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Nursing Theories and History

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  • 1. Foundations of NursingNursing Theories and HistoryPrepared by: Mark Fredderick R. Abejo R.N, M.A.N Faye Abdellah Patient – Centered Approaches to Nursing Model FOUNDATIONS OF NURSING Nursing Theories and History 21 Nursing Problems Lecturer: Mark Fredderick R. Abejo R.N, M.A.N  To maintain good hygiene.  To promote optimal activity; exercise, rest and sleep.  To promote safety. NURSING THEORIES and CONCEPTUAL  To maintain good body mechanics FRAMEWORK  To facilitate the maintenance of a supply of oxygen  To facilitate maintenance of nutrition  To facilitate maintenance of eliminationFlorence Nightingale  To facilitate the maintenance of fluid and electrolyte Developed and described the first theory of nursing balance Focused on changing and manipulating environment  To recognize the physiologic response of the body to in order to put the patient in the best possible disease conditions conditions for nature to act.  To facilitate the maintenance of regulatory mechanisms and functions Identified 5 environmental factors: fresh air, pure  To facilitate the maintenance of sensory functions water, efficient drainage, cleanliness/sanitation and  To identify and accept positive and negative light/direct sunlight. expressions, feelings and reactions Client’s environment is manipulated to include  To identify and accept the interrelatedness of emotions appropriate nose, nutrition, hygiene, light, comfort, and illness. socialization and hope.  To facilitate the maintenance of effective verbal and non-verbal communication  To promote the development of productive interpersonal relationship  To facilitate progress toward achievement of personal spiritual goals  To create and maintain a therapeutic environment  To facilitate awareness of self as an individual with varying needs.  To accept the optimum possible goals  To use community resources as an aid in resolving problems arising from illness.  To understand the role of social problems as influencing factors Defined nursing as service to individuals and families.Virginia Henderson Conceptualized nursing as an art and a science that Introduced The Nature of Nursing Model molds the attitudes, intellectual competencies and Identified 14 basic needs : technical skills of the individual nurse into the desire o Breathing normally and ability to help people, sick or well and cope with o Eating and drinking adequately their health needs. o Eliminating body wastes o Moving and maintaining desirable position Dorothy Johnson o Sleeping and resting Behavioral System Model o Selecting suitable clothes According to her, each o Maintaining body temperature within person as a behavioral normal range system is composed of o Keeping the body clean and well-groomed seven subsystem namely: o Avoiding dangers in the environment  Ingestive o Communicating with others  Eliminative o Worshipping according to one’s faith  Affiliative o Working in such a way that one feels a sense  Aggressive of accomplishment  Dependence o Playing/participating in various forms of  Achievement recreation  Sexual and Role Identity Behavior o Learning, discovering or satisfying the curiosity that leads to normal development Imogene King and health and using available health Goal Attainment Theory facilities. Described nursing as a helping She postulated that the unique function of the nurse is profession that assists to assists the clients, sick or well in the performance of individuals and groups in those activities contributing to health or its recovery, society to attain, maintain and that clients would perform unaided if they had the restore health necessary strength, will or knowledge. Believed that nursing involves in assisting the client in gaining independence as rapidly as possible or assisting him achieved peaceful death if recovery is no longer possible.Foundations of Nursing Abejo
