Historical and

Contemporary
Nursing
Practice
Fundamentals of Nursing
 Facts…
Period of Intuitive Nursing
Beliefs and Practices of Prehistoric Nursing
• He was nomad. His philosophy of life was “the best for the
most” and he was ruled by the law of self-preservation.
• Nursing was a function that belonged to women
• Believed that illness was caused by invasion of evil spirit
• Believed that medicine man called “shaman” or witch
doctor had the power to heal by using white magic.
Practices “trephining” (drilling a hole in the skull with a
stone or rock without anesthesia as a last resort to drive
evil spirit from the body
 Facts…
Period of Intuitive Nursing
Nursing in the Near East
• Man’s mode of living changed from nomadic style to an
agrarian society to an urban community life.
• Developed a means of communication and the beginnings
of a body of scientific knowledge
• Nursing remained the duty of slaves, wives, sister or
mother
• The care of the sick was still closely related to religion,
superstition and magic.
 Facts…
Contribution to Medicine and Nursing
Babylonia
• Code of Hammurabi : Provided laws that covered every facet of Babylonian
life including medical practice.
Egypt
• Egyptians introduced the art of embalming which enhance their knowledge
of human anatomy.
Israel
• Moses – “Father of Sanitation”
• He wrote the five book of the Old Testament which:
✓ Emphasized the practice of hospitality to strangers and acts of charity.
✓ Promulgated laws of control on the spread of communicable disease and
the ritual of male circumcision.
 Facts…
Contribution to Medicine and Nursing
Nursing in the Far East
China
• Strongly believed in spirits and demons.
• Prohibition of dissecting the dead human body.
• Give the world knowledge of material medica which prescribed methods of
treating wounds, infection and muscular afflictions.
India
• Men of medicine built hospitals, practiced an intuitive form of asepsis and
were proficient in the practice of medicine and surgery.
• Sushurutu made a list of function and qualifications of nurses.
 Facts…
Contribution to Medicine and Nursing
Nursing in the Far East
Greece
• Nursing was the task of untrained slave
• Introduced the caduceus
• Hippocrates, Father of Scientific Medicine
Rome
• Attempted to maintain vigorous health, because illness was a sign of
weakness.
• Care of the ill was left to the slaves or Greek physician.
• Fabiola, made her home the first hospital in the Christian world.
 Facts…
Period of Apprentice Nursing
❖ Periods extends from the founding of religious nursing orders in The
Crusades and establishment of Kaiserwerth Institute for the Training of
Deaconesses.
❖ It is called the period of “on the job” training. Nursing care was performed
without any formal education and by people who were directed by more
experienced nurses.
❖ Military Religious Orders:
✓ Knights of St. John of Jerusalem
✓ Teutonic Knights, tent hospital for wounded
✓ Knights of St. Lazarus, nursing care for lepers
 Facts…
Period of Apprentice Nursing
Rise of Secular Orders,
✓ Order of St. Francis of Assisi
✓ The Bequines
✓ The Oblates
✓ Benedictines
✓ Ursulines
✓ Augustinians

❖ Hospitals were poorly ventilated and the beds were filthy.

❖ Overcrowding of patients
❖ Practice of environmental sanitation and asepsis were non-existent.
❖ Older nuns prayed with and took good care of the sick; while the younger
nuns washed soiled linens
 Facts…
Period of Apprentice Nursing

Important Nursing Personage During The Period

of Apprentice
✓ St. Claire

✓ St. Elizabeth of Hungary “Patroness of Nurses”

✓ St. Catherine of Siena “First Lady with a Lamp”

 Facts…
Dark Period of Nursing

❖ The religious upheaval led by Martin Luther

destroyed the unity of the Christian faith.
❖ The wrath of Protestantism swept away
everything connected with Roman
Catholicism
 Facts…
Dark Period of Nursing

❖ Hundreds of hospitals were closed

❖ There were no provision for the sick, no one to
care for the sick.
❖ Nursing become the work of the least
desirable women.
 Facts…
Dark Period of Nursing
Several Leaders Sought to Bring Reforms
✓ John Howard

