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Chapter 1

Introduction to Nursing

Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Perspective/Early Civilizations
to the 16th Century
• Theory of animism
– Based on the belief that nature was alive, had
invisible forces, and possessed power
– Good spirits brought health; evil spirits brought
sickness and death.
– Roles of nurse and physician separate and distinct:
physician as medicine man; nurse as caring mother.
• Ancient Greek civilization
– Temples became center of medical care.
– Nurses cared for the sick in the home and
community; practiced as nurse-midwives.
Copyright © 2015 Wolters Kluwer • All Rights Reserved

nurses received low pay and worked long hours in unfavorable conditions.) • Early Christian period – Nursing has formal and more clearly defined role. direction. and leadership. exploration.Historical Perspective/Early Civilizations to the 16th Century (cont. – Nursing developed purpose. • 16th century – Shift from a religious orientation to an emphasis on warfare. and expansion of knowledge – Nursing had a poor reputation. deaconesses made visits to the sick. Copyright © 2015 Wolters Kluwer • All Rights Reserved .

– Organized nursing care for soldiers during the Crimean war of 1853-1856 – Nightingale challenged prejudices against women and elevated the status of all nurses. and wrote books about health care and nursing education. hygiene. – Identified the importance of health. • Nursing as we now know it began.Historical Perspective/18th–19th Century • Social reforms changed the roles of nurses and of women in general. – She established the first training school for nurses. sanitation. based on many of the beliefs of Florence Nightingale. and nutrition Copyright © 2015 Wolters Kluwer • All Rights Reserved .

Contributions of Florence Nightingale • Identified personal needs of patient and role of nurse in meeting them • Established standards for hospital management • Established nursing as a respected occupation for women • Established nursing education • Recognized the two components of nursing: health and illness • Believed that nursing is separate and distinct from medicine • Recognized that nutrition is important to health • Instituted occupational and recreational therapy for sick people • Stressed the need for continuing education for nurses • Maintained accurate records. recognized as the beginnings of nursing research Copyright © 2015 Wolters Kluwer • All Rights Reserved .

– Explosion in medicine and technology broadened the role of nurses. not just task oriented Copyright © 2015 Wolters Kluwer • All Rights Reserved .Historical Perspective/19th to 21st Century • Hospital schools organized to provide more easily controlled and less expensive staff for the hospital. – Growth of nursing as a professional discipline – Nursing schools began to focus on academics. • World War II – Large numbers of women worked outside the home and became more independent and assertive. • Female nurses were under the control of male hospital administrators and physicians.

Historical Perspective/1950s to Present • Nursing broadened in all areas – Practice in a wide variety of health care settings – The development of a specific body of knowledge – The conduct and publication of nursing research – Recognition of the role of nursing in promoting health – Growth of nursing as a professional discipline Copyright © 2015 Wolters Kluwer • All Rights Reserved .

collaborative care • American Nurses Association (ANA) definition—Social policy statement centers on: – Human experiences and responses – A knowledge base for nurses – Integration of objective and subjective data • Patient is central focus of all definitions – Includes physical. emotional. and spiritual dimensions of the patient Copyright © 2015 Wolters Kluwer • All Rights Reserved . social. prevention of illness.Definitions of Nursing • Originated from the Latin word nutrix (to nourish) • International Counsel for Nurses definition: – Promotion of health.

Four Blended Competencies • Cognitive – Utilizing scientific rationales to provide patient care • Technical – Employ technology to optimize care • Interpersonal – To initiate and maintain relationships with clients and professional colleagues • Ethical/legal – Practice which is conducted according to moral principles and within legal guidelines Copyright © 2015 Wolters Kluwer • All Rights Reserved .

Nursing’s Aims • Promote health • Prevent illness • Restore health • Facilitate coping with disability or death Copyright © 2015 Wolters Kluwer • All Rights Reserved .

and facilitating coping with disability or death • Factors which may affect health include: – Genetic inheritance – Cognitive abilities – Educational level – Race and ethnicity.Nursing’s Aim: Promoting Health • Identifying. analyzing. restoring health. and maximizing each patient’s individual strengths as components of preventing illness. culture – Age and gender – Developmental level – Lifestyle. environment – Socioeconomic status Copyright © 2015 Wolters Kluwer • All Rights Reserved .

