NUR
FUNDAMENTALS OF NURSING
LECTURE
NURSING
 “The act of utilizing the environment of the patient to assist him
in his recovery.” (Florence Nightingale)
 “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) that he would
perform unaided if he had the necessary strength, will, or
knowledge, and to do this in such a way as to help him gain
independence as rapidly as possible.” (Virginia Henderson)
 “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.” (American Nurses Association
2010)
 Nursing encompasses autonomous and collaborative care of
individuals of all ages, families, groups, and communities, sick
or well and in all settings. It includes the promotion of health, the
prevention of illness, and the care of ill, disabled and dying
people. (WHO)
 Nursing is an art and a science (Potter & Perry)
NURSE
 Comes from a Latin word “to nourish” or “to cherish”
 One who cares for the sick, the injured and the physically,
mentally, and emotionally disabled
 One who advised, instruct individuals, families, groups and
communities, in the prevention, treatment of illness and
diseases and promotion of health
 Essential member of health team, who cares for individuals,
families and communities in disease prevention and promotion
of health and healthy environment.
METAPARADIGM OF NURSING
 Person: is the recipient of nursing care and may include
individuals, patients, groups, families, and communities.
 Health: the degree of wellness or well-being that the client
experiences.
 Environment: the internal and external surroundings that affect
the client.
• Nursing: The nurse’s attributes, characteristics, and actions
provide care on behalf of or in conjunction with the client.
RECIPIENT OF NURSING
 Consumer: an individual, a group of people, or a community that
uses a service or commodity.
 Consumer of health care: people who use healthcare products
or services.
 Patient: an individual who is waiting for undergoing medical
treatment and care. The word patient comes from Latin word
meaning “to suffer” or “to bear”
 Client: an individual who engages the advice or services of
another who is qualified to provide this service. Client presents
the receivers of healthcare as collaborators in the care, as
people who are also responsible for their own health.
SCOPE OF NURSING
 Nurses provide care for three types of clients: individuals,
families, and community.
FOUR AREAS OF NURSING PRACTICE
 Promoting Health and Wellness: Nurses promote wellness in
clients who are both healthy and ill. It involves individual and
community activities to enhance healthy lifestyles.
 Preventing Illness: Goal of illness prevention programs is to
maintain health by preventing disease.
GABO, AMEERAH YESHZA B.
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 Restoring Health: Focuses on the ill client, extends from early
detection of disease through helping the client during the
recovery period.
 Caring for the Dying: Involves comforting and caring for people
of all ages who are dying. Goal is to improve the quality of life
for both the client and the family.
COMMON THEMES OF NURSING
 Caring, Art, Science, Client-centered, Holistic, Adaptive,
Concerned, Helping profession.
ROLES AND FUNCTION OF A NURSE
 Caregiver: included those activities that assist the client
physically and psychologically while preserving the client’s
dignity. Required nursing actions involves full care for the
completely dependent client, partial care for the partially
dependent client and supportive educative care to assist clients
in attaining their highest possible level of health and wellness.
 Communicator: nurses communicate with the client, support
individuals, other health professionals, and people in the
community.
 Teacher: nurse helps client to learn about their health and the
healthcare procedures they need to perform to restore or
maintain their health.
 Client Advocate: acts to protect. Nurses 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 psychologic or social problems, to develop
improved interpersonal relationships, and to promote personal
growth.
 Change Agent: nurse acts as a change agent when assisting
clients to make modifications in their behavior.
 Leader: nurse acts a s a leader when she influences others to
work together to accomplish a specific goal.
 Manager: nurse manages the nursing care of individuals,
families, and communities.
 Case Manager: nurse case managers work with the
multidisciplinary health care team to measure the effectiveness
of the case management plan and to monitor outcomes.
 Research Consumer- nurses often use research to improve
client care.
PROFESSION
 Occupation that requires extensive education or a calling that
requires special knowledge, skill, and preparation.
 Criteria of Profession
 Specialized education: is an important aspect of
professional status. In modern times, the trend in education
for the professions has shifted toward programs in colleges
and universities.
 Body of Knowledge: A number of nursing conceptual
frameworks contribute to the knowledge base of nursing
and give direction to nursing practice, education, and on-
going research.
 Service Orientation: Many consider altruism (selfless
concern for others) the hallmark of a profession. Nursing
has a tradition of service to others.
 Outgoing Research: Increasing research in nursing is
contributing to nursing practice.
 Code of Ethics: Nurses have traditionally placed a high
value on the worth and dignity of others.
 Autonomy: A profession is autonomous if it regulates itself
and sets standards for its members.