✓ Mother Mary Aikenhand

✓ Pastor Theodor Fliedner and Frederika

Munster Fliedner, established the Institute for

Training of Deaconesses at Kaiserwerth,
Germany. The first organized training school
for nurses.
 Societal Attitudes
❖ Before mid-1800s, woman's place in the home
❖ Victorian era
Women should be wives and mothers.
Negative image of Dickens character Sairy
Gamp
Positive image of Florence nightingale
Doctor's handmaiden
 Societal Attitudes
❖ Nurse as heroine, sex object,

surrogate mother, tyrannical

mother
❖ 1990s Tri-Council for Nursing to

improve image
 War
❖ Crimean War
Florence Nightingale
❖ American Civil War
Harriet Tubman
Sojourner Truth
Dorothea Dix
❖ World War I
Harsh environments and new injuries
 War
❖ World War I
Progress in the field of surgery
❖ World War II
Acute shortage of caregivers
Cadet Nurse Corps
❖ Vietnam War
Youngest group of medical personnel to
serve in wartime
 Harriet Tubman
(1820–1913)
was known as "The Moses of
Her People" for her work
with the Underground
Railroad. During the Civil
War she nursed the sick and
suffering of her own race.
Sojourner Truth
(1797–1883)
abolitionist, Underground
Railroad agent, preacher, and
women's rights advocate, was a
nurse for more than 4 years
during the Civil War and worked
as a nurse and counselor for the
Freedmen's Relief Association
after the war.
Nursing in America
❖Jeanne Mance, the first laywoman
who worked as a nurse in North
America. She founded the Hotel Dieu
of Montreal, a log cabin hospitals
❖Mrs. Elizabeth Seton, founded the

Sister of Charity of Emmitsberg,

Maryland
Nursing in America
American Reforms in Nursing

❖The Nurse’s Society of Philadelphia, organized a

school of nursing under the direction of Dr.
Joseph Warrington. Nurses were trained on the
job and attended some preparatory courses.
❖Women’s Hospital in Philadelphia, established a
six month course in nursing.
Nursing in America
Nursing during the Civil War

The American Medical Associa during the Civil War

created the Committee on Training of Nurses.
Dorothea Dix, established the Nurse Corps of the
United States Army.
Clara Barton, founded the American Red Cross
 Dorothea Dix
(1802–1887)
was the Union's
superintendent of
female nurses
during the Civil War.
 Clara Barton
(1821–1912)

organized the American Red

Cross, which linked with the
International Red Cross
when the U.S. Congress
ratified the Geneva
Convention in 1882.
Period of Educated Nursing
This period began on June 15, 1860
when the Florence Nightingale
School of Nursing opened at St.
Thomas Hospital in London
(St.Thomas Hospital School of
Nursing)
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, Notes
on Nursing: What It Is, and What It Is
Not, first published in England in 1859
and in the United States in 1860, was
intended for all women.
Period of Educated Nursing
Facts About Florence Nightingale
✓Recognized as the “Mother of Modern Nursing”
✓Also known as the “ Lady with a Lamp”
✓Born on May 12, 1820 in Florence Italy
✓Not contented with the social custom imposed upon her as
a Victorian Lady, she developed her self-appointed goal:
“To change the profile of nursing”
✓ Compiled notes of her visits to hospitals, her observation
of the sanitary facilities and social problems of the places
she visited.
 Period of Educated Nursing
Facts About Florence Nightingale
✓Advocated for care of those afflicted with disease caused by
lack of hygienic practices.
✓At the age of 31, she overcome her family’s resistance to her
ambitions. She entered the Deaconess School at Kaiserworth.
✓Worked as a superintendent for Gentlewomen during illness.
✓Upgraded the practice of nursing and made nursing an
honorable profession for gentlewomen.
✓Led the nurses that took care of the wounded during the
Crimean War.
 Period of Educated Nursing
Facts About Florence Nightingale

✓ Improved standards of care for war casualties

✓ Nursing's first scientist-theorist, nurse
researcher
✓ Notes on Nursing: What It Is, and What It Is
Not
✓ Nightingale Training School for Nurses
 Period of Educated Nursing
Important Persons/ Groups/ Events

❖ Linda Richards, First graduate nurse in the US

❖ Dr. William Halstead, Designed the first rubber gloves
❖ Caroline Hampton Robb, The first to nurse to wear gloves
while working as an operating room nurse.
❖ Clara Louise Maas, Engaged in medical research on yellow
fever, She died of yellow fever
 Linda Richards
(1841–1930)

