FUNDAMENTALS OF NURSING PRACTICE

FUNDAMENTALS OF NURSING
DEFINITION OF A PROFESSION

IS NURSING A PROFESSION?

NURSING AS A PROFESSION

Position: a group of task assigned to one individual

Occupation: a group of job that are similar intype of work and that are usually foundthroughout an
industry or work environment.
Profession: a type of occupation that meets certain criteria that raise it to a level above that of
anoccupation
Professional: a person who belongs to andpractices a profession.
Professionalism: demonstration of high level ofpersonal, ethical and high level of skillcharacteristics of a
member of a profession.

Webster Dictionary defines a profession as “an occupation or calling requiring advanced training and
experience in some specific or specialized body of knowledge which provides service to society in that
special field.”

CHARACTERISTICS OF A PROFESSION

 Education. A profession requires an extended education of its members, as well as a basic liberal
foundation.
 Theory. A profession has a theoretical body of knowledge leading to defined skills, abilities and
norms.
 Service. A profession provides a specific service.
 Autonomy. Members of a profession have autonomy in decision making and practice.
 Code of Ethics. The profession as a whole has a code of ethics for practice.

CRITERIA OF A PROFESSION

1. A profession must satisfy an indispensable social need and must be based upon well
established and socially accepted scientific principles.
2. It must demand adequate pre-professional and cultural training.
3. It must demand the profession of a body of specialized and systematized training.
4. It must give evidence of needed skills which the public does not possess; that is, skills which
are partly inherent and partly acquired.
5. It must have developed a scientific technique which is the result of tested experience.
6. It must require the exercise of discretion and judgment as to time and manner of the
performance of duty.
7. It must have a group of consciousness designed to extend scientific knowledge in technical
language.
8. It must have sufficient self- impelling power to retain its members throughout life. It must not be
used as a mere stepping stone to other occupations.
9. It must recognize its obligations to society by insisting that its members live up to an
established code of ethics.

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THE QUALITIES OF A PROFESSION

1. A profession applies its body of knowledge in practical services that are vital to human welfare,
and especially suited to the tradition of seasoned practitioners shaping the skills of newcomers to
the role.
2. It constantly enlarges the body of knowledge it uses and subsequently imposes on its
members a lifelong obligation to remain current in order to “do no harm”.
3. A profession functions autonomously in the formulation of professional policy and in
monitoring its practice and practitioners.
4. It utilizes in its practice a well- defined and well-organized body of knowledge that is
intellectual in nature and describes its phenomena of concern.
5. A profession has a clear standard of educational preparation for entry into practice.
6. A profession is distinguished by the presence of specific culture, norms, and other values that
are common among its members.

Activity1: Select one of the characteristics and one criteria of a

profession that you believe nursing has difficulty meeting. Describe the
actions that you believe should occur in the profession that would result
in the profession fully meeting that criterion.

DEFINITION OF A PROFESSIONAL NURSE

A 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.

DEFINITION OF A NURSING

“Nurse”- from the Latin word nutrix, meaning to nourish (Taylor, Lillis, &LeMone, 1997).

Nursing
 Nursing is an art and science.
 As a professional nurse, you will learn to deliver care artfully with compassion, caring
and a respect for each client’s dignity and personhood.
 As a science, nursing is based on a body of knowledge that is continually changing with
new discoveries and innovations.

 Nursing consists of autonomous and collaborative care of individuals of all ages, families,
groups and communities, sick or well and in all settings. It includes the promotion of health, the
prevention of illness, and the care of ill, disabled and dying peopleWorld Health Organization
“WHO”

 “the protection, promotion, and optimization of health and abilities, preventions of illness and
injury, alleviation of suffering through diagnosis and treatment of human response, and
advocacy in the care of individuals, families, communities, and populations”. American Nurses
Association (ANA)

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 Nursing, profession that assumes responsibility for the continuous care of the sick, the
injured, the disabled, and the dying.

CHARACTERISTICS OF NURSING

 Nursing is caring.
 Nursing involves close personal contact with the recipient of care.
 Nursing is concerned with services that take humans into account as physiological,
psychological, and sociological organisms.
 Nursing is committed to promoting individual, family, community, and national health goals
in its best manner possible.
 Nursing is committed to personalized services for all persons without regard to color,
creed, social or economic status.
Nursing is committed to involvement in ethical, legal, and political issues in the delivery of
health care.

