PERIODS OF NURSING HISTORY

• Intui ve Period
• Appren ce Period
• Educa ve Period
• Contemporary Period

INTUITIVE PERIOD
• Prehistoric  Early Chris an Era, More on intui on
• NOMADS – travel from one place to another
• Survival of the est
• “Best for the most” – mo o
• Sickness is due to “voodoo”
• Performed out of feeling of compassion for others
• Performed out of desire to help
• Performed out of wish to do good
• Nursing is given by the WOMEN
INTUITIVE PERIOD
• SHAMAN – uses white magic to counteract the black magic
--They are the doctors during those me.
• TREPHINING – drilling the skull
• Used to treat Psycho c pa ents
• Psycho c pa ents are believed to be possessed by evil spirits.
• Growth of religion – most important thing that happened
Growth of civiliza on
Law of self preserva on – inspire man in search of knowledge
RISE IN CIVILIZATION
From the mode of Nomadic life  agrarian society  gradual development of urban community life
Existence of means of communica on
Start of scien c knowledge  more complex life  increase in health problems  demand for more
nurses

Nursing as a duty of SLAVES and WIVES.

NURSING DID NOT CHANGE but there was progress in the prac ce of Medicine.
Care of the sick was s ll closely allied with supers ons, religion and magic
RISE IN CIVILIZATION
Near East – birth place of 3 religious ideologist:
Judaism
Chris anity
Mohammedism or Islam

- Near East culture was adopted by the Greeks and Romans combine wit the wonders of the Far East by
returning crusaders and explorers improved and was carried to Europe during the Renaissance Period
that resulted to greater knowledge then to the New World by the Early se lers.

RISE IN CIVILIZATION
New World – a ny area known as birth of monotheism that lies between Tigris and Euphrates River in
the Nile River arose the cultures of Babylonia, Egypt and Hebrew.
MONOTHEISM – believer of one God
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 BABYLONIANS

CODE OF HAMMURABI
• 1st recording on the medical prac ce
• Established the medical fees
• Discouraged experimenta on
• Speci c doctor for each disease
• Right of pa ent to choose treatment between the use of charms, medicine, or surgical
procedure
EGYPTIANS

• ART OF EMBALMING
• Mummi ca on
• Removing the internal organs of the dead body
• Ins lla on of herbs and salt to the dead
• Used to enhance their knowledge of the human anatomy. Since work was done and performed
on the dead, they learned nothing of Philosophy
• “THE 250 DISEASES”
• Documenta on about 250 diseases and treatments

HEBREW
• Teachings of MOSES
• Created Levi cus
• Father of sanita on
• Prac ce the values of “Hospitality to strangers” and the “Act of Charity” – contained in the book
of Genesis
• LEVITICUS – 3rd book of the Old Testament
• Laws controlling the spread of communicable diseases
• Laws governing cleanliness
• Laws on prepara on of food
• Puri ca on of man and his food
• The ritual of CIRCUMCISION – on the 8th day a er birth
MOSAIC LAW
▪ Meant to keep Hebrews pure so that they may enter the sanctuary without a ron ng God
Meant as a survival for health and hygienic reason only

CHINA
▪ Use of pharmacologic drugs
▪ “MATERIA MEDICA”
▪ Book that indicates the pharmacologic drug used for treatment no knowledge on anatomy.
▪ Use of wax to preserve the body of the dead
▪ Method of paper making
▪ FACTORS THAT HAMPERED THE ADVANCEMENT OF MEDICINE:
• Baby boys given girl’s name
• Prohibits dissec ng of human body thus thwar ng scien c study
INDIA
• SUSHURUTO
• 1st recording on the nursing prac ce
• Hampered by Taboos due to social structures and prac ces of animal worship
• Medicine men built hospitals
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 • Intui ve form of asepsis
• There was pro cient prac ce of Medicine and Surgery
• NURSES QUALIFICATIONS: Lay Brothers, Priest Nurses, combina on of Pharmacist, Masseurs, PT,
cooks
• There was also decline in Medical prac ce due to fall of Buddhism – state religion of India

GREECE
• AESCULAPUS
• Father of medicine in Greek mythology
• HIPPOCRATES
• Father of modern medicine
• 1st to reject the idea that diseases are caused by evil spirits
• 1st to apply assessment
• Prac ce medical ethics

CADUCEUS
• Insignia of medicine
• Composed of sta of travellers intertwined with 2 serpent (the symbol of Aesculapus and his
healing power). At the apex of the sta are two wings of Hermes (Mercury) for speed.
• NURSES  func on of untrained slaves

