Chapter 1 Evolution of Nursing and Nursing Education

What Is Nursing? • Profession that combines art and science • Balances clients’ independence

Evolution of Nursing • Origins of nursing • Religious influences • Demands of war

Origins of Nursing • Deborah – First nurse recorded • Hospitals in East and

Religious Influences • Male nurse-priests • The Crusades – Knights of St. John –

Demands of War • Greater need for nurses – Crimean War – Civil War

Florence Nightingale • • 1820 to 1910 Uncommonly educated Founder of modern nursing Reduced

Nursing Pioneers and Leaders • • • Lillian Wald Isabel Hampton Robb Jane Delano

Nursing Pioneers and Leaders • • • Lavinia Dock Mary Breckinridge Martha Franklin Amelia

Nursing Pioneers and Leaders • • • Mary Mahoney Harriet Neuton Phillips Linda Richards

Nursing in the th 20 Century • Flexner Report (1910) – Study of 155

Nursing in the th 20 Century • Early insurance plans: – Blue Cross and

Nursing in the th 20 Century • Landmark reports in nursing education: – Goldmark

Nursing in the th 20 Century • Contemporary reports: – – – National Commission

Nursing in the th 20 Century • Health care professionals’ competencies – Outcome from

Social Forces Affecting Nursing • 1960 s – – – Increase in access to

Social Forces Affecting Nursing • 1970 s – – Economic recession Professional autonomy debate

Social Forces Affecting Nursing • 1980 s – – – Nursing more specialized and

Social Forces Affecting Nursing • 1990 s – – More responsibility for nurse Aging

Nursing Education Overview • Licensure for entry to professional practice – Two levels of

Nursing Education Programs • • • Diploma Associate’s degree (AD) Bachelor of science in

Diploma Education • St. Thomas’s Hospital in London – Nightingale (1860) • U. S.

Associate’s Degree Programs • Mildred Montag (1951) • Aim: – Nursing technician for bedside

Baccalaureate Programs • First in 1909 • Slow growth since World War II (continued)

Baccalaureate Programs • American Association of Critical-Care Nurses (AACN) essential components: – – –

Master’s Degree Programs • First at Teacher’s College, New York (1899) • Growth in

Master’s Degree Programs • Nontraditional graduate programs for licensure Copyright © 2011 Delmar, Cengage

Professional Doctoral Programs • Various degrees – E. g. , Ph. D, DNSc, Ed.

Staff Development and Continuing Education • Necessary to maintain knowledge and skill needed for

Preparing Nurses for Tomorrow • Differentiated practice • Accelerated degree programs • Technology changes

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What Is Nursing? • Profession that combines art and science • Balances clients’ independence and dependence during illness • Promotes health in life • Maintains dignity in death Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Evolution of Nursing • Origins of nursing • Religious influences • Demands of war • Florence Nightingale • Nursing pioneers and leaders • Nursing in the 20 th century • Social forces affecting nursing Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Origins of Nursing • Deborah – First nurse recorded • Hospitals in East and West • Buddha’s influence • Spread of Christian service to ill Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Religious Influences • Male nurse-priests • The Crusades – Knights of St. John – Teutonic Knights – Knights of Lazarus • Emerging role of women Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Florence Nightingale • • 1820 to 1910 Uncommonly educated Founder of modern nursing Reduced mortality and morbidity during Crimean War • Opened Nightingale Training School of Nurses in London (1860) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nursing in the th 20 Century • Flexner Report (1910) – Study of 155 medical schools in United States (U. S. ) and Canada – Resulted in medical education reform – Adelaide Nutting proposed similar study for nursing education in 1911 (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nursing in the th 20 Century • Landmark reports in nursing education: – Goldmark (1923) – Brown (1948) – The Institute of Research and Service in Nursing Education (1950 s) – Canadian reports (1930 s) (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nursing in the th 20 Century • Contemporary reports: – – – National Commission on Nursing (1980) Institute of Medicine (1979) Secretary’s Commission on Nursing (1987) Healthy People (1979, 1991, 2000) Pew Health Professions Commission (1990 s) (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nursing in the th 20 Century • Health care professionals’ competencies – Outcome from Pew Health Professions Commission – List of competencies to address needs of clients Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Social Forces Affecting Nursing • 1960 s – – – Increase in access to health care Shortage of nurses and physicians Feminist movement Inception of nurse practitioners Focus on health maintenance (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Social Forces Affecting Nursing • 1970 s – – Economic recession Professional autonomy debate Development of nursing theories Integration of nursing education into university setting – Rise in political activism (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Social Forces Affecting Nursing • 1980 s – – – Nursing more specialized and autonomous Rapid technologic advances Nurse practitioner acceptance Greater demand for nursing services Proliferation of health maintenance organizations (HMOs) (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Social Forces Affecting Nursing • 1990 s – – More responsibility for nurse Aging population Nursing shaping policies for health care reform Stronger advocate for vulnerable populations Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nursing Education Overview • Licensure for entry to professional practice – Two levels of entry: • LPN • RN – NCLEX-PN or NCLEX-RN • Advanced practice Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Nursing Education Programs • • • Diploma Associate’s degree (AD) Bachelor of science in nursing (BSN) Master’s degree Professional doctorate Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Diploma Education • St. Thomas’s Hospital in London – Nightingale (1860) • U. S. programs – – Apprenticeship training in hospitals Dependent on medicine Standardization in 1940 s Reduction in popularity Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Associate’s Degree Programs • Mildred Montag (1951) • Aim: – Nursing technician for bedside • Expanded competencies in 2000 • Account for nearly two-thirds of all entry-level programs Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Baccalaureate Programs • American Association of Critical-Care Nurses (AACN) essential components: – – – Liberal education Professional values Core competencies Core knowledge Role development Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Master’s Degree Programs • First at Teacher’s College, New York (1899) • Growth in mid-20 th century – Need for qualified faculty in entry-level programs – Administrators – Advanced practice roles (continued) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Professional Doctoral Programs • Various degrees – E. g. , Ph. D, DNSc, Ed. D, DPH • Preparation as researchers and educators • Nontraditional doctoral programs for licensure (ND) Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Staff Development and Continuing Education • Necessary to maintain knowledge and skill needed for practice • Continuing education units (CEUs) • Lifelong learning Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Preparing Nurses for Tomorrow • Differentiated practice • Accelerated degree programs • Technology changes in nursing education • Service learning Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.