TFN MODULE 1 FIN.pdf

Theoretical Foundations in Nursing DEAN MARIA LUISA T. UAYAN, MSC, DHSC PROF. JACQUELINE MAE C. GABIANA, MAN, RN. Learning Outcomes ❖Describe the Evolution of Nursing ❖Describe the Different Eras in the development of Nursing ❖Explain the significance of each era in the pres...

Theoretical Foundations in Nursing DEAN MARIA LUISA T. UAYAN, MSC, DHSC PROF. JACQUELINE MAE C. GABIANA, MAN, RN. Learning Outcomes ❖Describe the Evolution of Nursing ❖Describe the Different Eras in the development of Nursing ❖Explain the significance of each era in the present day of Nursing Practice  Meaning of “Theory” and Related Concepts THEORY Is a set of propositions (statements / opinions), suppositions (assumptions / hypotheses), or constructs (ideas), that purport to explain, describe and predict a reality. It is an abstraction of a reality.  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.  Intuitive Period ▪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  Intuitive Period ▪Music and singing was often used to chase away spirits. ▪In some cases, TREPHINING was used. ▪TREPHINING is cutting a hole in the head of the afflicted to let out the evil spirit.  Prehistoric Medical Practice ▪Different prehistoric medical practices ▪Use of mercury ▪Blood Letting with the use of leeches ▪Lobotomies ▪Heroin for headaches ▪Electroconvulsive Therapy (ECT) ▪Trephining ▪Cannibalistic Medical Practices Prehistoric Medical Practices Radium Water Ecraseur Plombage Peg Legs Morphine for teething Starvation for Aneurysms Hydroelectric Baths for Migraines  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.  Mesopotamia Asipu – Medical Authority/ Exorcist- Healer Mental Illness is associated with Deities  Egypt Egyptians are considered “The Healthiest of all men” Medical information in the Edwin Smith Papyrus may date to a time as early as 3000 BC. It details cures ailment and anatomical observation.  Egypt Edwin Smith Papyrus is an ancient textbook on surgery almost completely devoid of magical thinking and describes in exquisite detail the examination, diagnosis, treatment, and prognosis of numerous ailments. The Kahun Gynaecological Papyrus treats women's complaints, including problems with conception. The earliest known physician is also credited to ancient Egypt ("Chief of Dentists and Physicians" for King Djoser in the 27th century BCE) Peseshet – Earliest known woman physician.  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  China Huangdi neijing - The foundational text of Chinese medicine written 5th century to 3rd century BC- Basis of traditional Chinese medicines, acupuncture and moxibustion  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 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 Apprentice Period Nursing performed without any formal education and by people who were directed by more experienced nurses Founding of religious order  The Beginning of Religious War A religious war or holy war is a war primarily caused or justified by differences in religion. The Crusades - They were Holy Wars waged in an attempt to recapture Holy Land from the Turks who denied Christ’s pilgrims permission to visit Holy Sepulcher.  Military Religious Orders and their Work Knights of St. John of Jerusalem (Italian) - Also known as “Knight Hospitalers” They founded Hospitals Teutonic Knights (German)- Established Tent hospitals for the wounded Knights of St. Lazarus- Founded primarily for nursing care of lepers in Jerusalem The Alexian Brothers were members of a monastic order founded 1348. They established the Alexian Brothers Hospital School of Nursing the largest School of Nursing under religious order. It operated exclusively for men in United States.  The Rise of Secular Order There was the rise of Religious Nursing Orders for women. Although Christianity promoted equality to all men, women were still concentrated in their roles as wives and mothers.  Secular Orders Founded during the period of Crusades Order of St. Francis of Assisi (1200- Present) The Beguines- composed of lay nurses who devoted their lives to the service of suffering humanity The Oblates (12th Century) Benedictines Ursulines  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.  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 Rise of Protestantism (1520-1562) From 1520 onwards, Martin Luther’s ideas and works could be found in France – they even influenced the court of Francis I. The king’s sister, Marguerite of Angoulême asked the Bishop of Meaux to reform his diocese so he asked James Lefèvre d’Etaples to come and join him. He was the author of a French version of the New Testament which had been considered heretical by the Sorbonne and was the founder of the Circle of Reformers in Meaux which had been forbidden by the Church. Luther’s works were translated into French, mostly printed in Switzerland and passed from one person to another in secret.  The Rise of Protestantism (1520- 1562) The Protestants, who were called ‘Lutherans’ at the time, belonged to the higher, literate class of society and were condemned as heretics by the Church. Persecution began in 1521: they had to pay fines, were sent to prison and even burnt at the stake.  The Start of dark period of Nursing The world of nursing, despite wars and plagues made considerable progress under the influence of Christianity. It maybe said that nursing owes its foundation to the work of benevolent men and women, the crusades and the guilds. But this progress in nursing was brought to a halt by industrial and political revolution and the Reformation in the 16th century.  Dark Period of Nursing 17th to 19th Century 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 religious upheaval led by Martin Luther destroyed the unity of the Christian faith. The wrath of Protestantism swept away from everything connected with Roman Catholicism in schools, orphanages and hospitals. Properties of hospitals and schools were confiscated. Dark Period of Nursing 17th to 19th Century Dark Period of Nursing 17th to 19th Century Theodore Fliedner – Reconstituted the deaconesses and later established the school of nursing in Kaiserwerth, Germany where Florence Nightingale had her first formal training for 3 months as a nurse.  