derived from alms & rents. Hospital de Indio (15 86)-established by the Franciscan Order.was built exclusively for patients with leprosy. Converted their house into quarters for the filipino soldiers. 2.    1. Nursing began during the Revolution against the Spanish Sovereignty in 1896.  Spanish Regime The religious orders exerted effort to care for the sick by building hospitals. Hospitals de Aguas Santas (1590) estabished in Laguna. Humanitarian work Concept of Nursing-as the taking care of the sick & the injured .to care for the Spanish King s soldiers & Spanish civilians. during the PhilippineAmerican War that broke out in 1899. During labor.       Prominent Women involved in Nursing Work   . near a medicinal spring. service was supported by alms & contributions from charitable institutions. If the birth became difficult witches were supposed to be the cause. Filipino women volunteered to take care of the sick & the wounded Filipino soldiers. Founded by the brotherood of Misericordia . installed a field in an state house in Tejeros: provided nursing care to the wounded. Rosa Sevilla de Alvero.   Difficult childbirth & some diseases (called pamao ) were attributed to nonos . rendered general services to the public. wife of Jose Rizal.

Bulacan was the location of the National head quarters. Of sound reputation. charity bazzars. & voluntary contributions. soldiers Requirements for membership: At least 14 y/o.  1. Provision of nursing care to wounded fil. . Established branches in the provinces. Malolos. 2. 2.Filipino Red Cross    1. age requirement for officer was 25y/o. Functions: Collection of war funds & materials through concerts.

provided nursing care t the wounded. Aug. Philosophy then was self-preservation Cause of illness was invasion of victim s body by an evil spirit Trephine is drilling a hole in the skull with a rock or stone to remove the evil spirit without the benefit of anesthesia Shaman or witch doctor had the power to heal by using white magic. Nurse s role: instinctive directed towards comforting. but he also had the ability to inflict greater harm through black magic. President of the Phil.  Trinidad Tecson.  Established when the American system of education was just introduced in the country. when not in combat. stays in the hospital at Biac na Bato to care for the wounded solders.  Dona Hilaria de Aguinaldo. provided nursing care to Filipino soldiers during the revolution.there was a great need for doctors & nurses to help prevent the recurring epidemic of communicable diseases. also provided nursing services to her troops.  Dona Maria Agoncillo de Aguinaldo. organized Filipino Red Cross under the inspiration of Apolinario Mabini. 19060). practicing midwifery and being wet nurse to a child without training or direction.  August. 1898.  Miss rose Nicolet.  Melchora Aquino (Tandang Sora). Red Cross in Batangas. Hospitals & Schools of Nursing 1.who was a graduate of . Second wife of Emilio Aguinaldo.  Capitan Salome. A revolutionary leader in Nueva Ecija.strong agitation for establishment of nursing schools began. Ina ng Biac Bato .waa the first superintendent. Iloilo Mission hospital School of Nursing (Iloilo City. gave them shelter & food. Wife of Emilio Aguinaldo.ran by the Baptist Foreign mission Society of America. Nursed the wounded soldiers. Revolutionary leader in Laguna.INTUITIVE: Reference to nursing was mother role because pre-historic man was a nomad who had to search for food and shelter.  1906.  Agueda Kahabagan.

 The applicant must have completed elementary education to seventh grade. placing it under the supervision of the Director of Health.the first Filipino nurse to occupy the position of chief nurse & superintendent in the country. Mrs Mary Coleman Masters. 1976 modified the organization of the school. 2. located in Intramuros & provided general hospital services.  19010.  1906. . with Rev. opened classes in nursing under the auspices of the Bureau of Education  Admission was based on entrance examination.  It had a free dispensary & dental clinic.22 nurses graduated & took the first board exam held in Iloilo Mission Hospital. St.  Miss Flora Ernst -American nurse.  1944. Paul s Hospital School of Nursing (Manila. & introduced several improvements.  1909-graduated the ist class of trained nurses. Mother Melanie as superintendent & Miss E chambers as Principal.  The civil hospital was abolished.New England Hospital for Women & Children in Boston. The Philippine General Hospital School of Nursing (1907)  Began in 1901 as a small dispensary. & became the Philippine General Hospital. that made nursing attractive & more practical.1907)  Established by the Archbishop of Manila.  Elsie McCloskey Gaches became the chief nurse.  Julia Nichols & Charlotte Clayton taught nursing subjects & American physicians served as lecturers. 3.mainly for civil officers & employees in Manila & later grew into Civil Hospital. with the support of Governor General Forbes & the Director of Health among others.  Anastacia Geron Tupas. Massachusetts.Act No.  1907.  The school became known as the Philippine General Hospital school of Nursing. took charge in 1942.  Training School for nurses opened in 1908. an educator advocated for idea of training Filipino girls for the profession of Nursing.

which was organized by Sr. the school was opened with three Filipino girls admitted. lived in a dormitory. Mary Johnston Hospital & School of Nursing (Manila. 1907)Funded by Methodist mission The nurses training course began with three fil. & received the same instruction in anatomy & physiology. practical nursing. materia medica. 4.1907) It began as a small dispensary in 1903. Educational preparation. Recommendations from three different persons well known in the community. at least completion of seventh grade. Good family & social standing. 5. 3. Rebecca Parrish together with the registered nurses Rose Dudely & Gertrude Dreisback. Mis Librada Javalera was the first fil. bacteriology & English. Luke s Hospital School of Nursing (Quezon City. Jose Fores was the first Filipino medical director 1907-1910. 5. Vitallana Beltran was the first Filipino superintendent. . It was burned down in 1945 & was reconstructed in 1947. the first year nursing students of PGHSN. Dr.4. The three schools agreed on how students were selected.the period of reorganization. 1907.         1. Good moral character. SLHSN. Director of the school. young girls from elementary grade. SPHSN had a common first year course-known as the Central School idea in nursing education. massage. 2.    St. They were later own fused in one class. These girls had their first year in combined classes with PGHSN & SPHSN Helen Hicks was the first principal. Sound physical & mental health.

