Fundamentals OF Nursing Practice PDF

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LECTUREMODULE 1: INTRODUCTORY CONCEPTS OFNURSINGCaring is central to nursing practice. Aesthetic qualities (elements placed into pattern to form a whole, symbolizing meaning beyond the elements themselves) can be reflected in all aspects of nursing practice – from notes written in a chart to theoret...

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LECTURE MODULE 1: INTRODUCTORY CONCEPTS OF NURSING

4. It started a formal training school for nurses.INSTITUTE OF PROTESTANT DEACONESSES

Caring is central to nursing practice. Aesthetic qualities (elements placed into pattern to form a whole, symbolizing meaning beyond the elements themselves) can be reflected in all aspects of nursing practice – from notes written in a chart to theoretical formulations, from a single brief interaction with an individual to sustained interactions with groups and communities, and from an unexpected encounter to a thoughtfully planned design for a system of care. In all of these ranges of nursing experience, nurses draw in and use science, ethics, and personal knowing, as well as aesthetic knowing. It is the dimension of aesthetic knowing that endows the experience with its aesthetic qualities and differentiates it from the impersonal performance of technical acts and routinized procedures.

5. She recruited female nurses to provide care to the sick and injured during the Crimean War. FLORENCE NIGHTINGALE

Communication is a complex, ongoing, dynamic process in which participants simultaneously create shared meaning in an interaction. The goal of communication is to approach, as closely as possible, a common understanding of the message sent and the one received. At times, this can be difficult because both participants are influenced by past conditioning, the present situation, each person’s purpose in the current communication and each person’s attitude toward self, the topic and each other. It is important that participants construct messages as clearly as possible, listen carefully, monitor each other’s response and provide feedback PRE-TEST I. Identification 1. It is an organization of an occupational group based on the application of special knowledge, which establishes its own rules and standards for the protection of the public and the PROFESSION. 2. It is practiced with an earnest concern for the art of care and the science of health. NURSING 3. They practice acupuncture for treating illnesses, eating seaweeds and liver, opium taken from white poppy (used for relieving severe pain), ephedrine (from the Mahung tree) used to treat asthma and URTI. CHINA

6. The process of intentional higher level of thinking to define a client’s problem, examine the evidence – based practice in caring for the client and make choices in the delivery of care. CRITICAL THINKING 7. He was known as the god of healing.ASCELEPIUS 8. It is the first college of nursing in the Philippines with its first Dean, Ricarda Mendoza.UST 9. It is a subjective awareness of information.FEELING 10. This role requires skills in therapeutic communication.COUNSELOR II. True or False. 1. A nurse leaning forward is an example of a gestureT 2. When the nurse crosses her legs during an interaction, she is assuming a non-defensive position.F 3. When communicating with a toddler, drawing a picture is an alternative way.T 4. Infants communicate by responding to body feelings.T 5. Leaning forward is more effective at the beginning of the interview.F III. Matching Type 1. There is always a superior whom one can consult if problems exist. 2. The focus of nursing is only on family and community 3. They are expected to be expert clinicians as well as expert generalists in nursing 4. They meet the needs of the workers. 5. They are responsible for providing sound, detailed instructions in the various courses. JNM

NURSING AS PROFESSION HISTORY OF NURSING Traditional female roles of wife, mother, daughter, and sister have already been included in the care and nurturing of other members of the family; therefore, nursing the sick was designated to the women of a tribe.

FOUR PERIODS OF NURSING DEVELOPMENT 1. Intuitive / Medieval Period ● Dated from the prehistoric times to early Christian era ● Nursing was instinctive and “untaught”; performed out of compassion for others and only wished to help. ● Primitive men believed that illness was caused by the entrance of evil spirit in the victim’s body. ● The medicine man or witch doctor called “shaman” had the power to heal through the use of white magic, charms, dances, incantations, massage and herbs. Trephination (drilling a hole in the skull), from the Greek word meaning “borer” was a way of releasing an evil spirit. - care of the sick was a task that belonged to women - intuitive and untaught Key: “instinctive or untaught” Two Theories: 1. Theory of Self Preservation (survival) 2. Animistic and Demonic

a. Egypt (3000 BC) Ancient Egyptians contributed significantly to health through the progress made in disease prevention. As citizens of one of the healthiest of ancient cultures, the Egyptians have contributed the following: ⮚ Hygienic Principles: Practices for hygiene and water sanitation. They developed sophisticated systems to supply pure water and dispose of human wastes/excreta. (restrictions on eating meat) (care in choosing edible foods in the deserts)

