FIELDS OF NURSING

➢      HOSPITAL NURSING

➢      COMMUNITY HEALTH NURSING – (School Health Nursing & Occupational   Health Nursing)

➢      INDEPENDENT NURSING PRACTICE

➢      NURSING EDUCATION

➢      PRIVATE DUTY NURSING

➢      MILITARY NURSING

➢      CLINIC NURSING

➢      ENTREPRENURIAL NURSING

➢      ADVANCED PRACTICE NURSING

FIELDS OF NURSING

HOSPITAL OR INSTITUTIONAL NURSING

➢     is a field of nursing that is devoted primarily to the rendering of all of the basic components of comprehensive patient care & family health nursing care in hospitals and related health care facilities.

POSITIONS OCCUPIED BY NURSES IN HOSPITALS:

1. Staff nurse

2. Head Nurse / Charge Nurse

3. Nurse Supervisor

4. Assistant Nurse Director or Assistant Chief Nurse

5. Nurse Director or Chief Nurse

MAIN RESPONSIBILITIES OF THE HOSPITAL NURSE

➢     Provides Bedside Care – performs nursing measures that will meet the patient’s physical, emotional, social and spiritual health needs

➢     Gives Health Education – teaches patients in all phases of care - the acutely ill, the convalescing and ambulatory patients

➢     Conducts Assessment – uses the nursing process

➢     Does Coordinating and Collaborating Activities

➢     Maintains Hospital Safety

➢     Initiates Discharge Planning – helps the family plan for patient’s health care needs when he returns home

➢     Specializes in Variety of Areas

ADVANTAGES OF HOSPITAL NURSING

➢     Presence of supervisors when the need for consultation arises

➢     Kept updated with new trends in medicine and nursing

➢     More staff development programs are available

➢     Opportunity to work in different areas

➢     Allowed to have two days off, sick leaves, holidays and vacations with pay

DISADVANTAGES OF HOSPITAL NURSING

➢     Possibility of understaffing due to limited budget.

➢     Lesser time to improve nursing skills  due to bulk of work

➢     More administrative problems

➢     Nurses usually feel burned-out and overworked

COMMUNITY HEALTH NURSING

➢     field of nursing whose focus of care is

○      Health Education

○      Prevention of illnesses/diseases

○      Treatment and care of the family’s and community’s health problems.

ADVANTAGES OF COMMUNITY HEALTH NURSING

➢     Health conditions of the community can easily be monitored by the nurse.

➢     It maximizes the effort of the nurse to improvise, coordinate, and appreciate the role in nation-building

DISADVANTAGES OF COMMUNITY HEALTH NURSING

➢     Limited to exposure to chronic & communicable diseases

➢     More hazards are present

➢     No fixed working hours

➢     Facilities and development of skills are limited

➢     Nurse must be outgoing not an introvert

SCHOOL HEALTH NURSING

➢     A specialized practice of professional nursing that advances the well-being, academic success, and life-long achievement of students.

RESPONSIBILITIES OF THE SCHOOL NURSE

➢     organizes, implements & evaluates the school health programs

➢     promotes health & safety in the school environment

➢     intervene with actual & potential health problems

➢     actively collaborates with other personnel & agencies

➢     loves children and should be able to work well with them.

OCCUPATIONAL HEALTH NURSING

➢     It is a specialty practice that provides for & delivers health & safety programs & services to workers, worker populations and community groups

➢     1958 – INDUSTRIAL NURSING was changed to OCCUPATIONAL HEALTH NURSING to reflect the broader and changing scope of practice within the specialty.

ADVANTAGES OF OCCUPATIONAL HEALTH NURSING

➢     Nurse practices autonomy

➢     Goes off-duty on weekends

DISADVANTAGES

➢     Nurse must be fully aware of his/her legal responsibilities as he gives immediate care to patients with serious injuries

➢     Nurses usually bargain individually for their salaries. Pay is less than hospital pay.

NURSING EDUCATION

➢     focus to teach the knowledge and skills that will enable a nurse to practice professional nursing.

POSITIONS OF THE NURSE

1. Faculty/Clinical Instructors – for the Undergraduate & Graduate programs

2. Level Chairpersons

3. Clinical Supervisor

4. Administrative Officer

5. Dean

PRIVATE DUTY NURSING

➢     a field of nursing that provides a variety of services to patients, including companionship and bathing.

CATEGORIES OF PRIVATE DUTY NURSE PRACTITIONERS

1. General Private Duty Nurse – provides basic nursing to any type of patient and his family

2. Private Duty Nurse Specialist

ADVANTAGES OF PRIVATE DUTY NURSING

➢     Has opportunities to make real friends through close association with the family and patient.

➢     Has the chance to travel and see the world

➢     Owns time, adjusts work and private life

➢     Has the chance to be updated with new knowledge or procedures

➢     Can give the best care and see its results.

DISADVANTAGES OF PRIVATE DUTY NURSING

➢     Patient can become dependent on the nurse

➢     less replacement for holidays / vacations

➢     less hospital personnel friends

➢     less assistance from the HN

➢     poor participation in professional activities

➢     no retirement, insurance and medical benefits

MILITARY NURSING

➢     Navy Nursing – nursing field that provides high-quality nursing care for sailors, marines and service members - and their families - wherever duty calls.

➢     Army Nursing – Nursing field whose mission is to provide responsive, innovative, and evidenced-based nursing care integrated on the Army Medical Team to enhance readiness, preserve life and function, and promote health and wellness for all those entrusted to their care.

➢     Air Force Nursing / Flight Nursing / Aero-space Nursing – nurse is responsible for patients, military or otherwise, who have been evacuated from battle areas to the nearest installation for treatment.

CLINIC NURSING

➢     Nurse acts as a receptionist, assists in physical examinations, performs laboratory examinations, do dressings, give injections, do referrals as well as give health teachings. Must possess good assessment skills and excellent teaching & communication skills, exhibit organizational & leadership ability.

ENTREPRENEURIAL NURSING

➢     Field of nursing that ventures into new opportunities in the world of business

➢     Requires the nurse to be capable of planning, organizing, financing, and operating his own business.

➢     Requires the nurse to work outside of an organization

➢     Responsible for indirect processes of care in his roles

ADVANCED PRACTICE NURSING

➢     APN is an umbrella term for nurses who have specialized education in the post-graduate level.

➢     Advance practice nurses - Registered Nurses who receive specialized training that allows them to practice independently or in partnership with doctors.

NURSES IN THIS FIELD MUST HAVE ACQUIRED THE

1. expert knowledge base

2. complex decision-making skills

3. clinical competencies for expanded practice.

PROPOSED REVISION OF THE PHILIPPINE NURSING PRACTICE REFORM ACT OF 2011

➢     Advanced Practice Nurse (APN)

-        is a “nurse who acquired substantial theoretical knowledge and decision making skills in the specialty area of nursing practice and proficient clinical utilization of this knowledge in implementing independent and inter-dependent nursing interventions” (Senate Bill 2720, 2016)

APN FIELDS OF SPECIALIZATION

●      Nursing Informatics

●      Renal Nursing

●      Oncology Nursing

●      Nurse-Midwife

●      Nurse Anesthetist

●      Gerontologic Nursing

●      Nurse Practitioner or Independent Nurse Practitioner

REASONS FOR AMENDMENT

1. It could be the answer to the increasing number of unemployed nurses and dearth of physicians especially in rural areas

2. With the advanced skills and training, there could be an increase in the morale and job satisfaction of nurses

3. Professional autonomy will be observed

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

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