Nursing History: Social, Philosophical, and Historical Forces Influencing the Development of Nursing-week 1

Nursing Education in 19th Century USA continued

-The Civil War created an immediate need for nurses to care for the large number of wounded soldiers. About 20,000 women and men served as nurses in both the North and the South. The praiseworthy nursing care rendered by Civil War nurses provided a reason for creating training programs for nursing.

What Factors Influenced Nursing?

1.Societal Influences 2.Historical and Political Influences 3.Spiritual and Religious Influences 4.Gender influences

In the 1960s, Nurse Practitioners emerged

new types of nurses, who specialized in different hospital settings were trained to deliver a variety of primary care services began to emerge. "Advanced practice nurses" enabled hospitals to deliver more efficient, less costly, and safer health care services. Nursing education also thrived in the latter half of the twentieth century. Significant federal financial support for educating nurses became available in the 1960s. Significantly, increased funding for nursing research permitted nursing to develop a sounder scientific basis for its practice.

Gender Influences

•Women as healers-Women have always been healers, primarily healers of women and the poor. But their journey as healers has not been easy and accepted by others. From the 14th to early 20th centuries, many women were persecuted for their independent healing abilities. (like witchcraft) •Women's status in society-Toward the 20th Century, the establishment of medicine as a profession requiring university training further diminished the role of women as healers since women were denied access to university. Consequently, women adopted the role of nurses in which they were expected to be "obedient" to the doctor. Not until recently have men sought nursing as a profession due to diverse opportunities and economic incentives

Promoting Health

Identifying, analyzing, and maximizing each patient's individual strengths as components of preventing illness, restoring health, and facilitating coping with disability or death

the year 1873......

defining moment in American nursing history. In 1873, three nurse educational programs—the New York Training School at Bellevue Hospital, the Connecticut Training School at the State Hospital and the Boston Training School at Massachusetts General Hospital—began operations. These three programs were based on ideas formulated by Florence Nightingale and were acknowledged as the precursors of professional nurse education in the United States.

During the 1920s and 1930s,

hospitals continued to expand adding more patient beds and delivering more complex care. Hospitals continued to rely on student nurses for patient care, but a trend emerged in which hospitals hired more nurses who had completed their education. These nurses, initially called "general duty nurses" but later referred to as "staff nurses," assumed greater importance in insuring that the hospitals operated efficiently. By the 1950s, staff nursing was nursing's main occupational field.

Nursing Education (1960s)

-Many proponents proposed removing nursing education from hospital training schools and placing it in institutions of higher education -By 1960, approximately 172 college-based nursing education programs awarded Bachelors of Science in Nursing degrees -Experts believed baccalaureate educated nurses would be better prepared to care for the complex needs of patients -Proponents of the traditional hospital-based diploma programs disagreed, arguing that nurses trained in hospital programs excelled at delivering bedside care

Lavina Dock (1858-1956)

-a nurse, feminist, author, pioneer in nursing education and social activist -assistant superintendent at Johns Hopkins School of Nursing -National League for Nursing

Lillian Wald (1867-1940)

-contributions to human rights and was the founder of American community nursing -founded the Henry Street Settlement in New York City and was an early advocate to have nurses in public schools

Private Duty Nursing

-employed by individual patients primarily in their homes and in the hospital, delivering care to individuals who could afford to pay for their own nurse. Private duty often did not provide dependable employment; nurses were hired on an unplanned basis by patients and were oftentimes without a regular source of income -cost of private duty was also quite high, limiting the number of patients employing private duty nurses -It was not until the mid-twentieth century that hospitals hired nurses as regular staff on a permanent basis, providing full professional nursing services to all hospitalized patients.

Mary Mahoney (1845-1926)

-first African-American woman to become a RN in 1879 -allowed more African-American students into nursing schools throughout the nation -co-founded the National Association of Colored Graduate Nurses in 1908

Clara Barton (1812-1912)- America's "Angel of the Battlefield."

-nurse during civil war -took action to get med supplies on battlefield due to lack of it -founded the American Red Cross in 1881 and led the organization until 1904

hypodermic needle origin

-proc of admin was not sterile -cleaned using several techniques: -passing the needle through a flame, soaking or drawing through with alcohol or a carbolic acid solution or boiling in a spoon of water over the alcohol lamp -wire was used to clean the inside of the needle, as was alcohol -Before stainless steel was used, the wire was left in the needle. The needles were sharpened by the user on a whetstone and the point was tested for burrs using gauze. These were not fine or sharp needles and it took a skillful nurse to administer an injection with minimal pain.