❖ America's first trained

nurse
❖ Initiated practice of
wearing uniforms
❖ National League for
Nursing Records. 1894–
1952.
 Period of Educated Nursing
Important Persons/ Groups/ Events

❖ Establishment of nursing organization; the American

Nurses Association and the National League for
Nursing Education.
❖ Development of private duty nursing, settlement
house nursing, school nursing, government service
of nurses and maternal and prenatal health nursing.
Period of Contemporary Nursing
❖ Period after World War II
❖ Establishment of the World Health Organization by the
UN
❖ Use of atomic / nuclear energy for medical diagnosis and
treatment
❖ Utilization of computers and use of sophisticated
equipment for diagnosis and therapy
❖ Health is perceived as a fundamental human right
Nursing Leaders

Mary Mahoney
(1845–1926)
First African American trained
professional nurse

Worked for acceptance and equal

opportunity
 Nursing Leaders

Lillian Wald
(1867–1940)
❖ founded the Henry Street Settlement
and Visiting Nurse Service (circa
1893), which provided nursing and
social services and organized
educational and cultural activities.
❖ She is considered the founder of
public health nursing.
 Nursing Leaders

Lavinia L. Dock
(1858–1956)
❖ was active in the protest movement
for women's rights that resulted in
the constitutional amendment in
1920 that allowed women to vote.
❖ Legislation to allow nurses control
their own profession
Precursor to National League of Nursing
 Nursing Leaders

Margaret Sanger
(1879–1966)
❖ considered the founder of Planned
Parenthood, was imprisoned for
opening the first birth control
information clinic in Baltimore in
1916.
❖
 Nursing Leaders

Mary Breckinridge
(1881–1965)
❖ a nurse who practiced midwifery in
England, Australia, and New Zealand,
founded the Frontier Nursing Service in
Kentucky in 1925 to provide family-
centered primary health care to rural
populations.
❖ Started one of the first midwifery
training schools in U.S.
 Men in Nursing
❖ Schools of nursing for men in U.S. from late
1880s to 1969

❖ American Assembly for Men in Nursing (AAMN)

Originally National Male Nurses Association
Recruitment, retention by changing image of
male nurses
 Men in Nursing
❖ Luther Christman
Discrimination because of gender
First man to be a dean at a university school of
nursing
❖ Barriers
Image of femininity
Belief that only homosexual men are nurses
Suspicion surrounding intimate touch
History of Nursing in the Philippines
Early Beliefs and Practices

❖ Beliefs about causation of disease: Enemy or a witch and

evil spirit
❖ People believed that evil spirits could be driven away by
persons with power to expel demons.
❖ People believed I special gods of healing, with the
priest-physician (called “word doctors”). If they used
leaves or roots, they were called herb doctors
(“Herbolarios”)
History of Nursing in the Philippines
Early Beliefs and Practices

❖ Herbicheros one who practiced witchcraft.

❖ Persons suffering from disease without any
identified cause were believed to be bewitched
by the “mangkukulam or mangagaway.
❖ Difficult childbirth were attributed to “nono”
History of Nursing in the Philippines
Earliest Hospitals

❖ Hospital Real de Manila ( 1577)

❖ San Lazaro Hospital ( 1578 )
❖ Hospital de Indio ( 1586 )
❖ Hospital de Aguas Santas ( 1590 )
❖ San Juan de Dios Hospital ( 1596 )
History of Nursing in the Philippines
Prominent Person Involved in Nursing Works
(Philipine Revolution)

❖ Josephine Bracken, installed a field hospital in

Tejeros for wounded.
❖ Rosa Sevilla de Alvero
❖ Dona Hilaria de Aguinaldo, organized Filipino
Red Cross.
History of Nursing in the Philippines
Prominent Person Involved in Nursing Works
(Philipine Revolution)

❖ Dona Maria Agoncillo de Aguinaldo, 2nd wife of Emilio

Aguinaldo, Pres. Of Filipino Red Cross in Batangas
❖ Melchora Aquino ( Tandang Sora )
❖ Capital Salome
❖ Agueda Kahabagan
❖ Trinidad Tecson, “ Ina ng Biac na Bato “
History of Nursing in the Philippines
Hospitals and School of Nursing

