CHAPTER 1 THE EVOLUTION OF NURSING - Nursing involves people in a variety of settings

NURSE - is a state licensed health care and situations and effectiveness depends on the
professional engaged in the practice of providing equality of those interactions.
nursing care both interdependently and - The art of nursing is often practiced in the
independently. environment that are unpredictable and
RESPONSIBLE OF NURSES: spontaneous.
- Assessing patient’s needs and problems and - This requires nurses to be creative in their
developing a plan of care either in collaboration or response to the individual client needs. Hence, the
in coordination with physicians, therapist, the term ‘art’ is used.
clients, and other team members. - Additional aspects of nursing considered artful
- Health maintenance of healthy individuals; and are: knowledge, judgement and skill exercised by
treatment of life-threatening emergencies in various nurses in their everyday practice.
health care settings; - Nurses develop the ability to sense, feel, perceive
- Treatment, safety, and recovery of acutely or and decide effectively how to deliver care in ways
chronically ill or injured people; that increasingly demonstrate mastery in their field
- Research and non-clinical functions necessary to of nursing practice.
the delivery of health care’ Hildegard Peplau - “mother of psychiatric nursing”
- Teaching and mentoring other nurses. 3 major components:
SCOPE OF WORK OF RN Medium - intellectual creativity of the nurse in
- Promote health, prevent disease, and help bringing about change towards health through
patients cope with illness: cultivating the potential clients.
- Advocate and educate patients, clients, families, Process - interaction initiated by the nurse that
and communities moves the patient towards an end point, which may
- Work w/ physicians during treatments and include the application of technical skills.
examinations. Product - result or outcome of nursing care,
- Administer medications; described as the improved functioning of the client
- Assist clients in convalescence and rehabilitation that may or may not include observable outcomes.
- Formulate, implement and evaluate nursing care NURSING AS AN ART 4 MAIN GOALS:
plan based on assessed needs and problems of 1. To understand the patient, their condition,
patients situation or need
- Teach patient and their families about self care 2. To enhance the patient’s capability
and health maintenance. 3. To improve the patient’s condition or situation
- Help individuals and groups take steps to improve w/in the framework of the nursing care plan; and
or maintain their health. 4. To prevent the recurrence of the problem or new
WHAT IS NURSING? problems that causes anxiety, disability, or distress.
- NURSING is derived from the latin word Virginia Henderson - one of the first modern
NUTRICIA, NUTRIZ, NUTRIRE, meaning to nurse, nurses to define nursing. In 1966, Henderson
nourish or cherish. Caring for others is the basis for defined nursing as:
nursing.  Assisting the individual, sick or well, in the
NURSING DEFINED IN 3 WAYS: performance of those activities contributing to
1. ART health, its recovery, promoting quality of life or to
2. SCIENCE a peaceful death that the client would perform
3. PRACTICE unaided if he/she had the necessary strength,
NURSING IS AN ART will or knowledge.
- Nursing is an art pertains to use imagination and  This definition was adapted by the International
creativity in caring. Council of Nurses (ICN) in 1973 and stills
- It doesn’t rely on mechanical details execution or holds wide appeal to the nursing profession. The
in the dexterity of the performer. ICN definition of nurses now: “nursing
- Florence Nightingale first defined nursing as: encompasses autonomous and collaborative
“The act of utilizing the environment of the patient care of individual of all ages, families, groups
to assist him in his recovery” Nightingale’s and communities, sick or well and in all settings.
definition marked the uniqueness of nursing Nursing includes the promotion of health,
practice in the health profession. prevention of illness and the care of ill, disabled
- Art is about the whole of nursing experience and dying people.
which goes beyond curing the patient which is the  Other key nursing roles include advocacy,
primary concern of physicians. promotion of a safe environment, research,
- There can be no curing without caring but there participation, in shaping health policies and
can be caring w/out curing. health systems management and education.
