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Nursing as a Prof, History

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Nursing as a Profession
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Nursing as aProfession

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Profession

• An organization of an occupational group based on the application of

special knowledge which establishes its own rules and standards for

protection of the public & professionals

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Nursing

• A profession within the health care sector focused on

the care of individuals, families, and communities so

they may attain, maintain, or recover optimal health

and quality of life.

• Nursing is the protection, promotion, and optimization

of health and abilities, prevention of illness and injury,

alleviation of suffering though the diagnosis andtreatment of human response, and advocacy in the care

of individuals, families, communities and populations.

(ANA, 2003)

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Primary Characteristics of Nursing

as a Profession• Education

• Theory

• Service

• Autonomy

• Code of Ethics

• Ongoing research

• Caring

• Professional organization

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Flexner’s Criteria for a Profession

Compared with Nursing

Patterns of Developing Profession

• Professions are basically

intellectual

• Professions are based on a

specific body of knowledge

that can be learned

• Professions are practical as

well as theoretical

Nursing Profession

• Nurses are educated in

institutions of higher learning

& function in a responsible andaccountable manner.

• Nursing continues to develop

its own specific body of

knowledge from which nursingpractice emerges.

• Evolved in response to needs

identified by society & is

guided by ethical code.

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Flexner’s Criteria for a Profession

Compared with Nursing

Patterns of Developing Profession

• Professional work can be

taught through professional

education

• Professions have strong

internal organization

• Practitioners are guided by

altruism

Nursing Profession

• Nurses are educated primarily

in different types of degree

programs

• PNA & other bodies provide

internal organization

• Many nurses enter nursing

profession out of desire to help

others

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• Professional Nursing- an art & science dominated by an ideal of service in

w/c certain principles are applied in the skillful care of the well & the ill.

• Professional Nurse – one who has acquired the art & science of nursing

through basic education, who interprets her role in nursing in terms of

social needs for w/c it exists

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Personal & Professional

Qualities• Has faith in the fundamental values that underlie the democratic way

of life

• Has sense of responsibility for understanding

• Has faith in the reality of spiritual & aesthetic value and the awareness

& pleasure of self-development

• Has basic knowledge, skills & attitudes necessary to address present-

day social problems

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Personal & Professional

Qualities• Has skill in using written & spoken language

• Appreciates & understands importance of good health

• Has emotional balance

• Likes hard work

• Appreciates high standards of workmanship

• Accepts and tries to understand people of all sorts

• Competent to provide excellent care

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Personal Qualifications of a

Nurse• Philosophy of Life

• Good Personality

Personal appearance

Character

Attitude

Charm

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Carper’s Fundamental Patterns

of Knowing• Ethical knowing

• Personal knowing

• Aesthetic knowing

• Empiric knowing

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Ethics: the component of moral knowledge

in nursing

• Guides and directs how nurses conduct theirpractice

• Requires• Experiential knowledge of social values

• Ethical reasoning

• Focus is on:• Matters of obligation, what ought to be done

• Right , wrong and responsibility• Ethical codes of nursing

• Confronting and resolving conflicting values,norms, interests or principles

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Sources of Ethical knowing

• Nursing’s ethical codes and professional standards

• An understanding of different philosophical positions

• Duty

• Social justice

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Personal knowing: acceptance of self that is

grounded in self-knowledge and confidence

• Concerned with becoming self-aware

• Self–awareness that grows over time through

interactions with others

• Used when nurses engage in the therapeutic use of self in

practice

• Scientific competence, moral/ethical practice, insight

and experience of personal knowing

• Personal reflection

• Informed by the response of others

• Openness to experience

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Personal knowing

• Personal knowing needs to be integrated or reconciled with

professional responsibilities

• Personal Knowing is the basis of the therapeutic use of self in

the nurse patient relationship

• Perceiving self feelings, and prejudices within the situation

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Aesthetic knowing: the art of nursing

Expressed through:

◦ Actions, bearing, conduct, attitudes, interaction

◦ Knowing what to do without conscious deliberation

Involves:

◦ Deep appreciation of the meaning of a situation

◦ Moves beyond the surface of a situation◦ Often shared without conscious exchange of words

◦ Transformative art/acts

◦ Brings together all the elements of a nursing care situation to createa meaningful whole

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Aesthetic knowing

• Perceiving the nature of a clinical situation and interpreting

this information

• To respond with skilled action

• It uses the nurses intuition and empathy

• Is based on the skill of the nurse in a given situation

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Empirics: the science of nursing

Based on the assumption that what is known is accessible through the physicalsenses: seeing, touching and hearing.

