UNIVERSITY OF SAINT LOUIS

Tuguegarao City

SCHOOL OF HEALTH AND ALLIED SCIENCES

Second Semester
S.Y. 2020-2021

CORRESPONDENCE LEARNING MODULE

FUNDAMENTALS OF NURSING PRACTICE LECTURE
PNCM 1046

Prepared by:

ROSALIE A. TURINGAN/JANINA CUZ ABAD

Instructors

Reviewed by:

JANINA C. ABAD
Program Chair/Department Head

Recommended by:

DR. DINDO V, ASUNCION

Academic Dean

Approved by:

DR. EMMANUEL JAMES PATAGGUAN

VP for Academics
Prelims Duration: Week 3-Week 4
CODE 429- F 07:30AM-10:30AM
CODE 430- S 07:30AM-10:30AM
CODE 431- M 01:30PM-04:30PM
CODE 432- T 01:30PM-04:30PM

I. Introduction

Welcome to the Second Semester of the school year 2020-2021, you are enrolled in the Correspondence
Learning Modality. I am ROSALIE A. TURINGAN, RN, MPA, MSN, your teacher for the subject
Fundamentals in Nursing Practice for BSN Sets 1 and 2, and your professor for FNP sets 3 and 4 will be
JANINA C. ABAD, RN, MSN. We wish you all the best especially those of you who really strived harder to
qualify this second semester of your first year nursing student life. Congratulations to everyone and
please tap yourself and say, “You did a good job....keep it up!”

Upon learning this course, you can soon apply all the learned concepts and great practices in your related
learning experiences. Fundamentals of nursing introduces you to the thorough assessment of patients, the
nursing process, communication between nurse and patient, cultural differences, functional health patterns, and
the overall framework of nursing practice. You The knowledge and skills you learn in this course will provide the
foundation for the many nursing responsibilities you will assume throughout your career as both a nurse and a
student. So stay relax and calm and take it one day at a time. It will take some time to adjust to the demands of
the nursing program. It will take some time to learn the skills needed to assess patients; do not feel discouraged
if you do not grasp the concepts right away. God bless everyone!

USL expects you to do the following:

- Let your parents pick up your module on the first day of the week.
- Send back your accomplished lessons/learning tasks as your parent will pick up the next.
- Contact us for any query that you want to make about your lessons or procedures in school. You can
reach us through the following:

Email Address: abad_janina_c@yahoo.com

Messenger: Janiña Marice
Cellphone Number: 09064014529

Email Address: rosalie.turingan@yahoo.vcom

Messenger: Rosalie Turingan
Cellphone Number: 09178994293
 - Comply with all requirements (written outputs, projects/, examinations and the like.)
PROGRAM LEARNING OUTCOMES
Practice Christian values and serve as a dynamic force as Louisian in the enhancement of life and in
NO1
the moral transformation of communities.
Apply knowledge of physical, social, natural and health sciences, and humanities in the practice of
NO2
nursing.
NO3 Apply guidelines in the principles of evidence-based practice in the delivery of care.
Communicate effectively in caring, speaking, writing and presenting using culturally appropriate
NO4
language.
NO5 Practice nursing in accordance with existing laws, legal, ethical and moral principles.
Perform safe, appropriate, humanistic, and holistic care to individuals, families, population groups and
NO6
communities utilizing the nursing process.
NO7 Document to include reporting, up to date client care accurately and comprehensively.
Engaged in lifelong learning with a passion to keep current with national and global developments in
NO8
general and nursing and health developments in particular.
Practice beginning management and leadership skills in the delivery of client care and in health
NO9
program development using the systems approach.
NO10 Work effectively in collaboration with inter- intra- and multi-disciplinary and multicultural teams.
NO11 Demonstrate responsible citizenship and pride in being a Filipino Louisian Nurse
NO12 Participate in research endeavors and in health development projects.

UNIVERSITY VISION

USL is a global learning community recognized for SCIENCE AND TECHNOLOGY across all disciplines, STRONG
RESEARCH and RESPONSIVE COMMUNITY ENGAGEMENT grounded on the CICM MISSION & IDENTITY for a
DISTINCTIVE STUDENT EXPERIENCE

UNIVERSITY MISSION
USL sustains a Catholic academic community that nurtures persons for the community, church and society
anchored on CICM’s MISSIO ET EXCELLENTIA.
The University of Saint Louis upholds the philosophy that education is meant for building of self and persons for
the Church and the Society. “Wisdom builds”. To these ends, the following are University of Saint Louis’ core
values integral in the formation of every member of the Louisian community.

a. Christian living. We are witnesses to the gospel values as taught and lived by Christ thus making god’s love
known and experienced by all.
b. Excellence. We seek and maintain uncompromising standard of quality in teaching, learning, and
stewardship of school resources.
c. Professional responsibility. We are committed to efficiently and responsibly apply the learned principles,
values and skills in the chosen field of discipline, taking initiative and command responsibility in one’s
professional advancement.
d. Social awareness and involvement. We engage ourselves with society by listening to the prevailing issues
and concerns in the society, thereby initiating and participating in constructive and relevant social activities
for the promotion of justice, peace and integrity of creation and for people’s wellness and development
consistent with the CICM charism.
e. Innovation, Creativity and Agility. We keep ourselves relevant and responsive to the changing needs of our
stakeholders by being flexible, solution oriented, and having cutting edge decisions and practices.
 SCHOOL OF HEALTH AND ALLIED SCIENCES

Vision

The School of Health and Allied Sciences (SHAS) of University of Saint Louis envisions itself to become a center
of excellence in health education and a source of globally competent, compassionate and vibrant health workers
committed to people's health care and wellness.

Mission

Compelled by Christ's attitude to the healthy and the sick, the SHS is committed to form Christ-like health
workers through dynamic curricular and extra-curricular programs that will train future health professionals for
true Christian living, academic excellence, professional responsibility, social awareness and involvement,
innovation, creativity and agility. As such, it strives to:
•provide a holistic basic education necessary for the proper understanding of principles and methods of modern
scientific health programs;
•form health practitioners who shall confidently demonstrate professional competencies and compassionate
attitude in the practice of the nursing profession;
•prepare its graduates for the practice of health related work in various settings by giving them enough
opportunities for actual participation in various programs in the health care system, be it
in the family, in the hospitals or in the community;
•develop the capabilities for professional competence through dynamic researches and comprehensive
outreach and community programs

DETAILS OF THE SUBJECT

DESCRIPTIVE TITLE: Fundamentals of Nursing Practice

CREDIT UNITS: 6 units (3 units lecture-54 hours, 3 units skills laboratory-102 hours)
INDEPENDENT STUDY: 20 – 30 Hours (20-30%)
PLACEMENT: First Year, Second Semester
PRE-REQUISITES: Chem 1 (General Chemistry), TFN (Theoretical Foundations of Nursing)
COURSE DESCRIPTION:
This course deals with concepts, principles, theories and techniques basic to nursing as a profession, science and
art. It emphasizes on the concept of man as a holistic being and the professional roles of the nurse in health care
setting. The learners are expected to utilize the nursing process and the basic nursing skills as primary tool in
health promotion, disease prevention, restoration and maintenance, and rehabilitation.

