History of Nursing - Part II

Category: Education

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Florence Nightingale, Florence in India, Modern Era, Nursing in brief


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FLORENCE NIGHTINGALE (The lady with the lamp):

FLORENCE NIGHTINGALE (The lady with the lamp) (12 May 1820 – 13 Aug 1910)

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Born - in Florence, Italy on May 12, 1820, to William and Frances Nightingale Second daughter of wealthy English parents. EARLY LIFE

Florence Nightingale:

Florence Nightingale Loved her dolls Helped a sick dog with a broken leg

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She and her sister had a carefree education Learnt Latin, German, French, Italian, Greek, Mathematics, Science, Politics, music and drawing. Traveled widely and met many outstanding people

Hospitals in 1830’s….:

Hospitals in 1830’s…. They were Dirty Badly run Nurses didn’t know what to do Often people who went into hospital died

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Interested in politics But attracted to social conditions and charitable institutions One day she visited a hospital THIS CHANGED HER LIFE HER AMBITION IN LIFE…..

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Attracted to nursing – A ‘ calling’ to fulfill a ‘ Mission of mercy’ Visited several convents, hospitals, schools, orphanages She studied medicine books herself for years Went to Kaiserwerth for 3 months training in Nursing Formed ideas about organized training for nurses At 33 years of age – Became Supdt. of an ‘Establishment for gentle women during illness’ Here, she showed her exceptional ability as an organizer and an administrator HER AMBITION IN LIFE…..

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Russia & France had religious sisters to care for their wounded But England had only trained men Nightingale received a letter of appeal from the Minister of war With 38 nurses from Catholic and Protestant Orders she set for Crimea THE CRIMEAN WAR (1854 – 1856) England and France were helping Turkey in a war against Russia.

Florence leaves London:

Florence leaves London No cheering No crowds “You’ll be back,” her family said

Wounded soldiers were transported by sea to the hospitals:

Wounded soldiers were transported by sea to the hospitals

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Wards - crowded, dirty, poorly ventilated, no water or sanitary facilities Food - poorly cooked and served at long intervals Soldiers lay on straw mats. Floor - covered with dirt and blood. The men still wore blood soaked uniforms. They died of cholera and other infections including wound infections They reached the Barracks Hospital at Scutari which had 1500 patients… Florence was shocked and appalled

She and her nurses put up tireless efforts , to change the scene :

She and her nurses put up tireless efforts , to change the scene 5 – 6 nurses shared one room including eating and sleeping. They – Scrubbed and cleaned, improved drainage Procured soaps, towels and clothing Opened diet kitchens, made good food Visited the sick and wrote letters for them Set up laundries, reading rooms and post offices for them

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In the night she carried a lamp, so she was called “The Lady with the Lamp”

The soldiers kissed her shadow as she passed by and got solace from their sufferings:

The soldiers kissed her shadow as she passed by and got solace from their sufferings

Her accomplishments at Crimea:

Her accomplishments at Crimea M ortality rate reduced drastically (from 42% to 2%) She established cleanliness and sanitation rules Patients received special diets and plenty of food Improved water supply Patients received proper nursing care Established a reputation which allowed her to improve nursing standards at home

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Founded the Nightingale School and Home for Nurses at St.Thomas’ Hospital … Beginning of professional nursing education By 1887 - Her nurses were working in six countries and U.S She was a nurse, philosopher, statistician and historian Her book ‘ Notes on hospitals’ and ‘ Notes on Nursing’ became the first definitive textbook for the field.

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She was world famous Changed hospitals all over the world Her picture on British £10 note A museum in London celebrates her life and work


HER CONTRIBUTIONS TO NURSING Founded many Schools of Nursing with theoretical and practical basis in the care of the sick. First to stress on aseptic precautions while caring for the patient. Her favourite dictum  “Do the Patient no harm”


A FACELIFT TO NURSING Through selfless devotion and sheer determination, she – Transformed the profession of nursing forever. Gave dignity and honor to Nursing Revolutionized hospital conditions

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Lived to a ripe old age of 90 years. 13 Aug 1910 - She died peacefully in her sleep Today the Nurses take the Florence Nightingale pledge before being formally initiated into the profession of Nursing.

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"The ultimate destination of all nursing is the nursing of the sick in their own homes.... I look to the abolition of all hospitals and workhouse infirmaries." – Florence Nightingale




NIGHTINGALE IN INDIA Indian mutiny of 1857 - Miss Nightingales interest turned to the health of the Army in India. Royal Commission appointed in 1859. In 1868, a sanitary department was established. 1888 – 10 qualified British nurses arrived in India to look after the British Army 1905 - Missionary nurses arrived as members of Missionary Medical Association. - Laid the foundation of systematic Nursing education Increasing need of adequately trained nurses felt -  1911 - South India Examining Board created  1912 - North India Examining Board created This was the very start of formalized nursing service in India.


