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THEORETICAL FOUNDATIONS IN NURSING presentation by: Hannah V. Lacambra, RN CLINICAL INSTRUCTOR HEALTH Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Presence or absence of disease W...

THEORETICAL FOUNDATIONS IN NURSING presentation by: Hannah V. Lacambra, RN CLINICAL INSTRUCTOR HEALTH Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Presence or absence of disease WELLNESS Wellness is considered, “an active process through which people become aware of, and make choices toward, a more successful existence” ---National Wellness Institute HEALTH & WELLNESS Health is a state of being, whereas Wellness is the state of living a healthy lifestyle. ILLNESS Illness is a highly personal state in which the person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is thought to be diminished. Disease can be described as an alteration in body functions resulting in a reduction of capacities or a shortening of the normal life span. Etiology causation of a disease or condition. Acute illness is typically characterized by symptoms of relatively short duration. Chronic illness is one that lasts for an extended period, usually 6 months or longer, and often for the person’s life. Illness behavior, a coping mechanism, involves ways individuals describe, monitor, and interpret their symptoms, take remedial actions, and use the health care system. Remission -when the symptoms disappear. Exacerbation -when the symptoms reappear. HOW DO WE DEFINE NURSING? Is the art of caring sick and well individual. It refers to the dynamic skills and methods in assisting sick and well individual in their recovery and in the promotion and maintenance of health. It involves the creative application of knowledge in the service of people NURSE Comes from a Latin word “to nourish” or “to cherish One who cares for the sick, the injured, and the physically, mentally, and emotionally disabled One who advise and instruct individuals, families, groups and communities in the prevention, treatment of illness and diseases and in the promotion of health. An essential member of a health team who cares for individuals, families and communities in disease and illness prevention and in the promotion of health and healthy environment. is a person who cares for the sick or infirm; specifically: a licensed health- care professional who practice independently or supervised by a physician, surgeon, or dentist and who is skilled in promoting and maintaining health (Merriam- Webster) The word "nurse" originally came from the Latin word "nutrire", meaning to suckle, referring to a wet-nurse; only in the late 16th century did it attain its modern meaning of a person who cares for the infirm. (Wikipedia) NURSING (as a science) It is the “body of abstract knowledge” arrived through scientific research and logical analysis Is the scientific knowledge and skills in assisting individual to achieve optimal health. It is the diagnosis and treatment of human responses to actual or potential problem. Nursing (as a profession) Profession- a calling in which its members profess to have acquired special knowledge by training or experience, or both so that they may guide, advise or save others in that special field. WEEK 1. HISTORICAL PERSPECTIVE IN NURSING Nursing has been called the oldest of the art, and the youngest of the profession. As such, it has gone through many stages and has been an integral part of social movements. Nursing has been involved in the existing culture, shaped by involved in the existing culture, shaped by it. The trend analysis and future scenarios provide a basis for sound decision making through mapping of possible futures and aiming to create preferred futures. Nursing began as a desire to keep people healthy and to provide comfort and assurance to the sick. Although the general goals of nursing have remained relatively the same over the centuries, ever - advancing science and the changing of society's needs have deeply influenced the practice of nursing. Nursing is an art and a science with a unique body of knowledge that draws from the social, the behavioral and the physical sciences. Nursing is a unique profession because it addresses responses of individuals and families to health promotion, health maintenance and health problems. FLORENCE NIGHTINGALE defined nursing over 100 years ago as the act of utilizing the environment of the patient to assist him in his recovery. Nightingale considered a clean, well -ventilated and quiet environment essential for recovery. Often considered the first nurse theorist, Nightingale raised the status of nursing through education. Nurses were no longer untrained housekeepers but people