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Nursing as a 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

Profession

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 and treatment of human response, and advocacy in the care of individuals, families, communities and populations. (ANA, 2003)

Nursing

Primary Characteristics of Nursing as a Profession


Education Theory Service Autonomy Code of Ethics Ongoing research Caring Professional organization

Professions are basically intellectual

Flexners Criteria for a Profession Compared with Nursing


Patterns of Developing Profession

Nursing Profession

Professions are based on a specific body of knowledge that can be learned Professions are practical as well as theoretical

Nurses are educated in institutions of higher learning & function in a responsible and accountable manner. Nursing continues to develop its own specific body of knowledge from which nursing practice emerges. Evolved in response to needs identified by society & is guided by ethical code.

Professional work can be taught through professional education Professions have strong internal organization Practitioners are guided by altruism

Flexners Criteria for a Profession Compared with Nursing


Patterns of Developing Profession

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

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

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 presentday social problems

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

Philosophy of Life Good Personality Personal appearance Character Attitude Charm

Personal Qualifications of a Nurse

Carpers Fundamental Patterns of Knowing


Ethical knowing Personal knowing Aesthetic knowing Empiric knowing

Guides and directs how nurses conduct their practice Requires Focus is on:
Experiential knowledge of social values Ethical reasoning

Ethics: the component of moral knowledge


in nursing

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

Sources of Ethical knowing


Nursings ethical codes and professional standards An understanding of different philosophical positions
Duty Social justice

Personal knowing: acceptance of self that is


grounded in self-knowledge and confidence
Concerned with becoming self-aware

Selfawareness 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

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

Aesthetic knowing: the art of nursing


Expressed through: Involves:
Actions, bearing, conduct, attitudes, interaction Knowing what to do without conscious deliberation 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 create a meaningful whole

Aesthetic knowing
To respond with skilled action

Perceiving the nature of a clinical situation and interpreting this information

It uses the nurses intuition and empathy Is based on the skill of the nurse in a given situation

Empirics: the science of nursing


A pattern of knowing that draws on traditional ideas of science Expressed in practice as scientific competence
Reality exists and truths about it can be understood

Based on the assumption that what is known is accessible through the physical senses: seeing, touching and hearing.

Competent action grounded in scientific knowledge including theories and formal description Involves conscious problem solving and logical reasoning Nursing theory

Empirical knowing
Positivist science Source of this knowledge
Research Theory

Knowledge is systematically organised into general laws and theories

Emancipatory knowing (Chinn and Kramer)

Emancipatory knowing addresses the social and political context of nursing and healthcare and 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

Fundamental patterns of knowing


Empiric

Ethical Emancipat ory

Personal

Aestheti c

Methods of turning knowing into knowledge


Problem based learning Clinical Supervision
An exchange between practicing professionals to enable the development of professional knowledge and skills

An instructional method in which students work in small groups Used to gain knowledge and acquire problem-solving skills.

Structured reflection on practice

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.

A. In the Philippines Early Care of the Sick Herbmen Nonos Mabuting Hilot

History of nursing

Health Care during Spanish Regime - Religious orders built hospitals in different parts of the Philippines.

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)

Nursing 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 Cross branch 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

History of nursing

Nursing 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 Baptist Foreign Mission Society of america o Miss Rose Nicolet o Miss Flora Ernst o April 1944 : First Nurses Board Exam 2. St. Pauls Hosp. School of Nursing (Manila, 1907) - established by Most. Rev. Jeremiah Harty, Archbishop of Manila o Rev. Mother Melanie o Miss E. Chambers

History of nursing

Nursing 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. Lukes Hosp. School of Nursing (Quezon City, 1907) o Miss Helen Hicks o Mrs. Vitaliana Beltran o Dr. Jose Flores

History of nursing

Nursing 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, Ilocos Norte, 1903) Mary Chiles Hosp. School of Nursing (Manila, 1911)

History of nursing

Nursing 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 Society o Miss Clara Pedrosa 9. Southern Islands Hosp. School of Nursing (Cebu, 1918) - organized by Anastacia Giron-Tupas o Miss Visitacion Perez

History of nursing

Nursing 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. Pauls SON in Iloilo City (1946) 6. North General Hosp. & SON (1946) 7. Siliman University SON (1947)

History of nursing

First 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 Masters 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

History of nursing

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

History of nursing Nursing Leaders in the Philippines:

Health & 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.

History of nursing

History of nursing in Other Lands


Period 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

History of nursing in Other Lands

Nursing in the Near East - Beliefs and Practices Mans 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

History of nursing in Other Lands


Nursing in the Near East - Contributions to Medicine & Nursing Babylonia Code of Hammurabi Egypt art of embalming - recorded 250 recognized diseases - slaves & patients families nursed the sick Israel Moses as Father of Sanitation

Nursing 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

History of nursing in Other Lands


- Sushurutu made a list of functions & qualifications of nurses

History of nursing in Other Lands

Nursing 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.

Period 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

History of nursing in Other Lands

History of nursing in Other Lands


Secular Orders founded during the Period of Crusades

Period 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. Order 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)

Period 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

History of nursing in Other Lands

History of nursing in Other Lands


Period of Apprentice Nursing Important Nursing Personages During the Period of Apprentices 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.

- 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)

History of nursing in Other Lands


The Dark Period of Nursing

History of nursing in Other Lands


The 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 Nurses Society of Philadelphia organized a school of nursing under the direction of Dr. Joseph Warrington in 1839. Womens Hospital in Philadelphia established a 6 month course in nursing to increase nurses knowledge while they worked.

History of nursing in Other Lands


The Dark Period of Nursing Nursing in America o Nursing 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

History of nursing in Other Lands


Period 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.

History of nursing in Other Lands


Period 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

History of nursing in Other Lands


Period 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

History of nursing in Other Lands

Period of Educated Nursing Other Important Persons/ Groups/ Events During the Period 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.

o Events & Trends Establishment 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

Period of contemporary nursing - period after World War II to present.

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