THEORETICAL FOUNDATIONS (NCMA 111) ⮚ Practiced since pre-historic times

< venice > among primitive tribes and lasted

through the early Christian era
LESSON 1: THE THEORETICAL FOUNDATIONS ⮚ INTUITION: the ability to
OF NURSING NEGLECTFUL understand something
immediately, without the need of
THEORIES
conscious reasoning
⮚ A systematic explanation of an event in
⮚ Nursing was “untaught” and
which constructs and concepts are identified
instinctive
and relationships are proposed and
⮚ Women’s role: to take care of
predictions are made (Streubert and
their child, the sick, and aged
Capenter, 1999)
⮚ No training programs
⮚ System of interrelated propositions used to
⮚ Practice of nursing is based on
predict, explain, understand, and control a
observation and experience
part of empirical world. (Adam, 1985)
COURSE OF EVENTS FAMOUS PEOPLE
⮚ Comprised of concepts, propositions, laws,
AND PRACTICES THEIR
and set of propositions that can be FORMED CONTRIBUTIONS
verbalized and communicated. EARLY CIVILIZATION
⮚ Ex: Big Bang Theory, The Theory of ⮚ Music or singing
Evolution was often used
to chase away
CONCEPTS the evil spirits
⮚ Is a symbolic statement describing a ⮚ In some cases,
phenomenon or group of phenomena trephining was
⮚ Are formulated in words to be able to used wherein
communicate meanings about realities in the they cut a hole
world or give meaning to phenomena that in the head of
can be directly seen or indirectly seen, the afflicted to
heard, taste, smelled, or touched (Faucett, let out the evil
1999) spirit out.
⮚ TYPES OF CONCEPTS:
● A. ABSTRACT – hope, love, desire CODE OF
● B. CONCRETE – airplane, HAMMURABI
temperature, weight (BABYLONIA)
⮚ Concepts can be formulated: ⮚ 1st recording on
● A word – grief, empathy, pain the medical
● Two words – patient’s satisfaction, practice
caring nurse ⮚ Established the
● Phrase – health promoting practices, medical fees
core competency standards ⮚ Discouraged
experimentation
HISTORICAL PERPECTIVE ⮚ Specific doctor
I. INTUITIVE NURSING (MEDIEVAL for each disease
PERIOD) ⮚ Right of patients
to use of
charms,
medicine, or,

THEORETICAL FOUNDATIONS 110 {VENICE} 1

 surgical drug used for
procedure treatment
⮚ Prohibited the
ART OF EMBALMING
dissection of
(EGYPT)
dead human
⮚ Mummification,
body as a
removing the
worship to
internal organs
ancestors
of the dead,
⮚ Use of wax to
instillation of
preserve the
herbs and salt to
body of the dead
the dead
⮚ Believed that in
⮚ Used to
using girl’s
enhanced their
clothes for male
knowledge of
babies keep
the human
evils away from
anatomy
them
⮚ Documentation
of about 250 SUHSHURUTU
diseases and (INDIA)
treatments ⮚ 1st recording on
⮚ Slaves and the nursing
patient’s families practice
nursed the sick ⮚ Medicine
men-built
TEACHINGS OF Moses is the “Father
hospitals
MOSES of
⮚ They use
(ISRAEL) Sanitation” and he
⮚ Laws of control wrote intuitive form of
of spread of five books in the Old. asepsis
communicable He ⮚ There was
disease and emphasized the proficient
the ritual of practice practice of
circumcision of of hospitality and Medicine and
charity Surgery
male child was
wherein anyone who is
also established CADUCEUS HIPPOCRATES also
sick is catered and
⮚ Nurses are helped. (ANCIENT redefined the concept
referred as GREECE) of
midwives, wet ⮚ INSIGNIA OF medicine. He is called
nurse, or child’s MEDICINE as
nurse. the father of
Scientific/Modern
MATERICA MEDICA Medicine.
(CHINA) He was the 1st to
⮚ Book that reject the idea that
indicated the diseases are caused
pharmacologic by evil spirits and to
apply assessment. He

THEORETICAL FOUNDATIONS 110 {VENICE} 2

 also practiced A. BEGININNING THE CRUSADERS
medical OF RELIGIOUS ⮚ KNIGHTS OF
ethics. WAR SAINT JOHN
ROME FABIOLA is a wealthy ⮚ From the 12th OF
⮚ A Roman made matron of the Roman Century-Crusa JERUSALEM
her home the Empire converted to des (Knights
first hospital in Christianity and used ⮚ This is war Hospitallers)
the Christian wealth to provide ⮚ TEUTONIC
between the
World houses of care and
Christian KNIGHTS
healing.
soldiers and –Established
IMPORTANT
NURSING EVENT the Muslim tent hospitals
⮚ Happened in Turks brought for the
this period: by prohibiting wounded
⮚ GROWTH OF Christians to ⮚ KNIGHTS OF
RELIGION visit the Holy SAINT
⮚ GROWTH OF Land. LAZARUS –
EARLIEST ⮚ In order to cared for
CIVILIZATION propagate people with
(Near East, Far Catholicism, leprosy,
East, Ancient the different syphilis, and
Greece, and religious skin
Ancient Rome) orders conditions
⮚ Illness is still established
believed to be Churches,
caused by evil schools,
spirits and orphanages,
nursing remains hospitals,
to be the and other
responsibility institutions in
of women in the
society. community
⮚ Through these
institutions,
II. APPRENTICE PERIOD (MIDDLE they intend to
AGES) bring the
⮚ Start of the training program for people to
Nurses Catholic faith.
⮚ Nuns and priests were considered ⮚ Priests and
to be the first trained. Thus, during nuns were
this era, nursing was thought to trained to
be a religious calling work in these
⮚ Care was done by Crusaders, institutions
Prisoners, and Religious Orders including
COURSE OF EVENTS FAMOUS PEOPLE hospitals
AND PRACTICES AND THEIR
FORMED CONTRIBUTIONS

THEORETICAL FOUNDATIONS 110 {VENICE} 3

THE RISE OF Many saints were led to the priest
SECULAR recognized for taking and nuns to go
ORDER care of sick during hiding for fear of
⮚ There was the this persecution
rise of Religious era, Hiding of the
Nursing Orders A. ST. CLARE priests and nuns
for Women. B. ST. result to a great
Although ELIZABET shortage of
Christianity H OF nurses during
promoted equality HUNGARY the 17th century.
to all men, women C. ST.
were still CATHERIN C. DARK PERIOD OF CHARLES DICKENS
concentrated in E OF NURSING (17TH – his
their roles as SIENA – CENTURY TO 19TH writings reflected the
known as CENTURY) attitude towards
wives and
the 1st ⮚ Because of nurses
mothers.
shortage of through his
⮚ Religious taboos Lady with
nurses, hospitals, character,
and social a Lamp
started to get Sairy Gamp, who
restrictions D. ST. cared
VINCENT women prisoners,
influenced nursing the sick by
DE PAUL thieves, drunks,
at the time of the neglecting
and prostitutes to
religious nursing them, stealing from
serve as nurses.
orders. them, and physically
⮚ This started the abusing them.
B. RISE OF Martin Luther is a bad image and
PROTESTANISM (1520 member of the reputation for
– 1562) Franciscan order, nurse. As a form
⮚ Because of denounced the of punishment for
abusers and practice these women,
corruption of of the Church to get nurses worked for
some popes, money from the a long period of
bishops, and people
time was not
cardinals, in the forgiveness of
given decent
their sins
peasants started living quarters and
to revolt against were constantly
the Catholic abused.
religion. They are ⮚ There was no
inspired by Martin formal education
Luther. for nurses
⮚ Protestants
started to destroy D. ESTABLISHMENT PASTOR
everything the OF THEODORE
THE 1ST TRAINING FLIEDNER and his
Church owned
SCHOOL OF NURSING wife
including
⮚ KAISSERSWERT FEDERIKA
hospitals, schools, established
H INSTITUTE OF
orphanages
DEACONESSES
churches, which