NURSING AS A SCIENCE  Also implies passive acceptance of the decision
 The primary aim of science is the expansion of a and care of the health professionals.
body of knowledge. The increasing knowledge Consumers
informs the thinking and practice of a particular  Refers to an individual, a group of people or a
discipline. community that uses a service or commodity.
 As a science, nursing is a health profession that Clients
establishes itself as separate from the practice  Refers to an individual, a group of people or a
of medicine. It has its own organized body of community who need or require health services
knowledge carried out through research utilizing regardless of health care needs.
the scientific method to arrive at its own general PERIODS OF NURSING
truths about its profession and practice. It seeks  Caring was born out of the desire to help which
to improve its nursing research output through was very common to have observed in women
its graduate programs and nursing journals. because they are compassionate and nurturing
The Association of Deans of Philippine in nature.
Colleges of Nursing (ADPCN) defines Nursing 1. Intuitive Period
as:  Nursing was instinctive. Humans naturally
 “A dynamic discipline. It is an art and a science provided care to their young and their mates.
or caring individuals, families groups and  The Filipino attitude of “maskipaps”or “maski-
communities geared toward promotion and papaano” was how this intuitive can be
restoration of health, prevention of illness, described
alleviation of suffering and assisting clients to 2. Apprenticeship Period
face death with dignity and peace”  Concept of On the Job Training and internship
 Nursing is giving direct care and advocacy in the 3. Educated Period
care of individuals, families, communities and  Kaiserwerth and Nightingale led the way to
populations. modern nursing, they developed systems of
Royal College of Nursing of the UK caring for the sick and wounded.
 Nursing is the use of clinical judgement in the NURSING THEMES
provision of care with health problems Superstitions & Witchcraft
 Nursing helps to achieve the best possible  Basic of treatment of illness
quality of life individuals whatever their disease  Sickness was a punishment for wrongdoing &
or disability, until death. that the signs of illness were evidenced of the
NURSING AS A PRACTICE presence of evil spirits
 Theoretical knowledge  ‘tawas ceremony’
 Clinical experience and Earliest Organized Nursing
 Technical skills  Nurses were men: middle ages
PURPOSE:  Notable: Knights of Jerusalem, Teutonic Knights
1. Schools should emphasize on theoretical and the Knights of St. Lazarus
knowledge and technical skills derived from a very  12th & 13th centuries: men and women were
rich clinical experience since nursing is a nurses
multifaceted practice.  Founded the Augustinian Sisters of the Hotel
2. Emphasis on technical skills and the manner of Dieu in Paris, world oldest order of nuns
appropriate applications in various clinical devoted purely to nursing - called “lay sisters”
situations is necessary, these nurses are skilled for Day Ages of Nursing
example in the art of finding a vein to inject a  Occured from 18th century to mid-19th century
needle. For an appropriate parenteral infusion.  Nursing condition was at it worst level due to low
3. Adequate theoretical knowledge and clinical standards of caregivers (wayward nurses of ill-
experience produces nurses who are intelligent repute, prostitutes, imprisoned men & women)
enough to know the why and wherefores of their  Nurses were uneducated in the proper care of
practice nurses who are intelligent enough to know the sick and dying.
the why and wherefore of their practice and Golden Age of Nursing
therefore tend to have correct judgement of any  C
nursing situations they are confronted with  In 1663, St Vincent de Paul founded the sisters
4. A synergy on the 3 aspects of nursing of Charity who visited the sick in their homes.
RECEPIENTS OF CARE  The Patron Saints of nurses: Agatha, Alexius,
Patients Camillus de Lellis, Catherine of Alexandria,
 Refers to an individual who seek for medical Catherine of Siena, John of God, Margaret of
care for his or her suffering, feeling of discomfort Antioch, Raphael the Archangel, and
or pain quietly or without complaint St.Elizabteh of Hungary
 It is also refers to a person who is waiting for or
undergoing medical treatment and care.
