FUNDA WEEK 6

HISTORY OF NURSING IN THE WORLD

➢     History provides current nurses with the same intellectual and political tools that determined nursing pioneers applied to shape nursing values and beliefs to the social context of their times.

➢     Nursing history is not an ornament to be displayed or anniversary days, nor does it consist of only happy stories to be recalled and retold on special occasions

➢     Nursing history is a vivid testimony, meant to incite, instruct and inspire today’s nurses as the bravely tread the winding path of a reinvented health care system

EARLY CIVILIZATION

➢     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 & 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 & 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

NURSING & THE CIVIL WAR

➢     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 II

○      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

PERIOD OF EDUCATED NURSING/ NIGHTINGALE ERA 19TH-20TH CENTURY

➢     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 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

HISTORY OF NURSING, CONCEPT OF NURSING AS AN OF CARING & TEACHING

HISTORY OF NURSING IN THE PHILIPPINES

EARLY BELIEFS, PRACTICES AND CARE OF THE SICK

➢     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

PROMINENT PERSONAGES INVOLVED DURING THE PHILIPPINE REVOLUTION

1. 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

2. Rosa Sevilla de Alvaro – converted their house into quarters for Filipino soldiers during the Phil-American War in 1899

3. Hilaria de Aguinaldo – wife of Emilio Aguinaldo who organized the Filipino Red Cross

4. Melchora Aquino (Tandang Sora) – considered the first military nurse in the Philippines

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

5. Captain Salomen – a revolutionary leader in Nueva Ecija who provided nursing care to the wounded  when not in combat

6. Agueda Kahabagan – revolutionary leader in Laguna who also provided nursing services to her troops

7. 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

SCHOOLS OF NURSING IN THE PHILIPPINES

1. St. Paul’s Hospital School of Nursing. Intramuros Manila – 1900

2. Iloilo Mission Hospital Training School of Nursing – 1906 – current name – CPU College of Nursing

3. St. Luke’s Hospital School of Nursing – 1907 – opened after four years as a dispensary clinic

4. Mary Johnston Hospital School of Nursing – 1907 – Mary Johnston Hospital built in 1908

5. Philippine General Hospital School of Nursing – 1910

6. UST College of Nursing – 1877 – 1st College of Nursing in the Philippines

7. MCU College of Nursing – June 1947 – 1st College that offered BSN - 4 year program

8. UP College of Nursing – June 1948

9. FEU Institute of Nursing – June 1955

10. UE College of Nursing – October 1958

FACTS ABOUT NURSING IN THE PHILIPPINES

➢     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

➢     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”

➢     November 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 on October 10, 2018 by Binay, Maria Lourdes Nancy S.

○      SBN-2069 (as filed)

○      11/12/2018

➢     An act providing for a comprehensive nursing law towards quality health system, repealing for this purpose republic act no. 9173 otherwise known as the Philippine Nursing Act of 2002

HISTORY OF THE USLS COLLEGE OF NURSING

➢     1946 Negros Occidental Provincial Hospital – then became the Corazon Locsin Montelibano Memorial Hospital School of Nursing

➢     Nursing Department of USLS traces its beginning at the Corazon Locsin Montelibano Memorial Hospital School of Nursing

○      The hospital was first known as the Negros Occidental Provincial Hospital

○      It was renamed Western Visayas Regional Hospital Corazon Locsin Montelibano Memorial Regional Hospital

○      There was a proliferation of private nursing schools and colleges all over the country

○      The increase in the number of schools of nursing led to the development of the BSN Program

○      This development made the Ministry of Health decide on the cessation of the Graduate in Nursing (GN) program

○      In December 1982, E.O. No. 851 s. 1982, Section 18 of the Ministry of Health ordered for the phrasing out of all schools of nursing connected with government hospitals

○      This move, on the part of the government, prompted CLMMH to tie up with La Salle College

