Marcelo Q. Buenavista Jr.

PERIODS OF NURSING
HISTORY
 Intuitive Period

 Apprentice Period

 Educative Period

 Contemporary Period
 INTUITIVE PERIOD
 Prehistoric Early Christian Era
 More on intuition
 NOMADS – travel from one place to
another
 Survival of the fittest
 “Best for the most” – motto
 Sickness is due to “voodoo”
 Performed out of feeling of compassion for
others
 Performed out of desire to help
 Performed out of wish to do good
 Nursing is given by the WOMEN
 INTUITIVE PERIOD
 SHAMAN – uses white magic to counteract the
black magic
 They are the doctors during those time.
 TREPHINING – drilling the skull
 Used to treat Psychotic patients
 Psychotic patients are believed to be possessed by
evil spirits.
 Growth of religion – most important thing that
happened
 Growth of civilization
 Law of self preservation – inspire man in search of
knowledge
 RISE IN CIVILIZATION
 From the mode of Nomadic life  agrarian
society  gradual development of urban
community life
 Existence of means of communication
 Start of scientific knowledge  more
complex life  increase in health problems
 demand for more nurses
 Nursing as a duty of SLAVES and WIVES.
NURSING DID NOT CHANGE but there was
progress in the practice of Medicine.
 Care of the sick was still closely allied with
superstitions, religion and magic
 RISE IN CIVILIZATION
 NearEast – birth place of 3 religious
ideologist:
 Judaism
 Christianity
 Mohammedism or Islam

- Near East culture was adopted by the Greeks

and Romans combine wit the wonders of the
Far East by returning crusaders and explorers
improved and was carried to Europe during the
Renaissance Period that resulted to greater
knowledge then to the New World by the Early
settlers.
 RISE IN CIVILIZATION
 New World – a tiny area known as
birth of monotheism that lies
between Tigris and Euphrates River
in the Nile River arose the cultures of
Babylonia, Egypt and Hebrew.

MONOTHEISM – believer of one God

 BABYLONIANS
 CODE OF HAMMURABI
1strecording on the medical practice
Established the medical fees
Discouraged experimentation
Specific doctor for each disease
Right of patient to choose treatment
between the use of charms, medicine, or
surgical procedure
 EGYPTIANS
 ART OF EMBALMING
 Mummification
 Removing the internal organs of the dead body
 Instillation of herbs and salt to the dead
 Used to enhance their knowledge of the human
anatomy. Since work was done and performed
on the dead, they learned nothing of Philosophy

 “THE 250 DISEASES”

 Documentation about 250 diseases and
treatments
 HEBREW
 Teachings of MOSES
 Created Leviticus
 Father of sanitation
 Practice the values of “Hospitality to strangers” and the
“Act of Charity” – contained in the book of Genesis
 LEVITICUS – 3rd book of the Old Testament
 Laws controlling the spread of communicable diseases
 Laws governing cleanliness
 Laws on preparation of food
 Purification of man and his food
 The ritual of CIRCUMCISION – on the 8th day after birth
 MOSAIC LAW
 Meant to keep Hebrews pure so that they may enter the
sanctuary without affronting God
 Meant as a survival for health and hygienic reason only
 CHINA
 Use of pharmacologic drugs
 “MATERIA MEDICA”
 Book that indicates the pharmacologic drug used
for treatment
 No knowledge on anatomy
 Use of wax to preserve the body of the dead
 Method of paper making
 FACTORS THAT HAMPERED THE ADVANCEMENT
OF MEDICINE:
 Baby boys given girl’s name
 Prohibits dissecting of human body thus thwarting
scientific study
 INDIA
 SUSHURUTO
 1st recording on the nursing practice
 Hampered by Taboos due to social structures and
practices of animal worship
 Medicine men built hospitals
 Intuitive form of asepsis
 There was proficient practice of Medicine and
Surgery
 NURSES QUALIFICATIONS: Lay Brothers, Priest
Nurses, combination of Pharmacist, Masseurs, PT,
cooks
 There was also decline in Medical practice due to
fall of Buddhism – state religion of India
 GREECE
 AESCULAPUS
 Father of medicine in Greek mythology
 HIPPOCRATES
 Father of modern medicine
 1st to reject the idea that diseases are caused by evil
spirits
 1st to apply assessment
 Practice medical ethics
 CADUCEUS
 Insignia of medicine
 Composed of staff of travellers intertwined with 2
serpent (the symbol of Aesculapus and his healing
power). At the apex of the staff are two wings of Hermes
(Mercury) for speed.
 NURSES  function of untrained slaves
 ROMANS
 Proper turnover for the sick people
 “If you’re strong, you’re healthy” –
motto
 Transition from Pagan to Christianity
 FABIOLA
Was converted to Christian and later she
converted her home to a hospital and
used her wealth for the sick.
 1st hospital in the Christian world
 APPRENTICE PERIOD
 11thcentury  1836
 On-the-job training period
 Refers to a beginner (on-the-job training).
It means care performed by people who
are directed by more experienced nurses
 Starts from the founding of Religious
Orders in the 6th century through the
Crusades in the 11th century (1836 – when
the deaconesses School of Nursing was
established in Kaiserswerth, Germany by
Pastor THEODORE FLEIDNER)
 APPRENTICE PERIOD
 There was a struggle for religious, political,
and economic power
 Crusades took place in order to gain
religious, political, and economic power or
for adventure
 During the Crusade in this period, it
happened as an attempt to recapture the
Holy Land from the Turk who obtained and
gain control of the region as a result of
power struggle. Christians were divided
due to several religious war and Christians
were denied visit to The Holy Sepulcher.
 MILITARY RELIGIOUS ORDERS
AND THEIR WORKS
 KNIGHTS OF ST. JOHN OF JERUSALEM
(ITALIAN)
 Alsocalled as “Knights of the Hospitalers”
 Established to give care
 TEUTONIC KNIGHTS (GERMAN)
 Took subsequent wars in the Holy Land
 Cared for the injured and established hospitals
in the military camps
 KNIGHTS OF ST.LAZARUS
 Carefor those who suffered Leprosy, syphilis,
and chronic skin diseases
 ALEXIAN BROTHERS
 A monasteric order founded in 1348. They established
the Alexian Brothers School of Nursing, the largest
School under religious auspices exclusively in US and it
closed down in 1969

