Learning Objectives Professional Nursing:

► Is an art and science, dominated by an ideal or

At the end of lecture-discussion, the students will be service in which certain
able principles are applied in the skillful care of the well
to: 1. Describe nursing as a profession, science and and the ill, and through relationship with the
art 2. client/patient, significant others, and other members
Explain the history of nursing of the health team.
3. Identify the personal and professional qualities of a Professional nurse:
nurse 4. ► Is one who has acquired the art and science of
Describe the different fields of Nursing nursing through her basic
5. Identify the basic roles to nursing care education, who interprets her role in nursing in terms
of the social ends for
Concept of Nursing which it exists – the health and welfare of society and
-Nursing is an art and science who continues to add
-As a professional nurse, you will learn to deliver care to her knowledge, skills, and attitudes through
artfully with continuing education and
compassion, caring, and respect for each patient’s scientific inquiry (research) or the use of the results of
dignity and personhood. such inquiry
-As a science, nursing practice is based on a body of
knowledge that is continually changing with new NURSING AS A PROFESSION Expectations
discoveries and innovations. Benner: from Novice to Expert
-The Quality of Care is at level of excellence that
benefits patients and their families Novice:
► beginning nurse or any nurse
Science and Art of Nursing Practice entering s situation in which there
► Nursing practice requires a blend of the most is no previous level of experience
current knowledge and ► Learning is through specific set of
practice standards with an insightful and rules or procedures
compassionate approach to
patient care Advanced beginner:
► The nurse’s care will reflect the needs and values ► A nurse who has had some level of
of society and experience with the situation
professional standards of care and performance, ► The nurse can identify meaningful
meet the needs of aspects or principles of nursing
each patient, and integrate evidence-based findings care
to provide highest level of care ► Experience may only be
► Nursing has a specific body of knowledge but it is observational in nature
also helpful to
socialize within the profession and practice to fully Competent:
understand and ► The nurse
apply this knowledge to develop professional ► is has been in same clinical position
expertise. for 2-3 years
► Understands the organization and
NURSING AS A PROFESSION specific care required by the type
of patients
Profession: ► Can anticipate nursing care and
► An organization of an occupational group based on establish long-range goals.
the application of special ► Has experience with all types of
knowledge which establishes its own rules and psychomotor skills
standards for the protection
of the public and the professionals. Proficient:
► A nurse
► With more than 2-3 years of
experience in the same clinical position
► Perceives a patient’s clinical
situation as a whole
► Can assess the entire situation and
transfer knowledge from previous
experiences
► Focus on managing care
Expert:
► The nurse
► Has intuitive grasp of an existing or
potential clinical problem
► Focus on multiple dimensions of
the situation
► Is skilled at identifying both
patient-centered problems and
problems related to the HCS
SCOPE AND STANDARDS OF PRACTICE
NURSING:
► Is the protection, promotion, and optimization of
health and abilities; prevention of
illness and injury, alleviation of suffering through the
diagnosis and treatment of
human response, and advocacy in the care
individuals, families and communities
(ANA, 2010)
► Encompasses autonomous and collaborative care
of individuals of all ages, families,
groups and communities, sick or well, and in all
settings (ICN, 2014)
► It includes the promotion of health; prevention of
illness; and the care of ill,
disabled and dying people.
Standards of professional Performance
► It describes a competent level of behavior in the
professional role ►
Provides method to assure that high-quality care is
rendered to patients
Code of Ethics
► Is the philosophical ideals of right and wrong;
which defines the principles a
professional will use to provide care
PROFESSIONAL RESPONSIBILITIES AND ROLES
1. Autonomy and Accountability
a. Autonomy – an essential of nursing professional
which involves initiation of
independent nursing interventions
b. Accountability – an individual is responsible
professionally and legally for the type and quality of
nursing care provided
2. Caregiver
➢ Helps patient to maintain and regain health,
manage disease and symptoms, and attain a maximal
level of function and independence through the
healing process
3. Advocate
➢ Protects your patient’s human and legal rights and
provide assistance in asserting
there rights
4. Educator
➢ Explain concepts and facts about health, describe
the reason for routine care
activities.