Dorothea Dix (1802-1887)

-spent 40 years lobbying for mental health care -founded 32 mental health institutions throughout her career -tirelessly campaigned for the rights of mentally ill people

porcelain bedpan and female urinal

-used late in the 19th into the 20th century -Very old utensils, before the late nineteenth century, were made of metals such as pewter, brass and some urinals were made of glass -At some time in the early 20th century, utensils (bedpans, urinals basins and others) were made of enamel and then stainless steel. The switch to plastics and other disposables took place in the 1960's.

glass medicine cups

-used to dispense liquid meds -Before disposable plastic and pre-measured dosages -nurse was responsible for cleaning them before use

Healthy People 2020 Health Promotion Guidelines

1.Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death. 2.Achieve health equity, eliminate disparities, and improve the health of all groups. 3.Create social and physical environments that promote good health for all. 4.Promote quality of life, healthy development, and healthy behaviors across all life stages.

Early Christianity

1.Based on imitating Jesus, ministering to those in need. 2.Service was viewed as a means of securing salvation. 3.Nursing began to have a formal and more clearly defined role. 4.Nursing led by belief that love and caring for others were important 5.Religious Orders: 1.Women (Deaconesses) made first visits to sick people, males gave nursing care and buried the dead.

Nurse Leaders of 19th Century

1.Clara Barton (1812-1912) 2.Mary Mahoney (1845-1926) 3.Lavina Dock (1858-1956) 4.Dorothea Dix (1802-1887) 5.Lillian Wald (1867-1940)

Middle Ages: Crusades (1095-1291)

1.Deplorable sanitary conditions, fatigue, poor nutrition, and spread of communicable diseases 2.Military nursing orders formed, which drew a large number of men into field of nursing 3.Nurses believed duty was to God and to the spiritual rather than need of patient. 1.Example: Mental illness viewed as possession by devil

Nursing Education in 19th Century USA: American Society of Superintendents of Training Schools of Nursing

1.Established by Isabelle Hampton Robb and Lavinia Dock in 1893 2.Goal was to set education standards for nurses 3.Code of Ethics was adopted by the society 4.Nightingale Pledge 5.Became the National League for Nursing

15th-19th century

1.Extensive population growth in cities 1.lack of hygiene and sanitation 2.increasing poverty resulted in serious health problem. 2.Society changed from having a religious orientation to one that emphasized warfare, exploration, and expansion of knowledge. 3.Many monasteries and convents closed, leading to shortage of people to care for sick. 4.Women who had committed crimes were recruited into nursing in lieu of serving sentences. 5.Only acceptable nursing role was within a religious order where services were provided as part of Christianity charity

Promoting Health: Factors Affecting Health

1.Genetic inheritance 2.Cognitive abilities 3.Educational level 4.Race and ethnicity; culture 5.Age and gender 6.Developmental level 7.Lifestyle; environment 8.Socioeconomic status

Nursing' Aims r/t Promoting Health: Rural and Urban Challenges

1.Geographical barriers 2.Lack of resources 3.Distance to resources 4.Lack of transportation 5.Financial barriers 6.Language and cultural barriers

Middle Ages (500-1500)

1.Hospes (hospitals) built. 2.Nurses delivered custodial care: depended on physicians for direction. 3.Nurse midwifery flourished. 4.Believed only God and devil had power to cause illness or promote healing 5.Treatment not approved by church deemed work of devil 6.Lay Women healers persecuted

Nursing in the 20th Century

1.Hospitals employed only a few graduate nurses and relied mostly on student nurses in early 20th Century 2.Private Duty Nursing 3.Hospital Staff Nurses 4.Nurse Practitioners emerged 5.Nursing Education 1.Federal Financial support 2.Institutions of higher learning versus hospital based education 6.Increased support for Nursing research

Fifteenth to Nineteenth Century: Florence Nightingale

1.Identified personal needs of patient and role of nurse in meeting them 2.Established standards for hospital management 3.Established nursing education and nursing as a respected occupation for women 4.Established nursing education 5.Recognized two components of nursing: health and illness 6.Believed nursing is separate and distinct from medicine 7.Recognized nutrition is important to health 8.Instituted occupational and recreational therapy 9.Stressed need for continuing education for nurses 10.Maintained accurate patient records

Nursing in during Wars in the 20th Century: WWI

1.Increased demand for nurses 2.Army School of Nursing established 3.Training focused on "service to the patient" rather than comprehensive care 4.Most nurses returned to previous jobs after the war 5. created critical demand for nurses 6. The success of military nurses in providing essential care during the war insured their participation in succeeding events. 7. special skills possessed by nurses were easily transferred to different fields of health care. For example, nurses were educated to administer anesthesia during surgery, leading to the specialty field of nurse anesthetists.

