History of Nursing
dead
I. Intuitive Nursing (Medieval Period)
o Period of Intuitive Nursing
o “Intuition”
o The ability to understand something
immediately, without the need for conscious
reasoning
o Nursing was “untaught” and instinctive
o Women’s Role: To take care of their child, the
sick, and aged
o Illness: caused by evil spirit through black magic
and voodoo
o Shaman or medicine man uses white magic,
hypnosis, herbs and charms. He also practiced…
o Trephining – drilling a hole in the skull with
stone without anesthesia as a last resort to
drive away evil spirits
o Nursing was a function that belongs to women
Contributions
o Code of Hammurabi in Babylonia
 1st recording on the medical practice
established the medical fee
 Discouraged experimentation
 Specific doctor for each disease
 Right of patent to choose treatment
between the use charms, medicine, or
surgical procedure
o Art of Embalming in Egypt, recorded 250
recognized disease
 Mummification, removing the internal
organs of the dead body, installation of
herbs and salt to the dead
 Used to enhance their knowledge of the
human anatomy
 Documentation about 250 diseases and
treatments
 Slaves and patients nurse the sick
o Moses is the father of Sanitation
 Teachings of Moses
 He wrote 5 books in the Old Testament and
emphasized the practice of hospitality and
charity
 Established: Laws of Control of Spread of
Communicable Disease and the Ritual of
Circumcision of Male Child
 Nurse referred as midwives, wet nurse,
child’s nurse
o Materia Medica in China (pharmacology)
 Book that indicates the pharmacologic drug
used for treatment
 No knowledge on anatomy
 Use of wax to preserve the body of the
 Use of pharmacologic drugs
o Sushurutu made a list of functions and
qualification of Nurses
 1st recording on the nursing practice
 Hampered by taboos due to social
structures and practices of animal worship
 Medicine men built hospitals
 They use intuitive form of asepsis (absence
of microorganisms)
 There was proficient practice of medicine
and surgery
o Caduceus the insignia of medical profession by
Greeks
 Hipprocrates
- the father of scientific/modern
medicine
- redefined the concept of medicine
- was the 1st to reject the idea that
diseases are caused by evil spirits and to
apply assessment
- practiced medical ethics
II. Apprentice Period (Middle Ages)
o Period of Apprentice
o Nursing care delivered by religious order
o Kaiserworth Institute for the training of
Deacones (Training School for Nurses)
o Crusades – Knight of Lazarus “lepers”
o Secular Orders
o Care was done by crusaders prisoners, religious
orders
o Fabiola – A wealthy matron of the Roman
Empire converted to Christianity and used
wealth to provide houses of care and healing
o The Crusaders - Knights of Saint John of
Jerusalem (knights Hospitalizers)
o Teutonic Knights – Knights of Saint Lazarus
(cared for people with Leprosy, Syphilis, and
skin conditions)
o No formal education for nurses
o Attitudes towards nurses are reflected thru the
writings of Charles Dickens through his
character SAIRY GAMP
 She cared for the sick by neglecting them,
stealing from them and physically abusing
them
o Nursing went down to the lowest level
o Nursing became the work of the least desirable
of women
 o Wrath of Protestantism confiscated properties
of hospitals and schools connected with
Catholic Church
o Pastor Theodore Fliedner and his wife Federika
established the first training school for nurses in
Kaiserwerth Germany
o Kaiserwerth Institute of Deaconesses (where
Nightingale received her 3-month course in
Nursing)
Contributions
o St. Clare – took vows of poverty, obedience,
service, gave nursing care to the sick and
wounded
o St. Elizabeth of Hungary – “patroness of nurses”
o St. Catherine of Sienna – the first “Lady with a
Lamp”, 25th child, a nurse, researcher, and
reformer of society and church
o 16th century – hospitals were established
o St. Vincent De Paul – organized the “le Charite”
and “sisters for Charity” group
o Pastor Theodore Fliedner and his wife Federika
Munster Fleidner established the Institute for
the Kaiserwerth, Germany which is the first
organized training school for nurses
III. Period of Educated Nursing (Nightingale Era
19th- 20th Century)
o Development of Nursing is greatly influenced
by:
 The aftermath of Crimean War and Civil
War
 Arousal of Social Consciousness
 Increased educational opportunities for
women
o Establishment of first nursing school
 St. Thomas Hospital in London – school of
Nursing by Florence Nightingale
o Linda Richards – First graduate nurse in the US
o Dr. William Halstead – designed the first rubber
gloves
o Establishment of nursing organizations like ANA
o Published books:
o 1860 – Nightingale Training School for Nurses
(St. Thomas Hospital)
 Served as model for other training schools
 Nightingale system was more on developing
profession within the hospital
 Curriculum includes theory and practice
 1st school of Nursing to provide theory-
based knowledge and clinical skill building
 Nursing evolved as an art and science
Who is Florence Nightingale?
