2. HISTORY OF NURSING
• Illness earlier was seen as
“magic”, “sin” or “punishment”.
• During 700-600 B.C - Sushruta
Samhita was written by the great
surgeon Sushruta, who said "the
physician, the patient, the drugs
and the nurse are four feet of
`Padas' of the medicine, upon
which the cure depends".
• The first nursing school started in
India in 250 B.C. during Charaka's
time and only men were
considered pure enough to be
nurses.
3. HISTORY
• 300AD Entry of women in to
nursing.
• 1633 -Sisters of Charity founded
by Louise de Marillac -established
the first educational program to be
affiliated with a religious nursing
order
• 1809 -Mother Elizabeth Seton
introduced the Sisters of Charity
into America, later known as the
Daughters of Charity.
4.
5. HISTORY
• 1884 - Mary Snively assumed
directorship of Toronto General
Hospital and began to form the
Canadian National Association
of Trained Nurses. Later
became the Canadian Nurses
Association.
• 1890 - establishment of the
Nurses Associated Alumni of
the United States and Canada
& this later became the
American Nurses Association.
6. • 1901 - first university affiliated
nursing program, Army Nurse
Corps established.
• 1901 - New Zealand was the first
country to regulate nurses
nationally, with adoption of the
Nurses Registration Act on
the12September 1901.
• It was here in New Zealand that
Ellen Dougherty became the first
registered nurse.
• 1911 - formed American Nurses
Association.
7. • 1920 - graduate nurse-
midwifery programs were
established.
• 1948 - Brown report says all
nursing programmes must be
affiliated to the university,
should have independent
budget.
• 1960 – Yale University defined
Nursing as a Profession.
8. • In the ancient era, until
17th century, formalized
nursing was not traced.
• Every village had a
dai/traditional birth
attendant to take care of
maternal and child health
needs of the people.
9. • Care was extended from the home to
the institutions as the Bir Hospital,
the eldest hospital of Nepal was
established in 1896 AD (1947 BS).
• There were no nurses to care
patient during the period of 1947-
1987 BS.
• The first school of Nursing was
established in 2013 (1956 A.D.) in
Lalitpur Nepal.
10.
11. PROFESSION
• A group must meet the following
criteria to be considered a
profession (Starr,1982)
1. the knowledge of the group must
be based on technical and scientific
knowledge.
2. the knowledge and competence of
memebers of the group must be
evaluated by a community of peers.
3. the group must have a service
orientation and a code of ethics.
12. MEANING
• The word “philosophy” has been derived from two greek
words “philos” and “sophia”
• means “love of” and “wisdom” thus philosophy means love of
wisdom.
• Philosophy search for wisdom and truth. Knowledge is a
constituent of wisdoms as wisdom helps us to analyze the
facts in the process of finding relationships.
• Wisdom which is a combination of intelligence, knowledge
and initiative helps us to recognize the value of life and to
identify our place in this world in the simplest form we can say
philosophy is the values and beliefs every individual has in his
life.
14. •Profession is defined as "a vocation
requiring advanced training and
usually involving mental rather than
manual work, as teaching,
engineering, especially medicine, law”
-Webster1989.
15. Sixessentialfeaturesofprofessionalnursing
1. Provision of a caring relationship that facilitates health and
healing.
2. Attention to the range of human experiences and responses to
health and illness within the physical and social environment.
3. Integration of objective data with knowledge gained from an
appreciation of patient or group’s subjective experiences.
4. Application of scientific knowledge to the processes of diagnostic
and treatment through the use of judgment and critical thinking.
5. Advancement of professional knowledge through scholarly
enquiry.
6. Influence of social and public policy to promote social justice.
•-ANA (2003)
16. Professions vs Occupations
Sr.n
o
Professions Occupations
1. • College or University • On the job training
2. • Prolonged education • Length varies
3. • Mental creativity • Largely manual work
4. • Decisions based on or science theoretical
constructs
• Guided decision making
5. • Values, beliefs & ethics integral part of
preparation
• Values, beliefs & ethics
not part of preparation
6. • Strong commitment • Commitment may vary
7. • Autonomous • Supervised
8. • Unlikely to change professions • Often change jobs
9. • Commitment > $ reward • Motivated by $ reward
10 • Individual accountability accountable • Employer is primarily
17. Criteria of profession:
Abraham Flexner (1916):
• Intellectual (opposite of physical).
