HISTORY OF NURSING
PERIODS OF NURSING
INTUITIVE NURSING/ PRIMITIVE NURSING/ INSTINCTIVE NURSING
(Primitive times – 6th century)
PRIMITIVE TIMES
- Women practice nursing because of low status in society.
- Took care of children and sick members of the family.
- Personalistic cause of disease.
- Sickness is due to active intervention of:
a. human – caused by witchcraft.
b. non human – caused by ghosts.
c. superhuman beings – caused by deities.
- Superstitious and believes in magic.
- Slave society “slave nurses”
- Wet nursing, take care of babies/children of their masters
- Women also practices midwifery.
- Masters/healers are the people who are responsible in decision making when
it comes to health.
6th CENTURY
- Founding of religious orders.
3 Attributes of Nurses
1. Self denial
2. Devotion to hard work and duty.
3. With spiritual calling.
Main Guiding Principles
1. “Love thy neighbor as thy self”.
Fundamentals of Nursing | Compiled by: Karl Gerald C. Manalili, UASN 2010
2. Parable of the Good Samaritan.
- Beneficence (doing good to others).
2 Types of Beneficence
1. Ordinary – doing good to others.
2. Ideal – entails sacrifice.
DIMENSIONS OF NURSING
1. Nursing Practice
2. Nursing Education
3. Nursing Research
FOCUS OF NURSING
1. Health Promotion – improve clients well being.
2. Health Maintenance
3. Health Instauration – help clients with illness to recover.
4. Care of the Dying – clients with cancer.
PATIENT CLIENT
- Has a disease - Not necessarily sick
- Very dependent on health - Health promotion act till
professional disease prevention
- Client collaborates with
health professional
ROLES OF NURSE
1. Nurse Educator
- 3 domains of learning
a. Cognitive – knowledge aspect
b. Psychomotor – skills
c. Affective – interest/emotion
2. Caregiver
- Attends to physical/emotional (mostly physical) needs of the client.
3. Nurses as Leader
- Process of influencing people to work towards the attainment of goals.
4. Manager
- Organizational goals/works within an organization.
PROCESS OF MANAGEMENT
a. Planning (resources)
b. Organizing (delegating tasks/tasking)
c. Directing (motivating people)
Fundamentals of Nursing | Compiled by: Karl Gerald C. Manalili, UASN 2010
d. Controlling – evaluation of output against standards.
5. Client advocate – protects rights of clients.
6. Change agent – improvement in organization.
7. Researcher – research process
8. Facilitator
NURSING THEORIES
A. GENERAL THEORIES
1. NIGHTINGALE’S ENVIRONMENTAL THEORY
Fundamentals of Nursing | Compiled by: Karl Gerald C. Manalili, UASN 2010
- What nursing has to do is to put the individual in best position for nature to
work on him.
- Nursing Action: manipulation of elements in the environment to contribute to
reparative process.
10 ELEMENTS FOUND IN ENVIRONMENT
1. Air – importance to have moving air in room of patient to contribute in
proper ventilation.
2. Light – patient should be near windows to be able to see sunlight and give
hope.
3. Health of houses – environmental sanitation.
4. Cleanliness
5. Beddings – change linens/beddings in patients room to promote comfort.
6. Nutrition
7. Variety – change in environment for patient.
8. Ventilation – promote warming.
9. Noise – due to nurses clothing or roaming around.
10. Chattering hopes – deals with social aspect; nurse should be cautious
with words when at bedside,
GOALS
talk about positive things.
2. VIRGINIA HENDERSON’S DEFINITION OF NURSING
INDEPENDENCE
- Assisting individualsKNOWLEDGE
sick or well in the performance of activity.
RESTORATION
- Role of nurse is complimentary. WILL
- Supplementary MAINTENANCE
STRENGTH
- Individual person is a whole, complete and individual being.
NURSE- PERSON INTERACTION
PEACEFUL DEATH
ENVIRONMENT
1-9 PHYSIOLOGIC
10 – 14 PSYCHOLOGICAL
12 – 13 SOCIOLOGIC
11 SPIRITUAL/MORAL
COPING MECHANISMS
1. Regulator – neural – chemical – endocrine.
2. Cognator – processed through cognition.
ADAPTIVE MODES
- Physiologic – adaptive mode
- Self concept mode
- Interdependence mode
- Role function mode
- Adaptive/effective response
- Maladaptive/ineffective response
B. ENVIRONMENT
- Environment has potential to alter system stability due to internal and external
stressors.
Nurse Patient
Counselor – identify stressor (with a need)
Resource Person – health educator
Surrogate – acts as caregiver
Congruent Goals
CONSERVATION OF
- Energy
- Structural Integrity
- Personal Integrity
- Social Integrity
Fundamentals of Nursing | Compiled by: Karl Gerald C. Manalili, UASN 2010
Promotion of “wholeness” of the client
towards health maintenance or health
restoration.
CONSERVATION
- Defends wholeness of living systems by ensuring their ability to confront
change
HEALTHY LIFESTYLE
- Adequate nutrition 3 times a day
- Regular exercise 3 times a week
- Not smoking
- Moderate intake of alcohol
Physiologic
Fundamentals of Nursing | Compiled by: Karl Gerald C. Manalili, UASN 2010
- sex, nutrition, shelter, clothing, water, elimination, rest and sleep
Safety and Security
- physical freedom from harm, psychological knowing what to expect from
others and what others expect from you.
