Historical Perspectives of Nursing and Concepts of Nursing

1. Historical Perspectives of Nursing and Concepts of Nursing

2. Objects • 【master】 Characteristics of nursing profession; • 【comprehend】 Florence Nightingale’s deeds and her Contributions to nursing science; Concept and Dimensions of Nursing • 【understand】 Historical Perspectives of Nursing

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

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

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

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

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

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

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

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

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

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

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

15. Fifteenth to Nineteenth Century • Period of Nightingaleshe was determined to become a nurse since she believed she was “called by God to help others and to improve the well-being of mankind”;she visited Kaiserswerth and received nurse’s training at 1850 for three months;

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

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

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

19. Stages of Nursing • Development of modern nursingNursing Education:in 1923, the Rockefeller Foundation funded a survey on nursing education, which recommended that nursing schools be independent of hospital and on a college level;in 1924, one of the schools of nursing was set up at Yale University;

20. Stages of Nursing • Development of modern nursingNursing practice:by 1920’s, nursing specialization was developing;the concept of the clinical nurse specialist arose;from period of Nightingale, the system of nursing management has been improving.

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

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

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

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

26. Body of Nursing knowledge • Fundamental knowledge:physical sciencefundamental medical psychological and social science • Knowledge specific to nursing:clinical nursing: fundamental nursing, specialty nursing, community nursingnursing managementnursing education

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

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

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

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

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

32. Dimensions of Nursing Practice • Nursing Education:based on nursing science and education theories;controlled by the state education and health care guide. • Nursing Management:systematic management of factors as nursing professional staff, technologies, equipment, information, financing. • Nursing Research:

33. Forms of nursing in hospital • Case management：cared by some fixed nurses • Functional nursing：centered by orders • Nursing in groups： • Primary nursing： • Systematic holistic nursing：philosophy, responsibility, forms

35. Case management

36. Functional nursing Orders, Fundamental nursing Shifts of nurses: day/night shift

37. Nursing in groups Group A Group B

38. NURSING HISTORY, EDUCATION AND ORGANIZATION

40. Nursing: An Art…A Science • By using scientific knowledge in a humane way, nursing combines rational, scientific methods with caring behavior. • Nursing focuses not on the illness but the client’s response to illness.

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

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

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

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

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

46. “Practical” Nursing • Women who cared for others, but who had no formal education, often called themselves “practical nurses.”

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

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

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

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