◦ Reality exists and truths about it can be understood

A pattern of knowing that draws on traditional ideas of science

Expressed in practice as scientific competence

◦ Competent action grounded in scientific knowledge including theories and formal

description◦ Involves conscious problem solving and logical reasoning

◦ Nursing theory

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Empirical knowing

• Positivist science

• Knowledge is systematically organised into general laws and

theories

• Source of this knowledge• Research

• Theory

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Emancipatory knowing (Chinn and

Kramer)

• Emancipatory knowing addresses the socialand political context of nursing and healthcareand critiques the four fundamental patterns of

knowing• It recognises serious social barriers to health

and well-being

• Emancipatory knowing requires an

understanding of the nature of knowledge

• Praxis is the process of emancipatory knowing.It requires both critical reflection and action

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Fundamental patterns of knowing

Emancipat

ory

Ethical

Empiric

Personal

 Aestheti

c

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Methods of turning knowing into

knowledge

• Problem based learning• An instructional method in which students work in small groups

• Used to gain knowledge and acquire problem-solving skills.

• Clinical Supervision• An exchange between practicing professionals to enable the

development of professional knowledge and skills

• Structured reflection on practice

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History of nursing in the Phils.

Early beliefs and practices

Diseases & their causes and treatment were shrouded with mysticism

& superstitions

1. Beliefs about causation of disease

2. People believed that evil spirits could be driven away by persons w/

powers to expel demons

3. People believed in special gods of healing w/ priest-physician as

intermediary.

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History of nursing

A. In the Philippines

Early Care of the Sick

“Herbmen”

“Nonos”

“Mabuting Hilot”

Health Care during Spanish Regime

- Religious orders built hospitals in different parts of the Philippines.

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History of nursing

Earliest Hospitals Established:

Hospital Real de Manila (1577)

San Lazaro Hospital (1578)

Hospital de Indio (1586)

Hospital de Aguas Santas (1590)

San Juan de Dios Hospital (1596)

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History of nursingNursing during the Philippine Revolution:

Josephine Bracken – installed field hospital in Tejeros Rosa Sevilla de Alvero – converted house into quarters for Filipino

soldiers

Dona Hilaria de Aguinaldo – organized Filipino Red Cross

Dona Maria Agoncillo de Aguinaldo – President of Filipino Red Crossbranch in Batangas.

Melchora Aquino – nursed the wounded Filipino soldiers

Capitan Salome – revolutionary leader in Nueva Ecija

Agueda Kahabagan – revolutionary leader in Laguna

Trinidad Tecson – “Ina ng Biac na Bato”

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History of nursingNursing during the Philippine Revolution:

Filipino Red Cross was established in Malolos, Bulacan Hospitals & Schools of Nursing

1. Iloilo Mission Hosp. School of Nursing (Iloilo City,1906) – ran by BaptistForeign Mission Society of america

o Miss Rose Nicolet

o Miss Flora Ernst

o April 1944 : First Nurses’ Board Exam

2. St. Paul’s Hosp. School of Nursing (Manila, 1907)

- established by Most. Rev. Jeremiah Harty, Archbishop of Manila

o Rev. Mother Melanie

o Miss E. Chambers

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History of nursingNursing during the Philippine Revolution:

Hospitals & Schools of Nursing

3. Philippine General Hosp. School of Nursing (1907)

o Elsie McCloskey-Gaches

o Anastacia Giron-Tupas

4. St. Luke’s Hosp. School of Nursing (Quezon City, 1907)

o Miss Helen Hicks

o Mrs. Vitaliana Beltran

o Dr. Jose Flores

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History of nursingNursing during the Philippine Revolution:

Hospitals & Schools of Nursing

5. Mary Johnston Hosp. & School of Nursing (Manila, 1907)

- was called Bethany Dispensary & funded by Methodist Mission

- burned down in 1945

- reopened in 1947 at Harris Memorial

6. Philippine Christian Mission Institute Schools of Nursing- 3 schools of Nursing operated by United Christian Missionary Society

of Inidianapolis, India namely:

Sallie Long Read Memorial Hosp. School of Nursing (Laoag, IlocosNorte, 1903)

Mary Chiles Hosp. School of Nursing (Manila, 1911)

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History of nursingNursing during the Philippine Revolution:

Hospitals & Schools of Nursing

Frank Dunn Memorial Hospital (Vigan, Ilocos Sur, 1911)

