UNIT 1. HISTORICAL EVOLUTION OF NURSING.pptx

UNIT 1 : HISTORICAL EVOLUTION OF NURSING BY MADAM SALIDA JOHARI HISTORY OF NURSING LEARNING OUTCOMES At the end of this lecture the students should be able to : 1.Explain the historical perspective of nursing. 2.Describe the impact of the evolution of professional nursing in curren...

UNIT 1 : HISTORICAL EVOLUTION OF NURSING BY MADAM SALIDA JOHARI HISTORY OF NURSING LEARNING OUTCOMES At the end of this lecture the students should be able to : 1.Explain the historical perspective of nursing. 2.Describe the impact of the evolution of professional nursing in current nursing practice PREHISTORIC PERIOD The practice of nursing in the prehistoric period was strongly guided by health belief Nursing and medical practice were delineated by beliefs of magic, religion, and supernatural Individual who are ill were considered to be cursed by evil spirits and evil gods that entered the human body and caused suffering and death if not cast out. PREHISTORIC PERIOD – con’t These beliefs dictated the behavior of primitive people who sought the scare away the evil gods and spirits Members of tribes participated in rituals, wore masks , and engaged in demonstrative dances to rid the sick of demonic possession of one’s body Sacrifices and offerings that sometimes included human sacrifices were made to rid the body evil gods , demons, and spirits. Many tribes used special herbs ,roots, and vegetables to cast out the ‘curse’ of illness EARLY CIVILIZATION – EGYPT EARLY CIVILIZATION – EGYPT Ancient Egyptians are noted for their accomplishment s at such an early period of evolution They were the first to use the concept of suture in preparing wounds They also the first person to be recorded as developing community planning that resulted in a decrease in public heath problems EARLY CIVILIZATION – EGYPT One of the main public health problems was the spread of disease through the consumption of water resources were sometimes contaminated Specific laws on cleanliness , food and preservation ,drinking ,exercise , and sexual relations were developed. Health beliefs of Egyptians determined preventive measures taken and personal health behaviors practiced. EARLY CIVILIZATION – EGYPT These health behaviors were usually carried out to accommodate the Gods. Some behaviors were also done to expressively appease the spirits of the dead(Ellis and Hartley, 2001) The Egyptians invented the development of the calendar and writing that denoted the initiation of recorded history EARLY CIVILIZATION – EGYPT The oldest records date back before Christ in sixteenth Century BC Egypt A document containing almost 1000 natural pharmacologic remedies was written to assist in the care and management of disease (Ellis and Hartley,2001) EARLY CIVILIZATION – EGYPT As in the case of Shiphrah and Puah , the midwives who saved the baby Moses ,nurses were used by kings and other aristocrats to deliver babies and care for the young , the elderly. And those who were sick Other documentation regarding nurses in Egypt is scant Shiphrah and Puah EARLY CIVILIZATION – INDIA EARLY CIVILIZATION – INDIA EARLY CIVILIZATION – INDIA From 2000 to 1200 BC , the earliest cultures of India were Hindu The sacred books of the Hindu , Vedas, were used to guide healthcare practices The Vedas included herbs , spices, displays of magic ,and charms These ingredient were used to rid the body of demons and cure illness The Indian documented information concerning prenatal care and childhood illnesses EARLY CIVILIZATION – INDIA Public hospitals were staffed by male nurses with qualifications and duties similar to those of the twentieth – century practical nurse The Hindu physicians performed major and minor surgeries , including limb amputations, cesarean deliveries and wound suturing. EARLY CIVILIZATION – INDIA Women were primarily responsible for caring the home and family , and they did not work outside the home (Ellis and Hartley , 2001;Walton, Barondess, and Locke, 1994 ) EARLY CIVILIZATION – CHINA EARLY CIVILIZATION – CHINA The teachings of Confucius (551- 479BC) had a powerful impact on the customs and practices of the people ancient China One tradition that exemplified their belief about health and illness was the ‘yin’ and ‘yang’ philosophy EARLY CIVILIZATION – CHINA The ‘yin’ represent the feminine forces, which were negative and passive. The ‘yang’ represents the masculine forces, which were positive and active  The Chinese believed that an imbalance between these two forces would result in illness , whereas balance between the ‘yin ‘ and ‘yang’ represented good health (Giger and Davidhizar, 1999) EARLY CIVILIZATION – CHINA The ancient Chinese used a variety of treatments believed to promote health and harmony , including acupuncture EARLY CIVILIZATION – CHINA Acupuncture involves insertion of hot and cold needles into the skin and underlying tissue to manage or cure illnesses such as pain, stroke or breathing difficulty and ultimately to affect the balance of ‘yin’ and ’yang’ Hydrotherapy, massage,and exercise were used as preventive health measures(Giger and Davidhizar, 1999) EARLY CIVILIZATION – CHINA The Chinese also used drug therapy to manage disease conditions and recorded more than 1000 drugs derived from animals, vegetables , and minerals ( Walton,Barondess , and Locke ,1994) EARLY CIVILIZATION – ROME EARLY CIVILIZATION – ROME The Roman Empire ( 27BC-476AD), a military dictatorship, adapted medical practices from the countries the conquered and physicians they enslaved EARLY CIVILIZATION – ROME The first military hospital in Europe was established in Rome The physicians were enslaved and forced to provide details about their medical practice Both male and female attendants assisted in the care of the attendants assisted in the care of the sick EARLY CIVILIZATION – ROME Galen was a famous Greek physician who worked in Rome and made important contributions to the practice of medicine by expending his knowledge in Anatomy, Physiology, Pathology , and medical therapeutics (Walton, Barondess, and Locke, 1994) THE MIDDLE AGES THE MIDDLE AGES The Middle Ages (476BC-1450 AD) followed the demise of the Roman Empire(Walton,Barondess, and Locke ,1994) Women used herbs and new methods of healing, whereas as men continues to use purging, leeching , and mercury for treatment. Eg: using leeching Eg : using mercury THE MIDDLE AGES This period also saw the Roman Catholic Church become a central figure in the organization and management of healthcare Most of the changes in health care were based on the Christian concepts of charity and the sanctity of human life THE MIDDLE AGES Wives of emperors and other women considered noble become nurses The women devoted themselves to caring for the sick , often caring a basket of food and medicine as they journeyed from house to house (Bahr and Johnson, 1995) THE MIDDLE AGES: emperor wives THE MIDDLE AGES Widower and unmarried women become nuns and deaconesses. Two of these deaconesses , Dorcas and Pheobe are mentioned in the Bible as outstanding for the care they provided to the sick (Freedman , 1995) THE MIDDLE AGES: Nun become nurses THE MIDDLE AGES During the Middle Ages physicians spent most of their time translating medical essay; they actually provided little medical care Poorly trained barbers who lacked any formal medical education performed surgery and medical treatments that were considered ‘bloody’ or ‘messy’ THE MIDDLE AGES: Performed Surgery THE MIDDLE AGES Nurses also provided some medical care ,although in most hospitals and monasteries female nurses who were not midwives were forbidden to witness childbirth , help with gynecologic examinations or even diaper male infants (Kalishand Kalish, 1986) THE MIDDLE AGES In addition , they not permitted to have contact with male patients ,administer enemas, or care for a man with a veneral disease. Nurse midwives provided the bulk of obstetric care within the community (Ellis and Hartley,2001) THE MIDDLE AGES During the Crusades ,which lasted for almost 200 years from 1096 to 1291,military nursing orders known as temples and hospitals were founded Monks and Christian knight provided nursing care and also defended the hospitals during battle , wearing a suit of armor under their religious habits The habits were distinguished by the maltese cross to identify the monks and knight as Christian warriors THE MIDDLE AGES The same cross was used years later on a badge designed for the first school of nursing and became a forerunner for the design of nursing pins (Ellis and Hartley,2001) THE RENAISSANCE PERIOD The Renaissance and Reformation period (1500-1700) also known as rebirth of Europe , followed the Middle Ages Major advancements were made in pharmacology ,chemistry , and medical knowledge including anatomy, physiology ,and surgery THE RENAISSANCE PERIOD During this period ,as a result of religious dissention between Roman Catholic Christians and the Protestant sects , many monasteries closed , and religious orders were dissolved THE RENAISSANCE PERIOD Roman Catholics Christians and the Protestants dissolved many of their religious facilities known for meeting the healthcare needs of the people Contrary to the Catholic teaching, the Protestant church believed that women’s duties involved childbearing and caring for the home, not working outside the home  THE RENAISSANCE  PERIOD Women of nobility no longer desired to work in hospitals. Individuals who worked as a nurses were female prisoners , prostitutes , and