Chapter 1

Historical and
Contemporary
Nursing
Practice
Learning Outcomes
1. Discuss historical and contemporary factors
influencing the development of nursing.
2. Identify the essential aspects of nursing.
3. Identify four major areas within the scope of
nursing practice
4. Identify the purposes of nurse practice acts and
standards for nursing practice.
Learning Outcomes
5. Describe the role of nurses.
6. Describe the expanded career roles and their functions.
7. Discuss the criteria of a profession and the
professionalization of nursing.
8. Discuss Benner’s levels of nursing proficiency.
9. Relate essential nursing values to attitudes, personal
qualities, and professional behaviors.
10. Explain the functions of national and international
nurses’ associations
Evolution of Nursing Practice
 Women’s roles and status
 Religious (Christian) values
 War
 Societal attitudes
 Visionary nursing leadership
Evolution of Nursing Practice
 WOMEN’S ROLES AND STATUS
 Traditional female roles of wife, mother, daughter,
and sister have always included the care and
nurturing of other family members.
 They have cared for infants and children, thus,
nursing could be said to have its roots in “the
home”
 The care provided was related to physical
maintenance and comfort.
Evolution of Nursing Practice
 RELIGIOUS (CHRISTIAN) VALUES
 The Christian value of “love thy neighbor as
thyself” and Christ’s parable of the Good
Samaritan that had a significant impact on the
development of Western Nursing.
 Fabiola
 Was a wealthy matron of the Roman Empire,
converted to Christianity and used her wealth to
provide houses of care and healing
The Knights of Saint Lazarus
(established circa 1200) dedicated
themselves to the care of people
with leprosy, syphilis, and
chronic skin conditions. From
the time of Christ to the mid-13th
century, leprosy was viewed as an
incurable and terminal disease.
 WAR

Harriet Tubman (1820–1913)

was known as “The Moses of
Her People” for her work with
the Underground Railroad.
During the Civil War (1861–
1865), she nursed the sick and
suffering of her own race.
 Sojourner Truth (1797–1883), abolitionist,
Underground Railroad agent, preacher, and
women’s rights advocate, was a nurse for over 4
years during the Civil War and worked as a nurse
and counsellor for the Freedmen’s Relief
Association after the war.
 Dorothea Dix (1802–1887)
was the Union’s
Superintendent of Female
Nurses during the Civil War.
 The “Spirit of Nursing”
monument that stands in Section
21, in Arlington National
Cemetery honors the nurses who
served in the Armed Services in
World War I.
NURSING LEADERS
 Florence Nightingale
 Clara Barton
 Lillian Wald
 Lavinia Dock
 Margaret Sanger
 Mary Breckinridge
, Florence Nightingale (1820–1910)
 Considered the founder of modern
nursing
 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.
(Bettman/CORBIS).
 Clara Barton (1812–1912)
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.
 Known for introducing nurse’s notes
and doctor’s orders.
 Initiated the practice of nurses wearing
uniforms.
 Mary Mahoney (1845–1926) was the first African American
trained nurse. (Schomburg Center for Research in Black
Culture, New York Public Library).
 Lavinia L. Dock (1858–1956)- Nursing leader and suffragist
 active in the protest movement for women’s rights that
resulted in the U.S. Constitution amendment allowing women
to vote in 1920. (Courtesy of Teachers College, Columbia
University).
 Lillian Wald (1867–1940) founded 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. (Copyright National Portrait Gallery,
Smithsonian Institution/Art Resources, NY).
 Margaret Sanger
 Nurse activist
 considered the founder of Planned Parenthood, was
imprisoned for opening the first birth control information
clinic in Baltimore in 1916. (Bettman/CORBIS).
 Mary Breckinridge
 A notable pioneer nurse, establish the frontier nursing
Service.
 In 1918, she work with the American Committee for
Devastated France, distributing food, clothing and supplies to
rural villages and taking care of sick children.
 Started one of the first midwifery training schools in the
United States.
What is the definition of
nursing?
 NURSING
 The act of utilizing the environment of the patient to assist him in
his recovery (FLORENCE NIGHTINGALE)
 To assist the individual, sick or well, in the performance of those
activities contributing to health or its recovery (or to peaceful
death)(VIRGINIA HENDERSON).
 Direct, goal oriented, and adaptable to the needs of the individual ,
the family and community during health and illness.(ANA,1973)
 The diagnosis and treatment of human responses to actual or
potential health problems (ANA, 1980)
 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. (ANA, 2003)
Other definitions of NURSING:
 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.
Who are the recipients of Nursing?
 Consumer
 Patient
 Client
Recipients of Nursing:
 CONSUMER
 Individual, a group of people, or a community that uses a service
or commodity.

 PATIENT
 A person who is waiting for or undergoing medical treatment and
care.