 Professional Organization: The ANA is a professional
organization that “advances the nursing profession by
fostering high standards of nursing practice, promoting the
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 rights of nurses in the workplace, projecting a positive and
realistic.
 Professional Identity: sense of oneself that is influenced by
characteristics, norms, and values of the nursing discipline,
resulting in an individual thinking, acting, and feeling like a
nurse.
BENNER’S STAGES OF NURSING EXPERTISE
 Benner (2001) describe the development of professional
expertise with the five levels of proficiency.
 Stage I: Novice- no experience. Performance is limited,
inflexible and governed by rules and regulations rather than
experience.
 Stage II: Advanced Beginner- demonstrate marginally
acceptable performance. Has experienced enough real
situations to make judgments.
 Stage III: Competent- has 2 or 3 years of experience.
Demonstrates organizational and planning abilities.
 Stage IV: Proficient- has 3 to 5 years’ experience. Perceives
situation as wholes rather than in terms. Has a holistic
understanding of the client, which improves decision making.
Focuses on long term goals.
 Stage V: Expert- performance is fluid, flexible, and highly
proficient; no longer requires rules, guidelines or maxims to
connect an understanding of the situation to appropriate action.
HISTORICAL PERSPECTIVE OF NURSING
 Intuitive/Medieval Period
 Nursing performed out of compassion.
 Untaught and Instinctive
 Nursing belong to women
 Was based only on experience and observation
 Shaman: uses white magic to counteract the black magic
 Trephining: drilling the skull
o Used to treat Psychotic patients.
o Psychotic patients are believed to be possessed by evil
spirits.
 Growth of religion: most important thing that happened
 Law of preservation: inspire man in search of knowledge
 Rise in Civilization
 Start of scientific knowledge → more complex life →
increase in health problems→ demand for more nurses
 Nursing as a duty of SLAVES and WIVES.
 NURSING DID NOT CHANGE but there was progress in
the practice of medicine.
 Care of the sick was still closely allied with superstitions,
religion and magic
 Different Civilization
 BABYLONIANS
o Code of Hammurabi
o 1st recording on the medical practice
o Established the medical fees
o Discouraged experimentation
o Specific doctor for each disease
o Right of patient to choose treatment between the use
of charms, medicine, or surgical procedure
 EGYPTIAN
o Art of embalming
o Mummification
o Removing the internal organ of the dead body
o Instillation of herbs and salt to the dead
o Used to enhance their knowledge of the human
anatomy. Since work was done and performed on the
dead, they learned nothing of Philosophy
o “THE 250 DISEASES”
o Documentation about 250 diseases and treatments
 HEBREW
o Teaching of moses
o Created Leviticus
o Father of sanitation
GABO, AMEERAH YESHZA B.
o Practice the value of “Hospitality to strangers” and the
“Act of Charity” – contained in the book of the old
Testament
o Laws controlling the spread of communicable diseases
o Laws governing cleanliness
o Laws on preparation of food
o Purification of man and his food
o The ritual of circumcision – on the 8th day after birth
o Mosaic Law: Meant to keep Hebrews pure so that they
may enter the sanctuary without affronting God. Meant
as a survival for health and hygienic reason only
 CHINA
o Use of pharmacologic drugs
o “MATERIA MEDICA” - Book that indicates the
pharmacologic drugs used for treatment
o No knowledge on anatomy
o Use of wax to preserve the body of the dead
o Prohibits dissecting of human body thus thwarting
scientific study
 INDIA
o SUSHURUTO - 1st recording on the nursing practice
o Hampered by Taboos due to social structures and
practices of animal worship
o Medicine men built hospitals
o Intuitive form of asepsis
o There was proficient practice of Medicine and surgery
o Nurses Qualifications; Lay Brothers, Priest Nurses,
combination of Pharmacist, Masseurs, PT, cooks
o There was also decline in Medical practice due to fall
of Buddhism – state religion of India
 GREECE
o AESCULAPIUS: Father of medicine in Greek
mythology
o HIPPOCRATES
 Father of modern medicine
 1st to reject the idea that diseases are caused by
evil spirits
 1st to apply assessment
 Practice medical ethics
o CADUCEUS
 Insignia of medicine
 Composed of staff of travelers intertwined with 2
serpent (the symbol of Aesculapius and his
healing power). At the apex of the staff are two
wings of
 Hermes (Mercury) for speed.
o NURSES → function of untrained slaves
 ROMANS
o Proper turnover for the sick people
o “if you’re strong, you’re healthy” – motto
o Transition from Pagan to Christianity
o Fabiola—was converted to Christian and later she
converted her home to a hospital and used her wealth
for the sick.
