HISTORY OF DEVELOPMENT OF NURSING PROFESSION

INTRODUCTION
The word `history¶ means a chronological record or account of past events and development. It is to understand the changes that occurred in terms of religion, economy and politics in the various cultures of the world through the ages and how these changes influenced nursing and brought it to the present day status of a profession. Nursing is an art and a science. The nursing profession like other careers has undergone many changes. So I would like to go in detail regarding the historical development in nursing profession.

DEFINITION OF NURSING
According to ICN (International Council Of Nurses), ³Nursing is the unique function of a nurse that is to assist the individual ,sick or well in the performance of those activities contributing to health or its recovery(or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge´.

THE GENESIS OF NURSING
Ancient history reveals no records of nursing in pre-historic times. What we know is by the findings of Archaeologists. Pre-historic man lived close to the nature and soon associated spiritual values to all natural objects, believing that thing like tree or river had a spirit or soul. Such a religion is known as Animism. According to them sickness comes due to following causes: y y y y Black magic Sorcery Breaking a taboo Bodily invasion of evil spirit

To get rid of these, the body had to be made unpleasant for them by starving, beating and nauseous medicines. The medicine man was one who paid close attention to signs and symptoms and thus knew what to do in some conditions. His influence increased, he took up the role of priest, and he was known as priest-physician. Contribution of primitive man towards nursing: Massage Fomentations Trephining Bone setting Amputation Hot and cold baths
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Abdominal sections Heat to control haemorrhage

INFLUENCE OF ANCIENT CULTURAL PRACTICES ON HEALTH CARE
After pre-historic period, writing was invented. Archaeological findings and Bible presentations help us to study the contributions of the ancient cultures. SUMERIANS When the Sumerians moved into the land between the River Tigris and Euphrates, they had developed a system of writing, a set of laws and advanced culture. They worshipped evil spirits as Gods and built temples to them hoping to please them so that disease and misfortune would be eradicated. The Medicine man became the Priest-physician who stayed in the temple. BABYLONIANS (Present IRAQ) 4000 to 3000 B.C They worshipped ³Bel´ or Marduk, who was identified with the planet Jupiter. Bel was a cruel God who frequently craved for human blood in return for his favour. Hammurabi, the king of Babylonia, developed a Code of laws. He tried to prevent the sufferings of the helpless and to reduce the cost of the medical care. Doctors were severely punished for their wrong treatments. They believed that illnesses were caused by sin and anger from God. Temples became centers for medical care. An animal was kept near the sick person so that the devil could enter into it, then the animal was dissected to study the liver. Contributions towards medicine: -Many clay models are found to describe liver, gallbladder etc. - Team approach was used. It consists of priest physician, nurse, pharmacist. PERSIANS (PERSIA- Present IRAN) Persians were a group of Iranian tribes. Cyrus the great was the leader of Persians. Zoroaster was religions head. His teaching Zoroastrianism is still practiced in Iran and India by Parsees who are descendants of Iranis of Persia. They believed in the theory of evil spirit of diseases and practiced spiritual assistance to cure illness. Their Holy book, the Avesta contained the ceremonial rules relating to the natural laws of birth and death and also stressed the principles of public health and sanitation. They played music in order to cure illness. After a person`s death his body was fastened to the roof of a special high tower called `Tower of Silence¶. Birds picked the flesh and bones dropped into the pit below. They had 3 types of practitioners:
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It include principles of personal hygiene related to Isolation. The priest. Women enjoyed equal rights and freedom in education. There were different tribes or civilization such as Mayas and Aztecs. setting of bones. The mother had a position of authority. ANCIENT EGYPT The oldest medical records are from Egypt. splinting. Records regarding diseases. ii. Those who treat with prayer and holy words and heal were called Dasture who were very popular. Women in Egypt had no career but had some freedom. Women of high rank became priestesses in the temples and some of them assisted the priest-physician in caring for the sick. surgery were preserved in papyrus paper. ANCIENT AMERICANS Archaeological findings had revealed different highly developed cultures of Ancient America. drugs. Such an embalmed body is known as µmummy¶. Incas.physicians were medical advisors and pharmacists. status and property rights. µHouses of Hospitality¶. disposal of excreta. Visiting and caring for the sick was a religious duty. sweating. Those who treat with herbs and heal were called physicians. hours of work. iii.i. rest & sleep. Those who treat with knife and heal were called surgeons. amputation. the fore runners of inns. disinfection. ANCIENT HEBREWS The best resource book on the history of the Hebrews is the Old Testament of the Bible. trephining and bandaging. Many rules and regulations in regard to social and religious custom and health and sanitary practices are compiled into Mosaic Code. hygiene. Medical laws became fixed codes and stated what a doctor could or could not do. They believed in ³one true God´. Priest-physician took the role of health inspector. hospitals were plentiful. Moses was one of the divinely motivated servant of God. thus they developed the art of embalming and bandaging the body to preserve it. 3 . poultice. Contributions towards medicine: They used all the ancient system of treating patients such as bloodletting. The early Egyptians believed in µlife after death¶. Their religion forbids dissection and hence research could not be carried on and medicine as a science declined. hotels. regulations to check animals before slaughtering/ eating. A nurse`s role included midwifery.

