Download - nursing history (world and philippine setting), definition of nursing, nursing programs, roles of a nurse, scope of nursing practice and prefessional crimes

Marcelo Q. Buenavista Jr.Marcelo Q. Buenavista Jr.

PERIODS OF NURSING PERIODS OF NURSING HISTORYHISTORY

Intuitive PeriodIntuitive Period

Apprentice PeriodApprentice Period

Educative PeriodEducative Period

Contemporary PeriodContemporary Period

INTUITIVE PERIODINTUITIVE PERIOD

Prehistoric Prehistoric Early Christian Era Early Christian Era More on intuitionMore on intuition NOMADS – travel from one place to anotherNOMADS – travel from one place to another

Survival of the fittestSurvival of the fittest ““Best for the most” – mottoBest for the most” – motto

Sickness is due to “voodoo”Sickness is due to “voodoo” Performed out of feeling of compassion for Performed out of feeling of compassion for

othersothers Performed out of desire to helpPerformed out of desire to help Performed out of wish to do goodPerformed out of wish to do good Nursing is given by the Nursing is given by the WOMENWOMEN

INTUITIVE PERIODINTUITIVE PERIOD

SHAMAN – uses white magic to counteract the SHAMAN – uses white magic to counteract the black magicblack magic They are the doctors during those time.They are the doctors during those time.

TREPHINING – drilling the skull TREPHINING – drilling the skull Used to treat Psychotic patientsUsed to treat Psychotic patients Psychotic patients are believed to be possessed by Psychotic patients are believed to be possessed by

evil spirits.evil spirits. Growth of religion – most important thing that Growth of religion – most important thing that

happenedhappened Growth of civilizationGrowth of civilization Law of self preservation – inspire man in search of Law of self preservation – inspire man in search of

knowledgeknowledge

RISE IN CIVILIZATIONRISE IN CIVILIZATION

From the mode of Nomadic life From the mode of Nomadic life agrarian agrarian society society gradual development of urban gradual development of urban community lifecommunity life

Existence of means of communicationExistence of means of communication Start of scientific knowledge Start of scientific knowledge more more

complex life complex life increase in health problems increase in health problems demand for more nurses demand for more nurses

Nursing as a duty of Nursing as a duty of SLAVES and WIVES. SLAVES and WIVES. NURSING DID NOT CHANGE but there was NURSING DID NOT CHANGE but there was progress in the practice of Medicine.progress in the practice of Medicine.

Care of the sick was still closely allied with Care of the sick was still closely allied with superstitions, religion and magicsuperstitions, religion and magic


Near East – birth place of 3 religious Near East – birth place of 3 religious ideologist:ideologist: JudaismJudaism ChristianityChristianity Mohammedism or IslamMohammedism or Islam

- Near East culture was adopted by the Greeks and - Near East culture was adopted by the Greeks and Romans combine wit the wonders of the Far East Romans combine wit the wonders of the Far East by returning crusaders and explorers improved by returning crusaders and explorers improved and was carried to Europe during the and was carried to Europe during the Renaissance Period that resulted to greater Renaissance Period that resulted to greater knowledge then to the New World by the Early knowledge then to the New World by the Early settlers.settlers.


New World – a tiny area known as New World – a tiny area known as birth of monotheism that lies birth of monotheism that lies between Tigris and Euphrates River between Tigris and Euphrates River in the Nile River arose the cultures of in the Nile River arose the cultures of Babylonia, Egypt and Hebrew.Babylonia, Egypt and Hebrew.

MONOTHEISM – believer of one GodMONOTHEISM – believer of one God

BABYLONIANSBABYLONIANS

CODE OF HAMMURABICODE OF HAMMURABI11stst recording on the medical practice recording on the medical practiceEstablished the medical feesEstablished the medical feesDiscouraged experimentationDiscouraged experimentationSpecific doctor for each diseaseSpecific doctor for each diseaseRight of patient to choose treatment Right of patient to choose treatment

between the use of charms, medicine, or between the use of charms, medicine, or surgical proceduresurgical procedure

EGYPTIANSEGYPTIANS

ART OF EMBALMINGART OF EMBALMING MummificationMummification Removing the internal organs of the dead bodyRemoving the internal organs of the dead body Instillation of herbs and salt to the deadInstillation of herbs and salt to the dead Used to enhance their knowledge of the human Used to enhance their knowledge of the human

anatomy. Since work was done and performed anatomy. Since work was done and performed on the dead, they learned nothing of Philosophyon the dead, they learned nothing of Philosophy

““THE 250 DISEASES”THE 250 DISEASES” Documentation about 250 diseases and Documentation about 250 diseases and

treatmentstreatments

HEBREWHEBREW Teachings of Teachings of MOSES MOSES

Created LeviticusCreated Leviticus Father of sanitationFather of sanitation

Practice the values of “Hospitality to strangers” and the Practice the values of “Hospitality to strangers” and the “Act of Charity” – contained in the book of Genesis“Act of Charity” – contained in the book of Genesis

LEVITICUS – 3LEVITICUS – 3rdrd book of the Old Testament book of the Old Testament Laws controlling the spread of communicable diseasesLaws controlling the spread of communicable diseases Laws governing cleanlinessLaws governing cleanliness Laws on preparation of foodLaws on preparation of food Purification of man and his foodPurification of man and his food The ritual of CIRCUMCISION – on the 8The ritual of CIRCUMCISION – on the 8thth day after birth day after birth

MOSAIC LAWMOSAIC LAW Meant to keep Hebrews pure so that they may enter the Meant to keep Hebrews pure so that they may enter the

sanctuary without affronting Godsanctuary without affronting God Meant as a survival for health and hygienic reason onlyMeant as a survival for health and hygienic reason only

CHINACHINA

Use of pharmacologic drugsUse of pharmacologic drugs ““MATERIA MEDICA”MATERIA MEDICA”

Book that indicates the pharmacologic drug used Book that indicates the pharmacologic drug used for treatmentfor treatment

No knowledge on anatomyNo knowledge on anatomy Use of wax to preserve the body of the deadUse of wax to preserve the body of the dead Method of paper makingMethod of paper making FACTORS THAT HAMPERED THE ADVANCEMENT FACTORS THAT HAMPERED THE ADVANCEMENT

OF MEDICINE:OF MEDICINE: Baby boys given girl’s nameBaby boys given girl’s name Prohibits dissecting of human body thus thwarting Prohibits dissecting of human body thus thwarting

scientific studyscientific study

INDIAINDIA

SUSHURUTOSUSHURUTO 11stst recording on the nursing practice recording on the nursing practice

Hampered by Taboos due to social structures and Hampered by Taboos due to social structures and practices of animal worshippractices of animal worship

Medicine men built hospitalsMedicine men built hospitals Intuitive form of asepsisIntuitive form of asepsis There was proficient practice of Medicine and There was proficient practice of Medicine and

SurgerySurgery NURSES QUALIFICATIONS: Lay Brothers, Priest NURSES QUALIFICATIONS: Lay Brothers, Priest

Nurses, combination of Pharmacist, Masseurs, PT, Nurses, combination of Pharmacist, Masseurs, PT, cookscooks

There was also decline in Medical practice due to There was also decline in Medical practice due to fall of Buddhism – state religion of Indiafall of Buddhism – state religion of India

GREECEGREECE

AESCULAPUSAESCULAPUS Father of medicine in Greek mythologyFather of medicine in Greek mythology

HIPPOCRATESHIPPOCRATES Father of modern medicineFather of modern medicine 11stst to reject the idea that diseases are caused by evil spirits to reject the idea that diseases are caused by evil spirits 11stst to apply assessment to apply assessment Practice medical ethicsPractice medical ethics

CADUCEUSCADUCEUS Insignia of medicineInsignia of medicine Composed of staff of travellers intertwined with 2 serpent Composed of staff of travellers intertwined with 2 serpent

(the symbol of Aesculapus and his healing power). At the (the symbol of Aesculapus and his healing power). At the apex of the staff are two wings of Hermes (Mercury) for apex of the staff are two wings of Hermes (Mercury) for speed.speed.