Love and Belongingness
- nurturance with affection
Self Esteem
- persons sense of achievement and independence, competence, confidence
and strength
Self Actualization
- not all people attain self actualization (attained by only 15%)
- Accepts himself
- Balance between rest and activity
- Open mind
- Positive outlook in life
HEALTH
- Health is a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity.
WELLNESS
- State of well being
- Subjective perception of balance, harmony and vitality engaging in attitudes
and behaviors that enhance the quality of life and maximizes personal
potential.
Agent
Host Environment
HEALTH AXIS
Death Peak
Wellness
Poor health Energetic, High level wellness
(in an unfavorable environment) (in an unfavorable
environment)
Environmental axis
Wellness model
. . . . . .
Premature Death
Treatment Models
- Movement to the right of the neutral point indicates high level of health and
well being for an individual and this may be achieved through awareness and
education and growth. In contrast, movement to the left of the neutral point
indicates a progressively decrease state of health
ILLNESS
- Highly personal state in which the person feels unhealthy or ill, may or may
not be related to disease
DISEASE
- Alteration in body function resulting in a reduction of capacities or a
shortening of the normal lifespan
ASSESSMENT
- Objective (physical exam) and subjective (nursing history)
SOURCES OF DATA
1. Primary – client
2. Secondary – relatives, members of health team
NURSING DIAGNOSIS
- Clinical judgment about an individual, family or community responses to
actual and potential health problems
- Professional nurses are responsible for making nursing diagnosis.
- Nursing diagnosis describe a continuum of health states.
First Priority – is any threat to the vital functions of breathing, heart beat,
blood pressure.
Medium Priority – health-threatening problems that may result in delayed
development or cause destructive physical or emotional changes.
Low Priority – problems that arise from normal development needs or those
that require minimal nursing support.
OBJECTIVES
- Should be SMART, client centered, statement of a single human response
EVALUATION
- Conclusion and supporting data
- Goal met
- Goal partially met
- Goal not met
GROWTH
Fundamentals of Nursing | Compiled by: Karl Gerald C. Manalili, UASN 2010
- Physical change
- Increase in size
- Periods of very rapid growth rate: pre – natal, neonatal, infancy, adolescence
DEVELOPMENT
- Increase in complexity of function and skill progression
- The behavioral aspect of growth
PRINCIPLES OF DEVELOPMENT
1 Growth and development are continuous orderly, sequential process
influenced by maturational environment and genetic factors
2. All humans follow the same pattern of growth
3. The sequence of each stage is predictable although the time of onset, the
length of the stage and the effects of each stage vary with the person.
4. Growth and development occur in cephalocaudal direction.
5. Growth and development occur in a proximal to distal direction
6. Development occurs from simple to complex or from single acts to
integrated acts.
7. Development becomes increasingly differentiated, begins with generalized
response and progresses to a skilled specific response.
8. The pace of growth and development is asynchronous or uneven.
- Selecting a mate
- Learning to live with a partner
- Starting a family and rearing
children
- Managing a home
- Getting started in an occupation
- Taking on civic responsibility
Late Maturity - Finding a congenial social group
COMMUNICATION
- Human function that enables people to relate with each other
MODES
Verbal – spoken language
Non-Verbal – symbols, sign language
ELEMENTS OF COMMUNICATION
1. Stimulus – reason why people communicate, motivation with each other
(object, ideas, feeling) referent
2. Message – idea, feelings and emotions
3. Sender – also known as encoder, one that sends the message
4. Channels – kinesthetic: tactile stimulus, visual: symbols, auditory: spoken
language
5. Receiver – decoder
6. Feedback – answer to questions, whether receiver understood or not
VITAL SIGNS
TEMPERATURE
1. Oral
- Most accessible and convenient
- Normal value: 37 o C – 98.6 o F
PULSE SITE
1. Temporal 6. Femoral
2. Carotid 7. Popliteal
3. Apical 8. Posterior tibial
4. Brachial 9. Dorsalis pedis
5. Radial
When palpating for pulse use 2 – 3 fingers except when taking the
apical pulse use stethoscope
Apical pulse is in the 5th intercostals space
Landmark is the angle of Louie
RESPIRATION
- Adult: 12 – 20 c/min
- Newborn – 30 – 60 c/min
Inaccurate interpretation
KOROTKOFF SOUNDS
Phases
1. Characterized by a thud, thump and tapping sound
2. Swooshing, whoosing sound
3. Sound decrease in intensity when compared to Korotkoff one
4. Muffling sound
5. Disappearance of sound
- in adults record Korotkoff 1 and Korotkoff 5 of able to hear Korotkoff 4
record also
- in children record Korotkoff 1 and Korotkoff 4
HYPERTENSION
Average of 2 or more diastolic reading on at least 2 subsequent visits is 90
mmHg or higher or when an average of 2 or more systolic readings on at
least 2 visits is higher than 140 mmHg
SYSTOLIC DIASTOLIC