FUNDAMENTAL OF NURSING PRACTICE

1. NURSING AS
A
PROFESSION

2. CRITERIA OF A PROFESSION
PROFESSION
 Defined as an occupation that requires
extensive education or a calling that requires
special knowledge, skill, and preparation.
A profession is generally distinguished from other
kinds of occupations by:
a) its requirement of prolonged, specialized
training to acquire a body of knowledge
pertinent to the role to be performed;
b) an orientation of the individual toward service,
either to a community or to an organization
c) ongoing research
d) a code of ethics
e) autonomy
f) a professional organization

3. CRITERIA OF A PROFESSION
• Specialized Education
• Body of Knowledge
• Service Orientation
• Ongoing Research
• Code of Ethics
• Autonomy
• Professional Organization

4. Personal and
Professional
Qualities of a
Nurse

5. ANA acknowledged five characteristics of
registered nursing (2010):
 Nursing practice is individualized.
 Nurses coordinate care by establishing
partnerships(with persons, families, support
systems, and other providers).
 Caring is central to the practice of the
registered nurse.
 Registered nurses use the nursing process
to plan and provide individualized care to
their healthcare consumers.
 A strong link exists between the
professional work environment and the
registered nurse’s ability to provide quality
healthcare and achieve optimal outcomes.

6.  What is your image of
nursing?
 List at least five attributes a
nurse should have, and at
least five responsibilities
that you consider to be a
part of nursing.

7. Theoretical Knowledge: knowing why
CRITICAL THINKING
 “The art of thinking about your
thinking while you are thinking in
order to make your thinking better:
more clear, more accurate, or more
defensible” (Paul, 1990).
 A combination of reasoned thinking,
openness to alternatives, an ability to
reflect, and a desire to seek truth.

9. What Are Critical-Thinking Skills?
 Objectively gathering information on a
problem or issue
 Recognizing the need for more information
 Evaluating the credibility and usefulness of
sources of information
 Recognizing gaps in one’s own knowledge
 Listening carefully; reading thoughtfully
 Separating relevant from irrelevant data and
important from unimportant data
 Organizing or grouping information in
meaningful ways
 Making inferences (tentative conclusions)
about the meaning of the information
 Visualizing potential solutions to a problem
 Exploring the advantages, disadvantages,
and consequences of each potential action

10. What Are Critical-Thinking Attitudes?
Attitudes are not the same as intellectual skills. They
are more like feelings and traits of the mind.
1. Independent thinking
2. Intellectual curiosity
3. Intellectual humility
4. Intellectual empathy
5. Intellectual courage
6. Intellectual perseverance
7. Fair-mindedness

11. WHY IS CRITICAL
THINKING IMPORTANT
FOR NURSES?
Complex Thinking Processes
1. Problem-Solving
2. Decision Making
3. Clinical Reasoning

12. Clients Are Unique.
Client’s Differences:
•Individual Differences
•Client’s Culture
•Client’s Roles
•Other Factors
oAge
oPersonal Bias
oPersonality
oPrevious Experience

13. NURSES APPLY KNOWLEDGE TO PROVIDE HOLISTIC
CARE
Some Aspects Of Nursing Itself That Require The Nurse To
Be A Critical Thinker:
 Nursing is an applied discipline.
 Nursing uses knowledge from other fields.
 Nursing is fast-paced.
A MODEL FOR CRITICAL THINKING
Model - a set of interrelated concepts that represents a
particular way of thinking about something—much in the
same way that the shape of a lens affects what you see.
 Contextual Awareness
 Using Credible Sources
 Exploring Alternatives and Analyzing Assumptions
 Reflecting and Deciding

14. WHAT ARE THE
DIFFERENT KINDS
OF NURSING
KNOWLEDGE?
Theoretical
Knowledge
Practical Knowledge Self-Knowledge Ethical Knowledge