NURSES NURSES function of untrained slaves function of untrained slaves

ROMANSROMANS

Proper turnover for the sick peopleProper turnover for the sick people““If you’re strong, you’re healthy” – If you’re strong, you’re healthy” –

mottomottoTransition from Pagan to ChristianityTransition from Pagan to ChristianityFABIOLAFABIOLA

Was converted to Christian and later she Was converted to Christian and later she converted her home to a hospital and converted her home to a hospital and used her wealth for the sick.used her wealth for the sick.

11stst hospital in the Christian world hospital in the Christian world

APPRENTICE PERIODAPPRENTICE PERIOD

1111thth century century 1836 1836 On-the-job training periodOn-the-job training period Refers to a beginner (on-the-job training). Refers to a beginner (on-the-job training).

It means care performed by people who It means care performed by people who are directed by more experienced nursesare directed by more experienced nurses

Starts from the founding of Religious Starts from the founding of Religious Orders in the 6Orders in the 6thth century through the century through the Crusades in the 11Crusades in the 11thth century (1836 – when century (1836 – when the deaconesses School of Nursing was the deaconesses School of Nursing was established in Kaiserswerth, Germany by established in Kaiserswerth, Germany by Pastor THEODORE FLEIDNER)Pastor THEODORE FLEIDNER)

APPRENTICE PERIODAPPRENTICE PERIOD

There was a struggle for religious, political, There was a struggle for religious, political, and economic powerand economic power

Crusades took place in order to gain Crusades took place in order to gain religious, political, and economic power or religious, political, and economic power or for adventurefor adventure

During the Crusade in this period, it During the Crusade in this period, it happened as an attempt to recapture the happened as an attempt to recapture the Holy Land from the Turk who obtained and Holy Land from the Turk who obtained and gain control of the region as a result of gain control of the region as a result of power struggle. Christians were divided due power struggle. Christians were divided due to several religious war and Christians were to several religious war and Christians were denied visit to The Holy Sepulcher. denied visit to The Holy Sepulcher.

MILITARY RELIGIOUS ORDERS MILITARY RELIGIOUS ORDERS AND THEIR WORKSAND THEIR WORKS

KNIGHTS OF ST. JOHN OF JERUSALEM KNIGHTS OF ST. JOHN OF JERUSALEM (ITALIAN)(ITALIAN) Also called as “Knights of the Hospitalers”Also called as “Knights of the Hospitalers” Established to give careEstablished to give care

TEUTONIC KNIGHTS (GERMAN)TEUTONIC KNIGHTS (GERMAN) Took subsequent wars in the Holy LandTook subsequent wars in the Holy Land Cared for the injured and established hospitals Cared for the injured and established hospitals

in the military campsin the military camps KNIGHTS OF ST.LAZARUSKNIGHTS OF ST.LAZARUS

Care for those who suffered Leprosy, syphilis, Care for those who suffered Leprosy, syphilis, and chronic skin diseasesand chronic skin diseases

ALEXIAN BROTHERSALEXIAN BROTHERS A monasteric order founded in 1348. They established A monasteric order founded in 1348. They established

the Alexian Brothers School of Nursing, the largest the Alexian Brothers School of Nursing, the largest School under religious auspices exclusively in US and it School under religious auspices exclusively in US and it closed down in 1969closed down in 1969

ST. VINCENT DE PAULST. VINCENT DE PAUL He organized the charity group called the “La Charite” He organized the charity group called the “La Charite”

and the “Community of Sisters of Charity” composed of and the “Community of Sisters of Charity” composed of women dedicated in caring for the sick, the poor, women dedicated in caring for the sick, the poor, orphaned, and the widowed. He founded the “Sisters of orphaned, and the widowed. He founded the “Sisters of Charity School of Nursing” in Paris, France where Charity School of Nursing” in Paris, France where Florence Nightingale had her 2Florence Nightingale had her 2ndnd formal education in formal education in Nursing.Nursing.

LOUISE de GRASLOUISE de GRAS Was the 1Was the 1stst Superior and co-founder of the Community of Superior and co-founder of the Community of

Sisters of CharitySisters of Charity

NURSING SAINTSNURSING SAINTS ST. CLAIRE OF ASSISI ST. CLAIRE OF ASSISI

Took vows of poverty, obedience to service and chastityTook vows of poverty, obedience to service and chastity Founded the 2Founded the 2ndnd order of St. Francis of Assisi order of St. Francis of Assisi

““the poor Claire”the poor Claire”

ST. ELIZABETH OF HUNGARYST. ELIZABETH OF HUNGARY The patroness of NursingThe patroness of Nursing A princessA princess Sees her calling to give care for the sickSees her calling to give care for the sick Fed thousands of hungry peopleFed thousands of hungry people

St. CATHERINE OF SIENASt. CATHERINE OF SIENA ““Little Saint” – took care of the sick as early as 7y/oLittle Saint” – took care of the sick as early as 7y/o ““11stst Lady with a Lamp” Lady with a Lamp”

RISE OF RELIGIOUS NURSING RISE OF RELIGIOUS NURSING ORDERORDER

Orders of St. Francis of AssisiOrders of St. Francis of Assisi 11stst order – founded by St. Francis order – founded by St. Francis 22ndnd order “the poor Claire” – founded by St. order “the poor Claire” – founded by St.

ClaireClaire 33rdrd “the tertiary order” “the tertiary order”

BeguinesBeguines OblatesOblates BenedictinesBenedictines UrsulitesUrsulites AugustiniansAugustinians

DARK PERIOD OF NURSINGDARK PERIOD OF NURSING From 17From 17thth century – 19 century – 19thth century century Also called the Period of Reformation until the American Also called the Period of Reformation until the American

Civil WarCivil War Hospitals were closedHospitals were closed Nursing were the works of the least desirable people Nursing were the works of the least desirable people

(criminals, prostitutes, drunkards, slaves, and opportunists)(criminals, prostitutes, drunkards, slaves, and opportunists) Nurses were uneducated, filthy, harsh, ill-fed, overworkedNurses were uneducated, filthy, harsh, ill-fed, overworked Mass exodus for nursesMass exodus for nurses The American Civil War was led by Martin Luther, the war The American Civil War was led by Martin Luther, the war

was a religious upheaval that resulted to the destruction in was a religious upheaval that resulted to the destruction in the unity of Christians.the unity of Christians.

The conflict swept everything connected to Roman The conflict swept everything connected to Roman Catholicism in schools, orphanages, and hospitalsCatholicism in schools, orphanages, and hospitals

DARK PERIOD OF NURSINGDARK PERIOD OF NURSING

THEODORE FLIEDNER THEODORE FLIEDNER (a pastor) reconstituted the Deaconesses and (a pastor) reconstituted the Deaconesses and

later be established the School of Nursing at later be established the School of Nursing at Kaiserswerth, Germany where Florence Kaiserswerth, Germany where Florence Nightingale had her 1Nightingale had her 1stst formal training for 3 formal training for 3 months as nursemonths as nurse

FLORENCE NIGHTINGALEFLORENCE NIGHTINGALE Practiced her profession during the Crimean WarPracticed her profession during the Crimean War ““Lady with a Lamp”Lady with a Lamp” From a well-known familyFrom a well-known family Went to Germany to studyWent to Germany to study

EDUCATIVE PERIODEDUCATIVE PERIOD Florence Nightingale eraFlorence Nightingale era Began in June 15, 1860 when Florence Nightingale School of Began in June 15, 1860 when Florence Nightingale School of

Nursing opened at St. Thomas Hospital in London England, Nursing opened at St. Thomas Hospital in London England, where 1where 1stst program for formal education of Nurses began program for formal education of Nurses began and contributed growth of Nursing in the USand contributed growth of Nursing in the US FACTORS THAT INFLUENCED DEVELOPMENT OF NURSING FACTORS THAT INFLUENCED DEVELOPMENT OF NURSING

EDUCATION:EDUCATION: Social forcesSocial forces Trends resulting from warTrends resulting from war Emancipation of womenEmancipation of women Increased educational opportunitiesIncreased educational opportunities

FLORENCE NIGHTINGALEFLORENCE NIGHTINGALE Mother of Modern NursingMother of Modern Nursing Lady with the LampLady with the Lamp Born on May 12, 1820 in Florence, ItalyBorn on May 12, 1820 in Florence, Italy Her SELF-APPOINTED GOAL – to change the profile of NursingHer SELF-APPOINTED GOAL – to change the profile of Nursing She compiled notes of her visits to hospitals, her observations She compiled notes of her visits to hospitals, her observations

of sanitation practices and entered Deaconesses School of of sanitation practices and entered Deaconesses School of Nursing at Kaiserswerth, Germany for 3 months.Nursing at Kaiserswerth, Germany for 3 months.