Nursing in during Wars in the 20th Century: WWII

1.Increased demand for nurses 2.Explosion in medicine and technology broadened role of nurses. 3.Growth of nursing as a professional discipline 4.Cadet Nurse Corps established 5.Nurses stayed in military after war 1.Civilian nursing: low pay, long shifts, atrocious conditions 2.Military nursing: prestige, good pay, and opportunity for advancement

Nursing Education in 19th Century USA

1.Most early nursing programs were supported by large hospitals. 1.Training was based on apprenticeship 2.Lack of educational standards 2.First three schools of nursing in the United States 1.Bellevue Hospital School of Nursing, New York 2.Connecticut Training School, New Haven 3.Boston Training School at Massachusetts General Hospital, Boston

Spiritual/Religious Influences

1.Nursing has existed in every culture 2.Spirituality and religion: 1.Contributes to moral foundation of nursing 2.Influences gender and activities of healers 3.Influences beliefs about values of individuals, life, death and health 4.Influences religious practices, and related cultural values. In most early cultures, nurses were dedicated to service on religious principles. In Europe before the foundation of modern nursing, Catholic nuns and the military provided nursing-like services. In the 19th century nursing became more a secular profession.

Societal Influences

1.Professions exist to meet needs of society. 2.Nursing serves interest of "larger whole of which it is a part." 1.Took time for nursing to be seen as a profession 3.Society grants professionals the exclusive right to practice within defined limits. 4.Professionals have a reciprocal duty to society to practice competently.

Nursing's Aims/Intentions

1.Promote health 2.Prevent illness 3.Restore health 4.Facilitate coping with disability or death

Stages of Nursing History

1.Stages of Nursing from Ancient times to nineteenth century Early Civilization Christianity Middle Ages Fifteenth to Nineteenth Century 2.Modern Nursing (now)

Why Study Nursing History?

1.To understand meaning of ideas and behavior 2.To avoid repeating mistakes 3.Use "recycled" solutions 4.Obtain sense of professional heritage and identity

Nursing in the 19th Century in U.S.

1.Urbanization changed the way sic people received medical care 2.Hospitals proliferated increasing the demand for nurses 3.Hospitals were built in large cities 4.Medical care varies in the hospitals ranging from poor to good

The post-World-War-II era

A large demand for nurses was needed to handle the increasingly complex care needs of patients yet there were fewer young women (the major population from which nursing drew its recruits) choosing nursing as a career. Nursing's image took on an heroic cast during the war, but the reality for most nurses, was that the work was demanding with few financial rewards and poor working conditions. Nursing failed to keep up economically with other occupations. Severe shortages of nurses characterized the immediate post war period, threatening the delivery of health services to the public.

Restoring Health

Activities to restore health range from early detection to recovery 1.Performing assessments that detect an illness 2.Referring questions and abnormal findings to other health care providers, as appropriate 3.Providing direct care to the person who is ill 4.Collaborating with other health care providers in providing care 5.Planning, teaching, and carrying out rehabilitation for illnesses such as heart attacks, arthritis, and strokes 6.Working in mental health and chemical-dependency programs

Societal Influences and Professions

Current Characteristics of a Profession •Autonomy •Public recognition •Prestige, Power, Authority •Expertise, Accountability, Theory, Ethics •Professional culture, licensure, high income, and credentialing •Scope of practice & professional standards These are more current characteristics of a profession. Nursing has always struggled with autonomy as for years nurses were subservient to doctors. Professional autonomy means having the authority to make decisions and the freedom to act in accordance with one's professional knowledge base. All the other criteria, nursing has acquiesced overtime.

Historical and Political Influences

Epidemics/Pandemics Wars Political climate Most sick care in the United Stated before the 19th century was provided by family and friends with the exception of periodic epidemics and plagues. Nurses, who work on the front lines during an epidemic or war, serve many roles: healthcare providers, communicators, advocates, comforters - all while putting their own health on the line. Nurses are critical during infectious disease outbreaks and war, to care for the sick and injured as they play a significant role in public health. Nurses have the potential to influence policy on a local and global scale. According to the American Nurses Association (ANA), nurses have a moral and professional obligation to be engaged in legislation that impacts patients. When nurses influence health policy, the delivery of healthcare is improved.

