Evolution (Development) of Nursing Profession Lecture Notes PDF

# Evolution (development) of nursing profession ## Learning objectives: * By the end of lecture discussion, the learners will be able to discuss: ### Journey of nursing development: 1. Ancient civilization. 2. Greece and the Roman empire. 3. Early Christian era. 4. The middle ages. 5. The renais...

# Evolution (development) of nursing profession ## Learning objectives: * By the end of lecture discussion, the learners will be able to discuss: ### Journey of nursing development: 1. Ancient civilization. 2. Greece and the Roman empire. 3. Early Christian era. 4. The middle ages. 5. The renaissance. 6. The reformation. 7. The 16th century to the 19th century. 8. The 19th century to the 21st century (today). * Definitions of nursing and nurse. * Goals of nursing care. * Nursing role in all settings. * Causes of increased need for nursing in Twenty-First Century * Advanced roles of nurse * Examples of health care settings. * Registered nurse. * Profession. * Professionalism. * Important requirements for a professional nurse. * Educational preparations in Egypt. * Introduction to rights and responsibilities for patients and student nurse. ## Outlines: * Introduction. * Journey of nursing development: * Ancient civilization. * Greece and the Roman empire. * Early Christian era. * The middle ages. * The renaissance. * The reformation. * The 16th century to the 19th century. * The 19th century to the 21st century (today). * Definitions: * Nursing. * Nurse. * Goals of nursing care. * Basic Nurses' requirements. * Nursing role in all settings. * Causes of increased need for nursing in Twenty-First Century * Advanced roles of nurse * Examples of health care settings. * Registered nurse. * Profession. * Professionalism. * Important requirements for a professional nurse. * Educational preparations in Egypt. * Introduction to rights and responsibilities for patients and student nurse. * References ## Introduction: Nursing is one of the oldest natural arts and vital professions all over the world. As long as the life is going on, care is needed, which is naturally is done by the mother (the essentia caregiver in the family). The word nurse was derived from the Latin word nutricius, which means nourishing, which is one of the most essential basic human needs. Simply nursing is caring of others in health as well as in illness. ## Journey of nursing development (phases) from ancient times until today (21st century) reading only: 1. Ancient civilization. 2. Greece and the Roman empire. 3. Early Christian era. 4. The middle ages. 5. The renaissance. 6. The reformation. 7. The 16th century to the 19th century. 8. The 19th century to the 21st century (today). ### 1. Ancient civilization: * During the earliest civilizations, illness was believed as supernatural power. In 5000 B.C. illness was considered to be a Devil spirit or punishment of God (literally disease means dis-ease). To be healthy means to obey God and stay away from the evil spirits. Witchcraft started control and heal the sick people as well as to curse the evil person. * The magicians, shaman, religious men and the sorcerers played the master role in treatment and punishment. Woman in those times was considered the man subordinate, even when she was the only care giver in the family in health by cleansing and nourishing as well as caring during illness by providing physical care and herbal medicine. * The ancient Egyptians medical practices were very impressive and the Egyptian Imhotep is known as the first physician. It is believed that he lived around 2700 B.C. the physician hired women — later known as midwives — to assist with childbirth. These women were firstly recorded as nurses. * Hebrews (Jewish) practice preventive medicine as long as 1200 to 600 B.C. ### 2. Greece and the Roman empire: * The Greeks Belief in Apollo, the Greek God of healing and Asclepius the, the Greek God of medicine. They established centers to care of the injured and sick people called hospitals or hostels. They used warm and mineral baths and massage as a treatment. The first recorded history of nursing was in this era. * Hippocrates (ابوقراط) (400 B.C.) separates medicine from religious for the first time of history. He followed the development of assessment standers for the client and the overall medical standers, ethics, observation system, holistic care, reporting, and client-centered care. He documented the mystical influence on disease. He recognized the need for nurses. The health care practitioners repeat the Hippocratic Oath when they graduated from medical school, Nightingale pledge and