THEORETICAL FOUNDATIONS 110 {VENICE} 4

 (were Nightingale the first training improved the
received her school standards for
three-month for nurses in the care of
course in Nursing) Kaisserswerth, war
⮚ Deaconess Germany casualties in
School of Crimea
Nursing ⮚ “Angel of
recognized as Crimea”
the first nursing ⮚ POLITICAL
school in the NURSE:
world founded by Reforms in
Theodore Fleidner hospital and
in 1836 at production and
Kaisers Werth, implementation
Germany of public health
⮚ To change the policies
bad reputation of ⮚ Nursing’s
nurses, Fliedner First
carefully chose Scientist-
the students Theorist
admitted at ⮚ Notes on
Deaconess Nursing: What
School it is, and what
it is not?
E. NIGHTINGALE ERA FLORENCE
⮚ She
⮚ The effects of the NIGHTINGALE
disapproved
previous period (1820-
1910) restriction on
marked the
⮚ Born in May admission of
beginning of a
12, 1820 patient and
formal education
(Coincides with considered this
system for
International Unchristian
Nursing when
Nurses’ Day) and contrary
Florence
⮚ Mother of the to health care
Nightingale
Modern ⮚ Upgraded the
School of Nursing
Nursing She practice of
opened at St.
believed she Nursing and
Thomas Hospital
was “Called made Nursing
in London
by God to an honorable
help others profession
and to ⮚ Led other
improve the nurses in
wellbeing of taking care of
the mankind” the wounded
⮚ “Lady with and sick
the Lamp” – soldiers during

THEORETICAL FOUNDATIONS 110 {VENICE} 5

 the Crimean TRAINING ⮚ First graduate
War SCHOOL FOR nurse in the
⮚ She was NURSES (ST. US; graduated
designated as THOMAS in September 1,
Superintende HOSPITAL) 1872 from the
nt of the ⮚ Served as New England
Female model for Hospital for
Establishmen other Women in
t of English training Boston
General schools 2. DR. WILLIAM
Hospital in ⮚ Nightingale HALSTEAD
Turkey during system was ⮚ Designed the
the Crimean more on first rubber
War developing gloves
profession 3. CAROLINE
within the HAMPTON ROBB
DEFINITION OF NURSING ACCORDING TO hospital ⮚ First nurse to
FLORENCE NIGHTINGALE ⮚ Curriculum wear rubber
⮚ “Act of utilizing the environment of the includes gloves while
patient to assist him in his recovery.” theory and working as an
III. PERIOD OF EDUCATED NURSING practice operating room
(NIGHTINGALE ERA 19 TH TO 20 TH ⮚ 1st school nurse
CENTURY) of nursing 4. ESTABLISHMENT
⮚ Florence Nightingale was one of the to provide OF NURSING
pioneers in establishing the idea of theory-base ORGANIZATIONS;
nursing schools from her base at St. d knowledge the American
Thomas’ Hospital in London in 1860, and clinical Nurses
when she opened the Nightingale skill Association and
Training School for Nurses’, now part building the National
of King’s College London ⮚ Nursing League for
⮚ Development of Nursing is greatly evolved as Nursing Education
influenced by: an art and –contributed to the
● A. The aftermath of science uplift of nursing
Crimean War and Civil ⮚ Formal profession
War education 5. ISABEL HAMPTON
● B. Arousal of social and service ROBB
consciousness began ⮚ The first
● C. Increased in
principal of the
educational
John Hopkins
opportunities for women
Hospital
School of
COURSE OF FAMOUS PEOPLE AND Nursing; the
EVENTS AND THEIR CONTRIBUTIONS
most influential
PRACTICES
in directing the
FORMED
1860 – 1. LINDA RICHARDS development of
NIGHTINGALE

THEORETICAL FOUNDATIONS 110 {VENICE} 6

 nursing during ⮚ Nursing students should be provided
this period with residence near their training
6. CLARA LOUISE hospitals
MAAS ⮚ Written orders of doctors were
⮚ Engaged in insisted Nurses should go with their
doctors during their rounds
medical
⮚ Training was required for administrative
research on
positions
yellow fever ⮚ Probationers kept diaries and case
during the notes of their work, examined by the
Spanish-Americ matron and home sister, and often by
an War Nightingale
7. DEVELOPMENT ⮚ A major component of training was
OF PRIVATE DUTY moral: ethical standards for the
NURSING patient
⮚ Settlement
house nursing IV. CONTEMPORARY NURSING (20TH
(PHN), NURSING)
government ⮚ This refers to the period after World
War I and the changes and
service of
development in the trends and
nurses, and
practices of Nursing occurring since
prenatal and 1945 after World War II.
maternal health ⮚ NURSING AFTER WORLD WAR I
nursing ⮚ Nursing is primarily hospital
8. PREPARATION OF sponsored program being trained by
STANDARD doctors and senior of nurses
CURRICULUM ⮚ Licensure of Nursing started
based on ⮚ Training of Nurses in diploma program
educational ⮚ Development of Baccalaureate and
objectives for Advanced Degree Program
schools of Nursing
9. EDITH CAVEL – VIRGINA HENDERSON
⮚ One of the FIRST MODERN NURSES TO
known as “Mata
DEFINE NURSING
Hari” served the ⮚ “The unique function of the nurse is to
wounded soldiers assist the individual, sick or well, in the
during World War I performance of those activities or its
recovery (or to peaceful death) that he
would perform unaided if he had the
CONCEPTS IN THE NIGHTINGALE SYSTEM OF
necessary strength, will, or knowledge,
EDUCATION and to do this in such a way as to help him
⮚ Government funds should be allotted gain independence as rapidly as possible.”
to nursing education (Henderson,1966)
⮚ First nurse political activist
⮚ Training schools of Nursing should be SCIENTIFIC AND TECHNICAL
in close affiliation ADVANCEMENT
⮚ Professional nurses should train ⮚ Health is perceived as a human right. (law)
nurses ⮚ Community involvement of nurses
⮚ Disposable supplies and equipment