educated in the care of the sick (Berman et al 2008). VIRGINIA HENDERSON was one of the first modern nurses to define nursing. The definition she posed in 1966 was adopted by the International Council of Nurses (ICN) in 1973 and still holds wide appeal to the nursing profession. Henderson defined nursing as: - Assisting the individual, sick or well, in the performance of those activities contributing to health, its recovery, promoting quality of life or to a peaceful death that the client would perform unaided if he or she had the necessary strength, will or knowledge. NURSING DEFINITIONS Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. (ICN, 2002) Nursing, as an integral part of the health care system, encompasses the promotion of health, prevention of illness, and care of physically ill, mentally ill, and disabled people of all ages, in all health care and other community settings. Within this broad spectrum of health care, the phenomena of particular concern to nurses are individual, family, and group "responses to actual or potential health problems" (ANA, 1980, P.9). NURSING DEFINITIONS The unique function of nurses in caring for individuals, sick or well, is to assess their responses to their health status and to assist them in the performance of those activities contributing to health or recovery or to dignified death that they would perform unaided if they had the necessary strength, will, or knowledge and to do this in such a way as to help them gain full of partial independence as rapidly as possible (Henderson, 1977, p.4) Within the total health care environment, nurses share with other health professionals and those in other sectors of public service the functions of planning, implementation, and evaluation to ensure the adequacy of the health system for promoting health, preventing illness, and caring for ill and disabled people. (ICN, 1987) DEFINITION OF A NURSE The nurse is a person who has completed a program of basic, generalized nursing education and is authorized by the appropriate regulatory authority to practice nursing in his/her country. Basic nursing education is a formally recognized programme of study providing a broad and sound foundation in the behavioral, life, and nursing sciences for the general practice of nursing, for a leadership role, and for post-basic education for specialty or advanced nursing practice. DEFINITION OF A NURSE The nurse is prepared and authorized : (1) To engage in the general scope of nursing practice, including the promotion of health, prevention of illness, and care of physically ill, mentally ill, and disabled people of all ages and in all health care and other community settings (2) To carry out health care teaching (3) To participate fully as a member of the health care team (4) To supervise and train nursing and health care auxiliaries (5) To be involved in research (ICN, 1987) Nursing also helps individuals carry out prescribed therapy, to be independent of assistance, and function to maximum potential as soon as possible (Crisp & Taylor 2005). RECIPIENTS OF NURSING The recipients of nursing are sometimes called consumers, patients or clients. A consumer is defined as an individual, a group of people or a community that uses a service or commodity. Individuals who use health care products or services are consumers of health care. A patient is a person who is waiting for or undergoing medical treatment and care. Usually, people become patients when they seek assistance because of illness or for surgery. Some nurses believe that the term ‘patient’ implies passive acceptance of the decisions and care of health professionals, and nurses are now increasingly using the term ‘client’ to refer to recipients of health care. A client is a person who engages the advice or services of another who is qualified to provide this service. The health status of a client is the responsibility of the individual in collaboration with health professionals (Berman et al 2008). WEEK 2. HISTORICAL HIGHLIGHTS Prehistoric to Early Christian Era More on “intuition” NOMADS – travel from one place to another Survival of the fittest INTUITIVE “Best for the most” – motto Sickness is due to “voodoo PERIOD/ Performed out of feeling of compassion for others MEDIVAL Performed out of desire to help Performed out of wish to do good PERIOD Nursing is given by the WOMEN SHAMAN - uses white magic to counteract the black magic They are the doctors during those time TREPHINING - drilling the skull Used to treat Psychotic patients. Psychotic patients are believed to be possessed by evil spirits. Growth of religion - most important thing that happened Growth of civilization Law of preservation – inspire man in search of