Models

• Models are representations of the

interaction among and between the
concepts showing patterns. They
present an overview of the theory’s
thinking and may demonstrate how
theory can be introduced into practice.
Conceptual framework
• A conceptual framework is a group of
related ideas, statements, or concepts. It
INTRODUCTION is often used interchangeably with
the conceptual model and with grand
• Nursing theory is the term given to the
theories.
body of knowledge that is used to
support nursing practice. Proposition
• Nursing theory is a framework designed
• Propositions are statements that
to organize knowledge and explain
describe the relationship between the
phenomena in nursing, at a more
concepts.
concrete and specific level.
• Theory-guided, evidence-based practice Domain
is the hallmark of any professional
• The domain is the perspective or
discipline.
territory of a profession or discipline.
• Nursing models are conceptual models,
constructed of theories and concepts
Process
Definition of terms • Processes are organized steps,
changes, or functions intended to bring
Philosophy
about the desired result.
• These are beliefs and values that define
a way of thinking and are generally
known and understood by a group or Paradigm
discipline.
• A paradigm refers to a pattern of shared
Theory understanding and assumptions about
reality and the world, worldview, or
• A belief, policy, or procedure proposed
widely accepted value system.
or followed as the basis of action. It
refers to a logical group of general
propositions used as principles of
Metaparadigm
explanation. Theories are also used to
describe, predict, or control phenomena • A metaparadigm is the most general
statement of discipline and functions as
Concept
a framework in which the more restricted
• Concepts are often called the building structures of conceptual models
blocks of theories. They are primarily the develop. Much of the theoretical work in
vehicles of thought that involve images. nursing focused on articulating
 relationships among four major objectives, course descriptions, and
concepts: person, environment, health, clinical performance criteria. The
and nursing. purpose was to explain the
fundamental implications of the
profession and enhance the
Why are Nursing Theories Important? profession’s status.

➢ Nursing theories help recognize what In Research

should set the foundation of practice
➢ The development of theory is
by explicitly describing nursing.
fundamental to the research process,
➢ By defining nursing, a nursing theory
where it is necessary to use theory as a
also helps nurses understand their
framework to provide perspective and
purpose and role in the healthcare
guidance to the research study. Theory
setting.
can also be used to guide the research
➢ Theories serve as a rationale or
process by creating and testing
scientific reasons for nursing
phenomena of interest. To improve the
interventions and give nurses the
nursing profession’s ability to meet
knowledge base necessary for acting
societal duties and responsibilities, there
and responding appropriately in nursing
needs to be a continuous reciprocal and
care situations.
cyclical connection with theory, practice,
➢ By providing nurses a sense of
and research. This will help connect
identity, nursing theory can help
the perceived “gap” between theory
patients, managers, and other
and practice and promote the theory-
healthcare professionals to
guided practice.
acknowledge and understand the unique
contribution that nurses make to the
healthcare service (Draper, 1990).
In Profession
➢ Clinical practice generates research
Purposes of Nursing Theories questions and knowledge for theory. In a
clinical setting, its primary contribution
➢ The primary purpose of theory in
has been the facilitation of reflecting,
nursing is to improve practice by
questioning, and thinking about what
positively influencing the health
nurses do. Because nurses and nursing
and quality of life of patients.
practice are often subordinate to
Nursing theories are also developed
powerful institutional forces and
to define and describe nursing care,
traditions, introducing any framework
guide nursing practice, and provide a
that encourages nurses to reflect on,
basis for clinical decision-making.
question, and think about what they
In Academic Discipline do provide an invaluable service.

➢ Much of the earlier nursing programs

identified the major concepts in one
Characteristics of a theory
or two nursing models, organized the
concepts, and build an entire nursing 1. Must be logical, relatively simple and
curriculum around the created generalizable.
framework. These models’ unique
2. composed of concepts and propositions
language was typically introduced
into program objectives, course 3. Provide the bases for testable hypothesis
 4. can be used by nurses to guide ad
improve their practice.
5. the main exponent of nursing-caring-
cannot be measured, it is vital to have the
theory to analyse and explain what nurses
do.

Classification of nursing theories

A. based on range/scope/generalization
and level of abstractness:
• Metaparadigm
• Grand theories
• Middle-range theories
• Practical-level theories
• Nursing metaparadigm
 the reliability of scientific theories, and
the ultimate purpose of science.
What is the importance of philosophy of
science in nursing?
• Philosophy helps nurses to think more
critically and reflect on how their own
values influence their practice and way
of being. A better understanding of the
importance of philosophy in the nurses'
world is not only relevant but vital to our
discipline and professional practice.
Factors influencing the philosophy of
Nursing education

B. Based on philosophical underpinnings • Beliefs and values regarding God, man,

life, health, diseases and nursing.
1) Developmental theories and models =
emphasize growth, development and • Person’s life experience and activities.
mutation
• Culture and background of the person.
2) Systems theories and models = view
Three Aspects of Philosophy
persons as open systems
• Metaphysics → Theory of Being →
3) Interaction theories and models = based
concerns in ultimate reality; purpose of
on the relationships among persons
existence and person’s life and goals.
• Axiology → Theory of Values →
c. Based on purposes/goal orientation concerns, values, ethics and aestethics.

A. Descriptive theories • Epistemology → Theory of Knowledge

→ finding out truth.
B. Explanatory theories
C. Predictive theories
TYPES OF PHILOSOPHIES
D. Prescriptive theories
1) Humanism
2) Naturalism
3) Idealism
4) Pragmatism
5) Realism
Philosophy of science
• Philosophy of science is a branch of
philosophy concerned with the
foundations, methods, and implications
of science. The central questions of this
study concern what qualifies as science,
 A. Humanism patient has as much to do with the
patient’s healing as medical
interventions. Humanistic nursing
focuses closely on how the relationship
between the patient and nurse develops
in addition the patient’s physical and
mental health.
In Nursing Education:
• Humanism philosophy allow fluidity in
nurse student’s beliefs and encourages
them to consider the humanness.
Paterson and Zderad believed nursing
education should be founded in
experience, and that a nurse’s training
should focus as much on the nurse’s
ability to relate to and interact with
patients as a scientific and medical
background.
In Nursing Leadership:
• Humanistic leaders are those with
emotional intelligence who constantly
question themselves and seek
awareness of themselves and others.
Trusting others, being ethical, having
compassion and participating as a
collective whole. These leaders has a
clear and aligned vision. Mission,
values and expected behaviours.
Influence of Humanism in Nursing In Nursing behaviour:
In Nursing Practice:
• Mutual subjective interaction between
• Florence Nightingale claimed that the nurse and patient which aims at
essence of nursing rests on the nurse’s facilitating recovery. It is characterized
capacity to provide humane, sensitive by empathy, respect for human
care to the sick, which she believed dignity, altruism, patient autonomy,
would allow healing. friendly environment and holistic
• Theorists: Benner and Watson, care.
Josephine Paterson and Loretta
Zderad → This approach to nursing
places an emphasis on the nurse-
patient relationship, in which both
people influence the outcome of the
nursing interventions. The function of
the nursing approach shows that the
relationship between the nurse and
 B. Naturalism • Nurse leaders supervise their staff to
see if their practice is in accordance with
naturalism philosophy principle.
• Virginia Henderson developed the
Nursing Need Theory to define the
unique focus of nursing practice. The
theory focuses on the importance of
increasing the patient's
independence to hasten their
progress in the hospital. Henderson's
theory emphasizes the basic human
needs and how nurses can meet those
needs