20. NURSES IN IN-SERVICE EDUCATION PROGRAMS
Nurses in this field need:
 Skills in nursing practice, therefore they must have experience of at
least two years in basic nursing practice.
 Understanding of skills in teaching. Supervision, and consultation.
 Understanding of the relationship of these persons to these
processes of administration and research.
 Understanding of the broad problems and desirable practices in
patient-care planning.
 Understanding of and skills in the use of problem-solving
approaches to resolve everyday problems in the practice of nursing
and in-service of the areas of concern.
 Understanding of the role and functions of the revising personnel in
this area of in-service education.
 Understanding of self and others involved in in-service education
within the various agencies in nursing.
 Ability to plan and implement programs for different kinds of nursing
personnel.

36. NURSING
HISTORY
PERIODS OF NURSING HISTORY
•Intuitive Period
•Apprentice
Period
•Educative Period
•Contemporary
Period

37.  Usually run by instinct
 Prehistoric  Early Christian Era
 NOMADS – travelers ( wander from one
place to another)
 Survival of the fittest
 “Best for the most” – motto
 Sickness is due to “voodoo”
 Performed out:
• of the feeling of compassion for others
• of desire to help
• of wish to do good
• care is given by the WOMEN
NOMADS

38.  SHAMAN – uses white magic to
counteract the black magic
• They are the doctors during those
times.
 TREPHINING – drilling the skull
• Used to treat Psychotic patients
• Psychotic patients are believed to be
possessed by evil spirits.
 Growth of religion – the most
important thing that happened
 Growth of civilization
 Law of self-preservation – inspire man
in search of knowledge
A shaman is a medicine man or woman.
SHAMAN
TREPHINING

39. Rise in Civilization
• From the mode of Nomadic life 
agrarian society  gradual development
of urban community life
• Existence of means of communication
• Start of scientific knowledge  more
complex life  increase in health
problems  demand for more nurses
• Nursing as a duty of SLAVES and
WIVES. NURSING DID NOT CHANGE
but there was progress in the practice of
Medicine.
• Care of the sick was still closely allied
with superstitions, religion, and magic
CODE OF HAMMURABI
• 1st recording on the medical
practice
• Established the medical fees
• Discouraged experimentation
• Specific doctor for each disease
• Right of the patient to choose
treatment between the use of
charms, medicine, or surgical
procedure
BABYLONIANS

40. ART OF EMBALMING
• Mummification
• Removing the internal organs of the
dead body
• Instillation of herbs and salt to the dead
• Used to enhance their knowledge of the
human anatomy. Since work was done
and performed on the dead, they
learned nothing of Philosophy
“THE 250 DISEASES”
• Documentation about 250 diseases and
treatments
EGYPTIAN
Teachings of MOSES
• Father of sanitation
Practice the values of “Hospitality to strangers”
and the “Act of Charity” – contained in the book
of Genesis
LEVITICUS – 3rd book of the Old Testament
• Laws controlling the spread of communicable
diseases
• Laws governing cleanliness
• Laws on the preparation of food
• Purification of man and his food
• The ritual of CIRCUMCISION – on the 8th day
after birth
MOSAIC LAW
• Meant to keep Hebrews pure so that they
may enter the sanctuary without affronting
God
• Meant as survival for health and hygienic
reasons only
HEBREW

41. • Use of pharmacologic drugs
• “MATERIA MEDICA”
• Book that indicates the pharmacologic
drug used for treatment
• No knowledge of anatomy
• Use of wax to preserve the body of the dead
• Method of paper making
• FACTORS THAT HAMPERED THE
ADVANCEMENT OF MEDICINE:
• Baby boys given girl’s name
• Prohibits dissecting of the human body
thus thwarting scientific study
INDIA
CHINA
SUSHURUTO
• 1st recording of the
nursing practice
Hampered by Taboos due to social
structures and practices of animal
worship
Medicine men built hospitals
Intuitive form of asepsis
There was proficient practice of
Medicine and Surgery
NURSES QUALIFICATIONS: Lay
Brothers, Priest Nurses, a combination
of Pharmacist

42. GREECE
NURSES  function of
untrained slaves
HIPPOCRATES
 Father of modern medicine
-1st to reject the idea that
diseases are caused by evil
spirits
- 1st to apply assessment
 Practice medical ethics
AESCULAPUS
 Father of medicine in Greek
mythology.
CADUCEUS
 Insignia of medicine
 Composed of a staff of travelers
intertwined with 2 serpents (the
symbol of Aesculapius and his
healing power). At the apex of the
staff are two wings of Hermes
(Mercury) for speed.

