1.

INTRODUCTION TO
NURSING
ENGLISH FOR NURSING 2. IN AND AROUND THE
HOSPITAL
3. NURSE DUTY
INTRODUCTION TO NURSING
Before one can fully grasp the nature of nursing or define its
practice, it is helpful to understand the roots and influencing
factors shaped its growth over time. Nursing today is far
different from nursing as it was practiced 50 years ago, and it
takes a vivid imagination to envision how the nursing
profession will change as we move forward into the 21st
century. To comprehend present-day nursing and at the same
time prepare for future, one must understand not only past
events but also contemporary nursing practices.
DEFINITION OF NURSING
DIFFERENT PEOPLE HAVE DEFINED NURSING DIFFERENTLY. HOWEVER, IN
THIS UNIT WE WILL SEE SOME OF THE COMMON DEFINITIONS OF
NURSING:

Nursing is provision of optimal conditions to enhance the person's reparative

processes and prevent the reparative process from being interrupted.
The practice of nursing is defined as diagnosing and treating human response to
actual or potential health problems through such services as case finding, health
teaching, health counseling; and provision of support to or restoration of life and
well-being and executing medical regimes prescribed by licensed or otherwise
legally authorized physician or dentist.
DEFINITION OF NURSING
Nursing is directed toward meeting both the health and illness need and man who is
viewed holistically as having physical, emotional, psychological intellectual, social
and spiritual condition.
Nursing is a humanistic science dedicated to compassionate concern with
maintaining and promoting health, preventing illness and caring for and
rehabilitating the sick and disabled.
DEFINITION OF NURSING
Nursing is a deliberate action, a function of the practical intelligence of nurses and
action to bring about humanely desirable conditions in persons and their
environments.
As a practice discipline nursing's scientific body of knowledge is used to provide an
essential service to people, that is to promote ability to affect health positively.
 HISTORY AND DEVELOPMENT OF NURSING
IT IS DIFFICULT TO TRACE THE EXACT ORIGIN OF THE
NURSING PROFESSION. HOWEVER, MORAL ACTION IS
THE HISTORICAL BASIS FOR THE CREATION, EVOLUTION
AND PRACTICE OF NURSING.
2.1 Nursing in Ancient civilization
2.2 Nursing in the Middle Ages
2.3 Dark Age of Nursing
2.4 The Development of Modern Nursing
NURSING IN ANCIENT
CIVILIZATION
The early record of ancient civilization offers little information about those who care
for the sick. During this time beliefs about the cause of disease were embedded in
superstition and magic and thus treatment often involved magical cures.
Ancient Egyptians developed community planning and strict hygienic rules to
control communicable diseases.
The first recorded Nurses were seen in the Babylonian civilization, there were
references to tasks and practices traditionally provided by nurses.
NURSING IN ANCIENT
CIVILIZATION
Nurses are mentioned occasionally in Old Testament as women who provide care
for infant, for the sick and dying and as midwives who assisted during pregnancy
and delivery.
In ancient Rome, care of the sick and injuries was advanced in Mythology and
reality. Although medicine as a science was developed there was little evidence of
establishing a foundation for nursing.
NURSING IN ANCIENT
CIVILIZATION
The ancient Greeks gods were believed to have special healing power. In 460 BC
Hippocrates born and credited with being the Father of medicine. He proved that
illness had natural cause and not to be of a religious or magical cause. Hippocrates
first proposed such concepts as physical assessment, medical Ethics, patient –
centered care and observation and reporting. He emphasized the importance of
patient care that contributed a lot for the groundwork of nursing.
In ancient India, male nurses staffed early Hospitals and women served as midwives
and nursed ill family members.
NURSING IN THE MIDDLE
AGES
During this time, monasticism and other religious groups offered the only
opportunities for men and women to pursue careers in nursing. It was the Christian
value of "love thy neighbor as thyself" that had a significant impact on the
development of western nursing. The principle of caring was established with
Christ’s parable of Good Samaritan providing care for a tired and injured stranger.
NURSING IN THE MIDDLE
AGES
In the third and fourth centuries several wealthy matrons of Roman empire,
including Marcella, Fabiola and Paula, converted to Christianity and used their
wealth to provide house of care and healing (the forerunner of hospital) for the poor,
the sick and homeless.