THEORETICAL FOUNDATIONS 110 {VENICE} 7

 ⮚ Expanded roles of nurses
⮚ WHO was established by United Nations
⮚ Use of computer and sophisticated
machines on hospitals
⮚ NOTES:
o “Nursing is caring” (womb to
tomb)
o “Nursing is an Art”
RECIPIENT OF NURSING
1. CONSUMER – Individual, group of people,
or community that uses a service or
community
2. PATIENT – person who is waiting for or
undergoing medical treatment and care
3. CLIENT – person who engages the
advices or services of another who is
qualified to provide this service
SCOPE OF NURSING
1. PROMOTING HEALTH AND WELLNESS -
Means engaging in attitudes and
behavior that enhance the quality of life
and maximize personal potential
2. PREVENTING ILLNESS - To maintain
optimal health by preventing disease
3. RESTORING HEALTH - Focuses on the ill
client and extends from early detection of
disease through helping the client during
the recovery period
4. CARE OF THE DYING - Involves
comforting and caring for people of all
ages who are dying
ROLES AND FUNCTION OF THE NURSE
1. CAREGIVER - Activities that assist the
client physically and psychologically while
preserving the client’s dignity
2. COMMUNICATOR - Nurses communicate
patient’s identified problems to other
members of healthcare team
3. COUNSELOR - Process of helping the client
recognize and with stressful psychologic or
social problems, to develop improved
interpersonal relationships, and to promote
personal growth
4. CHANGE AGENT - Assisting clients to
make modifications in their behavior
5. LEADER - Influences others to work
together to accomplish a specific goal
6. MANAGER - Delegates nursing activities to
ancillary workers and other nurses, and
supervises and evaluates their performance
7. CASE MANAGER - Works with the
multidisciplinary healthcare team to measure
the effectiveness of the case management
plan and monitor outcomes
8. RESEARCH CONSUMER EXPANDED
CAREER ROLES
⮚ Nurse Practitioner
⮚ Clinical Nurse Specialist
⮚ Nurse Anesthetist
⮚ Nurse Midwife
⮚ Nurse Researcher
⮚ Nurse Administrator
⮚ Nurse Educator
⮚ Nurse Entrepreneur
LESSON 02: HISTORY OF NURSING IN THE
PHILIPPINES
EARLY BELIEFS
⮚ Early Filipinos believes to superstitious
beliefs and practices in relation to health
and sickness
⮚ Evil spirits could be driven away by persons
with powers to expel demons
⮚ Illnesses were believed to be caused by
“mangkukulam or manggagaway”
⮚ HERBULARIOS – herb doctors
⮚ HERBICHEROS – practices witchcraft
⮚ MABUTING HILOT – also known as good
midwife who attends during childbirths
⮚ “NONO” – cause of difficult child birth
⮚ They use gunpowder exploded from a
bamboo pole close to the head of the
mother to drive the evil spirits away
HEALTHCARE DURING SPANISH REGIME
⮚ “Babaylan” (priest physician) and
“Albularyo” (Herb doctors) care for the
sick individuals
⮚ 1578 – male nurses were acknowledged
by Spanish friars referred as practicante or
enfermero.
⮚ Religious orders exerted their efforts to
care for the sick by building hospitals in
different parts of the Philippines
THEORETICAL FOUNDATIONS 110 {VENICE} 8
 ⮚ Provided
EARLY HOSPITAL nursing care to
1. HOSPITAL REAL DE MANILA (1577) the wounded
⮚ Established mainly for the care for night and day
the Spanish king’s soldiers, but
also admitted civilians 2. ROSA SEVILLA ⮚ Converted them
⮚ Founded by Gov. Francisco De DE ALVERO house into
Sande quarters for the
2. SAN LAZARO HOSPITAL (1578) Filipino
⮚ Founded by Brother Juan soldiers during
Clemente the Philippine-
⮚ Named after the Knights of St.
American War
Lazarus
that broke out
⮚ Administered for many years by
Hospitallers of San Juan De Dios during 1899
⮚ Built exclusively for patients with 3. DONA HILARIA ⮚ Wife of Emilio
leprosy DE Aguinaldo
3. HOSPITAL DE INDIOS (1586)
AGUINALDO ⮚ Organized the
⮚ Established by the Franciscan
Order Filipino Red
⮚ Hospital for the poor Filipino Cross under the
people inspiration of
⮚ Service was in general supported by Mabini
alms and contributions from
4. DONA MARIA ⮚ Second wife of
charitable persons
4. HOSPITAL DE AGUAS SANTAS (1590) AGONCILLO Emilio
⮚ Established in Laguna, near a DE Aguinaldo
medicinal spring because people AGUINALDO ⮚ Provided
believed that the spring has a nursing care to
healing power the Filipino
⮚ Founded by Brother J. Bautista of soldiers during
the Franciscan Order the revolution
5. SAN JUAN DE DIOS HOSPITAL (1596) ⮚ President of
⮚ Founded by the Brotherhood of the Filipino Red
Misericordia and administered by Cross branch
the Hospitallers of San Juan De in Batangas
Dios
⮚ Support was derived from alms 5. MELCHORA ⮚ Nursed the
and rents AQUINO wounded
⮚ Rendered general health service to A.K.A Filipino
the public “TANDANG soldiers
NURSING DURING PHILIPPINE REVOLUTION
SORA” (Katipuneros)
1. JOSEPHINE ⮚ Wife of Jose
and gave them
BRACKEN Rizal
shelter and food
⮚ Installed a field
hospital in an 6. CAPITAN ⮚ A revolutionary
estate house in SALOME leader in Nueva
Tejeros Ecija

THEORETICAL FOUNDATIONS 110 {VENICE} 9

 ⮚ Provided HOSPITAL SCHOOL NURSING’S FORMAL
nursing care to TRAINING (1901-1911)
the wounded
when not in ⮚ Formal training in hospital school of nursing
combat transpired. This began when American
missionary doctors and nurses that their
7. AGUEDA ⮚ Revolutionary manpower is insufficient.
KAHABAGAN leader in THIS RESULTS TO A DECISION TO TRAIN
Laguna FILIPINO NURSES THAT AMERICAN
⮚ Provided ESTABLISHED IN 1906.
nursing 1. ILOILO ⮚ Ran by the
services to her MISSION Baptists
troops HOSPITAL Foreign
SCHOOL OF Mission of
8. TRINIDAD ⮚ Stayed in the NURSING America
TECSON “INA hospital at Biak (Iloilo City, ⮚ There are no
NG BIAK NA na Bato to care 1906) strict
BATO” for her requirements
wounded for the
soldiers applicants as
long as they are
all willing to
HOSPITALS AND NURSING SCHOOLS
work.
⮚ 1907 – Training of Nursing Students by ⮚ APRIL 1944 –
the Americans Graduate
⮚ Filipino students studied the same nurses’ tool the
subject than that of the Americans but first Nurses
believed that the curriculum was never Board
the mirror image of the American Nursing Examination at
Curriculum the Iloilo
Mission
1ST TRAINING SCHOOL OF NURSING Hospital
⮚ ROSE
⮚ BELLEVUE HOSPITAL SCHOOL OF
NICOLET – a
NURSING
o Founded in 1873 in New York graduate of New
o It was the first school of nursing in England
the United States to be founded on Hospital for
the principles established by Women and
Florence Nightingale Children in
Boston was the
PENSIONADO ACT OF 1903 (ACT 854) first
superintendent
⮚ Allowing Filipino nursing students to study in for nurses
United States
⮚ Among of the first wave of nurses who went 2. SAINT PAUL’S ⮚ Established by
to the US HOSPITAL the Archbishop
SCHOOL OF of Manila,

THEORETICAL FOUNDATIONS 110 {VENICE} 10

 NURSING Jeremiah Harty ⮚ Applicant must
(Manila, 1907) under the have
supervision of completed
St. Paul de elementary to
Chartres located seventh grade
in Intramuros education
⮚ Provided
general
MARY COLEMAN MASTERS
hospital
⮚ In 1906, Mary Coleman Masters, an
services educator advocated for the idea of the
⮚ 1908 – when it training of Filipino girls for the
opened its profession of Nursing with the approval of
training school the government officials
for nurses ⮚ Opened the first dormitory for girls
⮚ MOTHER enrolled at the Philippine Normal Hall and
MELANIE – University of the Philippines
superintendent
⮚ MISS 4. ST. LUKE’S ⮚ Opened with
CHAMBERS - HOSPITAL three girls
Principal SCHOOL OF admitted
NURSING ⮚ These girls had
3. PHILIPPINE ⮚ Began in 1901 (Quezon City, them first year in
GENERAL as a small 1907) combined
HOSPITAL dispensary for classes with the
SCHOOL OF Civil officers and PGH School of
NURSING Employees, Nursing and St.
(Manila, 1907) soon grew into a Paul’s Hospital
Civil Hospital School of
⮚ Opened nursing Nursing
classes with ⮚ HELEN HICKS
Admission – The first
based on principal
Entrance ⮚ VITALIANA
examinations BELTRA – First
⮚ JULIA Filipino
NICHOLS AND superintendent
CHARLOTTE ⮚ DR. JOSE
CLAYTON: FORES - first
taught the medical
students director of the
Nursing hospital
subjects;
American 5. MARY ⮚ Started as a
physicians also JOHNSTON small dispensary
served as HOSPITAL AND on Calle
lecturers. SCHOOL OF

THEORETICAL FOUNDATIONS 110 {VENICE} 11

 NURSING Cervantes (now ⮚ First Executive Officers of the Board
(Manila, 1907) Avenida) Examiners for Nurses were physicians
⮚ Called the
Bethany MARY CHILES HOSPITAL SCHOOL OF
Dispensary NURSING (Manila, 1911)
⮚ Funded by the
⮚ MARY CHILES OF MONTANA – donated a
Methodist
large sum of money with which the present
Mission for the building the Gastambide was bought
relief of ⮚ Frank Dunn Memorial Hospital (Vigan,
suffering Ilocos Sur, 1912)
among women ⮚ San Juan De Dios Hospital School of
and children Nursing (Manila, 1913)
⮚ 1907 – Sister ⮚ Emmanuel Hospital School of Nursing
REBECCA (Capiz,1913)
PARRISH ⮚ Southern Islands Hospital School of Nursing
together with the (Cebu, 1918)
registered
nurses ROSE OTHER NURSING SCHOOLS
DUDLEY and
⮚ Zamboanga General Hospital School of
GERTUDE
Nursing (1921)
DREISBACH ⮚ Chinese General Hospital School of Nursing
organize the (1921)
Mary Johnston ⮚ Baguio General Hospital School of Nursing
School of (1923)
Nursing ⮚ Manila Sanitarium Hospital and School of
⮚ Nurse’s training Nursing (1930)
course began ⮚ St. Paul School of Nursing (1946)
with three ⮚ North General Hospital and School of
Filipino young Nursing (1946)
girls from ⮚ Siliman University School of Nursing (1947)
elementary as
ACCREDITED PROFESSIONAL ORGANIZATION
their first
(1921-1931)
students
⮚ The Filipino Nurses Association was
START OF NURSING PRACTICE (1911- 1921) established on October 15, and the
⮚ ACT 2943 – Amends Medical Law (Act. organization initiated the publication of
No. 310) allowing the regulation of nursing Filipino Nurse Journal which later changed
practice to The Philippine Journal of Nursing.
⮚ ACT 3025 – An act Regulating the
FIRST TRUE NURSING LAW (1919) Practice of Nursing Profession in the
Philippine Islands which necessitates that
⮚ Also known as Act 2808 all nurses who are practicing the
⮚ Board of Examiners for Nursing was profession to register yearly.
created ⮚ National League of Nurse
⮚ First Nursing Board Examinations was ⮚ Other organizations:
given on 1920 o A. ORNAP – for operating room
nurses