❖ Iloilo Mission Hospital School of Nursing ( Iloilo City,

1906 )
- In April 1944, 22 nurses graduated took the first
Nurses Board Examination at the Iloilo Mission
Hospital.
❖ St. Paul’s Hospital School of Nursing (Manila, 1907)
History of Nursing in the Philippines
Hospitals and School of Nursing

❖ Philippine General Hospital School of Nursing

( 1907 )
- Anastacia Giron-Tupas, the first Filipino
nurse to occupy the position of chief nurse
and superintendent in the Philippines.
❖ St. Luke’s Hospital School of Nursing ( Quezon
City, 1907)
History of Nursing in the Philippines
Hospitals and School of Nursing

❖ Mary Johnston Hospital and School of Nursing

( Manila, 1907 )
❖ Philippine Christian Mission Institute School of
Nursing
❖ San Juan de Dios Hospital School of Nursing
(1946)
History of Nursing in the Philippines
Hospitals and School of Nursing

❖ Emmanuel Hospital School of Nursing

( Capiz, 1913 )
❖ Southern Islands Hospital School of
Nursing
( Cebu, 1918 )
History of Nursing in the Philippines
Requirement for Admission

✓ At least completion of seventh grade

✓ Sound physical and mental health
✓ Good moral character
✓ Good family and social standing
✓ Recommendations from three different persons
well known in the community
History of Nursing in the Philippines
First College of Nursing in the Philippines

❖ University of Sto.Tomas College of Nursing

(1946)
❖ Manila Central University College of Nursing
(1947)
❖ University of the Philippines College of Nursing
(1948)
History of Nursing in the Philippines
Nursing Leaders in the Philippines

❖ Anastacia Giron – Tupas, First Filipino nurse to hold the position of

Chief Nurse Superintendent; founder of the Philippine Nurses
Association.
❖ Cesaria Tan, First Filipino to receive a Masters degree in Nursing
abroad.
❖ Socorro Sirilan, Pioneered in Hospital Social Service in San Lazaro
Hospital where she was the chief nurse.
History of Nursing in the Philippines
Nursing Leaders in the Philippines

❖ Rosa Militar, pioneer in school health education

❖ Sor Ricarda Mendoza, pioneer in nursing education.
❖ Socorro Diaz, first editor of the PNA magazine called “
The Message “
❖ Conchita Ruiz, First full time editor of the newly named
PNA magazine “The Filipino Nurse”
Nursing Education
❖ Controlled by state boards of nursing and
professional organizations
❖ Originally taught knowledge and skills for
hospital practice
❖ Now more varied practice settings, critical
thinking, health promotion and maintenance
❖ Two entry levels: RNs or LPN/LVN
Nursing Education
❖ NCLEX-RN exam, verified completion of
prescribed course of study
❖ Accredited programs
❖ Licensure
❖ Mutual recognition, multistate compact
Nursing Education in the Philippines.
❖ Philippine Regulatory Commission (PRC)
Licensing body
R.A No. 7164 or Philippine Nursing Act
of 2022.
❖ Philippine Board of Nursing
administrative body under the Philippine
regulation Commission that regulates the practice
of nursing in the Philippines.
Nursing Education in the Philippines.
Philippine Board of Nursing

Provide regulatory standards in the practice of Nursing by

implementing the Nurse Practice Act and by lobbying to
Congress any proposed amendment to any laws with direct
relationship to the practice of nursing.

To maintain high standards of nursing education by

auditing the performance of Philippine Nursing Schools.
Types of Education Programs
❖ Registered nursing programs
Diploma
Three-year programs
Have declined steadily since 1965
❖ Associate degree
Most take place in community colleges
ADN, AA, AS, AAS with major in nursing
Begun after Mildred Montag's dissertation
❖ Baccalaureate degree
Types of Education Programs
❖ Registered nursing programs

Baccalaureate degree
✓ Some accelerated programs for those who have a
baccalaureate degree in another field
✓ BSN completion programs for those with diploma,
associate degree
✓ Generally more autonomy, responsibility, career
advancement
Types of Education Programs
Graduate nursing programs
❖ Requirements for admission