C. Idealism

Influence of Naturalism in Nursing

In Nursing Practice:
• It encompasses the principle of
beneficence → doing good and acting in
a way that always has the patient’s best
interest.
In Nursing Behavior:
• Nurses acts as an advocate in all
avenues and to collaborate among
patient, family members and providers
to uphold and abide by the scope of
nursing ethics. Putting oneself to
another person’s shoes.
In Nursing Education:
• Students learn professional morality, Influence of Idealism in Nursing
ethics principles in order to show them
what is accepted and unaccepted in In Nursing Practice:
their professional practice. • Aligning related concepts in nursing-to-
In Nursing Leadership: nursing practice
In Nursing education:
• Students learn to consider patient D. Pragmatism
holistically. The body, mind and the
influence of the environment because
one aspect may affect the other.
• Theorists: Florence Nightingale →
Environmental Theory → use of aseptic
techniques.
• Martha Rodgers → “Science of Unitary
Human Beings” → Aims to assist people
in achieving their maximum health
potentials → scope of nursing goals.
• Hildegard Peplau → Holistic Nurse-
Patient Relationship.

In Nursing Research:
• Researches has been conducted and
revealed that necessity to care
holistically to the patient. Considering
the body, mind and the environment

In Nursing Behavior:
• The alternative, idealism brings with it a
new set of problems, particularly the
tendency to react against the perceived
dominance of the medical profession
instead of positioning a philosophy of Influence of Pragmatism in Nursing
nursing that reflects a more conservable
In Nursing Practice:
response.
• Pragmatism promotes respect for the
individual, as it appreciates that each
In Nursing leadership: person has unique needs. Additionally,
pragmatism promotes critical thinking
• Nurse managers supervise their staff to and flexibility in nursing practice, as
make sure that the care given to the nurses can explore a range of options
patient is in consideration of holistic
without negating a particular paradigm
principles.
or theory.
In Nursing Education:
• Pragmatism is an educational
philosophy that says that education
should be about life and growth. Two
important elements of pragmatism
include practical learning, which focuses
 on the real-world applications of In Nursing Education:
lessons, and experiential learning, which
• contributed to the development of the
involves learning through experience,
nursing discipline by providing the basis
not through simple ideas
of evidence-based nursing practice,
In Nursing Behavior: nursing research, nursing education,
and theoretical construction.
• In pragmatism, Man is the measure of
things, the truth is what work. Nursing theorist:
Pragmatism requires its adherent to look
• Imogene King’s → Goal Attainment
at specific practical consequences of
Theory → describes a dynamic,
act, ideas and concept.
interpersonal relationship in which a
Nursing Theorist: patient grows and develops to attain
certain life goals.
• Faye Glenn NJHM → 21 Nursing
Problem Theory → molds the attitudes,
intellectual competencies and technical
In Summary:
skills of the nurse into the desire and
ability to help people, sick or well to
cope up with their health needs.
• Virginia Henderson → Nursing Needs
Theory → individualized nursing care in
a creative manner.

E. Realism

Influence of Realism in Nursing

In Nursing Practice:
• Realism is grounded in the ontological
assumption that there is an objective
world that is independent of our beliefs,
perceptions, knowledge, theories, and
explanations.
 NOMADS –
• travel from one place to another
• Survival of the fittest •
Introduction TO NURSING • “Best for the most” – motto
• Sickness is due to “voodoo”
• Nursing began as a desire to keep
• Performed out of feeling of compassion
people healthy and to provide comfort
for others
and assurance to the sick.
• Performed out of desire to help
• Although the general goals of nursing
• Performed out of wish to do good
have remained relatively the same over
the centuries, ever-advancing science • Nursing is given by the WOMEN
and the changing of society’s needs
have deeply influenced the practice of
nursing. SHAMAN
• uses white magic to counteract the black
magic
The Evolution of Nursing • They are the doctors during those time.
• Intuitive Period
• Apprentice Period
• Educational Period TREPHINING
• Contemporary Period • drilling the skull
Stages of Nursing • Used to treat Psychotic patients
• Psychotic patients are believed to be
➢ Nursing from Ancient times to the possessed by evil spirits.
nineteenth century
Growth of religion
A. Early Civilization/INTUITIVE PERIOD
• most important thing that happened
A. Islam • Growth of civilization
B. Christianity Law of self-preservation
C. Middle Ages
• inspire man in search of knowledge
D. Fifteenth to Nineteenth Century
B. APPRENTICE PERIOD
C. DARK PERIOD OF NURSING
➢ From the mode of Nomadic life -
agrarian society gradual
development of urban community life
• Existence of means of
communication
• Start of scientific knowledge
Prehistoric Early Christian Era
- more complex life
➢ More on intuition - increases in health problems
 - demand for more nurses • CODE OF HAMMURABI
• Nursing as a duty of SLAVES and • 1st recording on the medical
WIVES. NURSING DID NOT CHANGE practice
but there was progress in the practice of
Medicine. • Established the medical fees

• Care of the sick was still closely allied • Discouraged experimentation

with superstitions, religion and magic • Specific doctor for each disease
• Right of patient to choose treatment
• Near East – birth place of 3 religious’ between the use of charms,
ideologist: medicine, or surgical procedure