Women were not the sole providers of nursing service in the third century in Rome.
There was an organization of men called the parabalani Brotherhood. This group of
men provided care to the sick and dying from the great plague in Alexandria.
DARK AGES OF NURSING
In this period Monasteries were closed and the work of women in religious order
was nearly ended. The few women who cared for the sick during this time were
prisoners or prostitutes who had little or no training in nursing. Because of this,
nursing was considered as the most minimal of all tasks, and had little acceptance
and prestige.
THE DEVELOPMENT OF
MODERN NURSING
Three images influenced the development of modern nursing.
 Ursuline Sisters of Quebec organized the first training for nurses.
 Theodore Flender revived the deaconess movement and opened a School in Kaiserwerth, Germany,
which was training nurses.
 Elizabeth Fry established the institute of Nursing Sisters.
THE DEVELOPMENT OF
MODERN NURSING
 But in the latter half of eighteenth century Florence Nightingale the founder of modern nursing
changed the form and direction of nursing and succeeded in establishing it as a respected profession.
She was born to wealthy and intellectual family in 1820. In spite of opposition from her family and
restrictive societal code for affluent young English woman to be a nurse Nightingale believed she was
"called” by God to help others and to improve the wellbeing of mankind. In 1847 she received three
month's training at Kaiserwerth. In 1853 she studied in Paris with sister of charity, after which she
returned to England to assume the position of super intendment of a charity hospital.
THE DEVELOPMENT OF
MODERN NURSING
Nightingale worked to free nursing from the bonds of the church. She saw nursing as
a separate profession from the church, yet she began her career as the result of the
mystic experience.
During the Crimean war, Florence Nightingale was asked to recruit a contingent of
female nurses. The Jamaica nurse Mary Grant was the first nurse recruited to provide
care to the sick and injured in the Crimean war. The achievements of Florence
Nightingale in the war were so outstanding that she was recognized by the queen of
England who awarded her the Order of Merit.
THE DEVELOPMENT OF
MODERN NURSING
When she returned to England she established the Nightingale School of Nursing,
which was opened in 1860. The school served as a model for other training schools.
Its graduates traveled to other counties to manage hospitals and nursing training
programs.
IN AND AROUND THE 1. Hospital Vocabulary
2. Hospital Department
HOSPITAL 3. Giving Direction
HOSPITAL VOCABULARY
ER - Emergency Room
ICU -Intensive Care Unit
EMT -Emergency Medical Technician
Paramedic - more advance than EMT- a health care professional whose primary role
is to provide advanced emergency medical care for critical and emergent patients
who access the emergency medical system
EMT-paramedic: EMTs can handle most of the basic health procedures like
performing CPR (cardiopulmonary resuscitation) and using oxygen on a patient, and
paramedic can perform more complex procedures like inserting IV lines,
administering drugs, and more.
HOSPITAL VOCABULARY
Stethoscope - a mdeical instrument for listening to the action of someone’s heart or
breathing
Gurney/strecher - a wheeled strecher using for transporting hospital patients
Diagnosis vs prognosis
 Diagnosis - identifying a present disease, illness, problem, etc, by examining and observation
 Prognosis - refers to predicting the course of the diagnosed disease, illness, problem, etc., and
determining treatment and outcome.
HOSPITAL VOCABULARY
Ward - a separate room in a hospital typically one allocated to a particular type of
patient
It is a misconception to think that when most patients are discharged/released from
the hospital they are ‘back to normal’
Top agent Raiola has routine/annual check-up
Syrine -a hollow cylinder shaped piece of equipment used for sucking liquid out of
something or pussing liquid into something, especially one with a needle that can be
put under the skin.
Gown - a robe worn by a patient in a hospital
HOSPITAL VOCABULARY
IV - Intravenous - A procedure where a needle inserted directly into a vein to deliver
liquids to the blood
Chemotherapy - a drug treatment that most often used to treat cancer by killing fast-
growing cells in your body. Chemotherapy is most often used to treat cancer, since
cancer cells grow and multiply more quickly than most cells in the body
Malignant brain tumor can invade or spread (metastasize) into healthy brain tissue,
and, rarely, to distant organs within the body. Benign rain tumor do not invade
nearby tissues or spread to other parts of the body.
Malignant - tending or likely to grow and spread in a rapid and uncontrolled way
that can cause death.
