Nursing

is a
healthcare
profession
focused on the care of individuals, families,
and communities so they may attain, maintain,
or recover optimal health and quality of life
from conception to death.
Nurses work in a large variety of specialties
where they work independently and as part of a
team to assess, plan,
implement and evaluate
care. Nursing Science is a
field of knowledge based on
the contributions of nursing
scientist
through
peer
reviewed scholarly journals
and
evidenced-based
practice.
History of nursing

Florence
Nightingale,
"Lady with the Lamp", a
pioneer of modern nursing
Western European concepts of nursing were
first practised by male Catholic monks who
provided for the sick and ill during the Dark
Ages of Europe.
During 17th century Europe, nursing care was
provided by men and women serving
punishment. It was often associated with
prostitutes and other female criminals serving
time. They had a reputation for being drunk
and obnoxious, a view amplified by the doctors
of the time to make themselves seem more
important and able. It was not until Florence
Nightingale, a well-educated woman from a
middle class family, became a nurse and
improved it drastically that people began to
accept nursing as a respectable profession.
Other aspects also helped in the acceptance of
nursing. In 1853 Theodore Fliedner set up a
hospital where the nurses he employed had to
be of good nature. Many people were
impressed with this facility, and because of it,

the British Institute of Nursing Sisters was set

up.
\A U.S. Navy recruiting poster from World War
II, showing a Naval nurse with a hospital ship
Prior to the foundation of modern nursing,
nuns and the military often provided nursinglike services.[1] The religious and military roots
of modern nursing remain in evidence today in
many countries, for example
in the United Kingdom, senior
female nurses are known as
sisters. It was during time
of war that a significant
development
in
nursing
history arose when English
nurse Florence Nightingale,
working
to
improve
conditions of soldiers in the
Crimean War, laid the
foundation
stone
of
professional nursing with the
principles summarised in the
book Notes on Nursing. Other
important nurses in the
development of the profession
include: Mary Seacole, who also worked as a
nurse in the Crimea; Agnes Elizabeth Jones
and Linda Richards, who established quality
nursing schools in the USA and Japan, and
Linda Richards who was officially America's
first professionally trained nurse, graduating in
1873 from the New England Hospital for
Women and Children in Boston.
New Zealand was the first country to regulate
nurses nationally, with adoption of the Nurses
Registration Act on the 12 September, 1901. It
was here in New Zealand that Ellen Dougherty
became the first registered nurse. North
Carolina was the first state in the United States
to pass a nursing licensure law in 1903.[2]
Nurses have experienced difficulty with the
hierarchy in medicine that has resulted in an
impression that nurses' primary purpose is to
follow the direction of physicians.[3] This
tendency is certainly not observed in
Nightingale's Notes on Nursing, where the

physicians
are
mentioned
relatively practical nurse, Enrolled nurse, and State
infrequently, and often in critical tones enrolled nurse) works independently or with a
particularly relating to bedside manner.[4]
Registered nurse. The most significant
differentiation between an
The modern era has seen the
LPN and RN is found in the
development of
nursing
requirements for entry to
degrees and nursing has
practice, which determines
numerous journals to broaden
entitlement for their scope of
the knowledge base of the
practice, for example in
profession. Nurses are often
Canada an RN requires a
in key management roles
bachelors degree and a LPN
within health services and
requires a 2 year diploma. A
hold research posts at
Registered
nurse
(RN)
universities.
provides
scientific,
psychological,
and
Nursing as a profession
technological knowledge in
the care of patients and
The authority for the practice of nursing is families in many health care settings.
based upon a social contract that delineates Registered nurses may also earn additional
professional rights and responsibilities as well credentials or degrees enabling them to work
as mechanisms for public accountability. In under different titles (Nurse Practitioner,
almost all countries, nursing practice is defined Clinical Nurse Specialist, Registered Nurse
and governed by law, and entrance to the First Assistant,[6] etc.).
profession is regulated at national or state
level.
Nurses may follow their personal and
The aim of the nursing community worldwide
is for its professionals to ensure quality care
for all, while maintaining their credentials,
code of ethics, standards, and competencies,
and continuing their education.[5] There are a
number of educational paths to becoming a
professional nurse, which vary greatly
worldwide, but all involve extensive study of
nursing theory and practice and training in
clinical skills.

professional interests by working with any

group of people, in any setting, at any time.
Some nurses follow the traditional role of
working in a hospital setting.
Nursing practice

Nursing practice is the actual provision of

nursing care. In providing care, nurses
implement the nursing care plan using the
nursing process. This is based around a
specific nursing theory which is selected based
Nurses care for individuals who are healthy on the care setting and population served. In
and ill, of all ages and cultural backgrounds, providing nursing care, the nurse uses both
and
who
have
physical,
emotional, nursing theory and best practice derived from
psychological, intellectual, social, and spiritual nursing research.
needs. The profession combines physical
science, social science, nursing theory, and Definition
technology in caring for those individuals.
Although nursing practice varies both through
In order to work in the nursing profession, all its various specialities and countries, these
nurses hold one or more credentials depending nursing organizations offer the following
on their scope of practice and education. A definitions:
Licensed practical nurse (LPN) (also referred
to as a Licensed vocational nurse, Registered

