NCM 103- FUNDAMENTALS OF NURSING

Concepts of Health, Wellness, & Well-Being

 Health, wellness, and well-being have many definitions and interpretations. The nurse should
be familiar with the most common aspects of the concepts and consider how they may be
individualized with specific clients.
Health
 There is no consensus about any definition of health. There is knowledge of how to attain a
certain level of health, but health itself cannot be measured.
 Traditionally health has been defined in terms of the presence or absence of disease.
Nightingale defined health as a state of being well and using every power the
individual possesses to the fullest extent.
 The World Health Organization (WHO) defined health:
o As a state of complete physical, mental, and social well-being, and not merely
the absence of disease or infirmity.
 The American Nurses Association defined health
o a dynamic state of being in which the developmental and behavioral potential of
an individual is realized to the fullest extent possible.
Wellness & Well-Being
 Wellness is a dynamic process that is ever changing. The well person usually has
some degree of illness and the ill person usually has some degree of wellness.
 This concept of a health continuum negates the idea that wellness and illness are
opposite because they may occur simultaneously in the same person in varying degrees.
 Health-Illness Continuum:

Dimensions of Wellness
 Physical
 Social
 Emotional
 Intellectual
 Spiritual
 Occupational
 Environmental
Models of Health
1. Clinical Model
2. Role Performance Model
3. Adaptive Model
4. Eudemonistic Model
5. Agent-Host-Environment Model
6. Health-Illness Continuum

Well-being
 "Well-being is a subjective perception of vitality (energy) and feeling well....can be
described objectively, experienced, and measured......and can be plotted (design) on a
continuum". It is a component of health.” (Dr. Abdul-Monim Batiha, Assistant
Professor, Critical Care Nursing Philadelphia university)

Factors influencing health status, beliefs, and practices:

1. Internal factors
2. External factors

Illness and Disease Illness

 A highly personal state in which the person's physical, emotional,
intellectual, social,developmental, or spiritual functioning is thought to be
diminished.
 Illness is usually associated with disease but may occur independently of it. Illness is
a highlypersonal state in which the person feels unhealthy or ill.

Disease
 Disease can be described as an alteration in body functions resulting in
a reduction ofcapacities or shortening of the normal life span.
 The causation of a disease is called its ETIOLOGY.
 There are many ways to classify illness and disease:
 Suchman describes five stages of illness:
o Stage 1 symptoms experiences.
o Stage 2 assumption of the sick role confirmation from family and friends.
o Stage 3 medical care contact.
o Stage 4 dependent client role.
o Stage 5 recovery or rehabilitation
Approaches to health maintenance:
 Health promotion
• Health protection
• Disease prevention

Impact of Illness
• On the Client
• On the Family: Depends on:
• Family Changes
THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM
• Health Care Delivery:
• Health Care Delivery System:
• Philippine Health Care System
• Levels of health care facilities
1. Primary Level of health care facilities
2. Secondary Level of health care facilities
3. Tertiary Level of health care facilities

