Foundation of Modern Nursing

Biniyam D Fundamentals of Nursing 05/14/2022
COLLEGE OF HEALTH SCIENCES

SCHOOL OF NURSING
FUNDAMENTALS OF NURSING
By: Biniyam D. (BSN, MSN)
September, 2021
Arbaminch, Ethiopia
1
Biniyam D Fundamentals of Nursing 05/14/2022
FOUNDATION OF MODERN NURSING
2
LEARNING OBJECTIVES:
After completing this unit, the learners will be able to:

 State the modern definition of nursing
 Outline the historical background of nursing world wide and in Ethiopia
 Discuss religious and civilization influence on nursing

 Describe how nursing standards affect nursing care
 Discuss the roles and career opportunities for professional nurses
05/14/2022 Biniyam D Fundamentals of Nursing 3

NURSING: Definition
 Nurse: comes from Latin word
 “nutrix”, meaning “to nourish”
 Person who;
 Nourishes, fosters, and protects
 Prepared to take care of sick, injured, and aged people
 With the expanding roles and functions of the nurse in today’s society,
however, any one definition may be too limited

Definition…
International Council of Nurses:

“Nursing encompasses autonomous and collaborative care of individuals of
all ages, families, groups and communities, sick or well and in all settings.
Nursing includes the promotion of health, prevention of illness, and the care
of ill, disabled and dying people.
Advocacy, promotion of a safe environment, research, participation in
shaping health policy and in patient and health systems management, and
education are also key nursing roles.” (ICN, 2002)

Definition…
American Nurses Association:
“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 of individuals,
families, communities, and populations.” (ANA, 2015).

Definition…
Nursing is an art and a science: a heart and a mind

 As an art: you learn to deliver care with compassion, caring, and respect for
each patient’s dignity
 As a science: nursing practice is based on a body of knowledge and
evidence-based practices
 At its heart, lies a fundamental respect for human dignity and an intuition
for a patient’s needs
 This is supported by the mind, in the form of rigorous core learning

HISTORIC PERSPECTIVES ON NURSING
Early Civilizations to the 16th Century

 Early civilizations: illness had supernatural causes
 Good spirits- health;
 Evil spirits- sickness and death

 Physician- medicine man treated disease by chanting, inspiring fear, or
opening the skull to release evil spirits
 Nurse- mother who cared for her family during sickness by providing
physical care and herbal remedies

History…
Early Civilizations
 The evolution of nursing dates back to 4000 BC,
 2000 BC- wet nurses is recorded in Babylonia and Assyria
Ancient Greece
 Temples: more like health spas rather than hospitals governed by priests
 Nursing: women was performed in the home
Roman Empire
 Eastern Roman Empire (Byzantine Empire): Hospitals were first established
 Caregivers: no formal training and volunteered their time to nurse the sick

History…
Middle Ages
 Byzantine cities: hospitals staffed by paid male assistants and male nurses
 Not enough physicians, caregivers were not required to receive any formal
training
 Dominant caregivers: Men

History…
Renaissance (AD 1400–1550),

 Interest in the arts and sciences emerged
 The time of many geographic explorations
 Universities established
 No formal nursing schools
 Women were not encouraged to leave their homes
 Gave care in the home

History…
Enlightenment and Industrial Revolution

 Introduced technology
 Health status factory workers received little attention
 Medical schools were founded

 France: barbers functioned as surgeons
 Performing: leeching, enemas, and extracting teeth

 Hospitals (almshouses) relied on women to make beds, scrub floors, and
bathe the poor

History…
At the beginning of the 16th century,

 Western societies changed from having a religious orientation to
emphasizing warfare, exploration, and expansion of knowledge
 Monasteries and convents closed, leading to a tremendous shortage of
people to care for the sick
 To meet this need, women who had committed crimes were recruited into
nursing in lieu of serving jail sentences
 Nurses also received low pay and worked long hours in unfavorable
conditions

History…
In the early Christian period,

 Nursing: led by the idea that love and caring for others were important
 Women: organized visits to sick people
 Male: gave nursing care and buried the dead

 11th to 13th C; male and female nursing orders were founded
 Hospitals were built to give a healthcare, and nursing became a respected

vocation

History…
Christian…
 In 1836: Theodor Fleidner revived the Church Order of caregiver to care for
those in a hospital he had founded
 These caregivers of Kaiserwerth became famous- the only ones formally
trained in nursing
 Florence Nightingale received her nurse’s training at the Kaiserwerth
Institute

