NUR 091

CHAPTER 1

Historical and Contemporary Nursing Practice

WOMEN’S ROLE  1836 : Theodor Fliedner

- Reconstituted the Order of Deaconesses
 Women have cared for infants and children thus and opened a small hospital and training
nursing could be said to have its roots in the home school in Kaiserswerth, Germany.
 Women who in general occupied a subservient and  Kaiserswerth School
dependent role, were called on to care for ill. - Where Florence Nightingale received her
training in nursing.
MEN’S ROLE
WAR
 Nursing school for men existed in United States
from late 1880’s until 1969.  Crimean War (1854 – 1856)
 Male nurses were denied in admission to the - Inadequacy of care given to soldiers led
Military Nurse Corps during World War II. to public outcry in Great Britain.
 It was believed that nursing was women’s work - Florence Nightingale and her nurses
and combat was men’s work. transformed the military hospitals by
 1971 : Steve Miller setting up sanitation practices such as
- Formed an organization called Men in hand washing.
Nursing  American Civil War (1861 – 1865)
 1974 : Luther Christman o Harriet Tubman
- Organized a group of male nurses. - Known as the “The Moses of her People”
 They reorganized and formed National Male For her work with Underground Railroad.
Nurses Association, but renamed - Nursed the sick and suffering of her own
 1981: American Assembly for Men in Nursing race.
(AAMN). o Sojourner Truth
- Provide framework for nurses, as a group, - Abolitionist, Underground Railroad
to meet, to discuss and influence factors, agent, preacher, women’s right advocate
which affect men as nurses. and worked as a nurse and counselor.
o Mother Biekerdyke & Clara Barton
RELIGION
- Searched battlefields and gave care to
 Benevolence was a Christian value of “love thy injured and dying soldiers.
neighbor as thyself” and Christ’s parable of Good o Walt Whitman & Louisa May Alcott
Samaritan has a significant impact. - Volunteered as nurses to give care to
 Fabiola injured soldiers in military hospitals.
- A wealthy matron of Roman Empire that o Dorothea Dix
converts to Christianity and provide - The Union’s superintendent of female
houses of care and healing(hospitals) for nurses in Civil War.
poor, sick, and homeless.  “The Spirit of Nursing” I Section 21 Nurses
 Knights of Saint John of Jerusalem (Knights Hospitalers) Section
Teutonic Knights - Monument stands in Arlington National
Knights of Saint Lazarus Cemetery that honors nurses who served
- Brother in arms provided nursing care to in the U.S armed services in World War I
their sick and injured comrades.
- Built hospitals, org, and management of  Cadet Nurse Corps
which set a standard for the - Established in World War II in response to
administration of hospitals. marked shortage of nurses.
 Knights of Saint Lazarus
- Dedicated themselves to the care of SOCIETAL ATTITUDES
people with leprosy, syphilis, and chronic  Before mid 1800s, nursing was without
skin conditions. organization, education, or social status.
 Alexian Brothers  Nurses in the hospital during this period were
- Organized care for victims of Black Plague poorly educated, and even incarcerated criminals.
in 14th Century in Germany.
  Sairey Gamp Lillian Wald

 Founder of Public Health Nursing

-
A character from Martin Chuzzlewit book
 With Mary Brewster, they were the first to offer
of Charles Dickens that represented the
trained nursing service to the poor in New York
negative image of nurses in 1800s.
slums
- Portrayed a drunk, disreputable nurse
 Founded the Henry Street Settlement and Visiting
who neglected, stole from and physically
Nurse Service, which provides nursing services,
abused the sick.
organized educational and cultural activities.
 Campaign for Nursing Future
- Launched in 2002, Johnson & Johnson Lavinia L. Dock
Corp promotes nursing as a positive
career choice.  A feminist, prolific writer, political activist,
- This campaign increases exposure to suffragette, and a friend of Wald
nursing profession, raises awareness  Participated in protest movement for women’s
about its challenges and encourage rights that in 1920 passage of 19th Amendment to
people to consider a career in nursing. the U.S Constitution, granted women the right to
vote
NURSING LEADERS  Founded American Society of Superintendents of
Training Schools for Nurses with assistance of
Florence Nightingale Mary Adelaide Nutting and Isabel Hampton Robb
 Lady with the Lamp Margaret Higgins Sanger
 First nurse to exert political pressure on
government  Public health nurse in New York, had a lasting
 Nursing’s first scientist-theorist for her work impact in women healthcare.
Notes on Nursing: What It Is, and What It Is Not  Imprisoned for opening the first birth control
 Believed she was “called by God to help others information clinic in America
and to improve the wellbeing of mankind”  Founder of Planned Parenthood
 Received 3 months training in nursing in Mary Breckinridge
Kaisersweth
 Developed Nightingale’s Training School for  notable pioneer nurse that established the
Nursing, opened in 1860 in St. Thomas Hospital Frontier Nursing Service
 Died at age 90  started one of the first mid- wifery training schools
in U.S
Clara Barton
Luther Christman
 Schoolteacher who volunteered as a nurse durinf
American Civil War.  one of the founders of AAMN, experienced
 Established the American Red Cross, which linked discrimination while in nursing school
in International Red Cross when U.S Congress  he was not allowed to a maternity clinical exp and
ratified Geneva Convention in 1882. denied access to two universities because of his
gender
Linda Richards  became the fist man to be a dean in a University at
 America’s first trained nurse Vanderbilt University
 Known for introducing nurse’s notes and doctor’s  first man nominated for ANA president
orders  first man elected to the American Academy of
 Initiated practice of nurses wearing uniforms Nursing (AAN) presented highest honor naming
 Credited for pioneering work in psychiatric and him “Living Legend”
industrial nursing  first man inducted into ANA’s Hall of fame

