Ch. 1 Evolution of Nursing Thought and Action Nursing
Images throughout history
The Angel of Mercy- is serene and content, is usually shown with a halo or other
religious symbol. Until 100 years ago, nurses cared for patients at great risks to
themselves. Even as recently as the 1950’s, antibiotics were not readily available, and
the chief cause of mortality was infectious disease.
-History demonstrates a strong link between nursing and religious orders.
- The values of service and devotion to the patient faded along with the influence of
Christianity during the 14th to the 16th centuries (renaissance)
The Handmaiden- This stereotype portrays the male physician as the dominant role, this
perception of nursing has changed with nurses doing more collaboration, planning and
providing care not only the direction of the physicians but also along with them.
- Although the handmaiden image was more widespread in the past, even then not all
nurses considered themselves to be subservient to physicians
The Battle-Ax- the nurse at the “torturer”, treating her patients with cruelty and disdain.
Care giving activities contribute to the persistence of the battle-ax image- drawing blood,
giving injections….
The naughty nurse- the sexy nurse image arose in the 20th century with burlesque
shows.
The Military Image – nurses are portrayed in uniform providing support at the battlefield
Hospitalers- specialized soldiers during the crusade who at the end of battle returned to
the outposts to care for the sick and injured
Describe the role of religion in the development of nursing.
In Eygpt, ancient Greece and Rome, temples were health centers as well as places of
worship. Nurses started off in monasteries but moved to hospitals due to persecution.
Ancient writings describe nursing responsibilities/attributes to include: knowledge of the
preparation, compounding, and administration of drugs, wisdom, purity and devotion to
the patient.
The association of nursing with religion has not always been positive
During the 15th and 19th centuries, the influence of Christianity began to wane and many
nurses with religious orders fled to avoid imprisonment and death. There was a shift in
medicine that moved practitioners from monasteries to universities.
-Many nursing programs are still affiliated with religious groups.
Identify the factors that led to the change of nursing from a vocation of men and
women to a predominantly female profession
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Define nursing in your own words.
Nurses assist the individual sick or well in activities that contribute to health or it’s
recovery, or a peaceful death.
The international council of nurses definition: pg 11.
“ Nursing encompasses autonomous and collaborative care of individuals of all ages,
families, groups and communities, sick and well and in all settings. Nursing includes the
promotion of health, prevention of illness and the care of ill, disabled and dying people.
Advocacy, promoting of a safe environment, research, participation in shaping health
policy and in patient and health systems management, and education are also key
nursing roles.”
Florence Nightingales contributions to nursing:
The establishment of nursing as a distinct profession
Introduction of a broad-based liberal education for nurses Major
reform in the delivery of care in hospitals
The introduction of standards to control the spread of disease of hospitals (
epidemiology), decrease of nosocomial infections
Major reforms in healthcare for the military
Lilian Wald and Mary Brewster-
Founded the Henry Street Settlement in New York to improve the health and social
conditions of poor immigrants, this is considered the start of public health nursing in the
U.S.
White Women- About 82% of RN’s are white, 6% are male. Major nursing organizations
agree that we need a more diversified nursing force.
Examples of nursing
activities Dependent
activities
-Administering prescribed medication
-Assisting with a diagnostic test
- Administering IV fluids
-Ensuring that the patient received the prescribed diet
Independent Activities
-Evaluating the patient’s response to medication and withholding the next dose if the
patient has a negative reaction
-Teaching the patient what to expect from the diagnostic test , preparing the patient for
the test.
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, -Evaluating the patient’s response to treatment, monitoring the flow rate
-Teaching a pregnant woman about additional nutrients needed in her diet.
Full- spectrum nurse:
Nurses use clinical judgement, critical thinking, and problem solving as they care for
patients.
Clinical Judgment- involved observing, comparing, contrasting and evaluating the client’s
condition to determine where change has occurred.
Critical thinking- is a reflective thinking process that involved collecting information,
analyzing the adequacy and accuracy of the information.
Problem solving- is a process by which nurses consider an issue and attempt to find a
satisfactory solution to achieve the best outcomes.
Learning outcomes… Pgs 12-24
Differentiate among the various forms of education
Practical and Vocational Nursing Education
• Known as LVNs or LPNs
• May attend one of approximately 1200 approved programs given at
technical or community college
• Usually lasts a year in both classroom and clinical teaching
• After completing education program must pass NCLEX-PN exam
Registered Nursing entry education
• 5 educational pathways lead to an RN
• All must complete NCLEX-RN
o Diploma programs
▪ Last 3 years focuses in clinical experiences
o Associate degree programs
▪ Offered in community college
▪ Account for 53% of RN programs in the U.S.
o Baccalaureate degree programs
▪ Lasts at least 8 semesters
▪ About 42% of nursing programs
o Master’s entry programs
▪ Usually has another baccalaureate degree in another field
▪ Programs are usually 3 years of full time study
▪ After education completion you are eligible to take
licensing exam and receive master’s degree in
nursing
o Doctoral entry
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, ▪ Very limited enrollment
Graduate Nursing Education
▪ Master’s degree program
o Prepares RNs to function in a more independent role
o Program usually lasts 2 or years or longer at the university level
▪ Doctoral programs
o Typically student has Baccalaureate and a Masters degree
o Prepares for advanced clinical practice
How Is Nursing Practice Regulated?
▪ Each state enacts its own nurse practice act
▪ Must be licensed as a nurse
▪ States require graduation from an approved nursing program
▪ Nursing is also guided by a standards of practice
o Provide a means by which a profession clearly describes the focus
of its activities, the receipts of service, and the responsibilities for
which its practioner are accountable
Give four examples of influential nursing organizations
▪ American and Canadian Nurses Associations
o Originally focused on establishing standards or nursing
o They track health-care legislation, serve as liaisons with national
government representatives
▪ National League for Nursing
o First to establish and maintain a universal standard of education
o Sets standards for all types of nursing education programs and
evaluate the programs
▪ International Council of Nursing
o Represents nursing on a global level
o More than 120 nations
▪ Sigma Theta Tau International
o National honor society for nursing
Name and recognize the four purposes of nursing care
▪ Health promotion
o Activities foster the highest state of well-being of the recipient of
the activities
▪ Illness prevention
o Focuses on avoidance of disease, infection, and
other comorbidities
o Activities are targeted to decrease the risk of developing an illness
or minimize the risk of exposure to disease
Health Restoration
▪ Activities foster a return to health for those already ill
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