NURSING HISTORY, EDUCATION AND ORGANIZATION

1. Basic Nursing: Foundations of Skills & Concepts Chapter 4 NURSING HISTORY, EDUCATION AND ORGANIZATION

2. 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.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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).

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

9. 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.

10. 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.

11. 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.

12. 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.

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

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

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

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

17. Nursing OrganizationsNational Association for Practical Nurse Education and Service, Inc. (NAPNES) • Purpose: To improve the quality, education, and recognition of nursing schools and LP/VNs in the U.S. • Established 1941. • Provides workshops, seminars, and continuing-education programs. • Evaluates and certifies continuing-education programs of others. • Provides individual student professional liability insurance program. For LPs/VNs. Publications: Journal of Practical Nursing; NAPNES Forum.

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

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

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