DEFINITION OF NURSE:

 Nurse is a person (male or female) who has completed a programme of basic nursing
education and authorized by appropriate authority to practice nursing

DEFINITION OF PROFESSIONAL NURSE:

 Professional nurse is a health worker identified by law as a registered nurse whether graduated
from bachelor or diploma degree, and does not include the assistant nurse

FOCUS: HUMAN RESPONSES

Human response is a way of looking at how individuals, families or communities react to all areas
of life that influence and impact them. The nurse focus on two types of responses- reactions to
actual health problems or illness (health-restoring response) and concerns about potential helath
problems (health supporting responses). More simply the nurse focuses on the responses in
both sick and well persons. Human responses are dynamic or changing, as the patient
progesses along the continuum between health and illness.

reactions to actual health problems or illness (health-restoring response)

concerns about potential helath problems (health supporting responses)

PERSONAL and PROFESSIONAL QUALITIES of a NURSE

 Interest and willingness to work and learn with individuals/ groups in a variety of setting
 A warm personality and concern for people
 Resourcefulness and creativity as well as well-balanced emotional condition
 Capacity and ability to work cooperatively with others
 Initiative to improve self and service
 Skill in decision making, communication and relating with others and being research
oriented
 Must be physically and mentally fit
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 Must have a Bachelor of Science degree in Nursing

 Must have license to practice nursing in the country

Activity2: Interview five of your friends who are not nurses. What is
their image of nursing? What do they understand of the role of the
nurse? Do they view nursing positively? What recurrent information is
mentioned?

HISTORY OF NURSING

HISTORY OF NURSING IN THE WORLD

Periods of Nursing History

 Intuitive Period / Medieval Period

 Apprentice Period
 Educative Period
 Contemporary Period

A. Intuitive Period / Medieval Period

 Prehistoric→ Early Christian Era, More on intuition

 NOMADS- travel from one place to another
 Survival to the fittest
 “best of the most”- motto
 Sickness is due to “voodoo”
 Performed out of feeling of compassion for others
 Performed out of desire to help
 Performed out of wish to do good
 Nursing is given by the WOMEN

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 SHAMAN-uses white magic to counteract the black magic

 They are the doctors during those times

 TREPHINING- driling the skull

Used to treat Psychotic patients
Psychotic patients are believed to be possesed by evil spirits.
 Growth of religion- most important thing that happened
 Growth of civilization
 Law of preservation- inspire man in search knowledge

Rise in Civilization

 From the mode of Nomadic life→agrarian society→gradual development of urban

community life
 Existence of means of communication
 Start of scientific knowledge→more complex life→increase in health problems→demand
for more nurses
 Nursing as a duty of SLAVES and WIVES. NURSING DID NOT CHANGE but there was
progress in the practice of medicine.
 Care of the sick was still closely allied with superstitions, religion and magic
 Near East- birth place of 3 religious ideologist:
 Judaism
 Christianity
 Mohammedism or ISlam

- Near East culture was adopted by the Greeks and Romans combined with the wonders of the
Far East by returning crusaders and explorers improved and was carried to Europe during the
Renaissance Period that resulted to greater knowledge then to the New World by the Early
settlers.

• New World – a tiny area known as birth of monotheism that lies between Tigris and Euphrates
River in the Nile River arose the cultures of Babylonia, Egypt and Hebrew.
• MONOTHEISM – believer of one God
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Different Civilization
BABYLONIANS
CODE OF HAMMURABI
• 1st recording on the medical practice
• Established the medical fees
• Discouraged experimentation
• Specific doctor for each disease
• Right of patient to choose treatment between the use of charms, medicine, or surgical
procedure

EGYPTIANS
ART OF EMBALMING
• Mummification
• Removing the internal organs of the dead body
• Instillation of herbs and salt to the dead
• Used to enhance their knowledge of the human
anatomy. Since work was done and performed on
the dead, they learned nothing of Philosophy
• “THE 250 DISEASES”
• Documentation about 250 diseases and
treatments

HEBREW
Teachings of MOSES
• Created Leviticus
• Father of sanitation
• Practice the values of “Hospitality to strangers” and the
“Act of Charity” – contained in the book of Genesis
• LEVITICUS – 3rd book of the Old Testament
• Laws controlling the spread of communicable diseases
• Laws governing cleanliness
• Laws on preparation of food
• Purification of man and his food
• The ritual of CIRCUMCISION – on the 8th day after birth