  • 2. Foundations of NursingNursing Theories and HistoryPrepared by: Mark Fredderick R. Abejo R.N, M.A.N 3. Nursing System – nursing interventions neededMadeleine Leininger when Individual is unable to perform the Transcultural Nursing Model necessary self-care activities: Nursing is a learned humanistic and scientific A. Wholly compensatory – nurse provides entire profession and discipline self-care for the client. which is focused on Example: care of a new born, care of client recovering human care phenomena from surgery in a post-anesthesia care unit and activities in order to assist, support, facilitate, B. Partial compensatory – nurse and client perform or enable individuals or care, client can perform selected self-care groups to maintain or activities, but also accepts care done by the nurse regain their well being for needs the client cannot meet independently. (or health) in culturally meaningful and beneficial Example: Nurse can assist post operative client to ways, or to help people face handicaps or death. ambulate, Nurse can bring a meal tray for client who Transcultural nursing as a learned subfield or branch can feed himself of nursing which focuses upon the comparative study and analysis of cultures with respect to nursing and C. Supportive-educative – nurse’s actions are to health-illness caring practices, beliefs and values with help the client develop/learn their own self-care the goal to provide meaningful and efficacious nursing abilities through knowledge, support and care services to people according to their cultural encouragement. values and health-illness context. Example: Nurse guides a mother how to breastfeed her Focuses on the fact that different cultures have baby, Counseling a psychiatric client on more adaptive different caring behaviors and different health and coping strategies. illness values, beliefs, and patterns of behaviors. Awareness of the differences allows the nurse to design culture-specific nursing interventions Hildegard Paplau Interpersonal ModelMyra Levin Defined nursing as an Four Conservation Principles interpersonal process of She advocated that nursing is a therapeutic interactions between human interaction and an individual who is sick or in proposed 4 conservation need of health services and principles of nursing which are a nurse especially educated to concerned with the unity recognize and respond to the and integrity of the individual. need for help.  Conservation of Energy Identified 4 phases of the Nurse – Patient relationship:  Conservation of Structural Integrity Orientation – individual/family has a “felt need” and  Conservation of Personal Integrity seeks professional assistance from a nurse (who is a  Conservation of Social Integrity stranger). This is the problem identification phase.  Identification – where the patient begins toBetty Neuman have feelings of belongingness and a Health care System Model capacity for dealing with the problem, Nursing is a unique profession creating an optimistic attitude from which that is concerned with all the inner strength ensues. Here happens the variables affecting an individual’s selection of appropriate professional response to stresses, which are: assistance. - intra ( within the individual )  Exploitation – the nurse uses - inter ( between one or more communication tools to offer services to the other people ) patient, who is expected to take advantage of - extrapersonal ( outside the all services. individual )  Resolution – where patient’s needs have The nurse helps the client, through primary, secondary already been met by the collaborative efforts between the patient and the nurse. and tertiary prevention to adjust to environment Therapeutic relationship is terminated and stressors and maintain client stability. the links are dissolved, as patient drifts away from identifying with the nurse as the helping personDorotheo Orem Self-Care and Self-Care Deficit Theory Defined Nursing: “The act of Martha Rogers assisting others in the provision Science of Unitary Human Beings and management of self-care Unitary Man, is an energy field in to maintain/improve human constant interaction with the functioning at home level of environment. effectiveness.” Human beings are more than Focuses on activities that adult and different from the individuals perform on their sum of their parts; the own behalf to maintain life, health distinctive properties of the and well-being. whole are significantly different Has a strong health promotion and maintenance focus. from those of its parts. Identified 3 related concepts: 5 basic assumptions: 1. Self-care – activities an Individual performs  The human being is a unified whole, possessing independently throughout life to promote and individual integrity and manifesting maintain personal well-being. characteristics that are more than and different 2. Self-care deficit – results when self-care agency from the sum of parts. (Individual’s ability) is not adequate to meet the known self-care needs.Foundations of Nursing Abejo
