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THE EVOLUTION OF NURSING THEORIES Ma. Jyrell Bonito, RN, MAN(c) OBJECTIVES At the end of this module, learners are expected to understand Searching for specialized nursing Nursing followed a path from concepts that: knowledge led nurse scholars to...

THE EVOLUTION OF NURSING THEORIES Ma. Jyrell Bonito, RN, MAN(c) OBJECTIVES At the end of this module, learners are expected to understand Searching for specialized nursing Nursing followed a path from concepts that: knowledge led nurse scholars to to conceptual frameworks to models to theories that guide research, theories, and finally to middle range education, administration, and theory, in this theory utilization era. professional practice. Nursing history demonstrates the Knowledge of the theory development significance of theory for nursing as process is basic to a personal a division of education (the understanding of the theoretical works discipline) and a specialized field of of the discipline practice (the profession). THE EVOLUTION OF NURSING A. Intuitive Period B. Apprentice Period C. Educational Period D. Contemporary Period INTUITIVE PERIOD (PRIMITIVE ERA – 6TH CENTURY) What is intuition? Nursing was “untaught” and instinctive. It was performed of compassion for others, out of the wish to help others. Nurse’s role was instinctive and directed toward comforting, practicing midwifery and being wet nurse to a child. THE EVOLUTION OF NURSING INTUITIVE PERIOD (PRIMITIVE ERA – 6TH CENTURY) What is intuition? Nursing was “untaught” and instinctive. It was performed of compassion for others, out of the wish to help others. Nurse’s role was instinctive and directed toward comforting, practicing midwifery and being wet nurse to a child. THE EVOLUTION OF NURSING INTUITIVE PERIOD (PRIMITIVE ERA – 6TH CENTURY) Nursing was a function that belonged to women. No caregiving training is evident Primitive men believed that illness was caused by the invasion of the victim’s body of evil spirits. Believed that medicine man was called shaman or witch doctor having the power to heal using white magic. Trephining THE EVOLUTION OF NURSING INTUITIVE PERIOD (PRIMITIVE ERA – 6TH CENTURY) Music or singing was often used to drive away spirits Trephination: is one of the oldest surgical procedures known to humanity and refers to a surgical procedure in which a circular piece of bone is drilled and excised, most commonly from the human skull. THE EVOLUTION OF NURSING INTUITIVE PERIOD (PRIMITIVE ERA – 6TH CENTURY) Prehistoric Medical Practice Use of mercury Blood Letting with the use of leeches Lobotomies Heroin for headaches Electroconvulsive Therapy (ECT) Trephining Cannibalistic Medical Practices THE EVOLUTION OF NURSING RISE OF THE EARLY CIVILIZATION AND ANCIENT CITIES AND THEIR CONTRIBUTION TO MEDICINE Mesopotamia No distinction between rational science and magic Diagnostic Handbook - introduced the methods of therapy and cause. The text contains a list of medical symptoms and often detailed empirical observations along with logical rules used in combining observed symptoms on the body of a patient with its diagnosis and prognosis THE EVOLUTION OF NURSING RISE OF THE EARLY CIVILIZATION AND ANCIENT CITIES AND THEIR CONTRIBUTION TO MEDICINE Mesopotamia Asipu – Medical Authority/ Exorcist- Healer Prophylaxis Mental Illness is associated with Deities THE EVOLUTION OF NURSING RISE OF THE EARLY CIVILIZATION AND ANCIENT CITIES AND THEIR CONTRIBUTION TO MEDICINE Egypt Egyptians are considered “The Healthiest of all men” Public Health System Medical information in the Edwin Smith Papyrus may date to a time as early as 3000 BC. It details cures ailment and anatomical observation THE EVOLUTION OF NURSING RISE OF THE EARLY CIVILIZATION AND ANCIENT CITIES AND THEIR CONTRIBUTION TO MEDICINE Egypt Edwin Smith Papyrus is an ancient textbook on The earliest known physician is also credited to surgery almost completely devoid of magical ancient Egypt ("Chief of Dentists and Physicians" thinking and describes in exquisite detail the for King Djoser in the 27th century BCE) examination, diagnosis, treatment, and prognosis Peseshet – Earliest known woman physician. of numerous ailments. The KahunGynaecological Papyrus treats women's complaints, including problems with conception. THE EVOLUTION OF NURSING RISE OF THE EARLY CIVILIZATION AND ANCIENT CITIES AND THEIR CONTRIBUTION TO MEDICINE India The Atharvaveda – Ancient text dealing with Medicine Ayurveda – “Complete knowledge for