COURSE LEARNING OUTCOMES:

After completion of the course, the students should be able to:
CLO 1: Utilize the nursing process in the holistic care of client for the promotion and maintenance of health
CLO 2: Ensure a well-organized recording and reporting system
CLO 3: Observe bioethical concepts/ principles and core values (love of God, caring, love of country and people)
CLO 4: Relate effectively with client/s and their family and the health team appropriately
CLO 5: Observe bioethical concepts/ principles and core values and nursing standards in the care of clients

GRADING SYSTEM:
CRITERIA PRELIMS MIDTERMS FINALS
Class Standing 60% 60% 60%
 Quizzes 30% 25% 25%
 LMS Tasks 20% 20% 20%
 Participation/Recitation 5% 5% 5%
 Attitude 5% 5% 5%
  SLP/Microteaching 5% 5% 5%
Periodical Examination 40% 40% 40%
TOTAL 100% 100% 100%

COURSE OUTLINE:
PRELIM I. Concept of Man, Health and Illness
A. Health and Illness
i. Recall concepts learned about man as an individual and as a member of the family
ii. Define Health, Wellness and Illness
iii. Explain the dimensions of wellness
iv. Discuss the Health-Illness Continuum
v. Enumerate the stages of wellness and Illness
vi. Describe the three levels of Prevention
B. Levels of Care
i. Health Promotion
ii. Disease Prevention
iii. Curative
iv. Rehabilitative
II. Nursing as a Profession
A. Profession
i. Definition
ii. Criteria
B. Nursing
i. Definition
ii. Characteristics
iii. Focus: Human Responses
iv. Personal and professional qualities of a nurse
C. History of Nursing
i. In the world
ii. In the Philippines (include the history of own nursing school)
iii. Development of Modern Nursing
D. Growth of Professionalism
i. Profession
ii. Specialized Education
iii. Body of Knowledge
iv. Ethics
v. Autonomy
vi. Carpers four patterns of knowing
1. Nursing science
2. Nursing ethics
3. Nursing Esthetics
4. Personal Knowledge
E. Overview of the Professional Nursing Practice
i. Level of Proficiency according to Benner
ii. Roles and Responsibilities of a Professional nurse
iii. Scope of Nursing Practice based on RA 9173
iv. Overview of the Code of Ethics for Nurses/Filipino Bill of Rights/Legal Aspects
v. Professional/legal and moral accountability / responsibility
F. Different Fields in Nursing
i. Institutional Nursing (hospital staff nursing)
ii. Community Health Nursing ( School nursing /industrial nursing/public health nursing )
iii. Independent nursing practice
iv. Nursing in Education
v. Nursing in other fields
III. Therapeutic Communication Skills
i. Effective communication
 ii. Purposes of therapeutic communication
iii. Components of communication
iv. Criteria for effective verbal communication
v. Guidelines for active & effective listening
vi. Guidelines for use of touch
vii. Developmental consideration in communication
viii. Communicating with people who are
ix. Physically challenged
x. Cognitively challenged
xi. Aggressive
xii. General guidelines for trans-cultural therapeutic Communication

WEEKLY STUDY AND ASSESSMENT

For the next two weeks of this grading period, the following shall be your guide for the different lessons and
tasks that you need to accomplish. Be patient, read it carefully before proceeding to the tasks expected of you.
GOOD LUCK!

Date Topic Activities or Tasks

WEEK 3-4 A. Nursing as a Asynchronous Learning
Profession Independent Study
i. Definition Virtual Meeting
ii. Characteristics Application
iii. Focus: Human Evaluation
Responses
iv. Personal and
professional qualities
of a nurse
B. History of Nursing
i. In the world
ii. In the Philippines
(include the history of
own nursing school)
iii. Development of
Modern Nursing
C. Growth of
Professionalism
i. Profession
ii. Specialized Education
iii. Body of Knowledge
iv. Ethics
v. Autonomy
vi. Carpers four patterns
of knowing
1. Nursing science
2. Nursing ethics
3. Nursing Esthetics
4. Personal Knowledge
D. Overview of the
Professional Nursing
Practice
i. Level of Proficiency
according to Benner
ii. Roles and
Responsibilities of a
Professional nurse
iii. Scope of Nursing
Practice based on RA
9173
iv. Overview of the Code
 of Ethics for
Nurses/Filipino Bill
of Rights/Legal
Aspects
v. Professional/legal and
moral accountability /
responsibility
E. Different Fields in
Nursing

Content A. Nursing as a Profession

B. History of Nursing
C. Growth of Professionalism
D. Overview of the Professional Nursing
Practice
E. Different Fields in Nursing
Learning Outcomes  Differentiate a profession and vocation
 Trace personal educational history in
preparation for their chosen career
 Trace the development of nursing, as a chosen
profession/ vocation
 Increase awareness on the qualities which
should be carried all throughout the career
 Integrate the bioethical concepts and ethico-
moral responsibilities in rendering nursing care
 Examine the differentiate fields on nursing and
specializations
 Compare the specific skills most commonly
performed in each field of nursing
 Rate the importance of interdependence and
collaboration of nurses on various fields in the
development of nursing in general

II. LEARNING CONTENT

NURSING AS A PROFESSION

Nursing is a profession within the health care sector focused on the care of individuals, families, and
communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be
differentiated from other health care providers by their approach to patient care, training, and scope of practice.
Nurses practice in many specialties with differing levels of prescription authority. Many nurses provide care
within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care
providers. However, nurse practitioners are permitted by most jurisdictions to practice independently in a
variety of settings. Since the postwar period, nurse education has undergone a process of diversification towards
advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.

Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient's
family, and other team members that focuses on treating illness to improve quality of life. In the United
Kingdom and the United States, advanced practice nurses, such as clinical nurse specialists and nurse
practitioners, diagnose health problems and prescribe medications and other therapies, depending on individual
state regulations. Nurses may help coordinate the patient care performed by other members of a
multidisciplinary health care team such as therapists, medical practitioners, and dietitians. Nurses provide care
both interdependently, for example, with physicians, and independently as nursing professionals.
To understand what nursing is, one must first define the word. Many definitions exist, some of which
misrepresent the complex knowledge and skill of professional nursing.

NURSE

Nurse is "a person, usually a woman trained to care for the sick ".

The word nurse originated from the Latin word nutrix, meaning" to nourish.'' Most definitions of nurse and
nursing describe the nurse as a person who nourishes, fosters, and protects and who is prepared to take care of
sick, injured, and aged people.

One who cares for the sick, the injured, and the physically, mentally, and emotionally disabled

One who advise and instruct individuals, families, groups and communities in the prevention, treatment of
illness and diseases and in the promotion of health.

An essential member of a health team who cares for individuals, families and communities in disease and illness
prevention and in the promotion of health and healthy environment.

PATIENT

- Comes from a Latin word, “to Suffer” or “to Bear”

- An individual who is in the state of physical, mental, and emotional imbalance
- An individual who seeks for nursing assistance, medical assistance, or for surgery due to illness or a disease.
- Is an individual who is waiting or undergoing medical or surgical care. One who is physically or mentally
disabled.

NURSING (as an art)

- Is the art of caring sick and well individual. It refers to the dynamic skills and methods in assisting sick
and well individual in their recovery and in the promotion and maintenance of health. It involves the
creative application of knowledge in the service of people
NURSING (as a science)
- It is the “body of abstract knowledge” arrived through scientific research and logical analysis
- Is the scientific knowledge and skills in assisting individual to achieve optimal health. It is the diagnosis
and treatment of human responses to actual or potential problem.
NURSING (as a profession)
- Profession- a calling in which its members profess to have acquired special knowledge by training or
experience, or both so that they may guide, advise or save others in that special field.

