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Chapter 1 The Evolution of Professional Nursing  Prehistoric and Early Civilization  Health beliefs  All illnesses were the work of the gods  Health practices  Acts intended to deter evil gods and demons  Egypt  Health beliefs and practices...

Chapter 1 The Evolution of Professional Nursing  Prehistoric and Early Civilization  Health beliefs  All illnesses were the work of the gods  Health practices  Acts intended to deter evil gods and demons  Egypt  Health beliefs and practices Preventive measures taken to appease the gods Developed specific laws on cleanliness, food use and preservation, drinking, exercise, and sexual relations  Nursing Nurses were used by kings and aristocrats to deliver babies and care for the sick  Early Civilization (Cont.)  Palestine  Health beliefs and practices Developed the Mosaic code  Nursing Hebrew priests took on the role of health inspectors  Greece  Health beliefs Believed that the gods and goddesses controlled health and illness Temples built to honor Aesculapius, the god of medicine  Medical science Aesclepius carried a staff intertwined with serpents, representing wisdom and immortality; staff was the model for medical caduceus Hippocrates is “father of medicine” disease attributed to natural causes  Early Civilization (Cont.)  India  Health beliefs and practices Vedas, sacred Hindu book was the source of information about health practices  Vedas emphasized hygiene and prevention of sickness  Medical science Developed procedures to perform major and minor surgical operations Importance of prenatal care was understood  Nursing Hindu physicians performed major and minor surgeries, including limb amputations, cesarean deliveries, and suturing wounds In rare instances women were allowed to work outside the home Public hospitals were constructed in 274 to 236 BC and staffed by male nurses  Early Civilization (Cont.)  China  Health beliefs Teachings of Confucius (551-479 BC) had a powerful impact on health practices Believed in the yin and yang philosophy; an imbalance between the two would result in ill health  Health practices Used treatments, including acupuncture, hydrotherapy, massage, and exercise, to promote health and harmony  Early Civilization (Cont.)  Rome  Adapted health and medical practices from the countries conquered and the physicians enslaved (27 BC to AD 476)  Established the first military hospital in Europe in Rome  Military orders made up exclusively of men were developed to care for the injured  Practiced advanced hygiene and sanitation  Middle Ages  Women used herbs and new methods of healing  Women cared for the sick in their homes  Men used purging, leeching, and mercury  Physicians spent more time translating medical essays than providing medical care  The Roman Catholic church became a central figure in health care  Wives of emperors and other women became nurses  Most changes in health care were based on charity and the sanctity of human life  The cross used during this period became a badge and forerunner for the design of nursing pins  Critical Thinking Question 2. The cross often portrayed on nursing pins today was derived from the cross: A. Worn by Florence Nightingale B. That identified monks and knights as Christian warriors C. That untrained nurses carried in the Middle Ages when assisting with birthing and to bless the birth of male infants D. Carried by Aesclepius, believed to be the god of medicine in ancient Greece The Renaissance and the Reformation Period  Major advancements in medicine: pharmacology, chemistry, and medical knowledge  “Dark ages” of nursing  Religious orders became almost extinct as a result of dissension between Roman Catholic Christians and Protestant sects  Nursing no longer appealed to women of high social status; hospital care was regulated to common women, prisoners, thieves, and drunks  Nursing became an undesirable job with poor pay, long hours, and strenuous work that was considered menial The Renaissance and the Reformation Period (Cont.)  Social conditions  Famine, plague, filth, and crime ravaged Europe  Nursing orders were established out of great concern for social welfare Sisters of Charity—recruited intelligent young women for nurse training, developed educational programs, and cared for abandoned children St. Vincent de Paul—established the Hospital for the Foundling to care for orphaned and abandoned children  The Colonial American Period  Mexico  First colonists in Mexico were members of Catholic religious orders  Hospital of the Immaculate Conception—first hospital in North America; built in Mexico City; first medical school; built at the University of Mexico  Individuals with infectious disease were isolated in almshouses or “pest houses”  The Colonial American Period (Cont.)  Colonial America  Health care was sadly deficient; life expectancy was low; plagues such as scarlet fever and smallpox were a constant threat  Physicians were poorly trained and used crude methods of treatment, such as bleeding and purgatives  Through the efforts of Benjamin Franklin, Pennsylvania Hospital was the first hospital built in the United States in 1751  Florence Nightingale  Early nursing career  Crimean War  Major accomplishments  Demonstrated the value of aseptic techniques and infection control procedures  Demonstrated the value of political activism to affect health care reform  Established the first nursing school in England  Kept careful statistics—documented a decrease in the death rate of soldiers from 42% to 2% as a result of health care reforms that emphasized sanitary conditions  Nursing in the United States  The Civil War period  Dorothea Dix—appointed to organize military hospitals, provide trained nurses, and disperse supplies; she received no official status and no salary for this position  Six million people hospitalized during the war—500,000 surgical cases; 2000 nurses served in the war  181 Black nurses, both men and women, served from 1863 to 1864. Caucasian nurses made $12.00 per month; Black nurses made $10.00  Epidemics plagued the country: syphilis, gonorrhea, malaria, smallpox, and typhoid  Critical Thinking Question 1. Nursing care during the era of the Civil War was: A. plagued by communicable diseases made worse by unsanitary conditions B. conducted under septic conditions previously recognized as important by Nightingale C. provided by trained nurses from many ethnic backgrounds from both the North and South D. provided by male nurses because females were forbidden to care for male soldiers Nursing in the United States (Cont.)  