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Foundation of modern Nursing
By: Ashagre Molla (BSN, MSN)
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Learning objectives of the chapter
At the end of this chapter, you are expected to:
Discuss the different definitions of nursing by different
professionals and organizations.
Explain the origin and historical development of nursing
profession
Discuss the contribution of Florence Nightingale and other
nurses for the development of nursing profession
Discuss the criteria of profession
Discuss the role of nurses
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Sub-topics
Definitions of nursing
Historical overview of nursing
Highlights of the historical evolution of professional nursing
History of nursing in Ethiopia
Nursing as a profession
Roles of nurses
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Definition of nursing
Nursing has been defined in many ways by different
professionals and organization
The act of utilizing the environment of the client to assist him
in his recovery Florence Nightingale
The diagnosis and treatment of human responses to actual or
potential health problems. - ANA
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Definition.
"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 a peaceful death) that he/she
would perform unaided if he/she had the necessary strength,
will or knowledge and to do this in such a way as to help
him/her gain independence as rapidly as possible." Virginia
Henderson
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Definition
Nursing encompasses autonomous and collaborative care of
individuals of all ages, families, groups and communities, sick
or well and in all settings.
Nursing includes the promotion of health, prevention of illness,
and the care of ill, disabled and dying people.
Advocacy, promotion of a safe environment, research,
participation in shaping health policy and in patient and
health systems management, and education are also key
nursing roles. - ICN
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Definition The nursing profession exists in response to a need of society
and holds ideas related to human health throughout the
lifespan. Nurses direct their energies towards thepromotion,
maintenance andrestoration of health; theprevention of
illness, the alleviation of sufferingand the insurance of a
peaceful death when life can no longer be sustained.
..Nursing, a dynamic and supportive profession
guided by its code of ethics, is rooted in caring, a concept
evident throughout in its four fields of activity: practice,
education, administration and research. CNA
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Common themes to Nursing
Holism
Caring
Teaching
Advocacy and supporting
Promoting, maintaining, and restoring health
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Historical overview of nursing
The study of history of nursing helps us:
to better understand the societal forces and issues that continue
to confront the profession.
to gain an appreciation of the role the profession has played in
the health care system
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History ..
Nursing is believed to be as old as human kind
The word nurse is often related to the Latin nutrix or
nutrio which means to nourish. The definition of the term and the practice of nursing has
changed greatly over time: wet nurse/dry nurse
Very little has been written about nursing as unique function in
ancient time.
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Nursing in an antiquity
A decision for a care giver was made long before he/she able
to make such choice.
In many societies the role of giving care was given to female
members
The earliest nurses learn their art through oral traditionspassed
from generation to generation.
Those who acquired reputation were sought after to provide
care for friends and families
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Nursing in an antiquity..
Nurses first organized in the early Christian era.
Nursing ideals (charity, service to others, and self-sacrifice)
were in harmony with early Christian church.
Fabiola deaconess credited for the establishment of first
Christian hospital in Rome
Throughout antiquity the safest nursing care was provided in
ones own home.
Care in hospitals were for those who have no family /away
from families
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Period of ..
Early hospitals were found by the members of religious
communities nuns and monks who devoted their lives for the
care of the sick.
Influence of
Ancient Egyptians
Babylonia
Indians
The Jews
The Greeks
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ANCIENT EGYPT
4000 B.C.
During this time the priests were the healers.
They had some knowledge in the sciences of anatomy and
physiology.
They could prepare some drugs for eye conditions and
surgery.
The healing treatment included prayers and sacrifices.
The actual care of the patients, such as dressing wounds was
done by helpers.
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Babylonia
The people thought diseases were the result ofsin.
The priests made their diagnoses and prognoses by observing
the behavior of animals
the flowing of water in rivers
the shape of oil on water surfaces
the irregularity of an animal liver
the smoke from a burning fire, and personal dreams
When a woman had difficulties in delivery, it was considered
to be the result of wrong doing.
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Indians
Indians had a highly developed culture and good sanitationsystem.
They had written a number of scientific books, which
described different types of diseases.
Some of their diagnostic examinations included: Inspection,
palpation, auscultation, taking pulse rate, and investigation of
urine.
Surgery was also highly practiced.
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Indians
For suturing intestines, certain types of ants were used to bitethe incision line.
When their bodies were cut off their mandibles remained
attached to the incision as sutures.
The people who cared for the sick were well instructed in
ethics.
They were required to be skilful, dedicated and prudent in both
body and mind.
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Greeks
Temple hospitals were built
The usual methods of deciding treatment
praying to god Aesculapius and then the patient sleep in
his dreams the god Aesculapius himself would reveal the
drugs to be given.
The true founder of medical science
Hippocrates, the father of modern medicine
Discovered diseases are not the result of evil-sprit
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The Christian era
The early Christians were inspired by the teachings ofChrist.
Christ taught people to help one another like brothers and
sisters.
Service to the sick and the poor was service to God.