Florence Nightingale defined nursing over 100 years ago as '' the act of utilizing the environment of the patient
to assist him in his recovery" (Nightingale, 1860).

Virginia Henderson was one of the first modern nurses to define nursing " the unique function of the nursing is
to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery
(or to peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge, and
to do this in such a way as to help him gain independent as rapidly as possible." (Henderson, 1966).

American Nurses Association (ANA) describes nursing practice as "direct, goal oriented and adaptable to the
needs of the individual, the family, and community during health and illness" (ANA, 1973).
Canadian Nurses Association (CNA) describe nursing practice as '' a dynamic, caring, helping relationship in
which the nurses assist the client to achieve and maintain optimal health (CNA, 1987).

Themes common to the definition of '' Nursing “

Nursing is caring
Nursing is an art
Nursing is a science
Nursing is client centered
Nursing is holistic
Nursing is adaptive
Nursing is concerned with health promotion, health maintenance, and health restoration
Nursing is a helping profession

The central focus in all definitions of nursing is the patient (the person receiving care) and includes the physical,
emotional, social, and spiritual dimensions of that persons.

- Nursing is no longer considered to be concerned primarily with illness care.

- Nursing's concepts and definitions have expanded to include the prevention of illness and the
promotion and maintenance of health for individuals, families, and communities.

Recipients of nursing

The recipients of nursing are sometimes called consumers, sometimes patients, and sometimes clients.
A consumer is an individual, a group of people, or a community that uses a service or commodity.
A patient is a person who is waiting for or undergoing medical treatment and care.
A client is a person who engages the advice or services of another who is qualified to provide this service.

Aims of Nursing

Four broad aims of nursing practice can be identified in the definitions of nursing:

1. To promote health
2. To prevent illness
3. To restore health
4. To facilitate coping with disability or death

To meet these aims, the nurse uses knowledge, skills, and critical thinking to give care in a variety of traditional
and expanding nursing roles. To achieve the goals of nursing, nurses rely on four essential competencies:
cognitive, technical, interpersonal, and ethical/ legal skills. These competencies, or skills, are used/ blended
together to perform knowledgeable and effective care.

Cognitive skilled nurses think about the nature of things sufficiently to" make sense" of their world.

Cognitively skilled nurses are able to accomplish the following:

Offer a scientific rationale for the patient's plan of care.

Select those nursing interventions that are most likely to yield the desired outcomes.
Use critical thinking to solve problems creatively.
Technically skilled nurses manipulate equipment skillfully to produce a desired outcome or result. Also technical
involves everything including good eye – hand coordination to an ability to troubleshoot when equipment
malfunctions, based on an understanding of the technical workings of the equipment.
Technically skilled nurses are able to accomplish the following:

Use technical equipment with sufficient competence and ease to achieve goals with minimal distress to
participants involved.
Creatively adapt equipment and technical procedures to the needs of particular patients.
Interpersonally skilled nurses establish and maintain caring relationships that facilitate the achievement of
valued goals. Nurses skilled in interpersonal relations are able to accomplish the following:

Use interactions with patients, their significant others, and colleagues to affirm their worth.
Elicit the personal strengths and abilities of patients and their significant others to achieve valued health
goals.
Provide the healthcare team with knowledge about the patient's valued and expectations.
Work collaboratively with the healthcare team as a respected and credible colleague to reach valued
goals.
Ethically and legally skilled nurses conduct themselves in a manner consistent with their personal moral code
and professional role responsibilities. Nurses skilled in ethical/legal competence are able to accomplish the
following:

Be accountable for their practice to themselves, the patients they serve, the caregiving team, and
society.
Act as effective patient advocates.
Mediate ethical conflicts among the patient, significant others, health care team, and other interested
parties.

Nursing practice involves four areas:

1- Promoting health and wellness

Wellness is a state of well – being. This means engaging in attitudes and behavior that enhance the quality of life
and maximize personal potential. Such as improving nutrition and physical fitness; restricting smoking;
preventing drug; alcohol misuse.

2- Preventing illness

The goal of illness prevention activities is to reduce the risk for illness, to promote good health habits, and to
maintain optimal functioning. Nurses prevent illness primarily by teaching and by personal example. Such
activities include the following:
-Educational programs in areas such as prenatal care for pregnant women, smoking cessation programs,
and stress reduction seminars.
-Community programs that encourage healthy lifestyles, such as physical fitness programs.
-Television, radio, or internet information on diet, exercise, and the importance of good health habits.
3- Restoring health

- Focus on the individual with an illness and range from early detection of a disease to rehabilitation and
teaching during recovery. Such activities include the following:
- Providing direct care to the ill person, such as administering medications, baths.
- Performing diagnostic and assessments that detect an illness e.g., BP, measuring blood sugar.
- Referring questions and abnormal findings to other health care providers as appropriate.
- Collaboration with other healthcare providers in providing care.
- Rehabilitating clients to their optimal functional level following physical or mental illness, injury.
- Working in mental health and chemical dependency programs.
4- Facilitating coping with disability or death

Nurses facilitate patient and family coping with altered function, life crisis, and death. Altered function
decreases an individual’s ability to carry out activities of daily living and expected roles.

Nurses can facilitate an optimal level of function through maximizing the person's strengths and potentials,
through teaching, and through referral to community support system. Nurses provide care to both patients and
families during end-of-life care, and they do so in hospitals, long-term-care facilities, and homes.

Settings for nursing

In the past, the acute care was the only practice setting open to most nurses. Today most nurses work in
hospitals, but increasingly they work in clients' homes, community agencies, ambulatory clinics, health
maintenance organizations (HMOs).

GROWTH OF PROFESSIONALISM

Nursing is gaining recognition as a profession. A profession has been defined as an occupation that requires
extensive education or a calling that requires special knowledge, skill, and preparation. A profession is generally
distinguished from other kinds of occupations by (a) its requirement of prolonged, specialized training to acquire
a body of knowledge pertinent to the role to be performed; (b) an orientation of the individual toward service,
either to a community or to an organization; (c) ongoing research; (d) a code of ethics; (e) autonomy; and (f) a
professional organization.

Two terms related to profession need to be differentiated: professionalism and professionalization.

Professionalism refers to professional character, spirit, or methods. It is a set of attributes, a way of life that
implies responsibility and commitment. Nursing professionalism owes much to the influence of Florence
Nightingale. Professionalization is the process of becoming professional, that is, of acquiring characteristics
considered to be professional.

Specialized Education
Specialized education is an important aspect of professional status. In modern times, the trend in education for
the professions has shifted toward programs in colleges and universities. Many nursing educators believe that
the undergraduate nursing curriculum should include liberal arts education in addition to the biologic and social
sciences and the nursing discipline. In the United States today, there are five means of entry into registered
nursing: hospital diploma, associate degree, baccalaureate degree, master’s degree, and doctoral degree.

Body of Knowledge
As a profession, nursing is establishing a well-defined body of knowledge and expertise. A number of nursing
conceptual frameworks contribute to the knowledge base of nursing and give direction to nursing practice,
education, and ongoing research.