Benign - a mild type or character that does not threaten health or life
HOSPITAL DEPARTMENT
Pathology : unit penyakit
Cardiology : unit penyakit jantung
Physiotherapy : pengobatan badan/fisik
Renal unit : unit ginjal
Pharmacy : apotek
Orthopedics : bagian tulang
HOSPITAL DEPARTMENT
Neurology : unit saraf
Paediatrics : unit penyakit anak
Dermatology : unit penyakit kulit
Haematology : unit penyakit darah
Obstetrics : unit kebidanan
Surgery : unit bedah
GIVING DIRECTION
Can you show me the way to admission department please?
It’s not too far to walk from here / it’s near to go on foot from here
Go straight ahead
Go straight or go a long this corridor
Go across this corridor
You can’t miss it
GIVING DIRECTION
Which way must I take to get to orthopedic ward?
You get to an intersection
You arrive at an intersection
You come to an intersection
You reach an intersection
Surgical ward is across the maternity unit
Excuse me, how can I get to a long-stay ward?
ASKING DIRECTION
Could you tell me the way to..?
Can you direct me to...?
Please tell me how I can get to ... from here
Which way is it to ...?
Is the way to ...?
I need direction to get to ...
- I would like to go to
-How can i get to...
A VISITOR IS AT MEDICIA HOSPITAL. HE IS ASKING A
NURSE THE WAY TO PATIENT WARD, IN MAWAR
ROOM.

Visitor : Excuse me, can you show me the way to Mawar Room?
Nurse : Of course, it is only about two minutes’ walk from here. Well, first go
straight ahead and then you arrive at a T junction of this street then turn left
and Mawar room is at your right side.
Visitor : where am I now?
Nurse : you are in ER (Emergency Room)
Visitor : thanks a lot for your information
Nurse : that is all right, have a nice visit
IMPORTANT VOCABULARIES
Across : di seberang
At the side of : di sini
Intersection : perempatan
Get to : tiba
Up the stairs : naik tangga
IMPORTANT VOCABULARIES
Through surgical room : lewat ruang bedah
Go along : susuri
T junction : pertigaan
Central hospital : rumah sakit pusat
Road/street : jalan raya
Straight a head : lurus
IMPORTANT VOCABULARIES
Turn left : belok kiri
Turn right : belok kanan
Round cafetaria : round cafetaria/café
Corridor : jalan beratap yang menghubungkan dua gedung
Drug store : toko obat
Take the elevator to second floor : naik lift ke lantai 2
NURSE DUTY 1.
2.
Process of Nursing
The Story of Edith Cavell
SIX STEPS OF NURSING
PROCESS
The nursing process is a critical thinking model based on a systematic approach to
patient-centered care that nurses use to perform clinical reasoning and make clinical
judgments when providing patient care. The nursing process is based on the
Standards of Professional Nursing Practice established by the American Nurses
Association (ANA). These standards are authoritative statements of the actions and
behaviors that all registered nurses, regardless of role, population, specialty, and
setting, are expected to perform competently.[1] The mnemonic ADOPIE is an easy
way to remember the ANA Standards and the nursing process, with each letter
referring to the six components of the nursing process: Assessment, Diagnosis,
Outcomes Identification, Planning, Implementation, and Evaluation. See an
illustration of the cyclical nursing process in Figure 2.3. [2]
ADOPIE
ASSESSMENT
The Assessment component of the nursing process is defined as, “The registered
nurse collects pertinent data and information relative to the health care consumer’s
health or the situation.”[3] A nursing assessment includes physiological data, as well
as psychological, sociocultural, spiritual, economic, and lifestyle data. Nursing
assistants should observe and report things to the nurse that they notice when
providing care, such as reddened or open skin, confusion, increased swelling, or
reports of pain.[4]
DIAGNOSIS
The Diagnosis phase of the nursing process is defined as, “The registered nurse
analyzes the assessment data to determine actual or potential diagnoses, problems,
and issues.”[5] A nursing diagnosis is the nurse’s clinical judgment about the client’s
response to actual or potential health conditions or needs. Nursing diagnoses are the
basis for the nursing care plans and are different than medical diagnoses. [6]
OUTCOME IDENTIFICATION
The Outcomes Identification phase of the nursing process is defined as, “The
registered nurse identifies expected outcomes for a plan individualized to the health
care consumer or the situation.”[7] The nurse sets measurable and achievable short-
and long-term goals and specific outcomes in collaboration with the patient based on
their assessment data and nursing diagnoses.[8] Nurses may communicate expected
outcomes to nursing assistants, such as, “The client will walk at least 100 feet
today.”