• Based on body of knowledge, that can be learned.
• Practical rather than theoretical.
• Can be taught through a process of professional
education.
• Has a string internal organization of members.
• Has practioner
18. William shepherd (1948):•
• Based on scientific principles.
• Demands: adequate pre-professional and cultural training.
• Demand: specialized and systematized knowledge.
• Must give: evidence of needed
• Scientific technique: tested experiences.
• Time judgment / duty Performance.
• Beneficial work.
• Group consciousness: scientific knowledge.
• Sufficient self impelling power.
• Obligation to society: code of ethics.
19. Kelly: - 1981
• Service provided is vital to humanity and welfare of society.
• Special body of knowledge: continually.
• Intellectual activity: accountability.
• Educated in institutions.
• Relatively independent: autonomy.
• Motivated by job / service.
• Code of ethics: to guide decisions.
• Organization (association): to encourage and support
practice.
20. CRITERIA FOR PROFESSION
FULFILLED BY NURSING
1. High intellectual level of functioning
2. High level of individual responsibility and accountability
3. Specialized body of knowledge
4. Evidence based nursing practice
5. Public services and altruistic activities.
6. well organized and strong representation.
7. code of ethics
8. competencies and professional license.
9. autonomy and independent practice
10. Professional Identity And Development
21. HIGH INTELLECTUAL LEVEL OF
FUNCTIONING
• Modern nurses use assessment
skill and knowledge, have the
ability to reason and make routine
judgment depending on patient’s
condition. Professional nurses
functions at a high intellectual
level. Florence nightingale raised
the bar for education and
graduates of her school were
considered to be highly educated.
22. 2.HIGH LEVEL OF INDIVIDUAL
RESPONSIBILITYAND ACCOUNTABILITY
• Nurses must be accountable
and demonstrate a high level
of individual responsibility for
the care and services they
provide. The concept of
accountability has legal, ethical
and professional implications
that include accepting
responsibility for action taken
to provide client care as well as
accepting responsibility for the
consequences of action that
are not performed.
23. 3.SPECIALIZED BODY OF KNOWLEDGE
• Nursing has developed into an
identifiable separate discipline, a
specialized body of knowledge
called as nursing science.
• It was compiled through the
research effort of nurses with
advanced educational degrees.
Although this body of specialized
knowledge is relatively small, it
forms a theoretical basis for the
practice of nursing today.
24. 4.EVIDENCE BASED NURSING
PRACTICE
• Evidenced based practice is
the practice of nursing in which
interventions are based on data
obtained from research that
demonstrate that, the findings
are appropriate and successful.
• It involves a systematic
process of uncovering,
evaluating and using
information from research as
the basis for making decisions
about providing client care.
25. 5.PUBLIC SERVICES AND ALTRUISTIC
ACTIVITIES.
• Individual is the focal point of
all nursing models and
nursing practice. Nursing has
been viewed universally as
being an altruistic profession
composed of selfless
individuals who place the lives
and well being of their clients
above their personal safety.
Dedicated nurses provide
care for victims of deadly
diseases with little regard for
their own welfare.
26. 6.WELL ORGANIZED AND STRONG
REPRESENTATION.
• Professional organizations
represent the members of
the profession and control
the quality of professional
practice.
• In Nepal NNC and NAN
are the two organizations
that represent nursing in
today’s health care
system. Many do belong
to specialty organizations
that represent a specific
area of practice.
27. 7. CODE OF ETHICS
• A code of ethics document may
outline the mission and values of
the business or organization,
how professionals are supposed
to approach problems, the
ethical principles based on the
organization's core values and
the standards to which the
professional is held. Some of the
ethical principles are autonomy,
justice, non-maleficence
28. 8.COMPETENCIES AND PROFESSIONAL
LICENSE.
• Nurses must pass a national
licensure examination to
demonstrate that they are qualified
to practice nursing.
• Only after passing the examination
the nurses are allowed to practice.
• The granting of a nursing license
is a legal activity conducted by the
individual state under the
regulations contained in the state’s
nursing practice act.