Nursing Ethics
Nurses have traditionally placed a high value on the worth and dignity of others. The nursing profession requires
integrity of its members; that is, a member is expected to do what is considered right regardless of the personal
cost. Ethical codes change as the needs and values of society change. Nursing has developed its own codes of
ethics and in most instances has set up means to monitor the professional behavior of its members.

Autonomy
A profession is autonomous if it regulates itself and sets standards for its members. Providing autonomy is one
of the purposes of a professional association. If nursing is to have professional status, it must function
autonomously in the formation of policy and in the control of its activity. To be autonomous, a professional
group must be granted legal authority to define the scope of its practice, describe its particular functions and
roles, and determine its goals and responsibilities in delivery of its services.

To practitioners of nursing, autonomy means independence at work, responsibility, and accountability for one’s
actions. Autonomy is more easily achieved and maintained from a position of authority. For example, all states
have passed legislation granting NPs supervisory,
collaborative, or independent authority to practice (Phillips, 2010), and currently, 27 states do not require
physician oversight of NPs to practice (Selway, 2012).

CARPER’S FOUR PATTERNS OF KNOWING

 OVERVIEW OF THE PROFESSIONAL NURSING PRACTICE

NURSING ROLES

Nurses assume a number of roles when they provide care to clients. For example, the nurse may act as a
counselor while providing physical care and teaching aspects of that care. The roles required at specific time
depend on the needs of the client and aspects of the particular environment.

Roles of Professional Nurse

Caregiver

- Nurses view each client as unique and consider the ''whole'' person in the caring process.
- Nurses address not only physiologic concerns but also spiritual, emotional, and social needs.
- The role of caregiver is the primary role of the nurse.
- TYPES OF CARE:
 Full Care  for completely dependent patient
 Partial Care  for partially dependent patient
 Supportive-Educative care  to assist clients in attaining their highest possible level of health and
wellness; for learnings
Decision Maker
 - Problem resolution requires the ability to make sound judgments and decision. Nurses must choose the
best approaches to client care, help clients participate in this decision making and use safe and effective
judgments when providing care, also involving other members of the health care team and the families
of clients in decision making to ensure that sound choices are made.
Client advocate
- The protection of human or legal rights and the securing of care for all patients based on the belief that
patients have the right to make informed decisions about their own health and lives.
- Acts to protect the client
- Nurse may represent the client’s needs and wishes to other health professionals, such as relaying the
client’s wishes for information to the physician.
- Nurses assist clients in exercising their rights and help them speak up for themselves
Communicator
- Communication is integral to all nursing roles. Nurses are the healthcare professionals who spend the
most time with clients; they have the best opportunity for observing, communicating, and identifying
problems or improvements in the plan of care.
- A communicator uses effective interpersonal and therapeutic communication skills to establish and
maintain helping relationships with patients of all ages in a wide variety of healthcare settings.
- Nurses communicate with the client, support persons, other health professionals, and people in the
community.
- Nurses identify client problems and then communicate these verbally or in writing to other members of
the health team
Educator
- Educating clients about diseases, prevention, nutrition and healthy behaviors is essential.
- Nurses must explain treatments and procedures, answer any questions clients have.
- Education is involved in all nursing activities.
- Nurses help clients learn about their health and the health care procedure they need to perform to
restore or maintain their health.
- Nurses assesses the client’s learning needs and readiness to learn, sets specific learning goals in
conjunction with the client, enacts teaching strategies, and measures learning.
- Nurses also teaches unlicensed assistive personnel to whom they delegate care, and they share their
expertise with other nurses and health professionals.
Case Manager and Coordinator
- Nurses manage and coordinate the activities, treatments that involve clients care in effective, efficient,
and in a manner that benefits the client.
- Work with the multidisciplinary health care team to measure the effectiveness of the case management
plan and to monitor outcomes.
- Works with primary or staff nurses to oversee the care of a specific caseload.
- Primary nurse or provides some level of direct care to the client and family
- Helps ensure that care is oriented to the client, while controlling costs.
Counselor
- The use of therapeutic interpersonal communication skills to provide information, make appropriate
referrals, and facilitate the patient's problem – solving and decision – making skills.
- Helping a client recognize and cope with stressful psychologic or social problems, to develop improved
interpersonal relationships, and to promote personal growth.
- Involves providing emotional, intellectual and psychologic support.
- Nurses counsel primarily healthy individuals with normal adjustment difficulties and focuses on helping
the person develop new attitudes, feelings, behaviors by encouraging the client to look at alternative
behaviors, recognizing the choices, and develop sense of control.
Change agent
- The nurse acts as a change agent when assisting others, that is, clients, to make modifications in their
own behavior. Nurses also act to make changes in a system, if it is not helping a client return to health.
 - Assisting others to make modifications in their own behavior.
- Nurses also often act to make changes in a system if it is not helping client return to health.
Leader
- The assertive, self- confident practice of nursing when providing care, effecting change, and functioning
with groups.
- Influences others to work together to accomplish a specific goal.
- Can be employed at different levels: individual client, family, groups of clients, colleagues, or the
community
Researcher
- The participation in or conduct of research to increase knowledge in nursing and improve patient care.
- Often use research to improve client care
- Have some awareness of the process and language of research
- Be sensitive to issues related to protecting the rights of human subjects
- Participate in the identification of significant researchable problems
- Be a discriminating consumer of research findings
Role Model
- Has good physical appearance
- Practices proper hygiene
- Practices healthy lifestyle
Administrator
- Assumes middle management position
- Connects the patient to other services of the hospital
- Expanded Career Roles
- Nurse practitioner, clinical nurse specialist, nurse midwife, nurse educator, nurse researcher, and nurse
anesthetist
- All of which allow greater independence and autonomy.
CONCEPT OF PROFESSION (Marie Jahoda)
- A profession is an organization of an occupational group based on the application of special
knowledge which establishes its own rules and standards for the protection of the public and the
professionals.
- A profession implies that the quality of work done by its members is of greater importance in its
own eyes and the society than the economic rewards they earn.
- Serves all of society and not the specific interests of a group
CHARACTERISTICS AND ATTRIBUTES OF A PROFESSIONAL PERSON
 Is concerned with quality. -KSA
 Is self-directed, responsible and accountable for his actions.
 Is able to make independent and sound judgment including high moral judgment.
 Is dedicated to the improvement of human life
 Is committed to the spirit of inquiry.
Professional Nursing
- art and science, dominated by an ideal of service in which certain principles are applied in skillful care of
the well and ill, and through relationship with the client, significant others and other members of the
health team.

Professional Nurse
- A person who has completed a basic nursing education program and is licensed in his country or state to
practice professional nursing.
QUALITIES AND ABILITIES OF A PROFESSIONAL NURSE
- Has faith in the fundamental values that underlie the democratic way of life:
o Respect for human dignity
o Self-sacrifice for the common good.
o Strong sense of responsibility for sharing in the solution of the problems of the society.
- Has a sense of responsibility for understanding those with whom he works or associates with through the
use of skills:
o Has the basic knowledge, skills and attitudes necessary to address present day social problems,
realistic and well organized thoughts through the use of critical thinking
- Has skills in using written and spoken language, both to develop own thoughts and to communicate them to
others.
- Appreciates and understands importance of good health
- Has emotional balance.
- Accepts and tries to understand people of all sorts, regardless of race, religion and color.

