History of Nursing profession.pptx.......

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1. History of Nursing profession Linda Mogambi RN, BSc, MSc .

2. Global trends in nursing Intuitive / pre-colonial Apprentice nursing Christian era / orders Military orders Educated nursing Contemporary nursing

3. Intuitive Nursing /Pre- Christian era Ancient practices of nursing, all over the world was carried out in different ways in different countries. This was untaught nursing carried out through instincts, and mostly carried out by women These practices continued to develop in response to needs created by a changing society as a result of people of diverse cultures being brought together by civilization .

4. Intuitive/ pre- colonial nursing Throughout history, general care of the sick was carried out by women Care of women during pregnancy and child birth was a hereditary family profession. The nurse was a domestic servant who gave instinctive care to the sick and needy and carried out the prescribed treatments Various ancient civilizations had their own unique way of unraveling the cause of ill health, and taking care of the sick in the society. There was no organized care, but this was based on instincts

5. Apprentice Nursing Learning on the job Extends from 6 th to 11 th century with religious nursing orders Orders were groups of people whose primary concern was to care for the sick, poor, orphans, widows, aged, slaves and prisoners

6. Christian Era Christian religion sprang from Judaism where care was given for charity and for Christian love As a result, monastic orders were established for the sick and care provided by women and men from the religious orders The order of the Deaconess was the first organized visiting service in the 4 th AD . This included a group of wealthy and influential Roman matrons, friends and followers of St. Jerome whose role included nursing among other Christian duties

7. Order of knights of Hospitallers of St John of Jerusalem; Had a branch in every country of Christdom where they founded and maintained hospitals. Nursing roles were performed by `serving brothers’. A subsidiary women’s order was formed whose members nursed in the hospital at Jerusalem. Today this exists as St. John’s Ambulance association and voluntary nursing corps. The Roman empire conquered most of Europe and built hospitals in monasteries during the reign of Constantine the Great. Nursing care was given to the sick, including soldiers wounded at war in Christian hospitals under care of deaconesses and deacons.

8. Christian Era cont… The underlying values at that time have been described as asceticism, which were; Dedicated individuals who committed their lives to the care of others Carers who denied their own needs in order to serve others Provision of basic needs of food, shelter and clothing Nursing was a vocation/ call and there was no monetary gain .

9. Military order (Renaissance period) Period characterized by Christian revolution and growth of protestant churches in Europe Most monasteries were done away with. This became the darkest age in nursing history Nursing was mainly done by uncommon women (prisoners and prostitutes)therefore viewed as menial and cheap The growth of nursing therefore stagnated Civilization growth was very slow and many pestilences affected the world such as natural calamities, diseases and poverty. This forced revival of several nursing groups and training of deaconesses in Europe

10. Educated nursing Started in 1860 by Florence Nightingale (mother of modern nursing) She was born in 1820 from a wealthy family and was well educated, travelled and collected information from public hospitals and later became recognized for her work Established the first nursing philosophy based on health maintenance and restoration Her views on nursing came from a spiritual philosophy developed in her adolescence and adulthood, and reflected the changing needs of the society.

11. Florence Nightingale’s values Nursing is a calling Religious beliefs should be used to help people improve their health and existence Nursing is more than an occupation The work is very important and should be thought of as a religious vow. Nursing is an art and science Needs specific formal education Art gives nurses room to be creative and proactive

12. Mankind can achieve perfection Outcomes in life can be controlled Perfection can be pursued by understanding laws of nature Nurses should provide optimum environment in which health can be achieved Nursing is distinct and separate from medicine Caring process is central to nursing Medical model concentrates on diagnosis and treatment

13. She saw the role of nursing as having charge of somebody’s health based on knowledge of how to put the body in such a state to be free from disease or recover from disease Opened a nursing school in1860 which was the first organized program for training nurses She was the first practicing nurse epidemiologist, and her statistical analyses connected poor sanitation with cholera and dysentery She viewed nursing as a search for truth in finding answers to health care questions or discovering and using God’s law in nursing practice She brought major reforms in hygiene, sanitation and nursing practice

14. Contemporary nursing Started at the end of world war II to-date Scientific and technological inventions made nursing move from unskilled laborer to a well-educated member of society Nursing theories and philosophies developed to define the role of a nurse in health care These emphasize on the caring process and partnership between the professional nurse and the client / patient. Nursing profession has been changing in keeping with changing technologies, educational systems, policies, socio-economical changes, political climate and health trends

15. Pre-colonial ways of caring for the sick in Kenya The way of life of indigenous African people in Kenya depended on their economic activity. There were two major economies i.e. Agriculturalists and Pastoralists Societal division of labor Different age groups had special roles to play in the society. The men provided food, the women took care of homes, youth defended the community etc. The elders and diviners performed religious rites and treated the sick in the community. Disease and sickness was regarded in a superstitious way.

16. Societal division of labour Disease was regarded as result of transgression against the ancestors or the divinity. Observances such as ritual cleansing, magic and witchcraft were associated with treatment of the sick. In addition to these, special group of people with knowledge of treatment of various diseases by herbs and roots existed in the community. This special group passed the knowledge to each generation from father to son. Diviners/seers had special powers to discern diseases that affected the community as a group or as individuals and refer them to people specialized in treating the specific disease .

