PERIODS OF NURSING

HISTORY
• Intuitive Period

• Apprentice Period

• Educative Period

• Contemporary Period
 INTUITIVE PERIOD
• Prehistoric  Early Christian Era
• More on intuition
• NOMADS – travel from one place to another
• Survival of the fittest
• “Best for the most” – motto
• Sickness is due to “voodoo”
• Performed out of feeling of compassion for others
• Performed out of desire to help
• Performed out of wish to do good
• Nursing is given by the WOMEN
 INTUITIVE PERIOD
• SHAMAN – uses white magic to counteract the black
magic
• They are the doctors during those time.
• TREPHINING – drilling the skull
• Used to treat Psychotic patients
• Psychotic patients are believed to be possessed by evil
spirits.
• Growth of religion – most important thing that happened
• Growth of civilization
• Law of self preservation – inspire man in search of
knowledge
 RISE IN CIVILIZATION
• From the mode of Nomadic life  agrarian
society  gradual development of urban
community life
• Existence of means of communication
• 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
 RISE IN CIVILIZATION
• Near East – birth place of 3 religious
ideologist:
• Judaism
• Christianity
• Mohammedism or Islam

- Near East culture was adopted by the Greeks and

Romans combine wit the wonders of the Far East by
returning crusaders and explorers improved and was
carried to Europe during the Renaissance Period that
resulted to greater knowledge then to the New
World by the Early settlers.
 RISE IN CIVILIZATION

• New World – a tiny area known as birth of monotheism

that lies between Tigris and Euphrates River in the Nile
River arose the cultures of Babylonia, Egypt and
Hebrew.

• MONOTHEISM – believer of one God

 BABYLONIANS

• CODE OF HAMMURABI
• 1st recording on the medical practice
• Established the medical fees
• Discouraged experimentation
• Specific doctor for each disease
• Right of patient to choose treatment between the use of charms,
medicine, or surgical procedure
 EGYPTIANS
• ART OF EMBALMING
• Mummification
• Removing the internal organs of the dead body
• Instillation of herbs and salt to the dead
• Used to enhance their knowledge of the human anatomy.
Since work was done and performed on the dead, they
learned nothing of Philosophy

• “THE 250 DISEASES”

• Documentation about 250 diseases and treatments
 HEBREW
• Teachings of MOSES
• Created Leviticus
• Father of sanitation
• Practice the values of “Hospitality to strangers” and the “Act of
Charity” – contained in the book of Genesis
• LEVITICUS – 3rd book of the Old Testament
• Laws controlling the spread of communicable diseases
• Laws governing cleanliness
• Laws on preparation of food
• Purification of man and his food
• The ritual of CIRCUMCISION – on the 8th day after birth
• 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
• Use of pharmacologic drugs
• “MATERIA MEDICA”
• Book that indicates the pharmacologic drug used for
treatment
• No knowledge on anatomy
• Use of wax to preserve the body of the dead
• Method of paper making
• FACTORS THAT HAMPERED THE
ADVANCEMENT OF MEDICINE:
• Baby boys given girl’s name
• Prohibits dissecting of human body thus thwarting
scientific study
 INDIA
• SUSHURUTO
• 1st recording on the nursing practice
• Hampered by Taboos due to social structures and practices of
animal worship
• Medicine men built hospitals
• Intuitive form of asepsis
• There was proficient practice of Medicine and Surgery
• NURSES QUALIFICATIONS: Lay Brothers, Priest Nurses,
combination of Pharmacist, Masseurs, PT, cooks
• There was also decline in Medical practice due to fall of Buddhism
– state religion of India
 GREECE
• AESCULAPUS
• Father of medicine in Greek mythology
• HIPPOCRATES
• Father of modern medicine
• 1st to reject the idea that diseases are caused by evil spirits
• 1st to apply assessment
• Practice medical ethics
• CADUCEUS
• Insignia of medicine
• Composed of staff of travellers intertwined with 2 serpent (the symbol of
Aesculapus and his healing power). At the apex of the staff are two wings
of Hermes (Mercury) for speed.
• NURSES  function of untrained slaves
 ROMANS

• Proper turnover for the sick people

• “If you’re strong, you’re healthy” – motto
• Transition from Pagan to Christianity
• FABIOLA
• Was converted to Christian and later she converted her home to a
hospital and used her wealth for the sick.

