Fundamental of pediatric

nursing

BY: -Lemesa A (BSc MSc)

1 02/17/2022
 Foundation of modern nursing

2 02/17/2022
 Historical Background of Nursing

 In the early ages, much of the practice of medicine was integrated

with religious practices.

 Before the development of modern nursing, women of nomadic

tribes performed nursing duties, such as helping the very young,
the old, and the sick, care-dwelling mothers practiced the nursing
of their time.
 As human needs expanded, nursing development broadened; its
interest and functions through the social climates created by
religious ideologies, economics, industrial revolutions, wars,
crusades, and education. In this way modern nursing was born
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 Historical Background of Nursing
4

 The intellectual revolution of the 18th and 19th centuries led to a

scientific revolution. The dynamic change in economic and
political situations also influenced every corner of human
development including nursing.

 It was during the time of Florence Nightingale that modern

nursing developed. She greatly modified the tradition of nursing
that existed before her era.

 She also contributed to the definition of nursing " to put the patient
in best possible way for nature to act." Since her time modern
nursing development has rapidly occurred in many parts of the
world. 02/17/2022
 Historical Background of Nursing
Early definition of Nursing
5

 A nurse is a person who nourishes, fosters, and protects—a person

who is prepared to care for the sick, injured, and aged.
 In this sense, “nurse” is used as a noun and is derived from the
Latin nutrix, which means “nursing mother.”

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 Modern definition by Nursing theorists
6
Florence Nightingale (1820-1910)

Florence Nightingale was born on May 12, 1820,



and named after the Italian city of her birth.

Florence Nightingale is considered the founder of modern nursing.



She came from wealthy upper-class family in England during the mid-

1800s.

She was familiar with the Greek and Latin classical languages, and


modern language of French, German, and Italian. She also studied history,

grammar, and philosophy.

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 Florence Nightingale…
7

 On October 7, 1837, Florence Nightingale heard, by her

account, the voice of God telling her that she had a mission in
life.

 It took her some years searching to identify that mission. This

was the first of four occasions where Florence Nightingale said
she heard the voice of God.

 By 1844, over parental objections, Florence Nightingale choose

a different path than the social life and marriage expected by her
parents, she chose to work in nursing, which was then quite a
respectable profession for women.
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 • Her family objected her plan; hospital conditions at that time
8

were known to be terrible, and nurses were known to be

questionable of moral.
 Ignoring all resistance, Nightingale manages and visit some
hospitals and health facilities .
 Nightingale parents eventually relent and in 1851, she went to
Kaiserwerth in Germany for three months of nursing training.
 She become superintendent/manger of the London charity-
supported Institution for Sick Gentlewomen in Distressed
circumstance 1853.
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9
 Soon reports in the newspapers were

describing the desperate lack of proper

medical facilities for wounded British

soldiers at front.

 Sidney Herbert, the war minster, already

knew Nightingale, and asked her to oversee

and lead a team of nurses 38 in number in

the military hospitals in Turkey, then she

volunteered to go to there. 02/17/2022

10

 She took a large group of women as nurses

 Florence Nightingale left England on October 21,

1854 and entered the military hospital at Scutari,
Turkey on November 5, 1854

 They found conditions appalling. Blankets were

rotting in warehouse while the men died without,
because no one had issued the proper forms for their
distribution.
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  The lavatory in the hospitals had no running water,
11
and the latrines were tubs to be emptied by hand. But
no one emptied them, since official regulations did not
specify which department was the responsible for
doing so.

 The result was that the hospital had a foul stench that
could be smelled for some distance outside its walls.

 For more men were dying in the hospitals of infection

than of wounds.
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  The Chief concern of many of the army doctors was that the
12
nurses might usurp/take some of their authority.

 Florence gradually managed to win the doctors and other

authorities over, and reform hospital procedures, with
spectacular results.

 She established more sanitary conditions and order supplies,

beginning with clothes and bedding.

 She used significant funds raised by the London Times

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  Once the medical situation ceased to be an
acute problem, she returned her attention
13
to other aspect of the soldiers’ welfare.
 She focused more administration than on
actual nursing.
 But she continued to visit the wards, and to
send letters back home from injured and ill
soldiers.
 Her rule that she be the only woman in the
wards at night earned her title’ The Lady
with the Lamp’.
 The mortality rate at the military hospital
fell from 60% at her arrival to 2 % with in
six months duration.