43. ROME
Proper turnover for the sick
people
“If you’re strong, you’re
healthy” – motto
Transition from Pagan to
Christianity
FABIOLA
• Was converted to
Christianity and later she
converted her home to a
hospital and used her
wealth for the sick.
1st hospital in the Christian
world
11th century  1836
On-the-job training period
Refers to a beginner (on-the-job training).
It means care performed by people who are
directed by more experienced nurses
Starts from the founding of Religious
Orders in the 6th century through the
Crusades in the 11th century (1836 – when
the deaconesses School of Nursing was
established in Kaiserswerth, Germany by
Pastor THEODORE FLEIDNER)

44. KNIGHTS OF ST. JOHN OF
JERUSALEM (ITALIAN)
• Also called as “Knights
of the Hospitalers”
• Established to give care
TEUTONIC KNIGHTS
(GERMAN)
• Took subsequent wars in
the Holy Land
• Cared for the injured and
established hospitals in the
military camps
KNIGHTS OF ST.LAZARUS
• Care for those who suffered
Leprosy, syphilis, and
chronic skin diseases

45. ALEXIAN BROTHERS
• A monasteric order
founded in 1348. They
established the Alexian
Brothers School of
Nursing, the largest
School under religious
auspices exclusively in
the US and it closed
down in 1969
ST. VINCENT DE PAUL
• He organized the charity
group called the “La Charite”
and the “Community of
Sisters of Charity” composed
of women dedicated to
caring for the sick, the poor,
the orphaned, and the
widowed. He founded the
“Sisters of Charity School of
Nursing” in Paris, France
where Florence Nightingale
had her 2nd formal education
LOUISE de GRAS
• Was the 1st
Superior and co-
founder of the
Community of
Sisters of Charity

46.  From 17th century – 19th century
 Also called the Period of Reformation
until the American Civil War
 Hospitals were closed
 Nursing was the work of the least
desirable people (criminals,
prostitutes, drunkards, slaves, and
opportunists)
 Nurses were uneducated, filthy, harsh,
ill-fed, overworked
 Mass exodus of nurses
 The American Civil War was led by
Martin Luther, the war was a religious
upheaval that destroyed the unity of
Christians.
 The conflict swept everything
connected to Roman Catholicism in
schools, orphanages, and hospitals
THEODORE FLIEDNER
• (a pastor) reconstituted the
Deaconesses and later
established the School of
Nursing at Kaiserswerth,
Germany where Florence
Nightingale had her 1st formal
training for 3 months as a
nurse
FLORENCE NIGHTINGALE
• Practiced her profession
during the Crimean War
• “Lady with a Lamp”
• From a well-known
family
• Went to Germany to
study

47. Florence Nightingale era
• Began on June 15, 1860, when Florence
Nightingale School of Nursing opened at
St. Thomas Hospital in London England,
where 1st program for the formal
education of Nurses began and
contributed to the growth of Nursing in
the US
• FACTORS THAT INFLUENCED
DEVELOPMENT OF NURSING
EDUCATION:
• Social forces
• Trends resulting from war
• Emancipation of women
• Increased educational opportunities
FLORENCE NIGHTINGALE
• Mother of Modern Nursing
• Lady with the Lamp
• Born on May 12, 1820, in
Florence, Italy
• Her SELF-APPOINTED GOAL –
to change the profile of Nursing
• She compiled notes of her visits
to hospitals, and her
observations of sanitation
practices and entered the
Deaconesses School of Nursing
at Kaiserswerth, Germany for 3
months.