17. Causes of diseases Non specific causes Pestilences affecting the community as a result of displeasure of the gods e.g. in epidemics Transgression of ancestors e.g. suffering of the whole family Breach of taboos (special rules laid down for observance by the whole community). Witch craft; misfortune brought about by enemies. Curative methods Ritual cleansing including purification, appease of ancestral spirits, isolation of cursed individuals

18. Specific causes of diseases Patient referred to herbalists for treatment Medical and surgical treatment was done by men while care of pregnant women and children was done by women. Treatment was based on presenting symptoms Minor surgeries d one to treat cuts and fractures Public health measures Prevention of accidents Precautionary measures; removal of two lower incisors, isolation of people suffering from diseases Care of expectant mothers and infants

19. Trends in nursing practice In 1888, Imperial British East African Company was formed in Kenya and it introduced medicine Training of nurses was possible in hospitals with missionary doctors and nurses in 1910 First trainees were mostly men and were trained and referred to as dressers. Female nurses were trained much later and were referred to as orderlies and worked as ungraded dressers.

20. Training took three years and included hygiene, dressing of wounds and ulcers, taking observations and assisting in minor operations. Nurses worked under direction and discretion of doctors and there was no division between doctor and nurse’s work. Due to lack of education, they had little understanding of what and why they were doing. Training was segmented, conducted by individual missionary groups. By 1930’s 8 mission institutions were training nurses, independently in Kenya.

21. 1939- first organized training for nurse orderlies by the government. This was limited to basic skills like ward cleaning, feeding, bathing. The trainees were to provide care to the soldiers fighting in world war II Characteristics of the first nursing training ; Closely linked to medical training (medical model), nurses carried out doctors instruction, functions included feeding, bathing, cleaning wounds , giving medication, cleaning wards and linen Nursing was task oriented with limited psychological and emotional care. Need for standardized training of nursing personnel felt in 1948 by medical missions. The govt and medical missions met several times between 1948-1949 to discuss the same.

22. This resulted in formation of Nurses and midwives Registration Ordinance enacted in June 1949. The Nursing council of Kenya was established in 1950 through an act of parliament. This started training of assistant nurses grade 1 and 2. 1950- Enrolled nurse training; 2 year certificate course on general nursing; post basic midwifery and health visitors. Up to 1964, nurses had been training in bits i.e. health visitors, midwifery and general nurses. The need for comprehensive nurse was on demand hence enrolled nursing started in Kisumu

23. 1966; comprehensive enrolled community health nursing comprising general nursing, midwifery and community health nursing, 2 year course- currently being phased out. 1968; WHO and Kenya government started Advanced nursing programmes . This was the first nursing program at the university. It aimed at boosting teaching staff. The training took 2 years 1987; Registered community health nursing – diploma course, 3 ½ years training- currently forms majority of nurses in Kenya, mainly offered at medical training colleges. This move was to increase number of community health nurses at registered level to be posted to the rural health centers to supervise training of enrolled community health nurses.

24. 1988; Bachelor of Science in nursing; 4 year course with 1 year internship, offered at the university level. Focuses to strengthen nursing leadership, administration and research. Currently several universities, both public and private offering the course. 2002; post graduate degrees in nursing i.e masters and doctorate in nursing

25. Professionalism in nursing Profession - A vocation/ an occupation that requires advanced training in specialized field. It involves intensive academic preparation in that special area Professional - group of individuals whose members possess specialized knowledge which is acquired through formal education beyond basis schooling and that knowledge is not common to all members of the society. This formal education is prescribed by the law of the land

26. Stages of becoming a profession Existence of a body of knowledge Use of scientific method to enlarge body of knowledge (research) Emergence of a full time occupation as a result of training Provision of public service Establishment of a training school Founding of a professional association and political agitation towards protection of the same Professional policy Professional activity Establishment of a formal code of ethics

27. Professional organizations International Council of Nurses (ICN) First international organization for professional nurses Founded in 1899 but accepted in 1900 By 1973, there were 80 countries in full membership to ICN Kenya became a member in 1961 It’s a professional body that helps nurses in the world get together and present a united front It’s a self governing body whose functions are unrestricted by race, nationality, creed, politics, color, sex or social status Objectives include; Assist nurses associations improve standards of practice and competence through updating members on new developments Promote development of strong nurses associations; assist countries with no associations, support countries trying to start one Serves as an authoritative voice of nurses and nursing internationally Improve status of nurses Formulate code of conduct for nursing

28. National Nurses Association of Kenya (NNAK) Started in 1956 Accepted in 1961 by ICN Objectives Links Kenyan nurses with other nurses in the world through ICN Maintain standards of nursing practice through continuous professional development Acts as a media through which nurses channel their grievances to their employer Enables nurses to solidify their common understanding of the profession and get feedback from different branches to enable them talk with one voice Publishing and dissemination of nursing research Enforces the code of ethics Promote general health and welfare of the society

29. Nursing Council of Kenya (NCK) Before the establishment of NCK under the Nurses Cap 257 of the Laws of Kenya, the activities of the Council were governed by Ordinances. NCK started in 1949 by an act of parliament. Functions Establish and improve standards of nursing and health care in Kenya Make provisions for training of nurses; approve training institutions, prescribe and regulate syllabus for training nurses Prescribe and conduct exams for those seeking registration and enrollment into the nurses register Set and maintain standards of nursing education, practice and professional conduct Advice the minister of health on nursing matters Compile and maintain registers, rolls and licenses for nurses as required in the ACT

30. Factors influencing changes in nursing profession Demographic changes. Change in disease patterns; rising incidence of chronic diseases, emerging and re-emerging infections Human rights movement; special needs for cohort age groups hence change in traditional ways of nursing Rise of medically underserved population with no access to medical care due to rising cost of living, natural calamities, conflicts, institutionalized individuals(schools, prisons, mental institutions).

31. Factors influencing changes in nursing profession Improved educational standards Social revolution; consumerism- nurses deal with well educated clients Clients' perceived needs, wishes and expectations influence delivery of health care Economic revolution; advanced technology Cultural and religious diversity of clients