Introduction to Professional Issues in Nursing and Nursing

8/3/2019 Introduction to Professional Issues in Nursing and Nursing

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Foundation of modern Nursing

By: Ashagre Molla (BSN, MSN)


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Learning objectives of the chapter

At the end of this chapter, you are expected to:

Discuss the different definitions of nursing by different

professionals and organizations.

Explain the origin and historical development of nursing

profession

Discuss the contribution of Florence Nightingale and other

nurses for the development of nursing profession

Discuss the criteria of profession

Discuss the role of nurses


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Sub-topics

Definitions of nursing

Historical overview of nursing

Highlights of the historical evolution of professional nursing

History of nursing in Ethiopia

Nursing as a profession

Roles of nurses


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Definition of nursing

Nursing has been defined in many ways by different

professionals and organization

The act of utilizing the environment of the client to assist him

in his recovery Florence Nightingale

The diagnosis and treatment of human responses to actual or

potential health problems. - ANA


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Definition.

"The unique function of the nurse is to assist the individual,

sick or well, in the performance of those activities contributing

to health or its recovery (or to a peaceful death) that he/she

would perform unaided if he/she had the necessary strength,

will or knowledge and to do this in such a way as to help

him/her gain independence as rapidly as possible." Virginia

Henderson


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Definition

Nursing encompasses autonomous and collaborative care of

individuals of all ages, families, groups and communities, sick

or well and in all settings.

Nursing includes the promotion of health, prevention of illness,

and the care of ill, disabled and dying people.

Advocacy, promotion of a safe environment, research,

participation in shaping health policy and in patient and

health systems management, and education are also key

nursing roles. - ICN


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Definition The nursing profession exists in response to a need of society

and holds ideas related to human health throughout the

lifespan. Nurses direct their energies towards thepromotion,

maintenance andrestoration of health; theprevention of

illness, the alleviation of sufferingand the insurance of a

peaceful death when life can no longer be sustained.

..Nursing, a dynamic and supportive profession

guided by its code of ethics, is rooted in caring, a concept

evident throughout in its four fields of activity: practice,

education, administration and research. CNA


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Common themes to Nursing

Holism

Caring

Teaching

Advocacy and supporting

Promoting, maintaining, and restoring health


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Historical overview of nursing

The study of history of nursing helps us:

to better understand the societal forces and issues that continue

to confront the profession.

to gain an appreciation of the role the profession has played in

the health care system


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History ..

Nursing is believed to be as old as human kind

The word nurse is often related to the Latin nutrix or

nutrio which means to nourish. The definition of the term and the practice of nursing has

changed greatly over time: wet nurse/dry nurse

Very little has been written about nursing as unique function in

ancient time.


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Nursing in an antiquity

A decision for a care giver was made long before he/she able

to make such choice.

In many societies the role of giving care was given to female

members

The earliest nurses learn their art through oral traditionspassed

from generation to generation.

Those who acquired reputation were sought after to provide

care for friends and families


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Nursing in an antiquity..

Nurses first organized in the early Christian era.

Nursing ideals (charity, service to others, and self-sacrifice)

were in harmony with early Christian church.

Fabiola deaconess credited for the establishment of first

Christian hospital in Rome

Throughout antiquity the safest nursing care was provided in

ones own home.

Care in hospitals were for those who have no family /away

from families


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Period of ..

Early hospitals were found by the members of religious

communities nuns and monks who devoted their lives for the

care of the sick.

Influence of

Ancient Egyptians

Babylonia

Indians

The Jews

The Greeks


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ANCIENT EGYPT

4000 B.C.

During this time the priests were the healers.

They had some knowledge in the sciences of anatomy and

physiology.

They could prepare some drugs for eye conditions and

surgery.

The healing treatment included prayers and sacrifices.

The actual care of the patients, such as dressing wounds was

done by helpers.


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Babylonia

The people thought diseases were the result ofsin.

The priests made their diagnoses and prognoses by observing

the behavior of animals

the flowing of water in rivers

the shape of oil on water surfaces

the irregularity of an animal liver

the smoke from a burning fire, and personal dreams

When a woman had difficulties in delivery, it was considered

to be the result of wrong doing.


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Indians

Indians had a highly developed culture and good sanitationsystem.

They had written a number of scientific books, which

described different types of diseases.

Some of their diagnostic examinations included: Inspection,

palpation, auscultation, taking pulse rate, and investigation of

urine.

Surgery was also highly practiced.


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Indians

For suturing intestines, certain types of ants were used to bitethe incision line.

When their bodies were cut off their mandibles remained

attached to the incision as sutures.

The people who cared for the sick were well instructed in

ethics.

They were required to be skilful, dedicated and prudent in both

body and mind.


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Greeks

Temple hospitals were built

The usual methods of deciding treatment

praying to god Aesculapius and then the patient sleep in

his dreams the god Aesculapius himself would reveal the

drugs to be given.

The true founder of medical science

Hippocrates, the father of modern medicine

Discovered diseases are not the result of evil-sprit


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The Christian era

The early Christians were inspired by the teachings ofChrist.

