Untitled

• Nursing is not just specific skills, but also not just someone with specific training.

Definitions of Nursing

• Florence Nightingale (1860): Nursing uses the environment to help patients recover.
• Virginia Henderson (1966): Nursing helps people do things that make them healthy or recover so they can be independent.
• Nursing is caring, an art, and a science that puts the patient first, is holistic, changes as needed, and focuses on keeping people healthy, helping them stay that way, and getting better, and it is a helpful job.

Nursing as an Art and Science

• Nursing as an Art: Giving care with kindness, respect, and honor to each patient.
• Nursing as a Science: Knowing a lot about things that keeps changing because new things are always being discovered.
• Art + Science = Providing very good care.

Profession

• A profession is a job that needs special knowledge, skill, and preparation.

Job vs. Profession

• Job: Mainly about earning money, not so much about growing as a person or being morally responsible.
• Profession: A career where you need to study and train a lot, follow ethical rules, be responsible, and keep learning.
• Professional Practice: Nurses give care using what they know, how well they can do things, and being responsible for themselves, their patients, their coworkers, and the community.

Characteristics of Nursing

• Nursing is Caring: Taking care of people is the most important thing in nursing, whether it's physical, mental, or emotional care.
• Personal Contact: Nurses work closely with the people they are caring for.
• Holistic Approach: When nurses help people, they think about them as physical, mental, and social beings.
• Commitment to Health: Nurses help people, families, communities, and countries be healthy.
• Personalized Services: Nursing is all about giving care that is tailored to each person, no matter their race, religion, or how much money they have.
• Ethical Involvement: Nurses are involved in moral, legal, and government issues that affect healthcare.

Focus of Nursing

• Nursing focuses on how people react to health issues.
• Health-restoring responses: Reactions to already existing health issues or illness.
• Health-supporting responses: Attention towards possible health problems.
• Nurses help both sick and well people, because health can change quickly.

Professional Qualities of a Nurse

• A bachelor's degree in nursing is required.
• Physical and mental health is required.
• A license to practice nursing is required.

Personal Qualities of a Nurse

• Compassionate: Understanding and caring about how others are suffering.
• Respectful: Helping patients feel valued, especially when they are in a weak position.
• Calm Under Pressure: Able to think clearly and make good decisions when things are stressful.
• Detail-Oriented: Paying attention to even the smallest parts of patient care.
• Good Communicator: Good at listening and explaining things clearly to patients.
• Knowledgeable: Good at thinking critically, understanding patients, managing diseases, and making care plans.

Roles and Functions of a Nurse

• Caregiver: Helps patients physically and mentally, while respecting their dignity.
• Communicator: An important part of nursing, helping to find problems and share information with the healthcare team.
• Client Advocate: Protects the rights of patients and communicates what they need.
• Counselor: Gives emotional and mental support to patients and helps them deal with stress or social problems.
• Change Agent: Helps patients change their behavior and pushes for changes in how care is given in hospitals.
• Teacher: Teaches patients about health and how to take care of themselves.
• Leader: Inspires others to work towards better healthcare.
• Manager: Organizes care, gives out tasks, and watches over how things are done.
• Case Manager: Plans care with a team of different specialists and keeps track of the results.
• Research Consumer: Uses research to make patient care better and finds problems that can be researched.
• Delivery: Gives care to patients.

Expanded Roles of Nurses

• Nurse Practitioner: Has more education, certified in different fields such as Family Nurse Practitioner, Pediatric Nurse Practitioner.
• Clinical Nurse Specialist: Has advanced education, is an expert in a specific area, and helps with direct care, education, advice, and research.
• Nurse Anesthetist: Has more training in anesthesiology, gives anesthesia services under the supervision of a doctor.
• Nurse Midwife: Has advanced training in midwifery, helps with care before, during, and after childbirth.
• Nurse Researcher: Studies nursing problems to make care better, usually needs advanced education.
• Nurse Administrator: Runs patient care, staffing, budgeting, and planning of programs.
• Nurse Educator: Teaches in schools or hospitals.
• Nurse Entrepreneur: Runs a healthcare business or service.

Scope of Nursing Practice

• Republic Act 9173 (Philippine Nursing Act of 2002) was approved on October 21, 2002.
• Purpose: To build a strong base for nursing through good education and practice.
• Coverage: Covers nursing care for all ages and health situations, both on their own and as part of a healthcare team.

Sec. 28 - Scope of Nursing Practice

• Nursing care is for people of all ages, from when they are born to when they are old.
• Independent Practice: Nurses must promote health and prevent illness.
• Collaborative Practice: Nurses work with other healthcare providers for curative, preventive, and rehabilitative care, alleviating suffering, health restoration, and ensuring a peaceful death when recovery is not possible.

Code of Ethics for Nurses

• Defines the rules that guide nurses in their work.

Basic Principles

• Advocacy: Protecting the health, safety, and rights of patients.
• Responsibility: Doing what they are supposed to do and keeping promises.
• Accountability: Taking responsibility for their actions.
• Confidentiality: Keeping patient's personal health information safe.

