Chapter 7

How Practical/Vocational Nursing Evolved

1
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Chapter 7
Lesson 7.1

2
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Learning Objectives
Describe the role of self-defined practical nurses throughout history Discuss four major events that influenced changes in practical nursing Identify the year and place the first school of practical nursing was founded

3
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Self-proclaimed Nurse
Those who, from the beginning of time, chose to care for individuals who were ill, injured, dying, or having babies Most often the individual doing this work was someone who seemed to have a gift or touch for helping others during a medical crisis
4
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Early Practical Nurse Training Programs

Carefully limited teaching to those things that would be known by a good homemaker or a competent maid Training included information that would in no way compete with that of the physicians of the time

5
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Modern Practical Nurses

Two major changes
A gradual increase in the required formal knowledge base A requirement for licensing to practice practical nursing

Taught basic skills during the educational program After licensing, the LPN/LVN is permitted to perform complex nursing skills, as delegated by the registered nurse (RN) and allowed by the nurse practice act
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Why Learn about Nursing History?

Reading nursing history helps you see your place among the many centuries of women and men who have given care, relief, and support to the sick Knowing about the changes that occurred in nursing, you will be ready to better understand and adapt to changes in the future
7
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Nursing in Ancient Cultures

Ancient Egypt
No direct evidence exists of nursing in Egypt Written records of procedures used in ancient Egypt were probably those of the male attendants who assisted the priests in caring for the ill Egyptian physicians were considered skillful at treating fractures The custom of embalming enabled the Egyptians to become well acquainted with organs of the body
8
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Nursing in Ancient Cultures

Babylonians
Intellectually, socially, and scientifically well developed Many wars brought them misery, illness, and injury There is evidence of some kind of medical and nursing service The men dominated women and men did the primary care of those who were sick and injured
9
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Nursing in Ancient Cultures

Ancient Hebrews
Illness and misfortune were blamed on Gods wrath according to the Old Testament and Talmud They had houses for the sick and homes for the aged, and began many practices of personal hygiene and public sanitation Combined health and dietary practices according to religious beliefs
10
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Nursing in Ancient Cultures

Ancient Greece
Hippocrates
The father of modern medicine Translated teachings that were once the secrets of priests into a textbook of medicine Introduced patient-centered care, medical ethics, a method of assessment, and a system of observing symptoms and applying carefully reasoned principles to care

Temples were built for restoration of health Priestesses served as attendants to care for the sick
11
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Nursing in Early and Middle Ages

Age of Christianity (1st to 5th Centuries)
Rome established military hospitals; relatives and friends did much of the practical nursing of the day As Christianity grew, nursing developed as a form of Christian charity Christian nurses, including both men and women, cared for members of their own sex
12
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Nursing in Early and Middle Ages

Dark Ages and Middle Ages (4761000 AD and 10001475 AD)
Both men and women were involved in nursing Female religious orders took care of the sick and poor, and male orders served on the battlefield The Knights Hospitalers was an interesting group of monks: a military order trained to fight as well as tend the sick and wounded
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

13

Nursing in Early and Middle Ages

The Renaissance (1400-1600 AD)
A time for rebirth of learning
The information of the ancient Greeks and Romans was sought and put to use

The disciplines of anatomy, physiology, and scientific healing were developed It was a cruel age marked by neglect of the poor, homeless, and ill
14
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Nursing in Early and Middle Ages

17th and 18th Centuries
Hospital care did not exist in the North American colonies Family members cared for those who became ill Untrained persons, and those in a few religious orders, did nursing First hospital in America built in Philadelphia
15
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Nursing during Industrialization

Increase in diseases
Movement of people to cities Unhealthy working conditions Child labor Overcrowding Unhygienic conditions in hospitals

Ignaz Philipp Semmelweis

A Hungarian obstetrician, first developed and used antiseptic methods in 1847
16
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Nursing in the 19th Century

Overcrowded, dirty, unventilated hospital wards Nursing was an inferior, undesirable occupation Lay people, often criminals and widows, replaced religious nursing attendants Drinking on duty and accepting bribes was common
17
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Practical Nursing

First School of Nursing founded in1836 Kaiserswerth Deaconess Institute in Germany Most famous pupil of this school was Florence Nightingale

18
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Nursing: Florence Nightingale

Born in Florence, Italy (1820-1910) Graduated from Kaiserswerth Deaconess Institute Became superintendent of The Institution for the Care of Sick Gentlewomen in Distressed Circumstances in London Appointed to the task of organization and supervision of nurses during the Crimean War Became known as The Lady with the Lamp
19
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Nursing: Florence Nightingale

First Nightingale Training School of Nursing in England (1860) Strict admission standards that emphasized high moral character and intelligence Graduates went to work in far-off places

20
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Nursing: Florence Nightingale

Major Contributions
Elimination of prejudice against women from better class entering nursing Move toward development of nursing as a respectable profession

Florence Nightingale Museum opened in London in 1989

21
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Chapter 7
Lesson 7.2

22
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Learning Objectives
Identify the year and place the first school of practical nursing was founded Name the year in which licensing for practical nursing first began Present the rationale for your personal stand on entry into nursing practice

23
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Nursing in America

1849: First hospital and nursing school established in Pennsylvania 1861-1865: Civil War 1881: First chapter of American Red Cross established 1892: First school of practical Nursing founded in United States
24
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Nursing in America

Home nursing before World War I Practical nurses also assumed the role of midwife Move toward public health nursing in 19th century
Henry Street Settlement Lillian Wald
25
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Nursing in America: 20th Century

Monitoring of practical nursing by states began (1903) National League of Nursing Education
Developed a nationwide system of standardization of nursing requirements for practical nursing

Mississippi: First state to require licensure for practical nurses

26
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Nursing in America: 20th Century

World War I Smith Hughes Act of 1917 Depression of the 1930s World War II

27
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Nursing in America: 20th Century

First licensing of practical nurses (1914) Practical nursing responsibilities increase after World War II Practical nursing duties outlined (1944) Joint Committee on Practical Nurses and Auxiliary Workers in Nursing Services recommended use of the title licensed practical nurse (1949) The committee differentiated between the tasks of the RN and the LPN
28
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Growth of Nursing in America: 20th Century

Public Law 911 (1956) American Nurses Association recommends 4-year collegiate RN and 2-year technical LPN programs (1965) Unlicensed assistive personnel hired for patient care (1990s) First computerized adaptive testing introduced in 1994 (NCLEX-PN Examination)
29
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.

Entry into Practice Issues

Nursing shortage: concern for patient safety Differences between RNs and LPNs Most appropriate entry educational level: ADN, BSN, or MSN?

30
Elsevier items and derived items 2009, 2005 by Saunders, an imprint of Elsevier, Inc. All Rights Reserved.