 Establishment of Kaiserswerth Deaconess  Development in the profession were encouraged
Institution (Theodore Fliedner) in Germany through acquisition of graduate and posgraduate
which became the center for training nurses. studies.
 Martin Luther, a reformist and protestant also  Laws supporting education programs and
supported the establishment of community practices were prompted
chests to raise funds for hospitals and nursing 4. Theory Era
home visits.  Realization that practice must be joined with
Military Nursing theory happened
Florence Nightingale - emerged to be such a  Contemporary practice: theory - practice and
great influence in the prevention of illness and practice - theory development (research)
promotion of health through caring for wounded PHILOSOPICAL VIEWS IN NURSING THEORY
soldiers for the Crimean war. She introduced the 1. ASCETISM
principles of personal and communal hygiene for  Refers to a basic lifestyle devoid of luxuries
the injured soldiers, obtained medical supplies,  Devotion to the spiritual life is present
organized a good food supply and generally  Emphasizes services and simplicity
established sanitary conditions such as hand  Nursing work is a form of charity from which
washing, getting fresh air and sunshine. (Lady hard work in nursing have originated
with the Lamp) 2. ROMANTICISM
Josephine Bracken (wife of Jose Rizal),  The result of the industrial revolution
Melchora Aquino (Tandang Sora), Trinidad emphasizing materialism
Tecson (Mother of Biak na Bato) cared for the  Nurses were held in a pedestal due to their
wounded soldiers from Philippine revolution. white uniforms
Rose Sevilla de Alvaro - convertede their house  Because of such romantic notion, man young
into quarters & Hilaria de Aguinaldo - wife of women were persuaded to took up nursing
Emilio Aguinaldo, organized the Filipino Red Cross 3. PRAGMATISM
PROFESSIONAL NURSING  FOCUS: providing immediate health delivery
 First nursing educational program (UST, 1879) especially during war time
 Introduced by American nurse in 1900s -  Educated nurses were assisted by other health
Nursing School in Iloilo, the Union Mission care workers in the practice of nursing by
Hospital (Iloilo Mission Hospital in 1906, it had identifying patient’s problems, providing
the distinction of first trained nurses in the diagnosis and interventions
Philippines in 1909. 4. HUMANISM
 In 1919, Act no. 2808, the first Nursing Law  FOCUS: human values and concerns
(True Nursing Law) was enacted regulating the  Important: understand human interrelationship
practice of Nursing Profession in the Philippines.  Nursing became more human - oriented and
 1920 - First Board exam was held service driven
 In 1953 - Republic Act 877 (Nursing Practice THE EVOLUTION OF NURSING
Law) was approved. 1. PRACTICE - Lowest level, intuitive or primitive, it
 The Board of Nursing was created by virtue of was a calling and an extreme desire to serve the
RA 4704 followed by the Philippine Nursing Act sick member of the family
of 1991, RA 7146 2. EDUCATION - primarily initiated by Florence
 R.A. 9173 (Philippine Nursing Act of 2002) Nightingale, apprenticeship, Hospital Nursing
enacted by Pres Gloria Macapagal - Arroyo on schools were established
July 2, 2002. 3. RESEARCH - added to nursing knowledge for
HISTORICAL ERAS IN NURSING EDUCATION nurses to critically think and make scientific
1. Curriculum Era decisions.
 Nursing educators teach based on the provided 4. THEORIES - was developed, taught and
curriculum discussed coming from the findings of research
 Those who seek to become a nurse had to and continuously pursued to enhance nursing
know, learn, and experience same things practice.
2. Research Era
 Nurses seek knowledge through research to CHAPTER 2: THE NURSING PROFESSION
enhance practice and make it evidence - based Occupation - Refers to work that takes up a
 Nursing journals, articles, researchers and person’s time and energies
dissertations become common.  Also know as “job”
3. Graduate Education Era  What a person does to pass time and make a
 Graduate programs were offered by several living
nursing schools  Primary motivator: ‘monetary compensation &
satisfaction of personal goals’
Profession - referred to people who entered the  Members adhere to a code of ethics
religious life who professed to live in poverty,  Professionals are well rewarded and achieve
obedience and chastity satisfaction in their chosen profession.