Bishops formed the religious orders of Deacons anddeaconesses.
Their duties were to attend to the sick and the poor in their
homes.
At this time nursing was regarded as a form of religiousdevotion.
Later hospices (houses for the sick and the poor) were built by
the monasteries.
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Christian era . . .
The monks and nuns cared for the sick, the poor and the aged.
Military orders founded hospitals in their kingdom.
During 17th century, Augustinian sisters lived religious life
and perform nursing care as directed by priests.
Later it becomes sisters of charity .
Their prime function was to care for the sick.
The sisters were instructed to obey the physicians and to serve
patients whole-heartedly.
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THE DARK PERIOD OF NURSING, (18th
Century.)
Despite new discoveries and great scientific progress in
medicine, the religious life of the community was shallow.
Only a few people were ready to join religious congregations.
Those who joined were illiterate, and to make matters worse,
Napoleon, the emperor of France closed all the monasteries
which catered for the sick and used them for non-religious
activities.
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THE DARK PERIOD OF NURSING, (18th
Century.)
This resulted in crude and unsatisfactory health services.
The wards were filthy, bed bugs and lice were abundant.
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THE CATHOLIC RELIGIOUS CONGREGATIONS
(19th C)
Napoleon permitted groups of dedicated females to start
religious congregations in order to care for the sick.
Theodor Fliedner established a hospital where women of good
character were trained as deaconesses.
They cared for the sick and young children in both hospitals
and homes.
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CIVILORDERS (THE RED CROSS)
The Red Cross Society was founded in Geneva in 1863 by a
Swiss bank manager called Henri Dunant.
Its goal has been and still is to train nurses in times of peace in
order to be able to care for the wounded in times of war.
Many girls were trained and were organized into associations.
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Civil Nursing
beginning of 19th century, nursing services started to be
delivered by civil nurses - women who did not belong to
religious congregations.
Florence Nightingale instituted the reforms in the care of the
sick, which form the basis for the modern practice.
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History of Nursing Ethiopia
In ancient Ethiopia illness was considered to be punishment
from sins or magic.
Most tribes and people had a medicine man or women called
"Hakims" or wegasha" who performed rituals, using various
plants and herbs to heal the sick.
The religious people were also providing care for the sick or
injured in the monks hospital in Debre-libanos.
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Nursing in Ethiopia . . .
In late 19th century before nurses training started, foreign
nurses were practicing in the health care delivery system of
Ethiopia.
In 1917 Sister Karin Holmer came as trained nurse to
Ethiopia.
In 1908, Emperor MenelikII established the 1st Ethiopian
Hospital, on the site of the Russian Hospital.
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Governmental public health services, now known as ministry
of public health, which is established in 1948.
Later on Emperor Hailesilassie established different hospitals
in deferent regions including Addis Ababa.
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The first clinic was established at the hot spring at Eilet near
Messwa in which sick people used to come for bathing.
The Princess Tsehai memorial Hospital was opened in 1951.
as a tribute initially from the British people as friendships with
Ethiopia - known as Army Hospital.
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Training of Medical personnel
Before the Italian occupation with exception of a mission
school for midwives in Eritrea, the only training in the public
health personnel consisted of auxiliary medical training in
several hospitals and missions.
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Training . . .
The growth of hospitals made it necessary to start the training
of Ethiopians to assist in staffing hospitals and clinics.
As a first step training, facilities for medical auxiliary
personnel were made available in the MenelikII Hospital.
For some years government and mission hospitals had been
engaged in training dressers and other nursing orderlies.
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Ethiopian Nurses
Princess Tsehai, the emperor youngest daughter was the first
graduated national nurse from Ormand street hospital London.
In 1948 the Ethiopian Red cross nursing school established by
the Emperor in the private Hospital Bet-Saida which later
changed to Haleslassie I Hospital.
Then during the Derg regime, this hospital is changed its
name to Yekatit 12 hospital, which still exists.
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In 1950, the school of nursing was established at Empress
Zewditu memorial hospital for male and female nurses.
In March 1953, the first eight nurses from Ethiopian Red
Cross of nursing and nine from Empress Zewditu memorial
hospital were graduated.
In 1951, two school of Nursing was stablished:
At the princess Tsehai memorial only for female nurses
In Nekemt at the Teferie Mekonnen Hospital
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Ethiopian Nurses . . .
In 1959 thepost basic training started at princess Tsehai
memorial hospital for midwifery nursing and four nurses
graduated in 1960.
In 1954 the Gonder Health College and training center opened
and gave training to community nurses.
In 1958 fifteen (15) community nurses graduated from this
center.
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Today?
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Historical evolution of professional nursing
Documentation of the profession is available only for the last
150 years
1 500 G.C.Nursing care primarily involves meeting the
hygiene and comfort needs of individuals and families.
Christians working in close association with an organized
church primarily provide care.
Nursing is no longer tiedto the church, and nurses are
educated in colleges and universities.