o “Nursing is an art: and if it is to be made an art,
It requires an exclusive devotion as hard a
preparation as any painter’s or sculptor’s work;
for what is the having to do with dead canvas or
dead marble, compared with having to do with
the living body, the temple of God’s spirit? It is
one of the Fine Arts: I had almost said, the
finest of Fine Arts.”
o Born May 12, 1820
o Coincides with International Nurses Day
o Was born to a wealthy and intelligent family
o She believed she was “called by God to help
others… and to improve the well-being of
mankind”
o “Lady with the Lamp”
o Improved the standards for the care of war
casualties in Crimea
o “Angel of Crimea”
o Nursing’s first scientist-theorist
o “Notes on Nursing: What it is, and what is not?”
o Definition on Nursing: “act of utilizing the
environment of the patient to assist him in his
recovery”
IV. Contemporary Nursing (20th Century)
o Period of Contemporary Nursing
o World War 2 to present
o Establishment of WHO and UN
o Constantly assuming the responsibilities of
taking care of the patients which were formerly
the sole responsibility of the physician
o Use of computers, and high technology in
providing care
o Col. Pearl Tucker developed a comprehensive
one-year course to prepare aerospace nurses
o Licensure of Nurses started
o Training of nurses in diploma program
o Development of Baccalaureate and Advanced
Degree Program
o Virginia Henderson – one of the first modern
nurse to define nursing
 “The unique function of the nurse is to
assist the individual, sick or well, in the
performance of those activities contributing
to health or its recovery (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 independence as rapidly as
possible.” (Henderson, 1966)
o Scientific and technical advancement:
 Health is perceived as a human right
 Community involvement of nurses
  Disposable supplies and equipment’s
 Expanded roles of nurses
 Who was established by United Nations
 Use of computer and sophisticated
machines on hospitals
History of Nursing in the Philippines
A. Early Beliefs and Practices
o Cause by enemy or evil spirits
B. Early Care of the Sick
o Herbicheros “one who practice witchcraft”
o Mabuting hilot (good midwife) attends
childbirth
C. Spanish Regime
o Earliest Hospitals established
 Hospital Real de Manila (1577)
- It was established mainly to care for the
Spanish king’s soldiers, but also
admitted Spanish civilians
- Founded by Gov. Francisco De Sande
 San Lazaro Hospital (1578)
- Founded by Brother Juan Clemente and
was administered for many years by the
hospitalizers of San Juan de Dios
- Built exclusively for patients with
Leprosy
 Hospital de Indio (1586)
 Hospital de Aguas Santas (1590)
 San Juan de Dios Hospital (1596)
- Founded by the Brotherhood of
Misericordia and administered by the
Hospitaliers of San Juan De Dios
- Support was delivered from ALMS and
Rents
- Rendered general health service to the
public
o Healthcare During Spanish Regime
 Babaylan (Priest Physician) and
Albularyo (Herb Doctor) care for sick
individuals
 1578 – Male nurses were acknowledged
by Spanish friars (practicante/Enfermo)
 Religious orders exerted their efforts to
care for the sick by building hospitals in
different parts of the Philippines
Prominent Persons During Revolution
o Josephine Bracken – wife of Jose Rizal, installed
field hospital in Tejeros
o Rosa Sevilla De Alvero – converted their house
into quarters for the Filipino soldiers during the
PH-USA was (1899)
o Dona Hilaria de Aguinaldo – organized the
Filipino Red Cross under the inspiration of
Apolinario Mabini