Ilocos Norte.  1. Miss Ciara Pedrosa was the first filipino principal. Emmanuel Hospital School of Nursing (Capiz.1918) Anastacia Giron-Tupas organized the school.   10.6. operated three schools of nursing: Salle Long Road Memorial Hospital School of Nursing (Laog. Other schools of Nursing established: Zamboanga General Hospital school of Nursing (1921) Chinese General Hospital school of Nursing (1921) Baguio General Hospital school of Nursing (1923) Manila Sanitarium & Hospital school of Nursing (1930) St. a Protestant organization of the Disciples of Christ. 2. Southern Islands School of Nursing (cebu.      Philippine Christian Institute Schools of Nursing The United Christian Missionary Society of Indianapolis. 11. Visitacion Perez was the first principal. The school is run by the Daughters of Charity since then Sister Taciana Trinanes was the first directress of the school.    . Benito Valdez.    8.1912 San Juan de Dios hospital School of Nursing ( Manila.00. 1903) Mary Chiles Hospital School of Nursing (1911) Frank Dunn Memorial Hospital (Vigan. Ilocos Sur. 7. Paul s school of Nursing in Iloilo city(1945) University of Santo Thomas college of Nursing (1945) The college began as the UST School of Nursing Education on feb. 3. Indiana.   9.1913) The school offered a three year training course for an annual fee of P100. 1913) The school was opened through the initiative of Dr.1941 Manila central University college of Nursing (1947) University of the Philippines College of Nursing (1948) Julita Sotejo was the first dean The first Colleges f Nursing in the Philippines 1.

Sor Ricarda Mendoza. Cesaria Tan. First fil. 4. Dean of the Philippine Nursing . 3. First full.the first fil. Anastacia Giron-Tupas. Loreto Tupaz. Conchita Ruiz. Florence Nightingale of Iliolo . Pioneered in Hospital Social Service in San Lazaro Hospital where she was the Chief Nurse. 7. 2. Rosa Militar. A pioneer in school health Education. First editor of the PNA magazine called the Message . founder of PNA.Nursing Leaders in the Philippines 1. A pioneer in nursing education 6. Nurse to hold the position of Chief Nurse Suprintendent. to receive a Mastrs degree in Nursing Abroad. 5. Socorro diaz.time editor of the newly named PNA magazine the filipino Nurse 8. Socorro Sirilan.

 June 1920. dark. cold.Dean of Philippine Nursing .Tupas. founder of PNA 6. fiery and full of life  Yin (Female Principle) negative.Dr Juan Cabarrus. Florence Nightingale of Iloilo 3. Leah Samaco. weak. Board of Examiner for Nurses 5. Anastacia Giron.Superintendent and Chief Nurse of PGH.President ADPCN 8. Loreta Tupaz. Anastacia Giron. First BON that gave the first nurse exam. . active. elevated nursing education to its professional level 4. China:  Belief in spirits and demons  Practice of ancestor worship prohibiting dissection of human body  Materia Medica (Pharmacology) 52 volumes of Chinese Medicine  Huae To exponent of acupuncture  Emperor Shen Nung father of Chinese Medicine  Diagnosis was made on the basis of the Pulse Theory  Yang and Yin Theory established some scientific basis for disease  Yang (Male principle) positive.Present PNA President 7.Chairman.Far East A.Tupas  The first Nursing Law Act No. an lifeless NURSING LEADERS: 1. 2808 .  June 1919 nurses were registered without taking the examination.Paquiz. the first Nursing Board Examination. Maria Tinawin. Annie Sand. Jovita Sotejo.An act Regulating the Practice of Nursing Profession in the Philippines Islands.Chief Nurse of the San Lazaro Hospital in Manila 2. Definition: Profession is an occupation or calling requiring advanced training and experience in some specific or specialized body or knowledge which provides service to society in that special field.Graduate of PGH 1929. Dean Carmelita Divinagracia. Belen del Rosario.

4. so that they may guide. it is a CARING profession. Is able to make independent & sound judgment including high moral judgment.  . by training or experience or both. Caring. A profession has theoretical body of knowledge leading to defined skills. 4. technological skills & desirable attitudes & values. responsible & accountable for his/her actions.Characteristics & Attributes of a Professional Person  Profession A calling in which members profess to have acquired special knowledge. Is self-directed. Is committed to the spirit of inquiry. A profession requires an extended education of its members. 6. The most unique characteristic of nursing as a profession is that. Service. Education. as well as basic liberal foundation. He/she possesses competence to practice the profession in terms of scientific knowledge. Nursing as a Profession 1. Theory. Code of Ethics. A profession provides basic service. serve or advice others in that special field 1. Demonstrates zest for continued studies including research which will steadily increase & improve knowledge. abilities & norms. 3. 2. 5. 3. Is concerned with quality. 5. The profession as whole has a code of ethics for practice. Is dedicated to improvement of life. 2. Members of a profession have autonomy in decision making & in Practice. Autonomy. skills & attitude needed by the profession.

Patterns of Developing Profession Profession are basically intellectual Nursing Profession Nurses are educated institution of higher learning & function in a responsible & accountable manner. Profession are based on a specific body of knowledge that can be learned. Nursing professionals accept great responsibility for providing for people s healthcare needs. Professions are practical as well as theoretical.Flexner s Criteria for a Profession compared with Nursing. Application of theory derived from research provides the rationale for action. Critical thinking is being emphasized to a great extent at all levels of nursing function. . The profession evolved in response to needs identified by society and is guided by an ethical code. Professional work can be taught through professional education Professions have strong internal organization. Practitioners are guided by altruism. Nursing has identified and continues to develop its own specific body of knowledge from which nursing practice emerges. Nurses are educated primarily in different types of degree programs baccalaureate degree and advanced nursing degree programs (Master s degree and Doctorate degree). The Philippines Nurses Association (PNA) and other bodies provide internal organization Many nurses enter the profession out of a desire to help others.