 Judaism EGYPTIANS

 Christianity  ART OF EMBALMING

➢ Mummification
 Mohammedism or Islam ➢ Removing the internal organs of
the dead body
• Near East culture was adopted by the
➢ Instillation of herbs and salt to the
Greeks and Romans combined with the
dead
wonders of the Far East by returning
➢ Used to enhance their knowledge
crusaders and explorers improved and
of the human anatomy. Since
was carried to Europe during the
work was done and performed on
Renaissance Period that resulted to
the dead, they learned nothing of
greater knowledge then to the New
Philosophy
World by the Early settlers.
“THE 250 DISEASES”
• Documentation about 250 diseases and
• a tiny area known as birth of treatments
monotheism that lies between Tigris and
Euphrates River in the Nile River arose ➢ Egyptian physicians are believed to have
the cultures of Babylonia, Egypt and specialized in certain diseases (such as
Hebrew. internal diseases, fractured bones, and
MONOTHEISM wounds). They also hired women, later
known as midwives, to assist with childbirth.
• believer of one God These women were the first records nurses.
HEBREW
• BABYLONIANS • Teachings of MOSES
• EGYPTIANS • Created Leviticus
• HEBREW • Father of sanitation
• CHINA • Practice the values of “Hospitality to
• INDIA strangers” and the “Act of Charity” –
• GREECE contained in the book of Genesis
• ROMAN EMPIRE LEVITICUS
BABYLONIANS – 3rd book of the Old Testament
 • Laws controlling the spread of should be prepared for administration,
communicable diseases cleverness, devotedness to the patient,
• Laws governing cleanliness and purity of mind and body.
• Laws on preparation of food Atharvaveda
• Purification of man and his food
• The ritual of CIRCUMCISION – on the • Ancient text dealing with Medicine
8th day after birth Ayurveda
• “Complete knowledge for long life”
MOSAIC LAW Medical system of India with 8 branches
of medicine
• Meant to keep Hebrews pure so that
they may enter the sanctuary without Charaka and Sushruta
affronting God
• 2 most famous medical texbooks that
• Meant as a survival for health and describes physical examinations,
hygienic reason only diagnosis, treatment and prognosis and
several surgical procedures.

CHINA Suśrutasamhitā

Huangdi neijing • Describes several surgical procedures

•
• The foundational text of Chinese
medicine written 5th century to 3rd GREECE
century BC- Basis of traditional Chinese
• The Greeks believed in Apollo, the
medicines, acupuncture and
Greek god of healing and prayed to him
moxibustion
for magic cures for their illness.
INDIA • 400 B.C., the famous Greek physician
Hippocrates believed that disease had
SUSHURUTO
natural, not magical, causes.
• 1st recording on the nursing practice
AESCULAPUS
• Hampered by Taboos due to social
structures and practices of animal • Father of medicine in Greek mythology
worship
HIPPOCRATES
• Medicine men-built hospitals
• intuitive form of asepsis • Father of modern medicine
• There was proficient practice of • 1st to reject the idea that diseases are
Medicine and Surgery caused by evil spirits
• NURSES QUALIFICATIONS: Lay • 1st to apply assessment
Brothers, Priest Nurses, combination of • Practice medical ethics
Pharmacist, Masseurs, PT, cooks
• There was also decline in Medical
practice due to fall of Buddhism – state CADUCEUS
religion of India
• In ancient India, early hospitals were • Insignia of medicine
staffed by male nurses who were • Composed of staff of travelers
required to meet four qualifications: intertwined with 2 serpent (the symbol of
knowledge of the manner in which drugs Aesculapius and his healing power). At
 the apex of the staff are two wings of • Holistic Approach to health care service
Hermes (Mercury) for speed. • Nursing in Hospitals in 830
• NURSES à function of untrained
slaves
• Maham a great lady served as a wet
Nurse of King Akbar in Mughal Empire
Roman Empire
• She nursed during Wars in India and
• After 300 B.C., early physicians built on Afghanistan
the groundwork of their Egyptian and
Greek predecessors.
• The Romans are best known for
• With the beginning of Christianity,
advances in the health of the public.
nursing began to have a formal and
• Proper turnover for the sick people more clearly defined role.
• Led by the belief that love and caring for
• “If you’re strong, you’re healthy” – motto others were important, women made the
• Transition from Pagan to Christianity first visits to sick people, male gave
nursing care and buried the dead.
• FABIOLA • Nursing became a respected vocation.
 Was converted to Christian and
later she converted her home to a
hospital and used her wealth for
the sick.
• More hospitals were built.
• 1st hospital in the Christian world • Nurses delivered custodial care and
depended on physicians for direction.
• Use of pharmacologic drugs
• Nurse midwifery, as one of the oldest
nursing roles, flourished.
“MATERIA MEDICA” • Much nursing care was provided by
- Book that indicates the monks and nuns, which was segregated
pharmacologic drug used for by sex.
treatment Fifteenth to Nineteenth Century

• No knowledge on anatomy • Many monasteries and convents closed,

• Use of wax to preserve the body of the leading to a tremendous shortage of
dead people to care for the sick.
• Method of paper making • Women who had committed crimes
• FACTOR THAT HAMPERED THE were recruited into nursing in lieu of
ADVANCEMENT OF MEDICINE: serving sentences.
o Prohibits dissecting of human
body thus thwarting scientific • The only acceptable nursing role was
study within a religious order where services
were provided as part of Christianity
charity.

• Ethos of Health Care Service

• 1st Muslim Nurse Rufaidah Bint Sa’ad
 11th century to 1836
  On-the-job training period • Cared for the injured and established
hospitals in the military camps
 Refers to a beginner (on-the-job
training). It means care performed by KNIGHTS OF ST. LAZARUS
people who are directed by more
experienced nurses • Care for those who suffered Leprosy,
syphilis, and chronic skin diseases
 Starts from the founding of Religious
Orders in the 6th century through the ALEXIAN BROTHERS
Crusades in the 11th century (1836 – • A monasteric order founded in 1348.
when the deaconesses School of They established the Alexian Brothers
Nursing was established in School of Nursing, the largest School
Kaiserswerth, Germany by Pastor under religious auspices exclusively in
THEODORE FLEIDNER) US and it closed down in 1969
APPRENTICE PERIOD ST. VINCENT DE PAUL
(6th Century- 18th Century)
• He organized the charity group called
 There was a struggle for religious, the “La Charite” and the “Community of
political, and economic power. Sisters of Charity” composed of women
 Period of “on the job” training. dedicated in caring for the sick, the
poor, orphaned, and the widowed. He
 Crusades took place in order to gain founded the “Sisters of Charity School
religious, political, and economic power of Nursing” in Paris, France where
or for adventure Florence Nightingale had her 2nd
 During the Crusade in this period, it formal education in Nursing.
happened as an attempt to recapture
the Holy Land from the Turk who
obtained and gain control of the region LOUISE de GRAS
as a result of power struggle. Christians • Was the 1st Superior and co-founder of
were divided due to several religious the Community of Sisters of Charity
war and Christians were denied visit to
The Holy Sepulcher.