Christ taught people to help one another like brothers and

sisters.

Service to the sick and the poor was service to God.

Bishops formed the religious orders of Deacons anddeaconesses.

Their duties were to attend to the sick and the poor in their

homes.

At this time nursing was regarded as a form of religiousdevotion.

Later hospices (houses for the sick and the poor) were built by

the monasteries.


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Christian era . . .

The monks and nuns cared for the sick, the poor and the aged.

Military orders founded hospitals in their kingdom.

During 17th century, Augustinian sisters lived religious life

and perform nursing care as directed by priests.

Later it becomes sisters of charity .

Their prime function was to care for the sick.

The sisters were instructed to obey the physicians and to serve

patients whole-heartedly.


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THE DARK PERIOD OF NURSING, (18th

Century.)

Despite new discoveries and great scientific progress in

medicine, the religious life of the community was shallow.

Only a few people were ready to join religious congregations.

Those who joined were illiterate, and to make matters worse,

Napoleon, the emperor of France closed all the monasteries

which catered for the sick and used them for non-religious

activities.


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THE DARK PERIOD OF NURSING, (18th

Century.)

This resulted in crude and unsatisfactory health services.

The wards were filthy, bed bugs and lice were abundant.


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THE CATHOLIC RELIGIOUS CONGREGATIONS

(19th C)

Napoleon permitted groups of dedicated females to start

religious congregations in order to care for the sick.

Theodor Fliedner established a hospital where women of good

character were trained as deaconesses.

They cared for the sick and young children in both hospitals

and homes.


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CIVILORDERS (THE RED CROSS)

The Red Cross Society was founded in Geneva in 1863 by a

Swiss bank manager called Henri Dunant.

Its goal has been and still is to train nurses in times of peace in

order to be able to care for the wounded in times of war.

Many girls were trained and were organized into associations.


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Civil Nursing

beginning of 19th century, nursing services started to be

delivered by civil nurses - women who did not belong to

religious congregations.

Florence Nightingale instituted the reforms in the care of the

sick, which form the basis for the modern practice.


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History of Nursing Ethiopia

In ancient Ethiopia illness was considered to be punishment

from sins or magic.

Most tribes and people had a medicine man or women called

"Hakims" or wegasha" who performed rituals, using various

plants and herbs to heal the sick.

The religious people were also providing care for the sick or

injured in the monks hospital in Debre-libanos.


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Nursing in Ethiopia . . .

In late 19th century before nurses training started, foreign

nurses were practicing in the health care delivery system of

Ethiopia.

In 1917 Sister Karin Holmer came as trained nurse to

Ethiopia.

In 1908, Emperor MenelikII established the 1st Ethiopian

Hospital, on the site of the Russian Hospital.


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Governmental public health services, now known as ministry

of public health, which is established in 1948.

Later on Emperor Hailesilassie established different hospitals

in deferent regions including Addis Ababa.


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The first clinic was established at the hot spring at Eilet near

Messwa in which sick people used to come for bathing.

The Princess Tsehai memorial Hospital was opened in 1951.

as a tribute initially from the British people as friendships with

Ethiopia - known as Army Hospital.


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Training of Medical personnel

Before the Italian occupation with exception of a mission

school for midwives in Eritrea, the only training in the public

health personnel consisted of auxiliary medical training in

several hospitals and missions.


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Training . . .

The growth of hospitals made it necessary to start the training

of Ethiopians to assist in staffing hospitals and clinics.

As a first step training, facilities for medical auxiliary

personnel were made available in the MenelikII Hospital.

For some years government and mission hospitals had been

engaged in training dressers and other nursing orderlies.


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Ethiopian Nurses

Princess Tsehai, the emperor youngest daughter was the first

graduated national nurse from Ormand street hospital London.

In 1948 the Ethiopian Red cross nursing school established by

the Emperor in the private Hospital Bet-Saida which later

changed to Haleslassie I Hospital.

Then during the Derg regime, this hospital is changed its

name to Yekatit 12 hospital, which still exists.


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In 1950, the school of nursing was established at Empress

Zewditu memorial hospital for male and female nurses.

In March 1953, the first eight nurses from Ethiopian Red

Cross of nursing and nine from Empress Zewditu memorial

hospital were graduated.

In 1951, two school of Nursing was stablished:

At the princess Tsehai memorial only for female nurses

In Nekemt at the Teferie Mekonnen Hospital


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Ethiopian Nurses . . .

In 1959 thepost basic training started at princess Tsehai

memorial hospital for midwifery nursing and four nurses

graduated in 1960.

In 1954 the Gonder Health College and training center opened

and gave training to community nurses.

In 1958 fifteen (15) community nurses graduated from this

center.


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Today?


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Historical evolution of professional nursing

Documentation of the profession is available only for the last

150 years

1 500 G.C.Nursing care primarily involves meeting the

hygiene and comfort needs of individuals and families.

Christians working in close association with an organized

church primarily provide care.

Nursing is no longer tiedto the church, and nurses are

educated in colleges and universities.