Expert  Performance is flexible & highly proficient  No longer requires rules.  Has experienced enough real situation to make judgements about them. . Stage II Advanced Beginner  Demonstrates marginally acceptable performance.  Differentiates important factors from less important aspects of care. inflexible. rather than experience. Stage III-Competent  Has 2-3 years experience  Demonstrates organizational & planning abilities.  Uses maxims as guides for what to consider in a situation.Benner s Stages of Nursing Expertise      Stage I Novice  No experience  Performance is limited. Stage V.  Focuses on long term goals.  Is inclined to take certain action because it felt right. Stage IV-Proficient  Has 3-5 years experience  Perceives situation as whole rather than as parts.  Recognizes the meaningful aspects of real situation. governed by context-free rules & regulations.  Demonstrates highly skilled intuitive & analytic activity in new situations.  Has holistic understanding of the client. which improves decision making. guidelines or maxims to connect an understanding of the situation to appropriate action.

Initiative to improve self and service. 8. communicating. . Have a license to practice nursing in the country 2.Professional Nurse Is one who has acquired the art and science of nursing through her basic education. 7. Resourcefulness and creativity as well as well-balanced emotional condition 4. 6.the health and welfare of society and who continues to add to her knowledge. A warm personality and concern for people. who interprets her role in nursing in terms of the social ends for it exists . 2. 5. Competence in performing work through the use of nursing process. Professional Nurse is a person who has completed a basic nursing education program and is licensed in his / her country or state to practice professional nursing. Be physically and mentally fit Personal Qualities and Professional Nurse Professional proficiencies: 1. Active participation in issues confronting nurses and nursing. Interest and willingness to work and learn with individuals/groups in a variety of setting. Capacity and ability to work cooperatively with others.  Qualifications and Abilities of a Professional Nurse Professional preparation: 1. skills. Skill in decision-making. 3. A Bachelor of Science degree in Nursing 3. and attitudes through continuing education and scientific inquiry (research) or the use of the results of such inquiry. and relating with others and being research oriented.

Basic three-year hospital-based program leading to the title Graduate in Nursing  Until 1983. social responsibilities & accountabilities. The performance for salary or remuneration. significant others. Professional Nursing Is an art and a science. Types of Educational Program 1. and through relationship with the client/patient. .     LPN/LVN Program Lasts 9 or 12 months ( classroom & clinical practice. (BSN). prevention of illness.  Council of Deans  Philippine Colleges of Nursing  Department of Education  Nursing Practitioners 19981998-1999: Effective Enforcement of the common two. 3. committed. behaviours: 1. restoration of health. Ability to practice legal. Only basic educational program in nursing ~ the four-year collegiate degree leading to the Bachelor of Science in Nursing (BSN). dominated by an ideal of service in which certain principles are applies in the skillful care of the well and the ill. alleviation of sufferings & assisting client to face death with dignity & in peace. Skills in practicing KSA for the promotion of health. competent. & confident). Practice is under the supervision of an RN.year Associate in Health Science Education (AHSE). A graduate takes the NCLEX-PN to obtain license. 2. Critical & creative thinking 4. Provide basic technical care to client. and other members of the health team. two The BSN intends to produce a professional nurse who demonstrates the ff. Caring behaviours ( compassionate. particularly that of diagnosing and treating human responses and potential health problems.  Basic Educational Program in Nursing Before 1983. of professional nursing service. ethico-moral.

Group or community.Registered Nursing Program  Diploma Program patterned after Florence Nightingale. .increasing variety of ways & setting. 9173. otherwise known as the the Philippine Nursing Act of 1991 . repealing for the purpose RA No.  2 years of liberal arts & basic 3 year diploma prog. Graduate Nursing Program  Master s Program-(1.Philippine Nursing Act.  Doctoral Program ( act providing for a more responsive nursing profession. Consumer. DNS) emphasis is on theory development.a person who is waiting for or undergoing medical treatment & care. 3. family. Associate Degree Program  First & only program for nursing that were systematically developed from planned research & controlled experimentation. The Recepients of nursing 1.5-2years) provides specialized knowledge & skills that enable nurses to assume advanced roles in practice. Patient. 5. education administration & research. Nursing Practice  Nurses practice in an ever. Baccalaureate Program  First school of nursing in a university setting. 2. 2.people who use health care products or services are consumer of health. traditionally we call them patients when they seek assistance because of illness or for surgery.a person who engages the advice or services of another who is qualified to provide care or to provide this services. who may be an individual. 3. 4. Client. research.  The focus of all nursing practice is the client.  RA No.7164.  Refers as the receivers of health care less as passive recepients & more as collaborators in the care. that is a person who are responsible for their health.

 5. dependents & authorized relative.  7. .nursing in hospitals & related health facilities. Community Health Nursing. Role can be developed in many settings including schools of nursing & hospital staff development departments. The nurse provides direct nursing care.  4. Nurses in private practice.   2. The practice focus on promotion. The nurse participates in all phases of patient care of the acutely ill. Military Nursing (The Nurse Corps) Provides comprehensive & quality nursing care to all military personnel.   Institutional Nursing. who have been evacuated from battle areas to the nearest installation for treatment.focus requires understanding the needs of a population.    6. General Private Duty Nurse Private Duty Especialist Nursing Education.Space Nursing. Responsible for patients. School Health Nursing. who undertakes to give a comprehensive nursing care to a client on one-to-one ratio. Flight Nursing or Aero. Private Duty Nursing. the convalescing & the ambulatory patient. they are responsible for the school s activities in the areas of health service.   3. She/he is an independent contractor. using the nursing process & critical thinking skills.Different Fields of Nursing 1. health education & environmental health & safety. Occupational health Nursing/Industrial Nursing. protection & supervision of workers health within the context of safety & healthy work a nursing approach that merges knowledge from the public health sciences with professional nursing theories to safeguard & improve the health of population in the community. military or otherwise. Community Health Nursing/Public Health Nursing. Provides & delivers health care services to workers. Public Health Nursing. or a collection of individuals who have in common one or more personal or environmental characteristics.