 ST. VINCENT DE PAUL

 He organized the charity group called the “La Charite”
and the “Community of Sisters of Charity” composed of
women dedicated in caring for the sick, the poor,
orphaned, and the widowed. He founded the “Sisters of
Charity School of Nursing” in Paris, France where
Florence Nightingale had her 2nd formal education in
Nursing.

 LOUISE de GRAS
 Was the 1st Superior and co-founder of the Community of
Sisters of Charity
 NURSING SAINTS
 ST. CLAIRE OF ASSISI
 Took vows of poverty, obedience to service and chastity
 Founded the 2nd order of St. Francis of Assisi
 “the poor Claire”

 ST. ELIZABETH OF HUNGARY

 The patroness of Nursing
 A princess
 Sees her calling to give care for the sick
 Fed thousands of hungry people

 St. CATHERINE OF SIENA

 “Little Saint” – took care of the sick as early as 7y/o
 “1st Lady with a Lamp”
 RISE OF RELIGIOUS NURSING
ORDER
 Orders of St. Francis of Assisi
 1st order – founded by St. Francis
 2nd order “the poor Claire” – founded by St.
Claire
 3rd “the tertiary order”

 Beguines
 Oblates
 Benedictines
 Ursulites
 Augustinians
 DARK PERIOD OF NURSING
 From 17th century – 19th century
 Also called the Period of Reformation until the American
Civil War
 Hospitals were closed
 Nursing were the works of the least desirable people
(criminals, prostitutes, drunkards, slaves, and opportunists)
 Nurses were uneducated, filthy, harsh, 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.
 The conflict swept everything connected to Roman
Catholicism in schools, orphanages, and hospitals
 DARK PERIOD OF NURSING
 THEODORE FLIEDNER
 (apastor) reconstituted the Deaconesses and
later be established the School of Nursing at
Kaiserswerth, Germany where Florence
Nightingale had her 1st formal training for 3
months as nurse
 FLORENCE NIGHTINGALE
 Practiced her profession during the Crimean
War
 “Lady with a Lamp”
 From a well-known family
 Went to Germany to study
 EDUCATIVE PERIOD
 Florence Nightingale era
 Began in June 15, 1860 when Florence Nightingale School of
Nursing opened at St. Thomas Hospital in London England,
where 1st program for formal education of Nurses began
and contributed growth of Nursing in the US
 FACTORS THAT INFLUENCED DEVELOPMENT OF NURSING
EDUCATION:
 Social forces
 Trends resulting from war
 Emancipation of women
 Increased educational opportunities

