A Historical Perspective of Nursing

Family members, charitable institutions, and at war fields by the people with
humanitarian Nursing care started with crude beginnings, but now attained a
professional status no less important than the medical profession. By the
beginning of the nineteenth century, a number of hospital-based training
schools From 1875 onwards, a number of Dufferin Hospitals were started for
women and children continued to work for provision of Medical Education and
Nursing Education for Women in India. Accordingly, training schools for Indian
women were started in various Dufferin Hospitals like In 1908, the Trained
Nurses’ Association of India, a Nurses’ Professional Organisation was of
Nursing and has been the force behind most of the educational reforms. from
Trained Nurses Association of India, and other organizations, courses in
Hospital Administration and Sister Tutor Programmes have been started in
Delhi in 1943 and later in Starting of a course in Psychiatric Nursing especially
for male nursing students in lieu of Midwifery and the Training of Nurses in
Public Health had been the important developments in the field of Nurse
Education.
This article criticizes the prevailing view that the history of nursing may be
understood solely in terms of relative helplessness. By moving away from the
stance of educators deeply concerned about the inability of the profession to
gain control over entrance requirements and into the realm of practice, we use
examples from our own work to discuss alternate histories of power. We
acknowledge historical circumstances of invisibility and gender biases. But we
argue that when we look at the history of practice, we see as much evidence of
strength, purpose, and successful political action. Finally, we call for an
acknowledgement of the rich and complex nature of the many different
histories we can tell in nursing. And we suggest that an admitted inability to
advance in one area of the discipline has not meant an inability to move
others.
Dr Giridhar Rao M S
 Values and Ethical Conduct of Nurses
Ethics can be difficult to define because people’s perceptions of ethical
behavior are often tied to their personal belief systems, such as religious
beliefs, but religious beliefs vary widely. Others may believe that ethical
behavior consists of following the laws, but as history clearly shows, some laws
(such as segregation laws) have been profoundly unethical. Ethical behavior is
often considered that which is accepted by society as a whole, but again,
history does not support that view. Some societies, for example, support
female genital mutilation, and this is now considered by much of the world to
be unethical. Introduction Purpose Goals Despite these difficulties, there are
some clear ethical standards that apply to the field of nursing, and nurses are
expected to adhere to a code of ethics in all provisions of care as well as in
their personal and professional lives. In addition to ethical standards, nurses
must be knowledgeable about the laws that impact not only their personal
conduct but also the field of nursing as a whole.
Ethical values are universal rules of conduct that provide a practical basis for
identifying what kinds of actions, intentions, and motives are valued.[1] Ethics
are moral principles that govern how the person or a group will behave or
conduct themselves. The focus pertains to the right and wrong of actions and
encompasses the decision-making process of determining the ultimate
consequences of those actions. Each person has their own set of personal
ethics and morals. Ethics within healthcare are important because workers
must recognize healthcare dilemmas, make good judgments and decisions
based on their values while keeping within the laws that govern them. To
practice competently with integrity, nurses, like all healthcare professionals,
must have regulation and guidance within the profession. The American
Nurses Association (ANA) has developed the Code of Ethics for this purpose.