29. 9. AUTONOMYAND INDEPENDENCE
OF PRACTICE:
• In reality nursing is both an
independent and interdependent
discipline. Nurses in all health
care setting must work with
physicians, hospital
administrators, pharmacists and
other groups in the provision of
care. To be considered a true
profession, nursing will need to be
recognised by other disciplines as
having practitioners who practice
nursing independently.
30. 10. PROFESSIONAL IDENTITYAND
DEVELOPMENT:
• Until nurses are fully
committed to the profession of
nursing, identify with it as a
profession and are dedicated
to its future development,
nursing will probably not
achieve professional status.
31. S0, Nursing is gaining recognition as a profession
based on the criteria that a profession must have:
• A well defined body of knowledge.
• A strong service orientation.
• Recognized authority by a professional group.
• A code of ethics: ICN.
• A professional organization that sets standards: INC /SNC/
TNAI.
• On going research.
• Autonomy.
Hence, nursing is a Nobel profession, Recognized
internationally.
32. • It means worth, importance, usefulness
or price.
• Value may be defined as condition of
being that a person seeks to actualize
directly intuited( seeing the truth
directly without reasoning) and
expressed the choices that the person
makes.
33. Values of professional nursing:
The values related the
professional nursing is of three
aspects i.e:
1. values covering the
professional nurse.
2. values covering the nurse
patient relationship.
3. values covering the
relationship of the nurse to
colleagues and to the
community follow.
36. Present value of ascetics
• 24 hr nursing duty hour
• Self discipline for professional growth
• Devotion to duty
• Quality care and service
Asceticism (1859-1890AD)
• Asceticism existed from nursing inception ( beginning)
and strongly supported during ‘ pre-nightingale era’
• The principle mainly focused on way of life was as self-
denial, willing to sacrifice life’s comfort and safety for the
sake of god( religion) or accept to bear hardship of life.
• This era was closely identified hardship.
• Nurses gave up home, family and futures devoted
themselves to duty for the sake of god and orders were
accepted as ascetics( saints)
• Nurses often thought of themselves as the salves of God
• They motivated by a spiritual objective of serving all
people without selfishness
37. Romanticism ( 1890-1940)
• This was the period of natural and or logical transition for
nursing philosophy.
• Thinking of hardship was derived to liberal thinking.
• Nurse’s practice diverted to feeling of and attitude of
romance, adventure, more towards social expectation,
being loyal to physician, to school of nursing and to the
client.
Romantic tittle for Florence nightingale “THE LADY
WITH LAMP”
• Increase dependence on physician, decrease
autonomy in nursing
• Support idealistic trait of women which affect
strongly nursing value system
• Idealistic romanticized view of woman are strongly
attached with idealistic romanticized view of nursing
as soft, feminine or romantic.
38. Pragmatism(1940AD onwards- second
world war:
• Pragmata (Greek word): acts, function,
activities.
• Its directly based on its use, function and
practical consequences of the fact and ideas.
• Increased need of nurses to work, shortages
of trained nurses increased need of more
manpower to provide care of sick people.
• So this pressure prepare the various
categories of group of nurses like nursing
assistance, nursing aids, emergency nurse
etc
VALUES:
• Decision was still remain under
physician need not for patients need
• Focus was on problem , disease,
disability and diagnosis, not to patients,
his family, his need .
39. Humanism
• Nursing values focuses towards the
patient as a wholesome not towards
physicians or the institution.
• A great change or transition in nursing
service is noted in this era i.e it moved to
non-hospital setting in community for
individual, family and neighborhood.
• Values:
• Client accepted as human being, a bio
psychosocial being NOT only a spiritual
being.
• Nursing – NOT a service to god, country
or physician, disease and diagnosis, but it
is for individual family and community
including their environment.
• Teaching- content integrated curriculum
model with the patient problem centered (
comprehensive nursing care)
• Service more accountable, decision
making and autonomy.
40. Humanistic existentialism
• It’s a modern philosophy
• It believes that person is unique
• Holistic approached used
• Basic priority is given to people
centered during nursing activities.
• This philosophy is made acceptable
for each individual client to make
personal choice about nursing care,
healing method.
• Nursing become more accountable,
more decision maker and autonomy
in function.