o 1st hospital in the Christian world
 Apprentice Period/Middle Ages
 11th century → 1836
 On-the-job training period
 Refers to a beginner (on-the-job training). It means care
performed by people who are directed by more experienced
nurses
 Starts from the founding of Religious Orders in the 6th
century (1836 – when the deaconesses School of Nursing
was established in Kaiserswerth, Germany by Pastor
 THEODORE FLEIDNER
o there was a struggle for religious, political, and
economic power
o Crusades took place in order to gain religious, political,
and economic power
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 o During the Crusade in this period, women were not the
sole providers of nursing services. These brothers in
arms provided nursing care to their sick and injured
comrades.
 Military Religious Orders and their Works
o KNIGHTS OF ST. JOHN OF JERUSALEM (ITALIAN)
 Also called as “Knights of the Hospitalers”
 Established to give care
 TEUTONIC KIGHTS (GERMAN)
o Took subsequent wars in the Holy Land
o Cared for the injured and established hospitals in the
military camps
 KNIGHTS OF ST. LAZARUS
o Care for those who suffered Leprosy, syphilis, and
chronic skin diseases
 ALEXIAN BROTHERS
o A monasteric order founded in 1348. They established
the Alexian Brothers School of Nursing, the largest
school under religious auspices exclusively in US
and it closed down in 1969.
o ST. VINCENT DE PAUL
o LOUISE de GRAS
 The Dark Period of Nursing
 From 17th century – 19th century
 Also called the Period of Reformation until the American
Civil War
 Hospitals were closed
 Nursing were the works of the least desirable people
(criminals, prostitutes, drunkards slaves, and opportunists)
 MARTIN LUTHER
o The American civil war was led by Martin Luther, the
war was a religious upheaval that resulted to the
destruction in the unity of Christians.
o The conflict swept everything connected to Roman
Catholicism in schools, orphanages, and hospitals
 THEODORE FLIEDNER
o (a pastor) reconstituted the deaconesses and later be
established the School of Nursing at Kaiserswerth,
Germany where Florence Nightingale had her 1st
formal training for 3 months as nurse
 FLORENCE NIGHTINGALE
o Practiced her profession during the Crimean War
o “Lady with a lamp
o From a well-known family
o Went to Germany to study
o During the Crimean War (1854–1856), the inadequacy
of care given to soldiers led to a public outcry in Great
Britain. The role Florence Nightingale played in
addressing this problem is well known. During the
American Civil War (1861–1865), several nurses
emerged who were notable for their contributions
o SOJOURNER TRUTH (1797–1883), abolitionist,
Underground Railroad agent, preacher, and women’s
rights advocate, was a nurse for more than 4 years
during the Civil War and worked as a nurse and
counselor for the Freedmen’s Relief Association after
the war.
o DOROTHEA TIX (1802–1887) was the Union’s
superintendent of female nurses during the Civil War.
 Educative Period/Nightingale Era
 Began in June 15, 1860 when Florence Nightingale School
of Nursing opened at St. Thomas Hospital in London
England, where 1st program for formal education of Nurses
began and contributed growth of Nursing in the US.
 Factors that influenced development of Nursing education
o Social forces
o Trends resulting from war
o Emancipation of women
o Increased educational opportunities
 FLORENCE NIGHTINGALE
GABO, AMEERAH YESHZA B.
o Mother of modern Nursing
o Born on May 12, 1820 in Florence, Italy
o Her self-appointed goal – to change the profile of
Nursing
o She complied notes of her visit with hospitals, her
observations of sanitation practices and entered
Deaconesses School of Nursing at Kaiserswerth
Germany for 3 months.
o Became the Superintendent of the Establishment for
Gentle Women during the illness (refers to the ill
governess or instructors of Nursing)
o She disapproved restriction on admission of patient
and considered this unchristian and contrary to health
care
o Upgraded the practice of Nursing and made Nursing a
honorable profession
o Led other nurses in taking care of the wounded and
sick soldiers during the Crimean War
o She was designated as Superintendent of the Female
Establishment of English General Hospital in Turkey
during the Crimean War
o She reduced the casualties of war by 42% - 2% thru
her effort by improving the practice of sanitation
techniques and procedure in the military barracks
o The concept of Florence Nightingale on Nursing
School
 School of Nursing should be self – supporting not
subject to the wimps of the Hospital.