Nursing encompasses autonomous and

collaborative care of individuals of all ages,
families, groups and communities, sick or well
and in all settings. Nursing i includes the
promotion of health, prevention of illness, and
the care of ill, disabled and dying people.
Advocacy, promotion of a safe environment,
research, participation in shaping health policy
and in patient and health systems management,
and education are also key nursing roles.
International Council of Nurses

[5]

The use of clinical judgement in the provision

of care to enable people to improve, maintain,
or recover health, to cope with health
problems, and to achieve the best possible
quality of life, whatever their disease or
disability, until death."
Royal College of Nursing UK [7]
Nursing is the protection, promotion, and
optimization of health and abilities; prevention
of illness and injury; alleviation of suffering
through the diagnosis and treatment of human
responses; and advocacy in health care for
individuals, families, communities, and
populations.
American Nurses Association[8]

profession has developed different theories

derived from sometimes diverse philosophical
beliefs and paradigms or worldviews to help
nurses direct their activities to accomplish
specific goals. Currently, two paradigms exist
in nursing, the totality paradigm and the
simultaneity paradigm.
Practice settings
Nurses practice in a wide range of settings,
from hospitals to visiting people in their homes
and caring for them in schools to research in
pharmaceutical companies. Nurses work in
occupational health settings (also called
industrial health settings), free-standing clinics
and physician offices, nurse-led clinics, longterm care facilities and camps. They also work
on cruise ships and in military service. Nurses
act as advisers and consultants to the health
care and insurance industries. Many nurses
also work in the health advocacy and patient
advocacy fields at companies such as Health
Advocate, Inc. helping in animals too.variety
of clinical and administrative issues.[10] Some
are attorneys and others work with attorneys as
legal nurse consultants, reviewing patient
records to assure that adequate care was
provided and testifying in court. Nurses can
work on a temporary basis, which involves
doing shifts without a contact in a variety of
settings, sometimes known as per diem
nursing, agency nursing or travel nursing.
Nurses work as researchers in laboratories,
universities, and research institutions.

The unique function of the nurse is to assist the

individual, sick or well, in the performance of
those activities contributing to health or its
recovery (or to peaceful death) that he would
perform unaided if he had the necessary Work Environment
strength, will or knowledge.
Virginia Avenel Henderson[9]
Nursing theory and process
Main articles: Nursing theory and Nursing
process
In general terms, the nursing process is the
method used to assess and diagnose needs,
plan outcomes and interventions, implement
interventions, and evaluate the outcomes of the
care provided. Like other disciplines, the

Internationally, there is a serious shortage of

nurses.[11] One reason for this shortage is due to
the work environment in which nurses
practice. In a recent review of the empirical
human factors and ergonomic literature
specific to nursing performance, nurses were
found to work in generally poor environmental
conditions. DeLucia, Ott, & Palmieri (2009)
concluded, "the profession of nursing as a
whole is overloaded because there is a nursing
shortage. Individual nurses are overloaded.
They are overloaded by the number of patients

they oversee. They are overloaded by the

number of tasks they perform. They work
under cognitive overload, engaging in
multitasking and encountering frequent
interruptions. They work under perceptual
overload due to medical devices that do not
meet perceptual requirements (Morrow et al.,
2005),
insufficient
lighting,
illegible
handwriting, and poor labeling designs. They
work under physical overload due to long work
hours and patient handling demands which
leads to a high incidence of MSDs. In short,
the nursing work system often exceeds the
limits and capabilities of human performance.
HF/E research should be conducted to
determine how these overloads can be reduced
and how the limits and capabilities of
performance can be accommodated. Ironically,
the literature shows that there are studies to
determine whether nurses can effectively
perform tasks ordinarily performed by
physicians. Results indicate that nurses can
perform such tasks effectively. Nevertheless,
already overloaded nurses should not be given
more tasks to perform. When reducing the
overload, it should be kept in mind that
underloads also can be detrimental to
performance (Mackworth, 1948). Both
overloads and underloads are important to
consider for improving performance." [12]
Regulation of practice
The practice of nursing is governed by laws
that define a scope of practice, generally
mandated by the legislature of the country or
area within which the nurse practices. Nurses
are held legally responsible and accountable
for their practice. The standard of care is that
of the "prudent nurse."
Nursing worldwide
Throught out the world nurses are known to be
caring individuals that people look for as
someone to advocate for the sick and provide
empathy towards the needy.
Nursing specialties

Nursing is the most diverse of all healthcare

professions. Nurses practice in a wide range of
settings but generally nursing is divided
depending on the needs of the person being
nursed.
The major divisions are:

the nursing of people with mental

health problems - Psychiatric and
mental health nursing
(Psychiatric nursing or mental health
nursing is the specialty of nursing that
cares for people of all ages with mental
illness or mental distress, such as
schizophrenia,
bipolar
disorder,
psychosis, depression or dementia.
Nurses in this area receive more
training in psychological therapies,
building a therapeutic alliance, dealing
with challenging behavior, and the
administration
of
psychiatric
medication.)