ROMANS

• Proper turnover for the sick people

• “If you’re strong, you’re healthy” – mo o
• Transi on from Pagan to Chris anity
FABIOLA
• Was converted to Chris an and later she converted her home to a hospital and used her wealth
for the sick.
• 1st hospital in the Chris an world

APPRENTICE PERIOD

• 11th century  1836

• On-the-job training period
• Refers to a beginner (on-the-job training). It means care performed by people who are directed
by more experienced nurses
• Starts from the founding of Religious Orders in the 6th century through the Crusades in the 11th
century (1836 – when the deaconesses School of Nursing was established in Kaiserswerth,
Germany by Pastor THEODORE FLEIDNER)

APPRENTICE PERIOD
• There was a struggle for religious, poli cal, and economic powerCrusades took place in order to
gain religious, poli cal, and economic power or for adventure during the Crusade in this period,
it happened as an a empt to recapture the Holy Land from the Turk who obtained and gain
control of the region as a result of power struggle. Chris ans were divided due to several
religious war and Chris ans were denied visit to The Holy Sepulcher.
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 MILITARY RELIGIOUS ORDERS AND THEIR WORKS
• KNIGHTS OF ST. JOHN OF JERUSALEM (ITALIAN)
• Also called as “Knights of the Hospitalers”. Established to give care

TEUTONIC KNIGHTS (GERMAN)

• Took subsequent wars in the Holy Land
• Cared for the injured and established hospitals in the military camps

KNIGHTS OF ST.LAZARUS
• Care for those who su ered Leprosy, syphilis, and chronic skin diseases
• ALEXIAN BROTHERS
• A monasteric order founded in 1348. They established the Alexian Brothers School of Nursing,
the largest School under religious auspices exclusively in US and it closed down in 1969

ST. VINCENT DE PAUL

• He organized the charity group called the “La Charite” and the “Community of Sisters of Charity”
composed of women dedicated in caring for the sick, the poor, orphaned, and the widowed. He
founded the “Sisters of Charity School of Nursing” in Paris, France where Florence Nigh ngale
had her 2nd formal educa on in Nursing.
LOUISE de GRAS
• Was the 1st Superior and co-founder of the Community of Sisters of Charity
• NURSING SAINTS
ST. CLAIRE OF ASSISI
• Took vows of poverty, obedience to service and chas ty
• Founded the 2nd order of St. Francis of Assisi
• “the poor Claire”
ST. ELIZABETH OF HUNGARY
• The patroness of Nursing
• A princess
• Sees her calling to give care for the sick
• Fed thousands of hungry people
St. CATHERINE OF SIENA
• “Li le Saint” – took care of the sick as early as 7y/o
• “1st Lady with a Lamp”

RISE OF RELIGIOUS NURSING ORDER

• Orders of St. Francis of Assisi
• 1st order – founded by St. Francis
• 2nd order “the poor Claire” – founded by St. Claire
• 3rd “the ter ary order”
▪ Beguines
▪ Oblates
▪ Benedic nes
▪ Ursulites
▪ Augus nians

DARK PERIOD OF NURSING

▪ From 17th century – 19th century
▪ Also called the Period of Reforma on un l the American Civil War
▪ Hospitals were closed
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 ▪
Nursing were the works of the least desirable people (criminals, pros tutes, drunkards, slaves,
and opportunists)
▪ Nurses were uneducated, lthy, harsh, ill-fed, overworked
▪ Mass exodus for nurses
▪ The American Civil War was led by Mar n Luther, the war was a religious upheaval that resulted
to the destruc on in the unity of Chris ans.
▪ The con ict swept everything connected to Roman Catholicism in schools, orphanages, and
hospitals
DARK PERIOD OF NURSING

THEODORE FLIEDNER
▪ (a pastor) recons tuted the Deaconesses and later be established the School of Nursing at
Kaiserswerth, Germany where Florence Nigh ngale had her 1st formal training for 3 months as
nurse
FLORENCE NIGHTINGALE
▪ Prac ced her profession during the Crimean War
▪ “Lady with a Lamp”
▪ From a well-known family
▪ Went to Germany to study

EDUCATIVE PERIOD

Florence Nigh ngale Era

• Began in June 15, 1860 when Florence Nigh ngale School of Nursing opened at St. Thomas
Hospital in London England, where 1st program for formal educa on of Nurses began and
contributed growth of Nursing in the US
FACTORS THAT INFLUENCED DEVELOPMENT OF NURSING EDUCATION:
• Social forces
• Trends resul ng from war
• Emancipa on of women
• Increased educa onal opportuni es
FLORENCE NIGHTINGALE
• Mother of Modern Nursing
• Lady with the Lamp
• Born on May 12, 1820 in Florence, Italy
• Her SELF-APPOINTED GOAL – to change the pro le of Nursing
• She compiled notes of her visits to hospitals, her observa ons of sanita on prac ces and
entered Deaconesses School of Nursing at Kaiserswerth, Germany for 3 months.