practical nurse depends on his oath. ### 3. Early Christian era: * Here nursing role became more apparent. Women performed duties that reflected component of today's nursing practice (nutrition, mobility, medications hygiene, counseling and comforting measures). * Deacons (person works for the church ministry) functioned as a visiting nurses dedicating their life to charity work in this era. ### 4. The middle ages: * Christianity improved the nursing status by attracting intelligent people from respectable families. Crusades results in establishing military nursing and male nurses. * In Muslim empire of southwest and central Asia, growing up of medical science continued by many physicians as Avicenna (ان سينا) who wrote the (Canon of medicine: **الْقَانُون**). ### 5. The renaissance:  “The revived (renew) of learning during the renaissance to motivate the advanced of medicine and nursing education”. ### 6. The reformation: This time encountered setback step (deterioration) where the dispersion of religious orders resulted in serious deterioration in hospital conditions and nursing care. Women role changed dramatically to be subordinate to men. This period is considered the dark age of nursing. ### 7. The 16th century to the 19th century: - Western societies emphasized warfare, exploration, and expansion of knowledge. To meet shortage of people to care of sick, women who committed crimes were recruited to be nurses with low pay under unfavorable conditions. - In 1836, Pastor Theodor Fiedner established the Kaiserswerth school of nursing in his parish in Kaiserswerth, Germany (one of the first formal nursing school in history. Florence Nightingale was one of the most famous students graduated in this school. - Start of Red Cross (1859) and Red Crescent (1963). ### 8. The 19th century to the 21st century (today): * Florence Nightingale lamp (learning lamp) is a symbol of nursing and nursing education. It represents the warmth of caring, the light of striving for excellence and the oil represents the energy and commitment of the nurse to heal others. .. * Then Nightingale started her contributions/principles/(policy: * Identify personal needs and nurse role to meet these needs. * Establish stander for hospital management. * Establish respectable occupation for women. * Establish and continue nursing education. * Recognize component of nursing (health and illness). * Believing that nursing is a separate and distinct from medicine. * Recognize nutrition is important to health. * Instituting occupational and recreational therapy for the sick. * Maintain accurate recording and research. * **Twenty-First Century:** * Today the profession faces multiple challenges. * Nurses and nurse educators are revising nursing practice and school curricula to meet the ever-changing needs of society, including an aging population, emerging infections, and disaster management. * Advances in technology and informatics, the high acuity level of care of hospitalized patients, and early discharge from health care institutions require nurses in all settings to have a strong and current knowledge base from which to practice. * Nursing is taking a leadership role in developing standards and policies to address the needs of the population now and in the future. **As time goes on, nursing will continue to develop more and more for health and welfare of the whole community. ** ### Definitions: * **Nursing** (reading only): Simplest definition of nursing is the art and science of caring. * **Nightingale' definition of nursing in 1859** "reading only: Nature alone cures. Surgery removes the bullet out of a limb, which is an obstruction to cure, but nature heals wounds... Medicine assists nature to remove the obstruction but does nothing more. Nursing is to put the patient in the best condition for nature to act upon him." * **The most recent definition of nursing: International Council of Nurses:** It encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. It includes 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. * **Nurse:** is the person who is prepared to take care of the sick, injured, and aged person. ## Goals of nursing care: * To promote health (physical, psychological, social, spiritual and cultural). * To prevent illness (primary, secondary and tertiary). * To treat human response to health or illness. * Advocacy of patient, clients and population. ## Nursing roles in all settings: | Role | Function | |--------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------| | Caregiver | Provide care for all, to meet physical, emotional, intellectual, sociocultural and spiritual needs. | | Communicator | Use of effective therapeutic communication skills to establish and maintain helping relationships with of all. | | Teacher/Educator | Teaches healthy behaviors, attitude and care to patients/client and their families. | | Counselor | Provide information, make appropriate referrals, and facilitate the patient's problem-solving and decision making skills. | | Leader | Ability to manage teams.