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14
 In April 1856 the war was over, and by mid July the
hospital was emptied and her work in Crimea over
and returned to England.

 In 1860, she established the Nightingale Training

School for nurses at Thomas’ Hospital in London

 Once the nurses were trained, they were sent to

hospitals all over Britain, where they introduced the
ideas they had learned, and established nursing
training on the Nightingale model.
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 Nightingale’s theories published in ‘Note on Nursing’

(1860), were hugely influential and her concerns for
sanitation, military health and hospital planning
established practices which are still in existence
today.

 She died on August 13, 1910

 Reading assignment (about contribution FN for nurse)

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 Virginia Henderson
16

Henderson (1897-1996) adopted by the International Council of

Nurses, stating that the unique function of the nurse is to help sick
or well individuals to perform activities that contribute to health,
recovery, or a peaceful death.
 The goal of nursing is to help the individual gain independence as
rapidly as possible” (The nature of nursing 1961)

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 Martha Rogers
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 “Nursing is a learned profession, a science and an art.

 The science of nursing is an organized body of

abstract knowledge, a synthesis of facts and ideas

 The art of nursing refers to use of this knowledge in

the delivery of nursing care for human betterment
(The science of Unitary Man, 1970)

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 American Nurse Association (1980)
18

 The diagnosis and treatment of human response to actual

or potential health problems”

 This definition further identifies the characteristics of

nursing as an independent profession, legitimizing the
assessment and identification of human responses, the use
of nursing knowledge to understand the responses, and the
application and evaluation of nursing actions taken to
meet needs for potential or actual health problem.

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 International Council of Nurse (ICN)

19
 this definition was written by Virginia Henderson and
adopted by the ICN in 1972.

 The unique function of the nurse to assist the individual,

sick or well, in the performance of those activities
contributing to health or its recovery (the peaceful death)
that he/she would unaided if he/she had the necessary
strength, will, or knowledge.

 And to do this in such a way as to help him again

independence as rapidly as possible.
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 Canadian Nurse Association (CNA)
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 It include toward the promotion, maintenance, and

restoration of health, the prevention of illness, the
alleviation of suffering and the ensuring of a peaceful
death when life cannot longer be sustained.

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 Canadian Nurse Association (CNA)….
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 N.B. Despite the multitude of definition of nursing, common

themes are evident: holism, caring, teaching, advocacy,
supporting, promoting, maintaining and restoring health.

 These all are components of nursing practice

 Nursing care involves creativity, sensitivity, and care based on

scientific rationale.

 All of these components are part of the practice, but nurses

should not limit themselves to these themes.
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 History of Nursing in Ethiopia

24

 Modern nursing in Ethiopia started in the later part of the 19th

century by Swedish Missionaries who came to Eritrea in 1866.

 Years later the nursing service was extended to other parts of the
country still by expatriate nurses from Sweden, Russia, and France.

 Thus the need for nurses was felt more than ever. Around 1928
elderly women were recruited and were given short term training to
serve as nurses and midwives.

 Princess Tsehai, the emperor’s youngest daughter was the first

graduated national nurse from Ormond street hospital
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London.
 History of Nursing in Ethiopia
25

 In 1949 the first School of Nursing (The Ethiopian Red Cross) was
opened in the former Haile Selassie I Hospital (Now Yekatit 12
Hospital beginning of the modern nurses education).

 Students were recruited from 8th grade and the training duration was 3
½ years.
 In 1954 Hailesellasie I Public Health College was established in Gondar
to train health officer, community health nurses and sanitarians to
address the health problem of most of the rural population.
 In line with this, the Centralized school of Nursing formerly under
Ministry of health and recently under Addis Ababa University Medical
Faculty and Nekemte School of nursing are among the senior nurse’s
training institutions.
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 History of Nursing in Ethiopia…
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 In 1977, three years after the downfall of the Emperor’s regime, the
nurse training was revised at a national level and a decision was
made to train one category of nurse namely "Comprehensive
nurse" who can function at all levels of health institutions.

 Thus the training of community nurses was discontinued. The

academic entry requirement at this time was raised to 12th grade
completion and the duration shortened to 2 ½ years.