EDUCATIVE PERIOD

FLORENCE NIGHTINGALE
• Became the Superintendent of the Establishment for Gentle Women during the Illness (refers to
the ill governess or instructors of Nursing
• She disapproved restric on on admission of pa ent and considered this unchris an and contrary
to health care.
• Upgraded the prac ce of Nursing and made Nursing a honorable profession led other nurses in
taking care of the wounded and sick soldiers during the Crimean War. She was designated as
Superintendent of the Female Establishment of English General Hospital in Turkey during the
Crimean War
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 • She reduced the casual es of war by 42%-2% thru her e ort by improving the prac ce of
sanita on techniques and procedure in the military barracks

EDUCATIVE PERIOD

THE CONCEPTS OF FLORENCE NIGHTINGALE ON NURSING SCHOOL:

• School of Nursing should be self-suppor ng not subject to the whimps of the Hospital.
• Have decent living quarters for students and pay Nurse instructors
• Correlate theories to prac ce
• Support Nursing research and promote con nuing educa on for nurses
• Introduce teaching knowledge that disease could be eliminated by cleanliness and sanita on
and Florence Nigh ngale likewise did not believed in the Germ Theory of Bacteriology.
• Opposed central registry of nurses
• Wrote Notes on Nursing, “What it is and what it is not.”
• Wrote notes on hospitals

EDUCATIVE PERIOD

OTHER SCHOOLS OF NURSING

• Bellevue Training School for Nurses – New York City
• Alexian Brothers Hospital School of Nursing in US exclusively for men. It opened in 1348 and it
closed down in 1969.

LINDA RICHARDS – the rst graduate nurse in US. Graduated in September 1, 1873.

2 NURSING ASSOCIATION / ORGANIZATIONS THAT UPGRADED NURSING PRACTICE IN US:

• American Nurses Associa on
• Na onal League for Nursing Educa on

CONTEMPORARY PERIOD

• World War II – present

• This refers to the period a er World War I and the changes and development in the trends and
prac ce of Nursing occurring since 1945 a er World War II.
• Includes scien c and technological development, social changes occurring a er the war.
• Nursing is o ered in College and Universi es

CONTEMPORARY PERIOD

DEVELOPMENT AND TRENDS:

• W.H.O established by U.N to ght diseases by providing health informa on, proper nutri on,
living standard, environmental condi ons.
• The use of Atomic energy for diagnosis and treatment.
• Space Medicine and Aerospace Nursing
• Medical equipment and machines for diagnosis and treatment
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 • Health related laws
• Primary Health Care – Nurses involvement in CHN
• U liza on of computers
• Technology advances such as development of disposable equipment and supplies that relieved
the tedious task of Nurses.
• Development of the expanded role of Nurses

CONTEMPORARY PERIOD

FACTORS AFFECTING NURSING TODAY:

• Economics
• Consumer’s Demand
• Family Structure
• Informa on and Telecommunica ons
• Legisla on

HISTORICAL PERSPECTIVE
• Women’s Roles
• Religion
• War
• Societal A tudes

HISTORICAL PERSPECTIVE
• WOMEN’S ROLES
• The role as a wife, mother, daughter, sister has always been included in the care of their family.
They cared for their infants, members of the family and members of the community (It could be
said that Nursing have its roots in the home). Has the will to serve for others (subservient). The
care provided were related to physical maintenance and comfort. They care given were
humanis c, nurturing comfor ng and suppor ng.

HISTORICAL PERSPECTIVE

RELIGION
• Played a signi cant role in the development of Nursing
• The Chris an values of LOVE THY NEIGHBOR AS THY SELF, PARABLE OF THE GOOD SAMARITAN
had a signi cant impact on Nursing
• CHRISTIANITY – the greatest impact in the in uence of religion in the development
• The religious values of self-denial, Spiritual Calling, Devo on to Duty, and Hard Work dominated
Nursing throughout the history and led to the development.
• Knights’ contribu ons, Fabiola’s contribu ons, the saints and other personali es
• Deaconesses – Theodore Fliedner