 FLORENCE NIGHTINGALE
 Mother of Modern Nursing
 Lady with the Lamp
 Born on May 12, 1820 in Florence, Italy
 Her SELF-APPOINTED GOAL – to change the profile of Nursing
 She compiled notes of her visits to hospitals, her observations
of sanitation practices and entered Deaconesses School of
Nursing at Kaiserswerth, Germany for 3 months.
 EDUCATIVE PERIOD
 FLORENCE NIGHTINGALE
 Became the Superintendent of the Establishment for
Gentle Women during the Illness (refers to the ill
governess or instructors of Nursing
 She disapproved restriction on admission of patient and
considered this unchristian and contrary to health care.
 Upgraded the practice of Nursing and made Nursing a
honorable profession
 Led other nurses in taking care of the wounded and sick
soldiers during the Crimean War
 She was designated as Superintendent of the Female
Establishment of English General Hospital in Turkey
during the Crimean War
 She reduced the casualties of war by 42%-2% thru her
effort by improving the practice of sanitation techniques
and procedure in the military barracks
 EDUCATIVE PERIOD
 THE CONCEPTS OF FLORENCE NIGHTINGALE ON
NURSING SCHOOL:
 School of Nursing should be self-supporting not subject
to the whimps of the Hospital.
 Have decent living quarters for students and pay Nurse
instructors
 Correlate theories to practice
 Support Nursing research and promote continuing
education for nurses
 Introduce teaching knowledge that disease could be
eliminated by cleanliness and sanitation and Florence
Nightingale likewise did not believed in the Germ Theory
of Bacteriology.
 Opposed central registry of nurses
 Wrote Notes on Nursing, “What it is and what it is not.”
 Wrote notes on hospitals
 EDUCATIVE PERIOD
 OTHER SCHOOLS OF NURSING
 Bellevue Training School for Nurses – New York City
 Alexian Brothers Hospital School of Nursing in US
exclusively for men. It opened in 1348 and it closed
down in 1969.

 LINDA RICHARDS – the first graduate nurse in US.

Graduated in September 1, 1873.

 2 NURSING ASSOCIATION / ORGANIZATIONS THAT

UPGRADED NURSING PRACTICE IN US:
 American Nurses Association
 National League for Nursing Education
 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
Universities
 CONTEMPORARY PERIOD
 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 development of
disposable equipment and supplies that relieved the
tedious task of Nurses.
 Development of the expanded role of Nurses
 CONTEMPORARY PERIOD
 FACTORS AFFECTING NURSING TODAY:
 Economics

 Consumer’s Demand

 Family Structure

 Information and Telecommunications

 Legislation
 HISTORICAL PERSPECTIVE
 Women’s Roles

 Religion

 War

 Societal Attitudes
 HISTORICAL PERSPECTIVE
 WOMEN’S ROLES
 The role as a wife, mother, daughter, sister has
always been included in the care of their family
 They cared for their infants, members of the
family and members of the community (It
could be said that Nursing have its roots in the
home)
 Has the will to serve for others (subservient)
 The care provided were related to physical
maintenance and comfort
 They care given were humanistic, nurturing
comforting and supporting
 HISTORICAL PERSPECTIVE
 RELIGION
 Played a significant role in the development of Nursing
 The Christian values of LOVE THY NEIGHBOR AS THY
SELF, PARABLE OF THE GOOD SAMARITAN had a
significant impact on Nursing
 CHRISTIANITY – the greatest impact in the influence of
religion in the development
 The religious values of self-denial, Spiritual Calling,
Devotion to Duty, and Hard Work dominated Nursing
throughout the history and led to the development.
 Knights’ contributions, Fabiola’s contributions, the saints
and other personalities
 Deaconesses – Theodore Fliedner
 HISTORICAL PERSPECTIVE
 WAR
Crimean War (Arm conflict between
England and allies Turkey, Sardinia vs.
Russia); 1854-1856
Florence Nightingale emerged and
became well-known (Crimean War)
She was asked by Sir Sidney Herbert of the
British war department to recruit contingent
of female nurses to provide care to the sick
and injured in Crimea.
She transformed military camps into
hospitals by setting up sanitation process:
hand washing and washing clothes regularly
 HISTORICAL PERSPECTIVE
 WAR
 American Civil War (1861-1865)
 Harriet Tubman and Sojourner Truth – provided care
and safety to slaves fleeing to the North on the
Underground Railroad
 Mother Biekerdyke and Clara Barton – searched the
battlefield and gave care to injured and dying soldiers
 Walt Whitman And Loiusa May Alcott – volunteered as
nurses to give care to injured soldiers in military hospitals
 World War II
 Created acute shortage of care
 Cadet Nurse Corps – established in response to markes
shortage of nurses
 Auxiliary health care workers became prominent
 Practical Nurses, aides, and technicians provided much of
the actual nursing care under the instruction and
supervision of better prepared nurse
 Medical specialties aros to meet the needs of hospitalized
clients
 HISORICAL PERSPECTIVE
 SOCIETAL ATTITUDES
 Nursing was without organization, no education, and social
status
 Women’s role was – in the home and no respectable woman
should have a career
 Victorian Middle Class Women – were just wives to their
husbands and children
 Nurses were poorly educated, some were incarcerated criminals
– This was reflected in the book written by Charles Dickens
through the character of Sairy Gamp – who cared for the
patients by stealing from them, physically abused them. This
literary works has greatly affected social attitudes about nursing,
the negative impression and image of nurses up to the
contemporary period.
 Guardian Angel or Angel of Mercy – image arose in the latter
part of 19th century because of work of Florence Nightingale in
the Crimean War. She brought respectability to the nursing
profession, nurses were viewed as noble, compassionate, moral,
religious, dedicated, and self-sacrificing
 Doctor’s handmaiden – image arising in the early 19th century
; this image evolved when women had yet to obtain the right to
vote; the family structures were highly paternalistic, and when
the medical profession portrayed increasing use of scientific
knowledge that was viewed as male domain.
 NURSING LEADERS
 Florence Nightingale