⮚ Papyrus Ebers = medical records containing 1,000 prescriptions for all kinds of diseases ⮚ Art of embalming = to treat/preserve a corpse from decay with preservatives (originally with spices), now by means of arterial injection. ➢

Egyptian Mythology – control of disease was in the hands of the gods ➢ Imhotep (he who comes in peace) – Egyptian God of Medicine (First acknowledged physician) EGYPTIAN RITES - health and healing beliefs of ancient civilization - superstition and black magic -injuries from wars and other tragic events

b. Babylonia (1900 BC) The earliest written reference to health is attributed to King Hammurabi of Babylonia (now Iraq), the Code of Hammurabi = the regulations and laws of this code were based on promoting fairness and equality. This code regulated specific health practices and conduct of the physicians. Now: Code of Ethics – involves rules and laws to follow to have equality or fairness

c. Greece (1500 – 100 BC) - Caduceus – insignia of the medical profession *emphasis on personal health & hygiene, exercise, and healthy diets The early Greeks are known for their practice of worshipping gods and goddesses all of whom were strong, beautiful and powerful. Apollo was the god of health while his son, Asclepius, was the god of healing, Hygeia, the daughter of Asclepius was the goddess of health. The Greeks focused on health with an emphasis on personal health and hygiene, exercise, and healthy diets. •

two serpents signifies rejuvenated knowledge and wisdom

(160 – 362 BC) Hippocrates, the Father of Medicine, identified the importance of incorporating JNM

social, environmental, mental, and physical factors in treating the person as a whole person.

d. Rome (500 BC – 500 AD) Health promotion practices of the ancient Romans, which included exercise, massage, and therapeutic baths, were more geared to those seeking luxury and personal indulgence. One similarity between the Greeks and the Romans is their philosophy regarding health and illness. Hippocrates and Galen, the Roman physicians both viewed health as an interaction between a person and his environment.

e. China The Chinese were perhaps the greatest advocates for health promotion of all ancient cultures. For them healthy life is one that is in harmony with the universe by maintaining a perfect balance between the dualistic forces of Yin (the female element associated with negative energy, and Yang (the male element associated with positive energy). This philosophy has lasted throughout the centuries and remains integral to concepts of health and health promotion practices throughout the modern worlds. Other contributions include: Acupuncture - a traditional method of producing analgesia by inserting wire-thin needles into specific areas on the body, and the Materia Medica, a list of plants,animals, and other substances believed to have medicinal properties was regarded as the most complete and comprehensive medical book ever written. - treating certain painful conditions and for producing regional anesthesia Materia Medica – same with Papyrus

f.

India

Ancient Hindus practiced hygiene by keeping the nails short and wearing of clean clothes. King Azoka established hospitals where nurses practiced as pharmacists, masseurs, and cooks.

The Vedas, the sacred book of the Hindus, contains important sources of information in the practice of medicine and surgery, while Charaka Samhita, an Indian doctor, introduced the team concept, which consists of the physician, pharmacist, nurse, and patient.

g. Palestine - developed Mosaic Code; law of cleanliness and one of the first organized method in disease control and prevention, and public health laws - principle of quarantine The Hebrews of Palestine also provided evidence of concern for [promoting health. Their greatest contribution was the creation of the Mosaic Code. The code contained an organized system for disease prevention, one of which was the principle of quarantine (segregation of those with communicable diseases) Palestinians were called “unitarians” because they believed in only one god who is the source of health and illness. They considered a person impure when the person had contagious disease, committed an evil act, entered a house where there was a dead person, or during a menstrual period. Bathing with water of purification was rendered to treat these conditions.