7. San Juan De Dios Hosp. School of Nursing (Manila, 1913)

- run by the Daughters of Charity, directed by Sister Taciana Trianes

8. Emmanuel Hosp. School of Nursing (Capiz, 1913)

- funded by the American Baptist Foreign Mission Societyo Miss Clara Pedrosa

9. Southern Islands Hosp. School of Nursing (Cebu, 1918)

- organized by Anastacia Giron-Tupas

o Miss Visitacion Perez

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History of nursingNursing during the Philippine Revolution:

Other Schools of Nursing:

1. Zamboanga General Hosp. SON (1921)

2. Chinese General Hosp. SON (1921)

3. Baguio General Hosp. SON (1923)

4. Manila Sanitarium & Hosp. SON (1930)

5. St. Paul’s SON in Iloilo City (1946)

6. North General Hosp. & SON (1946)

7. Siliman University SON (1947)

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History of nursingFirst Colleges of Nursing in the Philippines

UST College of Nursing (1946)

MCU College of Nursing (1947)

UP College of Nursing (1948) 

Nursing Leaders in the Philippines:

Anastacia Giron-Tupas – founder of PNA

Cesaria Tan – 1st Filipino to receive Master’s degree in Nursing abroad Socorro Sirilan – pioneer in Hosp. Social Service in San Lazaro Hosp.

Rosa Militar – pioneer in school health education

Sor Ricarda Mendoza – pioneer in nursing education

Socorro Diaz – 1st editor of PNA magazine called “The Message”

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History of nursingNursing Leaders in the Philippines:

Conchita Ruiz – 1st full-time editor of newly named PNA magazine “The

Filipino Nurse” Loreto Tupaz – Florence Nightingale of Iloilo

Health & Nursing organizations

Early institutions for child welfare:

1) Hospicio de San Jose (Manila, 1782)2) Asylum of San Jose (Cebu)

3) Asylum of Looban (Manila)e

4) Colegio de Santa Isabel (Naga City)

5) Gota de Leche (Manila, 1907)

6) Liga Nacional Filipiniana para la Protection de la Primera Infancia

7) Pulic Welfare Board

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History of nursingHealth & Nursing organizations

Nursing Organizations:

1) Philippine Nurses Association (PNA)

2) National League of Nurses

3) Catholic Nurses Guild of the Philippines

4) Others: ORNAP, MCNAP, CCNAPI, etc.

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History of nursing in Other LandsPeriod of Intuitive Nursing

- practiced during pre-historic times among primitive tribes & lasted

through early Christian era.

- Beliefs & Practices of Pre-historic Man:

He was nomad .

Nursing was the function that belonged to women.

Believed illness was caused by black magic or voodoo.

Believed that “shaman” has the power to heal by using white magic.

Practices “trephining”

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History of nursing in Other LandsNursing in the Near East

- Beliefs and Practices

Man’s mode of living changed from nomadic to agrarian society to an

urban community life.

Means of communication & beginnings of body of scientific

knowledge were developed

Nursing remained the duty of slaves, wives, sisters / mothers

Care of the sick was still closely related to religion, superstition &

magic

3 great religious ideologies were born namely: Judaism, Christianity &

Islam

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History of nursing in Other LandsNursing in the Near East

- Contributions to Medicine & Nursing

Babylonia – Code of Hammurabi

Egypt – “art of embalming”

- recorded 250 recognized diseases

- slaves & patient’s families nursed the sick

Israel – Moses as “Father of Sanitation”

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History of nursing in Other LandsNursing in the FarEast

China – people strongly believed in spirits & demons

- practiced ancestor worship

- gave the world knowledge of materia medica

(pharmacology)

India – men of medicine built hospitals, practiced

intuitive form of asepsis

- Sushurutu made a list of functions &

qualifications of nurses

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History of nursing in Other LandsNursing in the Ancient Greece

Nursing was the task of untrained slave

Greeks introduced Caduceus, the insignia of medical profession today

Hippocrates, “Father of Scientific Medicine”  was born in Greece

Nursing in Rome

Transition from pagan to Christian philosophy took place.

Romans attempted to maintain vigorous health

Care of the ill was left to slaves / Greek physicians

Fabiola made her home the first hospital in the Christian world.

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History of nursing in Other LandsPeriod of Apprentice Nursing

- period from founding of religious nursing orders in the Crusades

which began in 11th century and ended in 1835.

- period of “on the job” training

- when Crusades began

- Military religious orders were established such as:

1) Knights of St. John of Jerusalem

2) Teutonic Knights

3) Knights of St. Lazarus

- Alexian Brothers Hosp. SON: largest school of nursing under religious

order was founded

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History of nursing in Other LandsPeriod of Apprentice Nursing

- Rise of Secular Orders –when the rise of religious nursing orders for

women began.

