ADVANCE NURSING PRACTICE

UNIT 1
Nursing as a Profession
 History of development of nursing profession,
characteristics, criteria of the profession,
perspective of nursing profession-national, global
 Code of ethics (INC), code of professional conduct
(INC), autonomy and accountability,
assertiveness, visibility of nurses, legal
considerations
 Role of regulatory bodies
 Professional organizations and unions-self-
defense, individual and collective bargaining
 Educational preparations, continuing education,
career opportunities, professional advancement &
role and scope of nursing education.
 Role of research, leadership and management.
Quality assurance in nursing (INC).
 Futuristic nursing.
HISTORY OF DEVELOPMENT OF NURSING PROFESSION
WHY STUDY HISTORY?

 Looking Back gives you a vision of where you want to go

 Provides an understanding of the heritage behind Nursing as a career

 Highlights the contributions of eminent & inspirational nurses towards

development of the nursing profession.

ANCIENT CIVILIZATIONS & NURSING

 Illness earlier was seen as “magic”, “sin” or “punishment”

 During 700-600 B.C Sushruta Samhita was written by the great surgeon
Sushruta, who said "the physician, the patient, the drugs and the nurse are
four feet of `Padas' of the medicine, upon which the cure depends".

 The first nursing school started in India in 250 B.C. during Charaka's time
and only men were considered pure enough to be nurses.

 Other civilizations as Egyptians, Babylonians, Hebrews, Greeks and Romans

also shows evidences of nursing care.

 The earliest references to women as nurses are to be found in the Old

testament (500 BC)

And they journeyed from Bethel; and…she had hard labor. And it came to
pass, when she was in hard labor, that the midwife said unto her, Fear not;
thou shall have this son. (Genesis 35).

 Hippocrates in the 5th century BC known as “Father of Medicine”

 Hippocratic oath is from him

 Developed system of assessment, observation, record keeping

  Developed terms prognosis, diagnosis, cure

EARLY CHRISTIAN ERA (AD 60)

 Women began nursing as an expression of Christianity (acts of mercy)

 Women were recognized as important members of community

 Phoebe—considered the first Deaconess and visiting nurse

 Fabiola—was a wealthy Christian in Rome and founded the first public

hospital in Rome

 Paula-was a friend of Fabiola. She devoted herself for the services of the
sick. She built a hospital for strangers, pilgrims, and travelers & the sick. She
constructed a monastery in Bethlehem. They gave good nursing care for
the sick.

MIDDLE AGES (AD 476 –1475)

 Throughout the middle ages, care was provided primarily by religious

orders to sick and poor. The monasteries became the places of education,
medical care and nursing.

 Knight Hospitallers of St. John’s of Jerusalem cared for the injured on the
battle field —their symbol: a bright, Red Cross. Knights organized nursing
care.

 Some of nurses were nuns and deaconess.

RENAISSANCE (1500AD –1850AD) - THE DARK PERIOD OF NURSING.

 Rise of Protestantism meant that many Catholic monasteries offering

nursing care and medicine was closed down.

 Nursing ceased to be valued as an intellectual endeavor it lost much of its

economic support and social status
  The Protestants viewed the woman's places as being in the home raising
children. Hence nurses of this period consist of

 Wayward” women of low status who became “nurses” instead

of going to jail

 Women of ill repute

 Poor, single women with no family or hope of marriage

DAWN OF MODERN NURSING

 Pastor Theodur Fliedner opened the Kaiserwerth Deaconess Institute—the

first REAL nursing school

 Its most famous student: Florence Nightingale (1820-1910)

Florence Nightingale

 “Mother of Modern Nursing”

 Went to Kaiserwerth for 3months

 On Oct. 21, 1854, left with 38women for the Crimean War—British
casualties were high; within 6 months, death rate cut in half

 Made rounds at night with a lamp “Lady of the Lamp”

Her accomplishments at Crimean two years included

 Death rate decreased drastically

 She established cleanliness and sanitation rules

 Patients received special diets and plenty of food

 Improved water supply

 Patients received proper nursing care

  Nightingale established a reputation which allowed her to improve nursing
standards at home

 Nightingale established nursing school at St.Thomas’ Hospital, London upon

return

 By 1887, Nightingale had her nurses working in six countries and U.S.

 Nightingale developed basic philosophy: the profession of nursing different

from other existing programs

 Nightingale was a nurse, philosopher, statistician, historian

 Today Nightingale is considered the founder of modern nursing

NURSING IN MODERN INDIA

 Military nursing was the earliest type of nursing.

 Florence Nightingale had a great influence over nursing in India especially in

the army.

 St Stephens Hospital at Delhi was the first one to begin training the Indian
girls as nurses in 1867.

 1871, the first School of Nursing was started in Government General

Hospital, Madras.

 1897, Dr.B.C. Roy did great work in raising the standards of nursing and that
of male and female nurses.

 1908, the trained nurse’s association of India was formed

 In 1926, Madras State formed the first registration council

 The first four-year basic Bachelor Degree program were established in 1946
at the college of nursing in Delhi and Vellore

 The Indian Nursing Council was passed by ordinance on December 31st

1947. The council was constituted in 1949.
 First master’s degree course, a two-year postgraduate program was begun
in 1960at the College of Nursing, Delhi.

 1963, the School of Nursing in Trivandrum, instituted the first two years
post certificate Bachelor Degree program.