Other Opportunities  Immigration (USA. teaching. manager. Clinical Nurse Specialist (CNS).Clinic Nursing. 4. & other middle East countries are not required to take the board exam.  The field of nursing synonymous with specialization. depending on their specialty. Is responsible for the continued development & refinement of nursing knowledge & practice through investigation of nursing problems. Provides general anaesthesia for clients undergoing surgery.  Nurse practitioner function with more independence & autonomy than other nurses. Nurse Anaesthetist. does the billing. takes x-rays. Vienna.  Requires that a nurse possesses general skills. & treating minor health problems. under the supervision of a physician prepared in anaesthesiology. 9.  Nurses who work in Germany.  Entrepreneurship. answers phone. Advanced Nursing Practice. ECG. Expanded Nursing Roles 1. nurse clinician or clinical specialist. 2. Saudi Arabia.. The nurse acts as a receptionist.  Roles of clinical nurse specialists include clinician. consultant & researcher.g.Gerontology.  Clinical nurse specialists work in various settings. PE. changes dressing & assist in physical examination. 5. Nurse Midwife. Oncology0. 3.  Nurse anaesthetist are the RNs with advanced education in anaesthesiology. Critical Care. Has MA & may have advanced experience in specialized area of practice (e. Is educated in Nursing & midwifery & is licensed.  Day Care  Special school  Geriatric Care 8. Canada )  Short Term Employment. .  They are highly skilled in performing nursing assessment. 6. Pediatric. educator. Nurse Practitioner (NP).has advanced education (at least MA) & is a graduate of nurse practitioner program. Nurse Researcher. counseling. For example clinical nurse specialist or a nurse specialist..

Teacher. ensures that client s needs are met.    5. This role includes providing emotional. & will help the client to propose.the nurse promotes what is best for the client.  7. Change agent. Communication shapes relationships between nurses & clients. The nurse initiates changes & assists the client make modifications in the lifestyle to promote health. The nurse plans. implement & maintain change that promote the client s change. gives rewards fairly. The nurse provides health teaching to effect behaviour change which focuses on acquiring new knowledge or technical skills.   3. Counselling is the process of helping a client to recognize & cope with stressful psychologic or social problems. gives direction. Care Provider.   2. Client Advocate. protects the client s right. The nurse communicates with clients. The nurse s primarily concerned with the client s needs. develop. Counselling is done to help client increase their coping skills. Manager. 8. supports person & colleagues to facilitate all nursing actions. intellectual & psychologic support. . Team member/collaborator. 6.Roles & Functions of a Professional Nurse 1. The nurse supports the client by attitudes & actions that show concern for client welfare & acceptance of the client as a person. This involves the use of nursing process. staff. A vital role of a nurse. Referred as the mothering actions in nursing. 9. to develop improve interpersonal relationships & to promote personal growth. Communicator. 4. & represents both staff members & administration as needed. Leader. monitors operations. Counselor. The nurse works in a combined effort with all those involved in care delivery. The nurse through the process of interpersonal influence helps the client make decision in establishing & achieving goals to improve his well being. Effective communication is an essential element of all helping profession.

Case Manager. The nurse function as a resource person by providing skilled intervention. Resource Person. . (study of morality).  It came from the Greek word ethos which means moral duty.  Morality derived from the Greek word moralis which refers to social consensus about moral conduct for human beings & society.are specific ways of behaviour or of accomplishing ethical practices.(professional ethics). has expanded the role of the nurse. The nurse participates in scientific investigation & uses research findings in practice. 12.  Ethics a branch of philosophy that examines differences between right & wrong. The nurse coordinates the activities of other members of the health team. & information. Ethico-Moral-Legal Responsibilities in Nursing  Safe & compassionate nursing practice includes an understanding of the ethico-moral & legal boundaries within which nurses must function. Researcher.10.  Refers to expected standards of behaviour of a particular group. 11.  Morals.  Changes in the society  Advances in technology  Conflicts within the nurses role itself  Nurses conflicting loyalties & obligation. Nurses familiarity with ethico-moral-legal implications of nursing enhances their ability to be client advocate. when managing a group of client.    Ethical problems are created as a result of.  The nurse must understand the law to protect themselves from liability & to protect their client s right. such as nutritionists & physical therapist. As technology.  To be able to determine what is good or valuable for all people & to judge what is right & wrong. the ethical dilemmas associated with the client care have increased & often become legal issues as well.

Deontology or duty oriented theory. What is a good decision? Moral theories. Beliefs. Values. Moral Principles When a nurse is confronted with situations where moral judgment is necessary. Cognitive Moral Development.   Nurse s Ethical Decision are influenced by: Role perception & responsibilities. can be used as guidelines in analyzing dilemmas. 1. . Since nurses like others to treat them kindly and with respect.looks to the consequences of an action in judging whether the action is right or wrong. Nursing Code of Ethics. Teleology. judgment & choices.  The morality of a decision is not determine by its consequences.  Ethical theory that considers the intrinsic significance of the act itself as criterion for determination of right or wrong.Do unto others what you would like others do unto you. 5. A formal statement of a group s ideals & values. 1. Nurses should be aware of their values. Moral Principles.ethics problems requires nurses to think & reason in making decisions. & Attitudes. the nurse may be guided by the following principles or rules: The Golden Rule . they should be willing to do same to others too.  4. 6.   3. they can also serve as justification for the resolution of ethical problems. Provide direction for nurses to act morally.  2. Nurses are responsible for determining their own action & for supporting clients who are making ethical decision.

Examples: It is not morally good if a boy steals in order to alleviate his hunger because the action itself is already bad. The nurse refuses. The basis of action may be the following: That the action must be morally good That the good effect must be willed and the bad effect merely allowed That the good effect must not come from an evil action but from the initial action itself directly That the good effect must be greater than the bad effect. It is the gynecologist s intention to help the mother and not to harm her. she will die. 6. The Two-fold Effect when a nurse is faced with situation which may have both good and bad effects. It is the gynecologist s intention to help the mother and not to harm her.2. If the patient who has a cancer of the uterus submits to hysterectomy she will not be able to bear a child. The nurse is liable to such crime. In testifying before the court. No one is obliged to betray himself / herself. no one can force any person to answer a question if such will incriminate him / her. . The surgeon s action is morally good since saving the mother s life is of primary importance. If the patient who has a cancer of the uterus submits to hysterectomy she will not be able to bear a child. If she does not have the operation. The end does not justify the means. but recommends a doctor who is capable of performing. Example: Giving sleeping tablet to a chronically ill person so she / he can die in peace is morally wrong. 5. Examples: It is not morally good if a boy steals in order to alleviate his hunger because the action itself is already bad. she will die. If she does not have the operation. One who acts through an agent is himself responsible Example: A patient wants to have an abortion and asks a nurse if she can do it. Also the doctor himself did not will that the patient lose her child-bearing function. Also the doctor himself did not will that the patient lose her child-bearing function. The surgeon s action is morally good since saving the mother s life is of primary importance. since he / she is an accomplice of the said doctor.