5. Communicator
➢ It allows the nurse to know the patients as well as
their strengths, weaknesses and
needs
6. Manager
➢ Establish a collaborative patient-centered care to
provide safe, quality care with
positive patient outcomes
7. Leader
➢ The nurse helps client make decisions in
establishing and achieving goals to
improve his well-being through the process of
interpersonal influences
8. Counselor
➢ Helps the client to recognize and cope with
stressful psychologic or social
problems, to develop improved personal relationships
and to promote personal
growth. It also include providing of emotional,
intellectual and psychologic support.
9. Change agent ► First practicing nurse epidemiologist ► She
➢ Initiates changes and assist in the modification of volunteered during the Crimean war (1853)
client’s life style to promote health
10. Researcher The Civil War to the Beginning of the 20th Century
➢ Participates in scientific investigation and uses
research findings in practice. Clara Barton –
11. Case manager ► founder of American Red
➢ Coordinates the activities of the members of the Cross
HC team in managing a group of client’s care ► Tended soldiers on the
12. Collaborator battlefields, cleaning their
➢ Works together with all those involved in care wounds, meeting their basic
delivery, for mutually acceptable Mother Mary Ann Bickerdyke
plan in order to achieve common goal; thus the nurse ► Organized ambulance
initiates nursing actions in services and walked
the health team abandoned battlefields at
night, to look for wounded
CRITERIA OF PROFESSION Soldiers needs, and comforting them
in death
1. Education
► Requires an extended The Civil War to the Beginning of the 20th Century
education and basic liberal
foundation Harriet Tubman
2. Theory ► Active in the Underground Railroad Movement and
► Has theoretical body of knowledge helped to lead over 300 slaves to freedom
► Conceptual frameworks needed for nursing Mary Mahoney
practice, education & research ► The 1st professionally trained African-American
3. Service orientation nurse
► Altruism “hallmark of a ► Concerned with the effect
profession (selfless concern for others) culture had on health care
► Guided by rules, policies and ► Brought awareness of cultural diversity and
COE respect for the individual, regardless of background,
4. Autonomy race, color or religion
► Self-regulation and Late 19th century:
standards ► Expansion of hospitals
► Needed in making decisions Lilian Wald and Mary Brewster
and in practice ►Opened the Henry Street Settlement
4. Code of Ethics ►It focused on the health needs of poor
► Based on International Council of Nurses people who lived in tenements (NYC)
► Worth dignity of others and integrity of members
6. Caring Twentieth Century

HISTORICAL INFLUENCES Early 20th century development of scientific,

FLORENCE NIGHTINGALE- Lady with the Lamp
► Established the first nursing philosophy based on
health maintenance and restoration.
► Identified the role of nursing as having “charge of
somebody’s health” based on the knowledge of “how
to put the body in such a state to be free of disease or
to recover from disease.
► Developed the first organized program for training
nurses, the Nightingale Training School for
Nurses (St. Thomas Hospital, London)
research-based defined body of nursing knowledge
and practice
► Nurses began to assume expanded and advanced
practice roles
Mary Adelaide Nutting
► 1st nursing professor (Columbia Teacher’s College,
1906)
► Contributed in moving nursing education into
universities and Army and Navy Nurse Corps was
established

► 1920s specialization of nursing began
► Graduate Nurse-midwifery programs
began
► Last half of century : creation of specialty-nursing
organization
Twenty-First Century
► Nurse and nurse educators are revising nursing
practice and school curricula
to meet the ever-changing needs of society, including
aging population,
bioterrorism, emerging infections and disaster
management, the high acuity
level care of hospitalized patients, and early
discharge from health care
institutions require nurses in all settings to have a
strong and current knowledge base from which to
practice
► Nursing organizations and the RWJF involvement
in supporting nursing
scholars, decreasing the nursing shortage, and
improve the health of the
nation’s population
► Nursing takes a leadership role in developing
standards and policies to
address the needs of the population
CONTEMPORARY INFLUENCES
External forces affecting nursing:
► Importance of Nurses’ Self-Care
► A nurse cannot give fully engaged, compassionate
care to others when
there’s a feeling of depletion or do not feel cared for
herself. Nurses also
experience grief and loss.
► Compassion fatigue: a state of burnout and
secondary traumatic stress. It
occurs without warning and often results from giving
high levels of energy
and compassion over a prolonged period to those
who are suffering, often
without experiencing improved patient outcomes.
► Secondary traumatic stress: trauma that HCP
experience when witnessing
and caring for others suffering trauma.