History…
Florence Nightingale and the Birth of Modern

Nursing
 Considered as the founder of modern nursing
 Grew in wealthy upper-class family in England

 Education: Greek, Latin, history, mathematics,
& philosophy
 Interested in relieving suffering and caring for
the sick
 Since she was not a member of a religious
order, caring for others is not easy

History…
Nightingale…
 After study she became active in reforming health care
 Crimea war: created public’s awareness of the need for educated nurses
 She reduced morbidity and mortality rates

 Established Nightingale Training School of Nurses at St. Thomas’ Hospital
in London
 First school for nurses that provided both theory-based knowledge and
clinical skill building

History…
Nightingale…
Nightingale’s beliefs about nursing education were:
 A holistic framework inclusive of illness and health
 The need for a theoretical basis for nursing practice

 A liberal education as a foundation for nursing practice
 The importance of creating an environment that promotes healing

 The need for a body of nursing knowledge that was distinct from medical
knowledge

History…
Nightingale…
 Born
 May 12, 1820, Florence Italy

 “International Nurses Day”- ICN
 Died:
 August 13, 1910, London, UK

History…
The history of modern nursing in Ethiopia

In ancient Ethiopia,
 “Wegesha” or “Hakims”: person who gave care and provided treatment to an
ill person
 Use various plants and herbal medicine to treat sick persons
 The Orthodox Church was also engaged in giving care to the sick or injured
in the monks’ hospital in Debre Libanos and also used Holy water

History…
Modern nursing:
 Introduced in1866
 By Swedish missionaries who came to Eritrea (one of the previous

countryside of Ethiopia)
 Then nursing services were provided by Swedish, Russian and French
nurses
 In 1928: women took a short term training to serve as midwives and nurses

History…
Ethiopia…
 In 1939:
 Princess Tsehai become the first nurse trained in child health in the London
school of nursing
 Sister Meheret Paulos: the second nurse
 Graduated from Jerusalem and worked in the Egyptian British army and
hospitals in Ethiopia
 In 1949, after World War II,
 The Ethiopian Red Cross established the first nursing school at Haile
Selassie I hospital
 In 1953: the first batch of 17 nurses graduated

History…
Ethiopia…
 In 1951,
 Swedish missionaries opened nursing school at the Princess Tsehai

Memorial Hospital
 In 1954
 Teferi Mekonnen Hospital in Neqamte took the initiative to admit male

nurses too

History…
Ethiopia…
 In 1954,
 Haile Selassie I, the first Public Health College, opened in Gondar town
 Had three departments namely community nurse, health officer, and

sanitarians.
 In 1959
 The first post basic education nursing program, started, was post basic
midwifery with four students
 Inaugurated by Catherine Hamlin and her husband

History…
Ethiopia…
 In 1950,
 The Ethiopian Nurses Association (ENA) was established
 Has been a member of International Council of Nurses (ICN) since 1957.
 Played a great role in the formation of a nursing council with self-

regulatory responsibilities

History…
Ethiopia…
From 1974 to 1991, during the Derg era
 Nursing schools required students to be eighteen years of age and to have
completed 12th grade.
 The length of nursing programs was two and half years to receive the
highest award
 i.e., Diploma in nursing

History…
Ethiopia…
After 1991,
 Nursing education in Ethiopia completely transformed
 Many private and government universities opened and offered diploma and
baccalaureate nursing programs.
 A postgraduate nursing educational program was first inaugurated in Addis
Ababa University. Later, Mekelle, Gondar, and Jimma Universities also
launched
 Now, there are a lot of higher education institutions in Ethiopia that run
masters programs in different specialties of nursing

NURSING AS A PROFESSION
 The patient is the center of your practice
 Includes individuals, families, and/or communities
 To act professionally,
 Use your critical thinking skills to administer quality evidenced-based,
patient-centered care in a safe, prudent, and knowledgeable manner
 You are responsible and accountable to yourself, your patients, and your
peers

Profession…
Nursing is recognized increasingly as a profession based on the following

defining criteria:
 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

Profession…
Science and Art of Nursing Practice

 Because nursing is both an art and a science, nursing practice requires:
 Blend of current knowledge and practice standards
 Insightful and compassionate approach to your patients’ health care needs