FIVEFOLD NURSING FUNCTIONS

1. Promoting Health and Wellness
 Wellness – state of well-being. Engaging in attitudes and behavior that enhance the quality of
life and maximize personal potential
 For both healthy and ill.
 Involve individual and community activities to enhance healthy lifestyle, such as improving
nutrition and physical fitness, preventing drug and alcohol misuse, restricting smoking, and
preventing accidents and injury in the home and workplace.
2. Preventing Illness
 The goal is to maintain optimal health by preventing diseases
 Nursing activities includes immunizations, prenatal and infant care, and prevention of sexually
transmitted disease.
3. Pain/suffering Alleviation
 The goal is to provide relief from pain to promote comfortable healing process
4. Restoring Health
 Focuses on the ill client
 Extends from early detection of disease to helping the client during the recovery period
 Nursing Activities:
 Providing direct care to the ill person: administering medications, baths, and specific
procedures and treatments
 Providing diagnostic and assessment procedures: measuring BP and examining feces for
occult blood
 Consulting with other health care professionals about client’s problems
 Teaching clients about recovery activities: exercise that will accelerate recovery after a
stroke
 Rehabilitating clients to their optimal functional level following physical or mental
illness, injury, or chemical addiction
5. Creation of a spiritual environment
 Provision of spiritual care
 Involves comforting and caring for people of all ages who are dying
 Includes helping clients live as comfortable as possible until death and helping support persons
cope with death.
 Work in homes, hospitals, and extended care facilities
 Hospices are specifically designed for this purpose.
RA 9173
- known as the Philippine Nursing Act of 2002, an act providing for a more responsive nursing profession,
repealing for the purpose RA 7164 known as the “Phil. Nursing Act of 1991 and for other purposes.
- Includes organization of the board of nursing, examination and registration, scope of nursing practice
- SCOPE OF NURSING PRACTICE
A person shall be deemed to be practicing nursing within the meaning of this Act when he/she singly or
in collaboration with another, initiates and performs nursing services to individuals, families and
communities in any health care setting.
1.     It includes but not limited to: nursing care during conception, labor, delivery, infancy, childhood,
toddler, pre-school, school age, adolescence, adulthood and old age.
2.      As independent practitioners, nurses are primarily responsible for the promotion of health &
prevention of illness.
3.      As members of the health team, nurses shall collaborate with other health care providers for the
curative, preventive, and rehabilitative aspects of care, restoration of health, alleviation of suffering and
when recovery is not possible, towards a peaceful death.
4.      Provide nursing through the utilization of the nursing process.  Nursing care includes but not limited to:
a.      traditional and innovative approaches
b.      therapeutic use of self
c.      executing health care techniques and procedures, essential primary health care, comfort
measures, & health teachings
d.      administration of written prescriptions for treatment therapies, oral, parenteral medications,
e.      internal examinations during labor in the absence of antenatal bleeding
f.        delivery
g.      in case of suturing of perineal laceration, special training shall be provided according to
protocol established
5.  Establish linkages with community resources and coordination with the health team
6.  Provide health education to include families and communities
7.  Teach, guide and supervise students in nursing education programs including administration of services in
varied settings such as hospitals, and clinics and undertake consultation services; engage in such
activities that require the utilization of knowledge and decision making skills as registered nurses
8.  Undertake nursing and health human resources development training, which shall include but not limited
to the development of advance nursing practice
 HISTORY OF NURSING
Nursing has undergone dramatic change in response to societal needs and influences. A look at
nursing’s beginnings reveals its continuing struggle for autonomy and professionalization. In recent
decades, a renewed interest in nursing history has produced a growing amount of related literature.
This section highlights only selected aspects of events that have influenced nursing practice. Recurring
themes of women’s roles and status, religious (Christian) values, war, societal attitudes, and visionary
nursing leadership have influenced nursing practice in the past. Many of these factors still exert their
influence today.

Women’s Roles
Traditional female roles of wife, mother, daughter, and sister have always included the care and
nurturing of other family members. From the beginning of time, women have cared for infants and
children; thus, nursing could be said to have its roots in “the home.” Additionally, women, who in
general occupied a subservient and dependent role, were called on to care for others in the
community who were ill. Generally, the care provided was related to physical maintenance and
comfort. Thus, the traditional nursing role has always entailed humanistic caring, nurturing,
comforting, and supporting.
Religion
Religion has also played a significant role in the development of nursing. Although many of the world’s
religions encourage benevolence, it was the Christian value of “love thy neighbor as thyself” and
Christ’s parable of the Good Samaritan that had a significant impact on the development of Western
nursing. During the third and fourth centuries, several wealthy matrons of the Roman Empire, such as
Fabiola, converted to Christianity and used their wealth to provide houses of care and healing (the
forerunner of hospitals) for the poor, the sick, and the homeless. Women were not, however, the sole
providers of nursing services. The Crusades saw the formation of several orders of knights, including
the Knights of Saint John of Jerusalem (also known as the Knights Hospitalers), the Teutonic Knights,
and the Knights of Saint Lazarus. These brothers in arms provided nursing care to their sick and injured
comrades. These orders also built hospitals, the organization and management of which set a standard
for the administration of hospitals throughout Europe at that time. The Knights of Saint Lazarus
dedicated themselves to the care of people with leprosy, syphilis, and chronic skin conditions.

During medieval times, there were many religious orders of men in nursing. For example, the Alexian
Brothers organized care for victims of the Black Plague in the 14th century in Germany. In the 19th
century, they followed the same traditions as women’s religious nursing orders and established
hospitals and provided nursing care.

The deaconess groups, which had their origins in the Roman Empire of the third and fourth centuries,
were suppressed during the Middle Ages by the Western churches. However, these groups of nursing
providers resurfaced occasionally throughout the centuries, most notably in 1836 when Theodor
Fliedner reinstituted the Order of Deaconesses and opened a small hospital and training school in
Kaiserswerth, Germany. Florence Nightingale received her “training” in nursing at the Kaiserswerth
School.

Early religious values, such as self-denial, spiritual calling, and devotion to duty and hard work, have
dominated nursing throughout its history. Nurses’ commitment to these values often resulted in
exploitation and few monetary rewards. For some time, nurses themselves believed it was
inappropriate to expect economic gain from their “calling.”

War
Throughout history, wars have accentuated the need for nurses. During the Crimean War (1854–1856),
the inadequacy of care given to soldiers led to a public outcry in Great Britain. The role Florence
Nightingale played in addressing this problem is well known. She was asked by Sir Sidney Herbert of
the British War Department to recruit a contingent of female nurses to provide care to the sick and
injured in the Crimea. Nightingale and her nurses transformed the military hospitals by setting up
sanitation practices, such as hand washing and washing clothing regularly. Nightingale is credited with
performing miracles; the mortality rate in the Barrack Hospital in Turkey, for example, was reduced
from 42% to 2% in 6 months (Donahue, 2011, p. 118).

During the American Civil War (1861–1865), several nurses emerged who were notable for their
contributions to a country torn by internal strife. Harriet Tubman and Sojourner Truth provided care
and safety to slaves fleeing to the North on the Underground Railroad. Mother Biekerdyke and Clara
Barton searched the battlefields and gave care to injured and dying soldiers. Noted authors Walt
Whitman and Louisa May Alcott volunteered as nurses to give care to injured soldiers in military
hospitals. Another female leader who provided nursing care during the Civil War was Dorothea Dix.
She became the Union’s superintendent of female nurses responsible for recruiting nurses and
supervising the nursing care of all women nurses working in the army hospitals.

