nursing as a prof, history
TRANSCRIPT
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Nursing as aProfession
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Profession
• An organization of an occupational group based on the application of
special knowledge which establishes its own rules and standards for
protection of the public & professionals
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Nursing
• A profession within the health care sector focused on
the care of individuals, families, and communities so
they may attain, maintain, or recover optimal health
and quality of life.
• Nursing is the protection, promotion, and optimization
of health and abilities, prevention of illness and injury,
alleviation of suffering though the diagnosis andtreatment of human response, and advocacy in the care
of individuals, families, communities and populations.
(ANA, 2003)
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Primary Characteristics of Nursing
as a Profession• Education
• Theory
• Service
• Autonomy
• Code of Ethics
• Ongoing research
• Caring
• Professional organization
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Flexner’s Criteria for a Profession
Compared with Nursing
Patterns of Developing Profession
• Professions are basically
intellectual
• Professions are based on a
specific body of knowledge
that can be learned
• Professions are practical as
well as theoretical
Nursing Profession
• Nurses are educated in
institutions of higher learning
& function in a responsible andaccountable manner.
• Nursing continues to develop
its own specific body of
knowledge from which nursingpractice emerges.
• Evolved in response to needs
identified by society & is
guided by ethical code.
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Flexner’s Criteria for a Profession
Compared with Nursing
Patterns of Developing Profession
• Professional work can be
taught through professional
education
• Professions have strong
internal organization
• Practitioners are guided by
altruism
Nursing Profession
• Nurses are educated primarily
in different types of degree
programs
• PNA & other bodies provide
internal organization
• Many nurses enter nursing
profession out of desire to help
others
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• Professional Nursing- an art & science dominated by an ideal of service in
w/c certain principles are applied in the skillful care of the well & the ill.
• Professional Nurse – one who has acquired the art & science of nursing
through basic education, who interprets her role in nursing in terms of
social needs for w/c it exists
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Personal & Professional
Qualities• Has faith in the fundamental values that underlie the democratic way
of life
• Has sense of responsibility for understanding
• Has faith in the reality of spiritual & aesthetic value and the awareness
& pleasure of self-development
• Has basic knowledge, skills & attitudes necessary to address present-
day social problems
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Personal & Professional
Qualities• Has skill in using written & spoken language
• Appreciates & understands importance of good health
• Has emotional balance
• Likes hard work
• Appreciates high standards of workmanship
• Accepts and tries to understand people of all sorts
• Competent to provide excellent care
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Personal Qualifications of a
Nurse• Philosophy of Life
• Good Personality
Personal appearance
Character
Attitude
Charm
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Carper’s Fundamental Patterns
of Knowing• Ethical knowing
• Personal knowing
• Aesthetic knowing
• Empiric knowing
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Ethics: the component of moral knowledge
in nursing
• Guides and directs how nurses conduct theirpractice
• Requires• Experiential knowledge of social values
• Ethical reasoning
• Focus is on:• Matters of obligation, what ought to be done
• Right , wrong and responsibility• Ethical codes of nursing
• Confronting and resolving conflicting values,norms, interests or principles
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Sources of Ethical knowing
• Nursing’s ethical codes and professional standards
• An understanding of different philosophical positions
• Duty
• Social justice
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Personal knowing: acceptance of self that is
grounded in self-knowledge and confidence
• Concerned with becoming self-aware
• Self–awareness that grows over time through
interactions with others
• Used when nurses engage in the therapeutic use of self in
practice
• Scientific competence, moral/ethical practice, insight
and experience of personal knowing
• Personal reflection
• Informed by the response of others
• Openness to experience
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Personal knowing
• Personal knowing needs to be integrated or reconciled with
professional responsibilities
• Personal Knowing is the basis of the therapeutic use of self in
the nurse patient relationship
• Perceiving self feelings, and prejudices within the situation
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Aesthetic knowing: the art of nursing
Expressed through:
◦ Actions, bearing, conduct, attitudes, interaction
◦ Knowing what to do without conscious deliberation
Involves:
◦ Deep appreciation of the meaning of a situation
◦ Moves beyond the surface of a situation◦ Often shared without conscious exchange of words
◦ Transformative art/acts
◦ Brings together all the elements of a nursing care situation to createa meaningful whole
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Aesthetic knowing
• Perceiving the nature of a clinical situation and interpreting
this information
• To respond with skilled action
• It uses the nurses intuition and empathy
• Is based on the skill of the nurse in a given situation
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Empirics: the science of nursing
Based on the assumption that what is known is accessible through the physicalsenses: seeing, touching and hearing.
