FUNDA WEEK 6

Nursing History

Nursing history provides nurses with the intellectual and political tools used by nursing pioneers to shape nursing values and beliefs in different social contexts.

4000 BC - Primitive Care

-        mothers - nurses worked with priests in providing care for the sick

Before Mid 1800

-        Without organization, education, social status

-        Women stayed at home, reared children, were good housewives and caring mothers

Ancient Greece

-        Built temples to honor HYGEIA, the goddess of health

-        Priestesses (who were not nurses) attended to those housed in the temples

Roman Empire

-        3rd and 4th Century – wealthy matrons (FABIOLA) of the Roman Empire used their wealth to provide houses of care and healing

-        Caregives had no formal training in therapeutic modalities and cared for the sick as a religious duty

Middle Ages

➢     Military, religious, and lay orders of men provided care

➢     Knights hospitalers, the Teutonic Knights, the Teriaries, the Knights of St. Lazarus, the Holy Order of the Holy Spirit, and the Hospital Brothers of St. Anthony built hospitals and provided nursing care to their sick and injured comrades

➢     In the rural parts of Eastern Roman Empire and the West – nursing was viewed as a nurturing job for women

Renaissance

➢     The Protestant Reformation (AD 1500-1700) dissolved Catholic hospitals in many European countries a sick no longer had institutional care

Enlightenment and Industrial REvolution

➢     London – medical schools were founded

➢     France – barbers functioned as surgeons (leeching, enemas, extracting teeth)

➢     Early mid-1800, women (alcoholics & prostitutes) made beds, scrubbed floors, & bathed the poor

War and Religious Influences

➢     India – only men were considered “pure” enough to be nurses

Theodore Fliedner

➢     revived the Church Order of Deaconesses – opened a small hospital and KAISERSWERTH training school in Germany

Crimean War (1854-1856)

○      Sir Sidney Herbert of British War Department asked FLORENCE NIGHTINGALE to recruit female nurses, set up sanitation practices

■      Performed a miracle: mortality rate in BARRACK HOSPITAL in Scutari dropped from 42% to 2%

American Civil War (1861-1865)

○      Harriet Tubman and Sojourner Truth – provided care and safety to slaves who had to flee to the North on the Underground Railroad

○      Mother Biekerdyke and Clara Barton

○      Walt Whitman and Louisa May Alcott – authors who volunteered as nurses, cared for injured soldiers in the military hospitals

○      Dorothea Dix – became the Union’s superintendent of Female Nurses in Army Hospital - recruited and supervised nurses in the army hospital

World War 1

➢     brought progress in healthcare especially in the field of surgery

World War 2

○      Cadet Nurse Corps

■      was established due to increased casualties and acute shortage of caregivers

■      “practical” nurses, aides, & technicians a provided care under the instruction and supervision of better prepared nurses

The Women’s Movement (1848)

○      Women were not considered equal to men. Society did not value education for women. Women did not have the right to vote. In mid-1900s, more women were being accepted into colleges & universities

Nightingale Training School of Nurses

The first school of nursing, opened in 1860 at St. Thomas Hospital in London, providing both theoretical knowledge and clinical skills.

➢     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 began

PEriod of Contemporary Nursing

➢     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 mark this period:

a.     Health is perceived as a fundamental human right

b.     Nursing involvement in community health

c.     Technological advances – disposable supplies and equipments

d.     Expanded roles of nurses was developed

e.     WHO was established by the United Nations

f.       Aerospace Nursing was developed

g.     Use of atomic energies for medical diagnosis, treatment

h.     Computers were utilized-date collection, teaching, diagnosis, inventory, payrolls, record keeping, billing

i.       Use of sophisticated equipment for diagnosis and theraphy

Early Beliefs in the Philippines

➢     Early Filipinos subscribed to superstitious belief and practices in relation to health and sickness

➢     Diseases, their causes and treatment were associated with mysticism and superstitions

➢     Cause of disease was caused by another person (an enemy of witch) or evil spirits

➢     Persons suffering from diseases without any identified cause were believed bewitched by “mangkukulam”

➢     Difficult childbirth were attributes to “nonos”

➢     Evil spirits could be driven away by persons with no powers to expel demons

➢     Belief in special gifs of healing: priest-physician, word doctors, herbolarios/herb doctors

Early Hospitals During the Spanish REgime

➢     Religious orders exerted efforts to care for the sick by building hospitals in different parts of the Philippines:      

○      Hospital Real de Manila

○      San Lazaro Hospital

○      Hospital de Indios

○      Hospital de Aguas Santas

○      San Juan de Dios Hospital

Josephine Bracken

wife of Dr. Jose Rizal who installed a field in hospital in an estate in Tejeros that provided nursing care to the wounded night and day

Rosa Sevilla de Alvaro

1. converted their house into quarters for Filipino soldiers during the Phil-American War in 1899

Hilaria de Aguinaldo

wife of Emilio Aguinaldo who organized the Filipino Red Cross

Melchora Aquino (Tandang Sora)

considered the first military nurse in the Philippines

– nursed the wounded Filipino soldiers, gave them    shelter and food

Captain Salomen

a revolutionary leader in Nueva Ecija who provided nursing care to the wounded  when not in combat

Agueda Kahabagan

revolutionary leader in Laguna who also provided nursing services to her troops

Trinidad Tecson (Ina ng Biak na Bato)

– stayed in the hospital at Biac na Bato to take care for the wounded soldiers

-        Spanish domination ended a American occupation began

-        Need to establish nursing schools became urgent

-        Fast turnover of American doctors and nurses a need to train Filipino women to

Florence Nightingale

During the Crimean War, she recruited female nurses, implemented sanitation practices, and significantly reduced the mortality rate in Barrack Hospital.

