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HISTORICAL PERSPECTIVES IN NURSING

Pre-Nightingale Era Nursing the sick was designated to the woman of the tribes Illnesses were attributed to evil spirits within the body of the person who was ill The ancient practitioner used both black and white magic to cure illnesses

Early Civilization
Egyptian temples had

housing for the sick Deborah, the nurses companion of a child, was the first nurse noted in history India, was the first country to record the use in the care of the sick

300 AD

Women entered the nursing profession


1100-1200 AD

St. Anthonys Brothers Hospital was formed


Brothers of Misericordia, Italy was

formed Alexian Brothers were formed

1633
Sisters of Charity was founded

1809 Mother Elizabeth Seton, introduced the sisters of


Charity in America, later known as the Daughters of Charity

1836
Deaconess

Kaiserwerth, founded

Institute Germany

of was

1860
The

Nightingale Training School for Nurses at St. Thomas Hospital in London, England was established. Florence Nightingale published the

Nursing:What It Is and What It Is Not


Notes on

What is nursing? The act of utilizing the environment of the patient to assist him in his recovery (Florence Nightingale) The unique function of the nurse is to assist the individual, sick or well in the performance of those activities contributing to health or its recovery (Virginia Henderson)

Nursing is direct, goal

oriented and adoptable to the needs of the individual, the family, and community during health and illness (ANA) The diagnosis and treatment of human response to actual or potential health problems

DEFINITION OF TERMS

Profession - an occupation that requires extensive education or a

calling that requires special knowledge, skill and preparation (Kozier, et. al, 2004)
Professionalism - Refers to professional character, spirit or methods. It is

a set of attributes, a way of life that implies responsibility and commitment


Professionalization

- Is the process of becoming professional, that is, of acquiring characteristics considered to be professional

CRITERIA OF A PROFESSION
Distinct identity and Subculture

members of a profession have a common identity and subculture


Altruism

profession is motivated by altruism, with members working is some sense for the good of the society

Code of Ethics

nursing profession requires integrity of its members; that is, a member is expected to do what is considered right regardless of the personal cost
Autonomy

autonomous if it regulates itself and sets standards for its members Professional Organization operates under a mother organization

SCOPES OF NURSING
Involves four areas
1. Promoting health and wellness Engaging in attitudes and behavior that enhances

the quality of life and maximize personal potentials Acts like Enhancing healthy lifestyle Preventing drugs and alcohol misuse

2. Preventing Illness The goal is to maintain optimal health by preventing disease Acts like Immunization Prenatal and infant care Prevention of Sexually Transmitted Diseases (STDs)

3. Restoring Health Focus is on the ill client and extends from early detection of disease through helping the client during the recovery period Acts like Providing direct care to the ill Performing diagnostic and assessment procedures Consulting other health professional about the clients problems

4. Care of the Dying Involves comforting and caring for people of all ages who are dying

LEVELS OF PREVENTION
Primary prevention - The nurse identifies risk factors, attempts to eliminate

stressor and focuses on protecting health


- Elements
a. Health promotion b. Specific protection

Secondary prevention - intervention or active treatment after symptoms have occurred Elements: a. Strengthening resistance also known as health maintenance b. Early diagnosis/detection c. Health screening d. Prompt treatment Tertiary Prevention Rehabilitation - reestablishment of high level wellness

Theories that Focus on the Environment


To facilitate the bodys

reparative process by manipulating the environment Florence Nightingale Environmental Theory

Theories that Focus on the Client as an Individual/Holistic Approach


Faye Abdellah - The typology of 21

nursing problems - Holistic delivery of health care to meet the social, physical, intellectual, creative, emotional and spiritual needs of the family (21 problems)

Virginia Henderson - 14 Basic/Fundamental

Needs - To work interdependently with other health caregivers. Focus is on the independent satisfaction of 14 human needs (complementarysupplementary)

Ida Jean Orlando - Client is an individual with a

need that when met diminishes distress, increases adequacy and enhances wellbeing. - Three elements comprises a nursing situation; 1) Client behavior, 2)Nurse Reaction and 3) Nurse Actions

Dorothy Johnson - Behavioral System Model - Focuses on how the client

adapts to illness and how actual or potential stress can affect ability to adapt. The goal of nursing is
to reduce stress. Clients basic needs are categorized according to behavioral systems model

Dorothea Orem - Self-care Deficit model - Nursing care is necessary only if the client is unstable to fulfill biological, psychological, development or social needs

Sister Callista Roy - Adaptation model - The client is an adaptive system

(adaptation), thus the goal of nursing is to help the person adapt to this changes in physiological needs, self-concept, role function and interdependent relations during health and illness

Lydia Hall

- The client is composed of overlapping parts; person (core), pathologic state and treatment (cure) and body (care)

Focus on interaction between Client and environment


Myra Levine - 4 conservation principles - Health is viewed in terms

of conservation of clients energy, structural, personal and social integrity

Martha Rogers - The Science of Unitary Human

Being - Believes that nursing incorporates knowledge of basic sciences, physiology and nursing practice. Views nursing primarily as a sciences and is committed to research. The humanistic science of nursing, man is changing and coexisting with the environment

Hildegard Peplau - Pyschodynamic Nursing - To develop interaction between the client and the nurse

Imogene King - Goal Attainment Theory - To identify problems and to

identify goals focuses on the dynamic interpersonal relationship between the client and the nurse. Communication is used to help client re-establish positive adaptation to the environment

Betty Neuman - Based on the individual

relationship to stress, the reaction to it and reconstitution factors that are dynamic in nature. - Views the client as an open system consisting of a basic structure or central core of energy resources, surrounded by two concentric boundaries, referred to as lines of resistance

Jean Watson

- Human Caring Model - Believes that caring is central to nursing

The theories are common to these definitions


NURSING IS 1. Caring 2. An art 3. A science 4. Client centered 5. Holistic 6. Adaptive 7. Concerned with health promotion, maintenance, restoration 8. A helping profession

CONTINUING PROFESSIONAL EDUCATION


The term continuing education (CE) refers to

formalized experience designed to enlarge the knowledge or skills of practitioners (Kozier, et. al, 2004) Continuing education is the responsibility of each practicing nurse. Constant updating and growth are essential to keep abreast of scientific and technological change and changes within the nursing profession.