Black nurses made important contributions Harriet Tubman cared for wounded soldiers and conducted an “underground railroad” to lead slaves to freedom Sojourner Truth, known for her abolitionist efforts, as well as her nursing efforts, was an advocate of clean and sanitary conditions so patients could heal Susie King Taylor, although hired in the laundry, worked full time as a nurse on the battlefront with no pay or pension; not considered an official Union Army nurse  Volunteer nurses who made important contributions Clara Barton operated a war relief program; credited with founding the American Red Cross Louisa May Alcott authored detailed accounts of the experiences encountered by nurses during the war for a newspaper publication entitled Hospital Sketches Nursing in the United States (Cont.)  Number of nurse training schools increased after the war Offered little classroom education On-the-job training occurred in the hospital wards Students were used as supplemental hospital staff  1890s—Establishment of African-American hospitals and nursing schools gained momentum In 1886 John D. Rockefeller established the first school of nursing for Black women at the Atlanta Baptist Seminary, now known as Spelman College  Nursing in the United States (Cont.)  1900 to World War I  Advances in the nursing profession By 1910, most states passed legislation requiring nurse registration before entering practice Required entry level for nursing students was upgraded to high school graduate Nurse training programs were improved to include a more comprehensive course of study Lillian Wald developed a viable practice for public health nursing (The Henry Street Settlement House) located in the Lower East Side of New York City  Nursing in the United States (Cont.)  World War I and the 1920s  Advances in medical care and public health Improved hospital care and surgical techniques Environmental conditions improved; serious epidemics of the previous century became nonexistent  Advances in nursing Nurse anesthetists made their first appearance as part of frontline surgical teams U.S. Public Health Service sought the assistance of a nurse to establish nursing services at military outposts American Red Cross, founded by Clara Barton in 1882, became more active in urban settings and rural communities Mary Breckinridge established the Frontier Nursing Service  Nursing in the United States (Cont.)  Legislation Sheppard-Towner Act—first legislation to assist special populations and provide public health nurses with resources to promote the health and well-being of women, infants, and children  The Great Depression (1930-1940)  Social issues American economy was disintegrated with millions of people unemployed Nurses also were forced to join the ranks of the unemployed Nursing in the United States (Cont.)  Legislation “New Deal” enacted to rescue the country and provide for medical care and other services for the large numbers of indigent people Social Security Act of 1935 affected health care and provided avenues for public health nursing  Nursing in the United States (Cont.)  World War II  Legislation Programs enacted to expand nursing education and increase the number of nurses in all military branches  Advances in nursing Nursing became an essential part of the military advance Nurses recognized as an integral part of the military and attained officer rank  Nursing in the United States (Cont.)  Post World War II (1945-1950)  Social issues Unemployment dropped to all-time low Women were encouraged to return to childbearing and marriage rather than to continue employment outside the home  Advances in nursing Demonstrated value to the armed services during the Korean War Emerged as a true profession with minimum national standards for nursing education established Nursing in the United States (Cont.) By 1950, all states had adopted the State Board Test Pool Number of nursing baccalaureate programs grew Associate degree programs developed in community and junior colleges  Legislation Nurse Training Act of 1943—first instance of federal funding to support nurse training Hill-Burton Act—provided funding to construct hospitals; created a hospital construction boom that increased the demand for professional nurses Black nurses were barred from membership in the American Nurses Association because of segregation laws; all barriers were dropped in the early 1960s  Nursing in the United States (Cont.)  Nursing in the 1960s  Legislation had a major and lasting impact Community Mental Health Centers Act of 1963 Medicaid, Title XIX of the Social Security Act, 1965 Medicare, Title XVIII of the Social Security Act, 1965  Impact of Medicare reimbursement on nursing Hospital occupancy increased, resulting in an increased need for hospital nurses Nursing embraced the hospital setting as the usual practice site Home health movement was initiated  Nursing in the United States (Cont.)  Nursing in the 1970s  Nurses demanded fairer wages  Nurses developed community programs  Nurse practitioners recognized as cost-effective providers  Nursing in the 1980s  Types of patients needing health care changed Increasing numbers of homeless and indigent Emergence of acquired immunodeficiency syndrome (AIDS)  Spiraling health care costs became an issue Diagnosis-related group (DRG) system developed Hospitals reduced patients’ length of stay Case management emerged Outpatient and ambulatory services grew Managed care plans and HMOs grew  Nursing in the United States (Cont.)  Nursing in the 1990s  Managed care movement  Nursing in the twenty-first century  2010—Affordable Care Act (ACA) Provide insurance to over 32 million previously uninsured Americans  Robert Wood Johnson Foundation (RWJF) and IOM—Future of nursing Nurses should practice to full extent of training Nurses should achieve higher levels of education Nurses should be full partners with physicians and other health care professionals to re-design health care in the United States Improve health care workforce data collection to better assess and project workforce requirements  Nursing in the United States (Cont.)  Nursing in the twenty-first century  Nursing shortage expected to intensify as Baby Boomers age and the need for health care grows  Nursing schools struggling to expand capacity  Wave of faculty retirements expected over the next decade  Higher compensation in clinical and private-sector settings is luring educators away from teaching  Advancing Healthcare Transformation: A New Era for Academic Nursing, (AACN, March 2016) calls for enhanced academic partnerships  COVID-19 pandemic highlighted the critical role of nurses Nurses on the Frontlines During the COVID-19 Pandemic  Fear that they might be infected  Fear that they would endanger their families  Long work Shifts  Sress and depression  Shortage f supplies  Ethical dilemmas  Diverse unknowns  Coexistence of countless deaths