N516 FA24- Historical and social context for Nursing Practice.pptx

Contemporary Nursing: Historical and social context for practice NURS 516 Identify key historical figures and social/historical events that shaped modern nursing practice and care. Discuss how media influences the image of nursing. Hard to overstate the impact of war on the development o...

Contemporary Nursing: Historical and social context for practice NURS 516 Identify key historical figures and social/historical events that shaped modern nursing practice and care. Discuss how media influences the image of nursing. Hard to overstate the impact of war on the development of nursing….  No organized system of medical or nursing care. No plan to cope with the large number of wounded soldiers. No provisions for field hospitals. Civil Most tents to the rear of fighting, too far from the front. War Numerous epidemics When Civil War ended, need for nurses greatly recognized, number of nursing training schools increased  basically on-the-job training, cheap labor  US training schools followed Nightingale’s model set up at St. Late Thomas Hospital, London, in 1860. States began to require nurses to 19th be registered Most states upgraded education Centur requirements to high school completion prior to nursing y to training. 2 leading nursing organizations well World underway ANA: American Nurses Association – War I for nurses in the workforce NLN: National League for Nursing – for educational and practice standards Flexner Report The Flexner Report of 1910 transformed the nature and process of medical education in America Flexner criticized these schools as a loose and lax apprenticeship system that lacked defined standards or goals beyond the generation of financial gain. Flexner proposed medical schools in the German tradition of strong biomedical sciences together with hands-on clinical training. The Flexner Report caused many medical schools to close down and most of the remaining schools were reformed to conform to the Flexnerian model. 1917: Spanish Flu Pandemic Influenza epidemic swept across the country, second wave in 1919—increased demand for care…..  World War I and 1920’s World rapidly changing: Industrial Revolution Women granted the right to vote Women entering the work force Major advancements in medical and public health care Hospitals were the primary source for care Fleming discovered penicillin Insight that poor environmental conditions, poverty lead to poor health outcomes. WWI: great need for nurses to care for the injured. The Army School of Nursing  The Great Depression US economy prospered during WWI, but stock market crash  unemployment Many nurses unemployed as families couldn’t afford private duty nurses. FDR’s New Deal: Public health nursing became a major source of health care for women, infants, and children through the Civil Works Administration Improved hospital employment as well The Frontier Nursing Service Set up by Mary Breckinridge Service to women and children in low-income rural areas  All nursing divisions of the military had nursing shortages Hurry up and train nurses →Creation of the Cadet Nurses Corps Congress passed legislation to ↑ needed funds to expand nursing education World U.S. Public Health Service administered > $1 million to nursing. War II Wars point out need for nurses & schools of nursing Required to function under combat conditions Adapt care to different climates, facilities, and supplies Post WW II → ↑ use of LPNs to complement RN role  Nurse Training Act of 1943: Federal $ for nursing education Hill-Burton Act of 1946 $ to build hospitals, help states plan for other health care facilities → ↑demand for nurses. 1950’s Community Mental Health Centers Act of 1963 $ to build community outpatient mental – health centers → ↑ opportunities and demand for nurses in mental health 1960’s Medicare and Medicaid Act, 1965 Amendment to the Social Security Act of 1935 → ↑ access to care → ↑demand for nurses Home health movement American Nurses’ Association’s 1965 statement on the education of nurses  Women’s movement of the 1970’s ↑ opportunities in non-traditional female fields. Health care expanded further into the community 1970’s Birthing centers, hospice programs, day care centers. Need for nurses ↑ with Vietnam War (1965 – 1973)  Unstable economic developments: Rising health care costs 1980’s Hospital push to increase efficiency New issues in health care: : Crisis Homelessness HIV/AIDS emerges in Health care prospered Health New technologies Outpatient services Care Ambulatory services NURSING SHORTAGE AMA answer: Registered Care Techs 1990’s: Cost remains a major concern Nurses leaving nursing Crisis Major concern about the nation’s Contin health  shift from individual to health of the community ues Healthy People 2000  Cost remains a major