II. EVOLUTION OF NURSING

• Intuitive Era: In prehistoric times, nursing was done without training, usually by mothers because women are naturally more caring.
• People thought sickness was caused by evil spirits and based on instinct.
• Rennaisance Period (1500AD-1850AD): The Dark Period of Nursing, nurses were considered "wayward" women of low status who became nurses instead of going to jail.
• The Knights of Saint Lazarus (circa 1200) cared for people with leprosy, syphilis, and chronic skin conditions.
• Apprentice Era: Known as the “on the job training" period, nurses learned by doing, under the guidance of someone more experienced, but without any formal education.
• Experienced nurses taught new nurses, who were usually volunteers from religious groups. They nursed the sick and wounded from the wars.
• Pastor Theodore Fliedner and Frederika (wife) started the Kaiserswerth Institute to train Deaconesses in Germany, which was the first formal nursing school.
• Florence Nightingale (1820-1910) was the most famous student of Kaiserswerth Institute.
• Nursing was seen as a very low-paying job in the social hierarchy.
• Sojourner Truth (1797–1883) and Harriet Tubman (1820–1913) provided care and safety to slaves fleeing to the North on the Underground Railroad.
• Mother Biekerdyke and Clara Barton searched battlefields and gave care to injured and dying soldiers.
• Educative Era: Marked by the establishment of Florence Nightingale School of Nursing, the authoring of the first nursing theory, and pioneering nurse research efforts.
• Florence Nightingale demonstrated correlating theory and practice, updates, continuing education, research, self-supporting nursing school (separate from hospital) and changed the image of nursing and revolutionized practice.
• Contemporary Era: Modern nursing practice evolved toward a scientific, research-based defined body of nursing knowledge and practice.

PIONEERS IN NURSING

• Florence Nightingale (1820–1910) was the founder of modern nursing, known for improving wartime care, public health reform, and establishing the Nightingale Training School. She was also known as the "Lady with a Lamp" and "Mother of Modern Nursing".
• Clara Barton (1821-1912): Established the American Red Cross and aided in ratifying the Geneva Convention for humanitarian purposes.
• Linda Richards (1841-1930): She was America's first trained nurse, a pioneer in both psychiatric and industrial nursing, and she introduced nurse's notes and uniforms.
• Mary Mahoney (1845-1926) was the first African American professional nurse, and an advocate for racial equality in nursing.
• Lillian Wald (1867–1940) was the Founder of public health nursing, co-founder of the Henry Street Settlement, and a pioneer in school nursing.
• Lavinia Dock (1858–1956) was a feminist, political activist, and suffragette who helped establish the American Society of Superintendents of Training Schools for Nurses.
• Margaret Sanger (1879–1966) was an Advocate for women's reproductive rights and founder of Planned Parenthood.
• Mary Breckinridge (1881–1965) established the Frontier Nursing Service, which involved providing healthcare in rural America and creating the first midwifery training school.

Philippine Nursing Leaders

• Cesaria Tan: First Filipino Nurse to earn a Masters Degree in Nursing
• Magdalena Valenzuela: First Filipino Industrial Nurse
• Col. Elvegla Mendoza: First Female Military Nurse
• Dr. Julita Sotejo: Known as the Florence Nightingale of the Philippines, authored the Code of Ethics, and Founding member of the UP-CN
• Anastacia Giron-Tupas: Founding member of the PNA (first week of MAY)
• Rosario Montemayor Delgado: The first president of the FNA

III. NURSING AS AN ART

• Nursing as an Art: Giving care skillfully with kindness, respect, and dignity for each client.
• The Art of Nursing together with focus on Science results in the Provision of high-quality care.
• Caring is a universal thing that impacts human interactions.
• Caring is shaped by the culture, values, experiences, and relationships. -People who don’t have care experiences have a hard time acting in caring ways.

Carper's Four Patterns of Knowing in Nursing

Nursing Science/Empirical Knowing

• Knowing through the physical senses.
• Evident as scientific competence is put into practice.
• Knowledge comes from Research, Theory, and Evidence-Based Practice (EBP).

Nursing Ethics/Ethical Nursing

• Nursing practice is guided and directed by moral knowledge.
• Focus: what ought to be done, right from wrong, and responsibility.
• Comes from the Nursing Code of Ethics, Professional Standards, and moral theories.

Nursing Aesthetics/Aesthetic Knowing

• Expressed through actions, conduct, attitudes, and interactions.
• Understanding shared without words.
• Involves intuition, empathy, and skillful action to create meaningful nursing situations.
• The "aha" moment.

Personal Knowledge/Personal Knowing

• Comes from self-awareness, confidence, and reflection.
• Using oneself therapeutically during interactions with patients.
• Should be integrated with responsibilities through observation, reflection, and self-actualization.