INDIANS The earliest records of Indian medicine are to be found in the sacred books or Vedas. liver diet for anemia. Evidences from this books shows that doctors and attendants (nurses) were people of high moral character and hospitals were large and well equipped. They were allowed to practice dissection and so had good descriptions of internal organs and blood circulations. o Apollo (son of God) ± God of health 4 . Mohammadans invaded India. Buddhism declined. Dissection was forbidden. seaweed for thyroid disorders. hospitals for animals and universities (monasteries) of Taxila & Nalanda (Bihar). Listen.-236 B.D. On religious grounds.C. any kind of physical contact with the non-caste people and mlecha was considered contamination to Brahmins who were also the priest-physician. surgery. medicine remained in the hands of the priest-physicians who refused to touch blood or pathological tissue. vaccination. Old women were respected. Superstition and magic. medicine and surgery were practiced long before the Christian era. ANCIENT GREEKS The early Greeks believed medicine was of divine origin and was represented by many gods. Contributions towards medicine: They used vegetable and animal drugs. Women had no freedom. Baths to reduce fever. as the Brahmin influence gained strength and re-established itself. Sushruta known as the µFather of Surgery¶ in India wrote one book in surgery. This accelerated the process of decline of medicine. superstition and magic had been somewhat replaced by more up-to-date practice. treated syphilis and gonorrhoea. About 1000 A. Acupuncture and Acupressure was popular and now it is practiced all over the world.C) built public hospitals with male nurses and some older women. thus replaced the up-to-date practice of medicine. Their slogan was µLook. which deals with prevention and cure of diseases in medicine. The rigid Hindu caste system flourished.ANCIENT CHINESE In China. But. The Ajur-Veda is thought to have been given by Brahma and it is divided into a number of parts. They believed in certain superstition such as certain diseases due to evil spirit for which they used bloodletting treatment. In 2000 A. By 1 A. physiotherapy. King Ashoka (272 B. children`s diseases etc. Prevention of disease became a matter of first importance and hygienic practices were adopted. Charaka wrote one on µInternal medicine¶.D.D. Ask and Feel ¶and it was the rule for physical examinations.

poultices. His writings gave instructions about hot applications. mind & environment. They made drainage systems. drinking water aqueducts. He stressed fresh air.D. 5 . He developed the ways of doing physical examinations and of taking their history He stressed on equilibrium of body. special buildings were erected for these patients. The caduceus. public baths for men and women and public dispensaries. It composed of the staff of the traveler. Hippocrates is known as µthe Father of medicine¶. THE CADUCEUS ANCIENT ROMANS Medical advances are borrowed from Greece after they conquered it. cold sponging for fever.o o o Aesculapius (son of Apollo) ± God of healing Epigone ± (Aesculapius`s wife) ± The soother Hygeia ± (daughter of Apollo) ± Goddess of health Temples were built for these gods. After 170 A. He taught that treatment should be based on the diagnosis. The unclean such as the dying and obstetrical patients were not allowed to come in or to remain in the temple grounds. Priest-physician was in charge. fluids for kidney diseases and mouthwashes. entwined with serpents signifying rejuvenated knowledge and wisdom and at the apex of the staff are two wings of Mercury for speed. Contribution of Hippocrates He taught that doctors should observe their patients and then come to a conclusion as to the cause. Old women & men of good character did the nursing. symbol of medical profession is one of the gifts from the Greeks. cleanliness and good diet for health. These were regarded as the first European hospitals. People came here not only to worship the God but the sick came for treatment and cure. The early hospitals were made for soldiers and slaves. He suggested the use of music and work to occupy the attention of mental patients.

Benedict of Nursia. between the 9th and 10th centuries the monasteries went into decline.D. I became one of the most active organizations for social work. but modified by Christian ideals. Monasticism Feudalism Guilds 6 . When they were criticized they made their rules stricter and thus many lose interest. social insurance. according to which every physician in Ireland was to keep one door of his house open at all times. The practice of medicine was regulated by Brehon laws.) AND SOCIAL FORCES ON THE The era begins with the fall of the mighty Roman Empire and it is called the dark ages in history. GUILDS This was the first organisation of workmen and tradesmen who were not attached to monastic or feudal groups. The physician was required to refund the fees if he failed to heal a patient. EFFECTS OF SPIRITUAL DEVELOPMENT OF NURSING EARLY MIDDLE AGE (500-1000 A. The homeless turned to these landlords for protection. sickness insurance etc. came into existence along with monasticism. thus leaving many homeless. As the monastries became wealthier they gained more freedom and political power. They received protection. According to the felt needs 3 protective units developed: y y y MONASTICISM During the dark ages many of the monks and nuns proved themselves to be good organizers and administrators .One outstanding monk St. Barbaric tribes invaded Rome and the entire infrastructure were destroyed by them.THE IRISH CELTS They developed several medical laws and practiced moist heat in their treatment and believed in attending to the `peace of mind` of their patients. The Benedictine Rule was developed to meet their needs. so that the sick and the injured might be brought in. FEUDALISM Following the fall of Rome. As a result. Thus an ancient system known as feudalism. much of the agricultural land was controlled by a class of gentle farmers. The status of a woman was high and she was treated with reverence.