• 1st hospital in the Christian world

 APPRENTICE PERIOD
• 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 through the Crusades in the 11th century
(1836 – when the deaconesses School of Nursing
was established in Kaiserswerth, Germany by
Pastor THEODORE FLEIDNER)
 APPRENTICE PERIOD
• There was a struggle for religious, political, and
economic power
• Crusades took place in order to gain religious,
political, and economic power or for adventure
• During the Crusade in this period, it happened as an
attempt to recapture the Holy Land from the Turk
who obtained and gain control of the region as a
result of power struggle. Christians were divided
due to several religious war and Christians were
denied visit to The Holy Sepulcher.
 MILITARY RELIGIOUS
ORDERS AND THEIR WORKS
• KNIGHTS OF ST. JOHN OF JERUSALEM
(ITALIAN)
• Also called as “Knights of the Hospitalers”
• Established to give care
• TEUTONIC KNIGHTS (GERMAN)
• Took subsequent wars in the Holy Land
• Cared for the injured and established hospitals in the
military camps
• KNIGHTS OF ST.LAZARUS
• Care for those who suffered Leprosy, syphilis, and
chronic skin diseases
• ALEXIAN BROTHERS
• 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

• ST. VINCENT DE PAUL

• He organized the charity group called the “La Charite” and the
“Community of Sisters of Charity” composed of women dedicated in
caring for the sick, the poor, orphaned, and the widowed. He founded
the “Sisters of Charity School of Nursing” in Paris, France where
Florence Nightingale had her 2nd formal education in Nursing.

• LOUISE de GRAS
• Was the 1st Superior and co-founder of the Community of Sisters of
Charity
 NURSING SAINTS
• ST. CLAIRE OF ASSISI
• Took vows of poverty, obedience to service and chastity
• Founded the 2nd order of St. Francis of Assisi
• “the poor Claire”

• ST. ELIZABETH OF HUNGARY

• The patroness of Nursing
• A princess
• Sees her calling to give care for the sick
• Fed thousands of hungry people

• St. CATHERINE OF SIENA

• “Little Saint” – took care of the sick as early as 7y/o
• “1st Lady with a Lamp”
RISE OF RELIGIOUS NURSING
ORDER
• Orders of St. Francis of Assisi
• 1st order – founded by St. Francis
• 2nd order “the poor Claire” – founded by St. Claire
• 3rd “the tertiary order”

• Beguines
• Oblates
• Benedictines
• Ursulites
• Augustinians
 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)
• Nurses were uneducated, filthy, harsh, ill-fed, overworked
• Mass exodus for nurses
• 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.
• The conflict swept everything connected to Roman Catholicism in
schools, orphanages, and hospitals
 DARK PERIOD OF NURSING

• THEODORE FLIEDNER
• (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
• Practiced her profession during the Crimean War
• “Lady with a Lamp”
• From a well-known family
• Went to Germany to study
 EDUCATIVE PERIOD
• Florence 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:
• Social forces
• Trends resulting from war
• Emancipation of women
• Increased educational opportunities

• FLORENCE NIGHTINGALE
• Mother of Modern Nursing
• Lady with the Lamp
• Born on May 12, 1820 in Florence, Italy
• Her SELF-APPOINTED GOAL – to change the profile of Nursing
• She compiled notes of her visits to hospitals, her observations of sanitation
practices and entered Deaconesses School of Nursing at Kaiserswerth, Germany
for 3 months.
 EDUCATIVE PERIOD
• FLORENCE NIGHTINGALE
• Became the Superintendent of the Establishment for Gentle
Women during the Illness (refers to the ill governess or
instructors of Nursing
• She disapproved restriction on admission of patient and
considered this unchristian and contrary to health care.
• Upgraded the practice of Nursing and made Nursing a
honorable profession
• Led other nurses in taking care of the wounded and sick
soldiers during the Crimean War
• She was designated as Superintendent of the Female
Establishment of English General Hospital in Turkey during
the Crimean War
• 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
 EDUCATIVE PERIOD
• THE CONCEPTS OF FLORENCE NIGHTINGALE
ON NURSING SCHOOL:
• School of Nursing should be self-supporting not subject to the
whimps 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 Theory of
Bacteriology.
• Opposed central registry of nurses
• Wrote Notes on Nursing, “What it is and what it is not.”
• Wrote notes on hospitals
 EDUCATIVE PERIOD
• OTHER SCHOOLS OF NURSING
• Bellevue Training School for Nurses – New York City
• Alexian Brothers Hospital School of Nursing in US exclusively
for men. It opened in 1348 and it closed down in 1969.

