HISTORY OF NURSING IN THE WORLD

FOUR (4) PERIODS OF NURSING IN THE WORLD

1. PERIOD OF INTUITIVE NURSING

 Time: Pre-historic time to early Christian era

 Nursing was not taught . It is a product of instinct (intuitive)
Done out of love
Belief in “shaman” and magic.

2. PERIOD OF APPRENTICE NURSING

 Time: 11 t h century to 1836

 Nursing was taught informally (no school) by more experienced nurses.
o Theodore Fliedner – changed his home into a hospital.
 Apprentice

3. THE DARK PERIOD OF NURSING

 Time: 17 t h (Reformation until the US Civil War)

 Nursing became the work of the least desirable women.
o took bribes from patients
o stole food
 DARK PERIOD
4. PERIOD OF EDUCATED NURSING.

 Time: 1860
 Nursing was taught formally in school especially to women.

Example: FLORENCE NIGHTINGALE

o Strong willed and intelligent
o Florence Nightingale School of Nursing opened at St. Thomas
Hospital in London.

HISTORY OF NURSING IN THE PHILIPPINES

The Start of Nursing Practice (1911- 1921)

 First True Nursing Law was enacted through Act 2808.

 The first nursing board examination was given on 1920.
 The first executive officer of the Board Examiners for Nurses is a physician.

Early Beliefs, Practices and Care of the sick

 Early Filipinos subscribed to superstitious belief and practices in relation to health and
sickness
 Diseases, their causes and treatment were associated with mysticism and superstitions.
 Cause of disease was caused by another person (an enemy of witch) or evil spirits.
 Persons suffering from diseases without any identified cause were believed bewitched by
“mangkukulam.”
 Evil spirits could be driven away by persons with powers to expel demons.
 Belief in special Gods of healing: priest-physician (called “word doctors”).
 If they use leaves or roots they were called herb doctors (“herbolarios”).

Early Hospitals during the Spanish Regime

 Religious orders exerted efforts to care for the sick by building hospitals in different
parts of the Philippines.
 Hospital Real de Manila San Juan de Dios Hospital
 San Lazaro Hospital Hospital de Aguas Santas
 Hospital de Indios

Prominent Personages involved during the Philippine Revolution

1.Josephine Bracken – wife of Jose Rizal installed a field hospital in an estate in

Tejeros that provided nursing care to the wounded night
and day.
2.Rose Sevilla de Alvaro – converted their house into quarters for Filipino soldiers
during the Phil-American War in 1899.

3. Hilaria de Aguinaldo –wife of Emlio Aginaldo organized the Filipino Red Cross.

4.Melchora Aquino – (Tandang Sora) nursed the wounded Filipino soldiers, gave
them shelter and food.

5.Captain Salomen – a revolutionary leader in Nueva Ecija provided nursing

care to the wounded when not in combat.

6.Agueda Kahabagan – revolutionary leader in Laguna also provided nursing

services to her troops.
7. Trinidad Tecson (Ina ng Biak na Bato) – stayed in the hospital at Biac na Bato
to care for the wounded soldiers.
School of Nursing

 1900: St. Paul’s Hospital School of Nursing, Intramuros Manila.

 1906: Iloilo Mission Hospital Training School of Nursing.
 1907: St. Luke’s Hospital School of Nursing; opened after four years as a
dispensary clinic.
 1907: Mary Johnston Hospital School of Nursing.
 1909 – Distinction of graduating the 1st trained nurses in the Philippines
with no standard requirements for admission of applicants
except their “willingness to work.”
 1910: Philippines General Hospital school of Nursing.
 April 1946 – a board exam was held outside of Manila. It was held in
Iloilo Mission Hospital thru the request of Ms. Loreto Tupas,
principal of the school.

College of Nursing

1. 1877: UST College of Nursing – 1st College of Nursing in the Philippines.

2. June 1947: MCU College of Nursing – 1st college who offered BSN 4- year
program.
3. June 1948: UP College of Nursing
4. June 1955: FEU Institute of Nursing.
5. October 1958: UE College of Nursing.

1909

 3 female graduated as “qualified medical-surgical nurses.”

1919

 The 1st Nurses Law (Act#2808) was enacted regulating the practice of the nursing
profession in the Philippines. It also provided the holding of exam for the practice of
nursing on the 2nd Monday of June and December of each year.

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.

1921

 Filipino Nurses Association was established (now PNA) as the National Organization of
Filipino nurses.
 PNA: 1st President – Rosario Delgado
 Founder – Anastacia Giron-Tupas

1953

 Republic Act 877, known as the “Nursing Practice Law” was approved.

NURSING LEADERS
Florence Nightingale (1820-1910)
Considered the founder of modern nursing, Florence Nightingale (1820-1910) was influential in
developing nursing education, practice and administration. Her publication Her publication,
Notes on Nursing: What It Is, and What Is Not, first published in England in 1859 and in the
United States in 1860, was intended for all women.
Clara Barton (1821-1912)

She 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.