 Have decent living quarters for students and pay
Nurse instructors
 Correlate theories to practice
 Support Nursing research and promote continuing
education for nurses
 Introduce teaching knowledge that disease could
be eliminated by cleanliness and sanitation and
Florence Nightingale likewise did not believed in
the Germ of Bacteriology.
 Opposed central registry of nurses
 Wrote Notes on nursing, “What is and What it is
not.”
 Wrote notes on hospitals
 Nursing Leaders and their contributions to nursing
 Florence Nightingale (1820–1910)
o Considered the founder of modern nursing, was
influential in developing nursing education, practice,
and administration. Her publication, Notes on Nursing:
What It Is, and What It Is Not, first published in England
in 1859 and in the United States in 1860, was intended
for all women.
 Clara Barton (1821–1912)
o Organized the American Red Cross, which linked with
the International Red Cross when the U.S. Congress
ratified the Geneva Convention in 1882.
 Linda Richards (1841–1930) was America’s first trained
nurse.
 Lillian Wald (1867–1940)
o Founder of the Henry Street Settlement and Visiting
Nurse Service (circa 1893), which provided nursing
and social services and organized educational and
cultural activities. She is considered the founder of
public health nursing.
 Mary Mahoney (1845–1926) was the first African American
trained nurse.
 Lavinia L. Dock (1858–1956)
o She was active in the protest movement for women’s
rights that resulted in the constitutional amendment in
1920 that allowed women to vote.
 Margaret Sanger (1879–1966)
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 o She was considered the founder of Planned
Parenthood, was imprisoned for opening the first birth
control information clinic in Baltimore in 1916
 Mary Breckinridge (1881–1965)
o A nurse who practiced midwifery in England, Australia,
and New Zealand, founded the Frontier Nursing
Service in Kentucky in 1925 to provide family-centered
primary health care to rural populations.
 Men in Nursing
 Steve Miller: formed an organization called Men in Nursing.
 Luther Christman: He organized a group of male nurses in
Chicago. The two groups reorganized into the National
Male Nurses Association with the primary focus of recruiting
more men into nursing Period of Contemporary
 Nursing/20th Century
 This refers to the period after World War I and the changes
and development in the trends and practice of nursing
occurring since 1945 after World War II.
 Includes scientific and technological development, social
changes occurring after the war.
 Nursing offered in College and Universities
 Licensure of nurses started
 Specialization of Hospital and diagnosis
 Training of Nurses in diploma program
 Development of baccalaureate and advance degree
program
 2 Nursing Association/Organization that Upgraded Nursing
in US:
o American Nurses Association
o National League for Nursing Education
 Scientific and technological development as well as social
changes marks this period.
o Health is perceived as a fundamental human right
o Nursing involvement in community health
o Technological advances – disposable supplies and
equipments
o Expanded roles of nurses was developed
o WHO was established by the United Nations
o Aerospace Nursing was developed
o Computers were utilized-data collection, teaching,
diagnosis, inventory, payrolls, record keeping, and
billing.
o Use of sophisticated equipment for diagnosis and
therapy
 DEVELOPMENT AND TRENDS:
 W.H.O established by U.N to fight diseases by providing
health information, proper nutrition, living standards,
environmental conditions.
 The use of Atomic energy for diagnosis and treatment.
 Space Medicine and Aerospace Nursing
 Medical equipment and machines for diagnosis and
treatment
 Health related laws
 Primary Health Care – Nurses involvement in CHN
 Utilization of computer
 Technology advances such as development of disposable
equipment and supplies that relieved the tedious task of
Nurses.
 Development of the expanded role of Nurses
 Factors Affecting Nursing Today:
 Economics
 Consumer’s demand
 Family structure
 Information and Telecommunications
 Legislations
 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
GABO, AMEERAH YESHZA B.
 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 attributed to “nonos”
 Evil spirits could be driven away by persons with powers to
expel demons
 Belief in special Gods of healing: priest-physician, word
doctors, herbolarios/herb doctors
 Spanish colonial rule (1521-1898)
 The Philippine education system offered distinct and
unequal opportunities for Filipinos based on gender.
 Only limited numbers of women received primary education
in Spanish charitable institutions.
 Without an education women were unable to gain much
knowledge or power.
 The knowledge of caring for others came from family
members and personal experience with the sick.
 Nursing other individuals was seen as a task, not a job or
a profession.
 Early Hospitals during the Spanish Regime
 Religious orders exerted efforts to care for the sick by
building hospitals in different parts of the Philippines:
o Hospital Real de Manila San Juan de Dios Hospital
o San Lazaro Hospital de Aguas Santas
o Hospital de Indios
 Philippine Revolution
 Many women transformed their homes into quarters to
nurse Filipino soldiers and revolutionaries.