48. FLORENCE NIGHTINGALE
 Superintendent of the Establishment for
Gentle Women during the Illness (refers
to the ill governess or instructors of
Nursing
 disapproved restriction on the admission
of the patient and considered this
unchristian and contrary to health care.
 Upgraded the practice of Nursing and
made Nursing an honorable profession
 Led other nurses in taking care of the
wounded and sick soldiers during the
Crimean War
 designated as Superintendent of the
Female Establishment of English General
Hospital in Turkey during the Crimean
War
 reduced the casualties of war by 42%-2%
thru her effort by improving the practice
of sanitation techniques and procedures
in the military barracks
THE CONCEPTS OF FLORENCE
NIGHTINGALE ON NURSING SCHOOL:
• School of Nursing should be self-supporting
and not subject to the whims of the Hospital.
• Have decent living quarters for students and
pay Nurse instructors
• Correlate theories to practice
• Support Nursing research and promote
continuing education for nurses
• Introduce teaching knowledge that disease
could be eliminated by cleanliness and
sanitation and Florence Nightingale likewise
did not believe in the Germ Theory of
Bacteriology.
• Opposed central registry of nurses
• Wrote Notes on Nursing, “What it is and
what it is not.”
• Wrote notes on hospitals

49. • OTHER SCHOOLS OF NURSING
• Bellevue Training School for Nurses – New York City
• Alexian Brothers Hospital School of Nursing in the US exclusively for
men. It opened in 1348 and it closed down in 1969.
• LINDA RICHARDS – the first graduate nurse in the US. Graduated on
September 1, 1873.
• 2 NURSING ASSOCIATION / ORGANIZATIONS THAT UPGRADED
NURSING PRACTICE IN THE US:
• American Nurses Association
• National League for Nursing Education

50.  World War II – present
 This refers to the period after World War I
and the changes and development in the
trends and practice of Nursing occurring
since 1945 after World War II.
 Includes scientific and technological
development, and social changes occurring
after the war.
 Nursing is offered in Colleges and
Universities
• Space Medicine and Aerospace Nursing
• Medical equipment and machines for
diagnosis and treatment
• Health-related laws
• Primary Health Care – Nurses involvement
in CHN
• Utilization of computers
• Technology advances such as the
development of disposable equipment and
supplies that relieved the tedious task of
Nurses.
• Development of the expanded role of
Nurses
DEVELOPMENT AND TRENDS:
• W.H.O. was established by the U.N. to fight
diseases by providing health information,
proper nutrition, living standards, and
environmental conditions.
• The use of Atomic energy for diagnosis and
treatment.

51. SOCIETAL ATTITUDES
 Nursing was without organization, education, and
social status.
 Women’s role was – in the home and no respectable
woman should have a career
 Victorian Middle-Class Women – were just
wives to their husbands and children.
 Nurses were poorly educated, and some were
incarcerated criminals
• This was reflected in the book written by Charles
Dickens through the character of Sairy Gamp.
 who cared for the patients by stealing from
them, and physically abusing them. This
literary work has greatly affected social
attitudes about nursing, and the negative
impression and image of nurses up to the
contemporary period.

52. EARLY BELIEFS AND PRACTICES
 Beliefs About Causation of Diseases:
• Caused or inflicted by another person (enemy or witch)
• Evil spirits
 Beliefs That Evil Spirits Could Be Driven Off By Person With
Powers To Expel Bad Spirits:
• Believed in Gods of healing
• Word doctors – priest physicians
• Herbolarios – herb doctors
EARLY CARE OF THE SICK
 HERBICHEROS – herb men who practice witchcraft
 MANGKUKULAM / MANGANGAWAY – a person suffers from
disease without any identified cause and was believed bewitched by
such
 Difficult childbirth and some diseases (PMAO) attributed to (NONO)
midwives
 A difficult birth, witches were supposed to be the cause, gunpowder
exploded from a bamboo pole close to the head of the mother to
drive evil spirits