✓ Licensure as registered nurse

✓ Baccalaureate degree
✓ Evidence of scholastic ability
✓ Satisfactory achievement on standard qualifying
examination
✓ Letters of recommendation
Types of Education Programs
Graduate nursing programs
❖ Master's degree
CNS, NP or APRN, CNM, CNRA, CNL
❖ Doctoral programs
PhD
Faculty roles in nursing education, research
❖ DNP
Highest degree for nurse clinicians
Types of Education Programs
❖ Continuing education

✓ Formalized experiences designed to enhance knowledge,

skills of practicing professionals
✓ Responsibility of all practicing nurses
✓ Some states require a number of CE credits to renew
license
✓ In-service education program may be offered by
employer
 Definitions of Nursing
Common themes

✓ Caring
✓ Art/science
✓ Client centered, holistic, and adaptive
✓ Concerned with health promotion, health
promotion, and health maintenance
✓ Helping profession
 Recipents of Nursing Care
❖ Consumer
❖ Patient
Person waiting for, undergoing medical
treatment and care
❖ Client
Person who engages in advice, services of
another who is qualified to provide service

Increasingly used over patient

 Scope of Nursing
❖ Promotion of health and wellness
Individual and community activities to
enhance health lifestyles

❖ Prevention of illness
Immunizations
Prenatal and infant care
Prevention of STIs
 Scope of Nursing
❖ Restoring health

✓ Direct care to ill person

✓ Diagnostic and assessment procedures
✓ Consulting other health care professionals
✓ Teaching clients recovery activities
✓ Rehabilitating clients to optimal functional
level
 Scope of Nursing
Care for the dying

✓ Comforting people of all ages

✓ In homes, hospitals, extended
care facilities, and hospices
 Settings for Nursing
✓ Acute care hospitals
✓ Clients' homes
✓ Community agencies
✓ Ambulatory clinics
✓ Long-term care facilities
✓ Health maintenance organizations
(HMOs)
✓ Nursing practice centers
 Nurse Practice Acts

❖ Legal acts
❖ Regulated by state or area of

jurisdiction
❖ Common purpose to protect the

public
 Standards of Nursing Practice
❖ ANA

Standards of Practice
Standards of Professional Performance

❖ Specialty nursing organizations

 Roles and Functions of Nurse
❖ Caregiver

Assist client physically and psychologically while

preserving client's dignity

❖ Communicator

Identify client problems and communicate them to

other members of the health care team
 Roles and Functions of Nurse
❖ Teacher

Help clients learn about health and health care

procedures to restore or maintain health

❖ Client advocate

Represent, protect the client's needs and wishes

 Roles and Functions of Nurse
❖ Counselor

Help client to recognize and cope with stressful

psychological or social problems, develop improved
relationships, and promote personal growth

❖ Change agent

Assist clients to make modifications in behavior

 Roles and Functions of Nurse
❖ Leader

Influence others to work together to accomplish

specific goal(s)

❖ Manager

Manage care of individuals, families, and

communities Delegate nursing activities
 Roles and Functions of Nurse
❖ Case manager

Work with or act as primary nurse to oversee care of

specific caseload

❖ Research consumer

Use research to improve client care

 Expanded Career Role
✓ Nurse practitioner
✓ Clinical nurse specialist
✓ Nurse anesthetist
✓ Nurse midwife
✓ Nurse researcher
 Expanded Career Role
✓ Nurse administrator
✓ Nurse educator
✓ Nurse entrepreneur
✓ Forensic nurse
 Criteria of a Profession
❖ Profession
✓ Occupation that requires extensive education
✓ Special knowledge, skill, and preparation
❖ Professionalism
✓ Professional character, spirit, methods
❖ Professionalization
✓ Process of becoming professional
 Criteria of a Profession
❖ Specialized education
✓ Hospital diploma, associate degree, baccalaureate
degree, master's degree, and doctoral degree

❖ Body of knowledge
✓ Nursing conceptual frameworks

❖ Service orientation
✓ Altruism and service to others
✓ Guided by rules, policies, ethics
 Criteria of a Profession
❖ Ongoing research
✓ Contemporary practice-related issues