1909

3 female graduated as “qualified medical-surgical nurses” - Felipa de la Pena, Nicasia Casa, Dorotea Caldito

1920

➢     1st board examination for nurses - 93 candidates took the exam, 68 passed with the highest rating of 93.5% - Anna Dahlgren

Anna Dahlgren

93.5% highest rating first board

1921

➢     Filipino Nurses Association was established (now PNA) as the National Organization of Filipino Nurses – PNA: 1st President - Rosario Delgado

-        Founder – Anastacia Giron-Tupas

March 1, 1919

➢     1st nursing law was passed pursuant to Act No. 2808 known as “An Act Regulating the Practice of Nursing Profession in the Philippines”

June 19, 1953

– enactment of Republic Act 877, known as the “Philippine Nursing Act”

Nov 21, 1991

➢     approval of Republic Act 7164

October 21, 2002

➢     RA 9173, known as the “Philippine Nursing Act of 2002” - now the prevailing law regulating the practice of nursing

➢   17th Congress: Senate Bill NO. 2069

Comprehensive Nursing Law of 2018

Filed by Maria Lourdes Nancy Binay, this act aims to provide a comprehensive nursing law for a quality health system, repealing the Philippine Nursing Act of 2002.

Nursing as an art- Caring

Caring in nursing involves a deep concern for the welfare of others, fostering a connection between the nurse and the client.

Caring Practice Models

1. Culture Care Diversity & Universality…. Leininger

2. Theory of Human Care… Watson

3. Theory of Caritative Caring… Erikson

4. Core, Care, Cure… Hall

5. Nursing as Caring… Boykin and Schoenhofer

6. Theory of Caring… Swanson

7. Technological Nursing as Caring… Locsin

6 C’s Of caring by M.S. Roach (2013)

Compassion

Competence

Confidence

Conscience

Commitment

Comportment

Compassion

Awareness of one’s relationship to others, sharing their joys, sorrows, pain, and accomplishments. Participation in the experience of another.

Competence

Having the knowledge, judgment, skills, energy, experience, and motivation required to respond adequately to the demands of one’s professional responsibilities.

Confidence

Comfort with self, client, and others that allows one to build trusting relationships.

Conscience

Morals, ethics, and an informed sense of right or wrong. Awareness of personal responsibility.

Commitment

The deliberate choice to act in accordance with one’s desires as well as obligations, resulting in investment of self in a task or cause.

Comportment

Appropriate bearing, demeanor, dress, and language that are in harmony with a caring presence. Presenting oneself as someone who respects others and demands respect.

Caring for Self

Described as helping oneself grow and actualize one’s possibilities, nurturing oneself, and initiating & maintaining behaviors that promote healthy living and wellbeing.

Knowing

Understanding the other’s needs and how to respond to these needs.

Alternating

Moving back and forth between the immediate & long-term meanings of behavior, considering the past.

Patience

Enables the other to grow in his own way and time.

Honesty

Includes awareness and openness to one’s own feelings and a genuineness in caring for the other.

Trust

Involves letting go, to allow the other to grow in his own way and own time.

Humility

Acknowledging that there is always more to learn, and that learning may come from any source.

Hope

Belief in the possibilities of the other’s growth.

Courage

The sense of going into the unknown informed by insight from past experience.

Nursing as an Art- Teaching

An active process in which one individual shares information with others to provide them with facts to make behavioral changes, considered the hallmark of quality nursing care.

Benefits of Patient Education

1. Increased patient understanding

2. More active approach to healthcare

3. Enhanced motivation and better outcomes

4. Improved healthcare system

Focus on Teaching

1. Health Promotion

2. Disease Prevention

3. Health Restoration & Maintenance

4. Rehabilitation

Health Promotion

A way of thinking that revolves around a philosophy of wholeness, wellness, and well-being, enabling people to increase control over and improve their health.

Client Education Topics of Health Promotion

1. Parenting Skills

2. Nutrition

3. Exercise

4. Family Planning

Disease Prevention

Behavior motivated by a desire to actively avoid illness, detect it early, or maintain functioning within the constraints of illness.

Client Education Topics on Disease Prevention

1. Immunizations

2. Health Screenings

3. Smoking Cessation

4. Breast Self-examination

5. Safety measures (e.g. car seats)

Primary Prevention

Generalized health promotion and specific protection against disease, applied to generally healthy individuals or groups.

○      Teaching Role of the Nurse in Primary Prevention – As educators, nurses offer information and counseling to communities and populations that encourage positive health behaviors. Primary prevention is typically the most economical method of health care

Secondary Prevention

Emphasizes early detection of disease, prompt intervention, and health maintenance for individuals experiencing health problems.

○      Teaching Role of the Nurse in Secondary Prevention – Educae patients to reduce and manage controllable risks, modifying the individual’s lifestyle choices and using early detection methods to identify diseases in their beginning stages when treatment may be more effective. Teach clients about regular screenings, conducted by a preventative health care nurse

Tertiary Prevention

Begins after an illness, focusing on rehabilitating individuals and restoring them to an optimum level of functioning within the constraints of the disability.

○      Teaching Role of the Nurse in Tertiary Prevention

1.     Nurse helps patient make and execute a care plan

2.     Nurse encourages client to practice behavior modifications necessary to improve conditions

3.     Nurse discusses methods of minimizing negative effects of illness and preventing future complications

Health Restoration

Activities that help an ill client return to health.

Health Maintenance

Behavior directed toward sustaining the current level of health.

Rehabilitation

Process of helping an individual achieve the highest level of function, independence, and quality of life possible.

Acuity

– term that classifies where the client is on the care continuum, from being highly dependent on complex nursing care to being independent in self-care at the other end of the continuum