History Of Nursing Theory

Republic of the Philippines CAMARINES SUR POLYTECHNIC COLLEGES Nabua, Camarines Sur COLLEGE OF HEALTH SCIENCES  The history of professional nursing began with Florence Nightingale. She envisioned nurses as a body of educated women at a time when women were neither educated nor employe...

Republic of the Philippines CAMARINES SUR POLYTECHNIC COLLEGES Nabua, Camarines Sur COLLEGE OF HEALTH SCIENCES  The history of professional nursing began with Florence Nightingale. She envisioned nurses as a body of educated women at a time when women were neither educated nor employed in public service. Following her service of organizing and caring for the wounded in Scutari, during the Crimean War, her vision and establishment of a School of Nursing at St. Thomas’ Hospital in London marked the birth of modern nursing.  Nightingale’s pioneering activities in nursing practice and subsequent writings describing nursing education became a guide for establishing nursing schools in the United States at the beginning of the twentieth century (Kalisch & Kalisch, 2003; Nightingale, 1859/1969).  ERAS Moving nursing education from hospital-based CURRICULUM ERA diploma programs into college and universities 1900-1940 Research is the path to new knowledge RESEARCH Part of the curricula of developing graduate ERA programs. 1950-1970  Masters program in nursing emerged to meet the need for nurses with specialized education in GRAD EDU ERA nursing 1950-1970 Outgrowth of research era Research without theory produced isolated THEORY ERA information; however research and theory produced 1980-1990 nursing science EVOLUTION OF NURSING THEORIES Historical Major Emerging Emphasis Outcomes Eras Question Goal Curriculum What curriculum Courses Standardized Develop Era: 1900 to content should included in curricula for specialized 1940s student nurses nursing diploma knowledge and study to be nurses? programs programs higher education Research What is the focus for Role of nurses Problem studies Isolated studies Era: 1950 – nursing research? and what to and studies of do not yield 1970s research nurses unified knowledge  Historical Emerging Eras Major Question Emphasis Outcomes Goal Graduate What knowledge is Carving out an Nurses have an Focus graduate Education Era: needed for the practice advanced role important role in education on 1950 – 1970s of nursing? and basis for health care knowledge devt. nursing practice Theory Era: How do theses There are many Nursing theoretical Theories guide 1980-1990s frameworks guide ways to think works shifts the nursing research research and practice? about nursing focus to the patient and practice Theory What new theories are Nursing Theory Middle-range Nursing Utilization Era: needed to produce guide research, theory may be frameworks 21st Century evidence of quality practice, from quantitative produce care? education & or qualitative knowledge administration approaches (evidence) for quality care  Nightingale’s vision of nursing has been practiced for more than a century, and theory development in nursing has evolved rapidly over the past 5 decades, leading to the recognition of nursing as an academic discipline with a substantive body of knowledge. MID Nursing Knowledge Debates and Mid 1800’s 1960’s is distinct from discussion medical knowledge regarding the proper (Nightingale) direction and Nursing as a appropriate Vocational heritage discipline for nursing more than knowledge professional vision. development  MID Evaluation of 25 years of nursing research revealed that nursing lacked conceptual connections and theoretical frameworks. MILESTONES: 1. Standardization of curricula for nursing master’s education 2.Doctoral education for nurses should be in nursing Transition from vocation to profession Nursing practice is based on Nursing Science.  MID » Pre-paradigm period to Paradigm period » Introduced an organizational structure for nursing knowledge development to the nursing literature » Utilization phase of the Theory Era – emphasis shifts from the development to the use and application of what is known.  NURSING Theory In 1969, the 1st Conference brought leading scholars and theorists to discuss and debate on issues regarding nursing science and theory development.  Martha Raile Alligood, Nursing Theorists and Their Work, 9th Edition, Elsevier, edition printed in the Philippines, (2018) https://nursekey.com/introduction-to-nursing-theory-its- history-significance-and-analysis/ :  At the beginning of the twentieth century, nursing was not recognized as an academic discipline or a profession. The accomplishments of the past century led to the recognition of nursing in both areas. The terms discipline and profession are interrelated, and some may even use them interchangeably; however they are not the same.  OVERVIEW üDISCIPLINE is specific to academia and a branch of education, a department of learning, or a field of knowledge. üPROFESSION refers to a specialized field of practice, which is founded upon the theoretical structure of the science or knowledge of that discipline and the accompanying practice abilities.  DISCIPLINE PROFESSION Type of work that Branch of knowledge needs special training DEFINITION usually studied in higher or particular skill to education perform Applies knowledge to KNOWLEDGE Generates knowledge the practical world Focuses on how the Focuses on the final PRODUCT product is being created product Mathematics, biology, Doctor, accountant, EXAMPLES physics, languages, art lawyer, teacher, nurse SIGNIFICANCE OF NURSING THEORY AS A DISCIPLINE 1. University baccalaureate programs proliferated, masters programs in nursing were developed, and the curricula began to be standardized through the accreditation process. 