EDUCATIVE PERIODEDUCATIVE PERIOD FLORENCE NIGHTINGALEFLORENCE NIGHTINGALE

Became the Superintendent of the Establishment for Became the Superintendent of the Establishment for Gentle Women during the Illness (refers to the ill Gentle Women during the Illness (refers to the ill governess or instructors of Nursinggoverness or instructors of Nursing

She disapproved restriction on admission of patient and She disapproved restriction on admission of patient and considered this unchristian and contrary to health care.considered this unchristian and contrary to health care.

Upgraded the practice of Nursing and made Nursing a Upgraded the practice of Nursing and made Nursing a honorable professionhonorable profession

Led other nurses in taking care of the wounded and sick Led other nurses in taking care of the wounded and sick soldiers during the Crimean Warsoldiers during the Crimean War

She was designated as Superintendent of the Female She was designated as Superintendent of the Female Establishment of English General Hospital in Turkey Establishment of English General Hospital in Turkey during the Crimean Warduring the Crimean War

She reduced the casualties of war by 42%-2% thru her She reduced the casualties of war by 42%-2% thru her effort by improving the practice of sanitation techniques effort by improving the practice of sanitation techniques and procedure in the military barracksand procedure in the military barracks

EDUCATIVE PERIODEDUCATIVE PERIOD THE CONCEPTS OF FLORENCE NIGHTINGALE ON THE CONCEPTS OF FLORENCE NIGHTINGALE ON

NURSING SCHOOL:NURSING SCHOOL: School of Nursing should be self-supporting not subject School of Nursing should be self-supporting not subject

to the whimps of the Hospital.to the whimps of the Hospital. Have decent living quarters for students and pay Nurse Have decent living quarters for students and pay Nurse

instructorsinstructors Correlate theories to practiceCorrelate theories to practice Support Nursing research and promote continuing Support Nursing research and promote continuing

education for nurseseducation for nurses Introduce teaching knowledge that disease could be Introduce teaching knowledge that disease could be

eliminated by cleanliness and sanitation and Florence eliminated by cleanliness and sanitation and Florence Nightingale likewise did not believed in the Germ Theory Nightingale likewise did not believed in the Germ Theory of Bacteriology.of Bacteriology.

Opposed central registry of nursesOpposed central registry of nurses Wrote Notes on Nursing, “What it is and what it is not.”Wrote Notes on Nursing, “What it is and what it is not.” Wrote notes on hospitalsWrote notes on hospitals

EDUCATIVE PERIODEDUCATIVE PERIOD

OTHER SCHOOLS OF NURSINGOTHER SCHOOLS OF NURSING Bellevue Training School for Nurses – New York CityBellevue Training School for Nurses – New York City Alexian Brothers Hospital School of Nursing in US Alexian Brothers Hospital School of Nursing in US

exclusively for men. It opened in 1348 and it closed exclusively for men. It opened in 1348 and it closed down in 1969.down in 1969.

LINDA RICHARDS – the first graduate nurse in US. LINDA RICHARDS – the first graduate nurse in US. Graduated in September 1, 1873.Graduated in September 1, 1873.

2 NURSING ASSOCIATION / ORGANIZATIONS THAT 2 NURSING ASSOCIATION / ORGANIZATIONS THAT UPGRADED NURSING PRACTICE IN US:UPGRADED NURSING PRACTICE IN US: American Nurses AssociationAmerican Nurses Association National League for Nursing EducationNational League for Nursing Education

CONTEMPORARY PERIODCONTEMPORARY PERIOD

World War II – presentWorld War II – present This refers to the period after World War I This refers to the period after World War I

and the changes and development in the and the changes and development in the trends and practice of Nursing occurring trends and practice of Nursing occurring since 1945 after World War II.since 1945 after World War II.

Includes scientific and technological Includes scientific and technological development, social changes occurring development, social changes occurring after the war.after the war.

Nursing is offered in College and Nursing is offered in College and UniversitiesUniversities


DEVELOPMENT AND TRENDS:DEVELOPMENT AND TRENDS: W.H.O established by U.N to fight diseases by providing W.H.O established by U.N to fight diseases by providing

health information, proper nutrition, living standard, health information, proper nutrition, living standard, environmental conditions.environmental conditions.

The use of Atomic energy for diagnosis and treatment.The use of Atomic energy for diagnosis and treatment. Space Medicine and Aerospace NursingSpace Medicine and Aerospace Nursing Medical equipment and machines for diagnosis and Medical equipment and machines for diagnosis and

treatmenttreatment Health related lawsHealth related laws Primary Health Care – Nurses involvement in CHNPrimary Health Care – Nurses involvement in CHN Utilization of computersUtilization of computers Technology advances such as development of disposable Technology advances such as development of disposable

equipment and supplies that relieved the tedious task of equipment and supplies that relieved the tedious task of Nurses.Nurses.

Development of the expanded role of Nurses Development of the expanded role of Nurses


FACTORS AFFECTING NURSING TODAY:FACTORS AFFECTING NURSING TODAY: EconomicsEconomics

Consumer’s DemandConsumer’s Demand

Family StructureFamily Structure

Information and TelecommunicationsInformation and Telecommunications

LegislationLegislation

HISTORICAL PERSPECTIVEHISTORICAL PERSPECTIVE

Women’s RolesWomen’s Roles

ReligionReligion

WarWar

Societal AttitudesSocietal Attitudes


WOMEN’S ROLESWOMEN’S ROLES The role as a wife, mother, daughter, sister has The role as a wife, mother, daughter, sister has

always been included in the care of their familyalways been included in the care of their family They cared for their infants, members of the They cared for their infants, members of the

family and members of the community (It family and members of the community (It could be said that Nursing have its roots in the could be said that Nursing have its roots in the home)home)

Has the will to serve for others (subservient)Has the will to serve for others (subservient) The care provided were related to physical The care provided were related to physical

maintenance and comfortmaintenance and comfort They care given were humanistic, nurturing They care given were humanistic, nurturing

comforting and supportingcomforting and supporting


RELIGIONRELIGION Played a significant role in the development of NursingPlayed a significant role in the development of Nursing The Christian values of LOVE THY NEIGHBOR AS THY The Christian values of LOVE THY NEIGHBOR AS THY

SELF, PARABLE OF THE GOOD SAMARITAN had a SELF, PARABLE OF THE GOOD SAMARITAN had a significant impact on Nursingsignificant impact on Nursing

CHRISTIANITY – the greatest impact in the influence of CHRISTIANITY – the greatest impact in the influence of religion in the developmentreligion in the development

The religious values of self-denial, Spiritual Calling, The religious values of self-denial, Spiritual Calling, Devotion to Duty, and Hard Work dominated Nursing Devotion to Duty, and Hard Work dominated Nursing throughout the history and led to the development.throughout the history and led to the development.