• LINDA RICHARDS – the first graduate nurse in US.

Graduated in September 1, 1873.

• 2 NURSING ASSOCIATION / ORGANIZATIONS

THAT UPGRADED NURSING PRACTICE IN US:
• American Nurses Association
• National League for Nursing Education
 CONTEMPORARY PERIOD

• World War II – present

• 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 is offered in College and Universities
 CONTEMPORARY PERIOD
• DEVELOPMENT AND TRENDS:
• W.H.O established by U.N to fight diseases by providing
health information, proper nutrition, living standard,
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 computers
• Technology advances such as development of disposable
equipment and supplies that relieved the tedious task of
Nurses.
• Development of the expanded role of Nurses
 CONTEMPORARY PERIOD

• FACTORS AFFECTING NURSING TODAY:

• Economics

• Consumer’s Demand

• Family Structure

• Information and Telecommunications

• Legislation
 HISTORICAL PERSPECTIVE

• Women’s Roles

• Religion

• War

• Societal Attitudes
 HISTORICAL PERSPECTIVE
• WOMEN’S ROLES
• The role as a wife, mother, daughter, sister has
always been included in the care of their family
• They cared for their infants, members of the family
and members of the community (It could be said
that Nursing have its roots in the home)
• Has the will to serve for others (subservient)
• The care provided were related to physical
maintenance and comfort
• They care given were humanistic, nurturing
comforting and supporting
 HISTORICAL PERSPECTIVE
• RELIGION
• Played a significant role in the development of Nursing
• The Christian values of LOVE THY NEIGHBOR AS THY
SELF, PARABLE OF THE GOOD SAMARITAN had a
significant impact on Nursing
• CHRISTIANITY – the greatest impact in the influence of
religion in the development
• The religious values of self-denial, Spiritual Calling,
Devotion to Duty, and Hard Work dominated Nursing
throughout the history and led to the development.
• Knights’ contributions, Fabiola’s contributions, the saints and
other personalities
• Deaconesses – Theodore Fliedner
 HISTORICAL PERSPECTIVE
• WAR
• Crimean War (Arm conflict between England and allies Turkey, Sardinia vs. Russia);
1854-1856
• Florence Nightingale emerged and became well-known (Crimean War)
• She was asked by Sir Sidney Herbert of the British war department to recruit
contingent of female nurses to provide care to the sick and injured in Crimea.
• She transformed military camps into hospitals by setting up sanitation process: hand
washing and washing clothes regularly
 HISTORICAL PERSPECTIVE
• WAR
• American Civil War (1861-1865)
• Harriet Tubman and Sojourner Truth – provided care and safety
to slaves fleeing to the North on the Underground Railroad
• Mother Biekerdyke and Clara Barton – searched the battlefield
and gave care to injured and dying soldiers
• Walt Whitman And Loiusa May Alcott – volunteered as nurses to
give care to injured soldiers in military hospitals
• World War II
• Created acute shortage of care
• Cadet Nurse Corps – established in response to markes shortage of
nurses
• Auxiliary health care workers became prominent
• Practical Nurses, aides, and technicians provided much of the actual
nursing care under the instruction and supervision of better prepared
nurse
• Medical specialties aros to meet the needs of hospitalized clients
 HISORICAL PERSPECTIVE
• SOCIETAL ATTITUDES
• Nursing was without organization, no education, and social status
• Women’s role was – in the home and no respectable woman should have a career
• Victorian Middle Class Women – were just wives to their husbands and children
• Nurses were poorly educated, some were incarcerated criminals – This was
reflected in the book written by Charles Dickens through the character of Sairy
Gamp – who cared for the patients by stealing from them, physically abused
them. This literary works has greatly affected social attitudes about nursing, the
negative impression and image of nurses up to the contemporary period.
• Guardian Angel or Angel of Mercy – image arose in the latter part of 19th
century because of work of Florence Nightingale in the Crimean War. She
brought respectability to the nursing profession, nurses were viewed as noble,
compassionate, moral, religious, dedicated, and self-sacrificing
• Doctor’s handmaiden – image arising in the early 19th century ; this image
evolved when women had yet to obtain the right to vote; the family structures
were highly paternalistic, and when the medical profession portrayed increasing
use of scientific knowledge that was viewed as male domain.
• Heroine – evolved from nurses acts of bravery during World War II and their
contributions in fighting poliomyelitis – in the work of Australian nurse,
Elizabeth Kenney
 NURSING LEADERS
• Florence Nightingale