The arrival of World War I resulted in American, British, and French women rushing to volunteer their
nursing services. These nurses endured harsh environments and treated injuries not seen before. A
monument entitled “The Spirit of Nursing” stands in Arlington National Cemetery. It honors the nurses
who served in the U.S. armed services in World War I, many of whom are buried in Section 21, which is
also called the “Nurses Section” (Arlington National Cemetery, n.d.). Progress in health care occurred
during World War I, particularly in the field of surgery. For example, advancements were made in the
use of anesthetic agents, infection control, blood typing, and prosthetics.

World War II casualties created an acute shortage of caregivers, and the Cadet Nurse Corps was
established in response to a marked shortage of nurses. Also at that time, auxiliary health care workers
became prominent. “Practical” nurses, aides, and technicians provided much of the actual nursing care
under the instruction and supervision of better prepared nurses. Medical specialties also arose at that
time to meet the needs of hospitalized clients.

During the Vietnam War, approximately 11,000 American military women stationed in Vietnam were
nurses. Most of them volunteered to go to Vietnam right after they graduated from nursing school,
making them the youngest group of medical personnel ever to serve in wartime (Vietnam Women’s
Memorial Foundation, n.d.). Near the Vietnam Veterans Memorial (“The Wall”) stands the Vietnam
Women’s Memorial.

Harriet Tubman (1820–1913) was known as
“The Moses of Her People” for her work with
the Underground Railroad.
During the Civil War she nursed the sick and
suffering of her own race.
Sojourner Truth (1797–1883), abolitionist, Dorothea Dix (1802–1887) was the Union’s
Underground Railroad agent, preacher, and superintendent of female nurses during the
women’s rights advocate, was a nurse for more than Civil War.
4 years during the Civil War and worked as a nurse
and counselor for the Freedmen’s Relief Association
after the war.

Societal Attitudes
Society’s attitudes about nurses and nursing have significantly influenced professional nursing. Before
the mid-1800s, nursing was without organization, education, or social status; the prevailing attitude
was that a woman’s place was in the home and that no respectable woman should have a career. The
role for the Victorian middle-class woman was that of wife and mother, and any education she
obtained was for the purpose of making her a pleasant companion to her husband and a responsible
mother to her children. Nurses in hospitals during this period were poorly educated; some were even
incarcerated criminals. Society’s attitudes about nursing during this period are reflected in the writings
of Charles Dickens. In his book Martin Chuzzlewit (1896), Dickens reflected his attitude toward nurses
through his character Sairy Gamp. She “cared” for the sick by neglecting them, stealing from them, and
physically abusing them (Donahue, 2011, p. 112). This literary portrayal of nurses greatly influenced
the negative image and attitude toward nurses up to contemporary times.

Sairy Gamp, a character in Dickens’ book Martin

Chuzzlewit, represented the negative image of nurses in the
early 1800s.
In contrast, the guardian angel or angel of mercy image arose in the latter part of the 19 th century,
largely because of the work of Florence Nightingale during the Crimean War. After Nightingale brought
respectability to the nursing profession, nurses were viewed as noble, compassionate, moral, religious,
dedicated, and self-sacrificing.

Another image arising in the early 19th century that has affected subsequent generations of nurses and
the public and other professionals working with nurses is the image of doctor’s handmaiden. This
image evolved when women had yet to obtain the right to vote, when family structures were largely
paternalistic, and when the medical profession portrayed increasing use of scientific knowledge that, at
that time, was viewed as a male domain. Since that time, several images of nursing have been
portrayed. The heroine portrayal evolved from nurses’ acts of bravery in World War II and their
contributions in fighting poliomyelitis—in particular, the work of the Australian nurse Elizabeth Kenney.
Other images in the late 1900s include the nurse as sex object, surrogate mother, and tyrannical
mother.

During the past few decades, the nursing profession has taken steps to improve the image of the
nurse. In the early 1990s, the Tri- Council for Nursing (the American Association of Colleges of Nursing,
the American Nurses Association [ANA], the American Organization of Nurse Executives, and the
National League for Nursing [NLN]) initiated a national effort, titled “Nurses of America,” to improve
the image of nursing. Launched in 2002, the Johnson & Johnson corporation continues their “Campaign
for Nursing’s Future” to promote nursing as a positive career choice. Through various outreach
programs, this campaign increases exposure to the nursing profession, raises awareness about its
challenges (e.g., nursing shortage), and encourages people of all ages to consider a career in nursing.

NURSING LEADERS

NIGHTINGALE (1820–1910)
The contributions of Florence Nightingale to nursing are well documented. Her achievements in
improving the standards for the care of war casualties in the Crimea earned her the title “Lady with the
Lamp.” Her efforts in reforming hospitals and in producing and implementing public health policies also
made her an accomplished political nurse: She was the first nurse to exert political pressure on
government. Through her contributions to nursing education—perhaps her greatest achievement—she
is also recognized as nursing’s first scientist-theorist for her work Notes on Nursing: What It Is, and
What It Is Not (1860/1969).

Nightingale was born to a wealthy and intellectual family. She believed she was “called by God to help
others . . . [and] to improve the well-being of mankind” (Schuyler, 1992, p. 4). She was determined to
become a nurse in spite of opposition from her family and the restrictive societal code for affluent
young English women. As a well-traveled young woman of the day, she visited Kaiserswerth in 1847,
where she received 3 months’ training in nursing. In 1853 she studied in Paris with the Sisters of
Charity, after which she returned to England to assume the position of superintendent of a charity
hospital for ill governesses.

When she returned to England from the Crimea, a grateful English public gave Nightingale an
honorarium of £4,500. She later used this money to develop the Nightingale Training School for
Nurses, which opened in 1860. The school served as a model for other training schools. Its graduates
traveled to other countries to manage hospitals and institute nurse-training programs.

Despite poor health that left her an invalid, Florence Nightingale worked tirelessly until her death at
age 90. As a passionate statistician, she conducted extensive research and analysis (Florence
Nightingale International Foundation, 2014). Nightingale is often referred to as the first nurse
researcher. For example, her record keeping proved that her interventions dramatically reduced
mortality rates among soldiers during the Crimean War.
Nightingale’s vision of nursing changed society’s view of nursing. She believed in personalized and
holistic client care. Her vision also included public health and health promotion roles for nurses. It is
easy to see how Florence Nightingale still serves as a model for nurses today.

BARTON (1821–1912)
Clara Barton was a schoolteacher who volunteered as a nurse during the American Civil War. Her
responsibility was to organize the nursing services. Barton is noted for her role in establishing the
American Red Cross, which linked with the International Red Cross when the U.S. Congress ratified the
Treaty of Geneva ( Geneva Convention). It was Barton who persuaded Congress in 1882 to ratify this
treaty so that the Red Cross could perform humanitarian efforts in time of peace.

RICHARDS (1841–1930)
Linda Richards was America’s first trained nurse. She graduated from the New England Hospital for
Women and Children in 1873. Richards is known for introducing nurse’s notes and doctor’s orders. She
also initiated the practice of nurses wearing uniforms (ANA, 2013b). She is credited for her pioneering
work in psychiatric and industrial nursing.