Knights’ contributions, Fabiola’s contributions, the saints Knights’ contributions, Fabiola’s contributions, the saints and other personalitiesand other personalities

Deaconesses – Theodore FliednerDeaconesses – Theodore Fliedner


WARWARCrimean War (Arm conflict between Crimean War (Arm conflict between

England and allies Turkey, Sardinia vs. England and allies Turkey, Sardinia vs. Russia); 1854-1856Russia); 1854-1856

Florence Nightingale emerged and Florence Nightingale emerged and became well-known (Crimean War)became well-known (Crimean War)She was asked by Sir Sidney Herbert of the She was asked by Sir Sidney Herbert of the

British war department to recruit contingent British war department to recruit contingent of female nurses to provide care to the sick of female nurses to provide care to the sick and injured in Crimea. and injured in Crimea.

She transformed military camps into She transformed military camps into hospitals by setting up sanitation process: hospitals by setting up sanitation process: hand washing and washing clothes regularlyhand washing and washing clothes regularly

HISTORICAL PERSPECTIVEHISTORICAL PERSPECTIVE WARWAR

American Civil War (1861-1865)American Civil War (1861-1865) Harriet Tubman and Sojourner TruthHarriet Tubman and Sojourner Truth – provided care and – provided care and

safety to slaves fleeing to the North on the Underground safety to slaves fleeing to the North on the Underground RailroadRailroad

Mother Biekerdyke and Clara BartonMother Biekerdyke and Clara Barton – searched the – searched the battlefield and gave care to injured and dying soldiersbattlefield and gave care to injured and dying soldiers

Walt Whitman And Loiusa May AlcottWalt Whitman And Loiusa May Alcott – volunteered as – volunteered as nurses to give care to injured soldiers in military hospitalsnurses to give care to injured soldiers in military hospitals

World War II World War II Created acute shortage of careCreated acute shortage of care Cadet Nurse CorpsCadet Nurse Corps – established in response to markes – established in response to markes

shortage of nursesshortage of nurses Auxiliary health care workers became prominentAuxiliary health care workers became prominent Practical Nurses, aides, and technicians provided much of the Practical Nurses, aides, and technicians provided much of the

actual nursing care under the instruction and supervision of actual nursing care under the instruction and supervision of better prepared nursebetter prepared nurse

Medical specialties aros to meet the needs of hospitalized Medical specialties aros to meet the needs of hospitalized clientsclients

HISORICAL PERSPECTIVEHISORICAL PERSPECTIVE SOCIETAL ATTITUDESSOCIETAL ATTITUDES

Nursing was without organization, no education, and social status Nursing was without organization, no education, and social status Women’s role was – in the home and no respectable woman Women’s role was – in the home and no respectable woman

should have a careershould have a career Victorian Middle Class WomenVictorian Middle Class Women – were just wives to their – were just wives to their

husbands and childrenhusbands and children Nurses were poorly educated, some were incarcerated criminals – Nurses were poorly educated, some were incarcerated criminals –

This was reflected in the book written by Charles Dickens through This was reflected in the book written by Charles Dickens through the character of the character of Sairy GampSairy Gamp – who cared for the patients by – who cared for the patients by stealing from them, physically abused them. This literary works stealing from them, physically abused them. This literary works has greatly affected social attitudes about nursing, the negative has greatly affected social attitudes about nursing, the negative impression and image of nurses up to the contemporary period.impression and image of nurses up to the contemporary period.

Guardian Angel or Angel of MercyGuardian Angel or Angel of Mercy – image arose in the latter – image arose in the latter part of 19part of 19thth century because of work of Florence Nightingale in the century because of work of Florence Nightingale in the Crimean War. She brought respectability to the nursing profession, Crimean War. She brought respectability to the nursing profession, nurses were viewed as noble, compassionate, moral, religious, nurses were viewed as noble, compassionate, moral, religious, dedicated, and self-sacrificingdedicated, and self-sacrificing

Doctor’s handmaidenDoctor’s handmaiden – image arising in the early 19 – image arising in the early 19thth century ; century ; this image evolved when women had yet to obtain the right to this image evolved when women had yet to obtain the right to vote; the family structures were highly paternalistic, and when the vote; the family structures were highly paternalistic, and when the medical profession portrayed increasing use of scientific medical profession portrayed increasing use of scientific knowledge that was viewed as male domain.knowledge that was viewed as male domain.

HeroineHeroine – evolved from nurses acts of bravery during World War II – evolved from nurses acts of bravery during World War II and their contributions in fighting poliomyelitis – in the work of and their contributions in fighting poliomyelitis – in the work of Australian nurse, Australian nurse, Elizabeth KenneyElizabeth Kenney

NURSING LEADERSNURSING LEADERS

Florence NightingaleFlorence Nightingale

Clara BartonClara Barton

Lillian WaldLillian Wald

Lavinia L. DockLavinia L. Dock

Margaret Higgins SangerMargaret Higgins Sanger

Mary BreckinridgeMary Breckinridge

NURSING LEADERSNURSING LEADERS FLORENCE NIGHTINGALEFLORENCE NIGHTINGALE

Contributions are well documentedContributions are well documented Lady with the LampLady with the Lamp She was the 1She was the 1stst nurse to exert political pressure nurse to exert political pressure

on governmenton government Notes on Nursing: What It is and What It Is Not Notes on Nursing: What It is and What It Is Not

– – her greatest achievement ; made her be her greatest achievement ; made her be recognized as nursing’s 1recognized as nursing’s 1stst scientist-theorist scientist-theorist

Born on a wealthy and intellectual familyBorn on a wealthy and intellectual family She was given an honorarium of 4500 and She was given an honorarium of 4500 and

used it to develop Nightingale Training School used it to develop Nightingale Training School for Nurses, which was opened in 1860.for Nurses, which was opened in 1860.


CLARA BARTONCLARA BARTON A school teacher who volunteered as nurse A school teacher who volunteered as nurse

during the American Civil Warduring the American Civil War Her responsibility was to organize the nursing Her responsibility was to organize the nursing

servicesservices Established the American Red CrossEstablished the American Red Cross

LILIAN WALDLILIAN WALD Founder of Public Health NursingFounder of Public Health Nursing Wald and Mary Brewster were the 1Wald and Mary Brewster were the 1stst one to one to

offer trained nursing services to the poor in the offer trained nursing services to the poor in the New York slumsNew York slums


LAVINIA L. DOCKLAVINIA L. DOCK Feminist, prolific writer, political activist, Feminist, prolific writer, political activist,

suffragettesuffragette Friend of WaldFriend of Wald She participated in protest movements for She participated in protest movements for

women’s rights which granted women to vote.women’s rights which granted women to vote. Campaigned for legislation to allow nurses rather Campaigned for legislation to allow nurses rather

than physicians to control their professionsthan physicians to control their professions Founded the American Society of Founded the American Society of

Superintendents of Training Schools for Nurses Superintendents of Training Schools for Nurses on the United States and Canada – precursor to on the United States and Canada – precursor to the current National League for Nursingthe current National League for Nursing


MARGARET HIGGINS SANGERMARGARET HIGGINS SANGERPublic health nurse in New YorkPublic health nurse in New YorkHad a lasting impact on women’s health Had a lasting impact on women’s health

carecareImprisoned for opening the 1Imprisoned for opening the 1stst birth birth

control information clinic in Americacontrol information clinic in AmericaConsidered to be the founder of Considered to be the founder of

“Planned Parenthood”“Planned Parenthood”


MARY BRECKINRIDGEMARY BRECKINRIDGENotable pioneer nurseNotable pioneer nurseEstablished “Frontier Nursing Service Established “Frontier Nursing Service

(FNS)”(FNS)”She worked with the American She worked with the American

Committee for Devastated France, Committee for Devastated France, distributed food, clothing, and supplies distributed food, clothing, and supplies to rural villages and taking care of the to rural villages and taking care of the sick children.sick children.