2. Period of Apprentice / Middle Ages (500 AD – 1836) - on the job training - experienced nurses directed the new nurses - started when Ignatius Loyola and Martin Luther lead a revolt against the Roman Catholic Church. During the Dark Ages, after the fall of Rome, much of what was known about health and medicine of ancient worlds was lost. The Catholic Church claimed authority for the welfare of the society, and purity of the soul became the highest priorities. In the Middle Ages, the emphasis of health by early Christians was on treating disease and illness. Nursing care was performed without formal education. JNM

During the Crusades (holy wars, military religious orders established hospitals), several knighthood orders: The Knights Hospitaliers and the Knights of St. Lazarus (dedicated themselves to the care of the people with leprosy) composed of brothers in arms who provided nursing care to their injured comrades. It was during the European Renaissance (15001700) that colonies in America were being established. Health promotion in early colonial days was based on early survival against the elements of nature. The Industrial Revolution in the United States paved the way to discovery and exploration; nation became more independent through trade. With this transition period came the arrival of poor immigrants resulting in inadequate living and working conditions. The public health declined and death from preventable diseases increased, especially among children.

CHRISTIAN ORGANIZATIONS AND ORDERS “CRUSADES” ✓ Knights of St. John of Jerusalem - a.k.a. Knights of Hospitaliers - descendants of the Knights Templars - the first nursing order – Monastic Order of St. Augustine ✓ Sisters of Charity -established by St. Vincent de Paul in France NURSIG DURING THE AMERICAN CIVIL WAR (April 12, 1861) - no nurses available to give care to wounded soldiers - rich people took care of their patients at their houses - the actual nursing care of the injured was left to the religious sisterhoods and to volunteers

VOLUNTEERS In 1836, Theodore Fliedner and his wife Frederika, reestablished the Order of Deaconesses and opened a small hospital and training school in Kaiserwerth, Germany. The Deaconesses School of Nursing became the 1st formal training school for nurses, where at the age of 31, Florence Nightingale received her 3- month course in nursing. *Deaconesses – earliest order of women who worked in the church especially concerned with nursing care for the poor and also attended the sick in their home (those who are doing religious teaching) *St. Elizabeth of Hungary – known as the “Patroness of Nurses.” She is the daughter of the Hungarian King *St. Catherine of Siena – she was ”The First Lady with a Lamp.” It signifies evening rounds. She worked day and night to give nursing care to patients. - when plague (contagious disease) came to her town, she spent day and night giving care to patients by carrying lantern which held the same significance of Florence Nightingale.

Dorothea Lynde Dix - not a nurse but was appointed as superintendent of female nurses for the US government Mary Ann Bickerdyke - a widow, she helped in nursing wounded soldiers; she was an herb doctor a hospital supervisor, and known as “Mother of Calico” Clara Barton - founder of American Red Cross (1883) BETSY PRIG and SAIREY GUMP - 2 ill-bred nurses with selfish and cruel attitude, took bribes from patient, stole the foods of the patients. They used alcohol as tranquilizers.

3. Period of Educated Nursing / Nightingale Era (19th – 20th century) - Industrial Revolution – paved the way to the discovery and exploration; nations became more interdependent through trade - rapid transmission of communicable diseases - women – worked as servant in private homes or were dependent on their husband’s wages JNM

- prisoners or prostitutes – assigned to take care of the sick in hospitals or private homes FLORENCE NIGHTINGALE - an English lady from a wealthy family during the Victorian era - during the Crimean war – known to be the “Lady with the Lamp” - a nursing theorist, writer and statistician - Founder of Modern Nursing - recruited female nurses to provide care to the sick and injured during the Crimean War, with the help of Mary Grant Seacole, a Jamaican nurse - transformed the military hospitals by setting up diet kitchens, a laundry, recreation centers, and reading rooms - died on August 13, 1910 - Notes in Nursing became the backbone of the profession in many coutries in the world - graduate nurses who became missionary nurses and spread her system of nursing - ENVIRONMENTAL THEORY – maintaining a safe and clean environment to promote well-being OBSERVATIONS OF FRORENCE NIGHTINGALE 1. Social problems of places visited 2. Need for preventive medicine 3. Need of good nursing care 4. Lack of good hygiene practices

In 1854, Florence Nightingale was asked by Sir Sidney Herbert from the British Department of War to recruit nurses to provide care of the sick and wounded soldiers in the Crimean War. She gathered 38 volunteer nurses; their duties were to clean the barracks to reduce infection, cooked for the soldiers, established a laundry, provided recreation (exercises, games, health education), and wrote letters for the soldier’s family.

