Nursing History 1

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.

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.

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.

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.

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.

Pioneers of Nursing        

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 

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.

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.

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.

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)       

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)     

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)      

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)     

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.