HISTORY OF NURSINGHISTORY OF NURSING(PHILIPPINE SETTING)(PHILIPPINE SETTING)

EARLY BELIEFS AND PRACTICESEARLY BELIEFS AND PRACTICESBeliefs About Causation of Diseases:Beliefs About Causation of Diseases:

Caused or inflicted by other person (enemy or Caused or inflicted by other person (enemy or witch)witch)

Evil spiritsEvil spirits

Beliefs That Evil Spirits Could Be Driven Beliefs That Evil Spirits Could Be Driven Off By Person With Powers To Expel Bad Off By Person With Powers To Expel Bad Spirits:Spirits:Believed in Gods of healingBelieved in Gods of healingWord doctors – priest physiciansWord doctors – priest physiciansHerbolarios – herb doctorsHerbolarios – herb doctors


EARLY CARE OF THE SICKEARLY CARE OF THE SICK HERBICHEROS – herbmen who practice HERBICHEROS – herbmen who practice

witchcraftwitchcraft MANGKUKULAM / MANGANGAWAY – a person MANGKUKULAM / MANGANGAWAY – a person

suffers from disease without any identified cause suffers from disease without any identified cause and were believed bewitched by suchand were believed bewitched by such

Difficult child birth and some diseases (PMAO) Difficult child birth and some diseases (PMAO) attributed to (NONO) midwivesattributed to (NONO) midwives

Difficult birth, witches were supposed to be the Difficult birth, witches were supposed to be the cause, gunpowder exploded from a bamboo pole cause, gunpowder exploded from a bamboo pole close to the head of the mother to drive evil close to the head of the mother to drive evil spiritsspirits


EARLY HOSPITALS:EARLY HOSPITALS:Hospital Real de Manila – 1577 Hospital Real de Manila – 1577

11stst hospital established hospital establishedGov. Francisco de SandeGov. Francisco de SandeTo give service to king’s Spaniard soldiersTo give service to king’s Spaniard soldiers

San Lazaro Hospital – 1578 San Lazaro Hospital – 1578 Fray Juan ClementeFray Juan ClementeNamed after the Knights of St. LazarusNamed after the Knights of St. LazarusHospital for the lepersHospital for the lepers


EARLY HOSPITALS:EARLY HOSPITALS: Hospital de Indios – 1586 Hospital de Indios – 1586

Franciscan OrdersFranciscan OrdersHospital for the poor Filipino peopleHospital for the poor Filipino people

Hospital de Aguas Santas – 1590 Hospital de Aguas Santas – 1590 Fray Juan BautistaFray Juan BautistaNamed after its location (near spring) because people Named after its location (near spring) because people

believed that spring has a healing power.believed that spring has a healing power.

San Juan de Dios Hospital – 1596 San Juan de Dios Hospital – 1596 For poor people For poor people Located at Roxas BoulevardLocated at Roxas Boulevard


PERSONAGES:PERSONAGES: Dona Hilaria de AguinaldoDona Hilaria de Aguinaldo

11stst wife of Emilio Aguinaldo wife of Emilio AguinaldoEstablished Philippine Red Cross – February 17, 1899Established Philippine Red Cross – February 17, 1899

Dona Maria Agoncillo de AguinaldoDona Maria Agoncillo de Aguinaldo22ndnd wife of Emilio Aguinaldo wife of Emilio Aguinaldo11stst president of Philippine Red Cross (Batangas president of Philippine Red Cross (Batangas

Chapter)Chapter)

Josephine BrackenJosephine BrackenHelped Rizal in treating sick peopleHelped Rizal in treating sick people


PERSONAGES:PERSONAGES: Melchora AquinoMelchora Aquino

Took care of the wounded KatipunerosTook care of the wounded Katipuneros

Anastacia Giron TupazAnastacia Giron TupazFounder of Filipino Nurses Association – established Founder of Filipino Nurses Association – established

on October 15, 1922on October 15, 192211stst Filipino chief nurse of PGH Filipino chief nurse of PGH11stst Filipino Superintendent of Nurses in the Philippines Filipino Superintendent of Nurses in the Philippines

Francisco DelgadoFrancisco Delgado11stst president of Filipino Nurses Association president of Filipino Nurses Association


PERSONAGES:PERSONAGES: Cesaria Tan Cesaria Tan

11stst Filipino to receive Masteral Degree in Nursing abroad Filipino to receive Masteral Degree in Nursing abroad

Socorro Sirilan Socorro Sirilan Pioneer in Social Service at San Lazaro HospitalPioneer in Social Service at San Lazaro Hospital Also the chief nurseAlso the chief nurse

Rosa MilitarRosa Militar Pioneer in nursing educationPioneer in nursing education

Socorro DiazSocorro Diaz 11stst editor of PNA magazine called, “The Message” editor of PNA magazine called, “The Message”

Conchita RuizConchita Ruiz Full time editor of the PNA newly named magazine, “The Full time editor of the PNA newly named magazine, “The

Filipino Nurse Filipino Nurse


EARLY NURSING SCHOOLSEARLY NURSING SCHOOLSIloilo Mission Hospital and School of Iloilo Mission Hospital and School of

NursingNursingEstablished in 1906 under the supervision of Established in 1906 under the supervision of

Rose Nicolet (American)Rose Nicolet (American)Nursing course – 3yrs.Nursing course – 3yrs.Produced 1Produced 1stst batch of Nursing graduates in batch of Nursing graduates in

1909 – 22 nurses1909 – 22 nurses11stst TRAINED NURSES: TRAINED NURSES:

Nicasia CadaNicasia CadaFelipa Dela PenaFelipa Dela PenaDorotea CalditoDorotea Caldito

April 1944 – 1April 1944 – 1stst Nursing Board Exam at Iloilo Nursing Board Exam at Iloilo Mission HospitalMission Hospital


EARLY NURSING SCHOOLSEARLY NURSING SCHOOLSPGH School of Nursing – 1907 PGH School of Nursing – 1907 St. Paul School of Nursing – 1907 St. Paul School of Nursing – 1907 St. Luke’s School of Nursing – 1907 St. Luke’s School of Nursing – 1907 UST – 1946 UST – 1946 MCU – 1947 MCU – 1947 Fatima – 1947 Fatima – 1947

NURSING: DEFINITIONSNURSING: DEFINITIONS

NURSING (as an art)NURSING (as an art) Is the art of caring sick and well individual. It Is the art of caring sick and well individual. It

refers to the dynamic skills and methods in refers to the dynamic skills and methods in assisting sick and well individual in their assisting sick and well individual in their recovery and in the promotion and recovery and in the promotion and maintenance of healthmaintenance of health

NURSING (as a science)NURSING (as a science) Is the scientific knowledge and skills in Is the scientific knowledge and skills in

assisting individual to achieve optimal health. assisting individual to achieve optimal health. It is the diagnosis and treatment of human It is the diagnosis and treatment of human responses to actual or potential problemresponses to actual or potential problem


FLORENCE NIGHTINGALEFLORENCE NIGHTINGALE Nursing is the act of utilizing the environment of Nursing is the act of utilizing the environment of

the patient to assist him in his recovery.the patient to assist him in his recovery.

VIRGINIA HENDERSONVIRGINIA HENDERSON Nursing is the act of assisting the individual, sick Nursing is the act of assisting the individual, sick

or well, in the performance of those activities or well, in the performance of those activities contributing to health or its recovery (or to a contributing to health or its recovery (or to a peaceful death) that he would perform unaided peaceful death) that he would perform unaided if he had the necessary strength, will, or if he had the necessary strength, will, or knowledge, and to do this in such a way as to knowledge, and to do this in such a way as to help him gain independence as rapidly as help him gain independence as rapidly as possible.possible.