  • 3. Foundations of NursingNursing Theories and HistoryPrepared by: Mark Fredderick R. Abejo R.N, M.A.N  The individual and the environment are Carative Factors: continuously exchanging matter and energy with 1. The promotion of a humanistic-altruistic system of each other values  The life processes of human beings evolve 2. Instillation of faith-hope irreversibly and unidirectionally along a space- 3. The cultivation of sensitivity to one’s self and others time continuum 4. The development and acceptance of the expression of  Patterns identify human being and reflect their positive and negative feelings. innovative wholeness 5. The systemic use of the scientific problem-solving  The individual is characterized by the capacity method for decision making for abstraction and imagery, language and 6. The promotion of interpersonal teaching-learning thought, sensation and emotion 7. The provision for supportive, protective and corrective mental, physical, socio-cultural and spiritualSister Callista Roy environment Adaptation Model 8. Assistance with the gratification of human needs Viewed each person as a 9. The allowance for existential phenomenological forces unified biopsychosocial system in constant interaction with a changing environment. Rosemarie Rizzo Parse Person as an adaptive Theory of Human Becoming system consists of input, control, Emphasized free choice of processes, output and feedback. personal meaning in relating All people have certain needs value priorities, co-creating of which is divided into rhythmical patterns, in four different modes: physiological, self concept, role exchange with the environment, function and interdependence. and co transcending in many dimensions as possibilities unfold.Lydia Hall  Human becoming is freely choosing personal Three Components of Nursing : Care, Core and meaning in situation in the intersubjective Cure process of relating value priorities  Care: represent nurturance  Human becoming is co-creating rhythmic and is exclusive to nursing patterns or relating in mutual process in the  Core: involves therapeutic universe use of self and emphasizes  Human becoming is co-transcending the use of reflection multidimensionally with emerging possibilities.  Cure: focuses on nursing related to the physician’s orders Ernestine Weidenbach Developed the Clinical Nursing – A Helping Art Model She believed that nurses meetIda Jean Orlando the individual’s need for The Dynamic Nurse – Patient Relationship Model help through the Believed that the nurse helps patients meet a perceived identification of the needs, need that the patients cannot meet for themselves. administration of help and Observed that the nurse provides direct assistance to validation that actions were meet an immediate need for help in order to avoid or helpful. to alleviate distress or helplessness. Components of clinical practice: Philosophy, purpose, She also indicated that nursing actions practice and an art. can be:  Automatic  Deliberative Joyce Travelbee Advocated the three elements Interpersonal Aspects of Nursing Model composing nursing situation: The goal of nursing is to  Client behavior assist individual or  Nurse reaction family in preventing  Nurse action or coping with illness regaining health, finding meaning inJean Watson illness or maintaining Human Caring Model ( Nursing: Human Science maximal degree of health. and Human Care ) Nursing is the application of the art and human science through transpersonal caring transactions to help persons achieve mind-body-soul harmony, which generates self-knowledge, self-control, self-care and self-healing She defined caring as a nurturant way or responding to a valued client towards whom the nurse feels a personal sense of commitment and responsibility. It is only demonstrated interpersonally that results in the satisfaction of certain human needs. Caring accepts the person as what he/she may become in a caring environmentFoundations of Nursing Abejo
  • 4. Foundations of NursingNursing Theories and HistoryPrepared by: Mark Fredderick R. Abejo R.N, M.A.N HISTORY OF NURSING  It is called the period of “on the job” training. Nursing care was performed without any formal education and by people who were directed by more experiencedPERIOD OF INTUITIVE NURSING nurses.  Military Religious Orders:Beliefs and Practices of Prehistoric Man  Knights of St. John of Jerusalem He was nomad. His philosophy of life was “the best  Teutonic Knights, tent hospital for wounded for the most” and he was ruled by the law of self-  Knights of St. Lazarus, nursing care for preservation. lepers Nursing was a function that belonged to women  Rise of Secular Orders, Believed that illness was caused by invasion of evil  Order of St. Francis of Assisi spirit  The Bequines Believed that medicine man called “shaman” or witch  The Oblates doctor had the power to heal by using white magic.  