HISTORICAL PERSPECTIVE
❖ WAR
❖ Crimean War (Arm con ict between England and allies Turkey, Sardinia vs. Russia); 1854-1856.
Florence Nigh ngale emerged and became well-known (Crimean War) She was asked by Sir
Sidney Herbert of the Bri sh war department to recruit con ngent of female nurses to provide
care to the sick and injured in Crimea. She transformed military camps into hospitals by se ng
up sanita on process: hand washing and washing clothes regularly.
❖ WAR
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 ❖ American Civil War (1861-1865)
❖ Harriet Tubman and Sojourner Truth – provided care and safety to slaves eeing to the North on
the Underground Railroad
❖ Mother Biekerdyke and Clara Barton – searched the ba le eld and gave care to injured and
dying soldiers
❖ Walt Whitman And Loiusa May Alco – volunteered as nurses to give care to injured soldiers in
military hospitals
❖ World War II
❖ Created acute shortage of care
❖ Cadet Nurse Corps – established in response to markes shortage of nurses
❖ Auxiliary health care workers became prominent
❖ Prac cal Nurses, aides, and technicians provided much of the actual nursing care under the
instruc on and supervision of be er prepared nurse
❖ Medical special es aros to meet the needs of hospitalized clients

HISORICAL PERSPECTIVE
• SOCIETAL ATTITUDES
• Nursing was without organiza on, no educa on, and social status
• Women’s role was – in the home and no respectable woman should have a career
• Victorian Middle Class Women – were just wives to their husbands and children
• Nurses were poorly educated, some were incarcerated criminals – This was re ected in the book
wri en by Charles Dickens through the character of Sairy Gamp – who cared for the pa ents by
stealing from them, physically abused them. This literary works has greatly a ected social
a tudes about nursing, the nega ve impression and image of nurses up to the contemporary
period.
• Guardian Angel or Angel of Mercy – image arose in the la er part of 19th century because of
work of Florence Nigh ngale in the Crimean War. She brought respectability to the nursing
profession, nurses were viewed as noble, compassionate, moral, religious, dedicated, and self-
sacri cing
• Doctor’s handmaiden – image arising in the early 19th century ; this image evolved when women
had yet to obtain the right to vote; the family structures were highly paternalis c, and when the
medical profession portrayed increasing use of scien c knowledge that was viewed as male
domain.
• Heroine – evolved from nurses acts of bravery during World War II and their contribu ons in
gh ng poliomyeli s – in the work of Australian nurse, Elizabeth Kenney.

NURSING LEADERS

• Florence Nigh ngale

• Clara Barton
• Lillian Wald
• Lavinia L. Dock
• Margaret Higgins Sanger
• Mary Breckinridge

FLORENCE NIGHTINGALE
❖ Contribu ons are well documented
❖ Lady with the Lamp
❖ She was the 1st nurse to exert poli cal pressure on government
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 ❖ Notes on Nursing: What It is and What It Is Not – her greatest achievement ; made her be
recognized as nursing’s 1st scien st-theorist
❖ Born on a wealthy and intellectual family
❖ She was given an honorarium of 4500 and used it to develop Nigh ngale Training School for
Nurses, which was opened in 1860.

CLARA BARTON
❖ A school teacher who volunteered as nurse during the American Civil War
❖ Her responsibility was to organize the nursing services
❖ Established the American Red Cross

LILIAN WALD
❖ Founder of Public Health Nursing
❖ Wald and Mary Brewster were the 1st one to o er trained nursing services to the poor in the
New York slums

LAVINIA L. DOCK
❖ Feminist, proli c writer, poli cal ac vist, su rage e
❖ Friend of Wald
❖ She par cipated in protest movements for women’s rights which granted women to vote.
❖ Campaigned for legisla on to allow nurses rather than physicians to control their professions
❖ Founded the American Society of Superintendents of Training Schools for Nurses on the United
States and Canada – precursor to the current Na onal League for Nursing

MARGARET HIGGINS SANGER

❖ Public health nurse in New York
❖ Had a las ng impact on women’s health care
❖ Imprisoned for opening the 1st birth control informa on clinic in America
❖ Considered to be the founder of “Planned Parenthood”

MARY BRECKINRIDGE
• Notable pioneer nurse
• Established “Fron er Nursing Service (FNS)”
• She worked with the American Commi ee for Devastated France, distributed food, clothing, and
supplies to rural villages and taking care of the sick children.

HISTORY OF NURSING
(PHILIPPINE SETTING)

EARLY BELIEFS AND PRACTICES

Beliefs About Causa on of Diseases:

• Caused or in icted by other person (enemy or witch)
• Evil spirits
• Beliefs That Evil Spirits Could Be Driven O By Person With Powers To Expel Bad Spirits:
• Believed in Gods of healing
• Word doctors – priest physicians
• Herbolarios – herb doctors
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 EARLY CARE OF THE SICK
• HERBICHEROS – herbmen who prac ce witchcra
• MANGKUKULAM / MANGANGAWAY – a person su ers from disease without any iden ed cause
and were believed bewitched by such
• Di cult child birth and some diseases (PMAO) a ributed to (NONO) midwives
• Di cult birth, witches were supposed to be the cause, gunpowder exploded from a bamboo
pole close to the head of the mother to drive evil spirits