- Only by entering a convent that a woman could follow a

career, obtain an education & perform acts of charity that her faith

would help her gain grace in heaven.

Secular Orders founded during the Period of CrusadesOrder of St. Francis of Assissi (1200 – present)

- Believed in devoting their lives to poverty & service to the poor

a. First Order

b. Second Order (Poor Clares)

c. Third Order (Tertiary Order)

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History of nursing in Other LandsPeriod of Apprentice Nursing

Secular Orders founded during the Period of Crusades

The Beguines

- Lay nurses who devoted their lives to the service of suffering

humanity

The Oblates (12th century)

Benedictines

Ursulines

 Augustinians

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History of nursing in Other LandsPeriod of Apprentice Nursing

Important Nursing Personages During the Period ofApprentices Nursing

1. St. Clare – Founder of Second Order of St. Francis

Assissi

2. St. Elizabeth of Hungary – “Patroness of Nurses”

3. St. Catherine of Siena – first “Lady with a Lamp”

Hospitals were established for the care of the sick in

the 16th century.

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History of nursing in Other LandsThe Dark Period of Nursing

- extends from 17th to 19th century from period of reformation until the

US Civil War

- Nursing became the work of the least desirable women

Several leaders who sought to bring about reforms:

1) John Howard: prison reformer

2) Mother Mary Aikenhand: established Irish Sisters of Charity

3) Pastor Theodor Fliedner & Frederika Munster Fliedner: established

the Institute for the Training of Deaconesses at Kaiserwerth,

Germany (1836)

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History of nursing in Other LandsThe Dark Period of Nursing

Nursing in America

o Hotel Dieu of Montreal , a log cabin hospital was founded by Mdme

Jeanne Mance

o Pre-Civil War Nursing

In USA & Canada, religious nursing orders both Catholic & Protestant

carried out nursing

o American Reforms in Nursing

The Nurse’s Society of Philadelphia organized a school of nursing

under the direction of Dr. Joseph Warrington in 1839.

Women’s Hospital in Philadelphia established a 6 month course innursing to increase nurse’s knowledge while they worked.

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History of nursing in Other LandsThe Dark Period of Nursing

Nursing in AmericaoNursing during the Civil War

The AMA created the Committee on Training of

Nurses

Dorothea Lynde Dix: established the Nurse Corps of

the United States Army

Clara Barton: founded the American Red Cross

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History of nursing in Other LandsPeriod of Educated Nursing

- period began on June 15, 1860 when the Florence Nightingale School

of Nursing opened at St. Thomas Hospital in London.

Facts About Florence Nightingale

recognized as the “Mother of Modern Nursing”; also known as “Lady

with a Lamp”

born on May 12, 1820 in Florence, Italy

raised in England in an atmosphere of culture & affluence

Advocated for care of those afflicted w/ diseases caused by lack of

hygienic practices.

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History of nursing in Other LandsPeriod of Educated Nursing

Facts About Florence Nightingale

At the age of 31, she entered the Deaconess School at Kaiserwerth

Worked as a superintendent for Gentlewoman during illness

Upgraded practice of nursing & made nursing an honorable

profession for gentlewomen

Led nurses that took care of the wounded during the Crimean War

Place down her ideas in 2 published books: Notes on Nursing & Notes

on Hospitals

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History of nursing in Other LandsPeriod of Educated Nursing

Other Important Persons/ Groups/ Events During the Period of

Educated Nursing

Linda Richards: 1st graduate nurse in US

Dr. William Halstead : designed the 1st rubber gloves

Caroline Hampton Robb: 1st to wear rubber gloves as OR nurse

Isabel Hampton Robb: 1st principal of John Hopkins Hosp. SON

Clara Louise Maas: engaged in medical research on yellow fever

during Spanish-American War

Development of PDN, school nursing, prenatal & maternal health

nursing

f h d

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History of nursing in Other LandsPeriod of Educated Nursing

Other Important Persons/ Groups/ Events During thePeriod of Educated Nursing

Preparation of standard curriculum based on

objectives for schools of nursing (1913-1937)

Edith Cavell: “Mata Hari”, served the wounded

soldiers in World War I.

Period of contemporary

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Period of contemporary

nursing- period after World War II to present.

o Events & TrendsEstablishment of WHO by the United Nations

Use of atomic/nuclear energy for medical diagnosis & treatment

Utilization of computers for collecting data, teaching, record keeping,

billing, etc.Use of sophisticated equipment for diagnosis & therapy

Advent of space medicine brought about the development of

aerospace nursing

Health is perceived as a fundamental human right

Technological advances

Development of expanded role of the nurse


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