Early in the twentieth century nurses, who were primarily private duty nurses, owned their own syringe sets

It was not unusual for graduating nurses to be given a syringe set as a graduating gift. These may have been marked with a pharmaceutical company name, and in some schools, was a gift from the physicians.

Nurses, however, have historically had little involvement in policy that affects healthcare delivery. Why do you think that is?

Nurses tend to be underrated especially during the 19th century when nurses didn't have abundant educational resources. They were also undermined due to the treatment of doctors. Moreso looked at as maids and assistants of doctors rather than healers and patient advocates

Growth of Nursing in 21st Century

Nursing broadened in all areas as evidenced by: 1.Practice in a wide variety of health care settings 2.The development of a specific body of knowledge 3.The conduct and publication of nursing research 4.Recognition of the role of nursing in promoting health 5.Growth of nursing as a professional discipline

Nursing in the 19th Century in U.S. continued.....

Throughout the United States, most sick care took place in the home and was the responsibility of family, friends, and neighbors until the nineteenth century. Urbanization and industrialization changed the way sick individuals received medical care. Hospitals increased in numbers along with the demand for nurses who would be able to deliver care to the patients. Early nineteenth-century hospitals were built mainly in large cities. Nursing care in these institutions differed enormously. In hospitals operated by religious nursing orders, patients received high quality care. But, in other institutions, nursing care was more variable, ranging from good in some hospitals, to haphazard and poor in others.

wet cupping

Wet cupping involves breaking the skin after the application of the cup and was not generally performed by nurses.

Facilitating Coping With Disability and Death

•Maximizing person's strengths and potentials By: •Patient teaching •Referral to community support systems •Providing end-of-care -Hospice programs

The success of these first three schools led to......

a proliferation of similar nursing schools (often called nurse training programs). By 1900, somewhere between 400 to 800 schools of nursing were in operation in the U.S. These school was either affiliated with or owned by a hospital that provided the students with the clinical experience considered necessary for the education of a nurse. Students received two to three years of training. While in the program students carried out the majority of patient care activities offered in the hospital, receiving only a little bit of classroom education. At the end of the educational program, students received a diploma and were eligible to seek work as a trained nurse. Better oversight of nursing educational programs by state licensing boards as well as the increasingly complex demands of patient care led the schools to increase the amount of theoretical instruction and decrease the amount of direct work performed by students.

State nurses associations organized and were active in passing state nurse registration acts which.....

regulated and provided a licensing system for nursing practice. The successful passage of nurse registration acts, considered a significant legislative accomplishment at a time when women held little political power, also provided nurses with their modern legal title, registered professional nurses (RN).

invalid feeder

used to facilitate the feeding of invalids. A liquid or semi-soft food was placed in the feeder and the spout was then placed in the person's mouth. In the movie "The English Patient" the use of a feeder was shown in a brief flashback.

dry cupping

used to reduce inflammation of lung, kidney, muscles or other parts of the body before anti-inflammatory or antibiotics were developed.

Early Civilization continued

•Egyptian physicians hired women, later known as midwives, to assist with childbirth. •Medical records, surgery, drugs, embalming •Greeks believed in Apollo (Greek God of Healing) •400 B.C. Hippocrates believed disease had natural, not magical, causes; Hippocratic oath •Temples became center of medical care (illness was caused by sin). •Nurses cared for the sick at home; practiced as nurse-midwives. •Romans best known for advances in public health •Ancient Hebrews: Mosaic Health Code •Applied to every aspect of individual, family, and community life •Required inspection of food, detection and reporting of disease, methods of disposal of excreta, feminine hygiene, and isolation of those with communicable illness •In ancient India, early hospitals staffed by male nurses

Early Civilization (supernatural/evil spirits/animism)

•Many civilizations believed illness had supernatural causes •Theory of ANIMISM •Good spirits brought health; evil spirits brought sickness and death. •Roles of nurse and physician separate and distinct: •The physician was MEDICINE MAN who treated disease by chanting, inspiring fear, or opening skull to release evil spirits. •The nurse as caring mother usually was the one who cared for family during sickness by providing physical care and herbal remedies.

Preventing Illness

•Prevent the occurrence of an event by reducing the risk for illness, promoting good health habits, obtaining optimal functioning •Nurses prevent illness by teaching and personal example •Educational programs in areas such as prenatal care for pregnant women, smoking-cessation programs, and stress-reduction seminars •Community programs and resources encouraging healthy lifestyles •Literature, TV, radio, or Internet information on healthy diet, exercise, and good health habits •Health assessments in institutions, clinics, and community settings that identify areas of strength and risks for illness