those of undesirable character Nursing was no longer the respected profession it had once been. This period was referred to as the ‘Dark Ages of Nursing ‘( Ellis and Hartley , 2001) During the sixteenth and seventeenth centuries , famine, plague ,filth ,and horrible crimes ravaged Europe. Dark Ages of Nursing THE RENAISSANCE PERIOD King Henry VII eliminated the organized monastic relief programs that aided the orphans , poor , and other displaced people It became common to encounter homeless men, women ,and children begging in the streets Beggars were beaten ,branded ,and chained to the galleys of boats as punishment for their disgraceful behaviour (Ellis and Hartley,2001) THE RENAISSANCE PERIOD Out of great concern for social welfare ,several nursing groups , such as the Order of the Visitation of St Mary , St Vincent de Paul ,and the Sisters of Charity , were organized to give time , service ,and money to the poor and sick THE RENAISSANCE PERIOD The Sisters of Charity recruited young women for training in nursing developed educational programs , and cared for abandoned children In 1640 St Vincent de Paul established The Hospital for the Founding to care for many orphaned and abandoned children (Ellis and Harley , 1988) THE COLONIAL AMERICAN PERIOD The first hospital and the first medical school were founded in North America The Hospital of Immaculate built in Mexico City at University of Mexico THE COLONIAL AMERICAN PERIOD In the American colonies ,individuals with infectious diseases were isolated in almshouses or pest houses (Kalisch and Kalisch ,1986) Procedures such as purgatives and bleeding were widely used, leading to low life expectancy THE COLONIAL AMERICAN PERIOD Plagues such as yellow fever and small pox caused thousands of deaths Benjamin Franklin who was outspoken regarding the care of the sick insisted that a hospital be built to care for the sick THE COLONIAL AMERICAN PERIOD He believed that the community should be responsible for the management and treatment of those who are ill Through his efforts the first hospital was built in the United States in Philadelphia in 1751 THE COLONIAL AMERICAN PERIOD This hospital was called Pennsylvania Hospital (Oermann,1997) Staff in this and other early hospitals were often untreated and the public feared that poor patients were used for training purposes Individuals of wealth did not go to hospitals because they were seen as places to care for the ‘unfortunate ‘ people ( Ellis and Hartley,1988) FLORENCE NIGHTINGALE FLORENCE NIGHTINGALE Florence Nightingale was born in Florence ,Italy on May 12,1820 The Nightingale family was wealthy ,well traveled ,and well educated Nightingale was a highly intelligent ,talented ,and attractive woman FLORENCE NIGHTINGALE From an early age she demonstrated a deep concern for the poor and suffering At the age of 25 she become interested in training as a nurse However ,her family.who strongly opposed a nursing career ,preferred that she marry and take her place in society (Kelly and Joel ,1996) FLORENCE NIGHTINGALE In 1851 her parents finally permitted her to pursue nurse’s training Nightingale attended a 3 month nursing training program at the Institution of Deaconesses at Kaiserswerth , Germany In 1854 she began training nurses at the Harley Street Nursing Home and also served as superintendent of nurses at King’s College Hospital in London (Kalisch and Kalisch ,1995) FLORENCE NIGHTINGALE The outbreak of the Crimean War marked a turning point in Nightingale ‘s career In October 154 Sidney Herbert , British Secretary of War and an old friend of the Nightingale family, wrote to Nightingale begging her to lead a group of nurses to Crimea to work at one of the military hospitals under government authority and expense (Dolan,1978) FLORENCE NIGHTINGALE Nightingale accepted his offer and assembled 38 nurses who were sisters and nun from different Catholic and Anglican orders (Kelly and Joel ,1996) THE INFLUENCE OF FLORENCE NIGHTINGALE She establish the following : 1. Improved and reformed laws affecting health , morals and the poor 2. Reformed hospitals and improved workhouse and infirmaries 3. Improved medicine by instituting an army medical school and reorganizing the army medical department. THE INFLUENCE OF FLORENCE NIGHTINGALE She establish the following: 4.Improved the health of natives and British citizen in India and other health nursing 5. Established nursing as a profession with two mission : sick nursing and health nursing KEY POINTS A certain amount of the ritualistic mystique and belief in spirit or Gods pervaded care of the sick in early civilization Record of early civilizations emphasize treatment given by those designated as physician , but there appear to have been men and women fulfilling