ST. CLAIRE OF ASSISI

 Took vows of poverty, obedience
to service and chastity
 Founded the 2nd order of St.
Francis of Assisi
KNIGHTS OF ST. JOHN OF JERUSALEM
(ITALIAN)  “the poor Claire”
ST. ELIZABETH OF HUNGARY
• Also called as “Knights of the
Hospitalers”  The patroness of Nursing
• Established to give care
 A princess
TEUTONIC KNIGHTS (GERMAN)
 Sees her calling to give care for
• Took subsequent wars in the Holy Land the sick
  Fed thousands of hungry people • The conflict swept everything connected
to Roman Catholicism in schools,
St. CATHERINE OF SIENA
orphanages, and hospitals
 “Little Saint” – took care of the
THEODORE FLIEDNER
sick as early as 7y/o
• (a pastor) reconstituted the
 “1st Lady with a Lamp”. She was
Deaconesses and later be established
a hospital nurse, prophetess,
the School of Nursing at Kaiserswerth,
researcher and a reformer of
Germany where Florence Nightingale
society and the church
had her 1st formal training for 3 months
as nurse
FLORENCE NIGHTINGALE
• Practiced her profession during the
Crimean War
 Orders of St. Francis of Assisi • “Lady with a Lamp”
 1st order – founded by St. • From a well-known family
Francis • Went to Germany to study

 2nd order “the poor Claire” –

founded by St. Claire
 3rd “the tertiary order”
• Beguines
• United States of America
• Oblates
• Bellevue Hospital School of Nursing -
• Benedictines Founded in 1873 in New York.
• It was the first school of nursing in the
• Ursulites
United States to be founded on the
• Augustinians principles of nursing established by
Florence Nightingale
• OTHER SCHOOLS OF NURSING •
Bellevue Training School for Nurses
• From 17th century – 19th century
– New York City
• Also called the Period of Reformation
• Alexian Brothers Hospital School of
until the American Civil War
Nursing in US exclusively for men. It
• Hospitals were closed
opened in 1348 and it closed down in
• Nursing were the works of the least
1969.
desirable people (criminals, prostitutes,
• LINDA RICHARDS – the first graduate
drunkards, slaves, and opportunists)
nurse in US. Graduated in September 1,
• Nurses were uneducated, filthy, harsh,
1873
ill-fed, overworked
• Mass exodus for nurses
• The American Civil War was led by
Martin Luther, the war was a religious
upheaval that resulted to the destruction
in the unity of Christians.
  Emancipation of women
 Increased educational
opportunities
Philippines  Became the Superintendent of the
Establishment for Gentle Women during
• Iloilo Mission Hospital School of
the Illness (refers to the ill governess or
Nursing – Established in 1906 it is
instructors of Nursing
the first hospital in the Philippines which
trained Filipino nurse.  She disapproved restriction on
admission of patient and considered this
unchristian and contrary to health care.
 Upgraded the practice of Nursing and
made Nursing an honorable profession
The founder of Nursing  Led other nurses in taking care of the
Period of Nightingale wounded and sick soldiers during the
Crimean War
 Mother of Modern Nursing
 She was designated as Superintendent
 Lady with the Lamp of the Female Establishment of English
 Born on May 12, 1820 in Florence, Italy General Hospital in Turkey during the
Crimean War •
 Her SELF-APPOINTED GOAL – to  She reduced the casualties of war by
change the profile of Nursing 42%-2% thru her effort by improving the
 She compiled notes of her visits to practice of sanitation techniques and
hospitals, her observations of sanitation procedure in the military barracks
practices and entered Deaconesses  The founder of Nursing
School of Nursing at Kaiserswerth,  The lady with lamp
Germany for 3 months.;  The 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,
 Began in June 15, 1860 when Florence and organizing classes for orderlies;
Nightingale School of Nursing opened at  After the war, Nightingale established
St. Thomas Hospital in London England, the Nightingale Training School for
where 1st program for formal education Nursed at St. Thomas’ hospital in
of Nurses began and contributed growth London; the school served as a model
of Nursing in the US for other training school; as the founder
of modern nursing, Florence Nightingale
 FACTORS THAT INFLUENCED established the first nursing philosophy
DEVELOPMENT OF NURSING based on health maintenance and
EDUCATION: restoration.
 Social forces  Wrote Notes on Nursing, “What
 Trends resulting from war it is and what it is not.”
 Wrote notes on hospitals
 • Published in 1859 Notes on
Nursing provides a simple but practical
discussion of good patient care, along
with helpful hints. According to Florence
Nightingale, hygiene, sanitation, fresh
air, proper lighting, a good diet,
warmth, quietness and attentiveness
were necessary conditions for hospitals
and were to be ensured by trained
nurses.
• Environmental Theory and Statistical
Data
• Nightingale implemented handwashing
and other hygiene practices in the war
hospital in which she worked.
• More soldiers die because from infection
than from bullets.
• She advocated sanitary living conditions
as of great importance.

• Florence Nightingale was one of the

pioneers in establishing the idea of
nursing schools from her base at St
Thomas' Hospital, London in 1860 when
she opened the 'Nightingale Training
School for Nurses’, now part of King's
College London

Nightingale School of Nursing

Clara Barton (1812-1956)
• She was school teacher who
volunteered as nurse during American
civil war.
• Barton is noted for her role in
establishing the American Red Cross.

Liviana Dock (1858-1956)

• Her campaigned for legislation to allow
nurses rather than physicians to control
their profession.

Walt Whitman
• Men served as nurses. One notable
nurse during America Civil War (1861-
73) was Walt Whitman.
• He was a poet and writer who served as
Hospital Nurse in Washington.
• First Queer Nurse
 Isabel Hampton Robb: Founded
nursing organizations.
 Adelaide Nutting: First nurse appointed
as university professor.
 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
Lillian Wald (1867-1940): preceded registered nurse).
• Is considered the founder of public
health nursing.
• She offers trained nursing services to
the poor.
 Family Structure
• Information and Telecommunications
• Legislation
What is contemporary?
NURSES AND THEIR UNIFORM
How will you describe nurses and nursing
today?
CONTEMPORARY PERIOD
 World War II – present
 This refers to the period after World War
I and the changes and development in
the trends and practice of Nursing
occurring since 1945 after World War II.
 Includes scientific and technological
development, social changes occurring
after the war.
 Nursing is offered in College and
17th CENTURY
Universities
DEVELOPMENT AND TRENDS:
 W.H.O established by U.N to fight
diseases by providing health
information, proper nutrition, living
standard, environmental conditions.
 The use of Atomic energy for diagnosis
and treatment.
 Space Medicine and Aerospace Nursing
 Medical equipment and machines for
diagnosis and treatment
 Health related laws
 Primary Health Care – Nurses
involvement in CHN
 Utilization of computers
 Technology advances such as
18th CENTURY
development of disposable equipment
and supplies that relieved the tedious
task of Nurses.
 Development of the expanded role of
Nurses
FACTORS AFFECTING NURSING TODAY:
Economics
• Consumer’s Demand
NURSING UNIFORMS IN THE 19TH
CENTURY