o Dona Maria de Aguinaldo – President of the
Filipino Red Cross branch in Batangas
o Melchora Aquino (Tandang Sora) – nurse the
wounded Filipino soldiers and gave them
shelter and food
o Captain Salome – provided nursing to the
wounded when not in combat
o Agueda Kahabagan – provided nursing services
to her troop
o Trinidad Tecson – “Ina ng Biac na Bato” stayed
in the hospital at Biac na Bato to care for the
wounded soldier
Hospital and Nursing Schools
o Hospital School of Nursing’s Formal Training
(1901 – 1911)
A. Iloilo Mission Hospital School of Nursing (1906)
o Ms. Rose Nicolet of New England Hospital in
Boston was the 1st superintendent
o Ms. Flora Ernst took charge of the school in
1942
B. St. Paul’s Hospital School of Nursing (1907)
o Established by the Archbishop of Manila,
the most Reverend Jeremiah Harty under
the supervision of Sisters of St. Paul de
Chartres
C. Philippine General Hospital School of Nursing
(Manila, 1907)
o With the support of Governor Gen. Forbes
and the Director of Health opened classes in
Nursing
o Anastasia Giron-Tupas was the first Filipino
to occupy Chief Nurse position and
Superintendent in the Philippines
o Opened nursing classes with admission
based on entrance examination
o Applicant must have completed elementary
education to the seventh grade
D. St. Luke’s Hospital School of Nursing (Quezon
City, 1907)
o An Episcopalian Institution, began as small
dispensary in 1903.
o In 1907, the school opened with 3 Filipino
girls admitted
o These 3 girls had their first year in
combined classes with the PGH School of
Nursing and St. Paul’s Hospital School of
Nursing
 o Mrs. Vitaliana Beltran was the first Filipino
superintendent of nurses
E. Mary Johnston Hospital and School of Nursing
(Manila, 1907)
o Started as a small dispensary in Cervantes
(now Avenida)
o It was called Bethany Dispensary and was
founded by Methodist Mission
F. Philippine Christian Mission Institute School of
Nursing
G. Sallie Long Read Memorial Hospital School of
Nursing (1903, Laoag Ilocos Norte)
H. Mary Chiles Hospital School of Nursing (1911)
I. Frank Dunn Memorial Hospital (1912)
J. San Juan de Dios Hospital School of Nursing
(1913)
K. Emmanuel Hospital School of Nursing (Capiz,
1913)
L. Southern Island Hospital School of Nursing
(Cebu, 1918)
o Established under the Bureau of Health with
Anastacia Giron-Tupas as the organizer
First Colleges of Nursing in the Philippines
A. University of Sto. Tomas College of Nursing
(1946)
B. Manila Central University College of Nursing
(1948)
C. University of the Philippines College of Nursing
(1948)
o Ms. Julita Sotejo was its first Dean
Prominent Nursing Leaders in the Philippines
o Cesaria Tan – first Filipino nurse who had
Masters Degree in Nursing in the US
o Socoro Siliran – reformed social service for
indigenous patients at San Lazaro
o Magdalena Valenzuela – first Filipino Industrial
Nurse
o Annie Sand – founded the National League of
Philippine Government Nurses
o Cornel Elvegia Mendoza – first female Military
Nurse
o Loreto Tupaz
 known as the Dean of Philippine Nursing
Education
 Florence Nightingale of Iloilo
o Socorro Diaz – first editor of “The Message” first
journal of PNA, previously known as Filipino
Nurses Association
o Conchita Ruiz – first editor of “The Filipino
Nurses” the second journal of PNA
o Dr. Julita Sotejo
 Considered as “Florence Nightingale of the
Philippines
 Author of Code of Ethics for Nurses (PRC
BON Res. #633, 1982)
 Chairman, Committee on Legal Aspects of
Nursing which created the first Philippine
Nursing Law as Republic Act. No. 877 S.
