HISTORICAL INFLUENCES IN NURSING EDUCATION FLORENCE NIGHTINGALE THE CIVIL WAR TO THE BEGINNING OF THE TWENTIETH CENTURY CONTEMPORARY INFLUENCES IN NURSING EDUCATION IMPORTANCE OF NURSES’ SELF-CARE

1. REFERENCE: Fundamentals of Nursing 10TH EDITION, 2021
(Hall, Amy M. Perry, Anne Griffin Potter etc.)
HISTORICAL INFLUENCES
Nurses have always responded to their patients' needs. They responded during times of conflict by
fulfilling the needs of wounded soldiers in combat zones and military hospitals throughout the United
States and abroad. Nurses organize community-based immunization and screening programs,
treatment clinics, and health promotion activities in response to health care crises such as natural
disasters, disease outbreaks, or insufficient public health resources. When our patients are injured, ill,
or dying, they are most vulnerable.
Today's nurses are actively involved in the development of best practices in a variety of areas, including
pressure injury prevention, wound care management, pain management, nutritional management, and
care of persons throughout their lives. Nurse researchers are pioneers in advancing nursing and other
health care disciplines' expertise. Their work enables nurses to have access to the most up-to-date
evidence to support their practices.
FLORENCE NIGHTINGALE
Florence Nightingale pioneered the concept of health
maintenance and rehabilitation in nursing. She viewed
nursing as having "charge of someone's health" based
on knowledge of "how to put the body in a state
conducive to disease prevention or recovery." The next
year, she established the first organized program for
nursing education, the Nightingale Training School for
Nurses at London's St. Thomas' Hospital. Notes on
Nursing: What It Is and What It Is Not
Nightingale was the first nurse epidemiologist in
practice. Her statistical calculations established a link
between inadequate sanitation with cholera and
dysentery. She enlisted during the Crimean War in 1853
and journeyed at night, carrying her lamp, to the
battlefield hospitals. As a result, she was dubbed the
"woman with the lamp." Sanitary, nutritional, and basic
conditions at battlefield hospitals were inadequate, and
she was tasked with ensuring the sanitation facilities'
adequacy. The mortality rate at the Barracks Hospital in
Scutari, Turkey, decreased from 42.7 percent to 2.2
percent in six months as a result of her initiatives
(Donahue, 2011).
THE CIVIL WAR TO THE BEGINNING OF THE TWENTIETH CENTURY
The American Civil War (1860–1865) accelerated the
expansion of nursing in the country. Clara Barton, the
American Red Cross's founder, cared for soldiers on
the battlefield, cleaned their wounds, fulfilling their
necessities, and consoled them at the end of life.
During the Civil War, Dorothea Lynde Dix, Mary Ann

2. Ball (Mother Bickerdyke), and Harriet Tubman all
affected nursing (Donahue, 2011). Dix and Bickerdyke
organized hospitals and ambulances, appointed
nurses, cared for wounded soldiers, monitored and
supervised army supplies. Tubman was a leader in the
Underground Railroad campaign,
assisting in the emancipation of over 300 slaves
(Donahue, 2011).
Mary Mahoney was the first African-American nurse to
receive a professional education. She was concerned in
the intercultural and interracial relationships. As a
renowned nursing leader, she promoted cultural
knowledge and tolerance for individuals regardless of
their background, race, color, or religion.
In 1896, Isabel Hampton Robb assisted in the establishment of the Nurses'
Associated Alumnae of the United States and Canada. In 1911, this group was
renamed the ANA. She wrote numerous nursing textbooks and was a co-
founder of the American Journal of Nursing (Am J Nurs).
In the late nineteenth century, nursing in hospitals
proliferated. However, nursing in the community would not
considerably increase until 1893, when Lillian Wald and
Mary Brewster established the Henry Street Settlement,
which focused on the health problems of poor people
living in New York City's tenements (Donahue, 2011).
TWENTIETH CENTURY
In the early twentieth century, a push toward the
establishment of a scientifically defined body of nursing
knowledge and practice based on research began. Nurses
began to take on new responsibilities. Mary Adelaide
Nutting was instrumental in bringing nursing education to