2. Attention to the importance of nursing conceptualizations for the research process and the role of a conceptual framework in the purpose and design of research production of science and nursing theoretical works also began to publish. 3. Works began to be recognize for their theoretical nature, such as Henderson, Nightingale and Orlando, Peplau, and Wiedenbach were recognized for the theoretical nature of their earlier writings. The theoretical works have taken nursing to higher levels of education and practice as nurses have moved from the functional focus, or what nurses do, to a knowledge focus, or what nurses know and how they use what they know for thinking and decision making while concentrating on the patient. THEORETICAL WORKS HAVE TAKEN NURSING TO A HIGHER LEVEL  The emphasis has shifted from a focus on knowledge about how nurse function, which concentrated on the nursing process, to focus on what nurses know and how they use knowledge to guide their thinking and decision making while concentrating on the patient. SIGNIFICANCE OF NURSING THEORY AS A PROFESSION Clearly, nursing is recognized as a profession today having used the criteria for a profession to guide development. Nursing development was the subject of numerous studies by sociologists.  WHAT IS A PROFESSION? A profession is an occupation with ethical components, i.e, devoted to the promotion of human and social welfare. The services and knowledge by a profession are based on specialized skills. Professions are those occupations possessing a particular combination of characteristics. Nursing profession is an occupation based on the specialized intellectual study and training, the purpose of which is to supply skilled services with ethical components.  CRITERIA OF PROFESSION § Bixler and Bixler Criteria for Profession § Abraham Flexner’s criteria for a profession § Kelley’s criteria CHARACTERISTICS OF 1. Great Responsibility v Professionals deal in matters of vital importance to their clients and are therefore entrusted with grave responsibilities and obligations. v Given these inherent obligations, professional work typically involves circumstances where carelessness, inadequate skill, or breach of ethics would be significantly damaging to the client and/or his fortunes.  2. Accountability vProfessionals hold themselves ultimately accountable for the quality of their work with the client. v The profession may or may not have mechanisms in place to reinforce and ensure adherence to this principle among its members. If not, the individual professionals will (e.g. guarantees and/or contractual provisions). 3. Based on Specialized Theoretical Knowledge Professionals render specialized services based on theory, knowledge, and skills that are most often peculiar to their profession and generally beyond the understanding and/or capability of those outside of the profession. Sometimes, this specialization will extend to access to the tools and technologies used in the profession (e.g. medical equipment). 4. Institutional Preparation Professions typically require a significant period of hands-on, practical experience in the protected company of senior members before aspirants are recognized as professionals. After this provisional period, ongoing education toward professional development is compulsory. A profession may or may not require formal credentials and/or other standards for admission. Professionals have A control over and, correspondingly, ultimate U responsibility for their T own work. Professionals tend to define the terms, O processes, and conditions of work to be N performed for clients O (either directly or as preconditions for their M ongoing agency employment). Y Members of a profession exercise discrimination in choosing clients rather than simply accepting any interested party as a customer (as merchants do). 6. Clients Rather Than Customers. Professionals habitually work directly with their clients rather than through intermediaries or proxies. 7. Direct Working Relationships 8. Ethical Constraints. » Due to the other characteristics on this list, there is a clear requirement for ethical constraints in the professions. Professionals are bound to a code of conduct or ethics specific to the distinct profession (and sometimes the individual). Professionals also aspire toward a general body of core values, which are centered upon an uncompromising and unconflicted regard for the client's benefit and best interests. » In a profession, members achieve employment and success based on merit and corresponding voluntary relationships rather than on corrupted ideals such as social principle, mandated support, or extortion (e.g. union members are not professionals). Therefore, a professional is one who must attract clients and profits due to the merits of his work. In the absence of this characteristic, issues of responsibility, accountability, and ethical constraints become irrelevant, negating any otherwise-professional characteristics. 9. Merit-based 10. Capitalist Morality The responsibilities inherent to the practice of a profession are impossible to rationally maintain without a moral foundation that flows from a recognition of the singular right of the individual to his own life, along with all of its inherent and potential sovereign value; a concept that only capitalism recognizes, upholds and protects.