This form of guilds served as foundation for modern labour unions in an organized manner. and (in the form of a modern revival) that of St John of Jerusalem.Religious 3. John of God and St. St. etc. Knight of St. (Palestine.) CRUSADES The Crusades were a series of wars between Christians and Muslims for control of the Holy Land. the order of St Augustine. and developed the first ambulance service. It was originally established to treat virulent diseases such as leprosy. LATE MIDDLE AGES (1000. founded in the twelfth century by the crusaders of the Latin Kingdom.Bartholomew's in London. Names of the oldest foundations which still survive. Syria. John are also known as Knights Hospitaller.D.there are approximately 19. Lebanon. Nurses wore regular clothes no uniform . her lamp represented the sick at Sienna. RELIGIOUS ORDER Institutions were managed by the clergy and throughout the dark and middle ages the hospital and nursing systems were connected with religious bodies. Catherine of Sienna. Three (3) Types of Organization 1.1500A. St Camillus started the sign of the redcross which is still used today.done by volunteers like St. St Thomas's and St. and was charged with the care and defense of the Holy Land.000 hospital in Western Europe -There is spread of leprosy -Thousand years after Jesus Christ there was no attempt to organized nursing. Lazarus of Jerusalem originated in a leper hospital run by hospitaller brothers.Military 2. Israel.The guild methods have been followed in nursing and medical teachings. The Order of St. Two patron saints of nurses stem from this period.Care of the sick. Camillus de Lellis both started out as soldiers. 7 . Nurses were provided by the male and female monastic orders. a Christian organization that began as an Amalfitan hospital founded in Jerusalem in 1080 to provide care for poor. Secular MILITARY NURSING ORDERS Knight Hospitalers are the men who went to battle and then retired to nurse the sick. and later turned to nursing. After the Western Christian conquest of Jerusalem in 1099 during the First Crusade it became a religious/military order under its own charter. sufficiently indicate the original religious connexion. such as the Hotel Dieu in Paris. sick or injured pilgrims to the Holy Land.) Influence of crusades in nursing: -In 1244.

Even the secular orders were associated with the Church. Emancipation of women-fight for human right was a step in developing nursing into a profession. aged. and the beginning of capitalism and democratic forms of government. giving enemas and tooth extraction -women make beds. forced thinkers and philosophers to reevaluate their ideas and values. Capitalists were protected by law in his exploitation of workers. founded the Sisters of Mercy. Proliferation of factories with introduction of technology. accepting bribe. RESPONSE OF NURSING TO THE NEEDS OF SOCIETY RENAISSANCE Interests in arts and science emerged. with both men and women serving as nurses. -Leeching. This was a time of free thought. Bubonic Plague epidemic killed 25 to 50% Europe`s population. During the four hundred years the living was nearly unbearable. There were many Catholic orders caring for the sick during the Middle Ages. none the less. rise of progress in arts & culture but not in moral & religious values. the care provided was. The society was filled with thieves due to social deprivations. religious order emphasizing in nursing the poor and sick. physically and mentally ill. reformers and inventors were paving the way for a new world order. Mother Mary Catherine Mc Auley. it was not without its own growing pains. and practicing under very primitive conditions. scrubs floors and bathe the poor in alms houses. Care of the sick was entrusted to those who were proven guilty of a crime or theft. In France. The Industrial Revolution gradually brought forth a more equitable living style for the people. some scholars.barbers functioned as surgeons. It arrived with the onset of the Industrial Revolution. humane and caring. Caretakers were not given humane facilities like food & quarters. Caring for the sick was one of the order's important activities. INDUSTRIAL REVOLUTION The growing pains of the Reformation. so all the more they got buried into evil deeds like stealing the patient`s foods. 8 . Hospitals were for the weak. lacking knowledge of hygienic measures. individualism. A fee was charged for the hospitalizations. Geographical explorations done by Europeans. Educated by apprenticeship. they practiced: . Need for care of sick and poor escalated. There were child labor and sweet shops where disease and accidents were the norm. etc. contagious disease. However.SECULAR ORDER The Third Order of Saint Francis (Francis of Assisi) was a secular order whose members devoted their time and energy to enhancing the lives of their friends and neighbours in the communities where they lived.

Medical instruction continued along primitive lines. Nursing became the work of the least desirable of women who took bribes from patients. slept in cubbyhole near the hospital ward or patient and ate scraps of food when they could find them. In England. Elizabeth Fry (1780-1845): She was responsible for bringing about changes so that better care could be given to women and children in Newgate prison in London. As a result he witnessed many changes in the condition of the jails. In 1840 with the help of her sister and daughter.-factory workers endured long hours of work. His work set the pattern for modern social work. no one to care for the sick. THE REFORMATION The religious upheaval led by Martin Luther destroyed the unity of Christian faith. and formed colonies where these people could learn to support themselves. orphanages and hospitals. -Medical schools were founded Royal College of Surgeon in London (1800). They began to think in terms of equality and rights of individuals. stole the patient`s food and used alcohol as a tranquilizer.no standards for nurses working in the hospitals. The wrath of Protestantism swept away everything connected with Roman Catholicism in schools. After his release he set out to see other jails and submitted reports regarding the condition of jails to the rulers. as a prisoner of war. Nurses fled for their lives. The poverty which followed the wars brought a discontentment that flared up in a series of equally great revolutions: The American Revolution (1775-1783) The French Revolution (1789-1795) The Latin American Revolution (1800-1825) These revolutions changed the attitude of people towards human inequality. HUMANITARIANS St. Properties of hospitals and schools were confiscated. They worked seven days a week. she succeeded in organizing the 9 . To prevent begging he built municipal lodging houses. John Howard (1727-1789): He had an experience. Nursing sank to its lowest level . POLITICAL REVOLUTIONS The ambitions of the Kings led to war and the spirit of national competition. started trade schools. in a prison in France.Vincent de Paul (1576-1660): He became the outstanding philanthropist of his time. -End of 18th Century. hundreds of hospitals were closed. There were no provisions for the sick.