PLANNING
The Planning phase of the nursing process is defined as, “The registered nurse
develops a collaborative plan encompassing strategies to achieve expected
outcomes.” Assessment data, nursing diagnoses, and goals are used to select
evidence-based nursing interventions customized to each patient’s needs and
concerns. Goals and nursing interventions are documented in the patient’s nursing
care plan so that nurses, as well as other health professionals, have access to it for
continuity of care.[9]
NURSING CARE PLAN
Nursing care plans are part of the Planning step of the nursing process. A nursing
care plan is a type of documentation created by registered nurses (RNs) that
describes the individualized planning and delivery of nursing care for each specific
patient using the nursing process. Nursing care plans guide the care provided to
each patient across shifts so care is consistent among health care personnel. Some
nursing interventions can be assigned or delegated to licensed practical nurses
(LPNs) or nursing assistants with the RN’s supervision. [10] Although nursing
assistants do not create or edit care plans, they review this document to know what
care should be provided to each client within their scope of practice.
IMPLEMENTATION
The Implementation phase of the nursing process is defined as, “The nurse
implements the identified plan.”[11] Nursing interventions are implemented or
delegated with supervision according to the care plan to assure continuity of care
across multiple nurses and health professionals caring for the patient. Interventions
are also documented in the patient’s medical record as they are completed. [12] The
nursing assistant’s largest responsibility during the nursing process is safely
implementing their delegated interventions in the nursing care plan.
EVALUATION
The Evaluation phase of the nursing process is defined as, “The registered nurse
evaluates progress toward attainment of goals and outcomes.” [13] During evaluation,
nurses assess the patient and compare the findings against the initial assessment to
determine the effectiveness of the interventions and overall nursing care plan. Both
the patient’s status and the effectiveness of the nursing care must be continuously
evaluated and modified as needed. To assist the nurse in evaluation, nursing
assistants must report any changes in patient condition or new observations related to
new interventions. Because nursing assistants spend the most time with the residents,
it is important to communicate with the nurse if asked to implement an intervention
that is known to be ineffective with a resident so a different, more effective
alternative can be identified.
BENEFITS OF USING THE NURSING PROCESS
USING THE NURSING PROCESS HAS MANY BENEFITS FOR
ALL MEMBERS OF THE HEALTH CARE TEAM. THE BENEFITS
OF USING THE NURSING PROCESS INCLUDE THE FOLLOWING
[14]

Promotes quality patient care

Decreases omissions and duplications
Provides a guide for all staff involved to provide consistent and responsive care
Encourages collaborative management of a patient’s health care problems
Improves patient safety
BENEFITS OF USING THE
NURSING PROCESS
Improves patient satisfaction
Identifies a patient’s goals and strategies to attain them
Increases the likelihood of achieving positive patient outcomes
Saves time, energy, and frustration by creating a care plan or path to follow
EDITH CAVELL
Edith Cavell was born to a priest’s family in Norwich. Marton Eva Luckes trained
her as a nurse in Brussels. L’École Belge d’Infirmières Diplômées on the Rue de la
Culture in Brussels was the place where she became a matron. By 1910, Miss Cavell
‘felt that the profession of nursing had gained sufficient foothold in Belgium to
warrant the publishing of a professional journal’, and therefore launched the
nursing journal, L’infirmière. A year later, she was a training nurse for three hospi-
tals, 24 schools and 13 kindergartens in Belgium.
When World War I broke out, she was visiting her widowed mother in Norfolk. She
returned to Brussels where her clinic and nursing school were taken over by the Red
Cross.
In the autumn of 1914, after the German occupation of Brussels, Cavell began
sheltering British soldiers and funnelling them out of occupied Belgium to neu- tral
Holland. In the following months, an underground organization developed, allowing
her to guide some 200 Allied soldiers to safety, which placed Cavell in violation of
German military law. German authorities became increasingly suspi- cious of the
nurse’s actions, which were reinforced by Cavell’s own disregard and
outspokenness.