1953)
o Anastacia Giron-Tupas
 First Filipino Nurse with a title Nursing
Superintendent Chief Nurse at the PGH
 Founder of Filipino Nurses Association
(FNA)
o Rosario Montemayor Delgado
 Frist President of FNA
 Graduate of PPGH School of Nursing in 1912
Timeline
o 1909
 3 females graduated as “Qualified Medical-
Surgical Nurses”
o 1919
 The 1st Nurses Law (Act #2808) was enacted
regulating the practice of the nursing
profession in the Philippines islands. It also
provided the holding of exam for the
practice of nursing on the 2nd Monday of
June and December of each year
o 1920
 1st board examination for nurses was
conducted by the Board of Examiners, 93
candidates took the exam, 68 passed with
the highest rating of 93.5% - Anna Dahlgren
 Theoretical exam was held at the UP
Amphitheater of the college of Medicine
and Surgery. Practical exam at the PGH
Library
o 1921
 Philippine Nurses Association Building
 Filipino Nurses Association was established
(now PNA) as the National Organization of
Filipino Nurses
 PNA: 1st President – Rosario Delgado
 Founder – Anastacia Giron-Tupas
Scopes of Nursing
o Consumer – individual, group of people, or
community that uses a service or commodity
o Patient – person who is waiting for or
undergoing medical treatment and care
o Client – person who engages the advice or
services of another who is qualified to provide
this service
 o Promoting health and wellness
o Preventing illness
o Restoring health
o Care of the dying
Roles and Functions of the Nurse
o Caregiver
 Activities that assist the client physically and
psychologically while preserving the client’s
dignity
o Communicator
 Nurses communicate patient’s identified
problems to other members of health care
team
o Teacher
 Nurse helps clients about their health and
health care procedures they need to
perform to restore or maintain health
o Client Advocate
 Acts to protect the client
 Nurse may represent the client’s needs and
wishes to other health professionals
o Change Agent
 Assisting clients to make modifications in
their behavior
o Counselor
 Process of helping the client:
- recognize and cope with stressful
psychologic or social problems
- to develop improved interpersonal
relationships
- to promote personal growth
o Leader
 Influences others to work together to
accomplish a specific goal
o Manager
 Delegates nursing activities to ancillary
workers and other nurses, and supervises
and evaluates their performance
o Case Manager
 works with multidisciplinary healthcare
team to measure the effectiveness of the
case management plan and monitor
outcomes
o Nurse Entrepreneur
History of Nursing Theory
o Mid-1800’s
 recognized the unique focus of nursing and
declared nursing knowledge as distinct from
medical knowledge
o 1950s
 led the awareness of the need to develop
nursing theory
o Nursing practice was based on principles and
traditions
o Professional Nursing began with Florence
Nightingale
o Nightingales establishment of Nursing School in
ST. Thomas Hospital marked the birth of
Modern Nursing
o Development of Nursing as a profession
o Research and theory era produced Nursing
Science
o Pervading Question each Era:
 “What is the nature of the knowledge that
is needed for the practice of nursing?”