MOSAIC LAW
• Meant to keep Hebrews pure so that they may enter the sanctuary without affronting God
• Meant as a survival for health and hygienic reason only

CHINA
• Use of pharmacologic drugs - “MATERIA MEDICA”
• Book that indicates the pharmacologic drug used for treatment
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• No knowledge on anatomy • Use of wax to preserve the body of the dead

• Method of paper making
• FACTOR THAT HAMPERED THE ADVANCEMENT OF MEDICINE: Prohibits dissecting of
human body thus thwarting scientific study

INDIA
SUSHURUTO/ SUSHRUTA
• 1st recording on the nursing
practice
• Hampered by Taboos due to
social structures and practices of
animal worship
• Medicine men built hospitals
• Intuitive form of asepsis
• There was proficient practice of
Medicine and Surgery
• NURSES QUALIFICATIONS: Lay
Brothers, Priest Nurses, combination of Pharmacist, Masseurs, PT, cooks
• There was also decline in Medical practice due to fall of Buddhism – state religion of India

GREECE

ASCLEPIUS (OR ASKLEPIOS)

• ancient Greek god of medicine, and he
was also credited with powers of prophecy.

HIPPOCRATES
• Father of modern medicine
• 1st to reject the idea that diseases are caused by evil spirits
• 1st to apply assessment
• Practice medical ethics
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CADUCEUS
• Insignia of medicine
• Composed of staff of travellers intertwined with 2 serpent (the symbol of Aesculapus and his
healing power). At the apex of the staff are two wings of Hermes (Mercury) for speed.
• NURSES →function of untrained slaves

ROMANS
• Proper turnover for the sick people
• “If you’re strong, you’re healthy” – motto
• Transition from Pagan to Christianity
• FABIOLA -Was converted to Christian and later she converted her home to a hospital and used
her wealth for the sick.
• 1st hospital in the Christian world

B. APPRENTICE PERIOD/ MIDDLE AGES

• 11th century→1836
• On-the-job training period
• Refers to a beginner (on-the-job training). It means
care performed by people who are directed by more
experienced nurses
• Starts from the founding of Religious Orders in the
6th century through the Crusades in the 11th century
(1836 – when the deaconesses School of Nursing was
established in Kaiserswerth, Germany by Pastor
THEODORE FLEIDNER)

MILITARY RELIGIOUS ORDERS AND THEIR WORKS

KNIGHTS OF ST. JOHN OF JERUSALEM (ITALIAN)

• Also called as “Knights of the Hospitalers”
• Established to give care

TEUTONIC KNIGHTS (GERMAN)

• Took subsequent wars in the Holy Land
• Cared for the injured and established hospitals in the military camps

KNIGHTS OF ST.LAZARUS
• Care for those who suffered Leprosy, syphilis, and chronic skin diseases

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ALEXIAN BROTHERS
• A monasteric order founded in 1348. They established the Alexian Brothers School of Nursing,
the largest School under religious auspices exclusively in US and it closed down in 1969

ST. VINCENT DE PAUL

• He organized the charity group called the “La Charite” and the “Community of Sisters of
Charity” composed of women dedicated in caring for the sick, the poor, orphaned, and the
widowed. He founded the “Sisters of Charity School of Nursing” in Paris, France where Florence
Nightingale had her 2nd formal education in Nursing.

LOUISE de GRAS
• Was the 1st Superior and co-founder of the Community of Sisters of Charity

NURSING SAINTS
ST. CLAIRE OF ASSISI
• Took vows of poverty, obedience to service and chastity
• Founded the 2nd order of St. Francis of Assisi
• “the poor Claire”

ST. ELIZABETH OF HUNGARY

• The patroness of Nursing
• A princess
• Sees her calling to give care for the sick
• Fed thousands of hungry people

St. CATHERINE OF SIENA

• “Little Saint” – took care of the sick as early as 7y/o
• “1st Lady with a Lamp”

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RISE OF RELIGIOUS NURSING ORDER

• Orders of St. Francis of Assisi
 1st order – founded by St. Francis
 2nd order “the poor Claire” – founded by St. Claire
 3rd “the tertiary order”
• Beguines
• Oblates
• Benedictines
• Ursulites
• Augustinians