She was arrested on 3 August 1915 and charged with harbouring Allied soldiers. She
was held in St Gilles prison for 10 weeks, the last two in solitary confinement and
court-martialed.
The British government said they could do nothing to help her. Sir Horace Rowland
of the Foreign Office said, ‘I am afraid that it is likely to go hard with Miss Cavell; I
am afraid we are powerless’. The sentiment was echoed by Lord Robert Cecil,
Under-Secretary for Foreign Affairs. ‘Any representation by us’, he advised, ‘will do
her more harm than good’.
The United States, which had not yet joined the war, did not agree. Hugh S. Gibson,
First Secretary of the American legation at Brussels, made clear to the German
government that executing Cavell would further harm their nation’s already damaged
reputation. Later, he wrote: We reminded him (Baron von der Lancken) of the
burning of Louvain and the sinking of the Lusitania and told him that this murder
would stir all civilized countries with horror and disgust. Count Harrach broke in at
this with the remark that he would rather see Miss Cavell shot than have harm come
to one of the humblest German soldiers, and his only regret was that they had not
three or four English old women to shoot.
The German civil governor, Baron von der Lancken, is known to have stated that
Cavell should be pardoned because of her complete honesty and because she had
helped save so many lives, German as well as Allied. However, the German mili-
tary acted quickly to execute Cavell to deny higher authorities the opportunity to
consider clemency.
She was not arrested for espionage as many were led to believe, but for treason. Of
the 27 put on trial, Cavell and four others were condemned to death, among them
Philippe Baucq, an architect in his thirties who was also instrumental in the
escapes.
When in custody, Cavell was asked questions in French, with transcripts made in
German. This process gave the inquisitor the opportunity to misinter- pret her
answers. Although she may have been misrepresented, she made no attempt to
defend herself. Cavell was provided with a defender approved by the German
military governor. A previous defender, who was chosen for Cavell by her assistant,
Elizabeth Wilkins, was ultimately denied by the governor.
The night before her execution, she told the Reverend Stirling Gahan, the Anglican
chaplain who had been allowed to see her and to give her Holy Communion,
‘Patriotism is not enough, I must have no hatred or bitterness towards anyone.’ These
words are inscribed on her statue in St Martin’s Place, near Trafalgar Square in
London. Her final words to the German Lutheran prison chaplain, Paul Le Seur,
were recorded as, ‘Ask Father Gahan to tell my loved ones later on that my soul, as I
believe, is safe, and that I am glad to die for my country.’
Despite efforts by American minister Brand Whitlock and the Marquis de Villalobar,
the Spanish minister to Belgium, on Cavell’s behalf, on 11 October, Baron Von Der
Lancken allowed the execution to proceed. Sixteen men, com- posed of two firing
squads, carried out her sentence along with four Belgian men at Tir Nationalshooting
range in Schaerbeek, at 6 am on 12 October 1915. There are conflicting reports of
the details of Cavell’s execution. However, according to the eyewitness account of
the Reverend Le Seur, who attended Cavell in her final hours, eight soldiers fired at
Cavell while the other eight executed Philippe Baucq.
There is also a dispute over the sentencing imposed under German Military Code.
Supposedly, the death penalty equivalent to the offence committed by
Cavell was not officially declared until a few hours after her death.
With instructions from the Spanish minister, Belgian women immediately bur- ied
her body next to St. Gilles Prison. After the war, her body was taken back to Britain
for a memorial service at Westminster Abbey and again transferred to Norwich, to
finally be laid to rest at Life’s Green.
READING COMPREHENSION
ON THE BASIS OF THE ABOVE PASSAGE, ANSWER THE
FOLLOWING QUESTIONS:

Who was the teacher of Florence Nightingale and Edith Cavell?

Name the journal that Edith Cavell started. What was the language in which it was
published?
What happened to her clinic and nursing school after World War I broke out?
What did Edith do to earn the ire of the Germans? How far was their dis- sapproval
justified?
What was the charge under which Edith was arrested? From a purely legal point of
view, was it justifiable?
Explain Edith’s comment: ‘Patriotism is not enough, I must have no hatred or
bitterness towards anyone.’
Describe the way in which Edith was executed. Do you think it was uneces- sarily
cruel?