o Florence Nightingale
 Nursing knowledge is distinct from medical
knowledge
 Nurse’s function: putting the patient in the
best condition for nature (God) to act upon
him or her
 Care of the sick is based on knowledge of
persons and their surroundings – different
knowledge than what physician used

Expanded Career Roles

o Nurse Practitioner
o Clinical Nurse Specialist
o Nurse Anaesthetist
o Nurse Midwife
o Nurse Researcher
o Nurse Administrator
o Nurse Educator
 Historical Eras of Nursing Search for Specialized Knowledge
Major Questions Emphasis Outcomes Emerging Goal
Curriculum Era What content should Courses included in Standardized curriculum Develop specialized
(1900 – 1940s) nurses study to learn nursing program for diploma programs knowledge and higher
how to be a nurse? education
(curriculum content)
Research Era What is the focus for Role of nurses and Problem studies and Isolated studies do not
(1950 – 1970s) nursing research? what to research studies of nurses yield unified
knowledge
Graduate What knowledge is Carving out an Nurses have an important Focus graduate
Education (1950 – needed for the practice advanced role and role in health care education on
1970s) of nursing? basis for nursing knowledge
practice development
Theory Era (1980 How do these There are any ways Nursing theoretical works Theories guide nursing
– 1990s) frameworks guide to think about shift the focus of the research and practice
research and practice? nursing patient
Theory Utilization What new theories are Nursing theory Middle-range theory may Nursing framework
Era (Twenty-First needed to produce guides research, be from quantitative or produce knowledge
Century) evidence of quality practice, qualitative approaches (evidence) for quality
care? education, and care
administration

What is Theory? o The continued recognition of nursing theory as

o A systematic explanation of an event in which
constructs and concepts are identified and
relationships are proposed and predictions are
made
o A creative and rigorous structuring of ideas that
project a tentative, purposeful and systematic
view of phenomena
o A set of interpretative assumptions, principles
or propositions that help explain or guide action
Significance of Nursing Theory to Discipline
o Discipline
 Is specific to academia
 Refers to a branch of education, a
department of learning or a domain of
knowledge
o Discipline and profession is inextricably linked
o The discipline is dependent upon theory for its
continued existence
o Nursing as an academic discipline depends on
the existence of nursing knowledge
Significance of Nursing Theory to Profession
o Profession
 Refers to specialized field of practice,
founded upon the theoretical structure of
the science or the knowledge of the
discipline and accompanying practice
abilities
o The application of nursing knowledge in
practice is a criterion that is currently at the
forefront
a tool for the reasoning, critical thinking and
decision making required for the quality nursing
practice is important
Criteria for the Development of the Professional Status
of Nursing
o Functions autonomously in the formation of
professional policy and control of professional
activity
o Attracts individuals with intellectual and
personal qualities of exalting service above
personal gain
o Strives to compensate its practitioners by
providing freedom of action, continuous
professional growth and economic security
History and Philosophy of Science
o Wy should nurses be interested in the history
and philosophy of science?
o Nursing science provides us with knowledge to
describe, explain and predict outcomes
o It means that nurses can conduct clinical and
basic nursing research to establish the scientific
base for the care if individual across the life
span
o Philosophical foundation of science is
Rationalism and Empiricism
Philosophical Foundation of Science
o Rationalism
 Emphasizes the importance of a prior
reasoning as the appropriate method for
advancing knowledge
  A prior reasoning utilizes deductive logic o Universal (by experience)
o Empiricism o Ex: age, weight
 Is based on the idea that scientific 2. Associative Concepts
knowledge can be derived only from o Needs another concept for it to be
sensory experience identified
 Utilizes inductive knowledge o Exist only in some conditions
Early Twentieth Century Views of Science and Theory o Should be a prevalent factor for you to
o Philosopher = understanding of existing experience something
theories o Ex: income, social status, presence of
o Scientists = understanding what there is still to disease, anxiety
be observed 3. Relational Concepts
o Major Developments o Can be understood only through the
 Use of experimentation emerged combination or interaction of two or more
 Positivism which encloses the use of both o Ex: motherhood, marriage
logical and empiricism 4. Statistical Concepts
Emergent Views of Science and Theory in the Late 20th o Has something to do with numerical values
Century o Relate the property of one thing in term of
o New philosophy emphasized science as a its distribution in population
process of continuing research rather than a o Ex: average BMI, average birth rates in a
product focused on findings region
o Evolution of nursing science was further studied 5. Summative Concepts
and tested o You had already collected and summarized
o The role of nurses became more defined everything
depending on the different fields of expertise o Represent an entire complex entity of a
o Nurses now have a vital role in the maintenance phenomena
of health and survival of the sick and dying in o Ex: nursing, health
collaboration with other healthcare Concepts can be formulated
professionals o A word
Structure of Nursing Knowledge  Ex: grief, empathy, pain
1. Metaparadigm (Person, Health, Environment, o Two words
Nursing)  Ex: patient satisfaction, caring nurse,
2. Philosophy excellent performance
3. Conceptual Models o A phrase
4. Theory  Ex: mother-child bonding, health promoting
practice, core competency standards
Concepts Concepts can be categorized
o Topics, ideas, thoughts 1. Variable
o Symbolic statements describing a phenomena o Continuous concepts
o Phenomena – something to do with events, o Concepts that describe phenomena
facts, experiences, thoughts, what you felt or according to some dimension, classification
witnessed of a phenomena
o Can be formulated by words o Ex: Blood pressure, pain, quality of life,
o Can be communicated or described sexuality
Types of Concepts 2. Non-Variable
1. Abstract o Direct
o Intangible o Concepts that identify categories or class of
o Ex: love, hope, desire phenomena
2. Concrete o Answerable by yes/no
o Tangible o Ex: gender
o Ex: temperature, weight Sources of Concepts
Concepts were expanded by Dublin (1978) 1. Naturalistic Concepts
1. Enumerative Concepts o True evets, facts
o Always present o Observed, seen, experienced
 o Ex: body weight, expression
2. Research-based Concepts
o Qualitative, quantitative, mixed approach
o Ex: arguments that have been discontinued
Concepts of Nursing
o Is nursing an occupation or a profession?