 Critical thinking
 Since nursing has a specified body of knowledge, its important to

understand and develop your expertise.
 Takes time and commitment

Profession…
According to Benner's stages of nursing proficiency, a nurse goes through 5 levels
of proficiency:
 Novice: Beginning nursing student or any nurse with no previous level of
experience
 Advanced Beginner: A nurse who has had some level of experience with the
situation
 Competent: A nurse who has been in the same clinical position for 2 to 3 years
 Proficient: A nurse with more than 2 to 3 years of experience in the same

clinical position. Has gained experienced from multiple situations
 Expert: A nurse with diverse experience who has an intuitive grasp of an
existing or potential clinical problem

Profession…
Scope and Standards of Practice

 Giving care;
 According to standards of practice and follow a code of ethics
 Professional practice;
 Includes knowledge from social and behavioral sciences, biological and
physiological sciences, and nursing theories
 Incorporates ethical and social values, professional autonomy, and a sense
of commitment

Profession…
Scope and Standards of Practice…

 Began in 1960 by the American Nurses Association
 Includes:
 Standards of practice
 Standards of professionalism
 Goal;
 To guide nurses into making significant and visual contributions that

improve the health and wellbeing of all individuals, communities and
populations.

Profession…
Standard of practice
 Describes a duty of nurses at competent level of nursing care
 The level of care is demonstrated by a critical thinking model- nursing

process
 Includes all of the significant actions taken by nurses in providing care

Profession…
Standards of Nursing Practice…

1. Assessment: nurse collects pertinent data and information
2. Diagnosis: nurse analyzing the assessment data to determine the actual or
potential problems, and issues
3. Outcomes Identification: nurse identifies expected outcomes for a plan
4. Planning: nurse develops a plan that prescribes strategies to attain

expected, measurable outcomes
5. Implementation: nurse implements the identified plan
6. Evaluation: nurse evaluates attainment of outcomes

Profession…
Standards of Professional performance

 Describes the competent level of behavior in the professional role of the
nurse
 The method ensures that the nurse provides high quality care and knows
what is necessary to do so
 Provides measures to decide weather nursing care is meeting the standard

Profession…
Standards of Professional Performance…

1. Ethics: nurse practices ethically
2. Culturally Congruent Care: practices in a manner with cultural diversity
and inclusion principles
3. Communication: communicates effectively in all areas of practice
4. Collaboration: nurse collaborates with health care consumer and other key
stakeholders
5. Leadership: nurse demonstrates leadership in the professional practice
setting and the profession

Profession…
Standards of Professional Performance…

6. Education: seeks knowledge and competency
7. Evidence-Based Practice and Research: integrates evidence and research
findings into practice
8. Quality of Practice: contributes to quality nursing practice
9. Professional Practice Evaluation: evaluates one’s own and others’ nursing
practice
10. Resources Utilization: uses appropriate resources that are safe, effective,
and fiscally responsible
11. Environmental Health: practices in an environmentally safe and healthy
manner
Profession…
Code of Ethics
 Philosophical ideals of right and wrong that define the principles you will
use to provide care
 It is important for you to also incorporate your own values and ethics into
your practice

Profession…
Professional Responsibilities and Roles

 You are responsible for obtaining and maintaining specific knowledge and
skills
 Provide care and comfort for patients and have a constant obligation to meet
their needs.

Profession…
Professional responsibilities and roles…

Autonomy and Accountability
 Autonomy: initiation of independent nursing interventions
 Accountability: responsible for the type and quality of nursing care provided
Caregiver
 Helps patients to:
 Maintain and regain health,
 Manage disease and symptoms,

 Attain a maximal level of function and independence

Profession…

Advocate
 Protect your patient’s human and legal rights
Educator
 Explain concepts and facts about health
 Describe the reason behind care activities
Communication:
 Allows to gain knowledge of your patients
 Helps the nurse to meet the need of patients, families, and communities

Profession…

Manager
 Coordinate the activities of staff
 Has personnel, policy, and budgetary responsibility

 Uses appropriate leadership styles

Profession…
Career Development
 Nursing provides an opportunity to commit to lifelong learning and career
development
 Because of increasing educational opportunities for nurses, the growth of
nursing as a profession, and a greater concern for job enrichment, the
nursing profession offers different career opportunities.

Profession…
Career development…
 Nurses practice areas:
 Hospital settings,
 Community-based care,
 Ambulatory care,
 Home care,
 Nursing homes/extended care settings

Profession…
Some clinical practices and career opportunities as a nurse:
 Provider of care: a nurse provide direct care to the patient
 Advanced practice registered nurses (APRN): has advanced education in

the specialized area of practice, such as:
 Clinical nurse specialist (CNS): is an APRN with specialized practice,
practice may be specialized by the type of problem (eg: pain), population
(ex. Pediatric), a setting (ex. Critical care), a disease (ex. Diabetes), or a
type care (ex. Rehabilitation).

