Chapter 1
Introduction to Nursing
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Historical Perspective/Early Civilizations
to the 16th Century #1
 Theory of animism
o Good spirits brought health; evil spirits brought
sickness and death.
o Roles of nurse and physician separate and distinct:
physician as medicine man; nurse as caring mother.
 Ancient Greek civilization
o Temples became center of medical care.
o Nurses cared for the sick in the home and
community; practiced as nurse-midwives.
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Historical Perspective/Early Civilizations
to the 16th Century #2
 Early Christian period
o Nursing has formal and more clearly defined role;
deaconesses made visits to the sick.
o Nursing developed purpose, direction, and
leadership.
 16th century
o Shift from a religious orientation to an emphasis on
warfare, exploration, and expansion of knowledge
o Nursing had a poor reputation; nurses received low
pay and worked long hours in unfavorable conditions.
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Question #1
Tell whether the following statement is true or false.
In the beginning of civilization, the role of the physician
was carried out by the medicine man and the nurse was
the mother who cared for her family during sickness.
A. True
B. False
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Answer to Question #1
Answer: A. True.
Rationale: In the beginning of civilization, The physician
was the medicine man who treated disease by chanting,
inspiring fear, or opening the skull to release evil spirits.
The nurse usually was the mother who cared for her
family during sickness by providing physical care and
herbal remedies.
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Historical Perspective/19th to 20th Century
 Social reforms changed the roles of nurses and of women
in general.
 Nursing as we now know it began, based on many of the
beliefs of Florence Nightingale.
o Nightingale challenged prejudices against women
and elevated the status of all nurses.
o She established the first training school for nurses,
and wrote books about health care and nursing
education.
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Historical Perspective/19th to 21st Century
(cont.)
 Hospital schools organized to provide more easily
controlled and less expensive staff for the hospital.
 Female nurses were under the control of male hospital
administrators and physicians.
 World War II
o Large numbers of women worked outside the home
and became more independent and assertive.
o Explosion in medicine and technology broadened the
role of nurses.
o Growth of nursing as a professional discipline.
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Historical Perspective/1950s to Present
 Nursing broadened in all areas
o Practice in a wide variety of health care settings
o The development of a specific body of knowledge
o The conduct and publication of nursing research
o Recognition of the role of nursing in promoting health
o Increased emphasis on nursing knowledge as the
foundation for EBP lead to growth of nursing as a
professional discipline
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Contributions of Florence Nightingale #1
 Identified personal needs of patient and role of nurse in
meeting them
 Established standards for hospital management
 Established nursing education and nursing as a respected
occupation for women
 Recognized the two components of nursing: health and
illness
 Established nursing education
 Believed that nursing is separate and distinct from
medicine
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Contributions of Florence Nightingale #2
 Recognized that nutrition is important to health
 Instituted occupational and recreational therapy for sick
people
 Stressed the need for continuing education for nurses
 Maintained accurate records, recognized as the
beginnings of nursing research
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Definitions of Nursing
 Originated from the Latin word nutrix (to nourish)
 ICN definition—Promotion of health, prevention of illness,
collaborative care
 ANA definition—Social policy statement
 Patient is central focus of all definitions
o Includes physical, emotional, social, and spiritual
dimensions of the patient
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Question #3
A hospital nurse works collaboratively with a primary
care provider, social worker, physical therapist, and
home health care nurse to provide nursing care for a
patient following an MVA. What should be the central
focus of this care?
A. The nurses
B. The physician
C. The nursing care plan
D. The patient
E. The physical therapist
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Answer to Question #3
Answer: D. The patient
Rationale: The central focus in all definitions of nursing is
the patient (person receiving care), which includes the
physical, emotional, social, and spiritual dimensions of
that person. Nursing is no longer considered to be
concerned primarily with illness care.
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Four Blended Competencies
 Cognitive
 Technical
 Interpersonal
 Ethical/Legal
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Question #4
A nurse who uses critical thinking skills to develop a
nursing care plan for an expectant mother of triplets is
said to be using which skill?
A. Cognitive
B. Technical
C. Interpersonal
D. Ethical/Legal
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Answer to Question #4
Answer: A. Cognitive
Rationale: Cognitive skills involve thinking about the
nature of things sufficiently to make decisions regarding
care. Technical skills enable nurses to manipulate
equipment to produce a desired outcome. Interpersonal
skills involve caring relationships. Ethical/legal skills
enable nurses to conduct themselves morally and
professionally.
