Introduction To N

Ministry of higher education First Semester /First Class
and scientific research Academic year 2023- 2024

Duhok Polytechnic University
College of health and Medical
Techniques/Shekhan
Nursing Department
Lecture One
The Nature of Nursing
Historical and Contemporary Nursing
Practice
‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫جامعـة دهــوك التقــنية‬
The Nature of Nursing Historical and Contemporary
Nursing Practice
• Learning Outcomes
• Introduction
• Definitions of Nursing, patient, Nurse, hospitals,
Medical Records, Scope of Nursing
• Roles and Functions of the Nurse
• Needs of the Patient
• Uses of Medical Records
• Patient's Unit

Learning Outcomes
After completing this Lecture, The student will be able to:

1. Discuss historical factors and nursing leaders, female and
male, who influenced the development of nursing.
2. Describe the different types of educational programs for nurses.
3. Explain the importance of continuing nursing education.
4. Describe how the definition of nursing has evolved since

Florence Nightingale.
5. Identify the four major areas of nursing practice.

6. Identify the purposes of nurse practice acts and standards of
professional nursing practice.
7. Describe the roles of nurses.
8. Describe the expanded career roles of nurses and their

functions.
9. Describe factors influencing contemporary nursing practice.
10. Explain the functions of national and international nurses’

associations.

Nursing today is far different from nursing as it was practiced
years ago, and it is expected to continue changing during the 21st
century.
Nursing has undergone dramatic change in response to social
needs and influences.
Women in Nursing, From the beginning of time, women
have cared for infants and children. Nursing could be said to have
its roots in “the home.” Additionally, women, who in general
occupied a subservient and dependent role, were called on to care
for others in the community who were ill.

Generally, the care provided was related to physical maintenance
and comfort. Thus, the traditional nursing role has always entailed
humanistic caring, nurturing, comforting, and supporting.
Religion has also played a significant role in the development
of nursing. Although many of the world’s religions encourage
benevolence.
Men in Nursing Men have worked as nurses as far back as

before the Crusades. Although the history of nursing primarily
focuses on the female figures in nursing, schools of nursing for
men existed in the United States from the late 1880s until 1969.
During the 20th century, men were denied admission to most
nursing programs.

Definitions of Nursing:
Florence Nightingale defined nursing nearly 150 years ago as:
“The act of utilizing the environment of the patient to
assist him in his recovery” (Nightingale).
Nightingale considered a clean, well-ventilated, and quiet

environment essential for recovery. Often considered the first
nurse theorist, Nightingale raised the status of nursing through
education.

Virginia Henderson was one of the first modern nurses define
nursing as:
“The unique function of the nurse is to assist the individual, sick
or well, in the performance of those activities contributing to
health or its recovery (or to peaceful death) .
Henderson described nursing in relation to the client and the

client’s environment. Unlike Nightingale, Henderson saw the
nurse as concerned with both healthy and ill individuals.

In 1980 the ANA changed the definition of nursing to this:
“Nursing is the diagnosis and treatment of human responses to
actual or potential health problems”. The current definition of
nursing remains unchanged from the 2003 edition of Nursing’s
Social Policy Statement:
“Nursing is the protection, promotion, and optimization of health
and abilities, preventions 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, 2010).

Certain themes are common to many of these definitions:
• Nursing is caring.
• Nursing is an art.
• Nursing is a science.
• Nursing is client centered.
• Nursing is holistic.
• Nursing is adaptive.
• Nursing is concerned with health promotion, health
maintenance, and health restoration.
• Nursing is a helping profession.

Recipients of Nursing
The recipients of nursing are sometimes called consumers,
sometimes patients, and sometimes clients. A consumer is
“An individual, a group of people, or a community that uses
a service or commodity.
People who use health care products or services are consumers
of health care.
A patient is a person who is waiting for or undergoing
medical treatment and care. The word patient comes from a Latin
word meaning “to suffer” or “to bear.” Traditionally, the person
receiving health care has been called a patient. Usually, people
become patients when they seek assistance because of illness or
for surgery.

