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Historical Perspectives of Nursing and Concepts of Nursing


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Title: Historical Perspectives of Nursing and Concepts of Nursing

Historical Perspectives of Nursing and Concepts
of Nursing
  • ?master?
  • Characteristics of nursing profession
  • ?comprehend?
  • Florence Nightingales deeds and her
    Contributions to nursing science
  • Concept and Dimensions of Nursing
  • ?understand?
  • Historical Perspectives of Nursing

  • Nursing began as a desire to keep people healthy
    and to provide comfort and assurance to the sick.
  • Although the general goals of nursing have
    remained relatively the same over the centuries,
    ever-advancing science and the changing of
    societys needs have deeply influenced the
    practice of nursing.

Stages of Nursing
  • Nursing from Ancient times to the nineteenth
    century Early Civilization
    Christianity Middle Ages Fifteenth to
    Nineteenth Century

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Early Civilization
  • Egyptian physicians are believed to have
    specialized in certain diseases (such as internal
    diseases, fractured bones, and wounds). They also
    hired women, later known as midwives, to assist
    with childbirth. These women were the first
    records nurses.

Early Civilization
  • Greece
  • The Greeks believed in Apollo, the
    Greek god of healing and prayed to him for magic
    cures for their illness.
  • 400 B.C., the famous Greek physician
    Hippocrates believed that disease had natural,
    not magical, causes.

Early Civilization
  • Roman Empire After 300 B.C., early
    physicians built on the groundwork of their
    Egyptian and Greek predecessors. The
    Romans are best known for advances in the health
    of the public.

Early Civilization
  • India
  • In ancient India, early hospitals were
    staffed by male nurses who were required to meet
    four qualifications knowledge of the manner in
    which drugs should be prepared for
    administration, cleverness, devotedness to the
    patient, and purity of mind and body.

  • With the beginning of Christianity, nursing began
    to have a formal and more clearly defined role.
  • Led by the belief that love and caring for others
    were important, women made the first visits to
    sick people, male gave nursing care and buried
    the dead.
  • Nursing became a respected vocation.

Middle Ages
  • More hospitals were built.
  • Nurses delivered custodial care and depended on
    physicians for direction.
  • Nurse midwifery, as one of the oldest nursing
    roles, flourished.
  • Much nursing care was provided by monks and nuns,
    which was segregated by sex.

Fifteenth to Nineteenth Century
  • The extensive population growth in cities, the
    lack of hygiene and sanitation and the increasing
    poverty in urban centers resulted in serious
    health problem.
  • Society changed from one with a religious
    orientation to one that emphasized warfare,
    exploration, and expansion of knowledge.

Fifteenth to Nineteenth Century
  • Many monasteries and convents closed, leading to
    a tremendous shortage of people to care for the
  • Women who had committed crimes were recruited
    into nursing in lieu of serving sentences.
  • The only acceptable nursing role was within a
    religious order where services were provided as
    part of Christianity charity.

Fifteenth to Nineteenth Century
  • Period of NightingaleFlorence Nightingale was
    born in 1820 in a wealthy family
  • Period of Nightingaleher education included the
    mastery of several ancient and modern language,
    literature, philosophy, history, science,
    mathematics, religion, art and music

Fifteenth to Nineteenth Century
  • Period of Nightingaleshe was determined to
    become a nurse since she believed she was called
    by God to help others and to improve the
    well-being of mankindshe visited Kaiserswerth
    and received nurses training at 1850 for three

Fifteenth to Nineteenth Century
  • Period of Nightingalethe outbreak of the Crimean
    War gave Nightingale an opportunity for
    achievementNightingale and her nurses
    transformed the military hospitals by setting up
    diet kitchens, a laundry, recreation centers, and
    reading rooms, and organizing classes for

Fifteenth to Nineteenth Century
  • Period of Nightingaleafter the war, Nightingale
    established the Nightingale Training School for
    Nursed at St. Thomas hospital in London the
    school served as a model for other training
    schoolas the founder of modern nursing,
    Florence Nightingale established the first
    nursing philosophy based on health maintenance
    and restoration.

Stages of Nursing
  • Development of modern nursingIn the early
    twentieth century, a movement toward a
    scientific, research-based defined body of
    nursing knowledge and practice was seen

Stages of Nursing
  • Development of modern nursingNursing
    Educationin 1923, the Rockefeller Foundation
    funded a survey on nursing education, which
    recommended that nursing schools be independent
    of hospital and on a college levelin 1924, one
    of the schools of nursing was set up at Yale

Stages of Nursing
  • Development of modern nursingNursing
    practiceby 1920s, nursing specialization was
    developingthe concept of the clinical nurse
    specialist arosefrom period of Nightingale, the
    system of nursing management has been improving.