EARLY HOSPITALS:
• Hospital Real de Manila – 1577
• 1st hospital established
• Gov. Francisco de Sande
• To give service to king’s Spaniard soldiers
• San Lazaro Hospital – 1578
• Fray Juan Clemente
• Named a er the Knights of St. Lazarus
• Hospital for the lepers
• Hospital de Indios – 1586
• Franciscan Orders
• Hospital for the poor Filipino people
• Hospital de Aguas Santas – 1590
• Fray Juan Bau sta
• Named a er its loca on (near spring) because people believed that spring has a healing power.
• San Juan de Dios Hospital – 1596 For poor people
• Located at Roxas Boulevard

PERSONAGES:
Dona Hilaria de Aguinaldo
• 1st wife of Emilio Aguinaldo
• Established Philippine Red Cross – February 17, 1899
Dona Maria Agoncillo de Aguinaldo
• 2nd wife of Emilio Aguinaldo
• 1st president of Philippine Red Cross (Batangas Chapter)
Josephine Bracken
• Helped Rizal in trea ng sick people
Melchora Aquino
• Took care of the wounded Ka puneros
• Anastacia Giron Tupaz
• Founder of Filipino Nurses Associa on – established on October 15, 1922
• 1st Filipino chief nurse of PGH
• 1st Filipino Superintendent of Nurses in the Philippines
Francisco Delgado
• 1st president of Filipino Nurses Associa on
Cesaria Tan
• 1st Filipino to receive Masteral Degree in Nursing abroad
Socorro Sirilan
• Pioneer in Social Service at San Lazaro Hospital
• Also the chief nurse
Rosa Militar
• Pioneer in nursing educa on
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 Socorro Diaz
• 1st editor of PNA magazine called, “The Message”
Conchita Ruiz
• Full me editor of the PNA newly named magazine, “The Filipino Nurse

EARLY NURSING SCHOOLS

• Iloilo Mission Hospital and School of Nursing

• Established in 1906 under the supervision of Rose Nicolet (American)
• Nursing course – 3yrs.
• Produced 1st batch of Nursing graduates in 1909 – 22 nurses
• 1st TRAINED NURSES:
• Nicasia Cada
• Felipa Dela Pena
• Dorotea Caldito
▪ April 1944 – 1st Nursing Board Exam at Iloilo Mission Hospital

• PGH School of Nursing – 1907

• St. Paul School of Nursing – 1907
• St. Luke’s School of Nursing – 1907
• UST – 1946
• MCU – 1947
• Fa ma – 1947

NURSING: DEFINITIONS

NURSING (as an art)

• Is the art of caring sick and well individual. It refers to the dynamic skills and methods in assis ng
sick and well individual in their recovery and in the promo on and maintenance of health
NURSING (as a science)
• Is the scien c knowledge and skills in assis ng individual to achieve op mal health. It is the
diagnosis and treatment of human responses to actual or poten al problem

NURSING: DEFINITIONS

FLORENCE NIGHTINGALE
• Nursing is the act of u lizing the environment of the pa ent to assist him in his recovery.

VIRGINIA HENDERSON
• Nursing is the act of assis ng the individual, sick or well, in the performance of those ac vi es
contribu ng to health or its recovery (or to a peaceful death) that he would perform unaided if
he had the necessary strength, will, or knowledge, and to do this in such a way as to help him
gain independence as rapidly as possible.

NURSING: DEFINITIONS

CANADIAN NURSES ASSOCIATION (CNA)

• Nursing is a dynamic, caring, helping rela onship in which the nurse assist the client to achieve
and obtain op mal health. – 1987
THEMES THAT ARE COMMON TO THESE DEFINITION:
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 • Nursing is caring
• Nursing is an art
• Nursing is a science
• Nursing is client-centered
• Nursing is holis c
• Nursing is adap ve
• Nursing is concerned with health promo on, health maintenance, and health restora on
• Nursing is a helping profession

NURSING: DEFINITIONS

AMERICAN NURSES ASSOCIATION (ANA)

• 1973
• Nursing is direct, goal oriented, and adaptable to the needs of the individual, the family, and
community during health and illness.
• 1980
• Nursing is the diagnosis and treatment of human responses to actual or poten al health
problems.
• 1995
• ANA acknowledges FOUR ESSENTIAL FEATURES OF CONTEMPORARY NURSING PRACTICE:
• A en on to the full range of human experiences and responses to health and illness without
restric on to a problem-focused orienta on.
• Integra on of objec ve data with knowledge gained from understanding of the client or group’s
subjec ve experience.
• Applica on of scien c knowledge to the processes of diagnosis and treatment.
• Provision of caring rela onship that facilitates health and healing.

