Historical Perspective

Early Beliefs, Practices and Care of the sick

Early Hospitals during the Spanish Regime
Prominent personages involved during the Philippine Revolution
1. Philippines General Hospital school of Nursing – 1910
College of Nursing
1. UE College of Nursing – Oct 1958
1909
1921
 Filipino Nurses Association was established (now PNA) as the National Organization Of Filipino
Nurses
 PNA: 1st President – Rosario Delgado
 Founder – Anastacia Giron-Tupas
1953
 Republic Act 877, known as the “Nursing Practice Law” was approved.

Definitions of Nursing

 Florence Nightingale defined nursing as the act of utilizing the environment of the patient to assist him
in his recovery.
 ANA definition: nursing is the diagnosis and treatment of human response to actual and potential
health problems.
I. Health promotion:
 Examples: Reduce over weight, Stop cigarette smoking.
 Is increase people’s wellbeing and health potential.
 factors effects on health or illness:
 Genetics,
 educational level and
 development level.
 Improving nutrition and physical fitness.
 Preventing drug misuse.
II. Prevent illness Maintain optimum health by preventing disease.
Examples: Educational program (smoking, prenatal care), Immunization.
III. Restoring health : Focus of individual with illnesses and range from early detection to
rehabilitation and teaching during recovery.
Example: Direct care ( treatment, medication),
Performing diagnostic measurement ( Blood pressure, blood glucose)
Setting for Nursing
 In the past, the acute care hospital was the only practice setting.
 Today nurses works in hospitals, client’s home, community agencies, education settings, schools,
mental health…..etc.

Roles and Functions of the Nurses

 , skill, and preparation.
 Professionalization: is the process of becoming professional.

Criteria of a Profession

 Specialized education.
 Body of knowledge.
 Ongoing research.
 Code of ethics.
 Autonomy: is a state of independent and self directed with out any control from out side.
 Professional organization.

Nursing Organizations
 American Nurses Association (ANA)
 Canadian Nurses Association (CAN)
 National league for Nursing (NLN)International Council of Nurses (ICN)
Types of Nursing Educational Programs

 Diploma programs.
 Community College/associate Degree.
 Baccalaureate Degree Program.
 Graduated Nursing Education (Master’s &Doctoral Programs)
Metaparadigm of Nursing
 Client.
 Environment.
 Health.
 Nursing.
Definitions
 Health: a state of complete physical, social, mental, spiritual wellbeing not merely absence of
disease or infirmity.
 illness: any disturbance of body organs function.

Different fields of Nursing

a. Hospital Staff
b. Community Health nursing
c. Industrial Nursing
d. School Nursing
e. Private Nursing
f. Nursing in Education

COMMUNICATING
Communication
1. Is the means to establish a helping-healing relationship. All behavior communication influences
behavior.
2. Communication is essential to the nurse-patient relationship for the following reasons:
3. Is the vehicle for establishing a therapeutic relationship.
4. It the means by which an individual influences the behavior of another, which leads to the
successful outcome of nursing intervention.
Basic Elements of the Communication Process
1. Sender – is the person who encodes and delivers the message
2. Messages – is the content of the communication. It may contain verbal, nonverbal, and symbolic
language.
3. Receiver – is the person who receives the decodes the message.
4. Feedback – is the message returned by the receiver. It indicates whether the meaning of the
sender’s message was understood.
Modes of Communication
1. Verbal Communication – use of spoken or written words.
2. Nonverbal Communication – use of gestures, facial expressions, posture/gait, body movements,
physical appearance and body language
Characteristics of Good Communication
1. Simplicity – includes uses of commonly understood, brevity, and completeness.
2. Clarity – involves saying what is meant. The nurse should also need to speak slowly and
enunciate words well.
3. Timing and Relevance – requires choice of appropriate time and consideration of the client’s
interest and concerns. Ask one question at a time and wait for an answer before making another
comment.
4. Adaptability – Involves adjustments on what the nurse says and how it is said depending on the
moods and behavior of the client.
5. Credibility – Means worthiness of belief. To become credible, the nurse requires adequate
knowledge about the topic being discussed. The nurse should be able to provide accurate
information, to convey confidence and certainly in what she says.
Factors influencing the communication process
a. Development
b. Gender
c. Values and perceptions
d. Personal space
e. Territoriality
f. Roles and relationship
g. Environment
h. Congruence
i. Interpersonal attitudes
Barriers to communication
a. Stereotyping
b. Agreeing and disagreeing
c. Being defensive
d. Challenging
e. Probing
f. Testing
g. Rejecting
h. Changing topics and subjects
i. Unwarranted reassurance
j. Passing judgement
k. Giving common advice
Phases of the helping relationship
1. Pre-interaction phase
2. Introductory phase
3. Working phase
 4. Termination phase