Early Beliefs, Practices & Care of the sick

• These were the early beliefs of health
and illness in the Philippines
• → based on mysticism and
superstitions
• herb doctors (“herbolarios”)
• Persons suffering from diseases without
any identified cause were believed
bewitched by “mangkukulam” or
“manggagaway”.
NURSING UNIFORMS IN THE 20TH • Difficult childbirth and some diseases
CENTURY (called “pamao”) were attributed to
“nunos”. Midwives assisted in
childbirth. During labor, the “mabuting
hilot” (good midwife) was called in. If
the birth became difficult, witches were
supposed to be the cause. To disperse
their influence, gunpowder were
exploded from a bamboo cane close
to the head of the sufferer.

Health Care During the Spanish Regime

➢ The context of nursing has manifested
through simple nutrition, wound care,
NURSING UNIFORMS TODAY and taking care of an ill member of the
family. Certain practices when taking
care of a sick individuals entails
interventions from babaylan (priest
physicians) or albularyo (herb
doctor).
➢ In 1578, male nurses were
acknowledged as Spanish Friars’
assistants for caring sick individuals in
the hospital. These male nurses were
referred as practicantes or
enfermeros.
➢ Hospital Real de Manila (1577) – it was
established mainly to care for the
 Spanish king’s soldiers, but also during the revolution, President of the
admitted Spanish civilians; founded by Filipino Red Cross branch in Batangas.
Gov. Francisco de Sande.
➢ Melchora Aquino a.k.a. “Tandang
➢ San Lazaro Hospital (1578) – founded Sora” — nursed the wounded Filipino
by Brother Juan Clemente and was soldiers and gave them shelter and
administered for many years by the food. known as “Mother of Philippine
Hospitalliers of San Juan de Dios; built Revolution”
exclusively for patients with leprosy.
➢ Capitan Salome — a revolutionary
➢ Hospital de Indios (1586) – established leader in Nueva Ecija; provided nursing
by the Franciscan Order; service was in care to the wounded when not in
general supported by alms and combat.
contributions from charitable persons.
➢ Agueda Kahabagan — revolutionary
➢ Hospital de Aguas Santas (1590) – leader in Laguna, also provided nursing
established in Laguna; near a medicinal services to her troops
spring, founded by Brother J. Bautista of
➢ Trinidad Tecson (“Ina ng Biak-na-
the Franciscan Order.
Bato”) — stayed in the hospital at Biak
➢ San Juan de Dios Hospital (1596) – na Bato to care for wounded soldiers
founded by the Brotherhood of
➢ Josefa Llanes Escoda –Founder of
Misericordia and administered by the
Girls Scout of the Philippines.
Hospitaliers of San Juan de Dios;
support was delivered from alms and ➢ Nazaria Lagos -- (August 28, 1851 –
rents; rendered general health service to January 27, 1945) was a patriot of the
the public. Revolution in the Philippine–American
War. She was known as the Florence
Nightingale of Panay.
Nursing During the Philippine
Revolution
Hospitals and Nursing Schools
➢ Josephine Bracken — wife of Jose
Rizal, installed a field hospital in an ➢ Americans began training the first
estate house in Tejeros. She provided Filipino nursing students in 1907.
nursing care to the wounded night and
day. ➢ The first Filipino nursing students also
studied subjects that were more relevant
➢ Rosa Sevilla de Alvero — converted to their patients, such as “the nursing
their house into quarters for the Filipino of tropical diseases” and “industrial
soldiers; during the Philippine-American and living conditions in the islands,”
War that broke out in 1899 as described by Lavinia L. Dock’s 1912
book A History of Nursing: From the
➢ Dona Hilaria de Aguinaldo — wife of
Earliest Times to the Present Day
Emilio Aguinaldo who organized that
with Special Reference to the Work of
Filipino Red Cross under the inspiration
the Past Thirty Years.
of Mabini.
➢ Dona Maria Agoncillo de Aguinaldo
— second wife of Emilio Aguinaldo;
provided nursing care to Filipino soldiers
Hospital School of Nursing’s Formal Philippine General Hospital School of
Training (1901 – 1911) Nursing (Manila, 1907)
➢ The first hospital in the Philippines ➢ PGH began in 1901 as a small
which trained Filipino nurses in 1906 dispensary for Civil officers and
was Iloilo Mission Hospital, Employees in the City of Manila and
established by the Baptist later grew as a Civil Hospital. In 1906,
Missionaries. Mary Coleman Masters, an educator
advocated for the idea of training
➢ When this health institution was built,
Filipino girls for the profession of
there were no strict requirements for the
nursing with the approval of
applicants as long as they are all willing
Government officials, she first opened a
to work. This has been the beginning of
dormitory for Girls enrolled at the
development of more nursing schools in
Philippine Normal Hall and the
the country. In this period, Pensionado
University of the Philippines.
Act of 1903 (or Act 854) was
mandated, allowing Filipino nursing ➢ In 1907, with the support of Governor
student to study in United States. General Forbes and the Director of
Among of the first wave of nurses Health and among others, she opened
who went to United States classes in nursing under the
Auspices of the Bureau of Education.
Admission was based on an entrance
Iloilo Mission Hospital School of Nursing examination. The applicant must have
(Iloilo City, 1906) completed elementary education to the
seventh grade. Julia Nichols and
➢ It was ran by the Baptist Foreign Mission Charlotte Clayton taught the students
Society of America. Miss Rose Nicolet, nursing subjects. American physician
a graduate of New England Hospital for also served as lecturers.
Women and Children in Boston,
Massachusetts was the first ➢ In 1910, the Act No. 1976 modified the
superintendent for nurses. It moved organization of the school placing it
from its present location to Jaro Road, under the supervision of the Department
Iloilo City in 1929. Miss Flora Ernst, an of Health. The Civil Hospital was
American nurse, took charge of the abolished and the Philippine General
school in 1942. Hospital was established.