 CLIENT
 A person who engages the advice or services of another who is
qualified to provide this service.
 Presents the receivers of health care as collaborators in the care,
that is, as people who are also responsible for their own health.
Scope of Nursing Practice
 Promotion of health and wellness
 Prevention of illness
 Restoration of health
 Care for the dying
 Nurse Practice Acts
 Common purpose (to protect the public)
 Legal acts
 Regulate practice
 Jurisdiction specific
Standards of Nursing Practice
 ANA: Standards of Professional Performance
 Specialty nursing organizations
 PURPOSE:
 To describe the responsibilities for which nurse are
accountable
 Roles and Functions of Nurses

Nurses practice in a variety of settings. Clockwise from top left: pediatric nursing,
operating room nursing, geriatric nursing, home nursing, and community nursing.
Roles and Functions of Nurses
 Caregiver  Change agent
 Communicator  Leader
 Teacher  Manager
 Clientand patients’  Case manager
advocate  Research consumer
 Counselor
Expanded Career Roles
 Nurse practitioner  Nurse anesthetist
 Nurse administrator  Nurse midwife
 Clinical nurse  Nurse researcher
specialist
 Nurse educator
Things to Consider
 What are the criteria of a profession?
Criteria of a Profession
 Prolonged, specialized education
 Orientation toward service
 Ongoing research
 Code of ethics
 Autonomy
 Professional organization
Benner’s Stages of
Sta Nursing Expertise
ge
V,
Exp
ert
Stage IV,
Proficient

Stage III,
Competent

Stage II,
Advanced
beginner

Stage I,
Novice
Critical Values of Nursing
 Code of ethics
 Standards
 Nurse practice acts
 NSNA’s Code of Academic and Clinical Conduct
National and International
Nursing Organizations
 American Nurses Association (ANA)
 Canadian Nurses Association (CNA)
 National League for Nursing (NLN)
 National League for Nursing Accrediting Commiss
ion
(NLNAC)
 International Council of Nurses (ICN)
 National Student Nurses’ Association (NSNA)
 Sigma Theta Tau Honor Society
Factors Influencing Contemporary
Nursing Practice
 Economics
 Family Structure
 Science and technology
 Information and telecommunication
 Legislation
 demography
Post Test
 Which of the following women made
 significant contributions to the nursing care
 of soldiers during the Civil War? Select all
 that apply.

1. Harriet Tubman
2. Florence Nightingale
3. Fabiola
4. Dorothea Dix
5. Sojourner Truth
1. Correct: Harriet Tubman provided care and safety to
slaves fleeing to the North on the Underground Railroad.
2. Florence Nightingale contributed to the nursing care of
soldiers in the Crimean War.
3. Fabiola used her wealth to provide houses of caring and
healing during the Roman empire
4. Correct: Dorothea Dix was responsible for recruiting
nurses and supervising the nursing care of all women
nurses working in army hospitals.
5. Correct: Sojourner Truth provided care and safety to
slaves fleeing to the North on the Underground Railroad.
 Healthpromotion is best represented by
 which of the following activities?

1. Administering immunizations
2. Giving a bath
3. Preventing injuries in the home
4. Performing diagnostic procedures
1. Administering immunizations is an example of
illness prevention.
2. Giving a bath is aesthetic (i. e., not needed for
health promotion or disease prevention).
3. Correct: Health promotion focuses on
maintaining normal status without consideration
of diseases.
4. Performing diagnostic procedures focuses on
disease detection
 Who are America’s first two trained nurses?

1. Barton and Wald

2. Dock and Sanger
3. Richards and Mahoney
4. Henderson and Breckinridge
1. Barton established the American Red Cross. Wald
founded public health nursing.
2. Dock founded the American Society of Superintendents
of Training Schools for Nurses of the U.S. and Canada.
Sanger is the founder of Planned Parenthood.
3. Correct: Linda Richards was America’s first trained
nurse, and Mary Mahoney was America’s first black
trained nurse.
4. Henderson was one of the first modern nurses to define
nursing. Breckinridge established the Frontier Nursing
Service and one of the first midwifery training schools
in the U.S.
 A nurse with 2 to 3 years of experience who
 has the ability to coordinate multiple complex
 nursing care demands is at which stage of
 Benner’s states of nursing expertise?

1. Advanced beginner
2. Competent
3. Proficient
4. Expert
1. The advanced beginner demonstrates marginally
acceptable performance.
2. Correct.
3. The proficient practitioner, has 3 to 5 years of
experience and has developed a holistic
understanding of the client.
4. The expert practitioner, demonstrates highly
skilled intuitive and analytic ability in new
situations
 Which professional organization developed
 a code for nursing students?

1. ANA
2. NLN
3. AACN
4. NSNA
1. ANA, developed Standards of Nursing Practices.
2. NLN focuses on nursing education.
3. The American Association of Colleges of Nursing
(AACN), is the national organization that focuses
on the advancement and maintenance of America’s
baccalaureate- and higher degree nursing
education programs
4. Correct: The National Student Nurses’
Association developed the Code of Academic and
Clinical Conduct for nursing students in 2001.
 Which of the following social forces is most
 likely to significantly impact the future supply
 and demand for nurses?

1. Aging
2. Economics
3. Science/technology
4. Telecommunications
1. Correct: The aging population contributes to
more elders needing specialized care increasing
the demand.
2. Economics increases the demand for nursing
care.
3. Science and technology affects nursing practice.
4. Telecommunications affects nursing practice and
nursing care.