► Burnout: a state of physical and mental
exhaustion that often affects
HCPs because of the nature of their work
environment, it occurs when
perceived demands outweigh perceived resources
CONTEMPORARY INFLUENCES
External forces affecting nursing:
► The Affordable Care Act and Rising Health Care
Costs
► ACA affects how health care is paid for and
delivered
► Greater emphasis on health promotion, disease
prevention and illness management
► More nurses will be in community-based setting
like community care centers,
schools and senior centers
► Demographic changes
► Medically underserved
HISTORY OF NURSING IN THE PHILIPPINES
► Early beliefs and practices
► Diseases and causes and treatment were
shrouded with a mysticism and
superstitions
1. Beliefs about causation of disease (another person
like an enemy or
witch; evil spirits)
2. People believed that evil spirits could be driven
away by persons with
powers to expel demons
3. People believe in special gods of healing, with the
priest physician
(word doctors) as intermediary. Herbolarios (herb
doctors)
Early care of the sick
► Superstitious beliefs and practices in relation to
health and
sickness. Herbmen (Herbicheros) one who practice
witchcraft.
Midwife assisted in childbirth. During labor, the
‘mabuting hilot’ (good midwife) was called in. If there’s
difficulty in labor, witches
were supposed to be the cause. To disperse this
influence, gunpowder was exploded from a bamboo
cane close to the head of
the sufferer
Health Care During the Spanish Regime
► The religious orders exerted their efforts to care for
the sick by building hospitals in the various part of the
Philippines
1. Hospital real de Manila (1577) – was established
mainly to care for Spanish
King’s soldiers, but also admitted Spanish civilians
2. San Lazaro Hospital (1578) – built exclusively for
patients with leprosy,
founded by Brother Juan Clemenete and was
administered by Hospitalliers of
San Juan de Dios
3. Hospital de Indio (1586) – supported by alms and
contributions from charitable
persons and established by the Franciscan Order
4. Hospital de Aguas Santas (1590) – founded by
Brother J. Bautista of the
Franciscan Order in Laguna
5. San Juan de Dios Hospital (1596) – founded by
Brotherhood of Misericordia and
supported by the Hospitalliers of San Juan de Dios
Nursing During the Philippine Revolution:
► Prominent persons involved in nursing works were:
1. Josephine Bracken – installed a field hospital in
an estate
house in Tejeros; provided care to the wounded night
and day
2. Rosa Sevilla de Alvero – converted their house
into quarters for
the Filipino soldiers in 1899 during
Philippine-American War
3. Dona Hilaria de Aguinaldo – (wife of Emilio
Aguinaldo)organized Filipino Red Cross under the
inspiration of Apolinario Mabini
4. Dona Maria Agoncillo de Aguinaldo – (2nd wife
of Emilio Aguinaldo) – President of Filipino Red Cross
Batangas branch;
provided nursing care to Filipino soldiers during the
revolution
5. Melchora Aquino (Tandang Sora) – provided
nursing care to the wounded Filipino soldiers and
gave them shelter and
food
6. Capitan Salome – a revolutionary leader in Nueva
Ecija provided nursing care to the wounded when not
in
combat.
7. Agueda Kahabagan – provided nursing services
to her troops
and she was a revolutionary leader in Laguna
8. Trinidad Tecson – “Ina ng Biac na Bato’ cared for
the wounded soldiers in the hospital at Biac na Bato
► Hospitals and Schools of Nursing
1. Iloilo Mission Hospital School of Nursing (Iloilo
City, 1906)
➢ It was ran by Baptist Foreign Mission Society of
America; Miss Rose Nicolet (first
superintendent) Miss Flora Ernst an American nurse
took charge in 1942; in March 1944, 22 nurses
graduated and in April 1944 the graduated nurses
took the first Nurses Board Examination in Iloilo
Mission Hospital
2. St. Paul’s Hospital School of Nursing (Manila,
1907)
➢ The hospital was established by the Archbishop of
Manila, the Most Reverend Jeremiah Harty under the
supervision of the Sisters of St. Paul de Chartres. It
provided general services and had free dispensary
and dental clinic. In 1908, it opened its training school
for nurses with rev. Mother Melanie (superintendent)
and Miss E. Chambers (Principal)
3. Philippine General Hospital School of Nursing
(1907)
➢ Began in 1901 as a small dispensary mainly for
Civil Officers and Employees in Manila City, then
became a Civil Hospital
4. St. Luke’s Hospital School of Nursing (Quezon
City, 1907)