Caring Behaviors and Encounters in Nursing

• Understanding the patient is facilitated by continuity of care and expertise in clinical settings.
• Nursing Presence: A person-to-person encounter conveying closeness and a sense of caring that involves “being there” and “being with."
• Empowering the Client: Supporting patient autonomy and decision-making during treatment and allowing the patient freedom to choose their treatment options.
• Compassion: It is based on empathy, respect, and dignity and is how people see their care and relationships with healthcare providers.
• Competence: Understanding individual health and social needs and involving clinical and technical knowledge to deliver great care and treatments.
• Touch: A comforting approach that communicates concern and support, which includes both contact and non-contact touch.
• Listening: Being present and engaging in a nonjudgmental, accepting manner is essential for meaningful interactions with patients.

IV. NURSING AS SCIENCE

• This is based a body of knowledge and up-to-date standards, research, and nursing theories.

The Metaparadigm of Nursing

• Meta = "with"
• Paradigm = "pattern"

The Four Major Concepts

• Person: Those getting nursing care include individuals, families, groups, or communities.
• Environment: Everything inside and outside that affects the client, including physical, social, and emotional factors.
• Health: How well the client feels.
• Nursing: What the nurse does, and the way they act when providing care with the client.

Role of Nursing Theory

• In Education: Nursing was initially established as profession in universities to clarify the meanings and enhance its recognition.
• In Research: It provides philosophical foundations for research by identifying gaps and generating new ideas.
• Theories are broad and rarely guide research directly, focusing on specific concepts or exploring social structures, helping nurses to think, question, and improve their practice.
• Example theory: Orem's Self-Care Deficit Theory used in school for children with special needs.

Selected Nursing Theories

• Nightingale's Environmental Theory: According to Nightingale, nursing means and involves creating an environment for recovery with five key factors: pure/fresh aid, water, drainage, cleanliness, and light.
• Additional Important points: Keep patients warm and a quiet environment and take account of what the patient is eating

Peplau's Interpersonal Relations Model

• Is a helpful relationship between nurse and patient where the Nurse helps the client, by acting many different roles such as: stranger, teacher, resource person, surrogate, leader, and counselor in the nurse-client relationship with four phases:

1. Orientation: The client seeks help, and the nurse assists in understanding the problem and need for help.
2. Identification: The client's relationship to the nurse varies (dependence, interdependence, independence), and the nurse helps the client understand the interpersonal meaning of their situation.
3. Exploitation: The client uses all services best out of the relationship.
4. Resolution: Older needs and goals change to make solutions.

Orem's General Theory of Nursing

• Focuses on three related ideas: self-care, self-care deficit, and nursing systems and when nursing is required and how people can be assisted by the nurse and others.
• Self-Care: Actions done to maintain well-being.
• Self-Care Agency: Both self-care and dependent agents can perform self-care.
• Self-Care Requisites: Maintain self-care:

1. Universal Requisites: Things everyone needs like air, food, rest, safety.
2. Developmental Requisites: Maturation Needs
3. Health Deviation Requisites: Needs arising from health issues.

Therapeutic Self-Care Demand

• All the activity needed to maintain health.

Self-Care Deficit

• Lacking or lacking is when self-care causes the need for :
• Acting or doing for
• Teaching
• Supporting
• Provides environment

Types of Nursing Systems

• Wholly Compensatory Systems: Individuals who cannot control or monitor their environment
• Partly Compensatory Systems: Individuals who need help with some self-care activities.
• Supportive-Educative Systems: Individuals who need help with assistance learning self-care measures.

Leininger's Cultural Care Diversity and Universality Theory

• Human caring is universal but varies across cultures in its expressions, processes, and patterns in culturally competent nursing care.

Intervention Modes for Culturally Competent Care

1. Supporting and preserving culture.
2. Adapting care while respecting cultural values.
3. Culture Changing care for better outcomes .

Roy's Adaptation Model

• Adaptive systems that focuses on a individuals with feedback cycles
• Two elements: Physical and Mental

Four Adaptive Modes

1. Physiological Mode: Involves needs and way of body.
2. Self-concept mode: Body image

Evidence-Based Practice (EBP)

Is to integrate the current best practice with experts and patients.

• Cultivate a spirit of inquiry.
• Ask clinical questions.
• LSearch for the best evidence.
• Critically appraise the evidence.
• Intergrate the family.

Concerns with Solely Relying on Research for EBP

• Done In controlled non real environments.
• Not good for every patient.

Nursing Research

• It helps find research to see if they are good for the patients.

The Historical Context

• 1854 where the reforms affect mortality.
• Helps with innovation and new scientist

Approaches to Nursing Research

• Quantitative and qualitative approaches

Quantitative Research

• System data that the analysis is measured by numbers.
• That truth is absolute and can be discovered.

Qualitative Research

• System data that the analysis is measured by words.
• That reality is related.
• Phenomeoly means by live of experience.

The Research Process Outline

• It outlines the details step by step.

Nursing Roles

• Reading to keep up to date and being apart of teams

The PICO format:

• P - Patient
• I - Intervention
• C - Comparison
• O - Outcome

The rights of study participants

• Right to not be harmed and right to full.

V. NURSING AS A PROFESSION

• An occupation for skills and preparations.
• It has been professionalised so it means getting the characteristic
• And specialised to the education