knowledge INTUITIVE “Rise in Civilization” “Rise in Civilization” PERIOD/ From the mode of Nomadic life → agrarian society → gradual development of urban community life MEDIVAL Existence of means of communication Start of scientific knowledge → more complex life → increase in PERIOD health problems → demand for more nurses Nursing as a duty of SLAVES and WIVES. NURSING DID NOT CHANGE but there was progress in the practice of medicine. Care of the sick was still closely allied with superstitions, religion and magic “Different Civilization” 1. BABYLONIANS INTUITIVE CODE OF HAMMURABI First recording on the medical practice PERIOD/ Established the medical fees Discouraged experimentation MEDIVAL Specific doctor for each disease PERIOD Right of patient to choose treatment between the use of charms, medicine, or surgical procedure “Different Civilization” 2.EGYPTIANS INTUITIVE ART OF EMBALMING Mummification PERIOD/ Removing the internal organ of the dead body Instillation of herbs and salt to the dead MEDIVAL Used to enhance their knowledge of the human anatomy. PERIOD Since work was done and performed on the dead, they learned nothing of Philosophy “THE 250 DISEASES” -Documentation about 250 diseases and treatments “Different Civilization” 3.HEBREW Teachings of MOSES -Created Leviticus; Father of sanitation INTUITIVE Practice the values of “Hospitality to strangers” and the “Act of Charity” – contained in the book of Genesis PERIOD/ LEVITICUS – 3rd book of the Old Testament Laws controlling the spread of communicable diseases MEDIVAL Laws governing cleanliness Laws on preparation of food PERIOD Purification of man and his food The ritual of CIRCUMCISION on the 8th day after birth MOSAIC LAW Meant to keep Hebrews pure so that they may enter the sanctuary without affronting God Meant as a survival for health and hygienic reason only “Different Civilization” 4.CHINA INTUITIVE Use of pharmacologic drugs “MATERIA MEDICA” -Book that indicates the pharmacologic PERIOD/ drug used for treatment No knowledge on anatomy MEDIVAL Use of wax to preserve the body of the dead Method of paper making PERIOD FACTOR THAT HAMPERED THE ADVANCEMENT OF MEDICINE:- Prohibits dissecting of human body thus thwarting scientific study “Different Civilization” 5.INDIA INTUITIVE Hampered by Taboos due to social structures and practices of PERIOD/ animal worship Medicine men built hospitals MEDIVAL Intuitive form of asepsis There was proficient practice of Medicine and Surgery PERIOD “Different Civilization” 6.GREECE AESCULAPIUS- Father of medicine in Greek mythology, god of healing HIPPOCRATES- Father of modern medicine INTUITIVE 1st to reject the idea that diseases are caused by evil spirits 1st to apply assessment Practice medical ethics PERIOD/ CADUCEUS- Insignia of medicine Composed of staff of travellers intertwined with 2 serpent (the symbol of Aesculapus MEDIVAL and his healing power). At the apex of the staff are two wings of hermes (Mercury) for speed. NURSES → function of untrained slaves PERIOD “HIPPOCRATIC OATH AND NIGHTINGALEPLEDGE” Hippocratic oath is an oath historically taken by the Physicians and other healthcare professionals swearing to practice medicine honestly. It is widely believed to have been written by Hippocrates. Nightingale pledge- is a statement that nurses utter in order to prove their sincerity with their profession. Nurses undertake promise in front of the experiences practitioners that they would abide by the rules and regulations of nursing care. Also accompanies the Candle lighting segment ceremony (Capping & Pinning) “Different Civilization” 7.ROMANS INTUITIVE Proper turnover for the sick people PERIOD/ “if you’re strong, you’re healthy” – motto Transition from Pagan to Christianity MEDIVAL FABIOLA—was converted to Christian and later she converted her home to a hospital and used her wealth for the sick. (Roman PERIOD Matron)- high rank women 1st hospital in the Christian world 11th century → 1836 On-the-job training period -Refers to a beginner (on-the-job training). It means care performed by people who are directed by more experienced nurses Starts from the founding of Religious Orders in the 6th century B.APPRENTICE (1836 – when the deaconesses School of Nursing was established in Kaiserweith, Germany by Pastor THEODORE FLEIDNER) PERIOD/ There was a struggle for religious, political, and economic power Crusades took place in order to gain religious, political, and MIDDLE AGES economic power or for adventure During the Crusade in this period, it happened as an attempt to recapture the Holy Land from the Turk who obtained and gain control of the region as a result of power stuggle. Christians were divided due to several religious war and