Basic Nursing: Foundations of
Skills & Concepts
Chapter 4
NURSING
HISTORY,
EDUCATION AND
ORGANIZATION
Nursing: An Art…A Science
By using scientific knowledge in a
humane way, nursing combines rational,
scientific methods with caring behavior.
 Nursing focuses not on the illness but the
client’s response to illness.
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Historical Overview
Nursing is an ancient profession that has
evolved alongside human civilization.
 Religion heavily influenced this evolution.
Many early hospitals were tied to
organized religion.
 During the industrial revolution, scientific
methods became more important.
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Florence Nightingale
The founder of modern nursing.
 She established the first school for nurses
that provided theory-based knowledge
and clinical skill-building.
 Encouraged the belief that there is a body
of nursing knowledge distinct from
medical knowledge.
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Nightingale’s Accomplishments
Demonstrated the value of nursing care in
reducing morbidity rates in the Crimean
War
 Established the Nightingale School for
Nurses at St. Thomas’ Hospital in London
 Advocated the principles of cleanliness
and nutrition in promoting health
 Developed public awareness of the need
for nurses.
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The Civil War & Nursing
America’s tragic conflict underscored the
need for nursing.
 Clara Barton (1821-1912) volunteered her
nursing skills and organized the Red
Cross in the United States after the war.
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Pioneers of Nursing
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Lillian Wald: First community health nurse.
Isabel Hampton Robb: Founded nursing organizations.
Adelaide Nutting: First nurse appointed as university
professor.
Lavinia Dock: Author of early textbooks.
Mary Breckenridge: Serviced rural America.
Mamie Hale: Educator of midwives.
Mary Mahoney: America’s first African-American nurse.
Linda Richards: America’s first trained nurse. (Note: The term
trained nurse preceded registered nurse).
“Practical” Nursing
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Women who cared for others, but who
had no formal education, often called
themselves “practical nurses.”
Early Practical Nursing Schools
Ballard School. Opened in 1892 in New
York City by the YMCA.
 Thompson Practical Nursing School.
Established 1907 in Brattleboro, Vermont.
Still operating today.
 Household Nursing School. Founded in
1918 in Boston.
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Nursing Education Changes
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The Goldmark Report: Published in 1923, this
report concluded that for nursing to be on an
equal footing with other disciplines, nursing
education should occur in the university setting.
Institute of Research and Science
in Nursing Education Report: Resulted in the
establishment of practical nursing under Title III
of the Health Amendment Act of 1955. This led
to a growth in practical nursing schools in the
U.S.
Nursing Education: LP/VNs
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LPNs (Licensed Practical Nurses) and LVNs
(Licensed Vocational Nurses) work under the
supervision of an RN or other licensed provider
such as a physician or dentist.
Education is focused on basic nursing skills and
direct client care.
Educated in community colleges, hospitals,
vocational programs.
Nursing Education: RNs
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RNs (Registered Nurses) may operate
autonomously and may supervise
LP/VNsLVNS.
Education is focused on basic nursing skills and
direct client care.
Educated in universities, community colleges,
hospitals.
Diploma Programs
Typically 3 years in length and offered by
hospitals.
 Graduates receive diploma rather than a
college degree.
 Program emphasizes basic skills
particularly suited for hospital clients.
 Such programs contribute 6% of nurse
graduates.
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Associate Degree Programs
2-year program offered through community
colleges or as options at four-year universities.
 Graduate receives Associate Degree in Nursing
(ADN).
 Program stresses basic skill preparation with
clinical practice occurring increasingly in
community-based institutions (e.g. ambulatory
settings, schools and clinics).
 Such programs contribute 60% of nurse
graduates.
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Baccalaureate Degree Programs
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Typically 4 years in length, offered through
colleges and universities.
Graduate receives Bachelor of Science in
Nursing (BSN)
Emphasizes preparation for practice in
nonhospital settings, broader scientific content,
and systematic problem-solving tools for
autonomous and collaborative practice.
Such programs contribute 34% of all nursing
graduates.
Nursing Organizations
American Nurses Association (ANA)
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Purpose: To improve the quality of nursing care.
Established 1911.
Establishes standards for nursing practice.
Establishes a professional code of ethics.
Develops educational standards
Oversees a credentialing system.
Influences legislation affecting health care.
For RNs only.
Publications: American Journal of Nursing; American Nurse
Nursing Organizations
National Association for Practical Nurse Education
and Service, Inc. (NAPNES)
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Purpose: To improve the quality, education, and recognition of
nursing schools and LP/VNs in the U.S.
Established 1941.
Provides workshops, seminars, and continuing-education
programs.
Evaluates and certifies continuing-education programs of others.
Provides individual student professional liability insurance program.
For LPs/VNs.
Publications: Journal of Practical Nursing; NAPNES
Forum.
Nursing Organizations
National Federation of Licensed Practical
Nurses, Inc. (NFLPN)
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Purpose: Provide leadership for LP/VNs.
Established 1949.
Encourages continuing education.
Establishes principles of ethics.
Represents and speaks for LP/VNs in Congress.
Offers members best type of low-cost insurance.
For LPs/VNs.
Publication: AJPN (quarterly newsletter)
Nursing Organizations
National League for Nursing (NLN)
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Purpose: To identify the nursing needs of society and to
foster programs designed to meet these needs.
Established 1952.
Accredits nursing education programs.
Conducts surveys to collect data on education
programs.
Provides continuing-education programs.
Open to all nurses and non-nurses.
Publication: Nursing & Health Care.
Nursing Organizations
National Council of State Boards of Nursing, Inc. (NCSBN)
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Purpose: Provides an organization through which boards of nursing
act together on matters of common interest and concern.
Established 1978.
Develops and administers licensure examinations for RN and
LP/VN candidates.
Maintains a national disciplinary data bank.
Serves as the national clearinghouse of information on nursing
regulation.
Publications: Issues; NCLEX-RN Program Reports; NCLEX-PN
Program Reports.