Additionally, with the emphasis on health promotion and
prevention of illness many recipients of nursing care are not ill.
Moreover, nurses interact with family members and significant
others to provide support, information, and comfort in addition to
caring for the patient.
A client is a person who engages the advice or services of
another who is qualified to provide this service. The term client
presents the receivers of health care as collaborators in the care,
that is, as people who are also responsible for their own health.

Scope of Nursing
Nurses provide care for three types of clients:
1 - Individuals
2 - Families
3 - Communities.
Nursing practice involves four goals:

1 - Promoting health and wellness,
2 - Preventing illness,
3 - Restoring health,
4 - Caring for the dying.

Roles and Functions of The Nurse
Nurses assume a number of roles when they provide care to
clients. Nurses often carry out these roles concurrently not
exclusively of one another. For example, the nurse may act as a
counselor while providing physical care and teaching aspects of
that care.
The roles required at a specific time depend on:
1 - The needs of the client .
2 - Aspects of the particular environment.

Roles of The Nurses
1 - Caregiver
The caregiver role has traditionally included those activities that
assist the client physically and psychologically while preserving
the client’s dignity. The required nursing actions may involve full
care for the completely dependent client, partial care for the
partially dependent client, and supportive-educative care to assist
clients in attaining their highest possible level of health and
wellness. Caregiving encompasses the physical, psychosocial,
developmental, cultural, and spiritual levels. A nurse may provide
care directly or delegate it to other caregivers.

2 - Communicator
Communication is integral to all nursing roles. Nurses
communicate with the client, support persons, other health
professionals, and people in the community. In the role of
communicator, nurses identify client problems and then
communicate these verbally or in writing to other members of the
health care team. The quality of a nurse’s communication is an
important factor in nursing care. The nurse must be able to
communicate clearly and accurately in order for a client’s health
care needs to be met .

3 - Teacher
As a teacher, the nurse helps clients learn about their health and
the health care procedures they need to perform, to restore or
maintain their health. The nurse assesses the client’s learning
needs and readiness to learn, sets specific learning goals in
conjunction with the client.

4 - Counselor
Counseling:
Is the process of helping a client to recognize and cope with
stressful psychological or social problems, to develop improved
interpersonal relationships, and to promote personal growth.
It involves providing emotional, intellectual, and psychological
support. The nurse counsels primarily healthy individuals with
normal adjustment difficulties and focuses on helping the person
develop new attitudes, feelings, and behaviors by encouraging
the client to look at alternative behaviors, recognize the choices,
and develop a sense of control.

5 - Change Agent
The nurse acts as a change agent when assisting clients to make
modifications in their behavior. Nurses also often act to make
changes in a system, such as clinical care, if it is not helping a
client return to health. Nurses are continually dealing with change
in the health care system.

6 - Leader
A leader influences others to work together to accomplish
a specific goal. The leader role can be employed at different
levels: individual client, family, groups of clients, colleagues, or
the community. Effective leadership is a learned process requiring
an understanding of the needs and goals that motivate people.

7 - Manager
The nurse manages the nursing care of individuals, families, and
communities. The nurse manager also delegates nursing activities
to ancillary workers and other nurses, and supervises and
evaluates their performance. Managing requires knowledge about
organizational structure and dynamics, authority and
accountability, leadership, change theory, advocacy, delegation,
and supervision and evaluation

8 - Case Manager
Nurse case managers work with the multidisciplinary health care
team to measure the effectiveness of the case management plan
and to monitor outcomes. Each agency or unit specifies the role
of the nurse case manager. In some institutions, the case manager
works with primary or staff nurses to oversee the care of
a specific caseload.