Benedictines Practices “trephining” (drilling a hole in the skull with  Ursulines a stone or rock without anesthesia as a last resort to  Augustinians drive evil spirit from the body. Hospitals were poorly ventilated and the beds were filthy.Nursing in the Near East Overcrowding of patients  Man’s mode of living changed from nomadic style to Practice of environmental sanitation and an agrarian society to an urban community life. asepsis were non-existent.  Developed a means of communication and the Older nuns prayed with and took good beginnings of a body of scientific knowledge care of the sick; while the younger nuns  Nursing remained the duty of slaves, wives, sister or washed soiled linens. mother  Important Nursing Personage During The Period of  The care of the sick was still closely related to Apprentice religion, superstition and magic.  St. Claire  St. Elizabeth of Hungary “Patroness ofContribution to Medicine and Nursing: Nurses”Babylonia  St. Catherine of Siena “First Lady with a Code of Hammurabi : Provided laws that covered Lamp” every facet of Babylonian life including medical practice. DARK PERIOD OF NURSINGEgypt  The religious upheaval led by Martin Luther destroyed Egyptians introduced the art of embalming which the unity of the Christian faith. enhance their knowledge of human anatomy.  The wrath of Protestantism swept away everything connected with Roman Catholicism.Israel  Hundreds of hospitals were closed Moses – “Father of Sanitation”  There were no provision for the sick, no one He wrote the five book of the Old Testament which: to care for the sick.  Emphasized the practice of hospitality to  Nursing become the work of the least strangers and acts of charity. desirable women.  Promulgated laws of control on the spread  Several Leaders Sought to Bring Reforms: of communicable disease and the ritual of  John Howard male circumcision.  Mother Mary Aikenhand  Pastor Theodor Fliedner and FrederikaNursing in the Far East Munster Fliedner, established the InstituteChina for Training of Deaconesses at Kaiserwerth, Strongly believed in spirits and demons. Germany. The first organized training Prohibition of dissecting the dead human body. school for nurses. Give the world knowledge of material medica which Nursing in America prescribed methods of treating wounds, infection and  Jeanne Mance, the first laywoman who worked as a muscular afflictions. nurse in North America. She founded the Hotel DieuIndia of Montreal, a log cabin hospitals Men of medicine built hospitals, practiced an intuitive  Mrs. Elizabeth Seton, founded the Sister of Charity form of asepsis and were proficient in the practice of of Emmitsberg, Maryland medicine and surgery.  American Reforms in Nursing Sushurutu made a list of function and qualifications  The Nurse’s Society of Philadelphia, organized a school of nursing under the of nurses. direction of Dr. Joseph Warrington. NursesGreece were trained on the job and attended some Nursing was the task of untrained slave preparatory courses. Introduced the caduceus  Women’s Hospital in Philadelphia, Hippocrates, Father of Scientific Medicine established a six month course in nursing.Rome  Nursing During the Civil War Attempted to maintain vigorous health, because illness  The American Medical Associa during the was a sign of weakness. Civil War created the Committee on Care of the ill was left to the slaves or Greek Training of Nurses. physician.  Dorothea Dix, established the Nurse Corps Fabiola, made her home the first hospital in the of the United States Army. Christian world.  Clara Barton, founded the American Red CrossPERIOD OF APPRENTICE NURSING PERIOD OF EDUCATED NURSING  Periods extends from the founding of religious nursing  This period began on June 15, 1860 when the Florence orders in The Crusades and establishment of Nightingale School of Nursing opened at St. Thomas Kaiserwerth Institute for the Training of Deaconesses. Hospital in London (St.Thomas Hospital School of Nursing)Foundations of Nursing Abejo