. 9. . If one is willing to cooperate in the act. there is no violation of human rights. Example: If a nurse gets medicine from the hospital stock without permission or without prescription.7. is of right age. no injustice is done to him / her. he / she will be guilty of theft even if he / she got only one tablet of the same.Example: Patient with a Harelip or cleft palate may have their defects corrected by plastic surgery.Example: A patient subjects himself / herself willingly to an experimental drug and she / he has been told of the possible effects of the same. Defects of nature may be corrected. A little more or less does not change the substance of an act. . 8. and is sane.

Example: To promise that a patient with heart transplant will live may be impossible. Yet. 11. . If there may be some who may have slight reactions to the vaccine. Example: During an epidemic.10. such procedures are done in the hope of saving or prolonging a patient s life. The doctor or the nurse cannot be held to the impossible if they have done their best to take care of the patient and the latter dies. No one is held to the impossible. immunization against communicable diseases is administered to the people. The greatest good for the greatest number. the greater majority of the population shall be considered rather than the isolated few.

13. Formal cooperation in an evil act is never allowed. One of GOD s commandments is Thou shall not kill. The morality of cooperation. Immoral operations such as abortion shall not be participated upon by a nurse even if the doctor commands it. .12. Principle relating to the origin and destruction of life.

Autonomy  Self.Ethical Principles 1.governing  An individual has the right to make decisions and take independent actions without external control.  Based on the belief that a person has unconditional value and has the capacity to determine own destiny .

Examples     Consent on all treatments Knowing policies on advance directives like DNR Privileged Communication Physical privacy .

Persons who lack capacity to be autonomous    Infants Irrationally suicidal individuals Drug-dependent individuals .

The duty to do good to others and maintain balance between benefits and harms  One person takes action for the good of another person.  Act in ways that benefit others . Beneficence Do good.2.

Examples      Providing ALL patients including terminally ill patients with EQUAL CARING attention Organ donations Treating every patient with respect and courtesy Obligation to help others further their legitimate and important interests Contribute to the well being of another .

Immunization of infants . Experimental research Avoid harm as a consequence of doing good Ex.3. Nonmaleficence  Do no harm   Do not commit acts that cause deliberate harm Ex.

Never do shortcuts! Ask appropriate person if in doubt or unsure Continuing Professional Update .Examples      Working within the scope of nursing practice Observing safety rules and precautions Perform procedures according to protocols.

4. Veracity *Obligation to tell the truth *Not to lie or deceive others essential to the integrity of the client-provider relationship.


Admit mistakes promptly. Offer to do whatever is necessary to correct them Refusal to participate in any fraud Give an honest day work every day

5. Confidentiality  

Non- disclosure of private or secret information with which one is entrusted. Requires that information about client be kept private unless client consented.

Justice  Fair. equitable and appropriate treatment  To each equally  To each according to need  To each according to merit  To each according to social contribution  To each according to the person s rights  To each according to individual effort  To each as you would be done by  To each according to the greatest good to the greatest number .6.

7. Fidelity  Concept of faithfulness and the practice of keeping promises  Upholding the profession s code of ethics  Practice within the scope of nursing Examples: a. loyalty within the nurse. Contracts b.patient relationship .

the possible length of recuperation. the crisis involved. Except in emergencies when the patient lacks decision-making capacity and the need for treatment is urgent. and the medically reasonable alternatives and their accompanying risks and benefits.Patient s Bill of Rights: 1. The patient has the right to considerate and respectful care. the patient is entitled to the opportunity to discuss and request information related to the specific procedures and / or treatments. 2. .

The patient has the right to have an advance directive (such as a living will. . The patient has the right to make decisions about the plan of care prior to and during the course of treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy and to be informed of the medical consequences of this action. 4.3. health care) concerning treatment or designating a surrogate decision maker with the expectation that the hospital will honor the intent of that directive to the extent permitted by law and hospital policy.

The patient has the right consideration of his privacy. 6.4. to every 5. . The patient has the right to review the records pertaining to his / her medical care and to have the information explained or interpreted as necessary except when restricted by law. The patient has the right to expect that all communications and records pertaining to his / her care should be treated as confidential by the hospital.

or players that may influence the patient s treatment and care. a hospital will make reasonable response to the request of a patient for appropriate and medically indicated care and services. other health care providers. educational institutions. within its capacity and policies. 8.7. The patient has the right to ask and be informed existence of business relationships among the hospital. . The patient has the right to expect that.

The patient has the right to expect reasonable continuity of care when appropriate and to be informed by physicians and caregivers of available and realistic patient care options when hospital care is no longer appropriate. 10. The patient has the right to consent to or decline to participate in proposed research studies or human experimentation affecting his care and treatment or requiring direct patient involvement.9. and to have those studies fully explained prior to consent. .

treatment. The patient has the right to be informed of hospital policies and practices that relate to patient care. and responsibilities.11. .

A. Nursing Act of 1991 (R.A.Scope of Nursing Practice  The Phil. Nursing Act of 2002 (R. 7164) has been repealed by the Phil. 9173) .

when he/she singly or in collaboration with another. families. initiates & performs nursing services to individuals. infancy. . toddler. scope of Nursing Practice   A person shall be deemed to be practicing nursing within the meaning of this act. nursing care during conception. childhood. adulthood and old age. labour. pre-school. delivery. adolescence. school age. communities in any health care setting. It includes but not limited to.Section 28.

alleviation of suffering. nurses are primarily responsible for the promotion of health and prevention of illness. preventive and rehabilitative aspects of care. . nurses shall collaborate with other health care providers for the curative. As members of the health team. and when recovery is not possible. restoration of health. towards a peaceful death.  As independent practitioners.

comfort measures. In case of suturing of perineal laceration. oral. health teachings. internal examination during labour in the absence of antenatal bleeding and delivery. . It shall be the duty of the nurse to:  Provide nursing care through the utilization of the nursing process. special training shall be provided according to protocol established. topical and parenteral medications. traditional and innovative approaches. therapies. therapeutic of use of self. executing health care techniques and procedures . but is not limited to. Nursing care includes. and administration of written prescription for treatment. essential primary health care.