◦ Reality exists and truths about it can be understood
A pattern of knowing that draws on traditional ideas of science
Expressed in practice as scientific competence
◦ Competent action grounded in scientific knowledge including theories and formal
description◦ Involves conscious problem solving and logical reasoning
◦ Nursing theory
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Empirical knowing
• Positivist science
• Knowledge is systematically organised into general laws and
theories
• Source of this knowledge• Research
• Theory
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Emancipatory knowing (Chinn and
Kramer)
• Emancipatory knowing addresses the socialand political context of nursing and healthcareand critiques the four fundamental patterns of
knowing• It recognises serious social barriers to health
and well-being
• Emancipatory knowing requires an
understanding of the nature of knowledge
• Praxis is the process of emancipatory knowing.It requires both critical reflection and action
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Fundamental patterns of knowing
Emancipat
ory
Ethical
Empiric
Personal
Aestheti
c
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Methods of turning knowing into
knowledge
• Problem based learning• An instructional method in which students work in small groups
• Used to gain knowledge and acquire problem-solving skills.
• Clinical Supervision• An exchange between practicing professionals to enable the
development of professional knowledge and skills
• Structured reflection on practice
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History of nursing in the Phils.
Early beliefs and practices
Diseases & their causes and treatment were shrouded with mysticism
& superstitions
1. Beliefs about causation of disease
2. People believed that evil spirits could be driven away by persons w/
powers to expel demons
3. People believed in special gods of healing w/ priest-physician as
intermediary.
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History of nursing
A. In the Philippines
Early Care of the Sick
“Herbmen”
“Nonos”
“Mabuting Hilot”
Health Care during Spanish Regime
- Religious orders built hospitals in different parts of the Philippines.
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History of nursing
Earliest Hospitals Established:
Hospital Real de Manila (1577)
San Lazaro Hospital (1578)
Hospital de Indio (1586)
Hospital de Aguas Santas (1590)
San Juan de Dios Hospital (1596)
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History of nursingNursing during the Philippine Revolution:
Josephine Bracken – installed field hospital in Tejeros Rosa Sevilla de Alvero – converted house into quarters for Filipino
soldiers
Dona Hilaria de Aguinaldo – organized Filipino Red Cross
Dona Maria Agoncillo de Aguinaldo – President of Filipino Red Crossbranch in Batangas.
Melchora Aquino – nursed the wounded Filipino soldiers
Capitan Salome – revolutionary leader in Nueva Ecija
Agueda Kahabagan – revolutionary leader in Laguna
Trinidad Tecson – “Ina ng Biac na Bato”
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History of nursingNursing during the Philippine Revolution:
Filipino Red Cross was established in Malolos, Bulacan Hospitals & Schools of Nursing
1. Iloilo Mission Hosp. School of Nursing (Iloilo City,1906) – ran by BaptistForeign Mission Society of america
o Miss Rose Nicolet
o Miss Flora Ernst
o April 1944 : First Nurses’ Board Exam
2. St. Paul’s Hosp. School of Nursing (Manila, 1907)
- established by Most. Rev. Jeremiah Harty, Archbishop of Manila
o Rev. Mother Melanie
o Miss E. Chambers
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History of nursingNursing during the Philippine Revolution:
Hospitals & Schools of Nursing
3. Philippine General Hosp. School of Nursing (1907)
o Elsie McCloskey-Gaches
o Anastacia Giron-Tupas
4. St. Luke’s Hosp. School of Nursing (Quezon City, 1907)
o Miss Helen Hicks
o Mrs. Vitaliana Beltran
o Dr. Jose Flores
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History of nursingNursing during the Philippine Revolution:
Hospitals & Schools of Nursing
5. Mary Johnston Hosp. & School of Nursing (Manila, 1907)
- was called Bethany Dispensary & funded by Methodist Mission
- burned down in 1945
- reopened in 1947 at Harris Memorial
6. Philippine Christian Mission Institute Schools of Nursing- 3 schools of Nursing operated by United Christian Missionary Society
of Inidianapolis, India namely:
Sallie Long Read Memorial Hosp. School of Nursing (Laoag, IlocosNorte, 1903)
Mary Chiles Hosp. School of Nursing (Manila, 1911)
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History of nursingNursing during the Philippine Revolution:
Hospitals & Schools of Nursing
Frank Dunn Memorial Hospital (Vigan, Ilocos Sur, 1911)
7. San Juan De Dios Hosp. School of Nursing (Manila, 1913)
- run by the Daughters of Charity, directed by Sister Taciana Trianes
8. Emmanuel Hosp. School of Nursing (Capiz, 1913)
- funded by the American Baptist Foreign Mission Societyo Miss Clara Pedrosa
9. Southern Islands Hosp. School of Nursing (Cebu, 1918)
- organized by Anastacia Giron-Tupas
o Miss Visitacion Perez
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History of nursingNursing during the Philippine Revolution:
Other Schools of Nursing:
1. Zamboanga General Hosp. SON (1921)
2. Chinese General Hosp. SON (1921)
3. Baguio General Hosp. SON (1923)
4. Manila Sanitarium & Hosp. SON (1930)
5. St. Paul’s SON in Iloilo City (1946)
6. North General Hosp. & SON (1946)
7. Siliman University SON (1947)
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History of nursingFirst Colleges of Nursing in the Philippines
UST College of Nursing (1946)
MCU College of Nursing (1947)
UP College of Nursing (1948)
Nursing Leaders in the Philippines:
Anastacia Giron-Tupas – founder of PNA
Cesaria Tan – 1st Filipino to receive Master’s degree in Nursing abroad Socorro Sirilan – pioneer in Hosp. Social Service in San Lazaro Hosp.