long life” Medical system of India with 8 branches of medicine Charaka and Sushruta– 2 most famous medical texbooks that describes physical examinations, diagnosis, treatment and prognosis and several surgical procedures. Suśrutasamhitā- Describes several surgical procedures THE EVOLUTION OF NURSING RISE OF THE EARLY CIVILIZATION AND ANCIENT CITIES AND THEIR CONTRIBUTION TO MEDICINE Greece and Roman Empire Wound treatment The Romans attempted to maintain vigorous health, because illness was a sign of weakness. Care of the ill was left to the slaves or Greek physicians. Both groups were looked upon as inferior by Roman society THE EVOLUTION OF NURSING THE APPRENTICE PERIOD (6TH CENTURY- 18TH CENTURY) What is an apprentice? Period of “on the job” training. From the founding of the Religious orders in the 11th century up to 1836 with the establishment of the Kaiserwerth Institute for training of Deaconesses THE EVOLUTION OF NURSING THE APPRENTICE PERIOD (6TH CENTURY- 18TH CENTURY) Nursing performed without any formal education and by people who were directed by more experienced nurses Founding of religious order THE EVOLUTION OF NURSING THE APPRENTICE PERIOD (6TH CENTURY- 18TH CENTURY) Philippines: The sick needed a spin doctor(“herbolario” or “albolario”) to drive the: Dwarves Witches Omens Curses Evil Spirits THE EVOLUTION OF NURSING MILITARY RELIGIOUS ORDERS AND THEIR WORK Knights of St. John of Jerusalem (Italian) - The Alexian Brothers were members of a Also known as “Knight Hospitalers” They monastic order founded 1348. They founded Hospitals established the Alexian Brothers Hospital Teutonic Knights (German)- Established School of Nursing the largest School of tent hospitals for the wounded Nursing under religious order. It operated Knights of St. Lazarus- Founded primarily exclusively for men in United States for nursing care of lepers in Jerusalem THE EVOLUTION OF NURSING IMPORTANT NURSING PERSONAGES St. Clare - founder of the second order of St. Francis of Assisi. St. Elizabeth of Hungary – known as the “Patroness of Nurses”, she was the daughter of the Hungarian King. She lived her life frugally despite her wealth. THE EVOLUTION OF NURSING IMPORTANT NURSING PERSONAGES St. Catherine of Siena – The first lady with the lamp. She was a hospital nurse, prophetess, researcher and a reformer of society and the church THE EVOLUTION OF NURSING RENNAISANCE PERIOD (DARK PERIOD) Also known as the period of reformation and American civil war Hospitals were closed Nursing was the works of least desirable people Nurses were uneducated, filthy and overworked Mass exodus of nurses THE EVOLUTION OF NURSING 1ST TRAINING SCHOOL OF NURSING United States of America Bellevue Hospital School of Nursing - Founded in 1873 in New York. It was the first school of nursing in the United States to be founded on the principles of nursing established by Florence Nightingale THE EVOLUTION OF NURSING 1ST TRAINING SCHOOL OF NURSING Philippines Iloilo Mission Hospital School of Nursing – Established in 1906 it is the first hospital in the Philippines which trained Filipino nurse THE EVOLUTION OF NURSING 19TH CENTURY—THE HUMANISTIC INFLUENCE OF NIGHTINGALE In the mid 1800s in England, Pastor Theodore and Friederike Fliedner started a hospital in Kaiserworth, Germany. They created training programs for nurses when they realized there was no workforce for the hospital. It was with Fliedner’s program that Florence Nightingale “trained” THE EVOLUTION OF NURSING 19TH CENTURY—THE HUMANISTIC INFLUENCE OF NIGHTINGALE Florence Nightingale Born on May 12, 1820 Born to a wealthy English parents Known as “The mother of modern nursing” “The Lady with the Lamp” and “Professional Nurse Pioneer Most famous for her work during the Crimean War (1854-1856) THE EVOLUTION OF NURSING 19TH CENTURY—THE HUMANISTIC INFLUENCE OF NIGHTINGALE Under Florence’s leadership, the nurses brought cleanliness, sanitation, nutritious food and comfort to the patients. Nightingale was known for providing the kind of personal care, like writing letters home for soldiers, that comforted them and improved their psychological health THE EVOLUTION OF NURSING 19TH CENTURY—THE HUMANISTIC INFLUENCE OF NIGHTINGALE Her group of nurses transformed the hospital into a healthy environment within six months, and as a result, the death rate of patients fell from 40 to 2 percent. In 1857, Florence returned home a heroine. It was the soldiers in Crimea that initially named her the “Lady with the Lamp” because of the reassuring