• Clara Barton

• Lillian Wald

• Lavinia L. Dock

• Margaret Higgins Sanger

• Mary Breckinridge
 NURSING LEADERS
• FLORENCE NIGHTINGALE
• Contributions are well documented
• Lady with the Lamp
• She was the 1st nurse to exert political pressure on
government
• Notes on Nursing: What It is and What It Is Not – her
greatest achievement ; made her be recognized as nursing’s
1st scientist-theorist
• Born on a wealthy and intellectual family
• She was given an honorarium of 4500 and used it to
develop Nightingale Training School for Nurses, which was
opened in 1860.
 NURSING LEADERS
• CLARA BARTON
• A school teacher who volunteered as nurse
during the American Civil War
• Her responsibility was to organize the nursing
services
• Established the American Red Cross

• LILIAN WALD
• Founder of Public Health Nursing
• Wald and Mary Brewster were the 1st one to
offer trained nursing services to the poor in the
New York slums
 NURSING LEADERS
• LAVINIA L. DOCK
• Feminist, prolific writer, political activist,
suffragette
• Friend of Wald
• She participated in protest movements for women’s
rights which granted women to vote.
• Campaigned for legislation to allow nurses rather
than physicians to control their professions
• Founded the American Society of Superintendents
of Training Schools for Nurses on the United States
and Canada – precursor to the current National
League for Nursing
 NURSING LEADERS

• MARGARET HIGGINS SANGER

• Public health nurse in New York
• Had a lasting impact on women’s health care
• Imprisoned for opening the 1st birth control information clinic in
America
• Considered to be the founder of “Planned Parenthood”
 NURSING LEADERS

• MARY BRECKINRIDGE
• Notable pioneer nurse
• Established “Frontier Nursing Service (FNS)”
• She worked with the American Committee for Devastated France,
distributed food, clothing, and supplies to rural villages and
taking care of the sick children.
 HISTORY OF NURSING
(PHILIPPINE SETTING)
• EARLY BELIEFS AND PRACTICES
• Beliefs About Causation of Diseases:
• Caused or inflicted by other person (enemy or witch)
• Evil spirits

• Beliefs That Evil Spirits Could Be Driven Off By Person With Powers To Expel Bad
Spirits:
• Believed in Gods of healing
• Word doctors – priest physicians
• Herbolarios – herb doctors
 HISTORY OF NURSING
(PHILIPPINE SETTING)
• EARLY CARE OF THE SICK
• HERBICHEROS – herbmen who practice witchcraft
• MANGKUKULAM / MANGANGAWAY – a person suffers
from disease without any identified cause and were believed
bewitched by such
• Difficult child birth and some diseases (PMAO) attributed to
(NONO) midwives
• Difficult birth, witches were supposed to be the cause,
gunpowder exploded from a bamboo pole close to the head of
the mother to drive evil spirits
 HISTORY OF NURSING
(PHILIPPINE SETTING)
• EARLY HOSPITALS:
• Hospital Real de Manila – 1577
• 1st hospital established
• Gov. Francisco de Sande
• To give service to king’s Spaniard soldiers

• San Lazaro Hospital – 1578

• Fray Juan Clemente
• Named after the Knights of St. Lazarus
• Hospital for the lepers
 HISTORY OF NURSING
(PHILIPPINE SETTING)
• EARLY HOSPITALS:
• Hospital de Indios – 1586
• Franciscan Orders
• Hospital for the poor Filipino people

• Hospital de Aguas Santas – 1590

• Fray Juan Bautista
• Named after its location (near spring) because
people believed that spring has a healing power.

