History and Process of Nursing Care
History of Nursing
Prehistory
Nomadic lifestyle with organization in clans or tribes. Division of labor: men hunted, women cared for children, elderly, and sick. Knowledge transmitted orally through generations. Supernatural beliefs about illness and healing with herbs and medicinal plants.
Ancient Mesopotamia and Egypt
Settlements and the development of writing led to more accurate medical records. Supernatural beliefs about illness persisted. Doctor-priests provided treatment, including minor surgeries and midwifery. Medical knowledge advanced through observation, particularly through the study of mummies.
Ancient Greece
Development of scientific medicine, attributing diseases to natural causes like imbalances in bodily fluids. Observation of signs and symptoms, patient evaluation, and knowledge transmission were emphasized. Public health practices like hygiene, balanced diets, and healthy habits were promoted. Hospitals and ambulatory care centers emerged.
Ancient Rome
Public health advancements like aqueducts, sewage systems, and food reserves. Military and civilian hospitals were established, with doctors and caregivers often being slaves. Medical knowledge expanded through the conquest of other cultures.
Middle Ages
Christian hospitals provided charity care. Monasteries preserved and transmitted medical knowledge. The Crusades exposed Europeans to medical practices from other regions. Guilds and brotherhoods offered social protection. Universities emerged, and nursing was considered a trade rather than a university-level profession. Arab influence brought advancements in medical knowledge.
Modern Age
Lutheran countries faced challenges with unprepared healthcare staff. Catholic countries continued to rely on religious orders for healthcare. Hospitals transitioned from refuges for the poor to specialized care centers. Professional nursing emerged, with figures like Florence Nightingale establishing standards and the Red Cross being founded. Nursing roles diversified into practitioners, midwives, and caregivers.
Contemporary Age
Nursing became a non-religious profession, with formal education and training. Healthcare assistants (ATS) were introduced in the mid-20th century. In the late 20th century, Spain established higher diplomas and university degrees in nursing, along with regulated functions for auxiliary nurses and clinical assistants. Today, nursing is a regulated profession with various levels of education and specialization.
Nursing Care Process
Action Plan (PAI)
The nursing care process (PAI) is a systematic and organized approach to patient care, applying the scientific method to ensure consistent and effective care delivery. It consists of five consecutive stages:
1. Assessment
Collecting and analyzing data about the patient’s health status. This includes subjective and objective data, current and historical information, obtained through interviews, observation, and physical examination.
2. Nursing Diagnosis
Identifying the patient’s health problems based on the assessment data. Nursing diagnoses are distinct from medical diagnoses and focus on the patient’s response to health issues.
3. Planning
Developing a care plan to address the identified problems. This involves prioritizing care needs, defining goals, and outlining nursing activities to achieve those goals. Care plans can be individualized or standardized.
4. Implementation
Putting the care plan into action by performing the planned nursing activities. This requires adapting to the patient’s evolving needs, utilizing available resources, and following established protocols.
5. Evaluation
Assessing the effectiveness of the care plan and the achievement of goals. This involves monitoring the patient’s progress, making adjustments to the care plan as needed, and documenting the outcomes.
Features of PAI
- Systematic and dynamic process
- Patient-centered approach
- Requires documentation of nursing activities
- Facilitates communication among healthcare professionals
- Enables evaluation and quality improvement
- Supports research and education
- Can have legal value
Stages of PAI
Assessment
- Systematic data collection
- Data organization, verification, and validation
- Methods: clinical interview, observation, physical examination
Diagnosis
- Statement of a real or potential health problem
- Identification of contributing factors
- Validation through signs and symptoms
Planning
- Prioritizing care needs
- Defining achievable goals
- Developing a care plan with specific nursing activities
Implementation
- Putting the care plan into practice
- Adapting to the patient’s needs
- Utilizing resources effectively
- Following protocols and documenting activities
Evaluation
- Assessing goal achievement
- Monitoring patient progress
- Making adjustments to the care plan
- Documenting outcomes