Profession…
 APRN…
 A nurse practitioner (NP): provides healthcare to a group of peoples
usually in outpatient.
 A certified nurse-midwife (CNM): is an APRN who is also educated in
midwifery.
 Provide care for woman during labor, delivery, and care for the new born
 A certified registered nurse anesthetist (CRNA): is an APRN with
advanced education from a nurse anesthesia–accredited program.
 This nurse provides surgical anesthesia

Profession…
 Nurse Educator
 Works primarily in schools of nursing, staff development departments, and
patient education departments.
 Nurse Administrator
 Manages patient care and the delivery of specific nursing services

 Functions: budgeting, staffing, strategic planning, employee evaluation,
and employee development

Profession…
 Nurse Researcher
 Conducts evidence-based practice and research
 To improve nursing care and further define and expand the scope of nursing
practice
 Works in an academic setting, hospital, or independent professional or
community service agency

Profession…
 Career development in Ethiopia??


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Biniyam D Fundamentals of Nursing 05/14/2022

COLLEGE OF HEALTH SCIENCES

By: Biniyam D. (BSN, MSN)

FOUNDATION OF MODERN NURSING

After completing this unit, the learners will be able to:

 Discuss religious and civilization influence on nursing

 Discuss the roles and career opportunities for professional nurses

05/14/2022 Biniyam D Fundamentals of Nursing 3

05/14/2022 Biniyam D Fundamentals of Nursing 4

International Council of Nurses:

05/14/2022 Biniyam D Fundamentals of Nursing 5

American Nurses Association:

“Nursing is the protection, promotion, and optimization of health and abilities;

05/14/2022 Biniyam D Fundamentals of Nursing 6

Nursing is an art and a science: a heart and a mind

05/14/2022 Biniyam D Fundamentals of Nursing 7

Early Civilizations to the 16th Century

 Evil spirits- sickness and death

05/14/2022 Biniyam D Fundamentals of Nursing 8

 Nursing: women was performed in the home

05/14/2022 Biniyam D Fundamentals of Nursing 9

05/14/2022 Biniyam D Fundamentals of Nursing 10

Renaissance (AD 1400–1550),

 The time of many geographic explorations

 No formal nursing schools

 Women were not encouraged to leave their homes

 Gave care in the home

05/14/2022 Biniyam D Fundamentals of Nursing 11

Enlightenment and Industrial Revolution

 Medical schools were founded

 Performing: leeching, enemas, and extracting teeth

05/14/2022 Biniyam D Fundamentals of Nursing 12

At the beginning of the 16th century,

05/14/2022 Biniyam D Fundamentals of Nursing 13

In the early Christian period,

 Male: gave nursing care and buried the dead

 Hospitals were built to give a healthcare, and nursing became a respected

05/14/2022 Biniyam D Fundamentals of Nursing 14

05/14/2022 Biniyam D Fundamentals of Nursing 15

Florence Nightingale and the Birth of Modern

 Grew in wealthy upper-class family in England

05/14/2022 Biniyam D Fundamentals of Nursing 16

 She reduced morbidity and mortality rates

05/14/2022 Biniyam D Fundamentals of Nursing 17

 The need for a theoretical basis for nursing practice

 The importance of creating an environment that promotes healing

05/14/2022 Biniyam D Fundamentals of Nursing 18

 May 12, 1820, Florence Italy

05/14/2022 Biniyam D Fundamentals of Nursing 19

The history of modern nursing in Ethiopia

05/14/2022 Biniyam D Fundamentals of Nursing 20

 By Swedish missionaries who came to Eritrea (one of the previous

05/14/2022 Biniyam D Fundamentals of Nursing 21

05/14/2022 Biniyam D Fundamentals of Nursing 22

 Swedish missionaries opened nursing school at the Princess Tsehai

 Teferi Mekonnen Hospital in Neqamte took the initiative to admit male

05/14/2022 Biniyam D Fundamentals of Nursing 23

 Had three departments namely community nurse, health officer, and

05/14/2022 Biniyam D Fundamentals of Nursing 24

 The Ethiopian Nurses Association (ENA) was established

 Has been a member of International Council of Nurses (ICN) since 1957.

 Played a great role in the formation of a nursing council with self-

05/14/2022 Biniyam D Fundamentals of Nursing 25