Introduction to Nursing Nursing: a service that provides preventative, promotional, diagnostic, therapeutic rehabilitative & hospice /palliative care to people - Restoration of health - Promotion of Health - Providing emotional support (death prep) - Prevention of Illness Nurse: A licensed healthcare professional that dynamically works dependently, independently or interdependently for the restoration of patient health. History of Nursing Early Civilization: The theory of animism associates the presence of a “spiritual essence” within all matter. It was believed that good health was attributed to good spirits while sicknesses correlated sin, evil spirits & God’s displeasure. - Physician: Priests (care through prayer to rid spirits & natural remedies ) - Nurse: Mothers (care through physical care, herbal remedies and monitoring) - Medical institutes: Temples First hospital: Roman Empire established it under St. Jerome Christian Period: Nursing obtained a more formal role as people saw the importance of it. Nursing orders were founded during the 11th-13th century during crusades and memebers visited the sick, buried the dead and gave nursing care. Christian faith influenced dedication to care for poor / ill 16th Century: Western societies were not as religiously oriented and focused on warfare, exploration and knowledge causing a depletion in nurse care and medical institutions. Convicts filled in these gaps as nurses in lieu of jail sentences which arose bad reputations as well as low pay and overworking. 18th-19th Century: Modern Nursing Social reforms changed the outlook of nurses and women giving rise to more acceptance and opportunity https://www.medicalnewstoday.com/articles/323633 4000 BC:Deborah referred to as a nurse accompanied Rebekah ( genesis 24) Florence Nightingale Born May 12, 1820, raised by wealthy family in England and began nurse training at 31. Opportunity arose during the Crimean War in Turkey as medical aid was needed, she returned to England after the war and made many contributions : - Establishing a nursing school (St. Thomas, London 1860) - Writing books about nursing and healthcare - Identifying needs of patients - Establishing standards for hospital management - Recognizing nutrition is important for health 19th Century-Now Hospitals saw economic advantages of establishing schools as staff can be easily controlled and cheaper. Female nursing students and graduates were under control by male administrators following Victorian view of male dependency, this along with lack of educational standards slowed progress towards professionalism. During World War II many nurses began working outside home and gained independency, assertiveness and increased emphasis on education. Nursing continues to expand in many areas and aspects as technology is improved, becoming more accessible to women around the world. The role of nursing in promoting health, publication of research and recognition of nursing as a professional discipline are some examples of changes through the years. https://www.studocu.com/row/document/the-university-of-the- https://ceufast.com/blog/a-history-of-nursing-education? history-of-nursing-in-trinidad/84411314 id=CjwKCAjwoJa2BhBPEiwA0l0ImHUKz1IBm-zX1JNHuDpq6Be- west-indies-st-augustine/leadership-and-management-in-nursing/ gad_source=1&gbraid=0AAAAAD_vKCVSeRo9gHl6k3JoOokscw3Ud&gcl LeFf4shQ9l60aWDG6tC8QXpnQlYMjxoC82wQAvD_BwE Nursing in Trinidad & Tobago Essential Competencies of Nurses: Cognitively skilled: - Critical thinker Caring, empathetic, focused, helpful, dedicated, physical endurance, good thinker, good judgement, hard worker, effective communication skills, adaptable, emotionally stable - using knowledge for a scientific rationale of patients condition - Selecting plans with the highest possibility of the best outcome Interpersonally skilled: - Able to communicate with patients, partner’s & colleagues - Building relationships with patients to give colleagues valuable information - Work collaboratively with colleagues Technically skilled: - Able to effectively use equipment - Efficient manual dexterity and eye-hand coordination - Able troubleshoot in event of equipment malufunction Ethically / Legally skilled: - Mediate conflicts between patients, nurses and other staff - use legal safeguards - Be faithful to professional codes of conduct Change agent: Initiate changes / assist clients to make life modifications in themselves / the system / manager