Nursing in China
  • Ancient nursing practicethe concept of holism
    care on the basis of differential diagnosis
  • From the middle period of 19th century to the
    middle of the 20th century
  • During the latter half the 20th century

Concept of Nursing
  • 3 stages of the concept of nursingdisease
    centered, patient centered and human health
  • International Council of Nurses, in 1973, nursing
    is to assist the individual, sick or well, in the
    performance of those activities contributing to
    health or its recovery , preventing disease or
    peaceful death.

Concept of Nursing
  • The American Nurses Association, in 1980,
    nursing is the diagnosis and treatment of human
    responses to actual or potential health problems.

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Tasks of Nursing
  • Relieving pains
  • Maintaining health
  • Restoring health
  • Promoting health and wellness

Body of Nursing knowledge
  • Fundamental knowledgephysical
    sciencefundamental medical psychological and
    social science
  • Knowledge specific to nursingclinical nursing
    fundamental nursing, specialty nursing,
    community nursingnursing managementnursing

Characteristics of a Profession
  • Has practitioners who are motivated by altruism
  • Can be taught through a process of professional
  • Is basically intellectual (as opposed to
  • Improves its techniques by the use of scientific
  • Functions autonomously.

Nursing as a Profession, Kelly,1981
  • The services provided are vital to humanity and
    the welfare of society.
  • There is a special body of knowledge which is
    continually enlarged through research.
  • The services involve intellectual activities
    individual responsibility (accountability) is a
    strong feature.

Nursing as a Profession, Kelly,1981
  • Practitioners are educated in institutions of
    higher learning.
  • Practitioners are relatively independent and
    control their own policies and activities
  • Practitioners are motivated by service (altruism)
    and consider their word an important component of
    their lives.

Nursing as a Profession, Kelly,1981
  • There is a code of ethics to guide the decisions
    and conduct of practitioners.
  • There is an organization (association) which
    encourages and supports high standards of

Dimensions of Nursing Practice
  • Clinical Nursingfundamental nursing, to meet
    basic needs of clientsspecialty nursing, based
    on nursing science and specialty theories,
    knowledge and skills
  • Community-based health care, directed toward a
    specific population or group within the community

Dimensions of Nursing Practice
  • Nursing Educationbased on nursing science and
    education theoriescontrolled by the state
    education and health care guide.
  • Nursing Managementsystematic management of
    factors as nursing professional staff,
    technologies, equipment, information, financing.
  • Nursing Research

Forms of nursing in hospital
  • Case managementcared by some fixed nurses
  • Functional nursingcentered by orders
  • Nursing in groups
  • Primary nursing
  • Systematic holistic nursingphilosophy,
    responsibility, forms

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Case management
Functional nursing
Orders, Fundamental nursing
Shifts of nurses day/night shift
Nursing in groups
Group A
Group B

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Nursing An ArtA Science
  • By using scientific knowledge in a humane way,
    nursing combines rational, scientific methods
    with caring behavior.
  • Nursing focuses not on the illness but the
    clients response to illness.

Historical Overview
  • Nursing is an ancient profession that has evolved
    alongside human civilization.
  • Religion heavily influenced this evolution. Many
    early hospitals were tied to organized religion.
  • During the industrial revolution, scientific
    methods became more important.

Florence Nightingale
  • The founder of modern nursing.
  • She established the first school for nurses that
    provided theory-based knowledge and clinical
  • Encouraged the belief that there is a body of
    nursing knowledge distinct from medical

Nightingales Accomplishments
  • Demonstrated the value of nursing care in
    reducing morbidity rates in the Crimean War
  • Established the Nightingale School for Nurses at
    St. Thomas Hospital in London
  • Advocated the principles of cleanliness and
    nutrition in promoting health
  • Developed public awareness of the need for nurses.

The Civil War Nursing
  • Americas tragic conflict underscored the need
    for nursing.
  • Clara Barton (1821-1912) volunteered her nursing
    skills and organized the Red Cross in the United
    States after the war.