❖ Code of ethics
✓ Integrity
Member expected to do what is considered
right regardless of personal cost
 Criteria of a Profession
❖ Autonomy
✓ Self-regulating
✓ Setting standards for members
✓ Independence at work, responsibility, accountability for
one's actions

❖ Professional organization
✓ Governance
 Socialization to Nursing
❖ Socialization

Interactions with fellow students establish level and

direction of effort, goals, and activities; develop solidarity

❖ Students bound together by feelings of mutual

cooperation, support, and solidarity
Benner’s Stage of Nursing Expertise
Stage I: Novice
Stage II: Advanced beginner
Stage III: Competent
Stage IV: Proficient
Stage V: Expert
 Critical Value of Nursing
✓ Code of ethics
✓ Standards of nursing practice
✓ Nurse practice acts in the legal
system
✓ NSNA's Code of Academic and Clinical
Conduct
Factors Influencing contemporary Nursing Practice

✓ Social forces
✓ Affects entire health care

system
 Health Care Reform
❖ Affordable Care Act (ACA) in 2010
❖ The Future of Nursing: Leading Change,
Advancing Health
IOM report

Recommendations on how nursing

could provide better client care in new
systems
 Quality and Safety in Health Care
❖ Quality and Safety Education for Nurses (QSEN)

IOM six competencies

✓ Patient-centered care
✓ Teamwork and collaboration
✓ Evidence-based practice
✓ Quality improvement
✓ Safety
✓ Informatics
 Consumer Demands
❖ Consumers more aware of others' needs for care
Minority groups, poor

❖ Changing public concepts of health

Right of all people, not a privilege for the rich

❖ Active participants in making decisions about health

and nursing care
 Family Structure
❖ Need for and provision of nursing
services in context of new structures
❖ Single parents rearing children
❖ Young families living far from own
parents
❖ Adolescent mothers need specialized
nursing services.
 Science and Technology
❖ Actions of new drug therapies,
genetic technology
❖ Some nurses required to be highly
specialized
❖ Space program technology adapted
into health care aids
Information, Telehealth, and Telenursing
❖ Internet's influence on health care
❖ Telehealth
Medical information exchanged via electronic
communications to improve patient's health status
❖ Telenursing
Provide nursing practice at a distance
❖ No state boundaries
Licensure issues
 Legislation
❖ Patient Self-Determination Act (PSDA)
Each patient's rights to accept or refuse
medical care, use advance directives
❖ Wide variation in state regulation of nurse
practitioner practice
NPs cannot easily move from state to state
 Demography
❖ Study of population
❖ Statistics about distribution by age, place
of residence, mortality, morbidity
❖ Total population in North America
increasing
❖ Population shifting from rural to urban
❖ Many risk factors for death can be
prevented.
 The Current Nursing Shortage
❖ Projected to intensify as baby boomers
age
❖ By 2022
❖ Depends on location, setting
❖ Difficulty in declining U.S. economy
❖ New graduates not being interviewed at
hospitals
❖ High turnover rate
 Collective Bargaining
❖ ANA participates on behalf of nurses
through economic, welfare programs
❖ Economic concerns
❖ Issues about safe care for clients, selves
 Nursing Associations
❖ Voluntary accreditation
✓ Accreditation Commission for Education in
Nursing (ACEN)
✓ Commission on Collegiate Nursing Education
(CCNE)
❖ American Nurses Association—Political Action
Committee
✓ Organization to lobby for legislation affecting
health care
 Nursing Organizations
❖ American Nurses Association
✓ National professional organization for nursing in
the U.S. founded 1896
✓ Official journal American Nurse Today
✓ Official newspaper The American Nurse
❖ National League for Nursing
✓ Formed 1952
✓ Individuals and agencies
✓ Continuing education services
 Nursing Organizations
❖ International Council of Nurses
✓ Established 1899
✓ National organizations working together for
mission of representing nursing worldwide
❖ National Student Nurses Association
✓ Formed in 1953
✓ Student must be in state-approved nursing
education program to qualify
 Nursing Organizations
❖ International Honor Society: Sigma Theta
Tau
✓ Founded 1922
✓ Professional rather than social
✓ Potential members hold bachelor's degree
minimum, demonstrate achievement in
nursing
 Assignment

● PNA
● PNSA