• San Juan de Dios Hospital – 1596

• For poor people
• Located at Roxas Boulevard
 HISTORY OF NURSING
(PHILIPPINE SETTING)
• PERSONAGES:
• Dona Hilaria de Aguinaldo
• 1st wife of Emilio Aguinaldo
• Established Philippine Red Cross – February 17, 1899

• Dona Maria Agoncillo de Aguinaldo

• 2nd wife of Emilio Aguinaldo
• 1st president of Philippine Red Cross (Batangas Chapter)

• Josephine Bracken
• Helped Rizal in treating sick people
 HISTORY OF NURSING
(PHILIPPINE SETTING)
• PERSONAGES:
• Melchora Aquino
• Took care of the wounded Katipuneros

• Anastacia Giron Tupaz

• Founder of Filipino Nurses Association – established on
October 15, 1922
• 1st Filipino chief nurse of PGH
• 1st Filipino Superintendent of Nurses in the Philippines

• Francisco Delgado
• 1st president of Filipino Nurses Association
 HISTORY OF NURSING
(PHILIPPINE SETTING)
• PERSONAGES:
• Cesaria Tan
• 1st Filipino to receive Masteral Degree in Nursing abroad

• Socorro Sirilan
• Pioneer in Social Service at San Lazaro Hospital
• Also the chief nurse

• Rosa Militar
• Pioneer in nursing education

• Socorro Diaz
• 1st editor of PNA magazine called, “The Message”

• Conchita Ruiz
• Full time editor of the PNA newly named magazine, “The Filipino Nurse
 HISTORY OF NURSING
•
(PHILIPPINE SETTING)
EARLY NURSING SCHOOLS
• Iloilo Mission Hospital and School of Nursing
• Established in 1906 under the supervision of Rose Nicolet (American)
• Nursing course – 3yrs.
• Produced 1st batch of Nursing graduates in 1909 – 22 nurses
• 1st TRAINED NURSES:
• Nicasia Cada
• Felipa Dela Pena
• Dorotea Caldito
• April 1944 – 1st Nursing Board Exam at Iloilo Mission Hospital
 HISTORY OF NURSING
(PHILIPPINE SETTING)
• EARLY NURSING SCHOOLS
• PGH School of Nursing – 1907
• St. Paul School of Nursing – 1907
• St. Luke’s School of Nursing – 1907
• UST – 1946
• MCU – 1947
• Fatima – 1947
 NURSING: DEFINITIONS

• NURSING (as an art)

• Is the art of caring sick and well individual. It refers
to the dynamic skills and methods in assisting sick
and well individual in their recovery and in the
promotion and maintenance of health

• NURSING (as a science)

• Is the scientific knowledge and skills in assisting
individual to achieve optimal health. It is the
diagnosis and treatment of human responses to
actual or potential problem
 NURSING: DEFINITIONS
• FLORENCE NIGHTINGALE
• Nursing is the act of utilizing the environment of the
patient to assist him in his recovery.

• VIRGINIA HENDERSON
• Nursing is the act of assisting the individual, sick or
well, in the performance of those activities
contributing to health or its recovery (or to a
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.
 NURSING: DEFINITIONS
• CANADIAN NURSES ASSOCIATION (CNA)
• Nursing is a dynamic, caring, helping relationship in which
the nurse assist the client to achieve and obtain optimal
health. – 1987
• THEMES THAT ARE COMMON TO THESE
DEFINITION:
• Nursing is caring
• Nursing is an art
• Nursing is a science
• Nursing is client-centered
• Nursing is holistic
• Nursing is adaptive
• Nursing is concerned with health promotion, health
maintenance, and health restoration
• Nursing is a helping profession
 NURSING: DEFINITIONS
• AMERICAN NURSES ASSOCIATION (ANA)
• 1973
• Nursing is direct, goal oriented, and adaptable to the needs of the
individual, the family, and community during health and illness.
• 1980
• Nursing is the diagnosis and treatment of human responses to actual or
potential health problems.
• 1995
• ANA acknowledges FOUR ESSENTIAL FEATURES OF
CONTEMPORARY NURSING PRACTICE:
• Attention to the full range of human experiences and responses to health and
illness without restriction to a problem-focused orientation.
• Integration of objective data with knowledge gained from understanding of the
client or group’s subjective experience.
• Application of scientific knowledge to the processes of diagnosis and
treatment.
• Provision of caring relationship that facilitates health and healing.
 NURSE: DEFINITION