CANADIAN NURSES ASSOCIATION (CNA) CANADIAN NURSES ASSOCIATION (CNA) Nursing is a dynamic, caring, helping relationship in Nursing is a dynamic, caring, helping relationship in

which the nurse assist the client to achieve and obtain which the nurse assist the client to achieve and obtain optimal health. – 1987optimal health. – 1987

THEMES THAT ARE COMMON TO THESE DEFINITION:THEMES THAT ARE COMMON TO THESE DEFINITION: Nursing is caringNursing is caring Nursing is an artNursing is an art Nursing is a scienceNursing is a science Nursing is client-centeredNursing is client-centered Nursing is holisticNursing is holistic Nursing is adaptiveNursing is adaptive Nursing is concerned with health promotion, health Nursing is concerned with health promotion, health

maintenance, and health restorationmaintenance, and health restoration Nursing is a helping professionNursing is a helping profession


AMERICAN NURSES ASSOCIATION (ANA)AMERICAN NURSES ASSOCIATION (ANA) 19731973

Nursing is direct, goal oriented, and adaptable to the needs of Nursing is direct, goal oriented, and adaptable to the needs of the individual, the family, and community during health and the individual, the family, and community during health and illness.illness.

19801980 Nursing is the diagnosis and treatment of human responses to Nursing is the diagnosis and treatment of human responses to

actual or potential health problems.actual or potential health problems. 19951995

ANA acknowledges FOUR ESSENTIAL FEATURES OF ANA acknowledges FOUR ESSENTIAL FEATURES OF CONTEMPORARY NURSING PRACTICE:CONTEMPORARY NURSING PRACTICE:

Attention to the full range of human experiences and responses Attention to the full range of human experiences and responses to health and illness without restriction to a problem-focused to health and illness without restriction to a problem-focused orientation.orientation.

Integration of objective data with knowledge gained from Integration of objective data with knowledge gained from understanding of the client or group’s subjective experience.understanding of the client or group’s subjective experience.

Application of scientific knowledge to the processes of diagnosis Application of scientific knowledge to the processes of diagnosis and treatment.and treatment.

Provision of caring relationship that facilitates health and healing.Provision of caring relationship that facilitates health and healing.

NURSE: DEFINITIONNURSE: DEFINITION

NURSENURSE Comes from a Latin word “to nourish” or “to cherishComes from a Latin word “to nourish” or “to cherish One who cares for the sick, the injured, and the One who cares for the sick, the injured, and the

physically, mentally, and emotionally disabledphysically, mentally, and emotionally disabled One who advise and instruct individuals, families, One who advise and instruct individuals, families,

groups and communities in the prevention, groups and communities in the prevention, treatment of illness and diseases and in the treatment of illness and diseases and in the promotion of health.promotion of health.

An essential member of a health team who cares for An essential member of a health team who cares for individuals, families and communities in disease individuals, families and communities in disease and illness prevention and in the promotion of and illness prevention and in the promotion of health and healthy environment.health and healthy environment.

PATIENT: DEFINITIONPATIENT: DEFINITION

PATIENTPATIENT Comes from a Latin word, “to Suffer” or “to Comes from a Latin word, “to Suffer” or “to

Bear”Bear” An individual who is in the state of physical, An individual who is in the state of physical,

mental, and emotional imbalancemental, and emotional imbalance An individual who seeks for nursing assistance, An individual who seeks for nursing assistance,

medical assistance, or for surgery due to medical assistance, or for surgery due to illness or a disease.illness or a disease.

Is an individual who is waiting or undergoing Is an individual who is waiting or undergoing medical or surgical care. One who is physically medical or surgical care. One who is physically or mentally disabled.or mentally disabled.

NURSING PROGRAMSNURSING PROGRAMS Licensed Vocational Nursing Program / Licensed Practical Nursing Licensed Vocational Nursing Program / Licensed Practical Nursing

Program (LVN,LPN)Program (LVN,LPN)

REGISTERED NURSING PROGRAMS:REGISTERED NURSING PROGRAMS: Community College / Associate DegreeCommunity College / Associate Degree

Diploma ProgramDiploma Program

Baccalaureate Degree ProgramBaccalaureate Degree Program

GRADUATE NURSING EDUCATION:GRADUATE NURSING EDUCATION: Master’s DegreeMaster’s Degree

Doctoral DegreeDoctoral Degree

External DegreeExternal Degree

LVN / LPNLVN / LPN

Licensed Vocational Nursing Program / Licensed Vocational Nursing Program / Licensed Practical Nursing Program Licensed Practical Nursing Program (LVN,LPN)(LVN,LPN) Last for 9 – 12 monthsLast for 9 – 12 months Provide both classroom and clinical experiencesProvide both classroom and clinical experiences Provided by the community colleges, vocational Provided by the community colleges, vocational

schools, hospitals, or other independent health schools, hospitals, or other independent health agencies.agencies.

Under supervision of RNUnder supervision of RN Prepares students how to give basic direct Prepares students how to give basic direct

technical caretechnical care Graduate takes NCLEX – PN to obtain license as Graduate takes NCLEX – PN to obtain license as

a practical or vocational course.a practical or vocational course.

REGISTERED NURSING REGISTERED NURSING PROGRAMSPROGRAMS

Community College / Associate DegreeCommunity College / Associate Degree Arose in early 1950sArose in early 1950s 2-year program2-year program Technical nurse or bedside nurseTechnical nurse or bedside nurse ADN (AA or AS)ADN (AA or AS)

Diploma ProgramDiploma Program 3-year program3-year program Hospital-basedHospital-based Provide rich clinical experience for nursesProvide rich clinical experience for nurses Associated with colleges and universitiesAssociated with colleges and universities

REGISTERED NURSING REGISTERED NURSING PROGRAMSPROGRAMS

Baccalaureate Degree ProgramBaccalaureate Degree Program Early Baccalaureate Program Early Baccalaureate Program 5-year program (3-year 5-year program (3-year

diploma program in addition to 2 years of liberal arts)diploma program in addition to 2 years of liberal arts) Today’s Baccalaureate Degree Program Today’s Baccalaureate Degree Program 4-5-year 4-5-year

programprogram Offer courses in the liberal arts, sciences, humanities, Offer courses in the liberal arts, sciences, humanities,

and nursingand nursing Graduates must fulfill both the degree requirements of Graduates must fulfill both the degree requirements of

the college or university and the nursing program before the college or university and the nursing program before being awarded a baccalaureate degree.being awarded a baccalaureate degree.

BSNBSN Also admit RN who have diplomas or associate degrees.Also admit RN who have diplomas or associate degrees. Much backgroundMuch background More theoriesMore theories

GRADUATE NURSING GRADUATE NURSING EDUCATION EDUCATION

Master’s DegreeMaster’s Degree 1.5 – 2-year program1.5 – 2-year program Encourage the development of graduate study in nursingEncourage the development of graduate study in nursing Major emphasis was to be research and specialization for Major emphasis was to be research and specialization for

teaching and administrationteaching and administration Provide specialized knowledge and skills that enable nurses to Provide specialized knowledge and skills that enable nurses to

assume advanced roles in practice, education, administration, assume advanced roles in practice, education, administration, and research.and research.