• Create social and physical environments that promote good health for all. and improve the health of all groups. injury. disability. • Promote quality of life. Copyright © 2015 Wolters Kluwer • All Rights Reserved . longer lives free of preventable disease. and healthy behaviors across all life stages. eliminate disparities. and premature death.Healthy People 2020 Health Promotion Guidelines • Healthy People 2020 pertains to “health literacy” and also contains 12 “health indicators” used to gauge the nation’s health • Attain high-quality. • Achieve health equity. healthy development.

smoking-cessation programs.Nursing’s Aim: Preventing Illness • Educational programs in areas such as prenatal care for pregnant women. and good health habits • Health assessments in institutions. exercise. and community settings that identify areas of strength and risks for illness Copyright © 2015 Wolters Kluwer • All Rights Reserved . or Internet information on healthy diet. and stress-reduction seminars • Community programs and resources encouraging healthy lifestyles • Literature. TV. radio. clinics.

as appropriate • Providing direct care to the person who is ill • Collaborating with other health care providers in providing care • Planning.Nursing’s Aim: Restoring Health • Performing assessments that detect an illness • Referring questions and abnormal findings to other health care providers. and carrying out rehabilitation for illnesses such as heart attacks. arthritis. and strokes • Working in mental health and chemical-dependency programs Copyright © 2015 Wolters Kluwer • All Rights Reserved . teaching.

Nursing’s Aim: Facilitating Coping With Disability and Death • Maximizing person’s strengths and potentials – Patient teaching – Referral to community support systems • Providing end-of-care – Hospice programs Copyright © 2015 Wolters Kluwer • All Rights Reserved .

Interrelated Roles of Nurses • Communicator • Teacher • Counselor • Leader • Researcher • Advocate • Collaborator Copyright © 2015 Wolters Kluwer • All Rights Reserved .

Nursing as a Professional Discipline • Well-defined body of specific and unique knowledge • Strong service orientation • Recognized authority by a professional group • Code of ethics • Professional organization that sets standards • Ongoing research • Autonomy and self-regulation Copyright © 2015 Wolters Kluwer • All Rights Reserved .

Educational Preparation for Nursing Practice • Practical and vocational nursing education • Registered nursing education – Diploma in nursing – Associate degree in nursing – Baccalaureate in nursing • Graduate education in nursing – Master’s degree – Doctoral degree • Continuing education • In-service education Copyright © 2015 Wolters Kluwer • All Rights Reserved .

Guidelines for Nursing Practice • Standards of Nursing Practice – ANA Scope and standards of practice – Comprised of two components: • Standards of practice • Standards of professional performance • Nurse Practice Acts and Licensure • Nursing Process Copyright © 2015 Wolters Kluwer • All Rights Reserved .

including legal requirements and titles for RNs and LPNs • Establish criteria for the education and licensure of nurses Copyright © 2015 Wolters Kluwer • All Rights Reserved .Nurse Practice Acts • Define legal scope of nursing practice • Create a state board of nursing to make and enforce rules and regulations • Define important terms and activities in nursing.

The Nursing Process • One of the major guidelines for nursing practice • Helps nurses implement their roles • Integrates art and science of nursing • Allows nurses to use critical thinking and clinical reasoning • Defines the areas of care that are within the domain of nursing Copyright © 2015 Wolters Kluwer • All Rights Reserved .

The era of the educated consumer. The impact of health policy and regulation Copyright © 2015 Wolters Kluwer • All Rights Reserved . and genomic and palliative care 4. Changing demographics and increasing diversity 2. The shift to population-based care and the increasing complexity of patient care 5. The technological explosion 3.NLN Ten Trends to Watch For Nursing Education 1. alternative therapies. The cost of health care and the challenge of managed care 6.

NLN Ten Trends to Watch For Nursing Education (cont. The growing need for interdisciplinary education and collaborative practice 8. Significant advances in nursing science and research Copyright © 2015 Wolters Kluwer • All Rights Reserved . The current nursing shortage/opportunities for lifelong learning and workforce development 9.) 7.

National Supply and Demand Projections for Registered Nurses: 2000 to 2020 Copyright © 2015 Wolters Kluwer • All Rights Reserved .