emphasis will be placed on the effect that mass media had on the image of nursing during these periods.Because of its pervading influence. rest or recognition. Later the name changed to µProtestant Nursing Sisters¶. the original ³Angel of Mercy´. the poorly educated alcoholic nurse who worked in primitive conditions primarily performing domestic chores. spiritual. In the early 1900s nurses were viewed as honorable. self sacrificing and ritualistic. moral. Linkage between Mass Media and Nursing Image: Extensive research on the image of the nursing profession has been done by Kalisch and Kalisch. The image of nursing may also have its roots in the Victorian Age during which she lived. a group of women who did hospital visiting. 10 . The second prevailing image was Florence Nightingale. Unlike today. sacrifice and submission. in a novel by Charles Dickens.  Success and meaning through nursing. mothers and housekeepers.`Protestant Sisters of Charity`. Nurse heroines were characterized as being involved in a dual search. nurses appeared in a substantial number of literary endeavors. HISTORICAL DEVELOPMENT OF NURSING`S IMAGE Credit is given to Florence Nightingale for the written history and development of modern nursing. They identify six periods during which distinct corresponding images of the nursing profession can be seen. idealizing nurses and making them a totem of exemplary moral purity. physicians by the late 1800s were exclusively males and nurses were females. These expectations were not just encouraged but were demanded. During the Civil War. created the first generation of American mental asylums. At that time men were the laborers and the bread winners and almost all women were socialized into becoming wives.1887): She was an American activist on behalf of the indigent insane who. IMAGE OF NURSING The image of nursing has been and continues to be colorfully presented and distorted in all forms of expression in the society. In First World War media representations continued the ³Angel of Mercy´ image. through a vigorous program of lobbying state legislatures and the United States Congress. One image. During the ³Angel of Mercy´ era. The expectations of nurses were altruism. Dorothea Lynde Dix (1802 . was Sairy Gamp. she served as Superintendent of Army Nurses. Nursing was perceived as ³women`s work´ ± a natural extension of all of the altruistic qualities valued in women. In the hospital setting nurses were recognized as physical extenders. Even today the image of Florence Nightingale as the ³Lady with the lamp´ remains perhaps the most popular public image of the founder of modern nursing. The usual image of Florence Nightingale is of a self sacrificing young woman with no desire or need for money. Period 1: ANGEL OF NURSING (1854-1919) In the pioneer days of nursing there were two prominent images of nurses.

self-indulgent. power hungry and unmotivated persons and the once honored and virtuous film image of the nurse was a thing of the past. superficial and unreliable. chivalrous. Films were generated from Hollywood emphasized nursing as it was during the war. submissive and domestic. Their contributions to health care were not addressed. In films of this era nurse heroines were not cast as career nurses. the mother image of the nurse. The influenza epidemic also increased the importance of instructing nurses in the area of home nursing. Period 3: HEROINE (1930-1945) For the next 15 years. Nurses were described as faithful. In films of these years. reasonable. Nursing was simply a means to an end. Happiness and fulfillment through love and marriage. During the 1950s television programs usually portrayed nurses as worthy of respect and appreciated for their skills. nursing was acknowledged as a worthy and important profession that enabled women to earn an honorable living. Their careers culminate in marriage. Work as a nurse was often seen as a means to obtain amenities such as vacations or luxuries for the home and family. Nurses were increasingly depicted as being sexually promiscuous. The invention and use of aircraft in war. Adjectives such as courageous. fearless. Eventually nurses were portrayed as cold. Nurses became µsexual mascots¶ for health care teams and were seen in X-rated movies. Nurses were identified as educated and owning certain abilities. long suffering and subservient. which was popular in the mid 1940`s changed to the sex object image. nurse figures were cast primarily in series that accentuated the medical model and made physicians seem almost superhuman. co-operative. as well as chemical warfare. women entered a new domain of professional endeavors and activities. 11 . humanitarian and magnanimous were used to illustrate and portray nurses. Period 5: SEX OBJECT (1966-1982) After 1966. resulted in new problems in the health field. Period 2: GIRL FRIDAY (1920-1929) With the passage of the Women`s suffrage reform in 1919. clear headed. unassertive. The war provided an improvement of the profession`s image in novels. dependent. This attitude was conveyed in the enterprises of Hollywood in which nursing was depicted as a conscientious and admirable job choice. This dichotomous representation often resulted in a mixed image from 1916 to 1918. which represented a woman`s only legitimate destiny. During this decade. but accepted only until time for marriage. nurses were undervalued and poorly represented. uncaring. the nursing profession received its greatest attention in the propaganda films of First World War. Period 4: MOTHER (1946-1965) It may have been a natural development after Second World War that a major goal of many American women was to stay home and care for children. Nurses during this period were chronicled as maternal compassionate. Nurse were consistently cast as Red Cross nurses and represented as almost mythical womanhood. They were depicted in roles subordinate to physicians and employed in positions that they would easily surrender for marriage or children.