Rosa Militar – pioneer in school health education
Sor Ricarda Mendoza – pioneer in nursing education
Socorro Diaz – 1st editor of PNA magazine called “The Message”
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History of nursingNursing Leaders in the Philippines:
Conchita Ruiz – 1st full-time editor of newly named PNA magazine “The
Filipino Nurse” Loreto Tupaz – Florence Nightingale of Iloilo
Health & Nursing organizations
Early institutions for child welfare:
1) Hospicio de San Jose (Manila, 1782)2) Asylum of San Jose (Cebu)
3) Asylum of Looban (Manila)e
4) Colegio de Santa Isabel (Naga City)
5) Gota de Leche (Manila, 1907)
6) Liga Nacional Filipiniana para la Protection de la Primera Infancia
7) Pulic Welfare Board
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History of nursingHealth & Nursing organizations
Nursing Organizations:
1) Philippine Nurses Association (PNA)
2) National League of Nurses
3) Catholic Nurses Guild of the Philippines
4) Others: ORNAP, MCNAP, CCNAPI, etc.
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History of nursing in Other LandsPeriod of Intuitive Nursing
- practiced during pre-historic times among primitive tribes & lasted
through early Christian era.
- Beliefs & Practices of Pre-historic Man:
He was nomad .
Nursing was the function that belonged to women.
Believed illness was caused by black magic or voodoo.
Believed that “shaman” has the power to heal by using white magic.
Practices “trephining”
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History of nursing in Other LandsNursing in the Near East
- Beliefs and Practices
Man’s mode of living changed from nomadic to agrarian society to an
urban community life.
Means of communication & beginnings of body of scientific
knowledge were developed
Nursing remained the duty of slaves, wives, sisters / mothers
Care of the sick was still closely related to religion, superstition &
magic
3 great religious ideologies were born namely: Judaism, Christianity &
Islam
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History of nursing in Other LandsNursing in the Near East
- Contributions to Medicine & Nursing
Babylonia – Code of Hammurabi
Egypt – “art of embalming”
- recorded 250 recognized diseases
- slaves & patient’s families nursed the sick
Israel – Moses as “Father of Sanitation”
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History of nursing in Other LandsNursing in the FarEast
China – people strongly believed in spirits & demons
- practiced ancestor worship
- gave the world knowledge of materia medica
(pharmacology)
India – men of medicine built hospitals, practiced
intuitive form of asepsis
- Sushurutu made a list of functions &
qualifications of nurses
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History of nursing in Other LandsNursing in the Ancient Greece
Nursing was the task of untrained slave
Greeks introduced Caduceus, the insignia of medical profession today
Hippocrates, “Father of Scientific Medicine” was born in Greece
Nursing in Rome
Transition from pagan to Christian philosophy took place.
Romans attempted to maintain vigorous health
Care of the ill was left to slaves / Greek physicians
Fabiola made her home the first hospital in the Christian world.
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History of nursing in Other LandsPeriod of Apprentice Nursing
- period from founding of religious nursing orders in the Crusades
which began in 11th century and ended in 1835.
- period of “on the job” training
- when Crusades began
- Military religious orders were established such as:
1) Knights of St. John of Jerusalem
2) Teutonic Knights
3) Knights of St. Lazarus
- Alexian Brothers Hosp. SON: largest school of nursing under religious
order was founded
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History of nursing in Other LandsPeriod of Apprentice Nursing
- Rise of Secular Orders –when the rise of religious nursing orders for
women began.