NURSING AS A PROFESSION
• Profession
o An occupation that requires extensive education or a calling that requires
special knowledge, skill and preparation
 o Characteristics of a Profession
• Its requirements of prolonged, specialized training to acquire a body
of knowledge pertinent to the role to be performed.
• An orientation of the individual toward service, either to a community or
to organization
• Ongoing research
• Code of ethics
• Autonomy
• Professional organization
• Professionalism
1. Refers to professional character, spirit or methods.
2. Set of attributes, a way of life that implies responsibility and commitment.
3. Nursing professionalism is influenced by Florence Nightingale
• Professionalization
1. Is the process of becoming professional, that is, of acquiring characteristics
c0nsidered to be professional
• The Qualities of a Profession
1. A profession applies its body of knowledge in practical services that are vital to
human welfare, and especially suited to the tradition of seasoned practitioners
shaping the skills of newcomers to the role.
2. It constantly enlarges the body of knowledge it uses and subsequently imposes on
its members a lifelong obligation to remain current in order to “do no harm”.
3. A profession functions autonomously in the formulation of professional policy and
in monitoring its practice and practitioners.
4. It utilizes in its practice a well- defined and well-organized body of knowledge that is
intellectual in nature and describes its phenomena of concern.
5. A profession has a clear standard of educational preparation for entry into practice.
6. A profession is distinguished by the presence of specific culture, norms, and
other values that are common among its members.
• Professional Nursing
1. Professional Nursing (R.A. 9173)
• ARTICLE VI : Nursing Practice
 Section 28. Scope of Nursing. - A person shall be deemed to be
practicing nursing within the meaning of this Act when he/she singly
or in collaboration with another, initiates and performs nursing
services to individuals, families and communities in any health care
setting. It includes, but not limited to, nursing care during conception,
labor, delivery, infancy, childhood, toddler, preschool, school age,
adolescence, adulthood, and old age. As independent practitioners,
nurses are primarily responsible for the promotion of health and
prevention of illness. A members of the health team, nurses shall
collaborate with other health care providers for the curative,
preventive, and rehabilitative aspects of care, restoration of health,
alleviation of suffering, and when recovery is not possible, towards a
peaceful death.
• Scope of Nursing: (RA 9173ARTICLE VI Nursing Practice, Section
28)
• a) Provide nursing care through the utilization of the nursing
process. Nursing care includes, but not limited to, traditional and
innovative approaches, therapeutic use of self, executing health
care techniques and procedures, essential primary health care,
comfort measures, health teachings, and administration of written
prescription for treatment, therapies, oral topical and parenteral
medications, internal examination during labor in the absence of
 antenatal bleeding and delivery. In case of suturing of perineal
laceration, special training shall be provided according to
protocol established;
• (b) establish linkages with community resources and coordination
with the health team;
• (c) Provide health education to individuals, families
and communities;
• (d) Teach, guide and supervise students in nursing education
programs including the administration of nursing services in
varied settings such as hospitals and clinics; undertake
consultation services; engage in such activities that require the
utilization of knowledge and decision-making skills of a registered
nurse; and
• (e) Undertake nursing and health human resource development
training and research, which shall include, but not limited to, the
development of advance nursing practice;
• Provided, that this section shall not apply to nursing students who
perform nursing functions under the direct supervision of a
qualified faculty: Provided, further, that in the practice of nursing
in all settings, the nurse is duty-bound to observe the Code of
Ethics for nurses and uphold the standards of safe nursing practice.
The nurse is required to maintain competence by continual learning
through continuing professional education to be provided by the
accredited professional organization or any recognized professional
nursing organization: Provided, finally, that the program and
activity for the continuing professional education shall be
submitted to and approved by the Board.
• Qualifications and abilities of a Professional Nurse
1. Professional Preparation
 The professional nurse must :
 Have a license to practice nursing in the country;
 Have a Bachelor of Science degree in Nursing ; and
 By physically and mentally fit
2. Personal Qualities and Professional Proficiencies
 Interest and willingness to work and learn with individual/groups in
a variety of settings;
 A warm personality and concern for people;
 Resourcefulness and creativity as well as a well-balanced emotional
condition;
 Capacity and ability to work cooperatively with others;
 Initiative to improve self and service
 Competence in performing work through the use of nursing process
 Skill in decision-making, communicating, and relating with others and
being research oriented; and
 Active participation in issues confronting nurses and nursing
 BASIC NURSING PRINCIPLES
o Safety
o Therapeutic effectiveness
o Comfort
o Use of resources
o Good workmanship
o Individuality
  Classification of Fields of Nursing
o Hospital or Institutional nursing
o Public health nursing or Community health nursing (CHN)
o Private duty or Special
duty nursing
o Industrial or Occupational Health Nursing
o Nursing Education
 Qualifications of the Faculty
 Republic Act 9173 Section 26. Qualifications of the
Faculty. - A member of the faculty in a college of
nursing teaching professional courses must:
o (a) Be a registered nurse in the Philippines;
o (b) Have at least one (1) year of clinical practice
in a field of specialization;
o (c) Be a member of good standing in
the accredited professional
o organization of nurses; and
o (d) Be a holder of a master's degree in nursing,
education, or other allied
o medical and health sciences conferred by
a college or university duly
o Recognized by the Government of the
Republic of the Philippines.
o In addition to the aforementioned qualifications,
the dean of a college must
o have a master's degree in nursing

o Military Nursing
o School Nursing
o Clinic Nursing
o Independent Nursing Practice

NURSING AS AN ART involves:

1. CARING
2. COMMUNICATING
3. TEACHING
CARING:
o Caring Practice Models
 Nursing theory is the term given to the body of knowledge that is used to
support nursing practice.
 Nursing models are constructed of theories and concepts. They are used to
help nurses assess, plan and implement patient care by providing a
framework within which to work.
 Example is, The Human Caring Theory of Jean Watson initially
identified ten carative factors, referred to as the “core of nursing.” These
 factors later evolved into what is today the Human Caring Theory. Watson
calls the new factors “Clinical Caritas Processes,” which have a more
spiritual dimension of love and caring.
o The 6 C’s of Caring: Nurses who operate on these values ensure that the job gets done
in an effective and efficient manner and that patients are safe and treated well. This
refers to treating patients correctly, in a respectful and non- judgemental manner.
 Care,
 Compassion
 Competence
 Communication
 Courage and
 Commitment
o Caring for Self and Others
COMMUNICATION
 It involves :
o The Communication Process
o Modes of Communication. There are four main categories or
communication styles including verbal, nonverbal, written and
visual.
o Therapeutic Communication
 Therapeutic Communication Techniques
 Non therapeutic Communication Techniques
o Helping Relationship/Therapeutic Relationship
 Phases of the Relationship:
o Pre-interaction Phase
o Introductory, or Orientation, Phase
o Working phase
o Termination phase
o Communication and the Nursing Process

TEACHING
 Health Promotion and Disease Prevention
 Health Restoration and Maintenance
 Rehabilitation