   Establish linkages with community resources and coordination with the health team. families and communities. undertake consultation services. . guide and supervise students in nursing education programs including the administration of nursing services in varies settings such as hospitals and clinics. engage in such activities that require the utilization of knowledge and decision-making skills of a registered nurse. Teach. Provide health education to individuals.

the development of advanced nursing practice  Provided. which shall include. Undertake nursing and health human resource development training and research. that this section shall not apply to nursing students who perform nursing functions under the direct supervision of a qualified faculty: . but not limited to.

the nurse is dutybound to observe the Code of Ethics for nurses and uphold the standards of safe nursing practice. The nurse is required to maintain competence by continual learning through continuing professional education to be provided by the accredited professional organization or any recognized professional nursing organization: . Provided further. that in practice of nursing in all setting.

that the program and activity for the continuing professional education shall be submitted to and approved by the board. . Provided finally.

The rights & responsibilities of the nurse in the role of a citizen are the same as those individual under the legal system. 3. Is the quality or state of being legally responsible for one s obligations & actions & to make financial restitution for wrongful acts. Liability. Provider of Service. Standards of Care.Legal Roles of Nurses 1. It is by which a nurse acts or fails to act are legally defined by . 2.

4. A nurse who is employed by a hospital work as an agent of the hospital & the nurses contract with the clients is an implied one. nurse practice acts & by rule & reasonable prudent professional with similar preparation & experience would do in similar circumstances. Employee or Contractor for Service. Contractual Relationships.   Independent Nurse Practitioner Nurse Employed by a Hospital . 5.

 The nurse represents & acts for hospital & therefore must function within the policies of the agency. The rights & responsibilities of the nurse in the role of a citizen are the same as those individual under the legal system. Citizen. 6. .

clients. The result or client s response to these diagnostic tests & interventions. Documentation provides a written records that reflect client care provided on the . their families & health care organization. treatments & client education.Documentation -as written evidence of:     The interaction between & among health professionals. The administration of tests procedures.

  basis of assessment data & the clients response to interventions. Reporting & recording are the major communication techniques used by health care provider. The medical record serve as a legal document for recording all client s activities assessed & initiated by health care provider. .

2. The information contained in a record can be valuable source of data for research. Legal documentation.Purposes of documentation or Client Record 1. . In the cases of law suit the record serve as the description of what exactly happen to a client. 3. Research.the record serve as the vehicle by which health professionals who interact with a client communicate with each other. Communication.

4. a record can frequently provide a comprehensive view of the client. Use to monitor the care the client is receiving & the competence of the people giving the care . Education. Students In health disciplines often use client records as educational tools. Quality assurance Monitoring. 5. illness & treatments.

Health. Accrediting & licensing.Statistical information from client records can help an agency anticipate & plan for future needs. Helps facility receives reimbursement or received or obtained payment from Phil.6. 7. 8. Statistics. Phil. . Health Reimbursement. JCAHO.

The report should be completed as soon as possible always within 24 hours. .Incident Report     An agency record of any accident or incident. When an accident occurs the nurse should assist first the client. The IR is not part of the client s record. but the facts of the incident should be noted in the medical record.

time. & place of the incident. Describe the facts of the incident. Date. Document any circumstances surrounding the incident. Avoid any conclusion or blame. Information to include in an IR:       Identify client with the hospital number. Identify any equipment or medication. Identify all the witnesses to the incident. .

II. Nursing as a Science .

Abstract ideas or mental images of phenomena or reality.Definition of terms    Concept.(abstract or concrete ideas) Concepts helps us to name things & occurrences in the world around us & assist us in communicating with each other about the world. .the building blocks of theory.

is a group of related concepts. It provides overall view or orientation to focus our thoughts. Is a structure that links global concepts together & represents a unified whole of a larger reality. Can be visualized as an umbrella under which many theories can exist. The concepts in a conceptual framework are linked together to form proposition. .    Conceptual framework.

Theory. a statement that expresses the relationship between concepts & is capable of being tested. a supposition or system of ideas that is proposed to explain a given a set of concepts & propositions that provide an orderly way to view phenomena. . E. believed or denied. People & their Environment are open System ..

 1. Nursing Theory (purposes) To provide direction & guidelines for structuring. 2. Differentiating the focus of nursing from other professions. Purpose of a Theory: is to guide research to enhance the science by supporting existing knowledge or generating new knowledge. . a) professional nursing practice b) education c) research.

Serve to guide assessment.     In Practice Assist nurses to describe. evaluation of nursing care. which are essential for effective decision making & implementation. explain & predict everyday experiences. Provide a rationale for collecting reliable & valid data about the health status of clients. Help to establish criteria to measure the quality of nursing care. . intervention.

.     Help build a common nursing terminology to use in communicating with other health professionals. Ideas are developed & words defined. In Education Provide a general focus for curriculum design. Enhance autonomy of nursing through defining its own independent function. Guide curricular decision making.

& validate nursing intervention. interpret findings. .    In Research Offer a framework for generating knowledge & new ideas. select variables. Offer a systematic approach to identify questions for study. Assist in discovering knowledge gaps in the specific field of study.

   Florence Nightingale s Environmental Theory (1859) The first theory of Nursing. the body could repair itself. Notes on Nursing: What it is. & manipulating the environment in order to put patient in the best possible conditions for nature to act. what it is not. She believed that nurturing the environment. She focused on changing.General Nursing Theories 1. .

1) Pure fresh air 2) pure water 3) efficient drainage 4) cleanliness 5) light especially direct sunlight. Her general concept about ventilation.  She linked health with 5 environmental factors. Deficiency in these five factors produce lack of illness or illness. warmth. cleanliness. & diet remain integral parts of nursing & health care today. . quiet.

in gaining independence as rapidly as possible.   Virginia Henderson: Definition of Nursing (1955) She postulated that the unique function of the nurse is to assist the client sick or well. will or knowledge.2. . that client will perform unaided if they have the necessary strength. She further believed that nursing involves assisting the client. in the performance of those activities contributing to health or its recovery.