MAN / MSNMAN / MSN

Doctoral ProgramDoctoral Program PhD, DNS, NDPhD, DNS, ND Further prepares the nurse for advanced clinical practice, Further prepares the nurse for advanced clinical practice,

administration, education, and research.administration, education, and research. Content and approach vary among doctoral programs.Content and approach vary among doctoral programs. All emphasized researchAll emphasized research No specific timeNo specific time

EXTERNAL DEGREEEXTERNAL DEGREE

External DegreeExternal DegreeOffers credit for expertise gained Offers credit for expertise gained

outside formal classroom settingoutside formal classroom settingSeminarsSeminarspost- grad coursespost- grad coursesNo specific timeNo specific timeShort coursesShort courses

ROLES OF A NURSEROLES OF A NURSE CaregiverCaregiver CommunicatorCommunicator TeacherTeacher Client AdvocateClient Advocate CounselorCounselor Change AgentChange Agent LeaderLeader ManagerManager Case ManagerCase Manager Research ConsumerResearch Consumer Role ModelRole Model AdministratorAdministrator Expanded Career Roles Expanded Career Roles

ROLES OF A NURSEROLES OF A NURSE

CaregiverCaregiver Primary goalPrimary goal TYPES OF CARE:TYPES OF CARE:

Full Care Full Care for completely dependent patient for completely dependent patient Partial Care Partial Care for partially dependent patient for partially dependent patient Supportive-Educative care Supportive-Educative care to assist clients in attaining their to assist clients in attaining their

highest possible level of health and wellness; for learningshighest possible level of health and wellness; for learnings

CommunicatorCommunicator Integral to all nursing rolesIntegral to all nursing roles Nurses communicate with the client, support persons, other Nurses communicate with the client, support persons, other

health professionals, and people in the communityhealth professionals, and people in the community Nurses identify client problems and then communicate Nurses identify client problems and then communicate

these verbally or in writing to other members of the health these verbally or in writing to other members of the health teamteam

ROLES OF A NURSEROLES OF A NURSE TeacherTeacher

Nurses help clients learn about their health and the health care Nurses help clients learn about their health and the health care procedure they need to perform to restore or maintain their procedure they need to perform to restore or maintain their health.health.

Nurses assesses the client’s learning needs and readiness to Nurses assesses the client’s learning needs and readiness to learn, sets specific learning goals in conjunction with the client, learn, sets specific learning goals in conjunction with the client, enacts teaching strategies, and measures learning.enacts teaching strategies, and measures learning.

Nurses also teaches unlicensed assistive personnel to whom Nurses also teaches unlicensed assistive personnel to whom they delegate care, and they share their expertise with other they delegate care, and they share their expertise with other nurses and health professionals.nurses and health professionals.

Client AdvocateClient Advocate Acts to protect the clientActs to protect the client Nurse may represent the client’s needs and wishes to other Nurse may represent the client’s needs and wishes to other

health professionals, such as relaying the client’s wishes for health professionals, such as relaying the client’s wishes for information to the physician.information to the physician.

Nurses assist clients in exercising their rights and help them Nurses assist clients in exercising their rights and help them speak up for themselvesspeak up for themselves

ROLES OF A NURSEROLES OF A NURSE CounselorCounselor

Helping a client recognize and cope with stressful psychologic Helping a client recognize and cope with stressful psychologic or social problems, to develop improved interpersonal or social problems, to develop improved interpersonal relationships, and to promote personal growth.relationships, and to promote personal growth.

Involves providing emotional, intellectual and psychologic Involves providing emotional, intellectual and psychologic support.support.

Nurses counsel primarily healthy individuals with normal Nurses counsel primarily healthy individuals with normal adjustment difficulties and focuses on helping the person adjustment difficulties and focuses on helping the person develop new attitudes, feelings, behaviors by encouraging the develop new attitudes, feelings, behaviors by encouraging the client to look at alternative behaviors, recognizing the choices, client to look at alternative behaviors, recognizing the choices, and develop sense of control.and develop sense of control.

Change AgentChange Agent Assisting others to make modifications in their own behavior.Assisting others to make modifications in their own behavior. Nurses also often act to make changes in a system if it is not Nurses also often act to make changes in a system if it is not

helping client return to health.helping client return to health.

ROLES OF A NURSEROLES OF A NURSE LeaderLeader

Influences others to work together to accomplish a Influences others to work together to accomplish a specific goal.specific goal.

Can be employed at different levels: individual client, Can be employed at different levels: individual client, family, groups of clients, colleagues, or the communityfamily, groups of clients, colleagues, or the community

Case ManagerCase Manager Work with the multidisciplinary health care team to Work with the multidisciplinary health care team to

measure the effectiveness of the case management plan measure the effectiveness of the case management plan and to monitor outcomes.and to monitor outcomes.

Works with primary or staff nurses to oversee the care of Works with primary or staff nurses to oversee the care of a specific caseload.a specific caseload.

Primary nurse or provides some level of direct care to Primary nurse or provides some level of direct care to the client and familythe client and family

Helps ensure that care is oriented to the client, while Helps ensure that care is oriented to the client, while controlling costs.controlling costs.


Research ConsumerResearch Consumer Often use research to improve client careOften use research to improve client care Have some awareness of the process and language of Have some awareness of the process and language of

researchresearch Be sensitive to issues related to protecting the rights of Be sensitive to issues related to protecting the rights of

human subjectshuman subjects Participate in the identification of significant researchable Participate in the identification of significant researchable

problemsproblems Be a discriminating consumer of research findingsBe a discriminating consumer of research findings

Role ModelRole Model Has good physical appearance Has good physical appearance Practices proper hygienePractices proper hygiene Practices healthy lifestylePractices healthy lifestyle


AdministratorAdministrator Assumes middle management positionAssumes middle management position Connects the patient to other services of the Connects the patient to other services of the

hospitalhospital

Expanded Career RolesExpanded Career Roles Nurse practitioner, clinical nurse specialist, Nurse practitioner, clinical nurse specialist,

nurse midwife, nurse educator, nurse nurse midwife, nurse educator, nurse researcher, and nurse anesthetistresearcher, and nurse anesthetist

All of which allow greater independence and All of which allow greater independence and autonomy.autonomy.

SCOPE OF NURSING SCOPE OF NURSING PRACTICEPRACTICE

FOUR AREAS:FOUR AREAS:Promoting Health and WellnessPromoting Health and Wellness

Preventing IllnessPreventing Illness

Restoring HealthRestoring Health

Care of the DyingCare of the Dying


PROMOTING HEALTH AND WELLNESSPROMOTING HEALTH AND WELLNESS

Wellness – state of well-being. Engaging in Wellness – state of well-being. Engaging in attitudes and behavior that enhance the attitudes and behavior that enhance the quality of life and maximize personal potentialquality of life and maximize personal potential

For both healthy and ill.For both healthy and ill. Involve individual and community activities to Involve individual and community activities to

enhance healthy lifestyle, such as improving enhance healthy lifestyle, such as improving nutrition and physical fitness, preventing drug nutrition and physical fitness, preventing drug and alcohol misuse, restricting smoking, and and alcohol misuse, restricting smoking, and preventing accidents and injury in the home preventing accidents and injury in the home and workplace. and workplace.


PREVENTING ILLNESSPREVENTING ILLNESS

The goal is to maintain optimal health The goal is to maintain optimal health by preventing diseasesby preventing diseases

Nursing activities includes Nursing activities includes immunizations, prenatal and infant care, immunizations, prenatal and infant care, and prevention of sexually transmitted and prevention of sexually transmitted disease.disease.


RESTORING HEALTHRESTORING HEALTH

Focuses on the ill clientFocuses on the ill client Extends from early detection of disease to helping the Extends from early detection of disease to helping the

client during the recovery periodclient during the recovery period NURSING ACTIVITIES:NURSING ACTIVITIES:

Providing direct care to the ill person: administering Providing direct care to the ill person: administering medications, baths, and specific procedures and treatmentsmedications, baths, and specific procedures and treatments

Providing diagnostic and assessment procedures: Providing diagnostic and assessment procedures: measuring BP and examining feces for occult bloodmeasuring BP and examining feces for occult blood

Consulting with other health care professionals about Consulting with other health care professionals about client’s problemsclient’s problems

Teaching clients about recovery activities: exercise that will Teaching clients about recovery activities: exercise that will accelerate recovery after a strokeaccelerate recovery after a stroke

Rehabilitating clients to their optimal functional level Rehabilitating clients to their optimal functional level following physical or mental illness, injury, or chemical following physical or mental illness, injury, or chemical addictionaddiction


CARE OF THE DYINGCARE OF THE DYING

Involves comforting and caring for people of all Involves comforting and caring for people of all ages who are dyingages who are dying

Includes helping clients live as comfortable as Includes helping clients live as comfortable as possible until death and helping support possible until death and helping support persons cope with death.persons cope with death.