with nurses being recognizes as the pivotal provider for entry into the health care system. punitive. the late Martha Rogers (1914-1994) made a major contribution of nursing through her presentation of nursing through her presentation of principles regarding self image psychology. intelligent and virtuous. The mass media of the 1980`s did not improve the image of the profession. This principle is commonly known as the `self fulfilling prophecy¶.  Enlighten the public through all forms of media of the positive dynamics of nursing by showcasing personal stories as shared by clients. The law of belief: .The 1970`s represent the lowest point in film history for the nursing profession. Men and women in the nursing profession are dedicated to providing the highest standards of health care at the greatest expanse of excellence to the consumer. 2.  Enhance the minimum level of education for all nurses by involving in collaboration with community business and political and social endeavors. Certainly nurses were not portrayed as altruistic. Everything an individual subconsciously believes becomes reality. The ultimate image of nursing as we approach the millennium. Period 6: CAREERIST (1983-Present) The careerist has become the new image for the mid 1980`s and 1990`s portraying nurses as intelligent. The responsibility/ achievement relationship: . sophisticated. progressive. The factor contributing to the enhanced image of nursing in the careerist period is the collaborative practice that has encouraged nurses and physicians to practice in tandem for the quality of care for all.This model states that an individual experiences a confident self-concept.1. empathetic and assertive. NURSES OR NURSINGS IMAGE OF ITSELF The individual nurse`s attitudes. is for nursing is to: Touch the hearts of the homeless and abandoned by working for change in the policy of local health agencies. These principles focus on the self concept of the individual nurse. logical.This major principle of the model declares that whatever an individual strongly believes is actualized. Tracy explored specific principles of the self concept model and the two basic principles are as follows. Instead a new nurse characterization appeared. the attitude of being in control and achievement in equal proportions to the willingness and ability of that individual to take responsibility for her or his own life without blaming external factors. 12 . sadistic nurse who derives pleasure from client suffering.that of the malevolent and sadistic personally. Self Image Psychology In addition to her contribution to nursing theory. Movies such as ³Terms of Endearment´ endorse the image of the cold-hearted. behaviors and interactions constitute nursing`s self image.  Expand the involvement of political integration by visualizing total health care as the responsibility of the entire community.

The belief that is acceptable not to be at the bedside must be generated. As previously mentioned. They may believe that to be a `real¶ nurse one must work I a hospital providing direct client care and that when one moves away from the bedside or the hospital setting. encouraged and disseminated. clinics. Men choose medicine and women choose nursing. The Industrial Revolution is also responsible for the lingering gender-specific stereotypes that exist within nursing today. nursing was considered as much a male profession as a female one. a reason often cited for the continued voluntary exclusion of men from nursing. MEN AND THE IMAGE OF NURSING:In the field of nursing. Science. During the 1990`s however the increase in pay and prestige has influenced the public`s attitude shift concerning men in nursing. the public and nursing students that `real¶ nurses are involved in a variety of interesting and valuable professional activities in many diverse settings. one finds repeated documentation that men were the first nurses to experience large-scale conventional education in western civilization. status as a `real¶ nurse is lost. hospice. private business. male nurses are often considered social misfits unable to fit into a ³real man`s´ job.PROFESSIONAL PRIDE:Nurses frequently become trapped in one particular image. This image creates difficulty for some men who might otherwise be attracted to the field. industries. Real nurse also work in jails. discussed. reservations and in rural and urban area. Until the late nineteenth century. Nurses participate in all areas of life. colleges. hours and overall working conditions. 13 . She worked hard to establish nursing as a worthy career for respectable women and largely ignored the historical contributions of men. Collective Bargaining:It is the process by which unions participate in administrative divisions involving the terms of employment and the price of labor. Most nurses seek improvements in salaries. technology and business became the accepted standards for aspiring men in the nineteenth century. But when reviewing nursing history. settings. Nurses must begin to educate members of the profession. is the image of profession as feminine and nurturing. Today more than 40% of both men and women would approve of nursing as a career choice for their sons. homes. Several circumstances led to the decline and near extinction of men in nursing. Ironically Florence Nightingale was partly responsible because she consciously defined nursing as female. STRATEGIES FOR IMPROVING THE IMAGE OF NURSING IN THE 1990`s The strategies for improving the image of nursing in the 1990`s are as follows:1. Thus collective bargaining for a time became an attractive possibility as a positive and powerful organizational tool.

Development of Internal Media Committees:Internal media. These media watch groups must take responsibility for monitoring the media for all references to nursing. The 7 ³C´ s of Image Building:The foundation of nursing.Sharing the responsibility among the colleagues. There are many educational differences among nurses. relying on the knowledge of and belief in who you are.Giving of one`s self for the total journey. annual reports. 7. Numerous nurses and group of nurses suggest that external nursing media committees be organized within every hospital. 4. in the form of catalogs. television networks and advertisers.  Collaborative. brochures. It is suggested that the health care facilities should have an internal media committees and actively review all materials. every school of nursing and at each level of every nursing organization.Willing to risk for opportunity and learn through trial and error.  Committed. Education:One area that has done little to verify the profession relates to educational levels. The groups must respond to the media for positive and negative referrals to nursing.  Collegiality.  Competent. films and educational materials are important to any health care institutions relations but should be viewed as having equal importance to the image of nursing. it is confusing for the public and often for future nurses themselves. committee work and administrative records can be computerized.Achieving the most with the least. External Media Committees:The mass medias have the most pervasive influences on the public attitudes and opinions in contemporary life.The nursing profession and practice will also take on an improved public image by having more balance between men and women.Stepping out beyond the limits for the belief of what can be.  Creative. 14 . Entry into practice is remarkably controversial and divisive both inside and outside the profession.2.Caring with one`s whole being for another being. Nurses save time by accessing a computerized system. It should be their responsibility to write letters to producers. paying special attention to the effect these materials have on the image of nursing. 6. Documentation. Computer Technology:The image of nursing can be influenced by the increase in computer technology. its strategy for image building and its version for the future can be portrayed in the following seven Cs:  Compassionate. 5. the rewards and the criticism.  Change agent. advertisements. 3. quality management. care planning.Being open to share the responsibility. Elimination of Internal Sexism:It is suggested that increasing the number of male nurses will make the profession a different one. newsletters.