Saint Paul’s Hospital School of Nursing St. Luke’s Hospital School of Nursing
(Manila, 1907) (Quezon City, 1907)

➢ The hospital was established by the ➢ The hospital is an Episcopalian

Archbishop of Manila, Jeremiah Harty Institution. It began as a small
under the supervision of the Sisters of dispensary in 1903. In 1907, the
St. Paul de Chartres located in school opened with three girls
Intramuros. It provided general hospital admitted. These three girls had their
services. It opened its training school for first year in combined classes with
nurses in 1908, with Mother Melanie the PGH School of Nursing and St.
as superintendent and Miss Paul’s Hospital School of Nursing.
Chambers as Principal. Miss Helen Hicks was the first
principal. Mrs. Vitaliana Beltran was
 the first Filipino superintendent of has been run by the Daughters of
nurses and Dr. Jose Fores was the Charity since then. Sister Taciana
first medical director of the hospital. Tinanes was the first Directress of
the School.
➢ Emmanuel Hospital School of
Mary Johnston Hospital and School of Nursing (Capiz, 1913)
Nursing (Manila, 1907)
➢ It started as a small dispensary on
Capiz Emmanuel Hospital (CEH)
Calle Cervantes (now Avenida). It
was called the Bethany ➢ In 1913, the American Baptist
Dispensary and funded by the Foreign Mission Society sent Dr. PH
Methodist Mission for the relief of Lerrigo to Capiz for the purpose of
suffering among women and opening a hospital. Miss Rose
children. In 1907, Sister Rebecca Nicolet assisted him. The school
Parrish together with registered offered a 3-year training course for
nurses Rose Dudley and Gertude an annual fee of Php 100.00. Miss
Dreisbach, organized the Mary Clara Pedroso was the first principal
Johnston School of Nursing. The
nurses’ training course began with
three Filipino young girls fresh from Southern Islands Hospital School of
elementary as their first students. Nursing (Cebu, 1918)
➢ The hospital was established in 1911
under the Bureau of Health. The
Mary Chiles Hospital School of Nursing
school opened in 1918 with
(Manila, 1911)
Anastacia Giron-Tupas as the
➢ The hospital was established by Dr. organizer. Miss Visitacion Perez was
WN Lemon in a small house on the first principal
Azcarraga, Sampaloc, Manila. In
1913, Miss Mary Chiles of Montana
donated a large sum of money with The Start of Nursing Practice
which the preset building at (1911- 1921)
Gastambide was bought. The
Tuason Annex was donated by Miss ➢ In 1915, Promulgation of Act No.
Esperanza Tuason, a Filipino 2493 which amends Medical Law
Philanthropist. (Act No. 310) allowing the regulation
➢ Frank Dunn Memorial Hospital of nursing practice transpired during
(Vigan Ilocos Sur, 1912) this period. However, in 1919, the
First True Nursing Law was
enacted through Act 2808. During
this period the Board Examiners for
San Juan de Dios Hospital School of
Nursing was also created. The first
Nursing (Manila, 1913)
nursing board examination was
➢ In 1913, through the initiative of Dr. given on 1920. The first executive
Benito Valdez, the board of officer of the Board Examiners for
inspectors and the executive board Nurses is a physicians.
of the hospital passed a resolution to
open school of nursing. The school
A Much Established Professional Other Schools of Nursing
Organization: 1921 – 1931
 1. Zamboanga General Hospital School
➢ During this period, the precursor to of Nursing (1921)
the accredited professional
 2. Chinese General Hospital School of
organization in the Philippines was
Nursing (1921)
created. The Filipino Nurses
Association was established on  3. Baguio General Hospital School of
October 15, and the organization Nursing (1923)
initiated the publication of Filipino
Nurse Journal. Later, this journal  4. Manila Sanitarium Hospital and
was changed to The Philippine School of Nursing (1930)
Journal of Nursing. Amendment of  5. St. Paul School of Nursing in Iloilo
certain sections of the Act 2008 was City (1946)
conducted in 1922 under Act 3025
passed by the 5th Legislature. This  6. North General Hospital and School of
policy is entitled An Act Regulating Nursing (1946)
the Practice of Nursing Profession in  7. Siliman University School of Nursing
the Philippine Islands, which (1947)
necessitates all nurses who are
practicing the profession to register
yearly. In 1929, the organization The Degree of Bachelor of Science in
also became a member of the Nursing: 1941 – 1951
International Council of Nurses.
➢ Through the 1930s, Philippine ➢ A nursing curriculum which was
schools of nursing continued to based on the thesis presented by
adopt those aspects of American Julita V. Sotejo, graduate of the
professional nursing they deemed Philippine General Hospital School of
relevant and appropriate, such as Nursing, tackles on the development
higher admission standards and the of a nursing education within a
specialization of public health University-based College of Nursing.
nursing. This dissertation was the beginning
of nursing curriculum that have made
the Nursing Institution of the country
Public Health Nursing Development: as a baccalaureate course. During
1931 – 1941 this period, College of Nursing was
also created.
➢ In 1933, the nursing institution ➢ When the Japanese occupied the
have increased their requirement. Philippines in 1942, training and
During this period, they have practice at the hospital schools of
implemented that to enter nursing nursing in Manila was “violently
education an applicant must be disrupted.” However, U.S. colonial
able to complete secondary patterns in Philippine nursing
education. The first collegiate education soon returned after the
nursing graduates of the Philippines U.S. reclaimed the country in 1945
graduated from University of the and even after the Philippines gained
Philippines School of Public Health independence from the U.S. July 4,
Nursing in 1938. 1946.
The First Colleges of Nursing in the President Carlos P. Garcia under the
Philippines Proclamation No. 539. The continuous
of nurses had also resulted to the first
University of Santo Tomas-College of
round of migration, particularly in United
Nursing (1946)
States. In fact, between 1966 and 1985
➢ The college has offered excellent about 25,000 Filipino nurses have
education leading to a baccalaureate migrated to United States.
degree. Sor Taciana Trinanes was
its first directress.
Nursing Profession Development:
Manila Central University-College of
1971 – 2002
Nursing (1947)
➢ Regulation of the practice of health care
➢ The MCU Hospital first offered BSN
providers, the Presidential Decree No.
and Doctor of Medicine degrees in
223, was mandated which brought
1947 and served as the clinical field
about the establishment of the
for practice. Miss Consuelo Gimeno
agency, Professional Regulation
was its first principal.
Commission.
➢ During this period, the Philippine
University of the Philippines Manila-College Nursing Act of 1991 was also
of Nursing (1948) amended under Republic Act No.
7164 which expanded nursing practice
➢ The idea of opening the college to other roles such as management,
began in a conference between Miss teaching, decision making, and
Julita Sotejo and UP President. In leadership.
April 1948, the University Council
approved the curriculum, and the ➢ The qualification of nurses or
Board of Regents recognized the faculty’s in the academe was also
profession as having an equal updated to Master’s Degree in
standing as Medicine, Engineering Nursing or equivalent.
etc. Miss Julita Sotejo was its first
➢ Another important event in Philippine
dean.
Nursing history is the creation of
Nursing Certification Council in 1999
under the Board of Nursing through
Proliferation of Nurses as a Workforce: Resolution No. 14 which supervise the
1951 – 1971 new programs’ implementation
➢ The Philippine Nursing Law was conducted by Specialty Certification
approved under the Republic Act No. Boards. This improvement also
877 on June 19 1953. Then further prompted the start of Advanced Practice
amendment was created in 1966 which Nursing (APN) in the Philippines.
limits that practice of among nurses 21 ➢ 2002 → RA 9173 “Nursing Act of
years old and above. 2002”, signed into Law by President
➢ October 17, 1958. The increasing Gloria M. Arroyo
number of nurses in the Philippines
have also brought about the celebration
of Nurses’ Week (Last week of
October) which was proclaimed by
 • Cleanliness outside the house affects
the inside.
2. Ventilation and warming
• Keeping the air we breath pure without
chilling the patient.
Florence Nightingale
• If the person who repeatedly breathes
• The Environmental Theory
his own air would be sick or remain sick.
• Florence Nightingale often considered
the first nurse theorist. • Emphasis the importance of Room
• Defined nursing more than 100 years Temperature
ago as the “Act of utilizing the
3. Light
environment of the patient to assist him
in his recovery” • The use of direct sunlight was what the
patient wanted.
• The effects of sunlight upon the human
ENVIRONMENTAL THEORY
body.
• Linked health in 5 environmental
• Light affects or Circadian Rhythm (Body
factors (pure/fresh air, pure water,
Clock)
efficient drainage, cleanliness,
light) o Lack of environmental stimuli
• Stress the importance of keeping (isolation, ICU) can lead to
the client warm, maintaining a confusion or “INTENSIVE
noise-free environment, and PSYCHOSIS” related to lack of
attending to the client’s diet in the usual cycling of day and
terms of assessing intake, night.
timelines of the food, and its effect
4. Noise
on the person
• Patients should never be waken
intentionally or accidently during the
Sub-concepts of Environmental Theory first part of sleep.
• Examples of noise: jewelleries of
nurses, stethoscope, clanging of
keys. Snapping of rubber gloves,
machine movements, telephone
ringing etc..