➢ The hospital is an Episcopalian Institution which
began as a small
dispensary (1903) and the school opened with three
Filipino girls admitted (1907)
5. Mary Johnston Hospital and School of Nursing
(Manila, 1907)
➢ It was called Bethany Dispensary and was funded
by the Methodist
Mission for the relief of suffering among women and
children
6. Philippines Christian Mission Institute Schools
of Nursing
7. San Juan de Dios Hospital School of Nursing
(Manila, 1913)
8. Emmanuel Hospital School of Nursing (Capiz,
1913)
9.Southern Islands Hospital School of Nursing
(Cebu, 1918)
The first colleges of nursing in the Philippines:
1.University of Santo Tomas College of Nursing
(1946)
2.Manila Central University College of Nursing
(1947)
3.University of the Philippines College of Nursing
(1948)
► NURSING LEADERS IN THE PHILIPPINES:
1. Anastacia Giron-Tupas – founder of PNA; 1st
Filipino to hold the Chief Nurse Superintendent
position
2. Cesaria Tan – 1st Filipino to receive Masters
degree in Nursing abroad
3. Socorro Sirilan – Chiefnurse and Pioneered in
Hospital Social Services in San Lazaro Hospital
4. Rosa Militar – a pioneer in school health education
5. Ser Ricardo Mendoza – a pioneer in nursing
education
6. Socorro Diaz – 1st editor of the PNA magazine
“the Message”
7. Conchita Ruiz – 1st fulltime editor of PNA
magazine named “The Filipino Nurse”
8. Loreto Tupaz – Dean of the Philippine Nursing ;
Florence Nightingale of Iloilo
PERSONAL AND PROFESSIONAL QUALITIES OF
A NURSE PERSONAL QUALIFICATIONS OF A
NURSE
Philosophy of Life
► Concerned with those basic truths
that contribute to personal growth in
a systematic fashion and with those
principles that relate to the moral
values that shape the facets of the
character
Good personality
► Personality consists of the distinctive individual
qualities that differentiate one person from another
► It is the impression one makes on others
which will include more than that which
meets the eye
► Components:
1. Personal appearance
2. Character
3. Attitude
4. Charm
► Personality can be develop through:
1. Warmth of manner, a ready smile, sincere laugh,
genuine interest
in others
2. Complete sincerity
3. Sympathetic grooming
► Graduate education
► Provides the advanced clinician with strong skills in
nursing science and theory
► Emphasizes advance knowledge in the basic
sciences and research-based clinical
practice.
► Master’s degree in nursing
► Doctoral degree
Doctoral preparation
► Professional doctoral programs in nursing (DSN or
DSNc) prepare graduates to apply
research findings to clinical nursing
► Doctor of Philosophy (PhD) in Nursing is a
research and theory development
► Doctor of Nursing Practice (DNP) is a
practice-focused doctorate; terminal practice
degree and required preparation for all APRNs
Continuing and In-Service Education
Continuing education:
► involves formal, organized educational programs
offered by
universities, hospitals, state nurses associations,
professional nursing
organizations and educational and health care
institutions
► Updates your knowledge about the latest research
and practice
developments, helps in specializing in a particular
area of practice
developments, and teaches new skills and techniques
(Hale et.al,2010)
Continuing education programs help nurses
maintain current nursing
skills, gain new knowledge and theory, and obtain
new skills reflectingthe changes in the health care
delivery system
In-service education programs:
► are instruction or training provided by a HC agency
or
institution.
► Designed to increase knowledge, skills, and
competencies of
nurses and other health care professionals employed
by the
institution
► Often it focuses on new technologies
NURSE PRACTICE ACTS
► Regulate the scope of nursing practice and protect
public health, safety and welfare.
LICENSURE
► Provides standardized minimum
knowledge base for nurses
► License: legal credential awarded
by an individual state that grants
permission to that individual to
practice a given profession
CERTIFICATION
► granted on completion of an
education program and the passing
of a standardized examination
► Certified or registered
CAREER DEVELOPMENT
A. Advanced Practice Registered Nurses (APRN)
► Is the considered as the most independently
functioning nurse
► Has advanced education in pathophysiology,
pharmacology and
physical assessment and certification and expertise in
specialized
area of practice
CORE ROLES OF APRN
1. Clinical Nurse Specialist
➢ Is an expert clinician in a specialized area of
practice.