Mary Mahoney (1845-1926)

 Was the first African-American 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 the founder
of public health nursing.

Lavinia L. Dock

Participated in protest movements for women’s rights that resulted in

the constitutional amendment in 1920 that allowed women to vote.

Margaret Sanger (1879-1966)

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-entered primary health care to rural populations.
MEN IN NURSING

Luther Christman (1915-2011)

One of the founders of American Assembly for Men in

Nursing (AAMN). Graduated from Pennsylvania Hospital
School Nursing for Men in 1939. Experienced
discrimination while in nursing school. He was not allowed
a maternity clinical experience.

After his doctorate, as university dean.

First man nominated for president of the ANA.
First man elected to the American Academy of Nursing (he was named a “Living
Legend” by this organization)
First man inducted into ANA’s Hall of Fame for his extraordinary contributions to nursing.

NURSING THEORIES & CONCEPTUAL FRAMEWORKS

Definition of THEORY:

 Theory is an organized system of ideas presumed to describe, explain, predict and control
a given phenomenon.

Organized Knowledge

COMPONENTS OF A THEORY

1. CONCEPT – the building blocks of theories.

A mental image of a thing.
Example:
HOW THE ICE MELTS
2. DEFINITION - descriptions which convey a general meaning.

DEFINITION FROM BOOKS

– CONCEPTUAL DEFINITION (Books)

DEFINITION FROM A PERSON AS USED IN HER STUDY

– OPERATIONAL DEFINITION (STUDY)

Example: Florence Nightingale’s Definition of Nursing:

“Nursing is the act of using the environment of the patient to assist him in
his recovery.”

3. ASSUMPTION
o A statement of a research paper that specifies the connection of
factual concepts

o A person holds as TRUE based from OBSERVATION

(not proven by research)
Example: All patients are bad.

4. PROPOSITION (a judgement or opinion)

o Also called THEORETICAL STATEMENTS (proven by research)

o Explains the RELATIONSHIPS OF DIFFERENT CONCEPTS
Example:
FEAR OF INJECTIONS LESSER DAYS OF STAY IN HOSPITAL
(Concept #1) (Concept #2)

NO FEAR OF INJECTIONS LONGER DAYS OF STAY IN HOSPITAL

(Concept #1) (Concept #2)
PURPOSES OF NURSING THEORY

PURPOSE PICTURE DESCRIPTION

1. In EDUCATION Develops and guides nursing education,
and to improve the status of the
profession.

2. In RESEARCH Provides answers to questions encountered

in practice.

Guide data analysis and interpretation in a

given phenomenon.

3. In CLINICAL Serves as guide for what nurses do to

PRACTICE respect the different values and beliefs of
diverse people.

Example: How nurses could use Orem’s

self-care deficit theory to work with
children with special health care needs.

TYPES OF NURSING THEORIES:

NAME TITLE OF THEORY CONCEPT

1. Florence Environmental Nursing is the act of using the

Nightingale theory environment of the patient to assist
him in his recovery.

2. VIRGINIA Need theory Nursing is a unique function of the

HENDERSON nurse , to assist the individuals, sick
or well, in the performance of those
activities contributing to the health
or its recovery (or to peaceful death)
so he can gain independence as
rapidly as possible.
3. HILDEGARD Psychodynamic Nursing is a significant , therapeutic,
PEPLAU Nursing interpersonal process .
Nursing is a healing art (therapeutic)
Interpersonal of human relationship .
Relations in
Nursing

4. BETTY NEUMAN Health Care Nursing is concerned with the whole

Systems Theory person.

Models the individual’s relationship

to stress, reaction to it, and
reconstitution factors that are
dynamic (adaptation to stressors).

5. IMOGENE KING Goal Attainment Nursing is a process of action,

Theory reaction and interaction between
nurse and patient to achieve goals
for client.

Importance of a client’s participation

in decisions that influence care &
focuses on the nurse-client
interaction and the outcomes of care,

6. DOROTHEA Self-Care Deficit Nursing is a process of helping

OREM Theory of Nursing clients to identify ways to perform
self-care.

Self-care needs/requisites are actions

to maintain health and well-being.

Self-care deficit explains how people

can be assisted - wholly, partially or
supportive-educative nursing system.

7. FAYE GLENN Patient-Centered Nursing is based on the problem-

ABDELLAH Approach solving method.
1. Identify the problem
2. Select data
3. Make a hypothesis
4. Test the hypothesis
5. Conclude

Nursing seeks to determine the

health needs based on a 21-
problems list.

8. MADELEINE Transcultural
LEININGER Nursing Nursing is a humanistic and scientific
mode of helping a client through
specific CULTURAL CARING
PROCESSES (cultural values,
 beliefs and practices).