3. Martha Rogers: Science of Unitary Human Beings. the whole being greater than the parts. ( 1970)  Rogers views the person as an irreducible whole.or assisting him achieve peaceful death if recovery is no longer possible. The distinctive properties of the whole are significantly different from its part  Unitary man is an energy field in constant interaction with the environment .

  She believed that human being is characterized by the capacity for abstraction & imagery language & thought. sensation & emotion. Therapeutic touch.g.process by which energy is transmitted or transferred from one person to another with the intent of potentiating the feeling of healing process of who is ill or injured.. . E.

According to this theory self care is a learned behaviour & a deliberate action in response to a need .4. health & well being .   Dorothea Orem: Self care and Self care Deficit Theory (1971) She defined self care as the practice of activities that individuals initiate & perform on their own behalf in maintaining life.

water. 2. Health deviation requisites.results from . 3. 1. include the maintenance of air. solitude & social interaction.& the promotion of human functioning both physiological & social interaction needs. elimination.common to all people. Developmental requisites -are the needs that arise as the individual grows & develop. food. She identified 3 kinds of self care requisites: Universal requisites. activity & rest.

Theory of Self Care deficit. .    This theory purports (claims) that nursing care is needed when people are affected by the limitation that do not allow them to met their self care needs. The relationship between the nurse & client is established when a self care deficit is present. It impairs the individual to perform self care. It also determines the need for nursing care. the needs produced by disease or illness states.

. Attempts to answer the question What do nurses do ? Three types of Nursing Systems Wholly compensatory system: when the nurse is expected to accomplish all the patient s self care or to compensate for the client s inability to care for self or when the client needs continuous guidance in self care.Nursing System Theory   1.

2. . Partially compensatory: are designed for individuals who are unable to perform some ( but not all) self care activities. Both nurse & client engage in meeting self care needs. Supportive Educative (developmental): the that requires assistance in decision making behaviour control & acquisition of knowledge & skills.  3.

researchers.   Sister Callista Roy: Adaptation Model (1979. . & practitioners.1984) Widely used by nurse educator. She viewed each person as a unified biopsychosocial adaptive system in constant interaction with the changing environment.System Theories 1.

She viewed that the nurse must first assess how the client behaves in each adaptive mode & then determine what can be altered in that mode to produce more efficient & effective responses. . caring for a patient with fever. activity & rest. e.g.involves the body s basic physiologic needs & ways of adapting in regard to fluid & electrolytes.. circulation & oxygen etc.  1. Four adaptive Modes: Physiologic mode.

the physical self. self consistency & moral ethical self.includes two components.2. patient who will undergo surgery & caring for an obese client. Self Concept Mode. E. determine by the need for social integrity & refers to the performance of duties based on given positions within society. The role function mode.g.( sensation & body image) & the personal self ( whish involves of self ideal. 3.

E.4.. self. a grieving widow.involves one s relation with significant others & support system that provide help.. 2.g. body image. space & time. growth & development.perception. The interdependence mode.  1. affection & attention. Imogene King: theory of goal Attainment (1971) Derived from a conceptual framework of 3 dynamic interacting systems: Personal system. .

. authority power. Social system. transaction. communication. interact & transact. act & react.interaction. roles & stress.organization. 3.2.  Interpersonal system. status. & decision making. To identify problems & establish goals the nurse & client perceive one another.

. developmental & spiritual) surrounded by two cocentric boundaries or rings referred as lines of resistance. (1972) Based on the individual s relationship to stress. the reaction to it & reconstitution (state of adaptation to stressors) . She viewed the client as an open system consisting of a basic structure or central core of energy resources ( physiologic.3. psychologic. socio-cultural.   Betty Neuman: Health care system Model.

It is a protective buffer that prevents . or the state of adaptation developed & maintained overtime & considered normal for that person. The inner or normal lines of defense represents the persons state of equilibrium.   The two lines of resistance represent internal factors that help the client depend against on stressors. The flexible lines of defense is dynamic & can be rapidly altered over a short period of time.

to protect the client s basic structure & to obtain or maintain a maximum level of wellness.  1.identify risk factors. stressors from penetrating the normal lines of defence. The concern of nursing is to prevent stress invasion. attempt to eliminate the stressors & focuses on protecting the first line of defense strengthening the first line of . Nursing actions are carried out on the three preventive levels: Primary prevention.



defense. Secondary prevention- relate to intervention or active treatment initiated after symptoms have occurred. The focus is to strengthen the internal lines of resistance, reduce the reaction & increase resistance factors. Tertiary prevention- refers to interventions following that in the secondary level. It focuses on readaptation & stability &

protects reconstitution or return to wellness following treatment.  The nurse emphasizes educating the client in strengthening resistance to stressors & ways to help prevent recurrence of reaction or regression. 4. Dorothy Johnson: Behavioural System Model (1960)  She used her observation of behaviour over many years to formulate this theory.



Described the individual as a behavioural system composed of seven sub-systems: Attachment- Affiliative subsystem security seeking behaviour, provides survival & security. Its consequences are social inclusion, intimacy, & the formation & maintenance of a strong social bond. Dependency subsystem- promotes helping behaviour that calls for a nurturing response.

ridding the body waste in socially & culturally acceptable ways. . It governed by social & psychologic consideration as well as biologic.satisfies appetite. Its consequences are approval. 3. attention or recognition & physical assistance. 4. The Ingestive subsystem. The Eliminative subsystem.

 7.protects & preserves the self & society & within the limits imposed by society. The Aggressive subsystem.dually for procreation & gratification The Achievement subsystem-attempts to manipulate the environment. 6. It controls or masters an aspect of the self or environment to some standard of excellence.5. The Sexual subsystem. .

experience & learning & are influenced by biopsychosocial factors. nurturance. & stimulation. .  Each of the above subsystem has the same functional requirements. protection. The subsystem responses are developed through motivation.