NURSE: DEFINITION

NURSE
✓ Comes from a La n word “to nourish” or “to cherish
✓ One who cares for the sick, the injured, and the physically, mentally, and emo onally disabled.
One who advise and instruct individuals, families, groups and communi es in the preven on,
treatment of illness and diseases and in the promo on of health.
✓ An essen al member of a health team who cares for individuals, families and communi es in
disease and illness preven on and in the promo on of health and healthy environment.

PATIENT: DEFINITION

PATIENT
✓ Comes from a La n word, “to Su er” or “to Bear”
✓ An individual who is in the state of physical, mental, and emo onal imbalance. An individual who
seeks for nursing assistance, medical assistance, or for surgery due to illness or a disease. Is an
individual who is wai ng or undergoing medical or surgical care. One who is physically or
mentally disabled.
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 NURSING PROGRAMS
• Licensed Voca onal Nursing Program / Licensed Prac cal Nursing Program (LVN,LPN)
• REGISTERED NURSING PROGRAMS:
• Community College / Associate Degree
• Diploma Program
• Baccalaureate Degree Program

GRADUATE NURSING EDUCATION:

• Master’s Degree
• Doctoral Degree
• External Degree
• LVN / LPN
• Licensed Voca onal Nursing Program / Licensed Prac cal Nursing Program (LVN,LPN)
• Last for 9 – 12 months
• Provide both classroom and clinical experiences
• Provided by the community colleges, voca onal schools, hospitals, or other independent health
agencies.
• Under supervision of RN
• Prepares students how to give basic direct technical care
• Graduate takes NCLEX – PN to obtain license as a prac cal or voca onal course.

REGISTERED NURSING PROGRAMS

• Community College / Associate Degree
• Arose in early 1950s
• 2-year program
• Technical nurse or bedside nurse
• ADN (AA or AS)
• Diploma Program
• 3-year program
• Hospital-based
• Provide rich clinical experience for nurses
• Associated with colleges and universi es

REGISTERED NURSING PROGRAMS

• Baccalaureate Degree Program
• Early Baccalaureate Program  5-year program (3-year diploma program in addi on to 2 years
of liberal arts)
• Today’s Baccalaureate Degree Program  4-5-year program
• O er courses in the liberal arts, sciences, humani es, and nursing
• Graduates must ful ll both the degree requirements of the college or university and the nursing
program before being awarded a baccalaureate degree.
• BSN
• Also admit RN who have diplomas or associate degrees.
• Much background
• More theories
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 GRADUATE NURSING EDUCATION
• Master’s Degree
• 1.5 – 2-year program
• Encourage the development of graduate study in nursing
• Major emphasis was to be research and specializa on for teaching and administra on
• Provide specialized knowledge and skills that enable nurses to assume advanced roles in
prac ce, educa on, administra on, and research.
• MAN / MSN
• Doctoral Program
• PhD, DNS, ND
• Further prepares the nurse for advanced clinical prac ce, administra on, educa on, and
research.
• Content and approach vary among doctoral programs.
• All emphasized research
• No speci c me
• EXTERNAL DEGREE
• External Degree
• O ers credit for exper se gained outside formal classroom se ng
• Seminars
• post- grad courses
• No speci c me
• Short courses