THEORETICAL FOUNDATIONS 110 {VENICE} 12

 o B. ANSAP – ones who renders the Philippines
seminars for nurses (1946)
o C. MCNAP – for maternal and child ⮚ In 1947, the
nurses Bureau of
Private Schools
PUBLIC HEALTH NURSING DEVELOPMENT
permitted UST
(1931-1941)
to grant title
⮚ Nursing institution have increased them Graduate
requirement (1933) Nurse to the 21
⮚ Applicants must able to complete students who
secondary education were of
⮚ UNIVERSITY OF THE PHILIPPINES advanced
SCHOOL OF PUBLIC HEALTH NURSING standing from
– where the first collegiate nursing 1948 up to the
graduates of the Philippines graduated present
(1938) ⮚ SOR TACIANA
TRIANES – first
THE DEGREE OF BACHELOR OF SCIENCE IN directress
NURSING (1941-1951)
2. MCU COLLEGE ⮚ 1st College
⮚ JULITA V. SOTEJO, a graduate of the OF NURSING who offered
Philippine General hospital, presented her (June 1947) BSN as a
dissertation that tackles on the four-year
development of a nursing education program
within a university- based College of
⮚ The MCU
Nursing which become the basis of the
Nursing Curriculum in the Philippines Hospital first
⮚ Nursing became a Baccalaureate course offered BSN and
⮚ College of Nursing was created Doctor of
Medicine
RISE OF THE BSN CURRICULUM degrees in 1947
and served as
⮚ JAPANESE OCCUPATION (1942) – training the clinical field
and practice at the hospital schools of for practice
Nursing in Manila was “violently ⮚ CONSUELO
disrupted” GIMENO – first
⮚ 1945 - However, U.S. colonial patterns in principal
Philippine Nursing Education soon
returned after the U.S reclaimed the 3. UP COLLEGE ⮚ The idea of
country and even the Philippines gained OF NURSING opening the
independence from the U.S on July 4, 1946 (June 1948) college began in
a conference
THE FIRST COLLEGES OF NURSING IN THE between Miss
PHILIPPINES
Julita Sotejo and
UP president
1. UST COLLEGE ⮚ 1st College of
⮚ 1948 – the
OF NURSING Nursing in the
University
(1946)
Council