Mary Mahoney Ernest Grant

 First African American professional nurse  first male president of the American Nurses
 Worked for the acceptance of African Americans in Association (ANA) in Jan 2019
nursing and for the promotion of equal  first African American man to serve as ANA vice
opportunities. president
 Gained an award for significant contributions in  an internationally known expert on burn care and
interracial relationships fire safety
 NURSING EDUCATION Graduate Nursing Programs

 It focuses to teach the knowledge and skills that  Requirements for admission must:
would enable a nurse to practice in a hospital  Licensure as an RN
setting  Approved baccalaureate degree
 2 types of entry-level generalist nurses  Evidence of scholastic ability
 Registered Nurse (RN)  Satisfactory achievement, Graduate
 Licensed Practical or Vocational Nurse Record Examination GRE or Miller
(LPN) (LVN) Analogies Test MAT
 Letters of reco from supervisors
 Master’s Degree Programs
TYPES OF EDUCATION PROGRAMS - Prepare nurses for advanced leadership
roles in administration, clinical practice,
Licensed Practical (Vocational) Nursing Programs (LPN) or teaching
- Prepared nurses work in a clinical nurse
 Housed in community college, vocational schools,
specialist (CNS), nurse practitioner (NP)
hospitals or other independent health agencies
known as advanced practice registered
 Generally last 9 to 12 months, both classroom and
nurse (APRN), nurse midwife (CNM), and
clinical experience
nurse anesthetist (CRNA).
 At the end of the program, graduates take the
 Doctoral Programs
NCLEX-PN to obtain licensure as practical or
- Began in 1960 in United States.
vocational nurse
- Related fields are education, psychology,
 Employment of LPN’s has shifted away from acute
sociology, and physiology
care settings to care of older adults in community-
- 2 primary doctoral degree in nursing
based settings, including long term
 PhD “Doctor of Philosophy”
Registered Nursing Programs (RN) - assume faculty roles in nursing
education programs or work in
 3 Major routes that lead to eligibility for RN research programs
licensure  DNP “Doctor of Nursing Practice
 Completion of Diploma - practice-focused doctorate and
 Associate Degree the highest degree for nurse
 Baccalaureate Program clinicians
 Diploma Programs
- 3 year diploma programs were the Continuing Education
dominant nursing programs and the
 Formalized experiences designed to enhance the
major source of nursing graduates from
knowledge or skills of practicing professionals
late 1800s until mid-1960s
 Tend to be more specific and shorter
 Associate Degree Programs
 Designed to meet the ff. needs:
- First and only educational programs for
 Inform nurses of new
nursing that were systematically
technology and knowledge
developed from planned research and
 Help nurses attain expertise in
controlled experimentation
critical care nursing
 Baccalaureate Programs
 Provide nurses with info such as
- 1909, University of Minnesota
knowledge about legal and
- first school of nursing in a University
ethical aspects of nursing
setting
- most of early baccalaureate programs
were 5 years in length
- consist of basic 3-year diploma program
Plus 2 years liberal arts education
- Generally 4 years
- Include courses in liberal arts, sciences,
humanities, and nursing, nursing
leadership, nursing research and
community health nursing
 NURSING THEORIES Scope of Nursing