Provide a culturally-congruent
\ nursing care.

3 Intervention modes:
o Culture care preservation and
maintenance
o Culture care accommodation or
negotiation
o Culture care restructuring and
repatterning.

9. MARGARET Philosophy and Nursing is a human science of people

JEAN WATSON Science of Caring with CARING as its core.

10. PATRICIA From Novice to Nursing goes through five stages of

BENNER Expert skills acquisition

Novice (no experience)

1. Advanced beginner (1-2 years of
experience)
2. Competent (3-5 years of exp.)
3. Proficient (5-10 years of
experience)
4. Expert (> 10 years of experience)
 Carper’s and Benner’s Stages of Clinical Competence

Barbara Carper's fundamental ways of knowing.

Empirical
Factual knowledge from science.
Personal
Knowledge and attitudes derived from personal self-understanding and empathy.
Ethical
Attitudes and knowledge derived from an ethical framework, including an awareness of
moral questions and choices.

Aesthetic
Awareness of the immediate situation, seated in immediate practical action; including
awareness of the patient and their circumstances as uniquely individual.
 (Aesthetic in this sense is used to mean "relating to the here and now", from the Greek
αἰσθάνομαι (aisthanomai), meaning "I perceive, feel, sense.”

OVERVIEW OF THE PROFESSIONAL NURSING PRACTICE

Benner's Stages of Clinical Competence

 Stage 1: Novice

Beginners have had no experience of the situations in which they are expected to
perform.

Novices are taught rules to help them perform. As such, novices have no "life
experience" in the application of rules.

"Just tell me what I need to do and I'll do it."

 Stage 2: Advanced Beginner

Advanced beginners are those who can demonstrate marginally acceptable performance,
those who have coped with real situations to note, or to have pointed out to them by a
mentor, the recurring meaningful situational components.

These components require prior experience in actual situations for recognition. The
principles are based on experience.

 Stage 3: Competent

Competence develops when the nurse begins to see his or her actions in terms of long-
range goals or plans of which he or she is consciously aware.

Helps achieve efficiency and organization.

Have a feeling of mastery and the ability to cope with and manage the many
contingencies of clinical nursing.

 Stage 4: Proficient

The proficient performer perceives situations as wholes rather than in terms of parts or
aspects.

Proficient nurses:

 understand a situation as a whole.

 learns from experience what typical events to expect in a given situation and how
plans need to be modified in response to these events.
 uses maxims as guides which reflect what would appear to the competent or
novice performer as unintelligible nuances of the situation.
 has a deep understanding of the situation overall, however, the maxim provides
direction as to what must be taken into account.

 Stage 5: The Expert

 The expert nurse, with an enormous background of experience, now has an

intuitive grasp of each situation, has a deep understanding of the total situation.
 Highly skilled analytic ability.
 THE ROLE OF A PROFESSIONAL NURSE TODAY

Communicator

Nurses are prepared to collaborate with a healthcare team to effectively perform treatments and
procedures. Thus, nurses manage patient care. They ensure cohesive and coordinated care for
successful patient outcomes.

Holistic Caregiver

Nurses to demonstrate cultural awareness and sensitivity. Patients may have specific needs and
preferences due to their religion or gender. Nurses need to be respectful of, and knowledgeable
about, diverse backgrounds while remaining vigilant in providing quality care.

Instructor

Instruct patients about medical apps that can enhance traditional care. Patients can now use apps
to monitor their glucose, track their blood pressure or access helpful information.

Specialists

By choosing the appropriate medical specialization, nurses can address complications related to
diabetes, obesity, heart problems, kidney disease and dementia.
 Researcher

Nurses use research to deliver care. They gather and analyze data to glean insights they can
apply to facilitating patient care and pinpointing best practices.

What Are Some Trends in Nursing?

 Informatics.

Nursing informatics is a field of nursing that incorporates nursing, computer, and

information sciences to maintain and develop medical data and systems to support the practice of
nursing, and to improve patient care outcomes. Technologies that have evolved due to health
care/nursing informatics include:

 Computerized provider order entry (CPOE)

 Electronic medical records (EMRs)
 Test results
 Progress notes
 Nursing notes
 Medication records

 Genetics. The integration of genetics into nursing.

Genetics nursing is a nursing specialty that focuses on providing genetic healthcare to

patients.
 Genomics.

Genetics focuses on the individual genes in the genome, generally addressing those
conditions resulting from single gene errors. Genomic information focuses on the
interaction of specific genes within the genome and with external factors within the
environment.

 Telehealth.

the use of telemedicine and technology to conduct nursing and deliver care in a remote
location.

Counseling over the phone. However, technology today allows telehealth nursing to
reach patients, monitor their conditions and interact with them using computers, audio
and visual accessories and telephones.