Ch1 Intro

• Nursing


  Has had a significant effect on people's lives. Rapid change continues to transform the profession of nursing and health care system. Today, nurses bring knowledge, leadership, spirit, and vital expertise to expanding roles that afford increased participation, responsibility, and rewards.
• Historical Perspectives of Nursing

  • Nursing has undergone dramatic change in response to societal needs and influences. A look at nursing's beginning reveals its continuing struggle for autonomy and professionalization. In recent decades, a renewed interest in nursing history has produced a growing amount of related literature.
• Aspects of events that have influenced nursing practice

  • Women's Role
  • Religion
  • War
  • Societal Attitudes
• Women's Role


  • Traditionally female role of wife, mother, daughter, and sister have always included the care and nurturing of other family members. From the beginning of time, women have cared of infants and children; thus, nursing could be said have its root in "the home". Women were called on to care for others in community who were ill. The traditional nursing role has always entailed humanistic caring, nurturing, comforting, and supporting.
• Religion


  • A-Islam: Rufaidah bint Sa'ad - the first professional nurse in Islamic history. She lived at the time of the Prophet Muhammad (PBUH) at time 8 AH. Her history illustrates all the attributes expected of a good nurse. She was kind and empathetic. She had clinical skills that she shared with the other nurses whom she trained and worked with. She went out to the community and tried to solve the social problems that lead to disease. She was a public health nurse and a social worker. Rufaidah is an inspiration for the nursing profession in the Muslim world. In peace time she set up a tent outside the Prophet's mosque in Madina where she nursed the sick. During war she led groups of volunteer nurses who went to the battle-field and treated the casualties. She participated in the battles of Badr, Uhud, Khandaq, Khaibar, and others. Rufaidah's field hospital tent became very famous during the battles and the Prophet used to direct that the casualties be carried to her.

  1. Christian: At time of Roman empire, Fabiola was a saint, provide her wealth to provide houses of care and healing for poor, the sick, and homeless. The Crusades formed several orders of knights (Knights of John of Jerusalem, Teutonic Knights, and Knights of Saints Lazrus) these brothers of arm provided nursing care to their sick and injures comrades. These orders built hospitals, and organization and management of which set standards for administration of hospitals. In 1836, Theodor Fliedner reinstituted "the Order of Deconesses" and opened a small hospital and training school in Kaiserwerth, Germany, the same school were Florence Nightingale received her training in nursing.
• War


  • A-Crimean War: Led the urge to recruit females to care of sick and injured people in Crimea. Florence Nightingale and her nurses transformed the military hospitals by setting up sanitation practices, such as hand washing and washing clothing regularly.

  Nightingale's Accomplishments: Demonstrated the value of nursing care in reducing morbidity rates in the Crimean War. Established the Nightingale School for Nurses at St. Thomas' Hospital in London. Advocated the principles of cleanliness and nutrition in promoting health. Developed public awareness of the need for nurses.

  1. American Civil War: Nurses provided care to injured and dying soldiers.
  2. World War I: Women were rushing to volunteer their nursing services. Progress in health care occurred during this war, particularly in surgery (anesthetic agent use, infection control, blood typing, and prosthetics).
  3. World War II: Auxiliary health care workers became prominent. Practical nurses, aids, and technicians provided much of actual nursing care under instructions of better prepared nurses. Medical specialties also arose at the time to meet the needs of hospitalized clients.
• Societal Attitudes


  • Before 1800s nursing were without organization, education, or social status. The role of women were only wife or mothers. In hospitals they were poorly educated. At time of Nightingale she brought respect to nursing profession (they were seen them as noble, religious, and self sacrificing). Later on the image of nursing change positively.
• Florence Nightingale's Definition of Nursing

  "The act of utilizing the environment of the patient to assist him in his recovery"
• Virginia Henderson's Definition of Nursing

  "The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death)"
• Canadian Nurses Association (CNA) Definition of Nursing


  Described nursing practice as a dynamic, caring, helping relationship in which the nurse assists the client to achieve and obtain optimal health.
• American Nurses Association (ANA) Definition of Nursing (1973)


  "Direct, goal oriented, and adaptable to the needs of the individual, the family, and the community during health and illness"
• American Nurses Association (ANA) Definition of Nursing (2010, 2015)


  "Nursing is the protection, promotion, and optimization of health and abilities, preventions of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations"
• Recipients of Nursing

  Consumers, patients, clients. A consumer is an individual, group, or community that uses a service. A patient is a person who is waiting for or undergoing medical treatment and care. A client is a person who engages the advice or services of another who is qualified to provide this service.
• Nursing Education


  • The practice of nursing is controlled from within the profession, through state boards of nursing and professional nursing organizations. Nursing education has been evolved in response to new scientific knowledge, advanced technology, and cultural, political and socioeconomic changes in community. Current nursing curricula emphasize critical thinking and application of nursing knowledge for promoting, maintenance, restoration of health as provided by community and hospital settings.
• Types of Educational Programs


  • Licensed Practical (Vocational) Nursing Programs
  • Registered Nursing Programs: Diploma, Associate Degree, Baccalaureate Degree
  • Graduate Nursing Programs: Master's Degree, Doctoral Programs
  • Continuing Education
• Nursing programs