Needs of the Patient
1 - Breath normally
2 - Eat and drink adequately
3 - Eliminate body wastes
4 - Move and maintain desirable position
5 - Sleep and rest
6 - Select suitable clothes
7 - Keep the body clean and well groomed
8 - Communication with others in expressing
emotions , needs , fears or opinions
9 - Play or participate in various form of recreations
10 - Avoid dangers in the environment and avoid
injuring others

Definition Of The nurse :
The nurse is:
A person who has completed a program of basic
generalized nursing education and is authorized by
the appropriate regulatory authority to practice
nursing in his country .
The nurse is prepared and authorized to :

1 - To engage in the general scope of nursing practice
including the promotion of health , prevention of illness
and care of physically and mentally illness and disabled
people for all ages.

2 - To carry out health care teaching .
3 - To participate fully as a member of the health care team
4 - To supervise and train nursing and health care auxiliaries .
5 - To be involved in nursing researches .

Hospitals :
Hospitals vary in size from the 12-bed rural hospital to the 1,500-
bed metropolitan hospital.
Hospitals can be classified according to their ownership or control
as governmental (public) or nongovernmental (private. Military
hospitals provide care to military personnel and their families) .
Private hospitals are often operated by churches, companies
communities, and organizations. Although hospitals have other
functions, such as providing sources for health-related research
and teaching.

Hospitals are also classified by the services they provide.
General hospitals presents a variety of services, such as medical,
surgical, obstetric, pediatric, and psychiatric services, Other
hospitals offer only specialty services, such as psychiatric or
pediatric care. An acute care hospital provides assistance to
clients whose illness and need for hospitalization are relatively
. short term, for example several days

:Thevariety of health care services
Hospitals provide medical and nursing services usually
depends on their size and location. Large urban hospitals usually
have inpatient beds, emergency services, diagnostic facilities,
ambulatory surgery centers, pharmacy services, intensive and
coronary care services, and multiple outpatient services provided
by clinics. Some large hospitals have other specialized services
such as spinal cord injury , burn units, oncology services, and
infusion and dialysis units. In addition, some hospitals have
substance abuse treatment units and health promotion units.
Small rural hospitals often are limited to inpatient beds,
radiology and laboratory services, and basic emergency services

Medical Record ( Patient Chart )
A medical chart is a complete record of a patient's key clinical
data and medical history, such as demographics ,vital signs,
diagnoses, medications, treatment plans, progress notes, problems,
immunization dates, allergies, radiology images, and laboratory
and test results . The terms medical record, health record,
and medical chart are used interchangeably to describe the
systematic documentation of a single patient's medical history . A
patient's individual medical record identifies the patient and
contains information regarding the patient's case history at
. a particular provider

The medical record includes a variety of types of "notes“
entered over time by health care professionals :
- Recording observations
- Administration of drugs and therapies,
- Test results and x-rays
- Reports .
The maintenance of complete and accurate medical
records is a requirement of health care providers and
is generally enforced as a licensing or certification
pre requisite.

Uses
The information contained in the medical record allows :
1 - Health care provider to determine the patient's medical
history and provide informed care.
2 - The medical record serves as the central repository for
planning patient care and
3 - Documenting communication among patient and health
care provider and professionals contributing to the patient's
care.
4 - An increasing purpose of the medical record is to ensure
documentation of compliance with institutional,
‫ ثوليتةكنيكى يا دهؤك‬professional
‫زانكويا‬
or governmental regulation.
The traditional medical record for inpatient care can include :
1 - Admission notes, on-service notes

2 - Progress notes .
3- Preoperative notes
4 - Operative notes and postoperative notes
5 - Procedure notes
6 - Delivery notes and postpartum notes
7 - Discharge notes.

Medical history
The medical history is a longitudinal record of what has

happened to the patient since birth. It gives the clinician
a feel for what has happened before to the patient. As
a result, it may often give clues to current disease state.