3. universities when she became the first nursing professor at
Columbia Teachers College in 1906 (Donahue, 2011).
As nursing education evolved, nursing practice increased as well, culminating in the establishment
of the Army and Navy Nurse Corps. By the 1920s, nursing specialization was beginning to take
shape. Specialty nursing organizations such as the American Association of Critical Care Nurses, the
Association of Operating Room Nurses (AORN), the Infusion Nurses Society (INS), and the
Emergency Nurses Association (ENA) were founded in the latter half of the twentieth century. The
ANA founded the Center for Ethics and Human Rights in 1990 to provide a platform for nurses to
discuss difficult ethical and human rights issues and to develop activities and programs to enhance
nurses' ethical competence (Fowler, 2015b).
TWENTY-FIRST CENTURY
The profession now faces many obstacles. In addition to aging populations, bioterrorism, new
illnesses, and crisis management, nurses are revising nursing practice and school curricula. The
high-acuity level of hospitalized patients and early discharge from health care institutions
necessitate robust and current knowledge base for nurses in all settings. Through the Last Acts
Campaign, nursing and the Robert Wood Johnson Foundation are leading the way in defining
standards and policies for end-of-life care. The End-of-Life Nursing Education Consortium (ELNEC)
was created by the American Association of Colleges of Nursing (AACN) and the City of Hope
Medical Center (AACN, 2017)
CONTEMPORARY INFLUENCES
Numerous external variables influence nursing, including the need for self-care by nurses, health
care reform and rising health care expenditures, population demographic changes, human rights,
and an increasing number of medically underserved.
IMPORTANCE OF NURSES’ SELF-CARE
Nursing is a rewarding career. But it has physical and emotional responsibilities. You can't give
completely engaged, empathetic care to others if you're exhausted or uncared for. To be a healthy
professional, you and your coworkers will have several self-care needs.
You will grieve and lose in your schooling and profession. A difficult human story sometimes comes
before you have a chance to heal from an emotionally exhausting scenario. The nurses who work
in acute care settings frequently encounter intense pain that causes irritation, anger, remorse,
sorrow, or anxiety (Kelly et al., 2015). When first meeting a dying patient, nursing students describe
feelings of trepidation, fear, and sadness.
Nurses who are frequently exposed to sadness and loss may develop compassion fatigue. Poer et
al. (2013) define compassion fatigue as "a state of burnout and subsequent traumatic stress" (p. It
occurs without warning and generally occurs after continuous providing of high levels of energy
and compassion to persons in need, often without improved patient outcomes (Kelly and al., 2015).
Secondary traumatic stress occurs when health care providers watch and care for traumatized
patients. An oncology nurse who cares for cancer patients having long-term surgery and
chemotherapy, or a spouse who watches his wife deteriorate from Alzheimer's disease.
Burnout happens when perceived demands exceed perceived resources (Poer et al., 2013a). Because
of their work environment, health care providers often suffer from physical and mental tiredness. It
is common for nurses to become irritated, restless, and unable to focus and engage with patients
as a result of giving so much of themselves (Poer et al., 2013b). This occurs frequently due to a lack
of social support, organizational demands affecting staffing, and the nurse's incapacity to exercise

4. self-care. Compassion fatigue causes loss of enjoyment in formerly delightful activities,
hypervigilance, and anxiety.
Compassion fatigue affects nurses' health and wellness as well as patient care. It also impacts
organizations when nurses' job performance and personal life change, leading to nurses wanting
to quit the profession or specialization. As well as patient satisfaction and an agency's capacity to
retain caring, skilled staff (Ledoux, 2015).
It is also a problem that nurses must handle. Nurse retention and job satisfaction improve quickly
(Kelly et al., 2015.) Helping nurses cope with compassion fatigue and its implications for professional
nursing care (Wenel and Brysiewicz, 2017).
This type of fatigue may be a factor in lateral violence. Lateral violence in nurse-nurse relations
includes withholding information, making sarcastic remarks, and raising eyebrows or making faces.
New graduates and new unit nurses are especially susceptible to lateral or horizontal aggression
(Sanner-Stiehr and Ward-Smith, 2017).
Compassion fatigue and lateral violence are challenges that all nurses must manage. The strategies
of managing stress and conflict, developing connections with colleagues to share painful tales, and
self-care contribute to safe and effective care.