 After the dawn fall of the Derge regime, since 1991, the training
duration reduced by ½ years to only 2 years and the comprehensive
form of training changed to specialized form of training.
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 History of Nursing in Ethiopia…
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 The training of different types of nurses then started for two years in most
training institutions and begins to train clinical nurses, public health nurses
& midwives.

 However this fragmented form of training is not appreciated by most

faculty members of the respective institutions.

 A remarkable event to be mentioned in the history of nursing in Ethiopia is

the launching of post basic baccalaureate program in nursing in 1994 in the
former Jimma institute of health science (now Jimma University).

 The annual average output of baccalaureate program trainees were not

more than 30 and deployed in schools and management positions.
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 Additional public health professional training

institutions were opened in Alamaya University
and Dilla College of Teacher Education and Health
Sciences (1996).

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 History of Nursing in Ethiopia
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 At present, there are a number of governments owned and NGO

and private owned Universities/schools/Colleges are offering
nursing education in the country in Level I, II, III and IV, BSc and
MSc level.
 At the end of the training period, regional health bureau of
respective region registered and licensed them to practice the
profession in the country through the health professionals' council
and COC exam.

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 The Nursing profession and the role of
nurses
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 Nursing is a health care profession, focuses on care of

individual, families, and communities so that they attain,
maintain optimal health

Nursing as profession:
 In almost all countries, is defined and governed by law

 entrance to the profession is regulated at national level

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 Nursing as a developing profession
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Profession
 A Profession is a discipline widely recognized body of

learning derived from research, education and training at a

high level, and who are prepared to apply this knowledge and
exercise these skills in the interest of others. 
Professionals
 A person who is paid for getting involved in a particular

profession in order to earn a living as well as to satisfy the

laws of that profession can be understood as a Professional. 
Professionalism
 Professionalism covers comprehensively all areas of practice

of a particular profession. It requires skills and responsibilities

involved in the profession. 02/17/2022
 Nursing is a profession
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 A profession is a calling that requires special knowledge and

skilled preparation.
 A profession is generally distinguished from other kinds of
occupation

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 Criteria of profession
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 High intellectual level of functioning

 High level of individual responsibility and accountability
 Specialized body of knowledge
 Evidence based practice
 Public service and altruistic activities
 Well organized and strong representations
 Code of ethics
 Competencies and professional license
 Autonomy and independence of practice
 Professional identity and development
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34

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 Roles of Nurses
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Nurses are health care professions who are part of a health care team.
The main responsibilities of a nurse are to care for the patient.

They fulfill the orders concerning patient care, and they also
determine and seek to alleviate the health problems of the patient in
concert with other members of the health care team and whoever else
may be needed to adequately care for the patient.

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 Roles of Nurses
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1. Caregiver/Care provider:- the traditional and most essential role.

 Functions as nurturer, comforter, provider

 “mothering actions” of the nurse .

 Provides direct care and promotes comfort of client

 Activities involve knowledge and sensitivity to what matters and

what is important to clients.

 shows concern for client welfare and acceptance of the client as a

person 02/17/2022
 Roles of Nurses…
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2. Teacher – provides information and helps the client to learn or acquire

new knowledge and technical skills.

 encourages compliance with prescribed therapy.

 promotes healthy lifestyle
 interprets information to the client

3. Client advocate- involves concern for and actions in behalf of the client
to bring about a change.
 promotes what is best for the client, ensuring that the client’s needs are
met and protecting the client’s right.
 provides explanation in clients language and support clients decisions.

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 Roles of Nurses….
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4. Counselor- helps client to recognize and cope with stressful

psychologic or social problems; to develop an improve
interpersonal relationships and to promote personal growth

 provides emotional, intellectual to and psychologic support

 focuses on helping a client to develop new attitudes, feelings

and behaviors rather than promoting intellectual growth.

 encourages the client to look at alternative behaviors recognize

the choices and develop a sense of control.
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 Roles of Nurses…
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5. Change agent- initiate changes or assist clients to make

modifications in themselves or in the system of care.

6. Manager:-makes decisions, coordinates activities of others, allocate

resources, evaluate care and personnel.
 plans, give direction, develop staff, monitors operations, give the
rewards fairly and represents both staff and administrations as
needed .
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 Roles of Nurses…
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7. Researcher: participates in identifying significant researchable

problems.

 Participates in scientific investigation and must be a consumer of

research findings.

 Must be aware of the research process, language of research, a

sensitive to issues related to protecting the rights of human
subjects.

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