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1836

Theodor Fliender opens a small hospital and training school in

kaiserwort, Germany where Florence Nightingale receives her

nursing education.

Hospital based school of nursing continues to exist, but these

programmes have been declining in number as the profession

moves forward and requires education in academic settings.


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1854 1860

This is the period when Florence Nightingale, who named

superintendent of nursing, made major contribution to modern

nursing, cares for soldiers in the Crimean war.

She opened a training school at St. Thomas hospital in

London, and publishes Notes on Nursing, What it is, what it

is not.

Nightingales many contributions to nursing continue to

influence the profession.

The components of her theory apply even today, and nurses

around the world recognize the courage, dedication and work

of this early professional leader.


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1861- 1865

Dorothea Dix establishes the nurse corps of the UN army.

Dix was not a nurse but an advocate for the mentally ill

people.

Nurses continue to choose careers in the armed services where

opportunities for existing and rewarding careers are offered.


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1872

American first trained nurse, Linda Richards, graduate from

the New England Hospital for women in Boston.

Nursing continue to prepare educated, competent individuals

to provide nursing care in institutions of higher education.


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1974 the first Nightingale model school of nursing in Canada is set up

in St. Catherines, Ontario.

New Nursing programmes continue to develop.

The profession now offers several routes to a career in nursing

including diploma, associate degree, baccalaureate degree, masters

and doctoral degree.

1882: Clara Barton organizes the American National Red Cross.

The Red Cross continues to exist today, offering care to victims of

disasters, maintaining the nations blood supply and educating about

HIV/AIDS.


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1893

Lillian Wald and Merry Brewster found Henry Street

settlement, the first home visiting nurse organization in United

States.

Visiting nurse associations have grown and become essential

health care components in a society.

1897: The American society of superintendents of training

schools of the United States and Canada is organized.

It is renamed ANA in 1911 and CNA in 1907.


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1899

ICN is established which continues to represent and speak to

international nursing concerns.

1900: AJN- the first journal of nursing journal to be owned,

operated and published by nurses is developed.

AJNand The Canadian Nurses continue to be the major

references for clinical nursing practice.


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1923

Gold-mark report of the Rockefeller Foundation is published,

advocating financial support of university-based schools of

nursing.

Nursing organizations and leaders are working to improve

financial assistance to students.


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1940

WWII results in another nursing shortage.

EstherLucille Brown completes the Brown report on nursing

education, advocating that education for nursing belongs to

colleges and universities, not in hospitals.

Although hospital based schools of nursing continues to exist

they are declining in number, and the students are more

frequently choosing college and university educations.


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1953

National Student Nurses Association (NSNA) is established

which continues to encourage students of nursing to become

involved in professional issues.

Students are given opportunities to hold leadership positions at

state and national levels.

The equivalent organization in Canada is known as the

Canadian University Nursing Students Association.


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1965

ANA issues its first position paper on nursing education

calling for all nursing education to take place on institutions of

higher education and stipulating Baccalaureate as the

minimumpreparation for professional nursing and associate

degree for technical nursing practice.

The entry level debates have not been completely resolved.


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1985

National Center for Nursing Research is established at the

national institutes of Health in Bethesda, Maryland which

upgraded by President Clinton to institute in 1993.


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Nursing as a profession

The authority for the practice of nursing is based upon a social

contract that delineates professional rights and responsibilities

as well as mechanisms for public accountability.

In almost all countries, nursing practice is defined and

governed by law, and entrance to the profession is regulated at

national or state level.


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Profession

The aim of the nursing community worldwide is to develop the

profession guided by continuing education based on nursing

research, and to regulate standards of competency and ethics.

There are a number ofeducationalpaths to becoming a

professional nurse, which vary greatly worldwide, but all

involve extensive study ofnursing theory and practice and

training in clinical skills.


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Contd

Over the past 50 years, nursing has undergone dynamic

changes in its scope of practice.

Nurses have moved from simply observing and giving

prescribed medications to coordinating clinical information for

the entire health care team.

This coordination allows for the design of the best possible

plans of care.


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Criteria to be a profession

To provide a needed service

To advance its knowledge in its field

To protect its members and make it possible to practice effectively

Characteristics of a profession:

A basic profession requires an extended education of its members.

A profession has a theoretical body of knowledge leading to defend skills,

abilities and norms.

A profession provides specific service.

Members of a profession have autonomy in decision making and practice.

The profession has a code of ethics for practice.


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Role of nurses

Historically, the nurses sole duty was to provide care and

comfort to the sick.

Advances in technology, knowledge, health promotion, and

prevention have expanded the function of todays nurses.

Nursing function includes activities that nurses perform

independently (example, turning or positioning bed client

every 2 hours) or collaboratively (example, prescription of

medication by physicians and judgment of nurses for proper

administration)


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Role

Professional nurses are autonomous and assume the

responsibilities of care givers, decision makers, client

advocates, managers and coordinators of health care needs,educators, and communicators.

Introduction to Professional Issues in Nursing and Nursing

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