Pioneers of Nursing
  • Lillian Wald First community health nurse.
  • Isabel Hampton Robb Founded nursing
  • Adelaide Nutting First nurse appointed as
    university professor.
  • Lavinia Dock Author of early textbooks.
  • Mary Breckenridge Serviced rural America.
  • Mamie Hale Educator of midwives.
  • Mary Mahoney Americas first African-American
  • Linda Richards Americas first trained nurse.
    (Note The term trained nurse preceded registered

Practical Nursing
  • Women who cared for others, but who had no formal
    education, often called themselves practical

Early Practical Nursing Schools
  • Ballard School. Opened in 1892 in New York City
    by the YMCA.
  • Thompson Practical Nursing School. Established
    1907 in Brattleboro, Vermont. Still operating
  • Household Nursing School. Founded in 1918 in

Nursing Education Changes
  • The Goldmark Report Published in 1923, this
    report concluded that for nursing to be on an
    equal footing with other disciplines, nursing
    education should occur in the university setting.
  • Institute of Research and Sciencein Nursing
    Education Report Resulted in the establishment
    of practical nursing under Title III of the
    Health Amendment Act of 1955. This led to a
    growth in practical nursing schools in the U.S.

Nursing Education LP/VNs
  • LPNs (Licensed Practical Nurses) and LVNs
    (Licensed Vocational Nurses) work under the
    supervision of an RN or other licensed provider
    such as a physician or dentist.
  • Education is focused on basic nursing skills and
    direct client care.
  • Educated in community colleges, hospitals,
    vocational programs.

Nursing Education RNs
  • RNs (Registered Nurses) may operate autonomously
    and may supervise LP/VNsLVNS.
  • Education is focused on basic nursing skills and
    direct client care.
  • Educated in universities, community colleges,

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Diploma Programs
  • Typically 3 years in length and offered by
  • Graduates receive diploma rather than a college
  • Program emphasizes basic skills particularly
    suited for hospital clients.
  • Such programs contribute 6 of nurse graduates.

Associate Degree Programs
  • 2-year program offered through community colleges
    or as options at four-year universities.
  • Graduate receives Associate Degree in Nursing
  • Program stresses basic skill preparation with
    clinical practice occurring increasingly in
    community-based institutions (e.g. ambulatory
  • settings, schools and clinics).
  • Such programs contribute 60 of nurse graduates.

Baccalaureate Degree Programs
  • Typically 4 years in length, offered through
    colleges and universities.
  • Graduate receives Bachelor of Science in Nursing
  • Emphasizes preparation for practice in
    nonhospital settings, broader scientific content,
    and systematic problem-solving tools for
    autonomous and collaborative practice.
  • Such programs contribute 34 of all nursing

Nursing Organizations American Nurses
Association (ANA)
  • Purpose To improve the quality of nursing care.
  • Established 1911.
  • Establishes standards for nursing practice.
  • Establishes a professional code of ethics.
  • Develops educational standards
  • Oversees a credentialing system.
  • Influences legislation affecting health care.
  • For RNs only.
  • Publications American Journal of Nursing
    American Nurse

Nursing OrganizationsNational Association for
Practical Nurse Education and Service, Inc.
  • Purpose To improve the quality, education, and
    recognition of nursing schools and LP/VNs in the
  • Established 1941.
  • Provides workshops, seminars, and
    continuing-education programs.
  • Evaluates and certifies continuing-education
    programs of others.
  • Provides individual student professional
    liability insurance program.

Nursing OrganizationsNational Federation of
Licensed Practical Nurses, Inc. (NFLPN)
  • Purpose Provide leadership for LP/VNs.
  • Established 1949.
  • Encourages continuing education.
  • Establishes principles of ethics.
  • Represents and speaks for LP/VNs in Congress.
  • Offers members best type of low-cost insurance.
  • For LPs/VNs.
  • Publication AJPN (quarterly newsletter)

Nursing OrganizationsNational League for Nursing
  • Purpose To identify the nursing needs of society
    and to foster programs designed to meet these
  • Established 1952.
  • Accredits nursing education programs.
  • Conducts surveys to collect data on education
  • Provides continuing-education programs.
  • Open to all nurses and non-nurses.
  • Publication Nursing Health Care.

Nursing OrganizationsNational Council of State
Boards of Nursing, Inc. (NCSBN)
  • Purpose Provides an organization through which
    boards of nursing act together on matters of
    common interest and concern.
  • Established 1978.
  • Develops and administers licensure examinations
    for RN and LP/VN candidates.
  • Maintains a national disciplinary data bank.
  • Serves as the national clearinghouse of
    information on nursing regulation.
  • Publications Issues NCLEX-RN Program Reports
    NCLEX-PN Program Reports.
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