• 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 advise and instruct individuals, families, groups and
communities in the prevention, treatment of illness and
diseases and in the promotion of health.
• An essential member of a health team who cares for
individuals, families and communities in disease and illness
prevention and in the promotion of health and healthy
environment.
 PATIENT: DEFINITION

• PATIENT
• Comes from a Latin word, “to Suffer” or “to Bear”
• An individual who is in the state of physical, mental,
and emotional imbalance
• An individual who seeks for nursing assistance,
medical assistance, or for surgery due to illness or a
disease.
• Is an individual who is waiting or undergoing medical
or surgical care. One who is physically or mentally
disabled.
 NURSING PROGRAMS
• Licensed Vocational Nursing Program / Licensed Practical Nursing Program
(LVN,LPN)

• REGISTERED NURSING PROGRAMS:

• Community College / Associate Degree

• Diploma Program

• Baccalaureate Degree Program

• GRADUATE NURSING EDUCATION:

• Master’s Degree

• Doctoral Degree

• External Degree
 LVN / LPN
• Licensed Vocational Nursing Program /
Licensed Practical Nursing Program
(LVN,LPN)
• Last for 9 – 12 months
• Provide both classroom and clinical experiences
• Provided by the community colleges, vocational
schools, hospitals, or other independent health
agencies.
• Under supervision of RN
• Prepares students how to give basic direct technical
care
• Graduate takes NCLEX – PN to obtain license as a
practical or vocational course.
 REGISTERED NURSING
PROGRAMS
• Community College / Associate Degree
• Arose in early 1950s
• 2-year program
• Technical nurse or bedside nurse
• ADN (AA or AS)

• Diploma Program
• 3-year program
• Hospital-based
• Provide rich clinical experience for nurses
• Associated with colleges and universities
 REGISTERED NURSING
PROGRAMS
• Baccalaureate Degree Program
• Early Baccalaureate Program  5-year program (3-year diploma
program in addition to 2 years of liberal arts)
• Today’s Baccalaureate Degree Program  4-5-year program
• Offer courses in the liberal arts, sciences, humanities, and nursing
• Graduates must fulfill both the degree requirements of the college
or university and the nursing program before being awarded a
baccalaureate degree.
• BSN
• Also admit RN who have diplomas or associate degrees.
• Much background
• More theories
 GRADUATE NURSING
EDUCATION
• Master’s Degree
• 1.5 – 2-year program
• Encourage the development of graduate study in nursing
• Major emphasis was to be research and specialization for teaching and
administration
• Provide specialized knowledge and skills that enable nurses to assume
advanced roles in practice, education, administration, and research.
• MAN / MSN

• Doctoral Program
• PhD, DNS, ND
• Further prepares the nurse for advanced clinical practice,
administration, education, and research.
• Content and approach vary among doctoral programs.
• All emphasized research
• No specific time
 EXTERNAL DEGREE

• External Degree
• Offers credit for expertise gained outside formal classroom
setting
• Seminars
• post- grad courses
• No specific time
• Short courses
 ROLES OF A NURSE
• Caregiver
• Communicator
• Teacher
• Client Advocate
• Counselor
• Change Agent
• Leader
• Manager
• Case Manager
• Research Consumer
• Role Model
• Administrator
• Expanded Career Roles
 ROLES OF A NURSE
• Caregiver
• Primary goal
• TYPES OF CARE:
• Full Care  for completely dependent patient
• Partial Care  for partially dependent patient
• Supportive-Educative care  to assist clients in attaining their highest
possible level of health and wellness; for learnings

• Communicator
• Integral to all nursing roles
• Nurses communicate with the client, support persons, other health
professionals, and people in the community
• Nurses identify client problems and then communicate these verbally or in
writing to other members of the health team
 ROLES OF A NURSE
• Teacher
• Nurses help clients learn about their health and the health care
procedure they need to perform to restore or maintain their health.
• Nurses assesses the client’s learning needs and readiness to learn, sets
specific learning goals in conjunction with the client, enacts teaching
strategies, and measures learning.
• Nurses also teaches unlicensed assistive personnel to whom they
delegate care, and they share their expertise with other nurses and
health professionals.