sight of her carrying around a lamp to check on the sick and wounded during the night, and the title remained with her. THE EVOLUTION OF NURSING 19TH CENTURY—THE HUMANISTIC INFLUENCE OF NIGHTINGALE Published in 1859 Notes on Nursing provides a simple but practical discussion of good patient care, along with helpful hints. According to Florence Nightingale, hygiene, sanitation, fresh air, proper lighting, a good diet, warmth, quietness and attentiveness were necessary conditions for hospitals and were to be ensured by trained nurses. THE EVOLUTION OF NURSING 19TH CENTURY—THE HUMANISTIC INFLUENCE OF NIGHTINGALE Nightingale implemented handwashing and other hygiene practices in the war hospital in which she worked. More soldiers die because from infection than from bullets she advocated sanitary living conditions as of great importance. THE EVOLUTION OF NURSING EDUCATION PERIOD (18TH – 20TH CENTURY) Florence Nightingale was one of the pioneers in establishing the idea of nursing schools from her base at St Thomas' Hospital, London in 1860 when she opened the 'Nightingale Training School for Nurses’, now part of King's College London. THE EVOLUTION OF NURSING NIGHTINGALE SCHOOL OF NURSING The education of recruits involved a year of During the war a public subscription practical instruction in the wards, fund was set up for Florence supplemented with courses of lecturing, and Nightingale to continue her followed by two years of work experience in education of nurses in England, and the hospital. After graduation, many of the the Nightingale Training School at St. students staffed British hospitals, and others Thomas’ Hospital opened in 1860. spread the Nightingale education system to other countries. THE EVOLUTION OF NURSING NIGHTINGALE SCHOOL OF NURSING 1. Government funds should be 4. Nursing students should be provided with allotted to nursing education residence near their training hospitals First nurse political activist Written orders of doctors were insisted 2. Training schools of Nursing should Nurses should go with doctors during their be in close affiliation rounds 3. Professional nurses should train nurses THE EVOLUTION OF NURSING NIGHTINGALE SCHOOL OF NURSING 5. All nurses must be trained, in a 8. The “home sister” or “mistress of regular civil hospital probationers” organized the training 6. Training was fundamentally on the 9. District nurses had to be hospital trained apprenticeship model: hands-on, in (or they would not see enough serious the wards, under the ward sister cases) 7. Classes, given by medical doctors, 10. Midwifery nurses had to be hospital augmented training in the wards trained THE EVOLUTION OF NURSING NIGHTINGALE SCHOOL OF NURSING 11. Training was required for 14. Technical training had to be updated administrative positions 15. A Probationers’ Home should be 12. Probationers kept diaries and case provided, with a private room for each, notes of their work, examined by the comfortable (common) living matron and home sister, and often 16. Responsibility for probationers’ health by Nightingale. and safety, including rules to prevent 13. A major component of training septicemia and ongoing monitoring of was moral: ethical standards for probationers’ health patient care THE EVOLUTION OF NURSING NIGHTINGALE SCHOOL OF NURSING 17. Certificates and letters of 19. The superintendent herself must have reference had to be dated and were the highest knowledge of nursing, be herself relevant only for a short time resident in the hospital, make the training in 18. A matron should have a nursing her first object, and be herself a housekeeper under her so that she trained nurse of the highest order. could concentrate on the nursing and the nurse training THE EVOLUTION OF NURSING NIGHTINGALE SCHOOL OF NURSING 17. Certificates and letters of 19. The superintendent herself must have reference had to be dated and were the highest knowledge of nursing, be herself relevant only for a short time resident in the hospital, make the training in 18. A matron should have a nursing her first object, and be herself a housekeeper under her so that she trained nurse of the highest order. could concentrate on the nursing and the nurse training THE EVOLUTION OF NURSING CONTEMPORARY PERIOD (21ST CENTURY) What is nursing at present? Where is Nursing going? What is it in search of? THE EVOLUTION OF NURSING NURSING AFTER WORLD WAR I The silver lining of the great war Volume of patients drastically change the role of nurses The nurses performed triage as