MAHONEY (1845–1926)
Mary Mahoney was the first African American professional nurse. She graduated from the New
England Hospital for Women and Children in 1879. She constantly worked for the acceptance of
African Americans in nursing and for the promotion of equal opportunities (Donahue, 2011, p. 144).
The ANA (2013c) gives a Mary Mahoney Award biennially in recognition of significant contributions in
interracial relationships.

WALD (1867–1940)
Lillian Wald is considered the founder of public health nursing. Wald and Mary Brewster were the first
to offer trained nursing services to the poor in the New York slums. Their home among the poor on the
upper floor of a tenement, called the Henry Street Settlement and Visiting Nurse Service, provided
nursing services, social services, and organized educational and cultural activities. Soon after the
founding of the Henry Street Settlement, school nursing was established as an adjunct to visiting
nursing.

DOCK (1858–1956)
Lavinia L. Dock was a feminist, prolific writer, political activist, suffragette, and friend of Wald. She
participated in protest movements for women’s rights that resulted in the 1920 passage of the 19th
Amendment to the U.S. Constitution, which granted women the right to vote. In addition, Dock
campaigned for legislation to allow nurses rather than physicians to control their profession. In 1893,
Dock, with the assistance of Mary Adelaide Nutting and Isabel Hampton Robb, founded the American
Society of Superintendents of Training Schools for Nurses of the United States, a precursor to the
current National League for Nursing.

SANGER (1879–1966)
Margaret Higgins Sanger, a public health nurse in New York, has had a lasting impact on women’s
health care. Imprisoned for opening the first birth control information clinic in America, she is
considered the founder of Planned Parenthood. Her experience with the large number of unwanted
pregnancies among the working poor was instrumental in addressing this problem.

BRECKINRIDGE (1881–1965)
After World War I, Mary Breckinridge, a notable pioneer nurse, established the Frontier Nursing
Service (FNS). In 1918, she worked with the American Committee for Devastated France, distributing
food, clothing, and supplies to rural villages and taking care of sick children. In 1921, Breckinridge
returned to the United States with plans to provide health care to the people of rural America. In 1925,
Breckinridge and two other nurses began the FNS in Leslie County, Kentucky. Within this organization,
Breckinridge started one of the first midwifery training schools in the United States.
Considered the founder of modern
nursing, Florence Nightingale (1820–
1910) was influential in developing
nursing education,
practice, and administration. Her
publication, Notes on Nursing: What It
Is, and What It Is Not, first published
in England in 1859 and in the United
States in 1860, was intended for all
women.
Clara Barton (1821–1912)
organized the American
Red Cross, which linked with the
International Red Cross when the
U.S. Congress ratified the Geneva
Convention in 1882.
Linda Richards (1841–1930) was
America’s first trained nurse.
Lillian Wald (1867–1940)
founded the Henry Street
Settlement and Visiting Nurse
Service (circa 1893), which
provided nursing and social
services and organized
educational and cultural activities.
She is considered the founder of
public health nursing.

Mary Mahoney (1845–1926) was
the first African American trained
nurse.
Nursing leader and suffragist
Lavinia L. Dock (1858–1956) was
active in the protest movement for
women’s rights that resulted in the
constitutional amendment in 1920
that allowed women
to vote.
Nurse activist Margaret Sanger
(1879–1966), considered
the founder of Planned Parenthood,
was imprisoned for
opening the first birth control
information clinic in Baltimore in
1916.
Mary Breckinridge (1881–1965), a
nurse who practiced
midwifery in England, Australia,
and New Zealand, founded the
Frontier Nursing Service in
Kentucky in 1925 to provide
family-centered primary health care
to rural populations.

MEN IN NURSING
Men have worked as nurses as far back as before the Crusades. Although the history of nursing
primarily focuses on the female figures in nursing, schools of nursing for men existed in the United
States from the late 1880s until 1969. Male nurses were denied admission to the Military Nurse Corps
during World War II based on gender. It was believed at that time that nursing was women’s work and
combat was men’s work. During the 20th century, men were denied admission to most nursing
programs. The ANA denied membership to male nurses until 1930 and many state nursing associations
did not allow men to join until the 1950s (O’Lynn & Tranbarger, 2007, p. 68).

In 1971, a nurse who practiced in Michigan, Steve Miller, formed an organization called Men in
Nursing. In 1974, Luther Christman organized a group of male nurses in Chicago. The two groups
reorganized into the National Male Nurses Association with the primary focus of recruiting more men
into nursing. In 1981, the organization was renamed the American Assembly for Men in Nursing
(AAMN) (2011). The purpose of the AAMN is to provide a framework for nurses, as a group, to meet to
discuss and influence factors that affect men as nurses. In 2009 and 2010, members of the AAMN
discussed ways to change the image of men in nursing in both recruitment and retention. They
subsequently introduced the theme “Do what you love and you’ll love what you do”. This idea led to
the AAMN initiative “20 × 20 Choose Nursing,” which has the goal of increasing the enrollment of men
in nursing programs nationally from the current 10% to 20% by 2020 (Anderson, 2011).
Luther Christman (1915–2011), one of the founders of the AAMN, graduated from the Pennsylvania
Hospital School of Nursing for Men in 1939 and did experience discrimination while in nursing school.
For example, he was not allowed a maternity clinical experience, yet was expected to know the
information related to that clinical experience for the licensing exam. After becoming licensed, he
wanted to earn a baccalaureate degree in nursing, but was denied access to two universities because
of gender. After receiving his doctorate he accepted the position as dean of nursing at Vanderbilt
University. He was the first man to be a dean at a university school of nursing. He accomplished many
firsts: the first man nominated for president of the ANA, the first man elected to the American
Academy of Nursing (he was named a “Living Legend” by this organization), and the first man inducted
into ANA’s Hall of Fame for his extraordinary contributions to nursing (O’Lynn & Tranbarger, 2007).

Men comprised 9.6% of the nation’s nursing workforce in 2011 (U.S. Census Bureau, 2013). Men do
experience barriers to becoming nurses. For example, the nursing image is one of femininity, and
nursing has been slow to neuter this image. As a result, many people may believe that only
homosexual men enter nursing, which is not true. Other barriers and challenges for male nursing
students include the lack of male role models in nursing and caring (e.g., differences in caring styles
between men and women) and suspicion surrounding intimate touch (MacWilliams, Schmidt, & Bleich,
2013). The nursing profession and nursing education need to address these issues. Improved
recruitment and retention of men and other minorities into nursing will strengthen the profession.