 Clara Barton

 Lillian Wald

 Lavinia L. Dock

 Margaret Higgins Sanger

 Mary Breckinridge
 NURSING LEADERS
 FLORENCE NIGHTINGALE
 Contributions are well documented
 Lady with the Lamp
 She was the 1st nurse to exert political pressure
on government
 Notes on Nursing: What It is and What It Is Not
– her greatest achievement ; made her be
recognized as nursing’s 1st scientist-theorist
 Born on a wealthy and intellectual family
 She was given an honorarium of 4500 and
used it to develop Nightingale Training School
for Nurses, which was opened in 1860.
 NURSING LEADERS
 CLARA BARTON
A school teacher who volunteered as nurse
during the American Civil War
 Her responsibility was to organize the nursing
services
 Established the American Red Cross

 LILIAN WALD
 Founder of Public Health Nursing
 Wald and Mary Brewster were the 1st one to
offer trained nursing services to the poor in the
New York slums
 NURSING LEADERS
 LAVINIA L. DOCK
 Feminist, prolific writer, political activist,
suffragette
 Friend of Wald
 She participated in protest movements for
women’s rights which granted women to vote.
 Campaigned for legislation to allow nurses
rather than physicians to control their
professions
 Founded the American Society of
Superintendents of Training Schools for Nurses
on the United States and Canada – precursor to
the current National League for Nursing
 NURSING LEADERS
 MARGARET HIGGINS SANGER
Publichealth nurse in New York
Had a lasting impact on women’s health
care
Imprisoned for opening the 1st birth
control information clinic in America
Considered to be the founder of
“Planned Parenthood”
 NURSING LEADERS
 MARY BRECKINRIDGE
Notable pioneer nurse
Established “Frontier Nursing Service
(FNS)”
She worked with the American
Committee for Devastated France,
distributed food, clothing, and supplies
to rural villages and taking care of the
sick children.
 HISTORY OF NURSING
(PHILIPPINE SETTING)
 EARLY BELIEFS AND PRACTICES
Beliefs About Causation of Diseases:
Caused or inflicted by other person (enemy
or witch)
Evil spirits

Beliefs That Evil Spirits Could Be Driven

Off By Person With Powers To Expel Bad
Spirits:
Believed in Gods of healing
Word doctors – priest physicians
Herbolarios – herb doctors
 HISTORY OF NURSING
(PHILIPPINE SETTING)
 EARLY CARE OF THE SICK
 HERBICHEROS – herbmen who practice
witchcraft
 MANGKUKULAM / MANGANGAWAY – a person
suffers from disease without any identified
cause and were believed bewitched by such
 Difficult child birth and some diseases (PMAO)
attributed to (NONO) midwives
 Difficult birth, witches were supposed to be the
cause, gunpowder exploded from a bamboo
pole close to the head of the mother to drive
evil spirits
 HISTORY OF NURSING
(PHILIPPINE SETTING)
 EARLY HOSPITALS:
Hospital Real de Manila – 1577
1sthospital established
Gov. Francisco de Sande
To give service to king’s Spaniard soldiers

San Lazaro Hospital – 1578

FrayJuan Clemente
Named after the Knights of St. Lazarus
Hospital for the lepers
 HISTORY OF NURSING
(PHILIPPINE SETTING)
 EARLY HOSPITALS:
 Hospital de Indios – 1586
 Franciscan Orders
 Hospital for the poor Filipino people

 Hospital de Aguas Santas – 1590

 Fray Juan Bautista
 Named after its location (near spring) because people
believed that spring has a healing power.