THEORETICAL FOUNDATIONS 110 {VENICE} 13

 approved the
curriculum and
the Board of
Regents
recognized the
profession as
having and
equal standing
as Medicine
⮚ JULITA
SOTEJO – first
dean
4. FEU INSTITUTE
OF NURSING
(June 1955)
5. UE COLLEGE
OF NURSING
(October 1958)
HISTORY OF NURSING IN THE PHILIPPINES
1. PROLIFERATION OR NURSES AS A
WORKFORCE: 1951-1971
⮚ The PHILIPPINE NURSING LAW
was approved under the Republic
Act No. 877 on June 19, 1953
⮚ 1966 – further amendment was
created which limits the practice of
nurses among 21 years old and
above
⮚ PROCLAMATION NO. 539 –
Celebration of Nurses’ Week which
was proclaimed by President Carlos
P. Garcia
2. NURSING PROFESSION DEVELOPMENT
(1971-2001)
⮚ PRESIDENTIAL DECREE NO. 233 –
Establishment of the agency,
Professional Regulation
Commission
⮚ The Philippine Nursing Act of 1991
was also amended under the
REPUBLIC ACT OF 7164
⮚ NURSING CERTIFICATION
COUNCIL in 1999 under the Board of
Nursing through Resolution No. 14 –
supervise the new programs’
implementation conducted by
Specialty Certification Boards
⮚ This improvement also prompted the
start of Advanced Practiced Nursing
(APN) in the Philippines.
THE PHILIPPINE NURSING ACT OF 2002
⮚ The Philippine Nursing Act of 2002 was
enacted under the Republic Act No. 9173
which entails changes in existing policies
under Republic Act No. 7164.
⮚ These changes underscore on the
requirements for faculty and Dean of the
Colleges of Nursing, as well as the
conduct for Nursing Licensure Exam.
NURSING LEADERS IN THE PHILIPPINES
1. ANASTACIA GIRON-TUPAS
⮚ First Filipino nurse to hold the
position of Chief Nurse
Superintendent (PGH)
⮚ Founder of PNA (Philippine Nurses
Association)
2. CESARIA TAN
⮚ First Filipino nurse receive a
Master’s degree in Nursing abroad.
3. SOCORRO SIRILAN
⮚ Pioneered in Hospital Social
Service in San Lorenzo Hospital
where she was the Chief Nurse
4. ROSA MILITAR
⮚ A pioneer in school health
education.
5. SOR RICARDA MENDOZA
⮚ A pioneer in Nursing Education
6. SOCORRO DIAZ
⮚ First editor of the PNA magazine
called “The Message”
7. CONCHITA RUIZ
⮚ First full-time editor of the newly
named magazine “The Filipino Nurse”
8. LORETO TUPAZ
⮚ Dean of the Philippine Nursing
THEORETICAL FOUNDATIONS 110 {VENICE} 14
 ⮚ Florence Nightingale of Iloilo
9. MAGDALENA VALENZUELA
⮚ First Filipino Industrial Nurse
10. ANNIE SAND
⮚ Founded the national league of
Philippines Government Nurses
11. CORNEL ELVEGIA MENDOZA
⮚ First Female Military Nurse
FURTHER CHANGES IN NURSING LAW: 2001
TO PRESENT
⮚ PHILIPPINE NURSING ACT OF
1991: RA 7194
o An act increasing the bed
capacity of the Naval General
Hospital in the municipality of
Naval in Biliran, Leyte from 25
to 50 beds.
⮚ PHILIPPINE NURSING ACT OF
2002: RA 9173
⮚ COMPREHENSIVE NURSING LAW
OF 2015
o Senate Bill 2720, adopted by
both Senate and the House
o Declares that is the State
policy to uphold the dignity of
the nurses and assume
responsibility for the
protection, respect, and
improvement of the nursing
profession by instating
measures towards competent
and relevant nursing practices.
TIMELINE
1909
⮚ 3 Females graduated as “qualified
medical-surgical nurses”
1919
⮚ The 1st Nurses Law (Act No. 2808) was
enacted regulating the practice of the
nursing profession in the Philippine
Islands
⮚ 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
the exam with the highest rating of 93.5%
who was taken by Anna Dahlgren
⮚ Theoretical Exam was held at the UP
Amphitheater of the College of Medicine and
Surgery
⮚ Practical Exam at the Philippine General
Hospital Library
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 GIRONTUPAS
1953
⮚ Republic Act 877, known as the “Nursing
Practice Law” was approved.
INTRODUCTION TO NURSING THEORY
⮚ The history of professional nursing began
with Florence Nightingale
⮚ She envisioned nurses as a body of
educated women at a time when women
neither educated nor employed in public
service
⮚ Florence Nightingale vision and
establishment of a School of Nursing at
St. Thomas Hospital in London marked
the beginning of Modern Nursing
THEORY ERA
⮚ Contemporary phase where the emphasis
is on theory-based nursing practice and
theory development
⮚ Awareness that nursing is a profession
⮚ In mid-1800, Florence Nightingale
expressed firm conviction that nursing
THEORETICAL FOUNDATIONS 110 {VENICE} 15
 knowledge was distinct from medical
knowledge. Her concept of nursing function
is putting the patient in best condition for
nature to act upon him and that nursing is
based on person and environment
CURRICULUM ERA
⮚ Focuses on what must be studied and
learned to become a nurse from
hospital-based diploma program into college
and university
⮚ More and more nurses sought for higher
degree, from vocational heritage to an
academic discipline (profession)
RESEARCH ERA
⮚ Nurses started to participate in scientific
works
⮚ This course started to be introduced and
integrated in the Nursing
GRADUATION EDUCATION ERA
⮚ From Bachelor of Science in Nursing
(BSN) to Master’s Program
SIGNIFICANCE OF NURSING THEORY
⮚ Through the accomplishment of the past 20th
century that Nursing was recognized in
the academic discipline
⮚ Discipline and profession are interrelated
but they are not the same.
DISCIPLINE
⮚ Specific to academia
⮚ Refers to a branch of knowledge, education,
a department of learning or domain of
knowledge
PROFESSION
⮚ Refers to a specialized field of practice
⮚ Profession is founded on the theoretical
structure of the science or knowledge of
that discipline and accompanying abilities
HISTORY OF PHILOSPHY AND SCIENCE
⮚ SCIENCE
o Systematically organized body of
knowledge
o The intellectual and practical activity
encompassing the systematic
study of the structure and behavior
of the physical and natural world
through observation and experiment.
⮚ PHILOSOPHY
o Is the theorist viewpoint: what the
theorist assumes, believes, and
values, or hold to be true
NOTE:
⮚ EPISTEMOLOGY – A branch of philosophy
concerned with the theory of knowledge in
philosophical inquiry.
KNOWLEDGE
⮚ Information, skills, and expertise acquired by
a person through various life experiences or
formal learning
HISTORICAL VIEWS OF THE NATURE OF
SCIENCE
⮚ Two competing philosophical foundations of
science is rationalism and empiricism, have
evolved in the era of modern science with
several functions
RATIONALISM
⮚ Rationalist epistemology (scope of
knowledge) emphasizes the importance of
a priori reasoning as the appropriate
method for advancing knowledge
⮚ Deductive Reasoning (Cause and effect)
⮚ Theory- then research Strategy
⮚ Innate, Reason, and Deduction
⮚ Case/Application: Poor hand washing
technique will result in spreading diseases to
all patients
EMPIRICISM
⮚ The empiricist view is based on the central
idea that scientific knowledge can be
THEORETICAL FOUNDATIONS 110 {VENICE} 16
 derived only from sensory experience
(i.e., seeing, feeling, hearing facts)
⮚ Inductive Reasoning – collection of facts
precedes attempts to formulate
generalizations
⮚ Research-then theory strategy
⮚ Gathering facts through experience and
observation and then formulating theories
⮚ Case/Application: Differential Diagnosis
Patient – 31 years old productive cough for
two weeks, low grade fever occurring every
afternoon, vital signs all in normal rage,
weight, clinical observation Diagnostics –
X-ray (clear) Sputum Test – Negative History
– Smoker for 15 years, 1 pack of cigars
everyday
EARLY TWENTIETH CENTURY VIEWS OF
SCIENCE AND THEORY
⮚ During the first half of the century,
philosophers focused on the analysis of
theory structure, whereas scientists focused
on empirical research
⮚ According to H. Brown (1997), theory
determines what observations are worth
making and how they are to be understood,
and observation provides challenge to
accepted theoretical structures.
⮚ The continuing attempt to produce a
coherently organized body of theory and
observation is the driving force of the
research, and the prolonged failure of
specific research projects to lead scientific
revolutions
RA 9173: PHILIPPINE NURSING ACT OF 2002
⮚ Comprehensive legislation regulating
various aspects of nursing profession.
⮚ Begun and held: Metro Manila, 22nd of July
2002 approved on October 21, 2002
under the office of president Gloria
Macapagal Arroyo, along with the
president senate, Franklin M, Drillon,
⮚ Main objective: to provide for protection
and improvement of nursing profession
by instituting measures that shall result in
relevant nursing education, humane working
conditions, better career prospects and
dignified existence for nurses.
⮚ Inter alia: to provide for organization of
board of nursing, examination and
registration of nurses, nursing education,
nursing practice, as well as several related
matters. Repeals Nursing Act, 1991.
QUALIFICATIONS OF THE BOARD OF
NURSING
⮚ Creation of a Professional Regulatory Board
of Nursing referred to as a Board
composed of a Chairperson and six (6)
members which shall represent the three
areas of Nursing, which are nursing
education, nursing service, and
community health of nursing
⮚ They are appointed by the President from
among two recommendees of the
Professional Regulation Commission
⮚ The Board shall hold the office for a term of
three years until their successors have been
appointed and qualified
⮚ The qualifications are:
o A. Be a natural born citizen and
resident of the Philippines
o B. Be a member of good standing
of the accredited professional
organization of nurses
o C. Be a registered nurse and
holder of a master’s degree in
nursing, education or other allied
medical profession conferred by a
college or university duly recognized
by the Government
o D. Have at least ten (10) years of
continuous practice of the
profession prior to appointment (last
five years shall be in the Philippines)
o E. Not have been convicted of any
offense involving moral turpitude
EXAMINATION AND REGISTRATION
⮚ LICENSURE EXAMINATIONS shall be
given to the all applicants for license to
practice nursing are required to pass a
written examination that are given by the
Board in such places and dates
designated by the Commission;
THEORETICAL FOUNDATIONS 110 {VENICE} 17
 Provided, that it shall be in accordance
with Republic Act No. 8981, otherwise
known as the “PRC Modernization Act of
2000.”
⮚ The qualifications for Admission to the
Licensure Examination are the
o A. following: Citizen of the
Philippines or a citizen of a
country which permits Filipino
nurses to practice within its
territorial limits (the requirements
in that country are substantially
the same)
o B. He/she is of good moral
character
o C. Should be a holder of a
Bachelor’s Degree in Nursing from
a college that complies with the
standards of nursing education
⮚ In order to pass the examination, an
examinee must obtain a general average
of at least seventy-five percent (75%)
with a rating of not below sixty percent
(60%) in any subject. If an examinee got a
rating below 60% in any subject, he/she
needs to take the examination again in
that subject.
NURSING EDUCATION PROGRAM
⮚ States that it shall provide sound general
and professional foundation for the
practice of Nursing
⮚ Adhere strictly to specific requirements
embodied prescribed curriculum as
promulgated by the Commission on
Higher Education (CHED) policies and
standards of nursing education
⮚ NURSES WHO HAVE NOT ACTIVELY
PRACTICED THE PROFESSION for 5
years shall undergo 1 month of didactic
training and 3 months practicum
QUALIFICATIONS OF THE FACULTY
⮚ A. Be a registered nurse in the Philippine
⮚ B. Have at least 1 year of clinical practice in
a field of specialization
⮚ C. Be a member of a good standing in the
accredited professional organization of
nurses
⮚ D. Should be a holder of Master’s Degree in
Nursing or other allied medical health
sciences conferred by a college or university
The dean of a college must also have a master’s
degree and must at least have 5 years of
experience in Nursing.
NURSING PRACTICE
⮚ SCOPE OF NURSING
o States that 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.
o Includes, but not limited to, nursing
care during conception, labor,
delivery, infancy, childhood, toddler,
preschool. School age, adolescence,
adulthood, and old age
o NURSING CARE INCLUDES:
▪ I. traditional and innovative
approaches
▪ II. therapeutic use of self,
executing health care
techniques and procedures,
essential primary health care,
comfort measures, health
teachings
▪ III. administration of written
prescription for treatment,
therapies, oral topical and
parenteral medications,
▪ IV. internal examination during
labor in the absence of
antenatal bleeding and
delivery in case of suturing of
perineal laceration
o The nurse is duty-bound to observe
the Code of Ethics for nurses and
THEORETICAL FOUNDATIONS 110 {VENICE} 18
 uphold the standards of safe
nursing practice.
o The nurse is required to maintain
competence by continual learning
through continuing professional
education to be provided by the
accredited professional organization
or any recognized professional
nursing organization.
PENAL AND MISCELLANEOUS PROVISIONS
⮚ According to Section 35, Prohibitions in the
Practice of Nursing
o A fine of not less than P50,000 nor
more than P100,000 or
imprisonment of not less than 1
year nor more than six 6 years, or
both, upon the discretion of the court,
shall be imposed upon:
▪ A. Any person practice
Nursing in the Philippines
without a professional
license and identification
card or special temporary
permit
▪ B. Any person who uses as
his/her own certificate of
registration/professional
license and professional
identification card or special
temporary permit of another
▪ C. Any person who uses an
invalid certificate of
registration/professional
license, a suspended or
revoked certificate of
registration/professional
license, or an expired or
cancelled special/temporary
permits
▪ D. Any person who gives any
false evidence to the Board in
order to obtain a certificate of
registration/professional
license, a professional
identification card or special
permit
▪ E. Any person who falsely
poses or advertises as a
registered and licensed
nurse or uses any other
means that tend to convey the
impression that he/she is a
registered and licensed
nurse
▪ F. Any person who appends
B.S.N./R.N. or any similar
appendage to his/her name
without having been
conferred said degree or
registration; G. Any person
who, as a registered and
licensed nurse, abets or
assists the illegal practice of
a person who is not lawfully
qualified to practice nursing
LESSON 03: STRUCTURE OF NURSING
STRUCTURE OF NURSING KNOWLEDGE
5 COMPONENTS
1. Metaparadigm
2. Philosophies
3. Conceptual Models
4. Theories
5. Empirical Indicators
o The components of the structural
hierarchy are made up of concepts
and propositions
o CONCEPT – Is a word or phrase that
summarizes the essential
characteristics or properties of
phenomenon.
o PROPOSITION – Is a statement
about a concept or a statement of the
relation between two or more or
different concepts.
METAPARADIGM
⮚ The first component of the structural
hierarchy of knowledge.
THEORETICAL FOUNDATIONS 110 {VENICE} 19
 ⮚ It is the most abstract component of the time that nursing occurs, which can
structural hierarchy. range from high-level wellness to
⮚ The concepts and propositions of a terminal illness.
metaparadigm are admittedly extremely 4. The metaparadigm concept nursing
global and provide no definitive direction for refers to the definition of nursing, the
such activities is research and clinical actions taken by nurses on behalf of or in
practice. conjunction with the person, and the
⮚ “Meta” means with and “Paradigm” means goals or outcomes of nursing actions.
pattern of shared understanding and
assumption. PHILOSOPHY
⮚ The Metaparadigm of Nursing is made up
of four concepts, four non-relational ⮚ The second component of the structural
propositions, and four relational hierarchy of contemporary nursing
propositions. knowledge is the philosophy.
⮚ A statement encompassing ontological
⮚ 4 concepts of Metaparadigm of Nursing: claims about how those phenomena come
to be known, and ethical claims about what
o Person – Recipient(s) of care. Can the members of a discipline value.
be individual/community. Significant
as person. CONCEPTUAL MODELS
o Environment – Internal & External ⮚ The third component of the structural
Factors. Surrounding of patient that hierarchy of contemporary nursing
applied client. External beliefs and knowledge is the conceptual model.
practices. ⮚ A set of relatively abstract and general
o Health – Defined by person. Degree concepts that address the phenomena of
of well being central interest to a discipline, the
o Nursing – Nursing actions. propositions that broadly describe those
Attributes. Characterize of nurses concepts, and the propositions that state
toward patient. relatively abstract and general relations
between two or more of the concepts.
METAPARADIGM OF NURSING
INPUT THROUGHPUT OUTPUT
⮚ 4 non-related propositions Demographic ⮚ Level of Can for
1. The metaparadigm concept person Profile awarenes Muslim
refers to the individuals, families, A. Age in s on the Women
communities, and other groups who are marriage implement and their
participants in nursing. B. Age ation of families
2. The metaparadigm concept C. Educatio family
nal Programs
environment refers to the person’s planning.
Attainme on
significant others and physical ⮚ Natural
planning
surroundings, as well as to setting in nt and focusing
which nursing occurs, which ranges from D. Employm Modern on
the person’s home to clinical agencies to ent family achieving.
society as a whole. Status planning
3. The metaparadigm concept health refers practices. Sustainabl
to the person’s state of well-being at the e