5. Variety
• Nurses should provide variety in the
patient’s room to help avoid boredom
and depression.
1. Health of Houses (patient’s room)
• Encourage family members or
• Presence of pure air, pure water, significant others to engage with patient
efficient drainage, cleanliness and light
 • Need for change of environment → 9. Nutrition and Taking foods
advocate reading, writing, colouring
• Variety of foods served to patients.
classes (Diversional Therapy)
• Individuals desire different foods at
different times of the day.
6. Bed & Beddings
• Frequent small serving may be more
• An adult exhale about 3 pints of beneficial than large meals.
moisture through the lungs and skin in a
24-hour period → this matter enters the • No business must be done with the
sheets and stays there unless the patient while they are eating
beddings is changed and aired • Right food at right time
frequently.
• Caregivers must never lean against, sit
upon or unnecessary shake the bed. 10. Chattering Hopes and Advices

• Nursed must keep the beddings clean, • False hopes are depressing to patients.
neat and dry to position patient’s • Sick person should hear good news that
maximum support. Wrinkle-free would assist them in becoming healthier.
beddings.

11. Observations of the Sick

7. Cleanliness of Room and Walls
• Nurses must be taught what to observe.
• Removal of dusts with a damp cloth o Use of Nursing Process → ADPIE
rather than using a feather duster. ( Assessment → Diagnosis →
• Floors should be easily cleaned Planning → Intervention →
Evaluation)
• Furniture and walls be easily washed o Skills of the nurse in assessing
patient
• CLEAN ROOM IS A HEALTHY ROOM
o “If can not get the habit of
→ avoid clatters
observation, one way or other,
you had better give up being a
nurse, for it is not your calling,
8. Personal Cleanliness
however kind and anxious you
• Unwashed skin poisons the patient. may be.” (Florence
Nightingale)
• Bathing and drying the patient provide
great relieve to the patient.
• Keep the pores of the skin free from all 12. Petty Management
obstructing excretions. • Continuity of Care for the patient →
• Every nurse ought to wash her hand handovers.
very frequently (Nightingale). • Documentation of the plan of care
• Ways to assure: “What you do
when you are there, shall be done
when you are not there”.
The 4 Metaparadigms of Environmental
Theory

The 4 Metaparadigms of Environmental

Theory → NURSING
• By helping to control environmental
influences, nurses can aid in the
maintenance of health of their patients.

Application to Nursing Practice

• With the advent of technology, and with
it, globalization comes threat from the
environment
 • Global warming, industrial noise, air • She stressed Nursing’s duty to the
pollution, nuclear radiation treats, man- patient rather than to the doctor and
made environmental calamities fad diets provided a scientific basis for nursing.
continue to pose challenge to the nurse
• Basic Principles of Nursing (20th Century
practitioner today.
equivalent of Nightingales Notes on
Nursing) became the landmark book in
nursing.
Key Points on Florence Nightingale’s
Environmental Theory
• Focuses on nursing and the patient’s Concept of Nursing
environmental relationship
• Doing things for patients that they
• Helping process meets needs through would do for themselves. If they
the art of individualized care could. But I go on to say that the
nurse makes the patient independent
• Nurses should identify patients need-for- of him/her as soon as possible.
help by: OBSERVATIONS
• Assisting individuals to gain
independence in relation to the
performance of activities contributing
to health or its recovery. (Henderson,
1966)

Three Levels of Nurse-Patient Relationship

Personal Background
1. Substitutive- doing for the person
• Virginia Henderson was born in Kansas (doer)
City, Missouri 2. Supplementary- helping the person
• Enrolled in the Army Nursing School at (helper)
the Walter Reed Hospital in Washington. 3. Complementary- working with

• She took a temporary job in caring for

the World War I wounded soldiers.
10th & 14th-Psychological
11th-Spiritual & Moral
12th & 13th – Sociological

Assumptions to theory
 nurse will be administering. (doer,
helper, or partner)