(medical-paramedical-community). | | Researcher | The participation in or conduct of research to increase knowledge in nursing and improve patient care. | | Advocate | The protection of human or legal rights and the securing of care for a patients | ## Causes of increased need for nursing in Twenty-First Century: * **Higher Client Acuity in Hospital and Long-Term Settings** where there is an increase in clients with highly acute conditions because of the growth of home care for those with more manageable conditions. It requires higher levels of skill, additional education, and more specialization. * **Shift to Community-Based Care:** where many surgeries are now done on an outpatient basis; many clients receive care for chronic or long-term conditions at home. * **Technology:** Nurses, clients, and family members often must learn to operate highly sophisticated equipment to manage conditions in the home for diagnosis and treatment as insulin pump. The teaching role of nursing is very important. * **Social Factors:** homeless clients, preventing and treating many diseases such as the coronavirus disease 2019 (COVID-19) pandemic and tuberculosis increase the need for more healthcare services in the public sector. * **Lifestyle Factors and Greater Life Expectancy:** healthcare emphasize on prevention of disease, improving healthy lifestyles, and wellness programs. Many people are living much longer and are more active and healthier than before which require many more nurses to work in such fields. * **Changes in Nursing Education:** many nursing programs are available now to cover basic and specialized nursing services. * **Autonomy:** The social concept that influenced nurses to be more assertive and independent side by side with collaboration with others in the healthcare field. ## Advanced roles of nurse (Clinical Nurse Specialist): A clinical nurse specialist (CNS) is nurse who is an expert clinician in a specialized area of practice. Clinical nurse specialists provide diagnosis, treatment, and ongoing management of patients in all health care settings. They also provide expertise and support to nurses caring for patients at the bedside, help drive practice changes throughout an organization, and ensure the use of best practices and evidence-based care to achieve the best possible patient outcomes. The specialty may be identified by: * Population e.g., geriatrics * Health care setting e.g., critical care. * Disease specialty e.g., diabetes. * Type of care e.g., rehabilitation. * Type of problem e.g., pain ## Examples of settings for nursing care * Hospitals & Clinics * Emergency helicopter services * Public health offices * Industry * Schools & Offices * Mental health facilities * Prisons * Ambulatory surgery centers * Homes * Doctors' offices * Mobile healthcare units * Hospice. * Mosques & Churches * Emergency locations ## Registered nurse (RN): * Is a nurse licensed nationally and practice independently within the scope of nursing profession. * It has different levels of registration according to qualification. ## Profession: * It is a group of vocation (occupation) that requires specialized education, intellectual knowledge, competent practice and attitude. * Nursing Profession is autonomous: autonomy means independence in work, responsibility, and accountability for one's actions). ## Professionalism * It is the conduct and goals that mark a profession. ## Important requirements for a professional nurse: 1. Professional license. 2. Professional knowledge. 3. Professional skills. 4. Professional attitude. 5. Critical thinking abilities. 6. Critical caring abilities. 7. Continuous updating. 8. Professional leadership abilities. 9. Flexibility. 10. Professional advocacy. 11. Professional teaching and learning abilities. 12. Problem solving abilities. 13. Communication skills abilities. 14. Counseling abilities. 15. Enough experience. ## Educational preparation and career opportunities for registered nursing education in Egypt: * The primary types of educational programs lead to licensure as an RN: 1. Diplom Nursing Program (secondary nursing school education), 3 years nursing education). 2. Associate Degree Nursing Program (institute of nursing), 2 years nursing education. 