Evolution of Nursing: From Past to Present
Topic 1: Nursing: a profession
Florence Nightingale (1859)
…having “charge of the personal health of somebody . . . , and what nursing has to do . . . is to put the patient in the best condition for nature to act upon him.”
Virginia Henderson (1961)
“to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible
American Nursing Association (ANA)
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations (2010)
Healthcare regulatory bodies or professional Nursing bodies
- Establishes:
- a code of ethics,
- standards of care and practice,
- educational and practice requirements,
- and policies that govern the profession.
Definitions of nursing have evolved to reflect the essential features of professional nursing
- Provision of a caring relationship that facilitates health and healing
- Attention to the range of human experiences and responses to health and illness within the physical and social environments
- Application of scientific knowledge to the processes of diagnosis and treatment through the use of judgment and critical thinking
- Advancement of professional nursing knowledge through scholarly inquiry
Values and principles
- Humans manifest an essential unity of mind, body, and spirit.
- Human experience is contextually and culturally defined.
- Health and illness are human experiences. The presence of illness does not preclude health, nor does optimal health preclude illness.
- The relationship between the nurse and patient occurs within the context of the values and beliefs of the patient and nurse.
- Public policy and the healthcare delivery system influence the health and well-being of society and professional nursing.
- Individual responsibility and interprofessional
Criteria used to appraise the status of a profession
- A profession
- fulfils a specific role in society; has an specific goal; a unique contribution.
- In order to fulfil this goal needs specific knowledge, different to the knowledge of other professions.
- Is members need a specific education/preparation which is acquired in higher education centers.
- Needs to develop research in order to advance the knowledge
- Needs to adapt and respond to the changeable needs of society
Criteria for professions
A profession utilizes in its practice a well defined and well organised body of specialised knowledge (Bixler & Bixler, 1945)
- Nursing science (that explains not only “how” but also “why”)
- nursing science should be the bases of nursing practice as medical science is the basis of medical profession.
Criteria for nursing profession
- Each nurse remains accountable for the quality of care within his or her scope of nursing practice.
- Professional nursing’s scope of practice is dynamic and continually evolving, responsive to the
- changing needs of society
Advanced Nursing Practice
- Advanced nursing practice builds on the competencies of the registered nurse and is characterized by the integration and application of a broad range of theoretical and evidence-based knowledge that occurs as part of graduate nursing education.
Specialties
- Nurses may also develop expertise in a particular specialty. Specialization involves focusing on nursing practice in a specific area, identified from within the whole field of professional nursing.
Today´s challenges
- Increase demand for care: originated by health care reforms and society expectations (health is a right for everybody; avoid health disparities..)
- People has more access to information and expects to be involved in decision-making.
- Demographic changes
- People live longer: death average around 75-80 years old.
- Increase number of people with dependency
- Increase number of people with chronic illness
- Family context also has changed.
- ºCultural diversity and inmigration
- Rapid changes in health care settings
- Length of stay in hospitals has decreased
- More acute patients in hospitals
- Importance to follow up them in their homes of residential /rehabilitation settings
- Recognition of the importance of health promotion
- Refugees crises
- Poverty and social exclusion
- Global conflicts
- Discrimination..
- Economical crisis and its effect of health systems: lower nurse/patient ratios
- Complex and high technological health systems environments.