Roles of nurses & execution: Health promotion: - Educating patients on healthy lifestyles (sleep, diet excersise)) - Giving them a clear understanding of their ailments (causes, prevention & care) - Referring resources (pharmacies, doctors, physicians, therapists) - Screenings (blood tests, pressure, check ups) Preventing illness: - Providing health information/ education - Health assessments in institutions (eg. vaccinations in primary school) Health restoration: - Monitioring symptoms and progression of infirmity - Providing direct care (cleaning patients, feeding, administering medication) - Maintaining records & reports and referring them to coworker/ physicians Coping with disability and death - Emphasing patients’ remaining strength to motivate them to keep pushing - Hospice care for preparation of death - Providing emotional support - Referring to support systems (therapists) - Developing a collaborative relationship with patients and coworkers Health: The state of complete physical, mental, social and spiritual state, well being and functioning of an indidvidual not only the presence / absence of infirmity. (An adjustment & process that adapts the individual to physical & social environment). The optimum capacity of an individual for effective performance of roles / tasks Wellness: An active practice / process of being more aware & making healthy habits to promote good health / healthy lifestyle (in all aspects) Health literacy: The ability for patients to comprehend basic information necessary to maintain health (Patients with mental disabilities may have less health literacy) Nursing as a professional discipline: A profession is a calling that requires special knowledge, skill and preparation Nursing has been categorized as a profession based off the following criteria; - A systemic body of knowledge in field & ungoing knowledge base - Standarized formal higher education required - Service provision to society - Recognition of autonomy (Self-governance and independent decision making) - Code of ethics ( Set of rules to maintain structure and etiquette in workplace) - Evidence based practices and ongoing research - Recognized authority by a professional group - Protection of members (nursing council) Educational Preperation: Licensed practical nurse (LPN): Practical nursing program These are health care professionals responsible for patient care & comfort - Monitor patients & collecting data - Manage basic care (administering meds, tending to patients etc.) - Keep up to date medical records National Council Licensure Examination-Practical Nurse (NCLEX-PN) for licensure Registered nurse (RN): diploma, associate degree or baccalaureate A graduate trained nurse who is licensed by a state of authority after qualification (advanced responsibilities similar to LPNs) - Supervise LPNs - Create nursing care plans - Patient teaching/ education - Find cases (identification of patients & recommend resources) - Triage (assessment to determin urgency of patient care ) National Council Licensure Examination-Registered Nurse (NCLEX-RN) for licensure https://nursejournal.org/resources/lpn-vs-rn-roles/ Levels of graduate education (degrees in nursing) Masters: Preps for. educational settings, managerial roles (eg. clinical specialists, nurse–midwives and nurse practitioners) Doctoral: Preps for academic advancement, organizational management and to carry out research necessary to advance nursing theory and practice. Levels of healthcare Primary healthcare: check ups in the community (no issue, preventative) Secondary healthcare: There is a health concern (assistance needed) Tertiary healthcare: Bad enough to be hospitalized (serious assistance needed) Determinants of a healthy lifestyle -Good sleep - Healthy weight - Good energy - Feeing calm / Relaxed - Good digestion - Normal medical test results Healthy planning process: - Review & summaries data from assessment - Reinforce strengths & competencies of the client - Idenitfy health goals & related behavioural change options - Identify behavioural / health outcomes that indicate the plan has been successful from the client’s perspective - Address environmental & interpersonal facilitators & barriers to behaviour change - Determine the time frame for implantation of your goals - Commit to behaviour- change goals & supports needed to accomplish them Information required about client / patient - physical health status - physical fitness - nutritional status - sources of life stress - spirituality Physical - social support Spiritual Emotional Individual Social Intellectual Socio-political and economic influences on nursing 1. Demographic changes - Movement from rural to urban centers - Increased lifespan - Increased incidence of chronic , long term illnesses - Increasd incidence of diseases (cancer) 2. Women’s Healthcare Issues - Women’s liberation (1975) - Increased demand for colonic, political, occupational and educational equity - Federal government requires research studies to include women 3. Increasing Disaster 4. Human Rights Movement - Societal views of the rights of minorities - Nurses must respect human rights of all clients and their rights to quality care Next class: Nursing council, ethics aspects of nursing, nursing in Trinidad The Nursing Council Recognized body incorporated by law which: 1) Regulates the nursing & midwifery professions 2) Protects the public The Nursing Council of Trinidad and Tobago (NCTT): Established: June 1950 Persons in charge: The Nurses and Midwives ordinance then Nurses and Midwives Registration Act no.33 of 1960, chapter 12 no.19 Members: 17 council meme bee include (Vice) President & Treasurer Purpose: Provides for the 'Registration of Nurses and Midwives, enrolment of nursing assistants and other connected matters. Function: 1) Registration of nurses (general, psychiatric, Midwives, nursing assistants) 2) Sets standards for education, the practice of nursing & codes of conduct 3) Conducts exams at all levels of training 4) Reviwes transcripts of applicants 5) Interviews applicants seeking Trinibagonian registration 6) Revises curricula 7) Attends to matters pertaining to nursing students in accordance with act 8) Enforces appropriate disciplinary action for misconduct 9) Advocates for patients & public 10) Inspects & approves places of training, affiliate places of training for students Ethical Issues in Nursing Values: Strong personal belief / ideals persons strive to uphold (reflect cultural/ social influences, relationships and personal needs and develop / change over time) Ethics: Branch of philosophy concerned with determining right & wrong in relation to people’s decisions & actions (morals: personal standards) Professional Ethics: Principals & values with universal application & standrds of conduct in all situations Bioethics: Ethical principles specific for healthcare (direct patient care) Involves direct patient care, allocation of resources utilization of staff & research) Nursing ethics: (subset of Bioethics) Ethical standards that govern / guide nurses that acts as an expression of how nurses ought to conduct themselves Nosocomial: infections obtained in hospital Ethical Principles - Autonomy: independence, self-determination (concent for procedures) - Nonmalefience: Avoiding harming clients - Beneficence: Doing good for patients, best outcome is given - Justice: Fairness / equity - Veracity: Truthfulness, reciprocal relationship between nurse & patient - Fidelity: Practicing faithfully within boundaries of the state and law - Privacy: Limiting exposure of patient’s body - Confidentiality: Protection of private health care information Code of Ethics Set of rules of ethical / moral behavior for all circumstances to balance / prioritize certain practices in decision making. Primary Values: - Safe, compassionate, competent and ethical care - Promoting optimum health / well being - Respecting informed decision making - Main ing privacy / confidentiality - preserving dignity / recognizing worth of patients - Promoting justice and accountability Nursing standards: The desirable / achievable level of performance which expected Standards of Nursing Prac tice - Accountability - Continuing competence / educational - Application of knowledge, skills and judgement - Professional relationships and advocacy - Professional leadership - Self-Regulation (rest, health) Ethical dilemmas force a choice between 2 or more ethical principles (picking one can violate another) How to process ethical dilemmas: 1. Assess wether or not a situation is an ethical dilemma 2. Gather information relevant to the case 3. Examine / determine your own values on the case 4. Verbalize issue 5. Consider courses of action 6. Negotiate the outcoms 7. Evaluate action Pioneers of Nursing Mary Ann Todd Lincoln (1818-1882), Wife of Abraham Lincoln (16th President) - Aided soldiers in civil war, Helped US department of veteran affairs - Formalized roles for women in Healthcare Sophie Mannerheim (1863-1928) - Established Finland's first nursing school - Founded modern nursing in Finland - Promoted professionalization of nursing as a discipline Isabella Baumfree / Sojourner Truth (Black) (1797-1883) - First Africian American to win a court case against a white man - Speech: "Ain't I a Woman" (1851) - Recruited Africian American soldiers during Civil War & advocated for equality Lillian Hollandharvey (Black) (1912-1994) - Initiated the first baccalaureate program of nursing in Tuskegee - Made advanced nursing degrees more accessible to blacks Mary Mahoney (Black) (1845-1926) - First Africian American to graduate from a professional nursing program (1879) - Co-founder the National Association of Coloured Graduate nurses, NACGN (1908) Sarah Emma Edmonds (1841-1898) - Only female member of Grand Army of the Republic (advocated for females in military) - Disguised as a male nurse during civil war (patriarchy & male dominated) Louisa May Alcott (1832-1888) - Treated soldiers during civil war - Contracted typhoid fever - Known for her literacy legacy and service in healthcare Margaret Sanger - Launched the "Woman Rebel" advocating for birth control - Open the first birth control clinic (Brownsville clinic) - Influenced the crane ruling which allowed the use of birth control - Founded American birth control league - Developed the first oral contraceptive pill (created by Gregory Pincus) - Comstock law referred to as " Zombie law" Anna Caroline Maxwell (1851-1929) - The "American Florence Nightingale" - America’s first professional nurse - Established a nursing school at a Presbyterian hospital - Director of the St. Luke's training hospital school for nurses Florence Nightingale (1820-1910) - Lady with the Lamp - Established St. Thomas nursing school in London (1860) - Founder of modern nursing; known for her work during the Crimean War - Advocated for nursing education and nursing as a profession. Lilian D Wald (1867-1940) - Founded Henry St. Settlement (education, employment, housing) - Founded Nursing Organization of Public Health - Advocated for women's right, social reform and labor laws Clara Barton (1821-1912) - "Angel of the Battlefield" because of her Frontline nursing during civil war - Founded American red cross in 1881 (motivated by Mary Lincoln) Edith Cavell - Humanitarian efforts during World War II - Helped soliders escape through tunnels ( helped 200 escape to Hollon) Kofoworola Abeni Pitt (Black) - First black matron in University College Hospital in Ibadan Nigeria - Helped improve Healthcare infrastructure and conditions for nurses Malinda Ann Judson Richards (1841-1930) - Americas first formally trained nurse - Founder of modern nursing education - Established nursing schools in the US and Japan Hazel Winifred Johnson-Brown (Black) (1927-2022) - 1st Africian American female general and chief of US Army nurse corps - Diversified US Army nurse corps - Mentored young nurses & advocated for higher standards in military nursing edu Ruby Bradley (1907- 2002) - Frontline combat nurse in Korean war - Most decorated nurse ( over 34 medals including Florence Nightingale medal) - Assisted in 230 surgeries and delivered 13 American babies Christiane Reiman (1888-1979) - 1st Danish nurse to receive a bachelors and masters degree in nursing - Advocated for ICN and helped setting up services for the government Virginia Henderson (1897-1996) - Nurse, educator, researcher and author - Published "Principles of practical nursing" in 1955 - Developed the"Need theory" (essentials for health / well being of patients) Martha E. Roger's (1914-1994) - Nurse theorist and educator - Developed the theory of "science of unitary human beings" Mary Breckingridge (1881-1965) - Founded the Frontier Nursing Service in Kentucky - Established the first nurse midwivery school in the US (1939) - Advocated for heal are reform Helen Fairchild (1885-1918) - Served in hospital during World War I - Advocated for veterans and the rights / well being of nurses Mary Seacole (1805-1881)(Black) - Jamaician nurse - Challenged racial & gender stereotypes Dorothea Dix (1802-1887) - Made opportunities for females in nursing - Established schools in Boston - Established 32 hospitals and mental institutions - Reformed many asylum Elizabeth Grace (1846-1926) - Established the international nursing council - Medical practioner act (1919) - Registration Act - Midwives Act