FOUR HISTORICAL PERIODS IN NURSING

INTUITIVE PERIOD
 From Prehistoric to Early Christian Era
 Practices are more on intuition
 NOMADS – travel from one place to another
 Survival of the fittest
 “Best for the most” – motto
 people believe that 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
 SHAMAN – uses white magic to counteract the black magic
 They are the doctors during those time.
 TREPHINING – drilling the skull
 Used to treat Psychotic patients
 Psychotic patients are believed to be possessed by evil spirits.
 Growth of religion – most important thing that happened
 Growth of civilization
 Law of self-preservation – inspire man in search of knowledge
Rise in Civilization
 From the mode of Nomadic life  agrarian society  gradual development of urban community life
 Existence of the means of communication
 Start of scientific knowledge  more complex life  increase in health problems  demand for more
nurses
 Nursing was 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
Birth of 3 religious ideologists:
 Judaism
 Christianity
 Mohammedism or Islam
Monotheism – believer of one God

Different Civilizations
 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
 HEBREWS
 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 8 th day after birth
 MOSAIC LAW/LAW OF MOSES
 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
 No knowledge on anatomy
 Use of wax to preserve the body of the dead
 Prohibit dissecting of human body thus hampering the advancement of medicine.
 INDIA
  SUSHURUTO
 1st recording on the nursing practice

 Hampered by taboos due to social structures and practices of animal worship

 Medicine men built hospitals

 Intuitive/instinctive form of asepsis

 There was proficient practice of Medicine and Surgery
 NURSES QUALIFICATIONS: Lay Brothers, Priest Nurses, combination of Pharmacist, PT, cooks
 GREECE
 AESCULAPUS
 Father of medicine in Greek mythology
 HIPPOCRATES
 Father of modern medicine
 1st to reject the idea that diseases are caused by evil spirits
 1st to apply assessment
 Practice medical ethics
 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.
 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 (1 st hospital
in the Christian world and used her wealth for the sick.

APPRENTICE PERIOD
 11th century  1836
 On-the-job training period (beginner) is directed by more experienced nurses
 Started from the founding of Religious Orders in the 6 th century through the Crusades in 1836 – when
the deaconesses School of Nursing was established in Kaiserswerth, Germany by Pastor THEODORE
FLEIDNER
 There was a struggle for religious, political, and economic power
 Crusades took place in order to gain religious, political, and economic power or for adventure
 The Crusade in this period happened as an attempt to recapture the Holy Land from the Turk who
obtained and gained control of the region as a result of power struggle.
 Christians were divided due to several religious war and Christians were denied to visit The Holy
Sepulcher.
 MILITARY AND RELIGIOUS WORKERS
 KNIGHTS OF ST. JOHN OF JERUSALEM (ITALIAN)
 Also called as “Knights of the Hospitalers”
 Established to render care to the sick
 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
 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
 RISE OF RELIGIOUS ORDERS
 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
 THE 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/dirty, harsh, ill-fed, overworked
 Mass exodus for nurses
 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
EDUCATIVE PERIOD
 Florence Nightingale era
  Began in June 15, 1860 when Florence Nightingale School of Nursing opened at St. Thomas
Hospital in London England, where 1 st program for formal education of Nurses began and
contributed growth of Nursing in the US
 Florence Nightingale
 Mother of Modern Nursing
 Lady with the Lamp
 Born on May 12, 1820 in Florence, Italy
 Her SELF-APPOINTED GOAL – to change the profile of Nursing
 She compiled notes of her visits to hospitals, her observations of sanitation practices and
entered Deaconesses 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 Concepts of Florence Nightingale On Nursing School
 School of Nursing should be self-supporting not subject to the wimps 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 Germ Theory of Bacteriology.
 Opposed central registry of nurses
 Wrote Notes on Nursing, “What it is and what it is not.”
 Wrote notes on hospitals
 Other Schools of Nursing
 Bellevue Training School for Nurses – New York City
 Alexian Brothers Hospital School of Nursing in US exclusively for men. It opened in 1348 and it
closed down in 1969.
 LINDA RICHARDS – the first graduate nurse in US. Graduated in September 1, 1873.
 2 NURSING ASSOCIATION / ORGANIZATIONS THAT UPGRADED NURSING PRACTICE IN US:
 American Nurses Association
 National League for Nursing Education

CONTEMPORARY PERIOD
 World War II – present
 This refers to the period after World War I and the changes and development in the trends and practice
of Nursing occurring since 1945 after World War II.
 Includes scientific and technological development, social changes occurring after the war.
 Nursing is 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 standard, 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
 Technology advances such as development of disposable equipment and supplies that relieved
the tedious task of Nurses.
 Development of the expanded role of Nurses

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:
 Believed in Gods of healing
 Word doctors – priest physicians
 Herbolarios – herb doctors
 EARLY CARE OF THE SICK
 HERBICHEROS – herbmen who practice magic
 MANGKUKULAM / MANGANGAWAY – a person suffering from disease without any identified
cause and are believed to be bewitched by such
 Difficult birth is caused by witches
 Explosion of gunpowder 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
 To give service to the king’s Spaniard soldiers
 San Lazaro Hospital – 1578
 Named after the Knights of St. Lazarus
 Hospital for the lepers
 Hospital de Indios – 1586
 Hospital for the poor Filipino people
 Hospital de Aguas Santas – 1590
 Named after its location (near spring) because people believed that spring has a healing
power.
 San Juan de Dios Hospital – 1596
 For poor people
 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
 Melchora Aquino
  Took care of the wounded Katipuneros
 Anastacia Giron Tupaz
 Founder of Filipino Nurses Association – established on October 15, 1922
 1st Filipino chief nurse of PGH
 1st Filipino Superintendent of Nurses in the Philippines
 Francisco Delgado
 1st president of Filipino Nurses Association
 PERSONAGES:
 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
 Rosa Militar
 Pioneer in nursing education
 Socorro Diaz
 1st editor of PNA magazine called, “The Message”
 Conchita Ruiz
 Full time editor of the PNA newly named magazine, “The Filipino Nurse

EARLY NURSING SCHOOLS

 ILOILO MISSION HOSPITAL AND SCHOOL OF NURSING
 Established in 1906 under the supervision of Rose Nicolet (American)
 Nursing course – 3yrs.
 Produced 1st batch of Nursing graduates in 1909 – 22 nurses
 1st TRAINED NURSES:
 Nicasia Cada
 Felipa Dela Pena
 Dorotea Caldito
 April 1944 – 1st Nursing Board Exam at Iloilo Mission Hospital
 PGH School of Nursing – 1907
 St. Paul School of Nursing – 1907
 St. Luke’s School of Nursing – 1907
 UST – 1946
 Fatima – 1947
References Textbook:
Berman, A., Snyder, S. J., Kozier, B., Erb, G., Levett-Jones, T., Dwyer, T., ... & Park, T. (2016).
Kozier and Erb's fundamentals of nursing (Vol. 1). Pearson Australia.

Butcher, H. K., Bulechek, G. M., Dochterman, J. M. M., & Wagner, C. Nursing

Interventions classifications (NIC). (7th Edition) Elsevier Inc., 2018

Grace, Pamela J., Nursing Ethics and Professional Responsibility in Advance

Practice (3rd Edition) Jones & Bartlett Learning., 2018

Gulanick, Meg, Myers, Judith., Nursing Care Plans: Diagnoses, Interventions and
Outcomes (9th Edition) Elsevier Inc., 2017

Moorhead, Sue, et al, editors., Nursing outcomesClassification (NOC):

Measurement of Health Outcomes (6th Edition) Elsevier Inc.., 2018

Potter, P. A., Perry, A. G. E., Hall, A. E., & Stockert, P. A. (2016). Fundamentals of nursing.
Elsevier Mosby.

Activity Sheets: Self-made

Online references:
https://en.wikipedia.org/wiki/Nursing#:~:text=Nursing%20is%20a%20profession
%20within,health%20and%20quality%20of%20life.&text=Nurses%20provide%20care
%20both%20interdependently,and%20independently%20as%20nursing%20professionals.
Retrieved February 8, 2021

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t#id=3&iurl=http%3A%2F%2Fwww.angelfire.com%2Fns%2Fninquiry%2Fimages
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February 8, 2021