1
History of NursingDenise Filiatrault RN, BSN, MNc
2
Objectives Describe the evolution of nursing and nursing
education Discuss significant changes in nursing Identify nursing leaders Identify major organizations Identify components of the health care system Define nursing Define roles and responsibilities of the LPN and
RN
3
Illness?
Early records Illness = standing with God Medicine man & witchcraft
Evil spirits
Hippocrates (born 460 BC) Rejected ‘supernatural’ Holistic care origins Hippocratic Oath “Do no harm”
4
19th Century
Hospitals Overcrowded No training Nurses lower class women Unkempt Poor hygiene practices
Dirty conditions
5
In small groups answer…. What standards did Florence Nightingale
contribute to nursing, and how have they affected the standards of the nursing profession today?
What impact did WWI and WWII have on nursing?
Why did professional nursing organizations develop in the twentieth century, and what is their purpose today?
What characteristics define the LPN/LVN role?
6
Early Nursing Education Attendant Nurses
The Ballard School First school for training practical nurses Started in 1892 in Brooklyn, NY 3 months’ duration Trained students to care for the chronically ill,
invalids, children, and the elderly Main emphasis was on home care
Cooking, nutrition, basic science, basic nursing procedures Graduated as attendant nurses
7
Nursing Education
Lutheran Order of Deaconesses Established the first real school of
nursing Located in Kaiserwerther, Germany Florence Nightingale attended this
school http://www.nytimes.com/learning/gen
eral/onthisday/bday/0512.html
8
Nursing Education Florence Nightingale
Changed condition of the hospitals Cleaned units, washed clothes regularly, provided
sanitary conditions Through her patience, dedication, and empathetic
treatment, made a psychological change “Lady with the lamp”
Carried a lamp to light her way through the rows of beds of the injured and sick
9
Nursing from Occupation to Profession
Contributions of Florence Nightingale Defined nursing as both an art and a
science Differentiated nursing from medicine Identified personal needs of patient and
role of nurse in meeting them Established standards for hospital
management Established nursing education and
nursing as a respected occupation for women
10
Nursing from Occupation to Profession
Contributions of Florence Nightingale Stressed the need for continuing education for
nurses Recognized two components of nursing—health and
illness Recognized nutrition as important to health Instituted occupational and recreational therapy for
sick people Maintained accurate records/beginning of nursing
research
11
Nursing Education in the USA Most early nursing programs were
supported by large hospitals. First three schools of nursing in the United
States Bellevue Hospital School of Nursing, New York Connecticut Training School, New Haven Boston Training School at Massachusetts General
Hospital, Boston Goal was to set education standards for nurses Code of ethics was adopted by the society
Nightingale Pledge
12
Nursing in the USA
Nursing licensure First laws were established in 1903 Protect the public North Carolina, New Jersey, and New York
were first states Isabelle Hampton Robb and Mary Adelaide
Nutting Developed a program at Columbia University
to train and develop teachers of nursing
13
Nursing
World War I Increased demand for nurses Army School of Nursing was
established Training focused on “service to the
patient” rather than on comprehensive care
Most nurses returned to previous jobs after the war
14
Nursing World War I and World War II
Increased demand for nurses Army School of Nursing was established Training focused on “service to the patient”
rather than on comprehensive care Nurses stayed in the military after the war
Civilian nursing: low pay, long shifts, atrocious conditions
Military nursing: prestige, good pay, and opportunity for advancement
15
Nursing Education
Characteristics of health care changed rapidly as health care became an industry
Growth and diversity became the major emphasis
Beginning of contemporary nursing with specialized nursing care adapted to areas Private duty, school nursing,
industrial nursing, nurse anesthesia, and nurse-midwifery
16
Nursing Education Association of Practical Nurse
Schools Founded in 1941 Dedicated to practical nursing Planned the first standard curriculum
for practical nursing 1942: changed name to the National
Association of Practical Nurse Education (NAPNE)
1959: changed name to National Association for Practical Nurse Education and Service (NAPNES)
17
Nursing 1961: National League for Nursing
established a Department of Practical Nursing Programs
Developed an accreditation service for PN programs; Council of Practical Nursing Programs
1965: American Nurses Association Education should take place in institutions of learning Many hospital-based nursing programs were
disbanded Trend was changed from “training” nurses to
“educating” nurses
18
Contemporary Nursing Education Nursing programs are offered by various
organizations: high schools, trade or technical schools, hospitals, junior and community colleges, universities, private education agencies
Length of programs: 12 to 18 months Skills, theory, and clinical practice National Council Licensing Examination for
Practical Nursing (NCLEX-PN) Examination for licensure as LPN
19
Nursing
Licensing laws Protect the public from unqualified
persons practicing in almost any field or profession
Jurisdictions Area such as a state that has the
legal power to regulate nursing licensure and practice State board of nursing
20
Nursing as a Profession & Discipline
Practice in a wide variety of settings.