 San Juan de Dios Hospital – 1596

 For poor people
 Located at Roxas Boulevard
 HISTORY OF NURSING
(PHILIPPINE SETTING)
 PERSONAGES:
 Dona Hilaria de Aguinaldo
 1stwife of Emilio Aguinaldo
 Established Philippine Red Cross – February 17, 1899

 Dona Maria Agoncillo de Aguinaldo

 2nd wife of Emilio Aguinaldo
 1st president of Philippine Red Cross (Batangas
Chapter)

 Josephine Bracken
 Helped Rizal in treating sick people
 HISTORY OF NURSING
(PHILIPPINE SETTING)
 PERSONAGES:
 Melchora Aquino
 Took care of the wounded Katipuneros

 Anastacia Giron Tupaz

 Founder of Filipino Nurses Association – established
on October 15, 1922
 1st Filipino chief nurse of PGH
 1st Filipino Superintendent of Nurses in the Philippines

 Francisco Delgado
 1st president of Filipino Nurses Association
 HISTORY OF NURSING
(PHILIPPINE SETTING)
 PERSONAGES:
 Cesaria Tan
 1st Filipino to receive Masteral Degree in Nursing abroad

 Socorro Sirilan
 Pioneer in Social Service at San Lazaro Hospital
 Also the chief nurse

 Rosa Militar
 Pioneer in nursing education

 Socorro Diaz
 1st editor of PNA magazine called, “The Message”

 Conchita Ruiz
 Full time editor of the PNA newly named magazine, “The
Filipino Nurse
 HISTORY OF NURSING
(PHILIPPINE SETTING)
 EARLY NURSING SCHOOLS
IloiloMission Hospital and School of
Nursing
Established in 1906 under the supervision of
Rose Nicolet (American)
Nursing course – 3yrs.
Produced 1st batch of Nursing graduates in
1909 – 22 nurses
1st TRAINED NURSES:
 Nicasia Cada
 Felipa Dela Pena
 Dorotea Caldito
April 1944 – 1st Nursing Board Exam at Iloilo
 HISTORY OF NURSING
(PHILIPPINE SETTING)
 EARLY NURSING SCHOOLS
PGH School of Nursing – 1907
St. Paul School of Nursing – 1907
St. Luke’s School of Nursing – 1907
UST – 1946
MCU – 1947
Fatima – 1947
 NURSING: DEFINITIONS
 NURSING (as an art)
 Isthe art of caring sick and well individual. It
refers to the dynamic skills and methods in
assisting sick and well individual in their
recovery and in the promotion and
maintenance of health

 NURSING (as a science)

 Is the scientific knowledge and skills in
assisting individual to achieve optimal health.
It is the diagnosis and treatment of human
responses to actual or potential problem
 NURSING: DEFINITIONS
 FLORENCE NIGHTINGALE
 Nursing is the act of utilizing the environment
of the patient to assist him in his recovery.