o It can be both, but not an occupation alone
o All professions are occupations, but not all
occupations are professions
Characteristics of a Profession
1. Has autonomy
o Self-determination
o Autonomous as a profession – regulate
occupations and professions
2. Registration
o You have to be given the power to practice
your profession
o Under the PRC – Professional Regulatory
Commission
3. Power with autonomy over teaching and
occupation
o Ex: Board of Nursing
4. Code of Ethics
o Guiding principles on how to provide and
deliver care to the patient
o Responsibility to the patient, your
colleagues, or a person
Ethicomoral and Legal Foundation of Client Education
Ethical
o Refers to norms and standards of behavior
accepted by the society to which a person
belongs
Moral Values
o Refers to an internal belief system
o What one believes is right
Ethical Dilemmas
o Specific type of moral conflict in which two or
more principles apply but support mutually
inconsistent courses of action
A. Legal Rights and Duties
o Refers to rule governing behavior or
conduct that are enforceable by law under
threat of punishment
o Ex: fine, imprisonment, or both
o Ethics: right or wrong
B. Practice Arts
o Documents that:
 define a profession
 describe that profession’s scope of
practice
 provide guidelines for:
- state professional boards of nursing
regarding standards for practice
- entry to a professional via licensure
- disciplinary actions that can be taken
when necessary
o Developed to protect the public from
unqualified practitioners and to protect the
professional title
Code of Ethics
o Represents an articulation of nine provisions for
professional values and moral obligations with
respect to the nurse-patient relationship and
with respect of the profession and its mission
1. Honor the human dignity of all patient’s and
coworkers
2. Establish appropriate nurse-patient boundaries,
and focus on interdisciplinary collaboration
3. The nurse-patient relationship is grounded in
privacy and confidentiality
4. The nurse is accountable for personal actions
and the behaviors of those persons to whom
the nurse has delegated responsibilities
5. The nurse is responsible in maintaining
competence, preserving integrity and safety,
and continuing personal growth
6. The nurse has the responsibility to deliver high
quality care to patients
7. The nurse contributes to the advancement of
the profession
8. The nurse participates in global effort for both
health promotion and disease prevention
9. Involvement in professional nursing
organization supports the development of
professional policy
Principles to Patient Education
A. Autonomy
o Right of self-determination
o Greek “auto” – self; “nomos” – law
o Freedom autonomy, liberty, sovereignty,
self-government, independence, self-rule,
self-determination, self-sufficiency, home
rule,
o Patients right to make choices
independently
o Every individual receiving health care be
informed in writing of the right under state
law to make decisions about his or her
health care including right to refuse medical
and surgical care and right to initiate
advance directives.
B. Veracity
o Latin “Vera” – truth, “veracity” –
truthfulness
 o Truth telling
o Nurses are always confronted with issues of
truth telling
o Regardless of the situation, the nurse must
always tell the truth and the patient is
always entitled to the truth
o Opposite of the truth: dishonesty, deceit,
falsity, lying, mendacity, falsehood,
inaccuracy, inexactness
C. Confidentiality
o Personal information that is entrusted and
protected as privileged information via
social contact, healthcare standard or code
of legal covenant
o Healthcare provider may not disclose
information without consent of the patient
o If sensitive information were no protected,
the patient will loose trust to their providers
and would be reluctant to openly share
problems or even seek medical care at all.