Health Care Delivery System:

 The totality of all policies, facilities, equipments, products, human resources and services which
address the health needs problems and concerns of the people. It is large, complex, multi-level
and multi-disciplinary.
Health Sectors
 Government Sectors
 Non Government Sectors
 Private Sectors
Department of Health
 Vision: Health for all by year 2000 ands Health in the Hands of the People by 2020
 Mission: In partnership with the people, provide equity, quality and access to health care esp. the
marginalized
5 Major Functions:

1. Ensure equal access to basic health services

2. Ensure formulation of national policies for proper division of labor and proper coordination
of operations among the government agency jurisdictions
3. Ensure a minimum level of implementation nationwide of services regarded as public
health goods
4. Plan and establish arrangements for the public health systems to achieve economies of
scale
5. Maintain a medium of regulations and standards to protect consumers and guide
providers
Primary Strategies to Achieve Health Goals
 Support for health goal
 Assurance of health care
 Increasing investment for PHC
 Development of National Standard
Milestone in Health Care Delivery System
 RA 1082 – RHU Act
 RA 1891 – Strengthen Health Services
 PD 568 – Restructuring HCDS
 RA 7160 – LGU Code
Types of healthcare agencies and services:
1. Public health
2. Physician’s offices
3. Ambulatory care centers
4. Occupational health clinics
5. Hospitals
6. Subacute care facilities
7. Rehabilitation centers
8. Hospice centers
Providers of health care:
a. Nurse
b. Case manager
c. Dentist
d. Dietician or nutritionist
e. Occupational therapist
f. Paramedical technologist
g. Pharmacist
h. Physical therapist
i. Physician social worker
j. Spiritual support personnel

Factors Influencing the Communication Process

1. Development

 Language, psychosocial, and intellectual development move through stages across the lifespan.

2. Gender
  Girls tend to use language to seek confirmation, minimize differences, and establish intimacy.
Boys use language to establish independence and negotiate status within a group.

3. Values and Perception

 Values are the standards that influence behavior, and perceptions are the personal view of
event.

4. Personal Space

 Personal space is the distance people prefer in interactions with others.

 Proxemics is the study of distance between people in their interactions

 Communication 4 distances:

a. Intimate: Touching to 1 ½
b. Personal: 1 ½ to 4 feet
c. Social: 4 to 12 feet
d. Public: 12 to 15 feet

5. Territoriality

 Is a concept of the space and things that an individual considers as belonging to the self

6. Roles and Relationships

 Choice of words, sentence structure, and tone of voice vary considerably from role to role. (E.g.
nursing student to instructor, client and primary care provider, or parent and child).

7. Environment

 People usually communicate most effectively in a comfortable environment.

8. Congruence

 The verbal and nonverbal aspects of message match. E.g., when teaching a client how to care for
a colostomy, the nurse might say, “You won’t have any problem with this.” However, if the
nurse looks worried or disgusted while saying this, the client is less likely to trust the nurse’s
words.

9. Interpersonal Attitudes

 Attitudes convey beliefs, thoughts, and feelings about people and events.

 Caring and warmth convey a feeling of emotional closeness

 Respect is an attitude that emphasizes the other person’s worth and individuality. A nurse
coveys respect by listening open mindedly even if the nurse disagrees.Acceptance emphasizes
neither approval nor disapproval .The nurse willingly receives the client’s honest feelings.

Period of Intuitive Nursing/Medieval Period

 Nursing was “untaught” and instinctive. It was performed of compassion for others, out of the
wish to help others.

 Nursing was a function that belonged to women. It was viewed as a natural nurturing job for
women. She is expected to take good care of the children, the sick and the aged.

 No caregiving training is evident. It was based on experience and observation.

