INTRODUCTION TO NURSING.pptx

FOR FIRST YEAR GNM STUDENTS

1. INTRODUCTION TO NURSING SHAREEF KM, BSN, MSN

2. INTROduCTION TO NURSING Modern nursing is defined as a science and an art that focuses on promoting quality of life. Nursing has existed in various forms in every culture and it has changed greatly overtime from the oldest sense of “ a woman employed to take care of a child ” to the broadest sense in modern nursing as “ a professional promoting quality of life”.

3. Pioneers of nursing profession FLORENCE NIGHTINGALE VIRGINIA HENDERSON CLARA BARTON LILLIAN WALD LAVINIA. L. DOCK MARGARET SANGER

4. FLORENCE NIGHTINGALE Florence nightingale was born on 12 th May 1820 in Italy. She is considered as ‘ FOUNDER OF MODERN NURSING ’ She visited Kaiserwerth in 1847 and received 3 months training in nursing

5. Her achievements in improving the standards of care for war casualties in ‘Crimea’ earned her the title ‘ LADY WITH LAMP ’ She established Nightingale Training School at St Thomas Hospital, London in 1860. She is recognised as nursing’s first scientist-theorist for her work ‘NOTES ON NURSING- WHAT IT IS AND WHAT IT IS NOT’ in 1860. She died in London on 13 th August 1910. Since 1965, ‘ Internatinal Nurses Day’ has been celebrated on her birth day each year.

6. CRIMEAN WAR Florence nightingale's most famous contributions came during crimean war in 1853. T he crimean war broke out in between Russia and England and its allies. By 1854 approximately 18 thousand soldiers had been admitted to military hospitals. Poor care of wounded soldiers was being delivered by over worked medical staff. hygiene was being neglected and mass infections were common and many of the fatal.

7. CRIMEAN WAR- cntd .. N ightingale received a letter from secretary of war asking her to organise a corpse of nurses to attend the sick soldiers in Crimea. B y focusing on basic environmental factors like air water light drainage and cleanliness she reduced the death rate from 42 % to 2 %. Her activities and experiences in the crimean war served the foundations of modern nursing.

8. Virginia Henderson (1897 - 1996) Famous for he r  definition of Nursing . Developed in nursing need theory Listed 14 fundamental needs of individuals.

9. Clara Barton Organising nursing services in American civil war Played a role in establishing American Red cross

10. Lillian Wald Founder of public health Nursing Offered trained nursing services to poor in the New York slums

11. Lavinia L Dock Campaigned for legislation to allow nurses rather than physicians to control their profession

12. Margaret sanger Founder of planned parenthood Imprisoned for opening the first birth control information clinic in America.

13. Nursing C oncept Concept is defined as labels given to ideas objects and events, a summary of thoughts or a way to categorize thoughts or ideas. Eg : comfort, pain

14. Four Central concepts of Nursing are 1 . Person or client : the recipient of nursing care (includes individuals families groups and communities) 2. Environment : the internal and external surroundings that affect the client. 3. Health : the degree of wellness of well being that the client experiences. 4. Nursing : the attributes characteristics and actions of the nurse providing care on behalf of or in conjunction with the client.

15. Nursing theory N ursing theory is a creative and rigorous structuring of ideas that project a tentative purposeful and systematic view of phenomena 1. Environmental theory 2. Nursing need theory 3. Self care theory 4. Neuman's System model 5. Roy's Adaptation model

16. 1. Environmental theory Florence nightingale She linked health with 5 environmental factors      1. Pure or fresh air        2. Pure water        3. Efficient drainage       4. Cleanliness       5. Light, especially direct sunlight

17. 2. Nursing need theory Virginia henderson Viewed nurse's role as helping the client from dependence to independence

18. 3. Self care theory Dorothea Orem Includes three related concepts:        1. Selfcare        2. Self care deficit        3. Nursing systems Nursing systems of three types:        Wholly compensatory system        Partially compensatory system        Supportive educative system

19. 4. Neuman's System model Betty Neuman The client is viewed as an open system and nursing interventions focus on retaining or maintaining system stability.

20. 5. Roy's Adaptation model Sister Callista Roy Views the client as a bio psychosocial adaptive system that employees a feedback cycle of input ( stimuli), through put ( control process) and output behavior or adaptive responses.

21. Meaning of Nursing The word nurse originated from the Latin word ' nutrire ' which means ‘ to nourish’, ‘to protect’, ‘to educate’, ‘to support’ and ‘to supply ’. Dictionary meaning of nursing is to feed a baby. As a profession nursing means practice of providing care for sick and infirm. Three components of Nursing- head, heart and hand- are referred to as science spirit and skill of Nursing

22. Definitions of Nursing 1 . The art of utilizing the environment of a patient to assist him in his recovery . Florence nightingale (1860)

23. 2 . T he unique function of a nurse is to assist the individual, sick or well in the performance of those activities contributing to health or its recovery (or to peaceful death) that he would perform unaided if he had the necessary strength ,  will or knowledge and to do this in such a way that to help him gain independence as rapidly as possible. Virginia henderson (1960)