Interpersonal/Caring Theories 1. She defined nursing as an interpersonal process of therapeutic interaction between .is defined as understanding one s own behaviour to help others identify felt difficulties & applying principles of human relations to problem arising during the experience.   Hildegard Peplau: Interpersonal Model / Psychodynamic Nursing Theory (1952 ) Psychodynamic Nursing.

 1. The patient seeks help. an individual who is sick & in need of health services & a nurse especially educated to recognize & respond to the need for help. She identified four phases of nurse-patient relationship namely: Orientation: The nurse & client initially do not know each other. & the nurse assists the patient to understand the problem & the extent of need for help. .

Identification: during this phase, the patient assumes a posture of dependence, interdependence in relation to the nurse.  The nurse s focus to assure the person that the nurse understands, the interpersonal meaning of the patient situation. 3. Exploitation: in this phase the patient derives full value from what the nurse offers through the relationship.  The patient utilizes all available resources


to move toward a goal of maximum health or functionality. Resolution: refers to the termination phase of the nurse-patient relationship. It occurs when the patient s needs are met, & client can move toward new goal. Peplau further assumed that that the nursepatient relationship fosters growth for both the nurse & client.



Jean Watson: Philosophy & Science of Caring (1979 ). She believes that the practice of caring is central to nursing & it is the unifying focus for practice. Her theory is composed of ten (10) carative factors which are classified as nursing actions or caring process. Forming a humanistic-altruistic system of values.

Although the values are learned early in life. .  2. Instilling Faith & Hope. Feeling of faith & hope promote wellness by helping client adopt health seeking behaviours.  This factor relates to satisfaction through giving & extending of the sense of self. but they can greatly influenced by education.

3. Nurses who are able to recognize & express their feelings are better able to allow others to express theirs. This kind of relationship involves effective communication. It promotes & accepts the expression of positive.  4. Developing a helping trust (human care) relationship. & negative feelings. empathy & non possesive warmth.   Cultivating sensitivity to one s self & others. .

Using a creative problem-solving approach or caring process.5. . Promoting transpersonal teaching learning.  6. love & pain is risk taking experience. Sharing feelings of sorrow. 7. This factor separate caring from curing & shifts responsibility for wellness to the client. The nurse must be prepared for negative feeling.  Expressing positive & negative feelings.

protective or corrective mental. socio-cultural. .8. social. Recognizing & attending to the physical. emotional & physical changes. physical. & spiritual needs of the client.  Providing a supportive. The nurse must asses & facilitate the client s abilities to cope with mental. Assisting with gratification of human needs.  9. emotional. & spiritual environment.

Person possesses three spheres of being: mind . & soul. Existential psychology is a science of human existence that employs the method of phenomenologic analysis.spiritual forces.10. . body. Allowing for expression of these forces leads to better understanding of self & others.    Being sensitive to existential phenomenologic.

understand & be effective with people. there can be no cure without caring but there may be caring without curing .culture specific & culture-universal nursing practices. .    Madeleine Leininger: Transcultural Care Theory (1978) The goal of transcultural nursing is to develop a scientific & humanistic body of knowledge in order to provide.3. She believes culture is the broadest & the most holistic means to conceptualize.

intellectual competencies & technical skills of the individual nurse into the desire & ability to help people. therefore to society. She conceptualized nursing as an art & a science that molds the attitudes. & cope with their health needs. She defined nursing as service to individuals & families.   Faye Abdellah (1960): PatientCentered Approaches to Nursing Model. . sick or well.


III. Nursing as an Art .

Caring Theories    Peplau s Interpersonal Nursing Theory Watson s Philosophy & science of Caring Leinnenger s Transcultural Nursing Theory .

The most effective tool for demonstrating caring is not some technologically sophisticated machines with lights & alarms but rather oneself.Therapeutic Use of Self   A process in which nurses deliberately plan their actions & approach the relationship with a specific goal in mind before interacting with the client. .

   1.means anticipating the future by . This is an oppurtunity of the nurse to be with the person at a human to human level. Hope. caring are all expression of warmth. genuine interest. Respect. Therapeutic use of self makes the art of nursing as different from science of nursing. 2. Characteristics of therapeutic Relationship Warmth.exhibiting positive behaviour toward a client.

must be present for help to be given & received. ( consistency. honesty are essential in the development of trust.) . 3. 2. Trust. helping clients look realistically at their a bond or connection between people that is based on mutual trust. respect. Rapport. act & achieve. Hope is the energy source that allows individuals to plan.

Empathy understanding another perception of the required in every nurseclient relationship. 7.can assist in establishing a relationship because it helps break the ice.accepting client as a person & working with clients even those clients who exhibit undesirable behaviours. & establish trust. Active Listening. Acceptance. & can help strengthen relationship. . Humor. 6. decreases fear. 8.5.

necessary to be therapeutic. Self-awareness allow the nurse to remain objective. Kindness & genuine concern are demonstrated through compassionate acts. Being aware of one s feeling is the first step in developing therapeutic behaviour. .9.   compassion.  10. that is separate enough to distinguish one s own care what happen to another person. Self Awareness.

Flexibility. Non-judgmental approach. .the nurse must give themselves permission to try something new.acting without biases.a flexible nurse is one who is ready for the unexpected. to step outside the ordinary & not to be bound by tradition or fear.11. pre conceptions or stereotypes. Risk taking. 13. 12.

. Client may display some resistance behaviour. Getting to know each other & developing a degree of trust. it sets the tone for the rest of the relationship. Assessment of client is the most important goal .Client Relationship 1.inhibit involvement.Phases of Nurse.     Orientation phase: Introductory phase.

   Working Phase: The nurse & client begin to view each other as unique individuals. seeking clarification from the nurse. being attentive to instructions. Behaviours that indicate the client is in the working phase. They begin to appreciate this uniqueness & begin to care about each other. asking for more information about his role in recovery. . asking questions about own problem.2.

Planning for termination is actually initiated during the beginning of the relationship. Many methods can be used to terminate relationships.   Summarizing or reviewing the process can produce a sense of often difficult & filled with ambivalence. It focuses in evaluation of goal achievement & effectiveness of treatment.3.   Termination Phase. .

Thank You .

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