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Analyze the definitions of the major nursing theorists. What is similar among them? What is different? What concepts found in those definitions are most closely aligned with your perception of nursing? Develop your own definition of nursing and compare it to those of the theorists and to those of your classmates.
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Chapter 1
Exploring the Growth of Nursing
as a Profession
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History of Healthcare and Nursing #1
❖Healthcare in ancient cultures
❖Historic perspectives and early images of nursing
o Folk image
o Religious image
o Servant image
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History of Healthcare and Nursing #2
❖Early Providers of Nursing Care
o Sisters of Charity in France and the United
States
o Sisters of the Holy Cross in France and the
United States
o Catholic Religious Orders in Mexico and South
America
o Ursuline Sisters in Canada
o Deaconesses at Kaiserswerth, Germany, and
Pittsburgh, Pennsylvania
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The Nightingale Influence
❖Dramatically changed the form and direction of
nursing
❖Nursing as a profession was born
❖Care during the Crimean War demonstrated the
results of the improved care and need for nurses
❖Set standards for nursing education and made
significant recommendations for changes in how
hospitals operated and how nursing was practiced
❖Many of her recommendations are valid today
❖Wrote Notes on Nursing
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Florence Nightingale’s Basic Principles of
Nursing Education
❖ Trained teaching hospitals are associated with medical schools.
❖ Nurses reside in nurses’ houses.
❖ School matron is final authority in:
o Curriculum
o Living arrangements
o All aspects of the school
❖ Education includes theoretical material and practical
experience.
❖ Teachers are paid for instruction.
❖ Records are kept on students.
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The Beginning of Nursing Education in the
United States
❖Established shortly after Civil War
❖Curriculum fashioned after Nightingale School in
England
❖Early programs primarily apprenticeships, with long
hours during which students provided much of the
workforce of the hospital with little time left for
study
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Question #1
❖Is the following statement true or false?
❖Lavinia Dock dramatically changed the form and
direction of nursing with standards for nursing
education.
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Answer to Question #1
❖False
❖Rationale: Florence Nightingale dramatically
changed the form and direction of nursing with
standards for nursing education. Lavinia Dock was
one of the early graduates of the first trio of schools
modeled after the Nightingale model. Dr. Valentine
Seaman is said to have initiated the first system of
instruction for nurses at New York hospital.
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The Military Influence
❖ Major impact on nursing and practice of medicine
❖ Led to innovations put into practice during the heat of battle
and in response to needs of soldiers and veterans
❖ Always played an important role in the care of the wounded
and dying
❖ Over the years taken increasingly important roles
o Development of dispensaries
o Invention of ambulances
o Triage and surgery
o Red Cross, Army and Navy Nurses Corp
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Developing a Definition for Nursing #1
❖ Not clearly defined (see Table 1.5).
❖ Nursing is distinct from medicine.
❖ Medicine deals with diagnosis and treatment of disease.
❖ Nursing is concerned with caring for the whole person.
❖ Henderson: “The unique function of the nurse is to assist the
individual, sick or well, in the performance of those activities
contributing to health or its recovery (or to peaceful death)
that he would perform unaided if he had the necessary
strength, will, or knowledge. And to do this in such a way as to
help him gain independence as rapidly as possible.”
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Developing a Definition for Nursing #2
❖ American Nurses Association (ANA): “Nursing is the protection,
promotion, and optimization of health and abilities, prevention
of illness and injury, alleviation of suffering through the
diagnosis and treatment of human response, and advocacy in
the care in individuals, families, communities, and
populations.”
❖ National Council of State Boards of Nursing (NSCBN): “The
NSCBN Model Practice Act states that the practice of nursing
means assisting clients to attain or maintain optimal health,
implementing a strategy of care to accomplish defined goals
within the context of a client-centered healthcare plan, and
evaluating response in nursing care and treatment.”
❖ State board of nursing varies.
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Characteristics of a Profession #1
❖The position nursing occupies as a profession is
often judged against sociologically developed
characteristics or standards of a profession.
❖Not everyone agrees that nursing meets those
standards.
❖Nurses must possess a well-defined and wellorganized body of knowledge.
❖Enhance a systematic method by enlarging the body
of knowledge and improve education.
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Characteristics of a Profession #2
❖Ensure control of professional policy and activity and
autonomy.
❖Develop a code of ethics.
❖Attract professionals who will be committed to the
profession for a lifetime.
❖Compensate practitioners by providing autonomy,
continuous professional development, and economic
security.
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Differentiating Between the Terms
“Profession” and “Professional”
❖ Nursing has struggled with terms “profession” and
“professional.”
❖ At times, the characteristics of the professional become
confused with the formal concept of a profession.
❖ Nurses have worked to advance the standing of nursing
through the development of a code of ethics, standards of
practice, and peer review.
❖ American Association of Colleges of Nursing (AACN) refers to
“professional” nursing as requiring a baccalaureate degree in
nursing or higher.
❖ Defined by federal legislation.
❖ Popular view.
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Question #2
❖Is the following statement true or false?
❖Nursing deals with diagnosis and treatment of
disease.
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Answer to Question #2
❖False
❖Rationale: Medicine deals with diagnosis and
treatment of disease. Nursing is concerned with
caring for the whole person.
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Traditions in Nursing
❖Nursing has many traditions, some of which are
challenged today, no longer used, or still much
honored and valued
❖The Nursing Pin
❖The Nursing Cap
❖The Nursing Uniform
❖Ceremonies
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The Image of Nursing Today
❖Struggle with image
❖Groups waging campaigns to:
o Improve image
o Attract individuals even nonfemales to
profession
❖Critical issue because of nursing shortage
❖A positive image is needed to attract qualified
individuals into the profession
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The Nursing Shortage
❖Retirement of baby boomers due to entering senior
years, leading to potential increase in clients
❖Lack of clinical space and insufficient faculty at
nursing schools leading to turning away qualified
applicants
❖Always been considered a career appropriate for
women and not men
❖Lack of training for faculty
❖Working conditions have led to some nurses leaving
the field early; burnout
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Studies for and About Nursing
❖Since the beginning of the 20th century, nursing has
been a much-studied profession.
❖Early studies—nursing education.
❖Later studies
o Nursing image
o Nurses themselves
o Nursing’s role in healthcare delivery
❖See Table 1.7.
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Defining a Language for Nursing #1
❖ As nursing has developed as a profession, more attention has
been directed to establishing a unique classification and
nomenclature for nursing.
❖ Efforts are being made to do this on an international basis
❖ Nursing Terminologies
o NANDA International, Inc.
o Nursing Interventions Classifications
o Nursing Outcomes Classification
o The Omaha System
o Other Classification Systems
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Defining a Language for Nursing #2
❖Rationale
o Permits recognition and communication by
giving a name to what nurses do
o Provides uniform legal record of care
o Supports clinical decision-making
o Lays the groundwork for nursing research
o Captures cost of nursing services for billing and
accounting purposes
o Generates a structured retrieval database of
quality assurance
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Question #3
❖Is the following statement true or false?
❖The main cause of the nursing shortage has been
identified as burnout from long work hours.
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Answer to Question #3
❖False
❖The main cause of the nursing shortage has been
identified as many nurses who are baby boomers
are reaching retirement age and entering their
senior years. This will result in their possibly
becoming new clients leading to a shortage of
nurses to care for them. Burnout from long work
hours is recognized as a cause for some nurses
leaving the field early but not the main cause
currently.
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