 Primitive men believed that illness was caused by the invasion of the victim’s body of evil spirits.
They believed that the medicine man, Shaman or witch doctor had the power to heal by using
white magic, hypnosis, charms, dances, incantation, purgatives, massage, fire, water and herbs
as a mean of driving illness from the victim.

 Trephining – drilling a hole in the skull with a rock or stone without anesthesia was a last resort
to drive evil spirits from the body of the afflicted.

Period of Apprentice Nursing/Middle Ages

 Care was done by crusaders, prisoners, religious orders

  Nursing care was performed without any formal education and by people who were directed by
more experienced nurses (on the job training). This kind of nursing was developed by religious
orders of the Christian Church.

 Nursing went down to the lowest level

 Wrath/anger of Protestantism confiscated properties of hospitals and schools

connected with Roman Catholicism.

 Nurses fled their lives; soon there was shortage of people to care for the sick

 Hundreds of Hospitals closed; there was no provision for the sick, no one to care for the
sick

 Nursing became the work of the least desirable of women – prostitutes, alcoholics,
prisoners

 Pastor Theodore Fliedner and his wife, Frederika established the Kaiserswerth Institute for the
training of Deaconesses (the 1st formal training school for nurses) in Germany.

 This was where Florence Nightingale received her 3-month course of study in nursing.

Period of Educated Nursing/Nightingale Era 19th-20th century

 The development of nursing during this period was strongly influenced by:

1. trends resulting from wars – Crimean, civil war

2. arousal of social consciousness

3. Increased educational opportunities offered to women.

 Florence Nightingale was asked by Sir Sidney Herbert of the British War Department to recruit
female nurses to provide care for the sick and injured in the Crimean War.

 In 1860, The Nightingale Training School of Nurses opened at St. Thomas Hospital in London.

 The school served as a model for other training schools. Its graduates traveled to other
countries to manage hospitals and institute nurse-training programs.

 Nightingale focus vision of nursing Nightingale system was more on developing the
profession within hospitals. Nurses should be taught in hospitals associated with
medical schools and that the curriculum should include both theory and practice.

 It was the 1st school of nursing that provided both theory-based knowledge and clinical
skill building.

 Nursing evolved as an art and science

 Formal nursing education and nursing service begun

Facts about Florence Nightingale

 Mother of modern nursing. Lady with the Lamp because of her achievements in improving the
standards for the care of war casualties in the Crimean war.

 Born may 12, 1800 in Florence, Italy

 Raised in England in an atmosphere of culture and affluence

 Not contended with the social custom imposed upon her as a Victorian Lady, she developed her
self-appointed goal: To change the profile of Nursing

 She compiled notes of her visits to hospitals and her observations of the sanitary facilities, social
problems of the places she visited.

 Noted the need for preventive medicine and god nursing

 Advocated for care of those afflicted with diseases caused by lack of hygienic practices

 At age 31, she entered the Deaconesses School at Kaiserswerth in spite of her family’s resistance
to her ambitions. She became a nurse over the objections of society and her family.
  Worked as a superintendent for Gentlewomen Hospital, a charity hospital for ill governesses.

 Disapproved the restrictions on admission of patients and considered this unchristian and
incompatible with health care

 Upgraded the practice of nursing and made nursing an honorable profession for women.

 Led nurses that took care of the wounded during the Crimean war

 Put down her ideas in 2 published books: Notes on Nursing, What It Is and What It Is Not and
Notes on Hospitals.

 She revolutionized the public’s perception of nursing (not the image of a doctor’s handmaiden)
and the method for educating nurses.

Period of Contemporary Nursing/20th Century

 Licensure of nurses started

 Specialization of Hospital and diagnosis

 Training of Nurses in diploma program

 Development of baccalaureate and advance degree programs

 Scientific and technological development as well as social changes marks this period.

1. Health is perceived as a fundamental human right

2. Nursing involvement in community health

3. Technological advances – disposable supplies and equipments

4. Expanded roles of nurses was developed

5. WHO was established by the United Nations

6. Aerospace Nursing was developed

7. Use of atomic energies for medical diagnosis, treatment

8. Computers were utilized-data collection, teaching, diagnosis, inventory, payrolls, record

keeping, and billing.

9. Use of sophisticated equipment for diagnosis and therapy