patients came in on ambulance trains, directed corpsmen who had little medical training, managed entire wards of patients and performed a variety of procedures, including irrigating wounds and managing infection. Dependent to Independent nursing practice THE EVOLUTION OF NURSING NURSING AFTER WORLD WAR I Good Infection control and wound care even with the absence of antibiotics and electricity American nurses worked on base hospitals, hospital trains, hospital ships, field hospitals, camp hospitals and even evacuation hospitals and mobile units. Mobilizing women and women empowerment Nurses earned the respect of those they served with, and they were decision- makers. That was very different for them, not just as nurses but as women THE EVOLUTION OF NURSING NURSING AFTER WORLD WAR II New Opportunities for Women: Wartime and the American Workforce Nurses on the Front Lines The Scars of War: PTSD in WWII Nurses (Post Traumatic Stress Disorder) THE EVOLUTION OF NURSING RISE OF THE BSN CURRICULUM The Degree of Bachelor of Science in Nursing: 1941 – 1951 A nursing curriculum which was based on the thesis presented by Julita V. Sotejo, graduate of the Philippine General Hospital School of Nursing, tackles on the development of a nursing education within a University-based College of Nursing. THE EVOLUTION OF NURSING RISE OF THE BSN CURRICULUM When the Japanese occupied the Philippines in 1942, training and practice at the hospital schools of nursing in Manila was “violently disrupted.” However, U.S. colonial patterns in Philippine nursing education soon returned after the U.S. reclaimed the country in 1945 and even after the Philippines gained independence from the U.S. July 4, 1946. THE EVOLUTION OF NURSING RISE OF THE BSN CURRICULUM The First Colleges of Nursing in the Philippines University of Santo Tomas-College of Nursing (1946) - In 1947, the Bureau of Private Schools permitted UST to grant the title Graduate Nurse to the 21 students who were of advanced standing from 1948 up to the present THE EVOLUTION OF NURSING RISE OF THE BSN CURRICULUM The First Colleges of Nursing in the Philippines Manila Central University-College of Nursing (1947) The MCU Hospital first offered BSN and Doctor of Medicine degrees in 1947 and served as the clinical field for practice. THE EVOLUTION OF NURSING RISE OF THE BSN CURRICULUM The First Colleges of Nursing in the Philippines University of the Philippines Manila-College of Nursing (1948) The idea of opening the college began in a conference between Miss Julita Sotejo and UP President. In April 1948, the University Council approved the curriculum, and the Board of Regents recognized the profession as having an equal standing as Medicine, Engineering etc. Miss JulitaSotejo was its first dean. THE EVOLUTION OF NURSING NURSING AT PRESENT Nursing at present can be understood as an emerging profession, and an academic discipline. It is also a human science (Mitchell & Cody, 1992). Nursing practice today is an “interaction of the processes of knowing and doing” (Lindeman &McAthie, 1999, p. 35). The nurse of today is a knowledge worker, one who is consciously using knowledge while implementing and evaluating every nursing action (Lindeman &McAthie, 1999). THE EVOLUTION OF NURSING WHERE IS NURSING GOING? Nursing will continue to face the challenges in terms of knowledge development. As an emerging discipline (branch of educational instruction), it was influenced by logical positivism, and thus knowledge generation has stressed traditional, orthodox, and experimental methods, but this era has challenged this viewpoint because nurses are now torn between emphasizing a humanistic holistic focus or objectively and scientifically derive means of comprehending reality (McEwen & Wills, 2007). It is the contention of Brooks & Klein-Kracht(1983) that nursing has returned to its humanistic philosophical aspects and that it is going back to the basics to “recapture its roots.” THE EVOLUTION OF NURSING WHAT IS IT IN SEARCH OF? Nursing to this day is still in search of nursing knowledge. This search is evident in the statement “ The knowledge that constitutes the discipline has not yet been identified and structured, and agreement has not been reached concerning appropriate and needed inclusions”.( Schlotfeldt, 1992 as cited by McEwen et al, 2007). THE EVOLUTION OF NURSING THERE MAY BE TWISTS AND TURNS AS NURSING CONTINUES ITS JOURNEY. QUO VADIS? ONLY TIME CAN TELL… ANY QUESTIONS?

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