Overview from Nightingale to Current Day

Learning Objective 1 Describe the impact of nursing history and theory on the evolution of roles for professional nursing.

Nursing History Prehistoric – “curse”, “spirits” Early Civilization – Egypt, Greece, China, Middle Ages – Roman Catholic Church, Crusades (Hospitalers) Renaissance and Reformation – medical advances, “Dark Ages” of Nursing, plagues, Sisters of Charity

Nursing History, cont. Colonial America – purgatives and bleeding, pesthouses, 1 st hospital in Philadelphia Florence Nightingale – Crimean War – asepsis, patient records, statistics, 1 st nursing school in England Mary Seacole – Jamaican, Crimean War

Nursing History United States –Civil War – Dorothea Dix (military hospitals), Tubman, Truth, Taylor, Clara Barton; OJT; students staffed hospitals –1900 to WWI – nurse registry, public health nursing; ANA and NLN –WWI and the 1920s – home to hospital, insulin, PCN, military nurses, Vassar Camp School for Nurses, Frontier Nursing Service (Breckenridge)

Nursing History Great Depression – nurses became unemployed, Social Security Act of 1935 created nursing jobs World War II – nurses functioned under combat conditions Post WWII – national nursing education standards, ADN programs developed 1960’s – Medicare & Medicaid, hospital proliferation, home health growth

Nursing History 1970’s – APN’s, hospice, American Academy of Nursing, increase in male nurses 1980’s – DRG’s, case management, organ transplants, critical care, OP Services, nursing school enrollment drops, registered care technologists 1990’s – 12-hour shifts, shift differentials, AIDS,

Nursing History 21 st Century – aging population, increasing clinical errors, nation’s largest health care profession

Nursing Theory Steps of Scientific Process –Hypothesis – the “question” –Method – how will I answer the question –Data Collection – implement method –Results – statistics –Evaluation – compare results to hypothesis

Nursing Theory Terms –Concept – Labels given to ideas, objects, events; a summary of thoughts or a way to categorize thoughts or ideas –Conceptual Model – A structure to organize concepts (ideas) –Philosophy – Values and beliefs of the discipline

Nursing Theory Terms, cont. –Theory – The organization of concepts or constructs that shows the relationship of the ideas with the intention of describing, explain, or predicting; the purpose is the make scientific findings meaningful and generalizable; our goal in science has been to explain predict, and control.

Nursing Theory Major theorists –Florence Nightingale –Hildegard Peplum –Faye Abdellah –Ida Jean Orlando –Virginia Henderson –Myra Levine

Nursing Theory Major theorists, cont. –Martha Rogers –Betty Neuman –Dorothea Orem –Imogene King –Sister Callista Roy –Madeline Leninger

Nursing Theory Major Theorists, cont. –Jean Watson –Margaret Newman –Dorothy E. Johnson –Rosemarie Rizzo Parse –Patricia Benner

Nursing Theory A century between Nightingale and Peplum 1970’s saw most theories developed Theory development going on today Will a theory/model drive your practice?

Nursing Theory Summary of selected theories/conceptual models –Nightingale Founder of modern nursing Environmental adaptation Statistics –Peplum Interpersonal Relations as a Nursing Process: Man as an Organism that exists in an unstable equilibrium

Nursing Theory Summary of selected theories/conceptual models –Rogers Science of Unitary Human Beings: Humans as Energy Fields that interact constantly with the Environment –Orem Self-Care Deficit Model: Self Care, Self-Care Deficits, and Nursing Systems

Nursing Theory Summary of selected theories/conceptual models –Roy Adaptation Model: Assistance With the Adaption to Stressors to Facilitate the Integration Process of the Client –Watson Theory of Human Caring: Transpersonal Caring as the Fulcrum; Philosophy and Science as the Care of Nursing

Nursing Theory Summary of selected theories/conceptual models –Newman Health as Expanding Consciousness –Mishel Uncertainty of Illness

Critical Thinking Definitions –The rational examination of ideas, assumptions, principles, conclusions, beliefs, and actions –Reasonable reflective thinking that focuses on decisions about actions and beliefs –Purposeful, autonomous judgments that lead to interpretation, analysis, inference, evaluation,a and explanation

Critical Thinking Definitions –Self-directed rational thinking that validates what we know and identifies what we do not know –A set of requisite abilities necessary for defining problems, recognizing assumptions, developing hypotheses, drawing conclusion and validating inferences

Critical Thinking Components –Mental Operations Decision-making Reasoning –Knowledge Declarative – specific facts or information Operative – an understanding of the nature of that knowledge –Attitudes Curiosity Open-mindedness

Critical Thinking Skills –Interpretation – categorize, decode sentances, clarify meanings –Analysis – examine ideas, identify and analyze arguments –Influence – query evidence, conjecture alternatives, draw conclusions –Explanation – state results, justify procedures, present arguments –Self-regulation – self-examination, self-correction

Critical Thinking Behaviors –Recognize the existence of a problem (stimulus for change) –Consider new ways of problem-solving –Establish criteria for assessing the effectiveness of an action –Learn from one’s mistakes –Transfer learning from one situation to another –Create innovative solutions to complex problems

Critical Thinking Relationship to Nursing Process –Assessing –Planning –Diagnosis –Implementing –Evaluating Critical Thinking is necessary to the success of the Nursing Process

Review of Objective Describe the impact of nursing history and theory on the evolution of roles for professional nursing.