- Only by entering a convent that a woman could follow a
career, obtain an education & perform acts of charity that her faith
would help her gain grace in heaven.
Secular Orders founded during the Period of CrusadesOrder of St. Francis of Assissi (1200 – present)
- Believed in devoting their lives to poverty & service to the poor
a. First Order
b. Second Order (Poor Clares)
c. Third Order (Tertiary Order)
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History of nursing in Other LandsPeriod of Apprentice Nursing
Secular Orders founded during the Period of Crusades
The Beguines
- Lay nurses who devoted their lives to the service of suffering
humanity
The Oblates (12th century)
Benedictines
Ursulines
Augustinians
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History of nursing in Other LandsPeriod of Apprentice Nursing
Important Nursing Personages During the Period ofApprentices Nursing
1. St. Clare – Founder of Second Order of St. Francis
Assissi
2. St. Elizabeth of Hungary – “Patroness of Nurses”
3. St. Catherine of Siena – first “Lady with a Lamp”
Hospitals were established for the care of the sick in
the 16th century.
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History of nursing in Other LandsThe Dark Period of Nursing
- extends from 17th to 19th century from period of reformation until the
US Civil War
- Nursing became the work of the least desirable women
Several leaders who sought to bring about reforms:
1) John Howard: prison reformer
2) Mother Mary Aikenhand: established Irish Sisters of Charity
3) Pastor Theodor Fliedner & Frederika Munster Fliedner: established
the Institute for the Training of Deaconesses at Kaiserwerth,
Germany (1836)
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History of nursing in Other LandsThe Dark Period of Nursing
Nursing in America
o Hotel Dieu of Montreal , a log cabin hospital was founded by Mdme
Jeanne Mance
o Pre-Civil War Nursing
In USA & Canada, religious nursing orders both Catholic & Protestant
carried out nursing
o American Reforms in Nursing
The Nurse’s Society of Philadelphia organized a school of nursing
under the direction of Dr. Joseph Warrington in 1839.
Women’s Hospital in Philadelphia established a 6 month course innursing to increase nurse’s knowledge while they worked.
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History of nursing in Other LandsThe Dark Period of Nursing
Nursing in AmericaoNursing during the Civil War
The AMA created the Committee on Training of
Nurses
Dorothea Lynde Dix: established the Nurse Corps of
the United States Army
Clara Barton: founded the American Red Cross
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History of nursing in Other LandsPeriod of Educated Nursing
- period began on June 15, 1860 when the Florence Nightingale School
of Nursing opened at St. Thomas Hospital in London.
Facts About Florence Nightingale
recognized as the “Mother of Modern Nursing”; also known as “Lady
with a Lamp”
born on May 12, 1820 in Florence, Italy
raised in England in an atmosphere of culture & affluence
Advocated for care of those afflicted w/ diseases caused by lack of
hygienic practices.
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History of nursing in Other LandsPeriod of Educated Nursing
Facts About Florence Nightingale
At the age of 31, she entered the Deaconess School at Kaiserwerth
Worked as a superintendent for Gentlewoman during illness
Upgraded practice of nursing & made nursing an honorable
profession for gentlewomen
Led nurses that took care of the wounded during the Crimean War
Place down her ideas in 2 published books: Notes on Nursing & Notes
on Hospitals
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History of nursing in Other LandsPeriod of Educated Nursing
Other Important Persons/ Groups/ Events During the Period of
Educated Nursing
Linda Richards: 1st graduate nurse in US
Dr. William Halstead : designed the 1st rubber gloves
Caroline Hampton Robb: 1st to wear rubber gloves as OR nurse
Isabel Hampton Robb: 1st principal of John Hopkins Hosp. SON
Clara Louise Maas: engaged in medical research on yellow fever
during Spanish-American War
Development of PDN, school nursing, prenatal & maternal health
nursing
f h d
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History of nursing in Other LandsPeriod of Educated Nursing
Other Important Persons/ Groups/ Events During thePeriod of Educated Nursing
Preparation of standard curriculum based on
objectives for schools of nursing (1913-1937)
Edith Cavell: “Mata Hari”, served the wounded
soldiers in World War I.
Period of contemporary
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Period of contemporary
nursing- period after World War II to present.
o Events & TrendsEstablishment of WHO by the United Nations
Use of atomic/nuclear energy for medical diagnosis & treatment
Utilization of computers for collecting data, teaching, record keeping,
billing, etc.Use of sophisticated equipment for diagnosis & therapy
Advent of space medicine brought about the development of
aerospace nursing
Health is perceived as a fundamental human right
Technological advances
Development of expanded role of the nurse