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1836
Theodor Fliender opens a small hospital and training school in
kaiserwort, Germany where Florence Nightingale receives her
nursing education.
Hospital based school of nursing continues to exist, but these
programmes have been declining in number as the profession
moves forward and requires education in academic settings.
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1854 1860
This is the period when Florence Nightingale, who named
superintendent of nursing, made major contribution to modern
nursing, cares for soldiers in the Crimean war.
She opened a training school at St. Thomas hospital in
London, and publishes Notes on Nursing, What it is, what it
is not.
Nightingales many contributions to nursing continue to
influence the profession.
The components of her theory apply even today, and nurses
around the world recognize the courage, dedication and work
of this early professional leader.
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1861- 1865
Dorothea Dix establishes the nurse corps of the UN army.
Dix was not a nurse but an advocate for the mentally ill
people.
Nurses continue to choose careers in the armed services where
opportunities for existing and rewarding careers are offered.
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1872
American first trained nurse, Linda Richards, graduate from
the New England Hospital for women in Boston.
Nursing continue to prepare educated, competent individuals
to provide nursing care in institutions of higher education.
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1974 the first Nightingale model school of nursing in Canada is set up
in St. Catherines, Ontario.
New Nursing programmes continue to develop.
The profession now offers several routes to a career in nursing
including diploma, associate degree, baccalaureate degree, masters
and doctoral degree.
1882: Clara Barton organizes the American National Red Cross.
The Red Cross continues to exist today, offering care to victims of
disasters, maintaining the nations blood supply and educating about
HIV/AIDS.
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1893
Lillian Wald and Merry Brewster found Henry Street
settlement, the first home visiting nurse organization in United
States.
Visiting nurse associations have grown and become essential
health care components in a society.
1897: The American society of superintendents of training
schools of the United States and Canada is organized.
It is renamed ANA in 1911 and CNA in 1907.
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1899
ICN is established which continues to represent and speak to
international nursing concerns.
1900: AJN- the first journal of nursing journal to be owned,
operated and published by nurses is developed.
AJNand The Canadian Nurses continue to be the major
references for clinical nursing practice.
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1923
Gold-mark report of the Rockefeller Foundation is published,
advocating financial support of university-based schools of
nursing.
Nursing organizations and leaders are working to improve
financial assistance to students.
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1940
WWII results in another nursing shortage.
EstherLucille Brown completes the Brown report on nursing
education, advocating that education for nursing belongs to
colleges and universities, not in hospitals.
Although hospital based schools of nursing continues to exist
they are declining in number, and the students are more
frequently choosing college and university educations.
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1953
National Student Nurses Association (NSNA) is established
which continues to encourage students of nursing to become
involved in professional issues.
Students are given opportunities to hold leadership positions at
state and national levels.
The equivalent organization in Canada is known as the
Canadian University Nursing Students Association.
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1965
ANA issues its first position paper on nursing education
calling for all nursing education to take place on institutions of
higher education and stipulating Baccalaureate as the
minimumpreparation for professional nursing and associate
degree for technical nursing practice.
The entry level debates have not been completely resolved.
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1985
National Center for Nursing Research is established at the
national institutes of Health in Bethesda, Maryland which
upgraded by President Clinton to institute in 1993.
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Nursing as a profession
The authority for the practice of nursing is based upon a social
contract that delineates professional rights and responsibilities
as well as mechanisms for public accountability.
In almost all countries, nursing practice is defined and
governed by law, and entrance to the profession is regulated at
national or state level.
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Profession
The aim of the nursing community worldwide is to develop the
profession guided by continuing education based on nursing
research, and to regulate standards of competency and ethics.
There are a number ofeducationalpaths to becoming a
professional nurse, which vary greatly worldwide, but all
involve extensive study ofnursing theory and practice and
training in clinical skills.
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Contd
Over the past 50 years, nursing has undergone dynamic
changes in its scope of practice.
Nurses have moved from simply observing and giving
prescribed medications to coordinating clinical information for
the entire health care team.
This coordination allows for the design of the best possible
plans of care.
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Criteria to be a profession
To provide a needed service
To advance its knowledge in its field
To protect its members and make it possible to practice effectively
Characteristics of a profession:
A basic profession requires an extended education of its members.
A profession has a theoretical body of knowledge leading to defend skills,
abilities and norms.
A profession provides specific service.
Members of a profession have autonomy in decision making and practice.
The profession has a code of ethics for practice.
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Role of nurses
Historically, the nurses sole duty was to provide care and
comfort to the sick.
Advances in technology, knowledge, health promotion, and
prevention have expanded the function of todays nurses.
Nursing function includes activities that nurses perform
independently (example, turning or positioning bed client
every 2 hours) or collaboratively (example, prescription of
medication by physicians and judgment of nurses for proper
administration)
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Role
Professional nurses are autonomous and assume the
responsibilities of care givers, decision makers, client
advocates, managers and coordinators of health care needs,educators, and communicators.