The Nurse in Health Care


I. Eleven Key Areas of Responsibilities 1. Nursing Process 2. Safe and Quality Nursing Care 3. Management of Resources and Environment 4. Health Education 5. Legal Responsibilities 6. Personal and Professional Development 7. Quality Improvement 8. Research 9. Record Management 10. Communication 11. Collaboration and Teamwork

HOSPITAL OR INSTITUTIONAL NURSING


Advantages a. Nurses get rotated to different units and have the chance to determine their special area of choice b. They have an eight hour day and forty hour week duty which provides for two days of rest away from duty. They have provisions for sick leaves, holidays, and vacations with pay according to personal policies of institution c. They are considered an important member of the health team improving care to patients

Disadvantages a. There is a great possibility of understaffing which may require nurses to sacrifice some of their plans or put in overtime work. This is especially true in hospitals where budget for personnel is limited b. Because of the bulk work of some staff nurses do not find time anymore to improve their skills through continuing education programs. Or, if the hospitals are far flung, no continuing education programs are provided

PUBLIC HEALTH NURSING OR COMMUNITY HEALTH NURSING


Advantages a. Focus on nursing is on family and community health rather than individual basis. Here, the nurse will be able to see the total picture of the family and the community health b. It gives a nurse a better perspective of the health condition of the community and health programs conceived and implemented by the government and to appreciate the nurses role in nation building c. Focus of care is more on educative and preventive aspects. Thus the nurse have the privilege of contributing to the program for healthy citizenry especially among the rural poor

PRIVATE DUTY NURSING


- A private duty nurse is a registered nurse who undertakes to give comprehensive nursing care to a client on a one to one ratio. He or she is an independent contractor. The patient maybe provided care in the hospital or in the home

Disadvantages a. There are no fixed hours of work. The nurse may be called upon anytime of the day and night b. Facilities for care of the sick are limited so that practice or skills may also be limited c. The public health nurse may not be immediately aware of changes nor trends in fields of medicine or nursing

OCCUPATIONAL HEALTH NURSING (also known as company nurse)


Responsibilities
a. Attends to emergency cases b. c. d.

e.

within the company Custodian of employees health records Counselor Adviser of workers Health and safety teacher

Nurses who would like to consider teaching as their field

of choice should consider the following factors: a. They must be academically inclined. The basic educational requirement is a Bachelors Degree in Nursing, with an upward trend to a Masters level b. Teachers often work more than 40 hours per week. While this is not normally spent in classroom teaching, much time is spent in planning lessons preparing or correcting examinations, attending faculty meetings and serving in committees and counseling students.

c. Teachers in college of nursing should have a sound experience in the field they wish to teach. If they teach any clinical subject they should have at least a years experience as staff nurse in that particular area

MILITARY NURSING The Nurse Corps


Functions a. To meet Nursing needs of todays patients in Armed

Forces medical facilities b. To prepare each nurse Corps Officer to meet future assignments at higher level of responsibility in the different stations and general hospitals in peace and war c. To teach, train enlisted personnel who perform nursing function under supervision. Special emphasis is on enlisted members who function in setting where there are no nurses

Qualifications a. Must be a Filipino citizen b. Must be of good moral character and must possess a

c.
d.

e.
f. g. h.

pleasing personality Must be a registered nurse with a board rating of at least 80% Female candidates must be single, never been married nor positively found to have given birth to a living or stillborn child Must not be more than 32 years of age at the time of commission Must satisfy the following height requirement: Male -62 inches; Female 60 inches Must have at least one year hospital experience Must be mentally and physically fit for military service and cleared by appropriate agencies

III. ROLES AND FUNCTION OF A NURSE


1.

Caregiver - the primary role of the nurse. The nurse combines both arty and science of nursing to promote wellness through activities that prevent illness, restore health, and facilitate coping with disability or death.

2. Communicator - the use of effective interpersonal and therapeutic communication skills to establish and maintain helping relationships with patients of all ages in a wide variety of health setting.

3. Teacher/Educator - the use of communication skills to assess, implement, and evaluate individualized teaching plans to meet learning needs of patients and their families

4. Counselor - the use of therapeutic interpersonal communication skills to provide information, makes appropriate referrals, and facilitates the patients problem solving and decision-making skills

5. Leader - the assertive, self-confident practice of nursing when providing care, effecting change, and functioning with groups

6. Researcher - the participation in or conduct of research to increase knowledge in nursing and improve patient care 7. Advocate - the protection based on the of human or legal rights and the securing of care for all the patients based on the belief that patients have their right to make informed decisions about their own health and lives.

8. Change agent - the nurse assist clients to make modifications of their behavior 9. Manager - the manages the nursing care of individuals, families, and communities. The nurse-manager also delegates nursing activities to ancillary workers and other nurses, and supervises and evaluates their performance