THEORETICAL FOUNDATIONS 110 {VENICE} 20

 E. Socio ⮚ Level of developme ⮚ The fourth component of the Structural
Economi acceptanc nt goal 3 hierarchy of contemporary Nursing
c Status e on the “Ensure knowledge is the theory.
F. Number use of healthy ⮚ One or more relatively concrete and specific
of family lives and concepts that are derived from a conceptual
children planning. promote model, the propositions that narrowly
well being describe those concepts, and the
G. Source ⮚ Factors of
for all at all
of non-avail propositions that state relatively concrete
ages
informati ment on and specific relations between two or make
on on the the use of Sustainabl of the concepts.
use of family. e
contrace Developme GRAND THEORY
ption nt Goal 5 ⮚ Grand Theories are broad in scope. They
H. Preferred “Promote are made up of concepts and propositions
learning women that are less abstract and general than the
material empowerm concepts and propositions of a conceptual
on family ent and model but are not as concrete and specific
planning. gender as the concepts and propositions of a
equality”> middle-range theory

CONCEPTUAL MODELS
⮚ The term conceptual model is synonyms
with the terms: conceptual framework,
conceptual system, paradigm, and
disciplinary matrix.
⮚ Functions of a conceptual model
1. Provides distinctive frame of reference.
2. Tells how to observe and interpret the
phenomena of interest to the discipline.
3. Simplication of reality that includes only
those concepts that the model author
considers relevant and as aids to
understanding.

MIDDLE RANGE THEORY

⮚ Middle-range theories are narrower in scope
than grand theories. They are made up of a
limited number of concepts and propositions
that are written at a relatively concrete and
specific level.
⮚ Each middle-range theory addresses a more
or less relatively concrete and specific
phenomenon by describing what the
phenomenon is, explaining why it occurs, or
predicting how it occurs.
THEORY

THEORETICAL FOUNDATIONS 110 {VENICE} 21

FUNCTION OF A THEORY
⮚ One function of a theory is to narrow and
more fully specify the phenomena contained
in a conceptual model.
⮚ Another function is to provide a relatively
concrete for the interpretation of initially
puzzling behaviors, situations, and events.
EMPIRICAL INDICATORS
⮚ The fifth and final component of the
structural hierarchy of contemporary
nursing knowledge is the empirical
indicator
⮚ Nursing Empirical Indicators
⮚ Nurses have developed a plethora of
empirical indicators in the form of research
instruments and district clinical tools.
⮚ The function of empirical indicators is to
provide the means by which middle-range
theories are generated or tested. Empirical
indicators that are instruments yield data
that can be sorted into qualitative categories
or calculated as quantitative scores.
METHODS OF THEORY DEVELOPMENT
1. Theory-Practice-Theory – Directs that
theory development in nursing is based on
and parallel to other theories used in other
discipline/
Ex. Nurse Rodney wants to develop a new
theory that is inspired from Abraham
Maslow’s of need.
2. Practice-Theory – Directs that the theory
development is based on the life/work
experience and professional practice of the
theorist.
Ex. Nurse Harry is assigned in the ICU for
20 years, he developed a theory about
nurse’s coping mechanism in caring for
terminally ill patients called the “Theory of
attachment”
3. Research Theory – Directs that the theory
development is based on the extensive
research done by the theorist.
Ex. Prof. Rem did research on the reasons
why nurses stay in the hospital to work and
their reason for leaving she called it “Theory
of Tenure”.
THEORY DEVELOPMENT PROCESS’
⮚ Development of theory requires
understanding of selected scholarly terms,
definitions, and assumptions so that
scholarly review and analysis may occur.
Attention is given to terms and defined
meanings to understand and theory
development process that was used.
⮚ Three categories of theory components are
presented as a basis for understanding the
function of each element in the
theory-building process.
THEORY COMPONENTS
1. CONCEPTS AND DEFINITION
⮚ Concept – The building blocks of
theories, classify the phenomena of
interest. May be abstract or concrete.
⮚ Definition – Conveys general
meaning and reduce vagueness in
understanding a set of concepts.
⮚ Abstract – Concepts are mentally
constructed independent of a specific
time or place
⮚ Concrete – Directly experienced and
relate to a particular time or place.
2. RELATIONAL STATEMENTS
⮚ Propose relationship between and
among two or more concepts.
Concepts are the building blocks of
theory, and theoretical statements are
the chains that link blocks to build
theory. Concepts must be connected
with one another in a series of
theoretical statements to devise a
nursing theory.
THEORETICAL FOUNDATIONS 110 {VENICE} 22