  • 5. Foundations of NursingNursing Theories and HistoryPrepared by: Mark Fredderick R. Abejo R.N, M.A.N Prominent Person Involved in Nursing Works (Philippine  Facts About Florence Nightingale Revolution)  Recognized as the “Mother of Modern Nursing”  Also known as the “ Lady with a Lamp”  Josephine Bracken, installed a field hospital in  Born on May 12, 1820 in Florence Italy Tejeros for wounded.  Not contented with the social custom imposed  Rosa Sevilla de Alvero upon her as a Victorian Lady, she developed her  Dona Hilaria de Aguinaldo, organized Filipino Red self-appointed goal: “To change the profile of Cross. nursing”  Dona Maria Agoncillo de Aguinaldo, 2nd wife of  Compiled notes of her visits to hospitals, her Emilio Aguinaldo, Pres. Of Filipino Red Cross in observation of the sanitary facilities and social Batangas problems of the places she visited.  Melchora Aquino ( Tandang Sora )  Advocated for care of those afflicted with disease  Capital Salome caused by lack of hygienic practices.  Agueda Kahabagan  At the age of 31, she overcome her family’s  Trinidad Tecson, “ Ina ng Biac na Bato “ resistance to her ambitions. She entered the Deaconess School at Kaiserworth. Hospitals and School of Nursing  Worked as a superintendent for Gentlewomen during illness.  Iloilo Mission Hospital School of Nursing ( Iloilo  Upgraded the practice of nursing and made City, 1906 ) nursing an honorable profession for - In April 1944, 22 nurses graduated took the first gentlewomen. Nurses Board Examination at the Iloilo Mission  Led the nurses that took care of the wounded Hospital. during the Crimean War.  St. Paul’s Hospital School of Nursing (Manila, 1907)Important Person/Groups/Events During Period of Educated  Philippine General Hospital School of NursingNursing ( 1907 )  Linda Richards, First graduate nurse in the US - Anastacia Giron-Tupas, the first Filipino nurse to  Dr. William Halstead, Designed the first rubber occupy the position of chief nurse and superintendent gloves in the Philippines.  Caroline Hampton Robb, The first to nurse to wear  St. Luke’s Hospital School of Nursing ( Quezon gloves while working as an operating room nurse. City, 1907 )  Clara Louise Maas, Engaged in medical research on Requirements for Admission: yellow fever, She died of yellow fever  At least completion of seventh grade  Establishment of nursing organization; the American  Sound physical and mental health Nurses Association and the National League for  Good moral character Nursing Education.  Good family and social standing  Development of private duty nursing, settlement house  Recommendations from three different nursing, school nursing, government service of nurses persons well known in the community and maternal and prenatal health nursing.  Mary Johnston Hospital and School of NursingPERION OF CONTEMPORAY NURSING ( Manila, 1907 )  Period after World War II  Philippine Christian Mission Institute School of  Establishment of the World Health Organization by Nursing the UN  San Juan de Dios Hospital School of Nursing  Use of atomic / nuclear energy for medical diagnosis (1946) and treatment  Emmanuel Hospital School of Nursing  Utilization of computers and use of sophisticated ( Capiz, 1913 ) equipment for diagnosis and therapy  Southern Islands Hospital School of Nursing  Health is perceived as a fundamental human right. ( Cebu, 1918 ) HISTORY OF NURSING IN THE First Colleges of Nursing in the Philippines PHILIPPINES  University of Sto.Tomas College of Nursing (1946)  Manila Central University College of NursingEARLY BELIEFS AND PRACTICES (1947)  Beliefs about causation of disease: Enemy or a witch  University of the Philippines College of Nursing and evil spirit (1948)  People believed that evil spirits could be driven away by persons with power to expel demons. Nursing Leaders in the Philippines  People believed I special gods of healing, with the priest-physician (called “word doctors”). If they used  Anastacia Giron – Tupas, First Filipino nurse to leaves or roots, they were called herb doctors hold the position of Chief Nurse Superintendent; (“Herbolarios”) founder of the Philippine Nurses Association.  Herbicheros one who practiced witchcraft.  Cesaria Tan, First Filipino to receive a Masters  Persons suffering from disease without any identified degree in Nursing abroad. cause were believed to be bewitched by the  Socorro Sirilan, Pioneered in Hospital Social Service “mangkukulam or mangagaway. in San Lazaro Hospital where she was the chief nurse  Difficult childbirth were attributed to “nono”  Rosa Militar, pioneer in school health education  Sor Ricarda Mendoza, pioneer in nursing education.Earliest Hospitals  Socorro Diaz, first editor of the PNA magazine called  Hospital Real de Manila ( 1577) “ The Message “  San Lazaro Hospital ( 1578 )  Conchita Ruiz, First full time editor of the newly  Hospital de Indio ( 1586 ) named PNA magazine “The Filipino Nurse”  Hospital de Aguas Santas ( 1590 )  San Juan de Dios Hospital ( 1596 )Foundations of Nursing Abejo

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