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.  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. Florence Nightingale  Nightingale Era 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)  Nightingale Era 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.  Nightingale Era 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.  Nightingale Era 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.  Nightingale Era 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.  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.  Nightingale School of Nursing During the war a public subscription fund was set up for Florence Nightingale to continue her education of nurses in England, and the Nightingale Training School at St. Thomas’ Hospital opened in 1860. The education of recruits involved a year of practical instruction in the wards, supplemented with courses of lecturing, and followed by two years of work experience in the hospital. After graduation, many of the students staffed British hospitals, and others spread the Nightingale education system to other countries. Concept in the Nightingale system of Education 1. Government funds should be allotted to nursing education First nurse political activist 2. Training schools of Nursing should be in close affiliation 3. Professional nurses should train nurses 4. Nursing students should be provided with residence near their training hospitals Written orders of doctors were insisted Nurses should go with doctors during their rounds Concept in the Nightingale system of Education 5. All nurses must be trained, in a regular civil hospital 6. Training was fundamentally on the apprenticeship model: hands-on, in the wards, under the ward sister 7. Classes, given by medical doctors, augmented training in the wards 8. The “home sister” or “mistress of probationers” organized the training 9. District nurses had to be hospital trained (or they would not see enough serious cases) 10. Midwifery nurses had to be hospital trained Concept in the Nightingale system of Education 11. Training was required for administrative positions 12. Probationers kept diaries and case notes of their work, examined by the matron and home sister, and often by Nightingale. 13. A major component of training was moral: ethical standards for patient care 14. Technical training had to be updated 15. A Probationers’ Home should be provided, with a private room for each, comfortable (common) living 16. Responsibility for probationers’ health and safety, including rules to prevent septicemia and ongoing monitoring of probationers’ health Concept in the Nightingale system of Education 17. Certificates and letters of reference had to be dated and were relevant only for a short time 18. A matron should have a housekeeper under her so that she could concentrate on the nursing and the nurse training 19. The superintendent herself must have the highest knowledge of nursing, be herself resident in the hospital, make the training in nursing her first object, and be herself a trained nurse of the highest order.  Contemporary Period (21st Century) What is contemporary? How will you describe nurses and nursing today?  Nursing after World War I World War I - World War I (often abbreviated as WWI or WW1), also known as the First World War or the Great War, was a global war originating in Europe that lasted from 28 July 1914 to 11 November 1918 Conflict between the great powers of Europe were divided into two coalitions: the Triple Entente—consisting of France, Russia and Britain—and the Triple Alliance of Germany, Austria-Hungary and Italy  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  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.  Nursing After World War II New Opportunities for Women: Wartime and the American Workforce Nurses on the Frontlines The Scars of War: PTSD in WWII Nurses (Post Traumatic Stress Disorder)  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.  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.  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.  Rise of the BSN Curriculum 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.  Rise of the BSN Curriculum 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 Julita Sotejo was its first dean.  Nursing in Today’s Society Change is the only constant thing in the world. “Nursing is caring” (Womb to Tomb) “Nursing is an Art” Nursing is an Art  Nursing in Today’s Society Recipient of Nursing - Patients, community, family, clients and co-workers Scope of Nursing 1. Promoting Health and Wellness 2. Preventing Illness 3. Restoring Health 4. Care for the Dying  Nursing in Today’s Society Caregiver - activities that assist the client physically and psychologically Communicator - communicate verbally or in writing Teacher - assess learning needs and readiness to learn, enacts teaching strategies Client Advocate - acts to protect client (i.e. exercise rights) Counselor - helps to cope with psychologic or social problem Change Agent - acts to make changes (i.e. technologic change, medications) Leader - in luence others to work together Manager - assigns and delegates nursing activities Case Manager - ensures care to clients while controlling costs Research Consumer - uses research to improve care f Expanded Career Roles Certi ed Nurse Practitioner (CNP) Certi ed Nurse Specialist (CNS) -provides care independently (adult -specialized area of nursing (oncology, gerontology, women’s health) diabetes, critical care, emergency department, pain) fi fi Expanded Career Roles Certi ed Registered Nurse Certi ed Nurse Midwife (CNM) Anesthetist (CRNA) - gynecological and family planning, -administers anesthesia, pre and pregnancy, childbirth, postpartum post anesthesia care care, newborn care fi fi Expanded Career Roles Nurse Researcher Nurse Administrator Nurse Educator Informatics Nurse Nurse Entrepreneur Forensic Nurse Specialist (INS) References: 1. Aligood, M. & Tomey, A. (2018) Nursing Theorists and their Work, 9th edition, Singapore 2. McEwen, Melanie (2019) Theoretical Basis for Nursing, 5th Ed. Wolters Kluwer Thank you!