Christians were denied visit to The Holy Sepulcher MILITARY RELIGIOUS ORDERS AND THEIR WORKS 1. KNIGHTS OF ST. JOHN OF JERUSALEM (ITALIAN) B.APPRENTICE Also called as “Knights of the Hospitalers” Established to give care PERIOD/ Established ambulance service Major organizer of the International RedCross MIDDLE AGES Military in its character 2. TEUTONIC KIGHTS (GERMAN) Took subsequent wars in the Holy Land Cared for the injured and established hospitals in the military camps MILITARY RELIGIOUS ORDERS AND THEIR WORKS 3. KNIGHTS OF ST. LAZARUS Care for those who suffered Leprosy, syphilis, and chronic skin B.APPRENTICE diseases (Alexian Brothers School of Nursing) PERIOD/ 4.ALEXIAN BROTHERS A monasteric order founded in 1348. They established the Alexian MIDDLE AGES Brothers School of Nursing, the largest school under religious auspices exclusively in US and it closed down in 1969. 5. ST. VINCENT DE PAUL- SISTERS OF CHARITY 6. LOUISE de GRAS -patron saint of sick people, widows and orphans in 1960s Prior to Florence Nightingale Is the Dark Age for Nursing because…Nursing is considered as: B.APPRENTICE A very low job in terms of social hierarchy. A job for the uneducated and poor. PERIOD/ A desperate occupation. Who are the nurses? Women of lowest social standing MIDDLE AGES Wayward women of low status, instead of going to prison, they were asked to served as nurses. monastic women or untrained helpers of low repute. Poor unmarried woman with no family or no chance of getting married. The Dark Period of Nursing From 17th century – 19th century Also called the Period of Reformation until the American Civil War B.APPRENTICE Hospitals were closed Nursing were the works of the least desirable people (criminals, PERIOD/ prostitutes, drunkards, slaves, and opportunists) Nurses were uneducated, filthy, harsh, ill-fed, overworked MIDDLE AGES Mass exodus for nurses The American civil war was led by Martin Luther, the war was a religious upheaval that resulted to the destruction in the unity of Christians. The conflict swept everything connected to Roman Catholicism in schools, orphanages, and hospitals THEODORE FLIEDNER -(a pastor) reconstituted the deaconesses and later be established the School of Nursing at Kaiserswerth, Germany-where Florence Nightingale had her B.APPRENTICE first formal training for 3 months as nurse PERIOD/ Florence Nightingale -An English lady from a wealthy family during the Victorian era MIDDLE AGES -During the Crimean War known to be the “Lady with the Lamp” -A nursing theorist, writer and statistician. -Changed the image of nursing -NOTES on NURSING (1859) -“What it is and What it is not” (Florence Nightingale School of Nursing ) Began in June 15, 1860 when Florence Nightingale School of Nursing opened at St. Thomas Hospital in London England, where 1st program for formal education of Nurses began and contributed growth of Nursing in the US School of Nursing C.EDUCATIVE In 1860, Nightingale laid the foundation of professional nursing PERIOD/NIGHT when the first school of nursing was established. Nightingale Training School at St. Thomas’ ANGLE ERA Hospital FACTORS THAT INFLUENCED DEVELOPMENT OF NURSING EDUCATION: i. Social forces ii. Trends resulting from war iii. Emancipation of women iv. Increased educational opportunities THE CONCEPT OF FLORENCE NIGHTINGALE ON NURSING SCHOOL: School of Nursing should be self – supporting not subject to the whimps of the Hospital. C.EDUCATIVE Have decent living quarters for students and pay Nurse instructors PERIOD/NIGHT Correlate theories to practice Support Nursing research and promote continuing education ANGLE ERA for nurses Introduce teaching knowledge that disease could be eliminated by cleanliness and sanitation and Florence Nightingale likewise did not believe in the Germ Theory of Bacteriology OTHER SCHOOLS OF NURSING LINDA RICHARDS -the first graduate nurse in United States Graduated in September 1, 1873 C.EDUCATIVE -the first American trained Nurse (1870) became a great nursing pioneer in USA and Japan. PERIOD/NIGHT 2 NUSING ASSOCIATION / ORGANIZATION THAT ANGLE ERA UPGRADED NURSING PRACTICE IN US: -American Nurses Association (ANA) -National League for Nursing Education (NLNE) World War II – present This refers to the period after World War I and the changes and development in the trends and practice of Nursing occurring since 1945 after World War II. D.CONTEMPORARY Includes scientific and technological development, social PERIOD changes occurring after the war. Nursing is offered in College and Universities FACTORS AFFECTING NURSING TODAY: Economics Consumer’s Demand Family Structure Information and Telecommunications Legislation

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