• Client Advocate
• Acts to protect the client
• Nurse may represent the client’s needs and wishes to other health
professionals, such as relaying the client’s wishes for information to
the physician.
• Nurses assist clients in exercising their rights and help them speak up
for themselves
 ROLES OF A NURSE
• Counselor
• Helping a client recognize and cope with stressful psychologic or
social problems, to develop improved interpersonal relationships, and
to promote personal growth.
• Involves providing emotional, intellectual and psychologic support.
• Nurses counsel primarily healthy individuals with normal adjustment
difficulties and focuses on helping the person develop new attitudes,
feelings, behaviors by encouraging the client to look at alternative
behaviors, recognizing the choices, and develop sense of control.

• Change Agent
• Assisting others to make modifications in their own behavior.
• Nurses also often act to make changes in a system if it is not helping
client return to health.
 ROLES OF A NURSE
• Leader
• Influences others to work together to accomplish a specific
goal.
• Can be employed at different levels: individual client, family,
groups of clients, colleagues, or the community

• Case Manager
• Work with the multidisciplinary health care team to measure
the effectiveness of the case management plan and to monitor
outcomes.
• Works with primary or staff nurses to oversee the care of a
specific caseload.
• Primary nurse or provides some level of direct care to the
client and family
• Helps ensure that care is oriented to the client, while
controlling costs.
 ROLES OF A NURSE
• Research Consumer
• Often use research to improve client care
• Have some awareness of the process and language of research
• Be sensitive to issues related to protecting the rights of human
subjects
• Participate in the identification of significant researchable
problems
• Be a discriminating consumer of research findings

• Role Model
• Has good physical appearance
• Practices proper hygiene
• Practices healthy lifestyle
 ROLES OF A NURSE

• Administrator
• Assumes middle management position
• Connects the patient to other services of the hospital

• Expanded Career Roles

• Nurse practitioner, clinical nurse specialist, nurse midwife,
nurse educator, nurse researcher, and nurse anesthetist
• All of which allow greater independence and autonomy.
SCOPE OF NURSING PRACTICE

• FOUR AREAS:
• Promoting Health and Wellness

• Preventing Illness

• Restoring Health

• Care of the Dying

SCOPE OF NURSING PRACTICE
• PROMOTING HEALTH AND WELLNESS

• Wellness – state of well-being. Engaging in attitudes

and behavior that enhance the quality of life and
maximize personal potential
• For both healthy and ill.
• Involve individual and community activities to
enhance healthy lifestyle, such as improving
nutrition and physical fitness, preventing drug and
alcohol misuse, restricting smoking, and preventing
accidents and injury in the home and workplace.
SCOPE OF NURSING PRACTICE

• PREVENTING ILLNESS

• The goal is to maintain optimal health by preventing diseases

• Nursing activities includes immunizations, prenatal and infant
care, and prevention of sexually transmitted disease.
SCOPE OF NURSING PRACTICE
• RESTORING HEALTH

• Focuses on the ill client

• Extends from early detection of disease to helping the client
during the recovery period
• NURSING ACTIVITIES:
• Providing direct care to the ill person: administering
medications, baths, and specific procedures and treatments
• Providing diagnostic and assessment procedures: measuring BP
and examining feces for occult blood
• Consulting with other health care professionals about client’s
problems
• Teaching clients about recovery activities: exercise that will
accelerate recovery after a stroke
• Rehabilitating clients to their optimal functional level following
physical or mental illness, injury, or chemical addiction
SCOPE OF NURSING PRACTICE

• CARE OF THE DYING

• Involves comforting and caring for people of all ages who are
dying
• Includes helping clients live as comfortable as possible until
death and helping support persons cope with death.
• Work in homes, hospitals, and extended care facilities
• Hospices are specifically designed for this purpose.
 BIOETHICAL ISSUES IN
• NURSING
“DO NOT RESUSCITATE” ORDER (DNR)
• Physician may order “no code” or “do not resuscitate” for client who are in
stage of terminal, irreversible illness, or expected death. DNR order that no
effort be made to resuscitate the client in the event of respiratory or cardiac
arrest.

• ABORTION
• Termination of pregnancy before the fetus reaches the stage of viability.