DARK PERIOD OF NURSING

• From 17th century – 19th century
• Also called the Period of Reformation until the American Civil War
• Hospitals were closed
• Nursing were the works of the least desirable people (criminals, prostitutes, drunkards, slaves,
and opportunists)
• Nurses were uneducated, filthy, harsh, ill-fed, overworked
• Mass exodus for nurses

MARTIN LUTHER
• The American Civil War was led by Martin Luther, the war was a religious upheaval that
resulted to the destruction in the unity of Christians.
• The conflict swept everything connected to Roman Catholicism in schools, orphanages, and
hospitals

THEODORE FLIEDNER
• (a pastor) reconstituted the Deaconesses and later be established the School of Nursing at
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Kaiserswerth, Germany where Florence Nightingale had her 1st formal training for 3 months as
nurse

FLORENCE NIGHTINGALE
• Practiced her profession during the Crimean War
• “Lady with a Lamp”
• From a well-known family
• Went to Germany to study

C. EDUCATIVE PERIOD/ NIGHTINGALE ERA

(Florence Nightingale School of Nursing )

 Began in June 15, 1860 when Florence Nightingale School of Nursing opened at St.
Thomas Hospital in London England, where 1st program for formal education of Nurses began
and contributed growth of Nursing in the US

FACTORS THAT INFLUENCED DEVELOPMENT OF NURSING EDUCATION:

 Social forces
 Trends resulting from war
 Emancipation of women
 Increased educational opportunities

Florence Nightingale
 Mother of modern Nursing
 Lady with the Lamp
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 Born on May 12, 1820 in Florence, Italy

 Her SELF-APPOINTED GOAL – to change the profile of Nursing
 She complied notes of her visit to hospitals, her observations of sanitation practices and
entered Deaconessess School of Nursing at Kaiserswerth Germany for 3 months.
 Became the Superintendent of the Establishment for Gentle Women during the illness
(refers to the ill governess or instructors of Nursing)
 She disapproved restriction on admission of patient and considered this unchristian and
contrary to health care.
 Upgraded the practice of Nursing and made Nursing a honorable profession
 Led other nurses in taking care of the wounded and sick soldiers during the Crimean War
 She was designated as Superintendent of the Female Establishment of English General
Hospital in Turkey during the Crimean War
 She reduced the casualties of war by 42% - 2% thru her effort by improving the practice of
sanitation techniques and procedure in the military barracks

THE CONCEPT OF FLORENCE NIGHTINGALE ON NURSING SCHOOL:

 School of Nursing should be self – supporting not subject to the whimps of the Hospital.
 Have decent living quarters for students and pay Nurse instructors
 Correlate theories to practice
 Support Nursing research and promote continuing education for nurses
 Introduce teaching knowledge that disease could be eliminated by cleanliness and sanitation
and Florence Nightingale likewise did not believed in the GermTheory of Bacteriology.
  Opposed central registry of nurses
  Wrote Notes on hursing, “What is ang What it is not.”
 Wrote notes on hospitals

OTHER SCHOOLS OF NURSING

 LINDA RICHARDS – the first graduate nurse in

United States Graduated in September 1, 1873
 2 NUSING ASSOCIATION / ORGANIZATION
THAT UPGRADED NURSING PRACTICE IN US:

 American Nurses Association

 National League for Nursing Education

D. Contemporary Period
 World War II – present
 This refers to the period after World War I and the changes and ddevelopment in the trends
and practice of Nursing occuring since 1945 after World War II.
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 Includes scientific and technological development, social changes occuring after the war.
 Nursing offered in College and Universities

 DEVELOPMENT AND TRENDS:

 W.H.O established by U.N to fight diseases by providing health information, proper nutrition,
living standards, environmental conditions.
 The use of Atomic energy for diagnosis and treatment.
 Space Medicine and Aerospace Nursing
 Medical equipment and machines for diagnosis and treatment
 Health related laws
 Primary Health Care – Nurses involvement in CHN
 Utilization of computers
 Technolgy advances such as development of disposable equipment and suplies that
relieved the tedious task of Nurses.
 Development of the expanded role of Nurses

FACTORS AFFECTING NURSING TODAY:

 Economics
 Consumer’s demand
 Family structure
 Information and Telecommunications
 Legislations

