Introduction
Nursing is a profession
focused on assisting individuals, families, and communities in attaining,
maintaining, and recovering optimal health and functioning. Modern
definitions of nursing define it as a science and an art that focuses
on promoting quality of life as defined by persons and families, throughout
their life experiences from birth to care at the end of life.
Nursing has existed
in various forms in every culture, although the definition of the
term and the practice of nursing has changed greatly over time. The
oldest sense of the word in the English language a woman employed
to suckle and generally care for a younger child. The former being
known as a wet nurse and the latter being known as a dry nurse.
In the 15th century,
this developed into the idea of looking after or advising another,
not necessarily meaning a woman looking after a child. Nursing has
continued to develop in this latter sense, although the idea of nourishing
in the broadest sense refers in modern nursing to promoting quality
of life.
It
was during time of war that a significant development in nursing history
arose when Florence Nightingale, working to improve conditions of soldiers
in the Crimean War, laid the foundation stone of professional nursing
with the principles summarised in the book Notes on Nursing. Florence
Nightingale was fundamental in establishing the realization of the need
for nurses and she could be considered the "Mother of Modern Nursing."
Other important nurses in the development of the profession include:
Mary Seacole, who also worked as a nurse in the Crimea; Agnes Elizabeth
Jones and Linda Richards, who established quality nursing schools in
the USA and Japan, and Linda Richards who was officially America's first
trained nurse, graduating in 1873 from the New England Hospital for
Women and Children in Boston.
New
Zealand was the first country to regulate nurses nationally, with adoption
of the Nurses Registration Act on the 12th of September , 1901. Ellen
Dougherty was the first registered nurse. North Carolina was the first
state in the United States to pass a nursing licensure law in 1903.
Nurses have experienced
difficulty with the hierarchy in medicine that has resulted in an
impression that nurses primary purpose is to follow the direction
of medics. This tendency is certainly not observed in Nightingale's
Notes on Nursing, where the doctors are mentioned relatively infrequently
and often in critical tones, particularly relating to bedside manner.
The modern era has seen the development of nursing degrees and nursing
has numerous journals to broaden the knowledge base of the profession.
Nurses are often in key management roles within health services and
hold research posts at universities.
The aim of the
nursing community worldwide is to develop the profession guided by
continuing education based on nursing research, and to regulate standards
of competency and ethics. There are a number of educational paths
to becoming a professional nurse, which vary greatly worldwide, but
all involve extensive study of nursing theory and practice and training
in clinical skills.
The authority
for the practice of nursing is based upon a social contract that delineates
professional rights and responsibilities as well as mechanisms for
public accountability. In almost all countries, nursing practice is
defined and governed by law, and entrance to the profession is regulated
at national or state level.
Nursing practice
is primarily the caring relationship between the nurse and the person
in their care. In providing nursing care, nurses are implementing
the nursing care plan, which is based on a nursing assessment.
Definition
Although nursing
practice varies both through its various specialities and countries,
these nursing organisations offer the following definitions:
Nursing encompasses
autonomous and collaborative care of individuals of all ages, families,
groups and communities, sick or well and in all settings. Nursing
includes the promotion of health, prevention of illness, and the care
of ill, disabled and dying people. Advocacy, promotion of a safe environment,
research, participation in shaping health policy and in patient and
health systems management, and education are also key nursing roles.
International
Council Of Nurses
The use of clinical
judgement in the provision of care to enable people to improve, maintain,
or recover health, to cope with health problems, and to achieve the
best possible quality of life, whatever their disease or disability,
until death."
Royal
College Of Nursing UK
Nursing is the
protection, promotion, and optimization of health and abilities; prevention
of illness and injury; alleviation of suffering through the diagnosis
and treatment of human responses; and advocacy in health care for
individuals, families, communities, and populations.
Nursing
theory and Nursing process
In general terms,
the nursing process is the method used to assess and diagnose needs,
plan and implement interventions, and evaluate the outcomes of the
care provided. Like other disciplines, the profession has developed
different theories derived from sometimes diverse philosophical beliefs
and paradigms or worldviews to help nurses direct their activities
to accomplish specific goals. Currently, two paradigms exist in nursing,
the totality paradigm and the simultaneity paradigm.
Nurses practice
in a wide range of settings, from hospitals to visiting people in
their homes and caring for them in schools to research in pharmaceutical
companies. Nurses work in occupational health settings, free-standing
clinics and physician offices, nurse-run clinics, long-term care facilities,
and camps. They also work on cruise ships and in military service.
Nurses act as advisers and consultants to the healthcare and insurance
industries. Some are attorneys and others work with attorneys as legal
nurse consultants, reviewing patient records to assure that adequate
care was provided and testifying in court. Nurses can work on a temporary
basis, which involves doing shifts without a contact in a variety
of settings, sometimes known as per diem nursing, agency nursing or
travel nursing.
Regulation
of practice
The practice of
nursing is governed by laws that define a scope of practice, generally
mandated by the legislature of the political division within which
the nurse practices. Nurses are held legally responsible and accountable
for their practice. The standard of care is that of the "prudent
nurse."
List
of nursing specialties
Nursing is the
most diverse of all healthcare professions. Nurses practice in a wide
range of settings but generally nursing is divided depending on the
needs of the person being nursed.
-
the nursing of people with mental health problems - Psychiatric
and mental health nursing
-
the nursing of people with learning or developmental disabilities
-
the nursing of children - Pediatric nursing.
-
the nursing of older adults - Geriatric nursing
-
the nursing of people in their own homes - Home health nursing (US),
District nursing and Health visiting (UK).
There are also
specialist areas such as cardiac nursing, orthopedic nursing and oncology
nursing.