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Nursing as a Profession

Nursing as a Profession

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

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 and treatment of human response, and advocacy in the care of individuals, families, communities and populations.

(ANA, 2003)

Primary Characteristics of Nursing as a Profession

Education

Theory

Service

Autonomy

Code of Ethics

Ongoing research

Caring

Professional organization

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 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.

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

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 present- day 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

Personal Qualifications of a Nurse

Philosophy of Life

Good Personality

Personal appearance Character

Attitude

Charm

Carper’s Fundamental Patterns of Knowing

Ethical knowing

Personal knowing

Aesthetic knowing

Empiric knowing

Ethics: the component of moral knowledge in nursing

Guides and directs how nurses conduct their practice

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

Sources of Ethical knowing

Nursing’s 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

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

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:

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 create a meaningful whole

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

Empirics: the science of nursing

Based on the assumption that what is known is accessible through the physical senses: 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

Empirical knowing

Positivist science

Knowledge is systematically organised into general laws and theories

Source of this knowledge

Research

Theory

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

Ethical

Empiric

Emancipat

ory

Aestheti

c

Personal

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

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.

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.

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)

History of nursing

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. 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

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. Luke’s 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. Paul’s 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 – 1 st 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 – 1 st editor of PNA magazine called “The Message”

History of nursing

Nursing Leaders in the Philippines:

Conchita Ruiz – 1 st 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

Health & Nursing organizations

1)

2)

3)

4)

Nursing Organizations:

Philippine Nurses Association (PNA) National League of Nurses Catholic Nurses Guild of the Philippines Others: ORNAP, MCNAP, CCNAPI, etc.

Association (PNA) National League of Nurses Catholic Nurses Guild of the Philippines Others: ORNAP, MCNAP, CCNAPI,
Association (PNA) National League of Nurses Catholic Nurses Guild of the Philippines Others: ORNAP, MCNAP, CCNAPI,
Association (PNA) National League of Nurses Catholic Nurses Guild of the Philippines Others: ORNAP, MCNAP, CCNAPI,

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

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

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 & patient’s families nursed the sick

Israel – Moses as “Father of Sanitation”

History of nursing in Other Lands

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

- 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.

History of nursing in Other Lands

Period of Apprentice Nursing

-

period from founding of religious nursing orders in the Crusades which began in 11 th 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

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

would help her gain grace

in heaven.

of charity that her faith

Secular Orders founded during the Period of Crusades

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)

History of nursing in Other Lands

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 (12 th century)

Benedictines

Ursulines

Augustinians

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 16 th century.

History of nursing in Other Lands

The Dark Period of Nursing

-

extends from 17 th to 19 th 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

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 in nursing to increase nurse’s knowledge while they worked.

History of nursing in Other Lands

The Dark Period of Nursing Nursing in America oNursing 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: 1 st graduate nurse in US Dr. William Halstead: designed the 1 st rubber gloves Caroline Hampton Robb: 1 st to wear rubber gloves as OR nurse Isabel Hampton Robb: 1 st 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.

Period of contemporary

nursing

period after World War II to present.

-

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