History of Nursing in the Philippines

 EARLY BELIEFS AND PRACTICES

 Beliefs about Causation of diseases:
 Caused or inflicted by other person (enemy or witch)
 Evil spirits
 Beliefs that evil spirits could be driven off by person with powers to expel bad spirits:

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 Believed in Gods of Healing

 Word doctors – priest physicians

HERBULARIOS – herb doctors

EARLY CARE FOR THE SICK

 HERBICHEROS- herbmen who practice witchcrafts

 MANGKUKULAM/MAGAGAWAY- a person suffering from disease without any identified
cause and were believed bewitched by such
 Difficult child birth and some diseases attributed to (NONO) midwives
 Difficult childbirth, witches were supposed to be the cause, gunpowder exploded from a
bamboo pole close to the head of the mother to drive evil spirits.

EARLY HOSPITALS:

Hospital Real de Manila – 1577

 1st hospital established
 Gov. Francisco de Sande
 To give service to the king’s Spaniard soldiers

San Lazaro Hospital – 1578

 Fray Juan Clemente
 Named after the Knights of St. Lazarus
 Hospital for the lepers

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Hospital de Indios – 1586

 Franciscan Orders
 Hospital for the poor Filipino people

Hospital de Aguas Santas - 1590

 Fray Juan Bautista
 Named after its location (near spring)
because people believed that spring
has a healing power.

San Juan de Dios Hospital – 1596

 For poor people
Located at Roxas Boulevard

PERSONAGES

Dona Hilaria de Aguinaldo

 1st wife of Emilio Aguinaldo
 Established Philippine Red Cross – February, 17 1899

Dona Maria Agoncillo de Aguinaldo

 2nd wife of Emilio Aguinaldo
 1st president of Philippine Red Cross
(Batangas Chapter)

Josephine Bracken
 Helped Rizal in treating sick people

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Melchora Aquino
 Took care of the wounded Katipuneros

Anastacia Giron Tupas

 Founder of Filipino Nurses Association – established on October 15, 1922
 1st Filipino chief nurse of PGH
 1st Filipino Superintendent of Nurses in the Philippines

Cesaria Tan
 1st Filipino to receive Masteral Degree in Nursing abroad

Socorro Sirilan

 Pioneer in social service at San Lazaro Hospital

 Also the Chief Nurse

Francisco Delgado
 1st president of Filipino Nurses Association

Socorro Diaz
 1st editor of PNA magaziine called, “The Message”

Conchita Ruiz
 Full time editor of the PNA newly named magazine, “The Filipino Nurse”
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Sor Ricarda Mendoza

 Pinoneer in Nursing Education

Loreto Tupaz
 “Dean of the Philippine Nursing”
 Florence of Iloilo

 EARLY NURSING SCHOOLS

 Iloilo Mission Hospital School of Nursing
 Established in 1906 under the supervision of Rose Nicolet (American)
 Nursing course – 3 years
 Produced 1st batch of nursing graduates in 1909 – 22 nurses
 1st TRAINED NURSES
- Nicasia Cada
- Felipa dela Pena
- Dorotea Caldito
 April 1946 – 1st nursing board exam at IloIlo Mission Hospital
 Mary Johnson School of Nursing
 PGH School of Nursing – 1907

Hospitals and School of Nursing

1. Ilo-ilo Mission Hospital School of Nursing (Ilo-ilo City,
1906)
 Ran by the baptist forreign mission society of America.
 Miss Rose Nicolet, graduate of New England. Hospital for
women and children. In Boston, Masachusetts was the first
superintendent for nurses. It moved to its present location in
Garo road, Ilo-ilo city 1929.
 Miss Flora Ernst, an American nurse,
took charge of the school in 1942.

2. St. Paul’s Hospital School of

Nursing (Manila, 1907)
 The hospital was established by the Archbishop of
Manila, the most Reverend, Jeremiah harty under the
supervision of the sisters of St. Paul the charters.Located in the
Intramuros, and it provided general hospital services

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3. Manila Central University

College of Nursing
 In 1947, offered the BSN course
 Miss Consuelo Gimeno was its first principal.

4. University of the Philippines College of Nursing

 The idea of opening the college began in conference between
Miss Julita
Soteja and the UP President Gonzales
 In 1948, the university council approved the curriculum, and
the board of regents recognized the profession as having equal
standing as medicine, law, engineering, etc.
 Miss Julita Sotejo was its first dean.

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