53. EARLY HOSPITALS
 Hospital de Indios – 1586
• Franciscan Orders
• Hospital for the poor Filipino people
 Hospital de Aguas Santas – 1590
• Fray Juan Bautista
• Named after its location (near spring) because people
believed that spring has a healing power.
 San Juan de Dios Hospital – 1596
• For poor people
• Located at Roxas Boulevard
PERSONAGES
 Anastacia Giron Tupaz
• Founder of Filipino Nurses Association –
established on October 15, 1922
• 1st Filipino chief nurse of PGH
• 1st Filipino Superintendent of Nurses in the
Philippines
 Francisco Delgado
• 1st president of the Filipino Nurses Association
 Cesaria Tan
• 1st Filipino to receive a Masteral Degree in
Nursing abroad
 Socorro Sirilan
• Pioneer in Social Service at San Lazaro
Hospital
• Also the chief nurse
 Rosa Militar
• Pioneer in nursing education
 Socorro Diaz
• 1st editor of PNA magazine called, “The
Message”
 Conchita Ruiz
• Full-time editor of the PNA’s newly named
magazine, “The Filipino Nurse “
 Dona Hilaria de Aguinaldo
• 1st wife of Emilio Aguinaldo
• Established Philippine Red Cross – February 17, 1899
 Dona Maria Agoncillo de Aguinaldo
• 2nd wife of Emilio Aguinaldo
• 1st president of the Philippine Red Cross (Batangas
Chapter)
 Josephine Bracken
• Helped Rizal in treating sick people
 Melchora Aquino
• Took care of the wounded Katipuneros

54. EARLY NURSING
SCHOOLS
 Iloilo Mission Hospital and School of Nursing
• Established in 1906 under the
supervision of Rose Nicolet (American)
• Nursing course – 3yrs.
• Produced 1st batch of Nursing graduates
in 1909 – 22 nurses
• 1st TRAINED NURSES:
o Nicasia Cada
o Felipa Dela Pena
o Dorotea Caldito
• April 1944 – 1st Nursing Board Exam at
Iloilo Mission Hospital
 PGH School of Nursing – 1907
 St. Paul School of Nursing – 1907
 St. Luke’s School of Nursing – 1907
 UST – 1946
 MCU – 1947
 Fatima – 1947
Licensed Vocational Nursing
Program / Licensed Practical Nursing
Program (LVN, LPN)
REGISTERED NURSING
PROGRAMS:
o Community College / Associate Degree
o Diploma Program
o Baccalaureate Degree Program
GRADUATE NURSING
EDUCATION:
o Master’s Degree
o Doctoral Degree
External Degree

55. NURSING PROGRAM
4-year basic program for the degree
of Bachelor of Science in Nursing.
• The curriculum provides for a
common two-year program for all
health. The Associate in Health
Science Education (AHSE) is the
two-year common course offered by
the College developed by the
provisions of Republic Act (RA) No.
7722 or the “Higher Education Act of
1994” and CHED order No. 59,
series 1996. The AHSE program
constitutes the general education
component of all baccalaureate
degrees leading to the Health
profession
The first level is focused on the study
of physical, biological, social sciences
and humanities.
NURSING PROGRAM
The second level provides a more intensive and
deeper insight cognizant to the concept of man as a
bio-psychosocial-cultural
The 1st semester of the 3rd level concentrates on the
study of maternal & child-care and basic human
function as a means of laying the groundwork for the
2nd semester study of the illness state of a person.
The 2nd semester of the 3rd level examines the
concept of illness, particularly from the social,
epidemiological, ecological, economic as well as
cultural facets. An emphasis is given to pathological
processes and coping techniques. This is with the
end view of acquiring the competencies required in
the care of a sick client.
The 1st semester of the 4th level extends the nursing
care of a sick client to include the promotion of health
in the prevention and control of illness and
disabilities, cure, and rehabilitation. The
2nd semester of 4th level is focused on the
acquisition of competencies necessary for
professional practice.