CHARACTERISTICS OF THEORY
1. A theory must be “falsifiable”
2. A theory must be simple in terms of the
general principles involved.
3. It must be workable
4. It must be elegant or beautiful (Symmetry,
Simplicity, Accuracy)
5. The theory should be as general as
possible.
6. It should have few or no anomalies
7. If possible, the theory ought not to be purely
statistical.
8. The theory should bring out analogies and
use models.
PURPOSE OF NURSING THEORY
⮚ Education
⮚ Research
⮚ Clinical Practice
⮚ It guides nursing practice and
generates
PURPOSES OF NURSING THEORY
⮚ It guides nursing practice and generates
knowledge
⮚ It helps to describe and explain nursing
⮚ It enables nurse to know what they are
doing and why they are doing
LESSON 04:
FLORENCE NIGHTIMGALE
⮚ The Environmental Theory
o Florence Nightingale often
considered the first nurse theorist.
o Defined nursing more than 100 years
ago as the “Act of utilizing the
environment of the patient to assist
him in his recovery”
o Linked health in 5 environmental
factors (pure/fresh air, pure water,
efficient drainage, cleanliness,
light)
o Stress the importance of keeping the
client warm, maintaining a noise-free
environment, and attending to the
client’s diet in terms of assessing
intake, timelines of the food, and its
effect on the person
⮚ 10 Aspects of the Environmental Theory
1. Environment - Patients should have
clean air and a
temperature-controlled
2. Patients - Should have access to
direct sunlight and not be subjected
to unnecessary noise, especially
when sleeping
3. Rooms - Should be kept clean
4. Hospital facilities - Should be
well-constructed
5. Bedding - Should be changed and
aired frequently
6. Patients - Should be kept clean
7. Nurses - Should wash hands
frequently.
8. Patients - Should be offered a variety
of scenery, such as new books or
flowers, to prevent boredom
9. Nurses - Should be positive but not
offer false hope to patients or
10. Patients - Should be kept clean and
nurses should wash hands frequently
Offer a variety of small meals instead
of large ones, and do not do patient
care while patient is eating as it is
distracting Consider not only the
individual patient but the context of
where he or she lives
WHAT ARE YOUR 2 CENTS?
THEORETICAL FOUNDATIONS 110 {VENICE} 23
 ⮚ (1) PERSON
o In Florence Nightingale’s theory, the
Person, one of the elements in the
four metaparadigms, is the
individual receiving care 
o Nightingale’s perception of the
Person is that the person is a
multidimensional being, that
includes biological, psychological,
social and spiritual components
o BIOLOGICAL
▪ Addressed by the use of
medicine and nursing to
address various diseases
o PSYCHOLOGICAL AND SOCIAL
COMPONENTS
▪ Consists of self-concept,
feelings, thought-processes
and social interactions
o SPIRITUALITY
▪ Intertwined with Nightingale’s
own spiritual beliefs; that the
person is valued 
▪ Nightingale theory of the
Person is based on holism.
Holism is the concern of
integrating the biological,
social, psychological and
spiritual with its
environment 

⮚ (2) HEALTH
o Health is viewed as the combined
result of environmental, psychological
and physical factors, not just the
THE HOSPITAL WINDOW absence of disease.
o Nightingale states that “health is not
only to be well, but to be able to use
well every power we have.”
o This is consistent with our perception
of health today, where one does not
have to be disease free to be healthy
but to maximize their potential to be
in a healthy state. 
o Disease is portrayed as dys-ease,
THE 4 METAPARADIGMS OF ENVIRONMENTAL or the absent of comfort. 

THEORETICAL FOUNDATIONS 110 {VENICE} 24

 o Nightingale isolated 5 factors
essential in securing an individual’s
health; these include pure air, pure
water, efficient drainage,
cleanliness and light
o Nightingale’s 6 D’s of “Dys-ease”
⮚ (3) ENVIRONMENT
o There exist five environmental
components which are all essential to
an individual’s health. These are
known collectively as the “health of
houses”, and outline factors of the
physical environment which must
receive attention  maintain a therapeutic environment. Her
o The underlying principle of
maintaining health of houses is to put
the patient in a condition which is
best for nature to act upon him or her.
An environment that promotes health
allows the patient to retain their
energy, or “vital powers” for use
towards self-healing
⮚ (4) NURSING
o Nightingale’s view on nursing is one
that is largely intertwined by factors
pertaining to the environment.
o Nightingale believed that many of the
symptoms and sufferings of patients
were not directly related to their
disease or ailment, but rather
consequences of poor environmental
conditions
o The duties of nursing include
providing essentials such as fresh
air, warmth, light, cleanliness,
quiet and a proper diet.  By helping
to control environmental
influences, nurses can aid in the
maintenance of health of their
patients. 
MAJOR ASSUMPTIONS
1. NURSING – Every woman at one time in her
life would be a nurse in the sense that
nursing is being responsible for someone
else’s health.
2. PERSON – Patient. The nurse was in
control of and responsible for the patient’s
environmental surroundings.
3. HEALTH – Being well and using every
power to the fullest extent. She envisioned
the maintenance of health through
prevention of disease by environmental
control and social responsibility.
4. ENVIRONMENT – Nursing was to assist
nature in healing the patient. Create and
assumptions and understanding about the
environmental conditions were most relevant
to her philosophy.
JEAN WATSON
⮚ "We are the light in institutional darkness,
and in this model, we get to return to the
light of our humanity." -Dr. Jean Watson
⮚ (June 10, 1940 – present) Watson was born
Margaret Jean Harmon and grew up in the
small town of Welch, West Virginia, in the
THEORETICAL FOUNDATIONS 110 {VENICE} 25
 Appalachian Mountains. She was the involved in the relationship as encompassed
youngest of eight children and was by nursing.

surrounded by an extended
family–community environment. Watson
attended high school in West Virginia and
then the Lewis Gale School of Nursing in
Roanoke, Virginia, where she graduated in
1961.
⮚ Educated: BSN, University of Colorado,
1964, MS, University of Colorado, 1966,
PhD, University of Colorado, 1973
⮚ Distinguished Professor of Nursing and
Chair in Caring Science at the University of
Colorado Health Sciences Center.
⮚ Fellow of the American Academy of Nursing.
⮚ Dean of Nursing at the University Health
Sciences Center and President of the
National League for Nursing
⮚ Undergraduate and graduate degrees in
nursing and psychiatric-mental health
nursing and PhD in educational psychology
and counseling.
⮚ Six (6) Honorary Doctoral Degrees.
⮚ Research has been in the area of human
THE TEN (10) CARITAS PROCESSES
caring and loss.
1. Cultivating the practice of loving- kindness
⮚ In 1988, her theory was published in
and equanimity toward self and other as
“nursing: human science and human care”. foundation to caritas consciousness

THE THEORY 2. Being Authentically Present- Enabling,

OF
TRANSPERSONAL
CARING
⮚ Watson bases her theory for nursing
practice on the following 10 curative factors.
Each has a dynamic phenomenological
component that is relative to the individuals
sustaining, and honoring faith, hope, and
deep belief system and the inner subjective
world of self/other
3. Cultivation of one’s own spiritual practices
and transpersonal self, going beyond
ego-self