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QSEN Competencies
 Patient-centered care
 Teamwork and collaboration
 Quality improvement
 Safety
 Evidence-based practice
 Informatics
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Nursing’s Aims
 Promote health
 Prevent illness
 Restore health
 Facilitate coping with disability or death
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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
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Factors Affecting Health
 Genetic inheritance
 Cognitive abilities
 Educational level
 Race and ethnicity; culture
 Age and gender
 Developmental level
 Lifestyle; environment
 Socioeconomic status
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Healthy People 2020 Health Promotion
Guidelines
 Attain high-quality, longer lives free of preventable
disease, disability, injury, and premature death.
 Achieve health equity, eliminate disparities, and improve
the health of all groups.
 Create social and physical environments that promote
good health for all.
 Promote quality of life, healthy development, and healthy
behaviors across all life stages.
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Preventing Illness
 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
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Restoring Health
 Performing assessments that detect an illness
 Referring questions and abnormal findings to other
health care providers, as appropriate
 Providing direct care to the person who is ill
 Collaborating with other health care providers in
providing care
 Planning, teaching, and carrying out rehabilitation for
illnesses such as heart attacks, arthritis, and strokes
 Working in mental health and chemical-dependency
programs
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Facilitating Coping With Disability and
Death
 Maximizing person’s strengths and potentials
o Patient teaching
o Referral to community support systems
 Providing end-of-care
o Hospice programs
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Interrelated Roles of Nurses
 Caregiver
 Communicator
 Teacher/Educator
 Counselor
 Leader
 Researcher
 Advocate
 Collaborator
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Question #5
Tell whether the following statement is true or false.
A nurse who explains a surgical procedure to a patient in
order to obtain informed consent is fulfilling the role of
counselor.
A. True
B. False
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Answer to Question #5
B. False.
Rationale: A nurse who explains a surgical procedure to a
patient in order to obtain informed consent is fulfilling the
role of advocate.
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Nursing as a Professional Discipline
 Well-defined body of specific and unique knowledge
 Strong service orientation
 Recognized authority by a professional group
 Code of ethics
 Professional organization that sets standards
 Ongoing research
 Autonomy and self-regulation
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Educational Preparation for Nursing
Practice
 Practical and vocational nursing education
 Registered nursing education
o Diploma in nursing
o Associate degree in nursing
o Baccalaureate in nursing
 Graduate education in nursing
 Continuing education
 In-service education
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Guidelines for Nursing Practice
 Standards of Nursing Practice
 Nurse Practice Acts and Licensure
 Nursing Process
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Nurse Practice Acts
 Define legal scope of nursing practice
 Create a state board of nursing to make and enforce
rules and regulations
 Define important terms and activities in nursing,
including legal requirements and titles for RNs and LPNs
 Establish criteria for the education and licensure of
nurses
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Question #6
Which of the following establishes criteria for the
education and licensure of nurses?
A. Nursing process
B. Nurse practice acts
C. ANA standards of nursing practice
D. National League for Nursing
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Answer to Question #6
Answer: B. Nurse practice acts
Rationale: Nurse practice acts regulate the practice of
nursing, including education and licensure. Nursing
process is a guideline for nursing practice, enabling
nurses to implement their roles. ANA standards of
nursing practice protect and allow nurses to carry out
professional roles. The National League of Nursing fosters
the development and improvement of nursing services.
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The Nursing Process
 One of the major guidelines for nursing practice
 Helps nurses implement their roles
 Integrates art and science of nursing
 Allows nurses to use critical thinking and clinical
reasoning
 Defines the areas of care that are within the domain of
nursing
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NLN Ten Trends to Watch For Nursing
Education #1
 Changing demographics and increasing diversity
 The technological explosion
 Globalization of the world’s economy and society
 The era of the educated consumer, alternative therapies,
and genomic and palliative care
 The shift to population-based care and the increasing
complexity of patient care
 The cost of health care and the challenge of managed
care
 The impact of health policy and regulation
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NLN Ten Trends to Watch For Nursing
Education #2
 The growing need for interdisciplinary education and
collaborative practice
 The current nursing shortage/opportunities for lifelong
learning and workforce development
 Significant advances in nursing science and research
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Early Signs of Fatigue in Nursing
Profession
 Compassion fatigue
 Burnout
 Secondary traumatic stress
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