In 1860, Florence Nightingale opened the Nightingale Training School for Nurses at St. Thomas Hospital in London. It was the 1st school of nursing that provides both theory-based knowledge combined with clinical practice; thus, nursing evolved as a science and art. Thus, Florence Nightingale became known to be the Mother/Founder of Modern Nursing.

Her belief in health as a wellness-illness continuum is evident in her Notes on Nursing, in which she wrote, “the same laws of health or of nursing, for they are in reality the same, obtain among the well as among the sick”. A compilation of her visits to hospitals and her observations of the facilities and social problems were written in her Notes on Hospital. Titles/Positions given to Florence Nightingale: Angel of Crimea, and the Lady with a Lamp.

Until the end of WW, I, the general trend was rapid expansion in the establishments of hospitals, with nursing schools dependent on them for support. During the war, greater numbers of women were accepted for entrance, and fewer considerations were given to selection requirements. Most schools by this time had adopted a 3year programs, but the 8-hour a day originally proposed with those programs was less quickly adopted.

By 1920, there was an increasing criticism on the hospital system of educating nurses. Thus, a special post-basic course was offered at Teachers College, Columbia University, NY to prepare nurses to be teachers.

In response to the postwar influenza epidemic and the emphasis on teaching the principles of healthful living to individuals, family, and community, a postbasic public health nursing program was also developed.

The rapid uncontrolled urbanization, industrialization, and immigration resulted in congestion, poverty, malnutrition and disease and set the stage for renewed interest in health promotion. To improve the health of all Americans, the government developed innovations in health care. 38 women volunteered - 10 Roman Catholic, 14 Protestants, 14 practical Nurses Duties during Crimean War: 1. Cleaned the area, the barracks to reduce infection JNM

2. Cooked for the soldiers 3. Establish a laundry staffed by the soldiers’ wives 4. Provided recreation; exercises, games, health education, etc. 5. Wrote letters for the families of the soldiers WOUNDED AT SCUTARI Nightingale Pledge: Mrs. Lystra Gretter I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.

SYSTEM OF EDUCATION • •

St. Thomas Hospital School of Nursing in London with 15 students for 1 year. Brown dress, white caps, and white apron

SYSTEMS OF NURSING • • • • •

Self-supporting Decent living quarters Paid both by the school and hospital Correlate theories into practice Taught the why’s (rationale) and how’s (steps) of nursing

4 NOTES COMPILED BY F.N. 1. Notes on Nursing 2. Notes on Hospitals 3. Notes on matters affecting the health and efficiency of the British army 4. Subsidiary notes as to the introduction of female nurses into the military hospitals in peace and order

4. Period of Contemporary Nursing

- social changes and scientific changes - major advances in medical technology and disease control - 1940’s new drug, diagnostic methods, and methods of treatment regimen - 1950’s heralded a new era in medical care Following WW II, major advances in medical technology and disease control approached the miraculous. New drugs, diagnostic methods, and methods of treatment regimen in the 1940’s and 1950’s heralded a new era in medical care, resulting in saving millions of lives. It is no surprise that advances in medicine and health care came with a higher price tag. By the early 1970’s, the public who had become enraptured by the awesome advances in disease diagnosis and treatment began to make the connections between health and lifestyles. Epidemiological studies were conducted in the US and Britain that provided evidence linking human behavior with chronic disease. In recognition of the effects of lifestyle and behavior on disease, the US government established the Office of Disease Prevention and Health Promotion (ODPHP) in 1976. In 1979, the US Public Health Service published Healthy People: Surgeon General Report on Health Promotion and Disease Prevention. This document outlined three major strategies for reaching national goals for health: preventive services for individuals provided by health professionals; individual protection measures to be taken by the government and industries; and health promotion actions to be taken by individuals and communities. In the late 90’s the Healthy People 2010, incorporated recent scientific advances in preventive medicine, disease surveillance, vaccine and therapy development, and information technology. WHO –...