ROLES OF A NURSE
• Caregiver
• Communicator
• Teacher
• Client Advocate
• Counselor
• Change Agent
• Leader
• Manager
• Case Manager
• Research Consumer
• Role Model
• Administrator
• Expanded Career Roles
ROLES OF A NURSE
• Caregiver
• Primary goal
• TYPES OF CARE:
• Full Care  for completely dependent pa ent
• Par al Care  for par ally dependent pa ent
• Suppor ve-Educa ve care  to assist clients in a aining their highest possible level of health
and wellness; for learnings
• Communicator
• Integral to all nursing roles
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 Nurses communicate with the client, support persons, other health professionals, and people in
•
the community
• Nurses iden fy client problems and then communicate these verbally or in wri ng to other
members of the health team
ROLES OF A NURSE
• Teacher
• Nurses help clients learn about their health and the health care procedure they need to perform
to restore or maintain their health.
• Nurses assesses the client’s learning needs and readiness to learn, sets speci c learning goals in
conjunc on with the client, enacts teaching strategies, and measures learning.
• Nurses also teaches unlicensed assis ve personnel to whom they delegate care, and they share
their exper se with other nurses and health professionals.
• Client Advocate
• Acts to protect the client
• Nurse may represent the client’s needs and wishes to other health professionals, such as
relaying the client’s wishes for informa on to the physician.
• Nurses assist clients in exercising their rights and help them speak up for themselves
ROLES OF A NURSE
• Counselor
• Helping a client recognize and cope with stressful psychologic or social problems, to develop
improved interpersonal rela onships, and to promote personal growth.
• Involves providing emo onal, intellectual and psychologic support.
• Nurses counsel primarily healthy individuals with normal adjustment di cul es and focuses on
helping the person develop new a tudes, feelings, behaviors by encouraging the client to look
at alterna ve behaviors, recognizing the choices, and develop sense of control.
• Change Agent
• Assis ng others to make modi ca ons in their own behavior.
• Nurses also o en act to make changes in a system if it is not helping client return to health.
ROLES OF A NURSE
• Leader
• In uences others to work together to accomplish a speci c goal.
• Can be employed at di erent levels: individual client, family, groups of clients, colleagues, or the
community
• Case Manager
• Work with the mul disciplinary health care team to measure the e ec veness of the case
management plan and to monitor outcomes.
• Works with primary or sta nurses to oversee the care of a speci c caseload.
• Primary nurse or provides some level of direct care to the client and family
• Helps ensure that care is oriented to the client, while controlling costs.
ROLES OF A NURSE
• Research Consumer
• O en use research to improve client care
• Have some awareness of the process and language of research
• Be sensi ve to issues related to protec ng the rights of human subjects
• Par cipate in the iden ca on of signi cant researchable problems
• Be a discrimina ng consumer of research ndings
• Role Model
• Has good physical appearance
• Prac ces proper hygiene
• Prac ces healthy lifestyle
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 ROLES OF A NURSE
• Administrator
• Assumes middle management posi on
• Connects the pa ent to other services of the hospital
• Expanded Career Roles
• Nurse prac oner, clinical nurse specialist, nurse midwife, nurse educator, nurse researcher, and
nurse anesthe st
• All of which allow greater independence and autonomy.

SCOPE OF NURSING PRACTICE

FOUR AREAS:
✓ Promo ng Health and Wellness
✓ Preven ng Illness
✓ Restoring Health
✓ Care of the Dying

SCOPE OF NURSING PRACTICE

PROMOTING HEALTH AND WELLNESS

✓ Wellness – state of well-being. Engaging in a tudes and behavior that enhance the quality of life
and maximize personal poten al
✓ For both healthy and ill.
✓ Involve individual and community ac vi es to enhance healthy lifestyle, such as improving
nutri on and physical tness, preven ng drug and alcohol misuse, restric ng smoking, and
preven ng accidents and injury in the home and workplace.

SCOPE OF NURSING PRACTICE

✓ PREVENTING ILLNESS
✓ The goal is to maintain op mal health by preven ng diseases
✓ Nursing ac vi es includes immuniza ons, prenatal and infant care, and preven on of sexually
transmi ed disease.
SCOPE OF NURSING PRACTICE
✓ RESTORING HEALTH
✓ Focuses on the ill client
✓ Extends from early detec on of disease to helping the client during the recovery period

NURSING ACTIVITIES:
• Providing direct care to the ill person: administering medica ons, baths, and speci c procedures
and treatments
• Providing diagnos c and assessment procedures: measuring BP and examining feces for occult
blood
• Consul ng with other health care professionals about client’s problems
• Teaching clients about recovery ac vi es: exercise that will accelerate recovery a er a stroke
• Rehabilita ng clients to their op mal func onal level following physical or mental illness, injury,
or chemical addic on

SCOPE OF NURSING PRACTICE

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 • CARE OF THE DYING
• Involves comfor ng and caring for people of all ages who are dyingIncludes helping clients live as
comfortable as possible un l death and helping support persons cope with death.
• Work in homes, hospitals, and extended care facili es
• Hospices are speci cally designed for this purpose.

BIOETHICAL ISSUES IN NURSING

• “DO NOT RESUSCITATE” ORDER (DNR)
• Physician may order “no code” or “do not resuscitate” for client who are in stage of terminal,
irreversible illness, or expected death. DNR order that no e ort be made to resuscitate the client
in the event of respiratory or cardiac arrest.
• ABORTION
• Termina on of pregnancy before the fetus reaches the stage of viability.
• EUTHANASIA
• “mercy killing” The act of painlessly pu ng to death persons su ering from incurable or
distressing disease.
• HUMAN CLONING
• Human reproduc on / replica on
• SEX TRANSPLANT
• Sex change

PROFESSIONAL CRIMES
▪ CRIME – act commi ed in viola on of Public Law and punishable by a ne and/or
imprisonment
▪ FELONY – serious in nature (ex. Murder)
▪ MISDEMEANOR – less serious in nature (ex. Negligence)
▪ MANSLAUGHTER – 2nd degree crime; uninten onal
▪ TORT – civil wrong against a person
TYPES:
▪ Inten onal
▪ Uninten onal
• NEGLIGENCE
• The doing of that thing, which a reasonably prudent person would not have done, or the failure
to do that thing which a reasonably prudent person would have done, in like or similar
circumstance.
• Act of omission or commission