concern Technological advances Lack of coordination in the health care system 2000’s: Focus on treatment, chronic disease management, rather than A prevention Quality of health care Challeng Aging population ing Time Diverse values, preferences, cultural backgrounds of patients Partnering with well-informed patients MAJOR nursing shortage  COVID-19 highlighted many issues within healthcare and nursing Cost remains a major concern Lack of coordination in the healthcare 2023: system Mistrust of the healthcare systems Today’s Increased awareness of health Environm disparities Issues of access to care ent Focus on social determents of health MAJOR nursing shortage Increase in travel nursing Highlighted pay differences Increase in nurses leaving the profession Positives Increased community health and resources Focus on prevention Increase in tele-health/video conferencing Social Factors that influence nursing Nursing education Women’s movement and feminism Nursing a traditional and oppressed female occupation… Men in nursing Cultural diversity of nurses and of patients Aging population Consumer movement Violence  How does the media image of nursing affect the profession? The image of nursing affects The image affects how The image influences how the public views our legislators & policymakers recruitment and retention, profession. view nursing especially a concern during nursing shortages What do these images say about nursing? Medical TV Shows What do these images say about nursing? Florence Nightingale (1820 to 1910) Wealthy family--Deep concern for the poor, the suffering 1851: Attended a 3-month training program in Germany (Harley Street Nursing Home) Crimean War: A turning point for Nightingale Barracks Hospital at Scutari Instituted public health principles: sanitary conditions, infection control Florence Nightingale (1820 to 1910) Major Influences on nursing practice Statistics First nursing research Publications leading to reforms Patient advocacy Nurse advocacy Florence Nightingale Influences on nursing education Early U.S. schools of nursing modeled after her training school at St. Thomas, England Recognized a distinct body of knowledge was necessary for the foundation of nursing. Advocated “holism”, whole person focus Recognized that environment influences health Two types of nursing: Care of the ill Promotion of health Dorothea Dix (1802 – 1887) Noted social reformer, the Union’s Superintendent of Female Nurses during Civil War. Convinced military officers that women could perform in the medical field and recruited more than 3,000 women to service with her. Known as “Dragon Dix”, she demanded the best care. After the war, she worked for better treatment of mentally ill and better prison conditions. Clara Barton (1821-1912) During Civil War, she noted lack of medical supplies, advertised for donations, started an organization to distribute the goods Her idea was such a success that she traveled with the army ambulances “for the purpose of distributing comforts for the sick and wounded, and nursing them” By the end of the war, Barton had performed most of the services that would later be associated with the American Red Cross. Louisa Parsons (1834- 1895) Established the University of Maryland SON 1889 Graduate of the St. Thomas SON in London Very much influenced by the model of teachings of Nightingale Mary Mahoney (1845-1926) 1st African American registered nurse in the U.S. Worked primarily as a private duty nurse along Eastern Seaboard of the U.S. Director of an orphanage in Long Island, NY One of the original members of the Nurses Associated Alumnae of the U.S. and Canada – which later became known as the American Nurses Association (ANA) Lillian Wald (1867-1940) Founder of the Henry Street Visiting Nursing Service & Henry Street Settlement Recognized that environment and health were related  1st public health nurses Focus was the needs of the poor immigrant families on the Lower East Side of New York City- children need a fair chance Approached insurance companies to provide free public health nurses to their policy holders (Met Life was the first to do – a novel idea at the time) Lucille Petry (1902-1999) WW II: Desperate need for nurses 1943, U.S. Cadet Nurse Corps was signed into law by President Franklin Roosevelt Lucille Petry, a nurse from Johns Hopkins School of Nursing, appointed as its director. Designated as Chief Nursing Officer of the U.S. Public Health Service, with rank of brigadier general, the 1st woman in the country to hold such rank. Esther McCready (1931-2020) In 1950, at only 19 years old, McCready sued for admission to UMSON, and the Maryland Court of Appeals ruled in her favor. Desegregated the University of Maryland. The case helped lay the groundwork for the 1954 landmark Brown v. Board of Education Supreme Court decision.