marketing strategies are important. Dress for Success:In the business world there are dresses for success. Marketing of nursing¶s unique role in health care delivery. e) Write and submit feature. j) Improve the community image. Regardless of how talented or how technically knowledgeable one is. Through research and education. Marketing of the profession in general to attract qualified candidates and to retain existing professionals. public education series. To be successful in business. collectively nursing is extremely powerful. d) Become politically active and knowledgeable. c) Provide all nurses including staff nurses to become salaried staff members rather than hourly wage earners. f) Demand that nurse authors be considered for editing health columns. i) Have nurse`s present educational talks at local shopping malls. l) Establish schools of nursing as research and information centres for people experiencing critical health care issues eg. one plays by the rules. n) Be positive. k) Revise and update nursing career literature. h) Create public forums-³spend a day with a nurse´. b) Strengthen involvement in professional organization. Volunteer for community sponsored activities. Dress is a powerful form of self expression. It is crucial that nursing services. powerful profession: Marketing of a more positive image. 15 . professional image and credibility can be either strengthened or sabotaged by the image one projects to others. Stanton and Stanton suggest that the following important areas are critical wonder to market nursing as a positive. Educating entry-level professionals to marketing strategies.8. stories on nurses for local media. tested and evaluated. Marketing:As the nursing profession works to upgrade its image. it will command respect. NURSES RESPONSIBILITIES FOR IMPROVING ITS OWN IMAGE a) Recognize that an image problem does exist and that each individual nurse has a responsibility to improve the profession`s image. AIDS. homelessness. evaluating marketing trends in relation to their effect on nursing 9. Marketing of the profession as a collective group. professional image of nursing. nursing programs and the nursing profession be strategically marketed to a wide range of audiences to promote nursing excellence and to project an achievement oriented. especially books in schools and public libraries that introduce the profession to prospective nurses. m) Be self confident. g) Provide technical assistance to the media. Successful marketing of nursing products and services that have been used.

Inspired by what she took as a Christian divine calling. p) Learn to describe nursing responsibilities in clear. Nightingale`s Beliefs:  Holistic framework inclusive of illness and health  Need for theoretical basis  Liberal Education as foundation for nursing practice  Importance of creating an environment that promotes healing  Need for the body of nursing knowledge distinct from medical knowledge 16 . near her family home. she committed herself to nursing (though discouraged by her parents). MODERN NURSING Progress in medicine and science during the past three centuries has increased the interested for better nursing service and nursing training. The first trained Nightingale nurses began work on 16 May 1865 at the Liverpool Workhouse Infirmary. Florence's older sister was named Parthenope. q) Continue to develop alternative nursing education programs designed for adult learner nurses to advance their education. Her parents were William Edward Nightingale (1794-1875) and Frances Nightingale née Smith (1789-1880). nursing was a career with a poor reputation. New scientific facts were discovered and many new precision instruments such as the stethoscope. She also campaigned and raised funds for the Royal Buckinghamshire Hospital Aylesbury. Thomas 'Hospital on 9 July 1860. Florence. a writer and a noted statistician. Fanny's father (Florence's maternal grandfather) was the abolitionist William Smith. FLORENCE NIGHTINGALE (12 MAY 1820 . which became her central focus when reports began to filter back to Britain about the horrific conditions for the wounded.13 AUGUST 1910) She came to be known as "The Lady with the Lamp". and was named after the city of her birth. This demonstrated a passion on her part. upper-class well-connected British family at the Villa Colombaia. William Nightingale was born William Edward Shore. She was born into a rich. and also a rebellion against the expected role for a woman of her status. experienced first in 1837 at Embley Park and later throughout Florence's life. filled mostly by poorer women. Florence Nightingale's most famous contribution came during the Crimean War. was a pioneer of modern nursing. which was to become a wife and mother. Likewise a new type of nurse who was trained in the art of carrying out these techniques was required. In order to keep up with the many changes it was necessary to increase the educational facilities for students of medicine. r) Increase visibility. non technical terms. By 1859. Grand Duchy of Tuscany. microscope and thermometer came into use. The person who responded to this call was one of those rare and gifted persons named Florence Nightingale. In those days.o) Share the positive aspects of the nursing profession with others. she set up the Nightingale Training School at St.

CRIMEAN WAR (1854-1856) The war was between Turkey and Russia. 17 . An appeal was made to the public. They were military hospitals.Nightingale`s Concept:  Having systematic method of assessing patient  Individualized care on the basis of patient¶s needs and preferences. But it was England who suffered a lot.  Nurses should be formally educated and function as client advocate.  Adequate ventilation has also been regarded as a factor contributing to changes of the patient's process of illness recovery. civilian hospitals. In her environmental theory the following factors are present in the patient's environment:  Pure or fresh air  Pure water  Sufficient food supplies  Efficient drainage  Cleanliness  Light (especially direct sunlight) Any deficiency in one or more of these factors could lead to impaired functioning of life processes or diminished health status.  Maintaining confidentiality. Miss Florence with her team of nurses landed at Scutari. HISTORY OF NURSING IN INDIA DEVELOPMENT OF HOSPITALS AND NURSING SERVICES By the end of the 19th century there were 4 types of hospitals which came into existence. In two days she set with 38 nurses to meet the wounded at Dardenells. Florence Nightingale was waiting for this chance. She spent her evenings visiting the sick. They took care of the wounded soldiers. writing letters to the soldier`s families. She accepted the responsibility of nursing the soldiers and did things no one else could or would do. Florence Nightingale proved to be an excellent commander. hospitals where European religious orders provided nursing staff and Protestant mission hospitals. She opened library and post office for soldiers. France and Russia had adequate help to take care of wounded sick soldiers through religions sisters.