 It is what a person has professed to have Ernest Greenwood’s (Characteristics of a
studied as a subject or matter carefully Profession)
 A professional is someone with something to SYSTEMATIC THEORY - There is knowledge from
say on the subject at hand. Also, he is someone the program of studies
who has acquired formal training and education AUTHORITY - has control over the nature and
with passing rigorous licensure examination extent of services they render
 A profession is a group while professional is the COMMUNITY SANCTION - Subject to licensure or
person certification by the state
 A professional is differentiated from an amteur ETHICAL CODE - Standards of behavior being
who may also know the same things but does so adhered by professionals
merely as a hobby. CULTURES - Well career oriented which leads to
 A profession has an institutionalized goal or high personal involvement at work and satisfaction
social mission. Individuals who pursue a LEGAL BASIS
profession continuously advance its collective  Article 3 Sec 9 of RA 9173 or the Philippine
body of knowledge toward improving Nursing Act of 2002 provides the legal basis for
professional practice. the legal basis for the maintenance of the
 A profession contributes to making the world nursing profession in the Philippines.
better place to live in.  The Board of Nursing shall monitor and enforce
 It it profession that requires special knowledge, quality standards of nursing practice necessary
skills, and preparation for the promotion of to ensure the maintenance of efficient, ethical
health and prevention of illness and technical, moral and professional standards
 Professional is someone who has acquired in the practice of nursing taking into account the
formal training and is conferred a baccalaureate health needs of the nation
degree and passes a rigorous licensure CORE COMPETENCIES
examination 1. Provide patient - centered care
 The work of a professional requires a person’s 2. Work in interdisciplinary teams
mental faculties and ability to work creatively 3. Employ evidence - based practice
 The motivation to take up a profession 4. Apply quality improvement
transcends monetary benefits. Service rather 5. Utilize informatics
than economic benefits is the primary KEY AREAS OF RESPONSIBILITIES IN
consideration PRACTICE
 Nursing as a profession is respected. Patient Care Competencies
“Professionalism is knowing how to do it, when  Safe and quality nursing core
to do it, and doing it”  Health education
VOCATION  Communication
 Derived from the Latin word vocare “to call or to  Collaboration
name” or “calling” Empowering Competencies
 It refers to the talents and gift God gave man  Legal responsibility
 Nursing is a Christ - like vocation  Ethico - moral responsibilities
 Nightingale herself believed that God talked to  Personal & professional development
her in her dream and called her to become a Enhancing Competencies
nurse  Research
 Everyone is welcome to choose nursing as a  Quality improvement
profession but only those who have the real Enabling Competencies
calling will be able to stay in the profession to  Management of resources and environment
serve those who are in need.  Records management
CAREER vs. JOB Personal Qualities of a Professional Nurse
Career - life long work, a commitment, way of 1. Justice - being correct, righteous, fair and
personal growth and means of higher levels of impartial
responsibility. 2. Prudence - the nurse exercise sound judgement
Job - short term with gratification coming from in practical matters
payment for hours worked or monetary satisfaction 3. Fortitude - the nurse take courage and control of
only. responses made to difficulties and danger
CRITERIA 4. Temperance - the nurse exercises rational
 Organized internally. control of life’s essential functions, basic emotional
 Motivated by altruism, members working in drives, and moderation in all aspects.
some sense for the good of society.
CORE VALUES OF NURSING PROFESSIONALS
1. Respect
2. Excellence
3. Leadership
4. Innovation
5. Comparison
“The Character of the Nurse is as Important as the
Knowledge she Possesses”
-Carolyn Jarvis