3. Baccalaureate Degree Nursing Program in Egypt it started in 1955 in Alexandria. (4 years nursing education). 4. Post graduate studies: specialized diplomas, master and PhD. ## Introduction to rights and responsibilities: * The code of ethics is the philosophical ideals of right and wrong that define the principles that will use to provide care to patients. * **Rights:** Are legal or moral permissions. * **Responsibility:** is the specific accountability associated with the performance of duties of a particular role. ## Patient's rights : 1. **The Right To Know** * Understand and use these rights. * Be informed of the name and position of all hospital staff who will be in charge of his / her care in the hospital.. * Receive complete information about his / her diagnosis, treatment and prognosis. * Receive all the needed information to give informed consent for any proposed procedure or treatment. * Refuse to take part in research. 2. **The Right To Privacy** * Privacy while in the hospital and confidentiality of all information and records regarding his / her care. * Physical privacy (his/her body). 3. **The Right To Treatment** * Receive treatment without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation or source of payment...etc. * Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints. * Receive emergency care if needed anytime and anywhere. * To have a no smoking room. * Complain without fear about the care and services. * Refuse treatment and be told what effect this may have on his / her health. ## Patients' Responsibilities: * Give complete information about him/herself * Report any changes to his condition * Keep the environment free from illicit drugs, alcohol or tobacco * Follow the hospital policies * Respect others. ## Nursing student's rights and responsibilities. * **Nursing student's rights:** 1. Have current, accurate and credible evidence based information and course content. 2. Have supportive and safe teaching and learning environment. 3. Have freedom from exclusion from an educational institution or clinical agency because of age, race, gender, religious, nationality, spiritual beliefs, or marital status...etc. 4. Have transparent and objective evaluation and marking processes. 5. Take reasoned exception if indicated. 6. Study in an environment that promote equal opportunities and mutual respect, free from harassment and discrimination. 7. Be a part of ongoing development of their educational programs. * **Nursing student's responsibility:** 1. Practicing the best of their abilities in research and other activities for ongoing development of nursing knowledge. 2. Maintaining a client's dignity and treating all clients with respect. 3. Protecting the confidentiality of their clients'. 4. Providing appropriate nursing care to all clients. 5. Completing assignment according to expected outcomes. 6. Seeking out and using available evidence, best practices, current information, research and technologies. **Finally, it is up to your student nurses to continue the positive change of nursing image in Egypt, by improving your knowledge, skills and attitude. ** ## References: 1. Potter P, Perry A, Stockert P, Hall A. Fundamentals of Nursing. 10th ed. St. Louis: Elsevier, 2021; 68-115 2. Rosdahl, C. Rosdahl's Textbook of Basic Nursing. 12th ed. Philadelphia: Lippincott Williams & Wilkins, 2021;55-99. 3. Kozier B, Erb, G, BermanA, Snyder Sh, Frandsen G, Buck M, Ferguson L, Yiu L, Stamler L. Fundamentals of Canadian Nursing; Concepts, Process, and Practice. 4th Canadian ed. Ontario: Pearson Canada Inc, 2018; 1-18. 4. Potter P, Perry A, Stockert P, Hall A, Ostendorf W.. Fundamentals of Nursing. 9th ed. St. Louis: Elsevier, 2017; 53-62. 5. Berman A, Snyder Sh, Frandsen G. Fundamentals of Nursing; Concepts, Process, and Practice. 10th ed. Boston: Pearson, 2016; 2-24. 6. Potter P, Stockert P. Perry A, Hall A.. Fundamentals of Nursing. 9th ed. St. Louis: Elsevier, 2017; 5-12. 7. Jensen Sh, Perry S. nursing health assessment, a best practice approach.. 2nd ed. Philadelphia: Wolters Kluwer. 2015. 8. Wikipedia, the free encyclopedia. Available at: http://en.wikipedia.org/wiki/Timeline_of_nursing_history,2009. Retrieved on 2014. 9. The Canadian Nursing Students' Association. Bill of Rights and Responsibilities for Student of Nursing. Available at: http://www.cnsa.com, 2012. ## Quiz - **Start of Quiz (10 questions)** **1. To be professional nurse, the nurse first should have:** a. Professional license. b. Professional communication skills c. Professional practical skills. d. Enough experience. **2. Nurses care of injured, sick and aged persons only ** (True / False) **End of Quiz (10 questions)**