MISSION HOSPITALS Mission hospitals were the first hospitals to provide the training of Indians as nurses. By the end of 19th century a large number of training schools which belonged to mission hospitals were started. So the Queen Victoria asked Lady Dufferin to look into the problem. This is called the Dufferin Fund. the first hospital of Jamsetjee Jeejeebhoy group of hospitals was started in Bombay.George. 18 . NURSING EDUCATION Nursing education in India begin with the brief period of six months . In 1871 Government general hospital Madras undertook plan to train nurses. Nursing in military hospitals were carried on by soldiers. The training for general nursing was extended to 2 years and then 3 years before the student went on for midwifery training. male orderlies and the menial staff. Religions taboos and prejudice against nursing career had prevented parents from sending their daughters to nursing course. in the beginning. So only those converted Christians joined the nursing courses. DUFFERIN HOSPITALS Although in the late 19th century lying-in hospitals were functioning they were over crowded.The need for theory as well as practical experience was felt. In 1885. In 1844. Most of the upper caste women could not make use of the medical facilities because of caste and fear of pollution.MILITARY HOSPITALS In 1664 the East Indian Company helped to start a hospital for soldiers at Fort St. In 1843. In 1908. The first batch of 6 students was trained in ³diploma in midwifery´ later this plan was changed to general nursing and midwifery. CIVILIAN HOSPITALS The need for attending to women during childbirth was felt by the colonial authorities as they noticed the heavy mortality among Indian women during childbirth. The National Association for supplying Female Medical Aid to the women of India was established. For this nurses were brought from England to train nurses. There were not enough women doctors or nurses to attend to them in homes. the lying-in hospital in Madras was started. Lying-in hospitals in Calcutta were established. Trained Nurses Association was formed to standardize the training schools for nurses. She was able to raise funds from friends and affluent people for the medical education of women and later for training of nurses.The basic programme for combined general nursing and midwifery developed rapidly after 1871. Madras.

Delhi. Communication skills and other subjects .Mary`s Hospital.M.(Curative. Health. In 1977. Institute of health sciences. A two year programme for Auxiliary nurse midwife was first established in 1951 at St. In 1926 Madras State formed the first Registration Council. THE INDIAN NURSING COUNCIL Indian Nursing Council (INC) Act was passed by the Parliament in 1947. health visitors and auxiliary nurse midwives. the School of Nursing in Trivandrum instituted the first post-certificate Bachelor Degree programme. psychology. and the Government General Hospital. The INC was constituted to establish a uniform standard of education for nurses. Ph. M. a lion`s share in prevention and promotion is carried out by Health Worker Female.The present basic programme for nursing education throughout India consists of a three. REGISTERATION OF NURSES As training for nurses.D. conduct examinations. 19 .A. a two ±year postgraduate programme.year programme in general nursing and midwifery. midwives. programme is also available in M. It was also felt that registration would give greater professional status.E Manipal. In 1963. midwives. take disciplinary actions etc. Vellore. She functions in community than in hospital. the need for legislation to provide basic minimum standards in education and training was felt.C.H. AUXILIARY NURSING The use of Auxiliary Nursing personnel to ease the shortage of professional nurses had been common in some countries when it was first put into practice in India.Phil in nursing is offered at RAK College of Nursing. prescribe rules of conduct. which meet the standards and requirement s by the Indian Nursing Council. The first Master`s Degree course. promotive and preventive). The first four year basic Baccalaureate Degree programme was established in 1946 at the Colleges of Nursing in Delhi and Vellore. These originated at the College of Nursing. Vellore. Hospital. Madras. Post-certificate courses were offered to prepare Indian nurses for responsible positions in hospitals and schools of nursing. Education. Mangalore and College of Nursing. and health visitors progressed. the ANM course was completely revised by the Indian Nursing Council and expanded to include subjects like sociology. STATE REGISTERATION COUNCILS State Registeration Council are to inspect and accredit schools of nursing in their state. was begun in 1960 at the College Of Nursing in Delhi in India.Among the three components of nursing. C. New Delhi. Punjab. Uniformity of training is maintained by recognition of schools.

The association has established within its jurisdiction the following organizations: 1. Midwives and ANM association 3. In 1912. The official organ of the TNAI is the Nursing Journal of India. The first attempt to train dais were carried out by missionaries as early as 1886. it was officially registered under the Societies Act XXI of 1860. Trained Nurses Associations of India was formed as it was felt that other graduate nurses were needed to uphold the dignity and honour of the nursing profession. the TNAI became affiliated with the ICN. The head office is located in New Delhi. They are:  Trained Nurses Associations of India  Nurses League of Christian Medical Association of India  Catholic Nurse`s Guild of India  Evangelical Nurse`s Fellowship of India  Nursing Research Society of India  Satellite Conference of Neuro-nurses of India  The Academy for Nursing Studies Trained Nurses Associations of India: In 1908. The Honorable Florence Macnaughton was the first President. A further step forward was taken in 1946 when community health nursing was integrated in the basic programme of the new degree courses which were started at the College of Nursing.COMMUNITY HEALTH NURSING In India community health nursing had its beginning when the terrible conditions under which children were born were recognized as a cause for the high mortality rate. Health visitor`s league 2. Student Nurses Association 20 . monthly publication. C. Vellore.C Hospital. In 1917. Delhi and the School of Nursing.M. under the University of Madras.The two associations worked together until 1922 when they joined together under the title ³Trained Nurses Associations of India´. NURSING ORGANISATIONS In the early 20th century many countries established National Nursing Associations.