• Faye Glenn Abdellah (March 13, 1919

– present) is a nursing research pioneer
who developed the “Twenty-One
Nursing Problems.” Her nursing model
was progressive for the time in that it
refers to a nursing diagnosis during a
time in which nurses were taught that
diagnoses were not part of their role in
health care.
• She was the first nurse officer to rank a
two-star rear admiral, the first nurse, and
the first woman to serve as a Deputy
Surgeon General.
• Abdellah and her brother witnessed the
explosion, destruction, and fire after the
ignited hydrogen killed many people.
Application of Theory That incident became the turning point
• Her theory is essential to clinical nurses in Abdellah’s life. It was that time when
today, especially within the context of she realized that she would never again
be powerless to assist when people
bedside nursing
were in such a dire need of assistance.
• Patient’s ability to perform the basic It was at that moment she vowed that
human need should be assessed before she would learn to nurse and become a
considering the kind of nursing care a professional nurse.
 3. Make generalizations about
available data concerning
similar nursing problems
presented by other patients.
4. Identify the therapeutic plan.
5. Test generalizations with the
patient and make additional
generalizations.
6. Validate the patient’s
conclusions about his nursing
problems.
7. Continue to observe and
evaluate the patient over a
period of time to identify any
Patient-centered approaches to Nursing attitudes and clues affecting
this behavior.
• Faye Abdellah’s work is a set of 8. Explore the patient’s and
problems in terms of nursing-centered family’s reaction to the
orientation used to determine then therapeutic plan and involve
patient’s needs. The nursing centered them in the plan.
orientation to client care appears to be 9. Identify how the nurse feels
contradicting the client centered about the patient’s nursing
approach that Abdellah professes to problems.
support. This can be observed by her 10. Discuss and develop a
desire to move away from disease comprehensive nursing care
centered orientation. plan.

10 Steps to Identify the Patient’s problems

• The assumptions Abdellah’s “21

Nursing Problems Theory” relate to
change and anticipated changes that
affect nursing; the need to appreciate
the interconnectedness of social
enterprises and social problems; the
impact of problems such as poverty,
racism, pollution, education, and so
forth on health and health care
delivery; changing nursing education;
continuing education for professional
nurses; and development of nursing
leaders from underserved groups.

Basic Needs
1. Learn to know the patient.
2. Sort out relevant and • The basic needs of an individual patient
significant data. are to maintain good hygiene and
physical comfort; promote optimal health
 through healthy activities, such as the understanding of the role of social
exercise, rest, and sleep; promote safety problems as influential factors in the
through the prevention of health hazards case of illness.
like accidents, injury, or other trauma
and the prevention of the spread of Abdellah’s Typology of 21 Nursing
infection; and maintain good body Problems
mechanics and prevent or correct
deformity
• The 21 nursing problems fall into three
categories: physical, sociological, and
Sustenal Care Needs emotional needs of patients; types
of interpersonal relationships between
• Sustenal care needs to facilitate the the patient and nurse; and common
maintenance of a supply of oxygen to all elements of patient care. She used
body cells; facilitate the maintenance of Henderson’s 14 basic human needs
nutrition of all body cells; facilitate the and nursing research to establish the
maintenance of elimination; facilitate the classification of nursing problems.
maintenance of fluid and electrolyte Abdellah’s 21 Nursing Problems are
balance; recognize the physiological the following:
responses of the body to disease
conditions; facilitate the maintenance of 1. To maintain good hygiene and
regulatory mechanisms and functions, physical comfort.
and facilitate the maintenance of 2. To promote optimal activity:
sensory function exercise, rest, sleep
3. To promote safety by preventing
Remedial Care Needs accidents, injuries, or other
trauma and preventing the spread
• Remedial care needs to identify and of infection.
accept positive and negative 4. To maintain good body
expressions, feelings, and reactions; mechanics and prevent and
identify and accept the interrelatedness correct the deformity.
of emotions and organic illness; facilitate 5. To facilitate the maintenance of a
the maintenance of effective verbal and supply of oxygen to all body cells.
non-verbal communication; promote the 6. To facilitate the maintenance
development of productive interpersonal of nutrition for all body cells.
relationships; facilitate progress toward 7. To facilitate the maintenance of
achievement of personal spiritual goals; elimination.
create and maintain a therapeutic 8. To facilitate the maintenance of
environment; and facilitate awareness of fluid and electrolyte balance.
the self as an individual with varying 9. To recognize the physiologic
physical, emotional, and developmental responses of the body to disease
needs conditions—pathologic,
physiologic, and compensatory.
10. To facilitate the maintenance of
Restorative Care Needs regulatory mechanisms and
functions.
• Restorative care needs include the 11. To facilitate the maintenance of
acceptance of the optimum possible sensory function.
goals in light of limitations, both physical 12. To identify and accept positive
and emotional; the use of community and negative expressions,
resources as an aid to resolving feelings, and reactions.
problems that arise from an illness; and
13. To identify and accept
interrelatedness of emotions and
organic illness.
14. To facilitate the maintenance of
effective verbal and nonverbal
communication.
15. To promote the development of
productive interpersonal
relationships.
16. To facilitate progress toward
achievement and personal
spiritual goals.
17. To create or maintain a
therapeutic environment.
18. To facilitate awareness of self as
an individual with varying
physical, emotional, and
developmental needs.
19. To accept the optimum possible
goals in the light of limitations,
physical and emotional.
20. To use community resources as
an aid in resolving problems that
arise from an illness.
21. To understand the role of social
problems as influencing factors in
the cause of illness.
 defined Nursing as “a participation in
care, core and cure aspects of patient
care, where CARE is the sole function of
nurses, whereas the CORE and CURE
are shared with other members of the
health team.”

• Lydia Eloise Hall (September 21, 1906

– February 27, 1969) was a nursing
theorist who developed the Care, Cure,
Core model of nursing. Her theory
 person and behaves according to their
feelings and values.

• The cure is the attention given to

patients by medical professionals. Hall
explains in the model that the nurse
shares the cure circle with other health
professionals, such as physicians or
physical therapists. These are the
interventions or actions geared toward
treating the patient for whatever illness
or disease they are suffering from.

• Lydia Hall used her knowledge of

psychiatry and nurse

• Lydia Hall used her knowledge of • The care circle addresses the role of
psychiatry and nursing experiences in
nurses and is focused on performing the
the Loeb Center to formulate her theory.
task of nurturing patients. This means
Also known as “the Three Cs of Lydia
the “motherly” care provided by nurses,
Hall,” it contains three independent but
which may include comfort measures,
interconnected circles: the core, the
patient instruction, and helping the
care, and the cure.
patient meet his or her needs when help
is needed.
• The core is the patient receiving
nursing care. The core has goals set by
him or herself rather than by any other