Chapter 1

Introduction to Nursing

Copyright 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Historical Perspective/Early Civilizations

to the 16th Century
Theory of animism
Based on the belief that nature was alive, had
invisible forces, and possessed power
Good spirits brought health; evil spirits brought
sickness and death.
Roles of nurse and physician separate and distinct:
physician as medicine man; nurse as caring mother.
Ancient Greek civilization
Temples became center of medical care.
Nurses cared for the sick in the home and
community; practiced as nurse-midwives.
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Historical Perspective/Early Civilizations

to the 16th Century (cont.)
Early Christian period
Nursing has formal and more clearly defined role;
deaconesses made visits to the sick.
Nursing developed purpose, direction, and
leadership.
16th century
Shift from a religious orientation to an emphasis on
warfare, exploration, and expansion of knowledge
Nursing had a poor reputation; nurses received low
pay and worked long hours in unfavorable conditions.

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Historical Perspective/18th19th Century

Social reforms changed the roles of nurses and of women
in general.
Nursing as we now know it began, based on many of the
beliefs of Florence Nightingale.
Organized nursing care for soldiers during the
Crimean war of 1853-1856
Nightingale challenged prejudices against women and
elevated the status of all nurses.
She established the first training school for nurses,
and wrote books about health care and nursing
education.
Identified the importance of health, sanitation,
hygiene, and nutrition
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Contributions of Florence Nightingale

Identified personal needs of patient and role of nurse in
meeting them
Established standards for hospital management
Established nursing as a respected occupation for women
Established nursing education
Recognized the two components of nursing: health and illness
Believed that nursing is separate and distinct from medicine
Recognized that nutrition is important to health
Instituted occupational and recreational therapy for sick people
Stressed the need for continuing education for nurses
Maintained accurate records, recognized as the beginnings of
nursing research
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Historical Perspective/19th to 21st Century

Hospital schools organized to provide more easily
controlled and less expensive staff for the hospital.
Female nurses were under the control of male hospital
administrators and physicians.
World War II
Large numbers of women worked outside the home
and became more independent and assertive.
Explosion in medicine and technology broadened the
role of nurses.
Growth of nursing as a professional discipline
Nursing schools began to focus on academics, not
just task oriented
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Historical Perspective/1950s to Present

Nursing broadened in all areas
Practice in a wide variety of health care settings
The development of a specific body of knowledge
The conduct and publication of nursing research
Recognition of the role of nursing in promoting health
Growth of nursing as a professional discipline

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Definitions of Nursing
Originated from the Latin word nutrix (to nourish)
International Counsel for Nurses definition:
Promotion of health, prevention of illness, collaborative
care
American Nurses Association (ANA) definitionSocial
policy statement centers on:
Human experiences and responses
A knowledge base for nurses
Integration of objective and subjective data
Patient is central focus of all definitions
Includes physical, emotional, social, and spiritual
dimensions of the patient
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Four Blended Competencies

Cognitive
Utilizing scientific rationales to provide patient care
Technical
Employ technology to optimize care
Interpersonal
To initiate and maintain relationships with clients and
professional colleagues
Ethical/legal
Practice which is conducted according to moral
principles and within legal guidelines

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Nursings Aims
Promote health
Prevent illness
Restore health
Facilitate coping with disability or death

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Nursings Aim: Promoting Health

Identifying, analyzing,
and maximizing each
patients individual
strengths as components
of preventing illness,
restoring health, and
facilitating coping with
disability or death

Factors which may affect

health include:
Genetic inheritance
Cognitive abilities
Educational level
Race and ethnicity;
culture
Age and gender
Developmental level
Lifestyle; environment
Socioeconomic status

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Healthy People 2020 Health Promotion

Guidelines
Healthy People 2020 pertains to health literacy and also
contains 12 health indicators used to gauge the nations
health
Attain high-quality, longer lives free of preventable
disease, disability, injury, and premature death.
Achieve health equity, eliminate disparities, and improve
the health of all groups.
Create social and physical environments that promote
good health for all.
Promote quality of life, healthy development, and healthy
behaviors across all life stages.

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Nursings Aim: Preventing Illness

Educational programs in areas such as prenatal care for

pregnant women, smoking-cessation programs, and
stress-reduction seminars
Community programs and resources encouraging healthy
lifestyles
Literature, TV, radio, or Internet information on healthy
diet, exercise, and good health habits
Health assessments in institutions, clinics, and
community settings that identify areas of strength and
risks for illness

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Nursings Aim: Restoring Health

Performing assessments that detect an illness
Referring questions and abnormal findings to other health
care providers, as appropriate
Providing direct care to the person who is ill
Collaborating with other health care providers in
providing care
Planning, teaching, and carrying out rehabilitation for
illnesses such as heart attacks, arthritis, and strokes
Working in mental health and chemical-dependency
programs

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Nursings Aim: Facilitating Coping With

Disability and Death
Maximizing persons strengths and potentials
Patient teaching
Referral to community support systems
Providing end-of-care
Hospice programs

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Interrelated Roles of Nurses

Communicator
Teacher
Counselor
Leader
Researcher
Advocate
Collaborator

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Nursing as a Professional Discipline

Well-defined body of specific and unique knowledge
Strong service orientation
Recognized authority by a professional group
Code of ethics
Professional organization that sets standards
Ongoing research
Autonomy and self-regulation

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Educational Preparation for Nursing

Practice
Practical and vocational nursing education
Registered nursing education
Diploma in nursing
Associate degree in nursing
Baccalaureate in nursing
Graduate education in nursing
Masters degree
Doctoral degree
Continuing education
In-service education
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Guidelines for Nursing Practice

Standards of Nursing Practice
ANA Scope and standards of practice
Comprised of two components:
Standards of practice
Standards of professional performance
Nurse Practice Acts and Licensure
Nursing Process

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Nurse Practice Acts

Define legal scope of nursing practice
Create a state board of nursing to make and enforce
rules and regulations
Define important terms and activities in nursing,
including legal requirements and titles for RNs and LPNs
Establish criteria for the education and licensure of
nurses

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The Nursing Process

One of the major guidelines for nursing practice
Helps nurses implement their roles
Integrates art and science of nursing
Allows nurses to use critical thinking and clinical
reasoning
Defines the areas of care that are within the domain of
nursing

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NLN Ten Trends to Watch For Nursing

Education
1. Changing demographics and increasing diversity
2. The technological explosion
3. The era of the educated consumer, alternative therapies,
and genomic and palliative care
4. The shift to population-based care and the increasing
complexity of patient care
5. The cost of health care and the challenge of managed
care
6. The impact of health policy and regulation

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NLN Ten Trends to Watch For Nursing

Education (cont.)
7. The growing need for interdisciplinary education and
collaborative practice
8. The current nursing shortage/opportunities for lifelong
learning and workforce development
9. Significant advances in nursing science and research

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National Supply and Demand Projections

for Registered Nurses: 2000 to 2020

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