Urdu and Hindi. Members of this organisation have contributed to professional nursing by writing and translating nursing textbooks in English. professionally. The first newsletter was released in July 1989. 21 . multi-aspect worker from health care. but she is multifacet. when one studies the history of nursing. `Nurses Link` is the official publication issued bimonthly by ENFI. The Academy for Nursing Studies: It is an organization that aims at improving the quality of nursing in India. It started in 1993 and is located at Hyderabad.The main objective of the association is to set high standards of neuro-nursing in the country. Nursing Research Society of India: It was established in 1986 to promote research within and around nursing environment. It has been set for the training of nurses. psycho-social and spiritual being. It provides moral protection and enables the members spiritually. Telugu. Evangelical Nurse`s Fellowship of India: It is a movement begun in 1946 by nurses who firmly believed that spiritual care is an integral part of comprehensive nursing. as man is essentially a biological. The conferences of the association are held as part of the annual conference of NSI. CURRENT TRENDS IN NURSING STATUS The social significance of Nursing as a profession or career becomes more and more interesting. Membership is open to nurses having post graduation qualifications. The Indian Journal of ³Nursing and Midwifery´ is the official publication of the organization. The Lotus and the Lamp´ is the national magazine of CNGI.Nurses League of Christian Medical Association of India: It was founded in 1931 as Nurse`s auxiliary of CMAI. The present nurse no more plays only caring service in the ward. Satellite Conference of Neuro-nurses of India: This originated as a subsection of Neurological Society of India in 1979. Tamil. preventive care to community health care. They provide a forum for nurses working in neuro centers¶ to discuss and work out solutions for their problems. socially and economically. Catholic Nurse`s Guild of India: This is an organisation formed in response to a call made by Pope Pius XII in 1956 to unite all catholic nurses into a Guild.

CONCLUSION Hereby I conclude with this topic. Changes in examinations for licensure of professional nurses can be foreseen. at the same time there is growing awareness of key role among health planners and implementers. however. status to health has come to the mankind. NURSING IN THE FUTURE Many new trends in nursing are likely to develop in the near future. or repeat registration.Registered nurses are the largest group of healthcare providers. SUMMARY History gives clue to cause and result of social development . Each nurse in her own way may contribute the progress of nursing as a career and profession. thereby contributing to the progress nursing in future. nursing examinations throughout the nation would all be the same. development and writing. intensive care units and increasing numbers of disposable items. is to have the Indian Nursing Council establish a National Examination system for nursing with in a period of ten years. Now the attitude of health is changing. Thus. Renewal of our license. intelligence must develop an aptitude for research. monitors.History of nursing is inter-woven with the general history. may be a major change which would directly affect us as a graduate nurse. I would like to thank Mr. People¶s role in health care is very significant. Clinical practice in nursing will be affected by the development of more scientific measurements of vital signs. It is expected that every nurse through her experience. By 2010 an anticipated national shortage of nurses put the nursing workforce in critical condition. Awareness of rights. 22 . Some can be predicted with certainty while others may be unexpected. One of the recommendations by the `High Power Committee on Nursing`.Sriram Sir who gave me this opportunity and also for his guidance.

Zwemer. April. Rasika.1.7.J.5.2627. New Delhi: Jaypee Brothers. Fundamentals of Nursing.nursing. 2005. 2003. Carol Lillis. allnurses. GlenoraErb.org/wiki/Nursing 14. Board Of Nursing Education Nurses league CMAI (South India Branch). Andrey Jean Berman. p.p.p. Professional Adjustments and Ethics for Nurses in India.37-39. 2001. p. 2004..p.13-24. 12.6.September:Vol. 10. 45.no. p.p. p..24-26. Rajnikanth. Revised Edition. First Edition. T K Indrani. IPublications: 1995.com/EBchecked/topic/422718/nursing/36766/History-of-nursing 15.281-286. Barbara Kozier.no. Sandra Millon Underwood. Diversity and Health: Responding To The queries of Inquisitive Minds. Chennai: B.p.com/.p. A New Text Book for Nurses in India.I.275-278. 2002. What Nurses & National Nurses Associations can do to Combat Counterfeit Medicines. Vol. 1. NURSING JOURNALS 8.britannica. History of Nursing./historical-factors-influenced 17. 9. Fundamentals of Nursing the Art & Science of Nursing Care.no.. K.p.4. Vol. May.8.p.2006. Sixth Edition. 45. Ann.no.com/.43-49.no. 2... A.. http://www. 6.25-36. Delhi: Pearson Education. Culture. Fourth Edition. Thresyamma. 4.p. 2005. INTERNET SOURCE 13.p. History of Nursing.Jayasekara. Vol.3 5. Sixth Edition. nursingplanet. p. 23 . http://en.p.The History of Nursing Services and Education in Srilanka and the Effects on Developing Professionalism.391-395. 3.1.. Nurses of India. First Edition.Nurses of India. New Delhi: J P Brothers. 6.BIBLIOGRAPHY 1. Philadelphia: Lippincott Publications. 2000.3.9. Priscilla Le Mone. 7. P. Florence Nightingale Some Lesser Known facts Nightingale Nursing Times.M Inspiration for Nurses.p.wikipedia.. nursingcrib.7-8. Vol. 2001.21-23. June. Fourth Edition.39-42. July. R..S.p. Fundamentals of Nursing Procedure Manual For General Nursing And Midwifery Course. Mumbai: Vora Medical Publications. 6. Carol Taylor.com/nursing.p.8-19. Publications.2005. C.. 2006./development-of-nursing-education-in-india 16. p. Chennai: B.Manelkar./historical-evolution-of-nursi.20-21. 11. Journal of Nursing Education. 9.67. Journal of Nursing Education.

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