 VIRGINIA HENDERSON
 Nursing is the act of assisting the individual,
sick or well, in the performance of those
activities contributing to health or its recovery
(or to a peaceful death) that he would perform
unaided if he had the necessary strength, will,
or knowledge, and to do this in such a way as
to help him gain independence as rapidly as
possible.
 NURSING: DEFINITIONS
 CANADIAN NURSES ASSOCIATION (CNA)
 Nursing is a dynamic, caring, helping relationship in
which the nurse assist the client to achieve and obtain
optimal health. – 1987
 THEMES THAT ARE COMMON TO THESE DEFINITION:
 Nursing is caring
 Nursing is an art
 Nursing is a science
 Nursing is client-centered
 Nursing is holistic
 Nursing is adaptive
 Nursing is concerned with health promotion, health
maintenance, and health restoration
 Nursing is a helping profession
 NURSING: DEFINITIONS
 AMERICAN NURSES ASSOCIATION (ANA)
 1973
 Nursing is direct, goal oriented, and adaptable to the needs
of the individual, the family, and community during health
and illness.
 1980
 Nursingis the diagnosis and treatment of human responses
to actual or potential health problems.
 1995
 ANA
acknowledges FOUR ESSENTIAL FEATURES OF
CONTEMPORARY NURSING PRACTICE:
 Attention to the full range of human experiences and
responses to health and illness without restriction to a
problem-focused orientation.
 Integration of objective data with knowledge gained from
understanding of the client or group’s subjective experience.
 Application of scientific knowledge to the processes of
diagnosis and treatment.
 Provision of caring relationship that facilitates health and
 NURSE: DEFINITION
 NURSE
 Comes from a Latin word “to nourish” or “to
cherish
 One who cares for the sick, the injured, and the
physically, mentally, and emotionally disabled
 One who advise and instruct individuals,
families, groups and communities in the
prevention, treatment of illness and diseases
and in the promotion of health.
 An essential member of a health team who
cares for individuals, families and communities
in disease and illness prevention and in the
promotion of health and healthy environment.
 PATIENT: DEFINITION
 PATIENT
 Comes from a Latin word, “to Suffer” or “to
Bear”
 An individual who is in the state of physical,
mental, and emotional imbalance
 An individual who seeks for nursing assistance,
medical assistance, or for surgery due to
illness or a disease.
 Is an individual who is waiting or undergoing
medical or surgical care. One who is physically
or mentally disabled.
 NURSING PROGRAMS
 Licensed Vocational Nursing Program / Licensed Practical Nursing
Program (LVN,LPN)

 REGISTERED NURSING PROGRAMS:

 Community College / Associate Degree

 Diploma Program

 Baccalaureate Degree Program

 GRADUATE NURSING EDUCATION:

 Master’s Degree

 Doctoral Degree

 External Degree
 LVN / LPN
 LicensedVocational Nursing Program /
Licensed Practical Nursing Program
(LVN,LPN)
 Last for 9 – 12 months
 Provide both classroom and clinical
experiences
 Provided by the community colleges,
vocational schools, hospitals, or other
independent health agencies.
 Under supervision of RN
 Prepares students how to give basic direct
technical care
 Graduate takes NCLEX – PN to obtain license as
a practical or vocational course.
 REGISTERED NURSING
PROGRAMS
 Community College / Associate Degree
 Arose in early 1950s
 2-year program
 Technical nurse or bedside nurse
 ADN (AA or AS)

 Diploma Program
 3-year program
 Hospital-based
 Provide rich clinical experience for nurses
 Associated with colleges and universities
 REGISTERED NURSING
PROGRAMS
 Baccalaureate Degree Program
 Early Baccalaureate Program  5-year program (3-year
diploma program in addition to 2 years of liberal arts)
 Today’s Baccalaureate Degree Program  4-5-year
program
 Offer courses in the liberal arts, sciences, humanities,
and nursing
 Graduates must fulfill both the degree requirements of
the college or university and the nursing program before
being awarded a baccalaureate degree.
 BSN
 Also admit RN who have diplomas or associate degrees.
 Much background
 More theories
 GRADUATE NURSING
EDUCATION
 Master’s Degree
 1.5 – 2-year program
 Encourage the development of graduate study in nursing
 Major emphasis was to be research and specialization for
teaching and administration
 Provide specialized knowledge and skills that enable nurses to
assume advanced roles in practice, education, administration,
and research.
 MAN / MSN

 Doctoral Program
 PhD, DNS, ND
 Further prepares the nurse for advanced clinical practice,
administration, education, and research.
 Content and approach vary among doctoral programs.
 All emphasized research
 No specific time
 EXTERNAL DEGREE
 External Degree
Offers credit for expertise gained
outside formal classroom setting
Seminars
post- grad courses
No specific time
Short courses
 ROLES OF A NURSE
 Caregiver
 Communicator
 Teacher
 Client Advocate
 Counselor
 Change Agent
 Leader
 Manager
 Case Manager
 Research Consumer
 Role Model
 Administrator
 Expanded Career Roles
 ROLES OF A NURSE
 Caregiver
 Primary goal
 TYPES OF CARE:
 FullCare  for completely dependent patient
 Partial Care  for partially dependent patient
 Supportive-Educative care  to assist clients in attaining
their highest possible level of health and wellness; for
learnings

 Communicator
 Integral to all nursing roles
 Nurses communicate with the client, support persons,
other health professionals, and people in the community
 Nurses identify client problems and then communicate
these verbally or in writing to other members of the
health team
 ROLES OF A NURSE
 Teacher
 Nurses help clients learn about their health and the health care
procedure they need to perform to restore or maintain their
health.
 Nurses assesses the client’s learning needs and readiness to
learn, sets specific learning goals in conjunction with the client,
enacts teaching strategies, and measures learning.
 Nurses also teaches unlicensed assistive personnel to whom
they delegate care, and they share their expertise with other
nurses and health professionals.