the nursing of people with learning or

developmental disabilities - Learning
disability nursing (UK)
(Developmental disability is a term
used in the United States and Canada to
describe
life-long
disabilities
attributable to mental and/or physical
impairments, manifested prior to age
18. It is not synonymous with
"developmental delay"[1] which is often
a consequence of a temporary illness or
trauma during childhood.
Learning disability (sometimes called
a learning disorder[1] or learning
difficulty), is a classification including
several disorders in which a person has
difficulty learning in a typical manner,
usually caused by an unknown factor or
factors. The unknown factor is the
disorder that affects the brain's ability
to receive and process information.
This disorder can make it problematic
for a person to learn as quickly or in the

same way as someone who isn't

affected by a learning disability.
Learning disability is not indicative of
intelligence level. Rather, people with a
learning disability have trouble
performing specific types of skills or
completing tasks if left to figure things
out by themselves or if taught in
conventional ways.)

the nursing of children - Pediatric

nursing.

the patient is deemed healthy and stable, with

appropriate discharge instructions.
The term is generally associated with care
rendered in an emergency department,
ambulatory care clinic, or other short-term stay
facility. An important aspect of the current
health care crisis in the US is the result of the
growing need for acute care despite a decrease
in the number of facilities which provide that
care. This mismatch has resulted from the
dramatic increase in the number of patients
who are uninsured or underinsured, and
therefore unable to pay for services rendered.
Those patients often turn to emergency
departments for their primary care needs. That
has resulted in overcrowding and made it
increasingly difficult to focus adequate
resources on those patients who present with
true emergencies.

(Child health nursing or pediatric nursing is

an area of nursing and medical practice with a
focus on providing holistic care to infants,
children and adolescents. It differs from
pediatrics, in that the emphasis in pediatrics is
ill-health and the alleviation of symptoms or
disease. There are different places Pediatric
nurses can work, one is they can work in a
pediatric ward at a hospital, and others choose Long-term care (LTC) is a variety of services
which help meet both the medical and nonto work in a pediatric doctors office.
medical need of people with a chronic illness
One of the major principles of pediatric or disability who cannot care for themselves
nursing is the concept of family centered care. for long periods of time.)
Pediatric nurses function to support the family
the nursing of people in their own
by providing nursing care that the family
cannot perform, educating and supporting them
homes - Home health nursing (US),
to maintain their normal caring activities and
District nursing and Health visiting
actively viewing the parents as partners in the
(UK). See also Live-in nurse
care process.)
(Home Care, (also referred to as domiciliary
the nursing of older adults - Geriatric care), is health care or supportive care
provided in the patient's home by healthcare
nursing
professionals (often referred to as home health
(Geriatric nursing is the specialty that care or formal care; in the United States, it is
concerns itself with the provision of nursing also known as skilled care) or by family and
services to geriatric or aged individuals.)
friends (also known as caregivers, primary
caregiver, or voluntary caregivers who give
the nursing of people in acute care and informal care). Often, the term home care is
long term care institutional settings.
used to distinguish non-medical care or
custodial care, which is care that is provided
(Acute care is a branch of secondary health- by persons who are not nurses, doctors, or
care where necessary treatment of a disease for other licensed medical personnel, whereas the
only a short period of time in which a patient is term home health care, refers to care that is
treated for a brief but severe episode of illness. provided by licensed personnel.
[1]
Many hospitals are acute care facilities with
the goal of discharging the patient as soon as District Nurses are senior nurses who manage
care within the community, leading teams of

community nurses and support workers.[1]

Typically much of their work involves visiting
house-bound patients to provide advice and
care, for example, palliative care, wound
management, catheter and continence care,
medication support. They may be trained to
assess patient's needs for equipment provision
such as mobility and independent living aids,
medical equipment such as specialist beds and
mattresses, as well as guidance in applying for
grants and welfare benefits. Their work
involves both follow-up care for recently
discharged hospital inpatients and longer term
care for chronically ill patients who may be
referred by many other services, as well as
working
collaboratively
with
general
practitioners in preventing unnecessary or
avoidable hospital admissions.
Health visitors are UK registered nurses who
have undertaken further training to work as
part of a primary health care team. As their
name suggests, their role is to promote mental,
physical and social well-being in the
community by giving advice and support to
families in all age groups. Limited resources
and staff within the NHS have traditionally
meant that their work has been focused on
childhood development, but the scope to
expand their roles is slowly improving. The
Healthy Child Programme published in
October 2009 influences the service available
to families. It is presented in three key
documents: The First Five Years, The Two
Year Review and The Healthy Child
Programme for 5-19 year olds.

They usually work with mothers once

postpartum care is handed over from the
midwives, advise on feeding, care and support
to both infants and parents, provide routine
child development checks and have
responsibility for child protection issues. They
are also able to help people of any age who
suffer from chronic illness or live with a
disability. They may run health promotion
schemes such as stop-smoking clinics.
Qualified health visitors are regulated by the
Nursing and Midwifery Council.)
There are also specialist areas such as cardiac
nursing, orthopedic nursing, palliative care,
perioperative nursing, obstetrical nursing, and
oncology nursing