Work in homes, hospitals, and extended care Work in homes, hospitals, and extended care facilitiesfacilities

Hospices are specifically designed for this Hospices are specifically designed for this purpose.purpose.

BIOETHICAL ISSUES IN BIOETHICAL ISSUES IN NURSINGNURSING

““DO NOT RESUSCITATE” ORDER (DNR)DO NOT RESUSCITATE” ORDER (DNR) Physician may order “no code” or “do not resuscitate” for Physician may order “no code” or “do not resuscitate” for

client who are in stage of terminal, irreversible illness, or client who are in stage of terminal, irreversible illness, or expected death. DNR order that no effort be made to expected death. DNR order that no effort be made to resuscitate the client in the event of respiratory or cardiac resuscitate the client in the event of respiratory or cardiac arrest.arrest.

ABORTIONABORTION Termination of pregnancy before the fetus reaches the stage of Termination of pregnancy before the fetus reaches the stage of

viability.viability.

EUTHANASIA EUTHANASIA ““mercy killing” The act of painlessly putting to death persons mercy killing” The act of painlessly putting to death persons

suffering from incurable or distressing disease.suffering from incurable or distressing disease.

HUMAN CLONINGHUMAN CLONING Human reproduction / replicationHuman reproduction / replication

SEX TRANSPLANTSEX TRANSPLANT Sex changeSex change

PROFESSIONAL CRIMESPROFESSIONAL CRIMES• CRIME – act committed in violation of Public Law CRIME – act committed in violation of Public Law

and punishable by a fine and/or imprisonmentand punishable by a fine and/or imprisonment

• FELONY – serious in nature (ex. Murder)FELONY – serious in nature (ex. Murder)

• MISDEMEANOR – less serious in nature (ex. MISDEMEANOR – less serious in nature (ex. Negligence)Negligence)

• MANSLAUGHTER – 2MANSLAUGHTER – 2ndnd degree crime; unintentional degree crime; unintentional

• TORT – civil wrong against a personTORT – civil wrong against a person• TYPES:TYPES:

• IntentionalIntentional• unintentionalunintentional

Types of Law

Private / Civil Public Law

Contract Law TortsCriminal Law

Felony MisdemeanorUnintentional Intentional

Negligence/ Malpractice

Failure to meet

standard of care

Must be present

DutyBreach of DutyForeseeability

CausationHarm/Injury

Damage

Assault / Battery

False Imprisonment

Invasion of Privacy

Defamation

Libel Slander

Common Elements

Willful Action

Intended to bring about consequences

Causation

PROFESSIONAL CRIMESPROFESSIONAL CRIMES

NEGLIGENCENEGLIGENCE The doing of that thing, which a reasonably The doing of that thing, which a reasonably

prudent person would not have done, or the prudent person would not have done, or the failure to do that thing which a reasonably failure to do that thing which a reasonably prudent person would have done, in like or prudent person would have done, in like or similar circumstance.similar circumstance.

Act of omission or commissionAct of omission or commission

THEORIES OF NEGLIGENCE:THEORIES OF NEGLIGENCE:Respondeat SuperiorRespondeat Superior – let the superior answer ; let – let the superior answer ; let

the principal answer for the acts of his agentthe principal answer for the acts of his agentRes Ipsa LoquiturRes Ipsa Loquitur – the thing speaks for itself; talks – the thing speaks for itself; talks

about the evidence; you cannot deny the negligence about the evidence; you cannot deny the negligence because of the presence of evidence.because of the presence of evidence.

Force Majeure Force Majeure – irresistible or superior force. It is a – irresistible or superior force. It is a fact or accident which human prudence can neither fact or accident which human prudence can neither foresee nor preventforesee nor prevent

PROFESSIONAL CRIMESPROFESSIONAL CRIMES MALPRACTICEMALPRACTICE

Any professional misconduct, or any unreasonable lack Any professional misconduct, or any unreasonable lack of skill, or fidelity in the performance of the professional of skill, or fidelity in the performance of the professional or fiduciary duties. or fiduciary duties.

For Nurses, Malpractice refers to the failure to follow a For Nurses, Malpractice refers to the failure to follow a reasonable professional standard of care, thereby, reasonable professional standard of care, thereby, resulting to injury of patientresulting to injury of patient

ELEMENTS OF NEGLIGENCE/MALPRACTICE:ELEMENTS OF NEGLIGENCE/MALPRACTICE: DutyDuty Breach of DutyBreach of Duty ForeseeabilityForeseeability CausationCausation Harm/InjuryHarm/Injury DamageDamage


INVASION OF PRIVACYINVASION OF PRIVACY Violation on the right of an individual to Violation on the right of an individual to

withhold herself and her life from public withhold herself and her life from public scrutiny. Violation on the right to remain alone scrutiny. Violation on the right to remain alone and the right to keep information.and the right to keep information.

FRAUDFRAUD False presentation of some facts with the False presentation of some facts with the

intention that will be acted upon by another intention that will be acted upon by another person.person.

Willful misrepresentationWillful misrepresentation


DEFAMATIONDEFAMATION Derogatory remarks about a personDerogatory remarks about a person Making false statements about a person that Making false statements about a person that

can result to the injury of his reputationcan result to the injury of his reputation

KINDS OF DEFAMATION:KINDS OF DEFAMATION:Slander – oral defamationSlander – oral defamationLibel – written defamationLibel – written defamation

ASSAULTASSAULT Attempt or threat or to touch another person Attempt or threat or to touch another person

unjustifiablyunjustifiably


BATTERYBATTERY Assault that is carried outAssault that is carried out Willful touching of a person (without consent) that may Willful touching of a person (without consent) that may

or may not cause harmor may not cause harm Performing procedures without consentPerforming procedures without consent

INCOMPETENCEINCOMPETENCE Lack of knowledge or skillsLack of knowledge or skills

FALSE IMPRISONMENTFALSE IMPRISONMENT Prevention of movement without consentPrevention of movement without consent Unlawful restraint or detention of another person against Unlawful restraint or detention of another person against

his or her wisheshis or her wishes

CONSENTCONSENT KINDS OF CONSENT:KINDS OF CONSENT:

Informed ConsentInformed Consent Implied ConsentImplied Consent

INFORMED CONSENTINFORMED CONSENT Agreement by the client to accept a course of treatment or a Agreement by the client to accept a course of treatment or a

procedure after complete information, including the risk of procedure after complete information, including the risk of treatment and facts relating to it, has been provided by the treatment and facts relating to it, has been provided by the physicianphysician

ELEMENTS OF INFORMED CONSENT:ELEMENTS OF INFORMED CONSENT: Consent must be given voluntarilyConsent must be given voluntarily Consent must be given by an individual with the capacity, Consent must be given by an individual with the capacity,

competence, and understanding.competence, and understanding. The client must be given enough information to be the ultimate The client must be given enough information to be the ultimate

decision maker.decision maker.

CONSENTCONSENT NURSE’S RESPONSIBILITYNURSE’S RESPONSIBILITY

Witnessing the exchange between the client and the Witnessing the exchange between the client and the physician.physician.

Establish that the client really did understand, that is, was Establish that the client really did understand, that is, was really informedreally informed

Witnessing the client’s signatureWitnessing the client’s signature

PEOPLE WHO ARE NOT ALLOWED TO PROVIDE CONSENT:PEOPLE WHO ARE NOT ALLOWED TO PROVIDE CONSENT: Minors – below 18 years old; except for married and already a Minors – below 18 years old; except for married and already a

parent parent Mentally illMentally ill Unconscious or injured in such a way that they are unable to Unconscious or injured in such a way that they are unable to

give consent.give consent.

IMPLIED CONSENTIMPLIED CONSENT In a life threatening situations and consent can not be In a life threatening situations and consent can not be

obtained from the client or relatives, the law generally obtained from the client or relatives, the law generally agrees that consent is assumed. agrees that consent is assumed.