THEORIES OF NEGLIGENCE:
• Respondeat Superior – let the superior answer ; let the principal answer for the acts of his agent
• Res Ipsa Loquitur – the thing speaks for itself; talks about the evidence; you cannot deny the
negligence because of the presence of evidence.
• Force Majeure – irresis ble or superior force. It is a fact or accident which human prudence can
neither foresee nor prevent

PROFESSIONAL CRIMES
• MALPRACTICE
• Any professional misconduct, or any unreasonable lack of skill, or delity in the performance of
the professional or duciary du es.
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 • For Nurses, Malprac ce refers to the failure to follow a reasonable professional standard of care,
thereby, resul ng to injury of pa ent

ELEMENTS OF NEGLIGENCE/MALPRACTICE:
• Duty
• Breach of Duty
• Foreseeability
• Causa on
• Harm/Injury
• Damage

PROFESSIONAL CRIMES
• INVASION OF PRIVACY
• Viola on on the right of an individual to withhold herself and her life from public scru ny.
Viola on on the right to remain alone and the right to keep informa on.
• FRAUD
• False presenta on of some facts with the inten on that will be acted upon by another person.
• Willful misrepresenta on
PROFESSIONAL CRIMES
• DEFAMATION
• Derogatory remarks about a person
• Making false statements about a person that can result to the injury of his reputa on
KINDS OF DEFAMATION:
• Slander – oral defama on
• Libel – wri en defama on
• ASSAULT
• A empt or threat or to touch another person unjus ably
PROFESSIONAL CRIMES
• BATTERY
• Assault that is carried out
• Willful touching of a person (without consent) that may or may not cause harm
• Performing procedures without consent
• INCOMPETENCE
• Lack of knowledge or skills
• FALSE IMPRISONMENT
• Preven on of movement without consent
• Unlawful restraint or deten on of another person against his or her wishes
• CONSENT
• KINDS OF CONSENT:
o IMPLIED CONSENT
o INFORMED CONSENT
o Agreement by the client to accept a course of treatment or a procedure a er complete
informa on, including the risk of treatment and facts rela ng to it, has been provided by
the physician
ELEMENTS OF INFORMED CONSENT:
• Consent must be given voluntarily
• Consent must be given by an individual with the capacity, competence, and understanding.
• The client must be given enough informa on to be the ul mate decision maker.
CONSENT
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 • NURSE’S RESPONSIBILITY
• Witnessing the exchange between the client and the physician.
• Establish that the client really did understand, that is, was really informed
• Witnessing the client’s signature
• PEOPLE WHO ARE NOT ALLOWED TO PROVIDE CONSENT:
• Minors – below 18 years old; except for married and already a parent
• Mentally ill
• Unconscious or injured in such a way that they are unable to give consent.

IMPLIED CONSENT
• In a life threatening situa ons and consent can not be obtained from the client or rela ves, the
law generally agrees that consent is assumed.

Concept of man

• Atomis c approach- views man as an organism composed of di erent organs systems where its
system is composed of organs and each organ is composed of ssues and cells.
• Holis c approach-this view traces man’s rela onship with other human beings in the supra
system of society.
o - views man as a whole organism with interrelated and inter dependent parts
func oning to produce behavior
• The Dimen on of man- Man as a physical being has such characteris cs as gene c endowment,
sex, other physical a ributes, structure and fnx.
• Man as a social being- capable of rela ng with others
• Man as spiritual being- capable of such virtues as faith,hope and charity
• Man as a cogni ve (thinking)-capable of percep on,cogni on and communica on (logical
thinking and reasoning)
• Man as a psychological being- capable of of ra onality. His ra onal side makes him merciful, kind
and compassionate.

Abraham Maslow’s heirarchy of basic needs

• NEED- IS SOMETHING THAT IS ESSENTIAL TO THE SURVIVALS OF hUMAN

*A basic need is something whose:

1. absence may lead to illness
2. presence may signal health or prevent illness
3. if unmet needs are met, health maybe restored.

• Concept of health,wellness and well-being

• Health- is a state of complete physical,mental, social well-being, not merely the absence of
disease or in rmity(WHO, 1947)
• Wellness and Well-being- a state of well being, a subjec ve percep on of balance,harmony and
vitality.
• Wellness di erent Dimen on
• Physical-the ability to carry-out daily task (grooming,mobility, etc.)to achieve tness of the di .
organ organ systems o the body.
• Social
• Emo onal
• Intellectual
• Spiritual
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