Wanda Lockwood, RN, BA, MA

Lisa M. Haddad; Robin A. Geiger
 Critical Thinking
Critical thinking is a multidimensional skill, a cognitive or mental process or set
of procedures. It involves reasoning and purposeful, systematic, reflective,
rational, outcome-directed thinking based on a body of knowledge, as well as
examination and analysis of all available information and ideas. Critical thinking
leads to the formulation of conclusions and the most appropriate, often
creative, decisions, options, or alternatives. Critical thinking includes
metacognition, the examination of one’s own reasoning or thought processes
while thinking, to help strengthen and refine thinking skills. Independent
judgments and decisions evolve from a sound knowledge base and the ability
to synthesize information within the context in which it is presented. Nursing
practice in today’s society mandates the use of high-level critical thinking skills
within the nursing process. Critical thinking enhances clinical decision making,
helping to identify patient needs and to determine the best nursing actions
that will assist the patient in meeting those needs. Critical thinking and critical
thinkers have distinctive characteristics. As indicated in the above definition,
critical thinking is a conscious, outcome-oriented activity; it is purposeful and
intentional. The critical thinker is an inquisitive, fair-minded truth seeker with
an open-mindedness to the alternative solutions that might surface.
Critical thinking is systematic and organized. The skills involved in critical
thinking are developed over time through effort, practice, and experience.
Skills needed in critical thinking include interpretation, analysis, evaluation,
inference, explanation, and self-regulation. Critical thinking requires
background knowledge and knowledge of key concepts as well as standards of
good thinking. The critical thinker uses reality-based deliberation to validate
the accuracy of data and the reliability of sources, being mindful of and
questioning inconsistencies. Interpretation is used to determine the
significance of data that are gathered, and analysis is used to identify patient
problems indicated by the data. The nurse uses inference to draw conclusions.
Explanation is the justification of actions or interventions used to address
patient problems and to help a patient move toward desired outcomes.
Evaluation is the process of determining whether outcomes have been or are
being met, and self-regulation is the process of examining the care provided
and adjusting the interventions as needed. Critical thinking is also reflective,
involving metacognition, active evaluation, and refinement of the thinking
process. The critical thinker considers the possibility of personal bias when
interpreting data and determining appropriate actions. The critical thinker
must be insightful and have a sense of fairness and integrity, the courage to
question personal ethics, and the perseverance to strive continuously to
minimize the effects of egocentricity, ethnocentricity, and other biases on the
decision-making process.

https://www.rnpedia.com/nursing-notes/fundamentals-in-nursing-notes/critical-thinking-
and-the-nursing-process/
 Health Care Delivery System
Health care delivery forms the most visible function of the health system, both
to patients and the general public. It concentrates on patient flows as well as
the organization and delivery of all services dealing with the diagnosis and
treatment of disease, or the promotion, maintenance and restoration of
health. It covers the main areas of service provision such as public health,
primary care, specialized care (often divided into secondary and tertiary care),
urgent and emergency care, pharmaceutical care, rehabilitation/intermediate
care, long-term care, services for informal cares, palliative care, mental health
care and dental care.
The Observatory’s engagement in this area focuses on describing, comparing
and analyzing the different delivery systems in use. It can build on the wealth
of detailed descriptions gathered as part of the longstanding Health Systems in
Transition (HiT) series and the Health Systems and Policy Monitor (HSPM).
Comparing health service provision across Europe is notoriously challenging.
The notions and definitions of terms used in different jurisdictions, the range
of services attributed to each type of health care delivery, and whether these
services take place in hospitals, in an ambulatory setting, or elsewhere, all
differ substantially.
Furthermore, the need for better integration of care is an inescapable trend
that will further blur the traditional boundaries of health service delivery. At
the same time this could offer real opportunities to put the patient at the
center of care and provide solutions for the growing numbers of people living
with multiple chronic diseases. As these and other concepts evolve, the
Observatory aims to analyze the evidence and distil lessons for policy-makers
seeking to improve their health care delivery systems.

https://eurohealthobservatory.who.int/themes/health-system-functions/health-care-
delivery
 Legal Aspects of Nursing
Nursing is a caring profession, which has its relevance and direct impact on the
life, health, and well-being of individual, families and communities. It is
therefore important to regulate the practice of nursing to ensure that
standards are maintained to achieve safe practice. The regulation of nursing is
achieved though credentialing, and standard of practice. Nursing practice is
governed by legal concepts, knowledge of which helps the nurse to make
decisions and take actions that are consistent with legal principles and thereby
protecting the nurse from liability.
According to Anarado (2002), the system of law rests on four principles that
include: Law is based on a concern for justice and fairness. The purpose of law
is to protect the rights of one party from the transgressions of another by
setting guidelines for conduct and mechanisms to enforce those guidelines.
Law uses punishment to inhibit antisocial behavior and to apply a just measure
of retribution. This may be in form of a fine or a period of time in prison.
However, for claims of damages for negligence, financial reparation is regarded
as compensation for injury sustained and not as a punishment for wrong
inflicted. The court relies on the evidence before it in order to pass judgment.
Actions are judged based on a universal standard of what a similarly educated,
reasonable and prudent person would have done under similar circumstances.

https://typesofnursing.com/nursing-laws-and-ethics-legal-aspects-of-nursing-
practice/