THE DEVELOPMENT OF MODERN NURSING
based on conscious, abstract, and analytical
Three images influenced the development of
modern nursing
 Ursuline Sisters of Quebec organized the
first training for nurses.
 Theodore Fliedner revived the deaconess
movement and opened a School in
 Kaiserwerth, Germany, which was training
nurses. Elizabeth Fry established the
institute of Nursing Sisters.
 She visited Kaiserswerth and received nurse’s
training at 1850 for three months;
 Nightingale and her nurses transformed the
military hospitals by setting up diet kitchens, a
laundry, recreation centers, and reading rooms,
and organizing classes for orderlies;
“PATRICIA BENNER’S PATTERNS OF KNOWING”
 introduced the concept that expert nurses
develop skills and understanding of patient care
over time through a sound educational base as
well as a multitude of experiences.
 She proposed that one could gain knowledge
and skills ("knowing how") without ever
learning the theory ("knowing that").
 She described 5 levels of nursing experience
as;
 NOVICE
▪ Beginner with no experience
▪ Taught general rules to help perform tasks
▪ Rules are: context-free, independent of specific
cases, and applied universally
▪ Rule-governed behavior is limited and inflexible
▪ Ex. “Tell me what I need to do and I’ll do it.
 ADVANCED BEGINNER
 Demonstrates acceptable performance
 Has gained prior experience in actual situations
to recognize recurring meaningful components
 Principles, based on experiences, begin to be
formulated to guide actions
 COMPETENT
 Typically a nurse with 2-3 years experience on
the job in the same area or in similar day-to-day
situations
 More aware of long-term goals
 Gains perspective from planning own actions
thinking and helps to achieve greater efficiency
and organization
 PROFICIENT
 Perceives and understands situations as whole
parts
 More holistic understanding improves decision-
making
 Learns from experiences what to expect in
certain situations and how to modify plans
 EXPERT
 No longer relies on principles, rules, or
guidelines to connect situations and determine
actions
 Much more background of experience
 Has intuitive grasp of clinical situations
 Performance is now fluid, flexible, and highly
proficient
“CARPER’S 4 WAYS OF KNOWING”
 Carper’s work was based on the assumption
that the patterns and structure of nursing
knowledge provide the unique perspectives to
the discipline and suggested that these patterns
are all necessary, interrelated, interdependent
and overlapping and create the whole of
knowing.
EMPIRICAL KNOWING
 Is the principal form relating factual and
descriptive knowing aimed at the expansion of
abstract and theoretical explanations.
 It is information source or base of knowing.
 It emphasizes scientific research is important to
nursing knowledge.
 It focuses on evidence-based research for
effective and accurate nursing practice.
EXAMPLE:
 A nursing student answers a question posed
by a clinical instructor based on what he
learned from the school.
AESTHETIC KNOWING
 Focuses on empathy – the ability for sharing or
vividly understanding another’s feelings.
 Is related to understanding what is of
significance to particular patients such as
 feelings, attitudes, points of view (Carper,
1978).
 It is also the manifestation of the creative and
expressive styles of the nurse (Kenney, 1996)
EXAMPLE:
 Nurse places himself in the “patient’s shoes”
when communicating, giving judgment and
providing care.
ETHICAL KNOWING
 Requires knowledge of different philosophical
positions regarding what is good and right in
making moral decisions
EXAMPLES:
 Nurse presents himself as a patient
advocate and defends his client’s right to
choose care
 Nurse explains the concepts behind organ
donation to a terminally-ill patient
PERSONAL KNOWING
 Encompasses knowledge of the self in relation
to other and to self. It involves the entirely of
the Nurse-Patient Relationship.
 It is the most difficult to master and to teach.
 It involves therapeutic use of self.
EXAMPLE:
 A nursing student, strives to promote a
meaningful personal relationship with his
elderly patient.
“OVERVIEW OF THE PROFESSIONAL NURSING
PRACTICE”
HOSPITAL/INSTITUTIONAL NURSING
 Nursing in hospitals and related health facilities
such as extended care facilities, nursing homes,
and neighborhood clinics, comprises all of the
basic components of comprehensive patient
care and family health.
 The concept of the modern hospital as a
community health center where in patient and
out patient are continuous describes the goal of
medical care in most general hospital
PUBLIC HEALTH NURSING OR COMMUNITY
HEALTH NURSING
 The National Health Program of the Philippines
gives as much emphasis on the promotion of
health and prevention of diseases rather than
care of the sick. It needs a deeper involvement
and close supervision with all members of the
health team.
PRIVATE DUTY NURSING
 Nurses in private practice are expected to be
expert clinicians as well as expert generalist in
nursing.
 They use the title Private Duty Nurse, Private
Nurse Practitioner, Special Duty Nurse or
Private Duty Nurse Specialist.
 A registered nurse who undertakes to give
comprehensive nursing care to a client on a one
on one ratio.
TWO CATEGORIES
1. General Private Duty Nurse providing basic
nursing care to any type of patient.
2. Private Duty Nurse Specialist skills in complicated
devices, interpreting, observing signs and
symptoms.
OCCUPATIONAL HEALTH NURSING OR INDUSTRIAL
NURSING
 Few nurses go into occupational health nursing.
This is because they often work alone, and must
therefore possess maturity, experience, and
wise judgment.
 The practice focuses on promotion, protection,
and supervision of workers health within the
context of a safe and healthy environment.
NURSING EDUCATION
 Qualifications of the Faculty:
1. Be a registered nurse in the Philippines
2. Have at least three years of clinical practice in a
field of specialization
3. Be a member of good standing in the accredited
professional organization of nurses
4. Be a holder of masters degree in nursing.
MILITARY NURSING
 Three broad areas:
1. To meet the nursing needs of today’s patient in
AFP medical facilities
2. To prepare each Nurse Corps Officer for future
assignments at a higher level of responsibility in the
different stations and general hospital in time of
peace and war
3. To teach and train enlisted personnel who
perform nursing functions under supervision.
 Nursing began as a desire to keep people
healthy and to provide comfort and assurance
to the sick.
The Nursing Profession has two different sides: It is
both science and art
“SISTER SIMON ROACH’S 6CS IN A NURSING
SITUATION”
CARE WITH COMPASSION
Awareness of one’s relationship to others, sharing
their joys, sorrows, pain, and accomplishments.