Surgical history
The surgical history is a chronicle of surgery performed
for the patient. It may have dates of operations, operative
reports, and/or the detailed narrative of what
the surgeon did.
Obstetric history
The obstetric history lists prior pregnancies and their
outcomes. It also includes any complications of these
pregnancies.

Medications and medical allergies
The medical record may contain a summary of the
patient's
current and previous medications as well as any medical
allergies.
Family history
The family history lists the health status of immediate
family members as well as their causes of death (if
known). It may also list diseases common in the family
or found only in one sex or the other.

Social history
The social history is a chronicle of human interactions. It

tells of the relationships of the patient, his/her careers and
trainings, and religious training. It is helpful for the
physician to know what sorts of community support the
patient might expect during a major illness. It may
explain the behavior of the patient in relation to illness or
loss.

Habits
Various habits which impact health, such as tobacco
use alcohol intake, exercise, and diet are chronicled, often
as part of the social history. This section may also include
more intimate details such as sexual habits and sexual
orientation .
Immunization history
The history of vaccination is included. Any blood tests
proving immunity will also be included in this section.

Chief Complaint
This is the main problem (traditionally called a complaint)
that has brought the patient to see the doctor or other
clinician. Information on the nature and duration of the
problem will be explored.
History of the present illness

A detailed exploration of the symptoms the patient is
experiencing that have caused the patient to seek medical
attention.

Physical examination
The Physical examination is the recording of observations of
the patient. This includes the vital signs, muscle power and
examination of the different organ systems, especially ones
that might directly be responsible for the symptoms the patient
is experiencing.
Assessment and plan
The assessment is a written summation of what are the most
likely causes of the patient's current set of symptoms. The plan
documents the expected course of action to address the
symptoms (diagnosis, treatment, etc.)

Patient's Unit:
Is a special area for the patient when he is in the hospital
for the treatment . The patient unit may be a furnished
private room or a section of a semi private room or
a ward . Patient's unit should be easy to clean equipment,
to make the surrounding pleasant to the patient .
The responsibility of the nurse are:

1 - Providing equipment
2 - Providing safety measures
3 - Providing atmospheric condition including
attention to the temperature , humidity ,
ventilation and good lighting

Contents of the patient's unit
1 – The furniture : include
- Bed
- Over bed table
- Bedside stand
- Chair
- Headlight or lamp
- Privacy screen
2 – Other equipment :
- Mattress
- Pillows
- Linen
- Plastic covers
- Covering of the pillows

3 – Patient's personal care equipment:
- Basin
- Soap dish
- Bedpan
- Mouth wash cap
4 – Patient's personal items:
- Tooth brushes
- Disposable tissues
- Shaving cream
- Razor blades


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Ministry of higher education First Semester /First Class

and scientific research Academic year 2023- 2024

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

After completing this Lecture, The student will be able to:

2. Describe the different types of educational programs for nurses.

3. Explain the importance of continuing nursing education.

4. Describe how the definition of nursing has evolved since

5. Identify the four major areas of nursing practice.

‫زانكويا ثوليتةكنيكى يا دهؤك‬

7. Describe the roles of nurses.

8. Describe the expanded career roles of nurses and their

9. Describe factors influencing contemporary nursing practice.

10. Explain the functions of national and international nurses’

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

Men in Nursing Men have worked as nurses as far back as

‫زانكويا ثوليتةكنيكى يا دهؤك‬

Nightingale considered a clean, well-ventilated, and quiet

‫زانكويا ثوليتةكنيكى يا دهؤك‬

Henderson described nursing in relation to the client and the

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

Nursing practice involves four goals:

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

The nurse is prepared and authorized to :

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

1 - Admission notes, on-service notes

‫زانكويا ثوليتةكنيكى يا دهؤك‬

The medical history is a longitudinal record of what has

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

The social history is a chronicle of human interactions. It

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

History of the present illness

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

The responsibility of the nurse are:

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

‫زانكويا ثوليتةكنيكى يا دهؤك‬

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