Trends and Ethics in Nursing Profession

Module 910322 Fadia Hasna RN, PhD February 2008

Unit 1: The Nursing Profession: Development and Historical Perspective

References 1. Hood. L., & Leddy. S., (2006) Leddy & Peppers Conceptual Basis of Professional Nursing (6th edition)- Lippincott Williams and Wilkins, USA Chapter 2: pp 39-66 Library number: 610.73 HOO 2. Zerwekh. J., &. J. (2003) Nursing Today: Transition and Trends (4th edition) Saunders, USA Chapter 2: pp 29-48 Library number: 610.73069 NUR 3. Cherry. B., & Jacob. S. (2005) Contemporary Nursing: Issues, Trends and Management (3rd edition) Elsevier Mosby, USA Chapter 1: pp 6-23 Library number: 610.73 CON 4. Ellis. JR., & Hartley. CL. (2004) Nursing in Todays World: Challenges, Issues and Trends (8th edition) JB Lippincott, USA chapter 1

Learning Outcomes
At the end of Unit 1 the student will be able to: 1. Discuss the health practices in early civilizations (Egypt, Palestine, Persia and Greece) 2. Explain early nursing roles re: ancient civilizations and the development of the profession through the Dark Ages 3. Describe the history of nursing in Islam with emphasis on Rufayda Al Islamiya 4. Describe Florence Nightingales contribution to the profession and impact on nursing 5. Describe the characteristics of early nursing education and the impact of wars on nursing education 6. List the first nursing organizations and identify the purpose of each 7. Identify the landmarks in the history of hospitals

Health Care in Ancient Cultures

1.

Egypt
Treating disease was considered the responsibility of priests Natural phenomena are the work of the Gods Health and security meant keeping the Gods happy Sickness is the presence of an evil spirit that must be driven out of the body through a variety of rites Oldest medical records discovered (3000 BC) Surgical sutures and techniques used, methods of birth control practiced, disease processes and remedies, pharmacopea with 700 drug classifications Community planning system to prevent transmission of diseases through water sources. First Egyptian physician known in history Imhotep (2900 BC)

Health Care in Ancient Cultures

2. Palestine:
Under Moses, Mosaic Laws (isolation of people with communicable diseases) Differentiation of clean from unclean One God: the role of the priest: supervisor of practices related to cleansing and purification Religion, law and medicine combined to control public health Meat eating after third day that the animal was slaughtered forbidden

Health Care in Ancient Cultures

3. Persia: Zoroaster (600 BC)
Two creators for the world: one good and one bad Fire, earth and water are sacred elements Immortality is a mental state Medical and surgical practices taken from Egypt Three types of physicians prepared as priest physicians: healing with the knife, herbs and exorcism

Health Care in Ancient Cultures

4. Greece:
Emphasis on healthy bodies through sports (Olympic games) Symbols of modern medicine came from their mythology Curative process started with animal sacrifice and continued with purifying rituals Latrion: first model of ambulatory clinics Hippocrates (400BC) emphasized natural causes for diseases, holistic and patient-centered approach Stressed on accurate observations and careful record keeping

The Development of the Nursing Image

1. The folk image of the nurse (women in the house caring for the old by trial and error) 2. The religious image of the nurse: nursing is a work of charity and mercy
Image mostly developed by the Catholic Church (Deaconesses were unmarried or widowed and carried a basket) Nursing included feeding the hungry, clothing the naked, visiting the prisons, sheltering the homeless, caring for the sick and burying the dead In 400 AD it included the Widows and the Virgins

Nursing in Islam

The writings of Hippocrates and Galen were translated to Arabic Hospitals were built and an extensive Materia Medica was built Rufayda Al Islamiya whose father Saad Al Aslamy was a healer in Saudi Arabia was like the Muslim Nightingale She trained women and young girls in the art of nursing and nursed the sick and wounded during times of war. The duties of the nurses in times of war were to provide water for the sick and wounded, tend to their injuries, give medicine as needed, provide comfort measures and transport the dead back to Madinah She devised the first nursing code of conduct and ethics based on Islam She established clinics in the Mosque She is the founder of the first school of nursing for women Characteristics of Rufayda Al Islamiya:
Kind and empathetic A capable leader and organizer Able to mobilize others Clinical and training skills Did not confine her nursing to the clinical situation and went out in the community

The Dark Ages of Nursing

The servant image of the nurse was prominent between the 16th century and the 19th century, there was a poor pay and image Hospital care was given to uncommon women to do i.e. prisoners, prostitutes and drunks No inspection for hygiene practices and cleanliness and the nurse was regarded as the most menial of servants.

The Influence of Florence Nightingale

Born in 1820 (beginning of the 19th century) She wanted to become a nurse despite resistance from her family She joined Kaiserwerth Institute in 1851 and never returned home to live In 1853 she became the supervisor of the Establishment for Gentlewomen During Illness and became superintendent After the Crimean War in 1854 she wrote to take a group of 38 nurses to care for the wounded In 1856 after the war she returned to England as a national heroine but she was ill (Post Traumatic Stress Disorder) She wrote Notes on Nursing in 1859 where she advocated nursing education reform In 1907 the Queen of England awarded her the British Order of Merit. First time given to a woman She died in 1910

Principles of Florence Nightingales School of Nursing

1.
2.

3.

4. 5.

Nurses would be trained in teaching hospitals with medical schools Nurses to be selected carefully and reside in nurses houses for discipline and to form their character The school matron has the final say over the school curriculum. The curriculum would include theoretic material and practical experience. Teachers are paid Records are kept on students who are required to attend lectures, take quizzes, write papers and keep diaries

The Establishment of Early Schools of Nursing

After the war in USA in 1869, the American Medical Association established a committee to study the training of nurses Conclusions: 1. Every large hospital must have a nursing school 2. The union between religious practice and nursing will benefit the sick 3. Nursing schools will be placed under the authority of county medical societies
In 1872, the New England Hospital for Women and Children established a formal one-year program to train nurses. In 1873 three more schools opened and they did not admit men. In 1888 the Mills School of Nursing at Bellevue Hospital opened to train nurses for patient care. In 1868 a school was organized in Sydney Australia The Mack training school started in Canada in 1884 The First School of Nursing in the Middle East was the American University of Beirut School of Nursing established in Lebanon in 1905

Characteristics of the Early Schools of Nursing

1. 2. 3. 4.
5. 6. 7. 8. 9. 10. 11. 12.

Strong military and religious influence Dedication (religious) and obedience (military) 21 years of age, young females and single First few months of training the nursing students are washing, scrubbing, polishing and folding Rules of conduct are rigid and unforgiving Nursing students were expected to be unselfish and think of the happiness and well-being of others Nursing education was largely an apprenticeship The day started at 5:30 in the morning and ended very late with prayers The work was primarily done on the hospital wards No standardization of the curriculum and no accreditation A 7 day workweek was a standard attrition rate was high in the early schools Few textbooks of nursing before 1900

Beginning of Nursing Organizations

1.
2. 3. 4. 5.

6.

In 1888 in England Mrs. Bedford Fenwick fought for nurse registration and founded the British Nurses Association; it later became the Royal British Nurses Association In 1896: The American Society of Superintendents of Training Schools for Nurses established by Isabel Hampton In 1907 the Canadian Society of Superintendents of training schools In 1912: The American organization changed the name to the National League for Nursing Education In 1899 the International Council of Nursing was established by Mrs. Bedford Fenwick. The first meeting was held in Buffalo in USA List of all nursing organizations on the web
http://nursingworld.org/index/