NURSING AS A SCIENCE CARE WITH COMPETENCE

 It is the “body of abstract knowledge”
NURSING AS AN ART
 Art of caring sick and well individualju
“CARING”
 An integral aspects of Nursing
 Caring is a dimension of human relating and
often referred to as the art of nursing.
 SMITH (2013) proposes that nursing cannot
exist without caring.
 Caring is sharing deep and genuine concern
about the welfare of another person.
CARING AS “HELPING THE OTHER GROW”
 MILTON MAYEROFF (1990) a noted
philosopher, has proposed that to care for
another is to help him grow and actualize
himself.
 Milton Mayeroff (1990) defines major
ingredients of caring that provide structure and
further description of this process:
Having the “knowledge, judgments, skills, energy,
and motivation required to respond adequately to
the demands of one’s professional responsibilities.
CARE WITH CONFIDENCE
Comfort with self, client, and others that allows one
to build trusting relationship.
CARE WITH CONSCIENCE
Morals, ethics, and informed sense of right and
wrong. Awareness of personal responsibility.
CARE WITH COMMITMENT
The deliberate choice to act in accordance with
ones desire as well as obligations, resulting in
investments of self in a task or cause.
CARE WITH COMPORTMENT
Appropriate bearing, demeanor, dress, and
language that are in harmony, with a caring
presence.

 KNOWING- understanding the other needs and

how to respond these needs
 ALTERNATING RHYTHMS- signifies moving back
and forth between the immediate and long
terming meanings of behavior, consider past
 PATIENCE- enables the other to grow in his own
way and time
 HONESTY- includes awareness and openness to
one’s own feelings and a genuineness in caring
for others.
 TRUST- involves letting go, to allow the other to
grow in his own way and own time.
 HUMILITY- means acknowledging that there is
always moreto learn, and that learning may
come from any source.
 HOPE- beliefs in the possibilities of the others
growth.
 COURAGE- sense of going into the unknown,
informed by the insight from past experience.