• EUTHANASIA
• “mercy killing” The act of painlessly putting to death persons suffering from
incurable or distressing disease.

• HUMAN CLONING
• Human reproduction / replication

• SEX TRANSPLANT
• Sex change
 PROFESSIONAL CRIMES
• CRIME – act committed in violation of Public Law and punishable
by a fine and/or imprisonment

• FELONY – serious in nature (ex. Murder)

• MISDEMEANOR – less serious in nature (ex. Negligence)

• MANSLAUGHTER – 2nd degree crime; unintentional

• TORT – civil wrong against a person

• TYPES:
• Intentional
• unintentional
 Types of Law

Private / Civil Public Law

Criminal Law
Contract Law Torts

Felony Misdemeanor
Unintentional Intentional

Negligence/ Assault / Battery

Common Elements
Malpractice

False Imprisonment Willful Action

Failure to Invasion of Privacy

Intended to
meet
bring about
standard of
Defamation consequences
care

Must be present
Causation

Libel Slander
Duty
Breach of Duty
Foreseeability
Causation
Harm/Injury
Damage
 PROFESSIONAL CRIMES
• NEGLIGENCE
• The doing of that thing, which a reasonably prudent person
would not have done, or the failure to do that thing which a
reasonably prudent person would have done, in like or
similar circumstance.
• Act of omission or commission

• THEORIES OF NEGLIGENCE:
• Respondeat Superior – let the superior answer ; let the principal
answer for the acts of his agent
• Res Ipsa Loquitur – the thing speaks for itself; talks about the
evidence; you cannot deny the negligence because of the presence
of evidence.
• Force Majeure – irresistible or superior force. It is a fact or
accident which human prudence can neither foresee nor prevent
 PROFESSIONAL CRIMES
• MALPRACTICE
• Any professional misconduct, or any unreasonable lack
of skill, or fidelity in the performance of the
professional or fiduciary duties.
• For Nurses, Malpractice refers to the failure to follow a
reasonable professional standard of care, thereby,
resulting to injury of patient

• ELEMENTS OF NEGLIGENCE/MALPRACTICE:
• Duty
• Breach of Duty
• Foreseeability
• Causation
• Harm/Injury
• Damage
 PROFESSIONAL CRIMES

• INVASION OF PRIVACY
• Violation on the right of an individual to withhold herself and
her life from public scrutiny. Violation on the right to remain
alone and the right to keep information.

• FRAUD
• False presentation of some facts with the intention that will be
acted upon by another person.
• Willful misrepresentation
 PROFESSIONAL CRIMES
• DEFAMATION
• Derogatory remarks about a person
• Making false statements about a person that can
result to the injury of his reputation

• KINDS OF DEFAMATION:
• Slander – oral defamation
• Libel – written defamation

• ASSAULT
• Attempt or threat or to touch another person
unjustifiably
 PROFESSIONAL CRIMES
• BATTERY
• Assault that is carried out
• Willful touching of a person (without consent) that may or
may not cause harm
• Performing procedures without consent

• INCOMPETENCE
• Lack of knowledge or skills

• FALSE IMPRISONMENT
• Prevention of movement without consent
• Unlawful restraint or detention of another person against his
or her wishes
 CONSENT
• KINDS OF CONSENT:
• Informed Consent
• Implied Consent

• INFORMED CONSENT
• Agreement by the client to accept a course of treatment or a
procedure after complete information, including the risk of
treatment and facts relating to it, has been provided by the
physician

• ELEMENTS OF INFORMED CONSENT:

• Consent must be given voluntarily
• Consent must be given by an individual with the capacity,
competence, and understanding.
• The client must be given enough information to be the ultimate
decision maker.
 CONSENT
• NURSE’S RESPONSIBILITY
• Witnessing the exchange between the client and the physician.
• Establish that the client really did understand, that is, was really informed
• Witnessing the client’s signature

• PEOPLE WHO ARE NOT ALLOWED TO PROVIDE CONSENT:

• Minors – below 18 years old; except for married and already a parent
• Mentally ill
• Unconscious or injured in such a way that they are unable to give consent.

• IMPLIED CONSENT
• In a life threatening situations and consent can not be obtained from the
client or relatives, the law generally agrees that consent is assumed.