 Client Advocate
 Acts to protect the client
 Nurse may represent the client’s needs and wishes to other
health professionals, such as relaying the client’s wishes for
information to the physician.
 Nurses assist clients in exercising their rights and help them
speak up for themselves
 ROLES OF A NURSE
 Counselor
 Helping a client recognize and cope with stressful psychologic
or social problems, to develop improved interpersonal
relationships, and to promote personal growth.
 Involves providing emotional, intellectual and psychologic
support.
 Nurses counsel primarily healthy individuals with normal
adjustment difficulties and focuses on helping the person
develop new attitudes, feelings, behaviors by encouraging the
client to look at alternative behaviors, recognizing the choices,
and develop sense of control.

 Change Agent
 Assisting others to make modifications in their own behavior.
 Nurses also often act to make changes in a system if it is not
helping client return to health.
 ROLES OF A NURSE
 Leader
 Influences others to work together to accomplish a
specific goal.
 Can be employed at different levels: individual client,
family, groups of clients, colleagues, or the community

 Case Manager
 Work with the multidisciplinary health care team to
measure the effectiveness of the case management plan
and to monitor outcomes.
 Works with primary or staff nurses to oversee the care of
a specific caseload.
 Primary nurse or provides some level of direct care to
the client and family
 Helps ensure that care is oriented to the client, while
controlling costs.
 ROLES OF A NURSE
 Research Consumer
 Often use research to improve client care
 Have some awareness of the process and language of
research
 Be sensitive to issues related to protecting the rights of
human subjects
 Participate in the identification of significant
researchable problems
 Be a discriminating consumer of research findings

 Role Model
 Has good physical appearance
 Practices proper hygiene
 Practices healthy lifestyle
 ROLES OF A NURSE
 Administrator
 Assumes middle management position
 Connects the patient to other services of the
hospital

 Expanded Career Roles

 Nurse practitioner, clinical nurse specialist,
nurse midwife, nurse educator, nurse
researcher, and nurse anesthetist
 All of which allow greater independence and
autonomy.
 SCOPE OF NURSING
PRACTICE
 FOUR AREAS:
Promoting Health and Wellness

Preventing Illness

Restoring Health

Care of the Dying

 SCOPE OF NURSING
PRACTICE
 PROMOTING HEALTH AND WELLNESS

 Wellness – state of well-being. Engaging in

attitudes and behavior that enhance the
quality of life and maximize personal potential
 For both healthy and ill.
 Involve individual and community activities to
enhance healthy lifestyle, such as improving
nutrition and physical fitness, preventing drug
and alcohol misuse, restricting smoking, and
preventing accidents and injury in the home
and workplace.
 SCOPE OF NURSING
PRACTICE
 PREVENTING ILLNESS

The goal is to maintain optimal health

by preventing diseases
Nursing activities includes
immunizations, prenatal and infant care,
and prevention of sexually transmitted
disease.
 SCOPE OF NURSING
PRACTICE
 RESTORING HEALTH

 Focuses on the ill client

 Extends from early detection of disease to helping the
client during the recovery period
 NURSING ACTIVITIES:
 Providing direct care to the ill person: administering
medications, baths, and specific procedures and treatments
 Providing diagnostic and assessment procedures:
measuring BP and examining feces for occult blood
 Consulting with other health care professionals about
client’s problems
 Teaching clients about recovery activities: exercise that will
accelerate recovery after a stroke
 Rehabilitating clients to their optimal functional level
following physical or mental illness, injury, or chemical
addiction
 SCOPE OF NURSING
PRACTICE
 CARE OF THE DYING

 Involves comforting and caring for people of all

ages who are dying
 Includes helping clients live as comfortable as
possible until death and helping support
persons cope with death.
 Work in homes, hospitals, and extended care
facilities
 Hospices are specifically designed for this
purpose.
 BIOETHICAL ISSUES IN
NURSING
 “DO NOT RESUSCITATE” ORDER (DNR)
 Physician may order “no code” or “do not resuscitate” for
client who are in stage of terminal, irreversible illness, or
expected death. DNR order that no effort be made to
resuscitate the client in the event of respiratory or cardiac
arrest.