THEORETICAL FOUNDATIONS 110 {VENICE} 26

4. Development and sustaining a helping trust
caring relationship
5. Being present to, and supportive of, the
expression of positive and negative feelings.
6. Creative use of self and all ways knowing as
part of the caring process; engage in the
artistry of caritas nursing
7. Engage in genuine teaching-learning
experience that attends to unity and being
and subjective meaning- Attempting to stay
within other’s frame of reference
8. Creating a healing environment at all levels
9. Administering sacred nursing acts of caring
healing by tending to basic human needs
10. Opening and attending to spiritual /
mysterious and existential unknowns of
life-death.
THE SEVEN (7) ASSUMPTIONS
1. Caring can be effectively demonstrated and
practiced only interpersonally.
2. Caring consists of curative factors that result
in the satisfaction of certain human needs.
3. Effective caring promotes health and
individual or family growth.
4. Caring responses accept person not only as
he or she is now but as what he or she may
become.
5. A caring environment is one that offers the
development of potential while allowing the
person to choose the best action for himself
or herself at a given point in time.
6. Caring is more “health genic” than is curing.
A science of caring is complementary to the
science of curing.
7. The practice of caring is central to nursing.
TRANSPERSONAL CARING THEORY
METAPARADIGM
⮚ PERSON
o Watson uses interchangeably the
terms human being, person, life,
personhood, and self. She views the
person as “a unity of
mind/body/spirit/nature”
o Watson states, “I make the point to
use mind, body, soul or unity within
an evolving emergent world
view-connectedness of all,
sometimes referred to as Unitary
Transformative
Paradigm-Holographic thinking.
⮚ HEALTH
o She defined health as “unity and
harmony within the mind, body, and
soul”; associated with the “degree of
congruence between the self as
perceived and the self as
experienced”
o Watson’s definition of health has
evolved. The positive state of
physical, mental and social well-being
with the inclusion of 3 elements;
1. A high level of overall physical,
mental and social functioning
2. A general adaptive maintenance
level of functioning
3. Absence of illness
⮚ ENVIRONMENT
o Watson speaks to the nurse’s role in
the environment as “attending to
supportive, protective, and or
corrective mental, physical, societal,
and spiritual environments”
o She emphasizes the person and the
environment has a connection,
nurses are part of the patient’s
environment and once a nurse enters
the patient’s room an expectation is
already present.
⮚ NURSING
o “Nursing is concerned with promoting
health, preventing illness, caring for
the sick and restoring health”
o According to Watson, the word nurse
is both a noun and a verb. To her,
THEORETICAL FOUNDATIONS 110 {VENICE} 27
 nursing consists of “Knowledge,
thought, values, philosophy,
commitment and action with some
degree of passion”
THEORETICAL ASSERTIONS
⮚ NURSING – Consist of knowledge, thought,
values, philosophy, commitment and action
with some degree of passion. Using the 10
curative factors, the nurse provides care to
various patients.
⮚ PERSONHOOD – Views person as a unity
of mind/body/spirit/nature. The body is a
living spirit that manifests one’s being in the
world
⮚ HEALTH – Unity and harmony within the
mind, body and spirit, associated with the
degree of congruence between the self as
perceived and the self as experienced.
⮚ ENVIRONMENT – Healing spaces can be
used to help others transcend illness, pain
and suffering. The aim of the environment is
to create healing places.
APPLICATION
THE BASICS IN CARITATIVE CARING ETHICS
KATIE ERIKSSON
THEORY OF CARATIATIVE CARING
⮚ Eriksson was born on November 18, 1943,
in Jakobstad, Finland.
⮚ 1965 graduated at the Helsinki Swedish
School of Nursing,
⮚ 1967 completed her Public Health Nursing
specialty education.
CARITATIVE CARING
⮚ Caritas refers when caring for the human
being in health suffering.
⮚ True caring, occurs when the one caring in a
spirit of caritas alleviates the suffering of the
patient.
⮚ It is not equated to service with quality
and compensation.
⮚ Love- Charity-faith-hope
PUBLISHED BOOKS
⮚ The Idea of Caring
⮚ The Suffering Human Being
ARE:
⮚ Human dignity
⮚ Caring communion
⮚ Invitation & responsibility
MAJOR ASSUMPTIONS
⮚ Nursing – Viewed as love and charity
⮚ Person – Human being is an entity of
body-soul and spirit
⮚ Environment - Ethos/home, human being’s
innermost space where it appears
nakedness.
⮚ Health - Soundness, freshness, & well being
THEORETICAL FOUNDATIONS 110 {VENICE} 28

PATRICIA BENNER
⮚ Patricia Benner was born in Hampton,
Virginia and spent her childhood in
California, where she received her early and
professional education. She obtained a
baccalaureate of arts degree in nursing from
Pasadena College in 1964. In 1970 she
earned a master’s degree in nursing, with
major emphasis in medical surgical nursing
from University of California, San Francisco
School of Nursing
⮚ Her PhD in stress, coping and health was
conferred in 1982 at the University of
California, Berkeley, and her dissertation
was published in 1984. Benner has a range
of clinical experience, including acute
medical surgical, critical care and home
health care.
NOVICE TO EXPERT THEORY
⮚ Benner adapted Hubert Dreyfus Model of
skill acquisition. Benner applied it to her
work “From novice to Expert” Benner’s
model is situational and describes five levels
of skill acquisition and development.
MAJOR CONCEPTS AND DEFINITION
⮚ NOVICE
• The person has no background
experience of the situation in which
he or she is involved. Context free
rules and objectives attributes must
be given to guide performance.
⮚ ADVANCED BEGINNER
• The person can demonstrate
marginally acceptable performance,
having coped with enough real
situations to note, or to have pointed
out by a mentor, the recurring
meaningful components of the
situation. Nurses functioning at this
level are guided by rules and are
oriented by task completion.
⮚ COMPETENT
• Consistency, predictability and time
management are important in
competent performance.
› Recognize patterns
› Prioritize
› Devise new rules and plan
› Less supervision
› High Anxiety
⮚ PROFICIENT
• Nurses at this level demonstrate a
new ability to see changing relevance
in a situation, including recognition
and implementation of skilled
responses to the situation as it
evolves.
• Nurses are more confident with their
knowledge and abilities
⮚ EXPERT
• Nurses have an intuitive grasp of the
situation, and as being able to identify
the region of the problem without
losing time considering a range of
alternative diagnoses and solutions.
• Expert nurses “know the patient”
• Key aspect of expert nurse
› Demonstrating a clinical grasp
and resource-based practice
› Possessing embodied know
how
› Seeing the big picture
› Seeing the unexpected
METAPRADIGM
⮚ NURSING
• Described nursing as a caring
relationship, an enabling condition of
connection and concern
• Caring is primary because caring sets
up the possibility of giving help and
receiving help.
• Nursing is viewed as a caring practice
whose science is guided by the moral
art and ethics of care and
responsibility
⮚ PERSON
THEORETICAL FOUNDATIONS 110 {VENICE} 29
 • The body of a person has 5 ⮚ ENVIRONMENT - She believes that the
dimensions, Benner pointed out that term situation is to be used rather than
nurses should attend to all these environment. Personal interpretation of the
dimensions of the body and seek to situation is bounded by the way the
understand the role of embodiment in individual is in it of past, present, & future.
particular situation of health illness Situation/ being situated conveys a social
and recovery environment with social definition &
meaningfulness.
⮚ HEALTH
• Is defined as what can be assessed,
whereas well-being is the human
experience of health or wholeness.
Health is described as not just the
absence of disease and illness. A
person may have the disease and not
experienced illness, because illness
is the human experience of loss or
dysfunction, whereas disease is what
can be assessed at the physical level

⮚ SITUATION
• Benner and Wrubel use the term
situation rather than environment,
because situation conveys a social
environment with social with social
definition and meaningfulness. The
person’s past, present, and future,
which include her or his own personal
meanings, habits, and perspectives,
influence the current situation.

MAJOR CONCEPTS

⮚ NURSING- Nursing is viewed as a caring

practice whose science is guided by the
moral art & ethics of care & responsibility’s
caring relationship, an enabling condition of
connection & concern. Nursing practice as
the care & study of the lived experience of
health, illness, & disease

⮚ PERSON - A person is a self- interpreting

being, that is, the person does not come into
the world predefined but gets defined in the
course of living a life.

⮚ HEALTH - Health is defined as what can be

assessed, whereas well-being is the human
experience of health or wholeness.

THEORETICAL FOUNDATIONS 110 {VENICE} 30