○      CLMMH provided academic and clinical training whereas La Salle College supplemented the general education requirements, the overall academic administration & granted the BSN degree

○      Phase out plans at CLMMH were completed in March 1984 adn in June 1985 La Salle College took over sole academic administration & operation of the Nursing Program

○      The take over of La Salle of Nursing Program has been remarkable & smooth primarily because its entire faculty force came from the CLMMH School of Nursing

○      In Jun3 1988, the institution was conferred a university status because of the strength of its academic programs

NURSING AS AN ART – CARING

➢     Caring is defined as sharing deep & genuine concern about the welfare of another person. Caring practice involves connection, mutual recognition, and involvement between nurse & client

WHAT ARE THE 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

THE 6 C’s OF CARING

➢     By M.S. Roach (2013), Caring: The Human Mode of Being

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

2. Competence – having the “knowledge, judgement, skills, energy, experience and motivation required to respond adequately to the demands of one’s professional responsibilities

3. Confidence – comfort with self, client, and others that allows one to build trusting relationships

4. Conscience – morals, ethics, and an informed sense of right or wrong. Awareness of personal responsibility

5. 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

6. 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

MAINTAINING CARING PRACTICE

➢     Caring for Self

-        Described as helping oneself grow and actualize one’s possibilities (Mayeroff, 1990)

-        Means nurturing oneself

-        Involves initiating & maintaining behaviors that promote healthy living  wellbeing

➢     Caring as “Helping the Other Grow”

MAJOR INGREDIENTS OF CARING

1. Knowing means understanding the other’s needs and how to respond to these needs

2. Alternating rhythms signifies moving back and forth between the immediate & long-term meanings of behavior, considering the pas

3. Patience enables the other to grow in his own way and time

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

5. Trust involves letting go, to allow the other to grow in his own way & own time

6. Humility means acknowledging that there is always more to learn, and that learning may come from any source

7. Hope is belief in the possibilities of the other’s growth

8. Courage is the sense of going into the unknown informed by insight from the past experience

NURSING AS AN ART – TEACHING

➢     Teaching – it is 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. It is a goal-directed process that provides opportunities for learning. This addresses the client's need for information.

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 OF TEACHING

1. Health Promotion

2. Disease Prevention

3. Health Restoration & Maintenance

4. Rehabilitation

HEALTH PROMOTION

➢     An important component of nursing practice, it is defined as a way of thinking that revolves around a philosophy of wholeness, wellness, and well-being. In teaching, it is a process of enabling people to increase control over and to improve their health

CLIENT EDUCATION TOPICS

1. Parenting Skills

2. Nutrition

3. Exercise

4. Family Planning

DISEASE PREVENTION

➢     Defined as behavior motivated by a desire to actively avoid illness, detect it early, or maintain functioning within the constraints of illness. In teaching, it focuses on specific efforts aimed at reducing the development and severity of chronic diseases & other morbidities.

CLIENT EDUCATION TOPICS

1. Immunizations

2. Health Screenings

3. Smoking Cessation

4. Breast Self-examination

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

LEVELS OF PREVENTION

➢     Primary Prevention – Generalized health promotion and specific protection against disease. It precedes disease or dysfunction and is 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 on early detection of disease, prompt intervention, and health maintenance for individuals experiencing health problems. Includes prevention of complications and disabilities

○      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, when a defect or disability is fixed, stabilized, or determined to be irreversible. Focus a to rehabilitate individuals and restore 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 AND MAINTENANCE

➢     Health Restoration – a process consisting of activities that help an ill client return to health

➢     Health Maintenance – defined as behavior directed toward sustaining the current level of health

➢     Client Education Topics

○      Medication Information

○      Community Resources

○      Information about treatment modalities

REHABILITATION

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

➢     Rehabilitation does not reverse or undo the damage caused by disease of trauma, but rather helps restore the individual to optimal health, functioning, and

➢     Emphasis of rehabilitation a functional ability and the changers of adaptations a client needs in daily lifestyle