 ABORTION
 Termination of pregnancy before the fetus reaches the stage of
viability.

 EUTHANASIA
 “mercy killing” The act of painlessly putting to death persons
suffering from incurable or distressing disease.

 HUMAN CLONING
 Human reproduction / replication

 SEX TRANSPLANT

 PROFESSIONAL CRIMES
• CRIME – act committed in violation of Public Law
and punishable by a fine and/or imprisonment

• FELONY – serious in nature (ex. Murder)

• MISDEMEANOR – less serious in nature (ex.

Negligence)

• MANSLAUGHTER – 2nd degree crime; unintentional

• TORT – civil wrong against a person

• TYPES:
• Intentional
• unintentional
 Types of Law

Private / Civil Public Law

Criminal Law
Contract Law Torts

Felony Misdemeanor
Unintentional Intentional

Negligence/ Assault / Battery

Common Elements
Malpractice

False Imprisonment Willful Action

Failure to Invasion of Privacy

Intended to
meet
bring about
standard of
Defamation consequences
care

Must be present
Causation

Libel Slander
Duty
Breach of Duty
Foreseeability
Causation
Harm/Injury
Damage
 PROFESSIONAL CRIMES
 NEGLIGENCE
 The doing of that thing, which a reasonably
prudent person would not have done, or the
failure to do that thing which a reasonably
prudent person would have done, in like or
similar circumstance.
 Act of omission or commission

 THEORIES OF NEGLIGENCE:
 Respondeat Superior – let the superior answer ; let
the principal answer for the acts of his agent
 Res Ipsa Loquitur – the thing speaks for itself; talks
about the evidence; you cannot deny the negligence
because of the presence of evidence.
 Force Majeure – irresistible or superior force. It is a
fact or accident which human prudence can neither
foresee nor prevent
 PROFESSIONAL CRIMES
 MALPRACTICE
 Any professional misconduct, or any unreasonable lack
of skill, or fidelity in the performance of the professional
or fiduciary duties.
 For Nurses, Malpractice refers to the failure to follow a
reasonable professional standard of care, thereby,
resulting to injury of patient

 ELEMENTS OF NEGLIGENCE/MALPRACTICE:
 Duty
 Breach of Duty
 Foreseeability
 Causation
 Harm/Injury
 Damage
 PROFESSIONAL CRIMES
 INVASION OF PRIVACY
 Violationon the right of an individual to
withhold herself and her life from public
scrutiny. Violation on the right to remain alone
and the right to keep information.

 FRAUD
 False presentation of some facts with the
intention that will be acted upon by another
person.
 Willful misrepresentation
 PROFESSIONAL CRIMES
 DEFAMATION
 Derogatory remarks about a person
 Making false statements about a person that
can result to the injury of his reputation

 KINDSOF DEFAMATION:
Slander – oral defamation
Libel – written defamation

 ASSAULT
 Attempt or threat or to touch another person
unjustifiably
 PROFESSIONAL CRIMES
 BATTERY
 Assault that is carried out
 Willful touching of a person (without consent) that may
or may not cause harm
 Performing procedures without consent

 INCOMPETENCE
 Lack of knowledge or skills

 FALSE IMPRISONMENT
 Prevention of movement without consent
 Unlawful restraint or detention of another person against
his or her wishes
 CONSENT
 KINDS OF CONSENT:
 Informed Consent
 Implied Consent

 INFORMED CONSENT
 Agreement by the client to accept a course of treatment or a
procedure after complete information, including the risk of
treatment and facts relating to it, has been provided by the
physician

 ELEMENTS OF INFORMED CONSENT:

 Consent must be given voluntarily
 Consent must be given by an individual with the capacity,
competence, and understanding.
 The client must be given enough information to be the ultimate
decision maker.
 CONSENT
 NURSE’S RESPONSIBILITY
 Witnessing the exchange between the client and the
physician.
 Establish that the client really did understand, that is, was
really informed
 Witnessing the client’s signature

 PEOPLE WHO ARE NOT ALLOWED TO PROVIDE

CONSENT:
 Minors – below 18 years old; except for married and
already a parent
 Mentally ill
 Unconscious or injured in such a way that they are unable
to give consent.

 IMPLIED CONSENT
 In a life threatening situations and consent can not be