NURSING EDUCATION IN INDIA Increasing need of adequately trained nurses felt -  1911 - South India Examining Board created  1912 - North India Examining Board created  1934 - M id India Board of Examination started 1935 onwards- State-wise councils started developing 1947 - Indian Nursing Council (INC) Act passed by the Parliament - INC upgraded the educational requirements to matriculated candidates Now India has 23 State Nursing Councils Colleges of Nursing started in Delhi (1946) and Vellore (1947) Nursing education in the country integrated into the system of higher education.

Period of contemporary nursing (World war II till date):

Period of contemporary nursing (World war II till date) Marked by scientific & technological developments and social changes Establishment of WHO by the UN Use of atomic energy for medical diagnosis and treatment Use of computers Use of sophisticated equipment for diagnosis and therapy Space medicine -  aerospace nursing Laws to hold health as a fundamental human right Nursing involvement in community health Technological advances – disposables have relieved the nurses of numerous tedious tasks Development of expanded and extended role of nurse

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NURSING DEFINED “ Nursing is the unique function of the nurse, that is 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.” - ICN


PRINCIPLES IN NURSING Nursing principles Safety – Mechanical, chemical, thermal, bacteriological Therapeutic effectiveness Comfort – Satisfaction Use of resources – Time, energy material Good workmanship – manual dexterity Individuality Scientific principles Anatomy & physiology Physics Microbiology Chemistry Nutrition Psychology Pharmacology Sociology


NURSING IS A PROFESSION Profession - An occupation that requires extensive education or a calling that requires special knowledge, skill and preparation. The knowledge and skills are developed in a scientific and learned manner Has ethical components, that is devoted to the promotion of human and social welfare.


REQUISITES FOR A PROFESSION Requires prolonged, specialized training to acquire a body of knowledge pertinent to the role to be performed Determines the qualification necessary for those who enter into practice Has own body of knowledge, based on social and scientific principles Respected in society as honourable Orients the individual toward service, either to a community or to an organization Has a code of ethics for practice Autonomy in decision making and practice Constantly enlarges its body of knowledge through ongoing research Recognizes its responsibilities to develop educational programs Maintains a professional organization


THE PROFESSIONAL NURSE A graduate of a recognized nursing school who has met the requirements for a registered nurse in a state in which she is licensed to practice Candidates satisfy basic requirements for selection Training in recognized school/ college of Nursing Completes the basic course of study acc to the prescribed syllabus by INC Length of course as per programme On successful completion – Diploma or Bachelor’s Degree in Nursing


NURSING CURRICULUM - SUBJECTS Physical & biological sciences Anatomy & Physiology Microbiology & Pathology Physics & Chemistry Nutrition Social sciences Psychology & Sociology History of Nursing & Professional adjustments Others Research methodology Nursing Education Computer science Medical sciences Medicine & Surgery Paediatrics & Obstetrics Materia Medica Psychiatry Nursing sciences Medical & Surgical nursing Obstetrics & Gynaecological nursing Paediatric Nursing Community Nursing


FUNCTIONS OF A PROFESSIONAL NURSE Provide basic care to clients Administer treatments as advised Observe patients response and adaptation to illness Observe patients response and adaptation to treatments Teach self care and counsel on health matters Supervise/ guide in rehabilitative activities related to daily living Participate in research work related to health care Plan care with the patient (trust & self worth) Coordinate all services for client care Teach & supervise nursing students, auxiliary personnel and clients Maintain own physical and mental health


QUALITIES OF A NURSE Love for fellow beings, honest, courteous, dignified & loyal Disciplined, obedient, alert & intelligent Technically competent, resourceful & economic Dependable & adjustable Able to inspire confidence Sympathetic, empathetic, tactful & poised Patient & with a sense of humour Physically and mentally healthy Generous Gentle & quiet


A NURSE.. N – Nobility, Knowledge U - Usefulness, Understanding R – Righteousness, Responsibility S - Simplicity, Sympathy E - Efficiency, Equanimity


NEED TO DEFINE NURSE’S ROLE Need of contemporary nursing Role expansion Increased emphasis on health promotion & illness prevention Concern for holistic care Inter related roles


EXPANDED ROLES OF NURSE Care giver – Through holistic approach Communicator Teacher Protector and Client Advocate Counselor Change agent Leader Manager Decision maker- Uses Nursing Process Rehabilitator Comforter


CAREER ROLES OF NURSE Nurse Educator Clinical Nurse specialist Nurse practitioner Certified Nurse Midwife Nurse Anaesthetist Nurse Administrator Nurse Researcher Flight Nurse Aerospace Nurse Industrial Nurse School Nurse Hotel Nurse Nurse informaticist


SOCIETY’S INFLUENCE ON NURSING Technological advances Demographic changes Consumer movement Health promotion Women’s movement Human Rights Movement

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Nursing continues to grow………