56. • Nursing Curriculum Now 5 Years
• 28 additional units or about three summers of
schooling
• For freshmen Nursing students, the
“Theoretical Foundation in Nursing” is
included in the first semester, and
“Fundamentals of Nursing Practice” in the
second.
• From a parent’s standpoint, these changes
have huge impacts on their family’s finances
and other children’s education. Some parents
I have interviewed said they might be forced
to sacrifice the education of some of their
children
• From an educator’s standpoint, if CHED
intended to “upgrade” or improve the existing
Nursing Curriculum, they should have
included in the new one some foreign
language subjects (French, German,
Norwegian or Spanish).

57. GRADUATE NURSING EDUCATION
 Master’s Degree
• 1.5 – 2-year program
• Encourage the development of graduate study in
nursing
• Major emphasis was to be research and
specialization for teaching and administration
• Provide specialized knowledge and skills that
enable nurses to assume advanced roles in
practice, education, administration, and research.
• MAN / MSN
 Doctoral Program
• PhD, DNS, ND
• Further prepares the nurse for advanced clinical
practice, administration, education, and research.
• Content and approach vary among doctoral
programs.
• All emphasized research
• No specific time
NURSING LAWS AFFECTING
NURSING EDUCATION
 Republic Act No. 9173 (RA 9173) -
also known as the Philippine Nursing
Act of 2002, is an act that focuses on
providing more responsible Filipino
nursing professionals. It repeals the
prior RA 7164, otherwise known as
the Philippine Nursing Act of 1991.
• Board of Nursing (BON) - in charge
of the implementation of the nursing
licensure examinations, in
collaboration with the Professional
Regulatory Commission (PRC).
• also takes charge of any national
issues and concerns involving Filipino
nurses.

58. Nursing Examination and Registration
• Article 4, Sections 12 to 13 and RA 9173 -
all nursing graduates must apply for a
professional license before becoming
eligible for nursing practice. This involves
passing a written examination given by the
Board of Nursing. To be admitted to the
examination, the applicant must be:
• a citizen of the Philippines or a citizen of a
country that permits Filipino nurses to
practice within its territorial limits, on the
same basis as the citizen of such country;
• an individual acknowledged with good
moral character;
• and a holder of a bachelor's degree in
nursing
Qualifications of the Chairperson and
Members of the Board
 a natural-born citizen and resident
of the Philippines
 a member of good standing of an
accredited professional organization
of nurses in the Philippines;
 a registered nurse and holder of a
master's degree in nursing,
education, or other allied medical
profession
 have at least 10 years of continuous
education

59. Act # 1931 – Created for the ESTABLISHMENT OF NURSING SCHOOLS in the country under the Bureau of
Education in 1909.
Act # 1975 – An act that transferred the school of NURSING UNDER THE BUREAU OF HEALTH.
Act # 2468 – An act that authorized the GRANTING OF THE TITLES of graduate in nursing and midwifery from the
school of nursing of Philippine General Hospital in 1915.
RA # 1080 – This act approved in 1954 is also known as, An Act Declaring the Bar and Board Examinations as “ CIVIL
SERVICE EXAMINATIONS” which means that when a four-year degree course graduate had passed the board
examinations or the Bar examinations for lawyers they automatically become first-grade civil service eligible.
General Order No. 18 – enjoins all citizens of the Philippines, universities, colleges, schools, government offices,
mass media, voluntary and religious organizations of all creeds, business and industrial enterprises to promote the
concept of family welfare, responsible parenthood and family planning.
Letter of Instruction No. 47 – directs all schools of medicine, nursing, midwifery and allied medical professions and
social work to prepare, plan, and implement the INTEGRATION OF FAMILY PLANNING in their curricula and to
require from their graduates sufficient appropriate licensing examination