Theory 3 Types of Clients

 System of ideas that is presumed to explain a given  Individuals

phenomenon  Families
 Used to describe, predict and control phenomena  Communities

Metaparadigms of Nursing 4 AREAS IN NURSING PRACTICE

 Focused on articulating relationship among four  Promoting Health and Wellness

major concepts; Person, Environment, Health and - Enhance healthy lifestyle such as
Nursing. improving nutrition and physical fitness
 Individuals or Clients are the - Preventing drug, alcohol misuse and
recipients of nursing care restricting smoking
 Environment the internal and - Preventing accidents and injury in the
external surrounding that affect the home and workplace
client  Preventing Illness
 Health degree of wellness or well- - Maintain optimal health by preventing
being that client experiences disease
 Nursing the attributes, characteristics, - Immunizations
and actions of nurse providing care - Prenatal and infant care
- Prevention of sexually transmitted inf
CONTEMPORARY NURSING PRACTICE
 Restoring Health
Definition of Nursing - Focuses on ill client, from early detection
of disease through during recovery
1973: ANA describes nursing practice as “ direct, goal period
oriented, and adaptable to the needs of individual, family - Administer meds, baths, treatments
and community during health and illness.” - Diagnostic and assessment procedures
such as measuring blood pressure and
1980: ANA describes nursing as “ diagnosis and treatment
feces
of human responses to actual or potential health problems”
- Consulting to healthcare prof
2003: Nursing’s Social Policy Statement “Nursing is the - Recovery activities and rehabilitating for
protection, promotion, and optimization of health and physical or mental illness, injury or drug
abilities, preventions of illness and injury.”  Caring for the Dying
- Help people who are dying have peace,
Recipients of Nursing comfort and dignity
 Consumers
- Individual, group of people or a
community that uses a service or ROLES AND FUNCTIONS OF THE NURSE
commodity
 Caregiver
- Use healthcare products or services
- Assist the client physically and
 Patient
psychologically while preserving the
- Individual who is waiting for or
clients dignity
undergoing medical treatment and care
- Involve full care to dependent patient,
- Means “to suffer” or “to bear”
partial care for the partially dependent
- Seeks assistance because of illness or
client and supportive-educative care to
surgery
assist clients attain wellness
 Client
- Individual who engages the advice or  Communicator
services of another who is qualified to - Nurses identify client problems and then
provide this service communicate verbally or in writing to
- Presents the receivers of healthcare other members of healthcare team.
 Teacher
- Helps client learn about their health and
healthcare procedures they need to
perform to restore or maintain their
health
 - assess client’s learning needs, and CRITERIA OF A PROFESSION
readiness to learn
Profession is an occupation that requires extensive
 Client Advocate
education or calling that requires special knowledge, skill,
- Acts to protect the client
and preparation
- Represent client needs and wishes to
other health professionals, such as It is generally distinguishes from other kinds of occupation
relaying client’s request for information by:
to the healthcare provider.
- Assist clients and help them speak up  Specialized education
 Counselor  Body of knowledge
- Counseling, process of helping client to  Service orientation
recognize and cope with stressful  Ongoing research
psychologic or social problems, to  Code of ethics
develop improved interpersonal  Autonomy
relationships and promote personal Contemporary nursing practice is influence by nursing
growth work-force issues and challenges:
- Provide emotional, intellectual, and
psychologic support  Healthcare reform
 Change Agent  Quality and safety in healthcare
- Assist clients to make modifications in  Consumer demands
their behavior  Family structure
- Act to make changes in the system, such  Science and technology
as clinical care  Internet
- Technologic change, change in the age of  Telehealth – delivery of health-related
the client population, and changes in services and information via
medications telecommunication techs
 Leader Telenursing – use of technology to provide
- Influences other to work together to nursing practice at distance
accomplish a specific goal  Legislation
 Manager Patient Self-Determination Act (PSDA) –
- Assigns and delegates nursing activities to requires all competent adults to be informed
ancillary workers and other nurses, and in writing on admission to a healthcare
supervises and evaluates their institution about their rights to accept or
performance refuse medical care
 Case Manager  Collective Bargaining
- Work with multidisciplinary healthcare  Work of nursing associations
team to measure the effectiveness of the
case management plan and to monitor
outcomes
 Research Consumer
- Use research to improve client care
- In clinical areas, nurses need to:
 Awareness of the process and
language of research
 Be sensitive to issues related to
protecting the rights of human
subjects
 Be a discriminating consumer of
research findings

CHAPTER 2
Evidence-Based Practice and Research in Nursing