  • BSN programs
  • Graduate nursing programs
• BSN programs


  Baccalaureate degree program, 4 years in length, located in universities and colleges, include courses in sciences, humanities, and nursing
• Graduate nursing programs


  • Master's degree, emphasize on research, provide specialized knowledge and skills that enable nurse to assume advanced role in practice, education, and administration
  • Doctoral program, offer doctoral degree in education, psychology, sociology, and physiology, doctoral in nursing philosophy and doctoral in nursing practice
• Continuing Education


  Enhance the knowledge or skills of practicing professionals, responsible for all practicing nurses, inform nurses to 1- new techniques and knowledge, 2- help nurses attain specialized area of practice, 3- provide knowledge about legal and ethical issues essential for nursing practice, require contact hours ranges from 15-30 hours per 2 years, one type of these programs in-service training programs to update knowledge and skills of employees
• Scope of Nursing


  • Providing care for individuals, families, and communities
• Areas of Nursing Practice

  • Promoting health and wellness
  • Preventing illness
  • Restoring health
  • Care of the dying
• Promoting Health and Wellness

  Wellness is a state of well-being, it means engaging in attitudes and behavior that enhance the quality of life and maximize personal potential, nurses promote wellness in clients who are both healthy and ill, this may involve individual and community activities to enhance healthy lifestyles, such as improving nutrition and physical fitness, preventing drug and alcohol misuse, restricting smoking, and preventing accidents and injury in the home and workplace
• Preventing Illness


  The goal of illness preventing programs is to maintain optimal health by preventing disease, nursing activities that prevent illness include immunizations, prenatal and infant care, and prevention of sexually transmitted disease
• Restoring Health


  Focuses on the ill client and it extends from early detection of disease through helping the client during the recovery period
• Caring for the Dying


  Involves comforting and caring of people of all ages who are dying, it involves clients live as comfortably as possible until death and helping support persons cope with their death
• Nursing Activities


  • Providing direct care to the ill person, such as administering medications, baths, and specific procedures and treatments
  • Performing diagnostic and assessment procedures, such as measuring blood pressure and examining feces for occult blood
  • Consulting with other health care professionals about client problems
  • Teaching clients about recovery activities, such as exercises that will accelerate recovery after a stroke
  • Rehabilitating clients to their optimal functional level following physical or mental illness, injury, or chemical addiction
• Settings for Nursing


  • Hospitals
  • Clients' homes
  • Community agencies
  • Ambulatory clinics
  • Long-term care
  • Health maintenance organization (HMOs)
  • Nursing practice centers
• Nursing Autonomy and Responsibility


  Nurses have different degrees of nursing autonomy and nursing responsibility in the various settings, they may provide direct care, teach clients and support persons, serve as nursing advocates and agents of change, and help determine health policies affecting consumers in the community and in hospitals
• Standards of Nursing Practice

  • Reflect the values and priorities of the nursing profession
  • Provide direction for professional nursing practice
  • Provide a framework for the evaluation of nursing practice
  • Define the profession's accountability to the public and client outcomes for which nurses are responsible
• ANA Standards of Clinical Nursing Practice

  • Assessment: the nurse collects patient health data
  • Diagnosis: the nurse analyzes the assessment data in determining diagnoses
  • Outcome identification: The nurse identifies expected outcomes individualized to the patient
  • Planning: the nurse develops a plan of care that prescribes interventions to attain expected outcomes
  • Implementation: the nurse implements the interventions identified in the plan of care
  • Evaluation: the nurse evaluates the patients progress toward attainment of outcomes
• Roles and Functions of the Nurse

  • Caregiver
  • Communicator
  • Teacher
  • Advocator
  • Counselor
  • Manager
  • Leader
  • Researcher
• Caregiver


  Encompasses the physical, psychosocial, developmental, cultural, and spiritual levels, the nursing process provides nurses with a framework for providing care, a nurse may provide care directly or delegate it to other caregivers
• Communicator


  Communication is integral to all nursing roles, nurses communicate with the client, support persons, other health professionals, and people in the community
• Teacher


  The nurse helps clients learn about their health and the health care procedures they need to perform to restore or maintain their health
• Advocate


  Acts to protect the client, in this role the nurse may represent the client's needs and wishes to other health professionals, they also assist clients in exercising their rights and help them speak up for themselves
• Counselor


  The process of helping a client to recognize and cope with stressful psychological or social problems, to develop improved interpersonal relationships, and to promote personal growth, it involves providing emotional, intellectual, and psychological support
• Change Agent


  When assisting others, that is, clients, to make modifications in their own behavior, nurses also often act to make changes in a system, such as clinical care, if it is not, helping a client return to health, nurses are continually dealing with change in the health care system
• Manager


  Manages the nursing care of individuals, families, and communities, the nurse manager also delegates nursing activities to other nurses, and supervises and evaluates their performance, nurses case managers work with the multidisciplinary health care team to measure the effectiveness of the case management plan and to monitor outcomes, each agency or unit specifies the role of the nurse case manager
• Leader


  Influences others to work together to accomplish a specific goal, the leader role can be employed at different levels: individual client, family, groups of clients, colleagues, or the community
• Expanded career roles such as those of nurse practitioner, clinical nurse specialist, nurse midwife, nurse educator, nurse researcher, and nurse anesthetist, all of which allow greater independence and autonomy