Develop a specific body of knowledge.
Conduct and publish nursing research.
Recognize role in promoting health.
Use nursing knowledge as base for nursing practice.
21
Aims of Nursing
To promote health To prevent illness To restore health To facilitate coping with disability
or death
22
Additional Roles of the Nurse Caregiver Communicator Teacher/Educator Counselor Leader Researcher Advocate Maybe a cheerleader too?
23
Practical Nursing Defined The activity of providing specific services
to patients under direct supervision of a licensed physician or dentist and/or RN
Assist individuals, sick or well, in the performance of those activities contributing to health, to their recovery, or to a peaceful death
Educated to be a responsible member of a health care team, performing basic therapeutic, rehabilitative, and preventive care for anyone who needs it
24
Role of the Nurse: 1887 In addition to caring for your 50 patients,
each nurse will follow these regulations: Daily sweep & mop the floors of your ward, dust the patient's
furniture & windowsills. Maintain an even temperature in your ward by bringing in a scuttle
of coal for the day's business. Each nurse on day duty will report every day at 7 a.m. & leave at 8
p.m. except on the Sabbath on which day you will be off from 12 noon to 2 p.m.
Graduate nurses in good standing with the director of nurses will be given an evening off each week for courting purposes or two evenings a week if you go regularly to church.
The nurse who performs her labors and serves her patients and doctors without fault for five years will be given an increase of five cents a day, providing there are no hospital debts outstanding.
25
In a small group: Discuss the Roles
Patient/Client Physician Physician Assistant Residents - Fellows ARNP Registered nurse LPN/LVN Nurses Aid Physical therapists
& Occupational Therapists
Respiratory therapists
Dietician Case Manager Radiology technician Pharmacists Janitor/Housekeeping Phlebotomist Social workers Nurse Managers House supervisors
26
In a small group:
Discuss how a multidisciplinary approach to patient care is affected by the influences of other disciplines, economic factors, environmental issues, and expectations of the patient.
How does the nurse fit into this realm?
27
In Class Activity Can I have a *not shy*
volunteer?
28
Expanded Educational Roles
Clinical nurse specialist (CNS)
Nurse practitioner (DNP, ARNP)
Nurse anesthetist (CRNA)
Nurse–midwife Nurse educator
Nurse administrator
Nurse researcher
Nurse entrepreneur
Nurse Lawyer (RN, JD)
29
Educational Preparation
Entry Level
LPN LPN-RN RN RN-BSN BSN
Graduate Level
RN – MN MN PhD now DNP CNS ARNP CRNA
Distribution - Nursing Education
http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurvey2004.pdf
31
Advance Practice
32
Nursing Research Systematic inquiry to develop knowledge
about issues of importance to the nursing profession Evidence-based practice projects Replications of current reseach Research integration through systematic
review Multisite and interdisciplinary studies Increased focus on health disparities
33
Nursing Research Evidence-based practice (EBP)
Basing clinical decisions on best possible evidence—especially high-quality researchLevel of Evidence
Which is stronger?Professional opinion vs. Randomized Control TrialWikipedia vs. Medline
34
Goals of Research Improve care of people in clinical setting. Study people and the nursing process.
Education Policy development Ethics Nursing history
Develop greater autonomy and strength as a profession.
Provide evidence-based nursing practice.
35
Components of a Research Journal Article
Abstract Introduction Methods Results Discussion References
36
Nursing Role in EB ResearchRead widely and criticallyAttend professional conferencesLearn to expect evidence that a
procedure is effectiveBecome involved in a journal clubPursue and participate in EBP
projects
37
Nursing Research Related Websites
Organization WebsiteAmerican Nurses Association
www.nursingworld.org
American Nurses Credentialing Center—Magnet Recognition
http://nursecredentialing.org/magnet/
American Nurses Foundation
www.nursingworld.org/anf
Cochrane Collaboration www.cochrane.orgFlorence Nightingale site www.countryjoe.com/nig
htingale/index.htmlJoanna Briggs Institute (Aus)
www.joannabriggs.edu.au
National of Research http://ninr.nih.gov/ninr/Sigma Theta Tau International
www.nursingsociety.org
38
Homework for Next Week
Go to one of the above websites and look around.
Post on the discussion board something interesting you found. See next week’s Required
Assignment for details