Circumstances breaching confidentiality is legally
permitted
a. When the patient has been the victim or subject
of a crime to which the nurse or the doctor is
the witness
b. When the nurse or the other health
professional suspects or are aware of child or
elder abuse, narcotic use, legally reportable
communicable disease, gunshot or knife wound,
or threat of violence towards someone
Breach of Confidentiality
o Ex: If the patient test positive for HIV/AIDS and
has no intention of telling his spouse about the
diagnosis, the physician has an obligation to
warn the spouse directly or indirectly
Nonmaleficence
o “do no harm”
o Ethics of legal determination involving
negligence and/or malpractice
o Negligence
 Conducts which fall below the standard
established by the law for protection of
others against unreasonable risk of harm
 Involves conduct of professionals that falls
below a professional standard of due care
o Malpractice
 A limited class of negligent activities
committed within the scope of performance
by those pursuing a particular profession
involving highly skilled and technical
services
Beneficence
o An ethical principle that addresses the idea that
a nurse’s actions should promote good
o “doing good”
o Properly carrying out critical tasks and duties
contained in job description; in policies,
procedures, and protocols set forth by health
care facility
Justice
o Fairness and the equitable distribution of goods
and services
o The focus of the law is the protection of the
consumer
Health Education
Role of the Nurse as an:
1. Educator
o Teaching is an essential responsibility of all
registered nurses in caring for both well and ill
clients
o That is why nurses must have a solid foundation
in the principle of teaching and learning
o Audience:
 Patients
 Family members
 Nursing students
 Nursing staff
 Other agency personnel
o The role of the educator is not primarily to
teach but to promote learning and to provide
for an environment conductive to learning
which is to create the teachable moment than
just waiting for it to happen
2. Facilitator of Learning
o The nurse should act as a facilitator by creating
environment conductive to learning that
motivates individuals to want to learn and
makes it possible for them to learn
o How?
 Assessment of learning needs
 Designing of teaching plan
 Implementation of instructional methods
and materials
 Evaluation of teaching and learning
3. Coordinator of Teaching
o The nurse coordinates with the other members
of the team and the family involving with clients
condition about then important topics to teach
to the client
4. Advocate for the Client
o According to Gilroth, 1990: Physicians are first
and foremost prepared “to treat, not to teach”
o Nurses are in ideal position to clarify confusing
information and make sense out of nonsense
 o As an advocate, nurses protects or client’s
human and legal rights if the need arises. We
act on behalf of the client to secure our
patient’s health care right.
In clients education,
o We provide additional information to help the
client to decide whether or not to accept the
treatment
o We provide interpreter to help family members
to communicate their concerns
Role of Family in Patient Education
o Family caregivers provide critical emotional,
physical and social support to the patient
o Including the family members in teaching
learning process helps to ensure the teaching
scenario as win-win situation for the nurse and
the client
o The family can be the educator’s ally in
preparing the client for discharge and become
self independent.

Nursing as an Art and Science

A. As an Art
o Is the art of caring for the sick and well
individual
o Refers to the dynamic skills and methods in
assisting sick and well individual in their
recovery and in the promotion and
maintenance of health
o Is the way of nursing knowledge is
expressed
o Is the heart of nursing
o Involves feeling gained by experience
o Sensitivity and empathy are an important
facet of this definition
o Enable the nurse to be aware of the client’s
perspective and be attentive to verbal and
non-verbal cues to the client’s physiologic
state.
B. As a Science
o Is the scientific knowledge and skills in
assisting individual to achieve optima health
o Is the diagnosis and treatment of human
responses to actual or potential problem
o Cognitive brain of nursing
o Includes knowledge from nursing research
o Facts and information necessary for
performing technical skills
o Interpersonal relationships and
communication is a part
o Sociocultural and developmental factors
affect the client’s behavior