 Prominent persons involved during the Philippine
Revolution
o Josephine Bracken: wife of Jose Rizal installed a field
hospital in an estate in Tejeros that provided nursing
care to the wounded night and day.
o Rose Sevilla de Alvaro: converted their house into
quarters for Filipino soldiers during the Phil-American
War in 1899.
o Hilaria de Aguinaldo: wife of Emlio Aginaldo organized
the Filipino Red Cross.
o Melchora Aquino (Tandang Sora): nursed the
wounded Filipino soldiers, gave them shelter and food.
o Captain Salomen: a revolutionary leader in Nueva
Ecija provided nursing care to the wounded when not
in combat.
o Agueda Kahabagan: revolutionary leader in Laguna
also provided nursing services to her troops.
o Trinidad Tecson (Ina ng Biak na Bato): stayed in the
hospital at Biac na Bato to care for the wounded
soldiers.
 American colonial rule
 The presence of Americans played a vital role in influencing
the development of nursing into a profession.
 Nurses and missionaries from the United States came to
act as nurse mentors for the Filipina women.
 Nursing education, like teaching and missionary work in the
Philippines, provided white American women with a sense
of purpose in the colony where American nurses took
charge and Filipino women began to learn under their
careful eyes.
 Filipinos began to learn more about the United States and
the opportunities that the country could hold for them, such
as extending their education and increased pay.
 This began the migration of nurses to the US as individuals
began travelling to and from the United States.
 School of Nursing
 St. Paul’s Hospital School of Nursing, Intramuros Manila –
1900.
 Iloilo Mission Hospital Training School of Nursing – 1906
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 o 1909 – Distinction of graduating the 1st trained nurses in individuals, families and communities in disease
the Phils. With no standard requirements for admission of prevention and promotion of health and healthy
applicants except their “willingness to work” environment.
o April 1946 – a board exam was held outside of Manila. It
was held in the Iloilo Mission Hospital thru the request of
Ms. Loreto Tupas, principal of the school.
o St. Luke’s Hospital School of Nursing – 1907; opened after
four years as a dispensary clinic.
o Mary Johnston Hospital School of Nursing – 1907
o Philippines General Hospital school of Nursing – 1910
 College of Nursing
 UST College of Nursing – 1st College of Nursing in the
Phils: 1877
 MCU College of Nursing – June 1947 (1st College who
offered BSN – 4 year program)
 UP College of Nursing – June 1948
 FEU Institute of Nursing – June 1955
 UE College of Nursing – Oct 1958
 1909: 3 female graduated as “qualified medical-surgical
nurses”
 1919: The 1st Nurses Law (Act#2808) was enacted
regulating the practice of the nursing profession in the
Philippines Islands. It also provided the holding of exam for
the practice of nursing on the 2nd Monday of June and
December of each year.
 1920
o 1st board examination for nurses was conducted by the
Board of Examiners, 93 candidates took the exam, 68
passed with the highest rating of 93.5%-Anna
Dahlgren Theoretical exam was held at the UP
Amphitheater of the College of Medicine and Surgery.
Practical exam at the PGH Library
 1921
o Filipino Nurses Association was established (now
PNA) as the National Organization Of Filipino Nurses
o PNA: 1st President – Rosario Delgado
o Founder – Anastacia Giron-Tupas
 1953: Republic Act 877, known as the “Nursing Practice
Law” was approved.
 Today
 The Philippines is the leader in exporting nurses to meet the
demands of the United States and other developed nations.
 Of all registered health practitioners, nurses are among the
largest group, even though there are very few nursing
positions or jobs available to them.
 Only 15-25% of jobs in the Philippines are provided for the
nursing population. The remainder of the work force go on
to seek out other professional career opportunities outside
the country.
 Per year, the national government has approximately
18,000 nursing positions with an eventual turnover of 1,000
careers.
 The increase of Filipino nurses overseas has attracted the
curiosity of other countries to better understand nursing in
the Philippines and what makes Filipino nurses
accommodating.
DIFFERENT NURSING PROFESSION
 Clinical Nursing Practice
 Public Health Nursing
 School Nursing
 Occupational Health Nursing


• One who cares for the sick, the injured and the
physically, mentally, and emotionally disabled
• One who advised, instruct individuals, families,
groups and communities, in the prevention, treatment of
illness and diseases and promotion of health
• Essential member of health team, who cares for

GABO, AMEERAH YESHZA B. BSN SEC-6 5