nursing roles CON’T KEY POINTS In early Egypt ,India ,China , Greece , and Rome ,as well as in the lands of Hebrews, setting rules of hygiene and sanitation , using herbs, and performing surgery were part of the care of the sick The Romans are generally credited with building the first hospitals , but in the Christian period ,’House for the sick’ were available for the sick ,poor ,often tendered by men or women in religious and secular orders. CON’T KEY POINTS In 1860,Florance Nightingale founded modern nursing at St Thomas in London with organized training programmes that include both theory and practice ,careful selection of students, and freedom from hospital control. CON’T KEY POINTS In her careful observation and recording and her use of statistics in matter affecting healthcare and administration in the British Army , in hospitals throughout Europe ,and in the community , Nightingale is often credited with being the first nurse researcher. CON’T KEY POINTS Nightingale made many pertinent observations and recommendations on nurses and nursing practice , such as the need for nurses to be free from other duties so that they could concentrate on nursing ,as well as the need for holistic care , home care, continuing education , adequate compensation , and satisfactory working environment. HISTORICAL DEVELOPMENT OF NURSING IN MALAYSIA The history of nursing in Malaysia began from year 1800 , with the formation of the East India Company when hospitals for the sick were established in Penang and Singapore Nursing of the sick was carried out by Catholic Nuns and later by English nurses from England. HISTORICAL DEVELOPMENT OF NURSING IN MALAYSIA At this time ,every state in Malaysia established and organized its own ‘On –The Job Training for nurses ’ Lectures in the theory and practice were given by the English matrons or assistant matron , sisters and doctors at the hospital level. MALAYSIAN NURSES IN MALAYSIAN CONTEXT Nursing in Malaysia earns heritage from British While British has evolved with time ,the old British system still with us In nursing service for example , we continue to use such as call matron , sisters, and tutors and not yet gained much in terms of autonomy and empowerment. IN MALAYSIAN CONTEXT Nursing practice is task oriented based on Doctors’ orders Leadership remains subservient to the medical profession either because it provides stability ,or because nursing does not know how to get rid of it Eg : the Nursing Board Malaysia(NBM) is chaired by a Medical Doctor for the last 60 years After few years back it was chaired by nursing CON’T After Independence, health services became mainly a central government responsibility with delegation of service delivery through state and district health administrations. CON’T Priorto the war, each straits/settlement organized and ran their own nursing services. All states were responsible to the director of medical services. The nurses receives lectures in practice and theory of nursing from the matron or assistant matron of the hospital. The doctors gave lectures to both nurses and hospital assistant. They sat for their own state examination and the standards varies from one state to another. On completion from training, nurses were promoted to staff nurse and later in considered suitable they become senior staff nurse. CON’T The expansion of medical and nursing services were greatly hindered during the emergency situations. But in 1959, most of the states in Malaya become free from communism and it marks the beginning of the development of health services throughout the country CON’T By 1978, the element of Primary Health Care (PHC) strategies enunciated at Alma-Ata were already evident in the Malaysia Health Care System. Concern for reduction in equity in access to health care for increasing coverage formalized in 1971 with the government 20 years perspective plan – NEP. In addition to rural communities, the urban poor had become the focus of attention. CONCLUSION From beginning of mankind, people have performed the functions known as ‘Nursing Care’ Nursing has come along way since its early days ,when nurses were untrained and look down upon by the rest of society Today’s nurses are well educated and have earned the trust and respect of the public The history of nursing shape the current healthcare system Nurses should continue and involve in development in science and technology as well as changes in society to determine the needs of society for the future. NURSING IN 20 AND 21ST CENTURY Practice (Group) Topic :‘The impact of historical evolution of Nursing to Malaysian nurses today’ Guidelines 1. You are required to Discuss and Present in power points 2. Time presentation: 15 minutes 3. Question & Answer session: 10 minutes