➢ The specialty may be identified by a population,
setting, disease
specialty, type of care or type of problem
2. Nurse Practitioner (NP)
➢ Provides health care to a group of patients usually
in an
outpatient ambulatory care or community-based
setting.
➢ Provides comprehensive care, directly managing
the nursing and
medical care of patients with complex problems and a
more
holistic approach than physicians
CORE ROLES OF APRN
3. Certified Nurse-Midwife (CNM)
➢ Also educated in midwifery and is certified
➢ Provides independent care for women during
normal pregnancy,
labor and delivery and care of the newborn. It also
includes some gynecological services (ex: Pap smear,
FP and treatment of minor vaginal infections)
4. Certified Registered Nurse Anesthetist (CRNA)
➢ Had advanced education from a nurse
anesthesia-accredited program
➢ Must have at least 1 year of critical care or
emergency experience.
➢ Provide anesthesia under the supervision and
guidance of the anesthesiologist (physician with
advanced knowledge of surgical anesthesia
B. Nurse Educator
► Has a master's degree in nursing or earned
doctorate in nursing or related field.
► Works primarily in nursing schools, staff
development departments of HC agencies and patient
education department.
► Needs clinical practice in order to provide the
students with practical skills and theoretical
knowledge
► Faculty member in nursing program educates
students to become professional nurse.
► Nursing faculty member is responsible in teaching
current nursing practice; trends; theory and
necessary skills in classroom, laboratories and clinical
settings
► Primary focus of nurse educator in a patient
education: to teach and coach patients and their
families how to self-manage their illness or disability
and make positive choices or change their
behaviors to promote health. Usually specialized or
has certification like a certified diabetes
educator (CDE) or ostomy care nurse
C. Nurse Administrator
► Manages patient care and the delivery of specific
nursing services within
a health care agency
► Has master’s degree in nursing administration,
hospital administration
(MHA), public health (MPH) or an MBA
► Functions includes:
► Budgeting
► Staffing
► Strategic planning of programs and services
► Employee evaluation
► Employee development
Nursing administration
Upper management position
(associate director or director of
nursing services)
Middle management position
(nurse manager, house supervisor)
Clinical care coordinator position (first)
-Director/Nurse executive positions require master’s
degree
-Chief nurse executive and Vice president positions
require preparation to doctoral level
-Nurse manager usually requires at least a
baccalaureate degree in nursing
D. Nurse Researcher:
► Conducts evidenced-based practice and research
► Works in and academic setting, hospital or
independent professional or community
service agency
► Requires a doctoral degree with at least a master’s
degree in nursing
E. Management
F. Entrepreneurship
FIELDS OF NURSING
1. Hospital or Institutional Nursing
2. Public Health Nursing or Community Health
Nursing
3. Private Duty or Special Duty Nursing
4. Industrial or Occupational Health Nursing
5. Nursing Education
6. Military Nursing
7. School Nursing
8. Clinic Nursing
9. Independent Nursing Practice
► Competencies of patient-centered care, teamwork
and collaboration, EBP, quality
improvement (QI), safety and informatics
Impact of Emerging technologies
► This helps nurses use noninvasive, more accurate
assessment tools, implement EBP,
collect and trend patient outcome data and use
clinical decision support system
► Electronic Health Record (HER) offers efficient
method to record and manage
patient health care information
Genomics
► Is a newer term that describes the study of all
genes in a person and interactions
of these genes with one another and with that
person’s environment (CDC, 2015)
► Genetics is the study of inheritance, or the way
traits are passed down from one
generation to another.
ASSIGNMENT FOR RECITATION
► Period of Intuitive Nursing
► Nursing in the Near East
► Beliefs and Practices
► Contributions to medicine and Nursing (Babylonia,
Egypt, Israel)
► Nursing in the Far East
► China, India
► Nursing in Ancient Greece
► Nursing in Rome
► Period of Apprentice Nursing
► The Dark period of Nursing

Trends in Nursing
Evidence-based Practice
► In the practice of nursing, it should be based on
current evidence, not just according to your education
or experiences and the policies and procedures of
health care facilities.
► The general public has knowledge on health care
needs, the cost of health care,
and the incidence of medical errors within health care
institution
Quality and Safety Education for Nurses (QSEN)
► Addresses the challenge to prepare nurses with
the competencies needed to
continuously improve the quality of care in their
environment