24. 3 . Nursing is the diagnosis and treatment of human responses to actual or potential health problems. ANA (1980)

25. Scope of Nursing Nurses provide care for three types of clients- individual, families and communities. Nursing practice involve the following areas. 1. To promote and maintain health and wellness 2. To prevent illness. 3. To restore health and function 4. To alleviate suffering 5. To facilitate independence 6. Care of dying

26. Roles and functions of nurse Nurses assume a number of roles when they provide care and oft en  carry out these roles concurrently Care giver Communicator Teacher Client advocate Counselor Change agent Leader Manager Case manager Research consumer Expanded career roles

27. 1. CAREGIVER I ncludes activities that assist the client physically and psychologically while preserving client's dignity. It may involve full care of completely dependent client. partial care of partially dependent client and supportive educative care to assist clients in attaining their highest possible level of health and wellness .

28. 2. COMMUNICATOR Nurse must be able to communicate clearly and accurately. Nurses communicate with client, support person, other health professionals and people in the community. Nurses identify clients problem and then communicate this verbally or in writing to the other members of the health team .

29. 3. TEACHER As a teacher the nurse helps clients to learn about the health and health care procedures they need to perform to restore or to maintain health. Nurse also teach unlicensed assistants  to whom they delegate care and share their expertise with other nurses and health professionals.

30. 4. CLIENT ADVOCATE A client advocate acts to protect the client. Nurse represent the client's needs and wishes to other health professionals and assist clients to exercise their rights .

31. 5. COUNSELOR Counseling is the process of helping a client to recognize and cope with stressful psychological or social problems to develop improved interpersonal relationships and to promote personal growth. It involves providing emotional intellectual  and psychological support.

32. 6. CHANGE AGENT The nurse act as a change agent when assisting clients to make modifications in their knowledge and behavior. Nurses often act to make changes in a system such as a clinical area if it is not helping a client return to health .

33. 7. LEADER A leader influences others to work together to accomplish a specific goal. Effective leadership is a learnt process .

34. 8. MANAGER The nurse manages the nursing care of individuals, families and communities. The nurse manager also delegates nursing activities to ancillary workers and other nurses and supervises and evaluates their performances . M anaging requires knowledge about organizational structure, authority and accountability, leadership, change theory, advocacy, delegation and supervision and evaluation.

35. 9. CASE MANAGER Nurse case managers work with the multidisciplinary healthcare team to measure the effectiveness of the case management plan and to monitor outcomes. Case managers help to ensure that care is oriented to the client while controlling costs .

36. 10. RESEARCH CONSUMER Nurses often use research to improve client care through evidence based practice.

37. 11. Expanded career roles This roles allow  greater independence and autonomy.

38. a) nurse practitioner b) clinical nurse specialist c) nurse anesthetist d) nurse midwife e) nurse researcher f) nurse administrator g) nurse educator h) nurse entrepreneur Expanded career roles

39. NURSE PRACTITIONER A nurse who has an advanced education and is a graduate of a nurse practitioner program. Usually deal with non emergency acute or chronic illness and provide primary care .

40. CLINICAL NURSE SPECIALIST A nurse who has an advanced degree or expertise and is considered to be an expert in the specialized area of practice.

41. NURSE ANESTHETIST A nurse who has completed advanced education in accredited program in anesthesiology. They carry out pre-operative assessments and administer general anesthetics for surgery under supervision of a physician .

42. NURSE MIDWIFE An RN who has completed a program in midwifery and is certified. The nurse gives prenatal and postnatal care and managers deliveries  in normal pregnancy.

43. NURSE RESEARCHER Nurse researchers investigate nursing problems to improve nursing care and to refine and expand nursing knowledge.

44. NURSE ADMINISTRATOR M anages client care including delivery of nursing service. The functions of nurse administrators include budgeting, staffing and planning programs.

45. NURSE EDUCATOR T hey are employed in nursing programs at educational institutions and are responsible for classroom and clinical teaching .

46. NURSE ENTREPRENEUR A nurse who usually has an advanced degree and manages a health related business.

47. HISTORY OF NURSING IN INDIA Military nursing was the earliest type of Nursing. In 1664 East India company started a hospital for soldiers at fort Saint George Madras. In 1797 a lying in hospital for the poor of Madras was built. I n 1854 government sanctioned a training school for midwives in Madras.

48. HISTORY OF NURSING IN INDIA- Contd.. In 1865 as an effect of 'suggestions on a system of nursing for hospitals in India ' by Florence nightingale reforms in military hospital lead to reform the civilian hospitals . G raduates were sent out from the Nightingale School of Nursing at Saint Thomas hospital England to start similar schools in our country. I n 1867 Saint Stephen's hospital at Delhi was the first one to begin a training for Indians as nurses.

49. HISTORY OF NURSING IN INDIA- Contd.. In 1871 the first school of nursing was started in government general hospital Madras . In 1891 Bai kashibai Ganpat what's the first Indian nurse to come for training. In 1908 trained nurses association of India ( TNAI ) was formed. I n 1918 training schools we re  started for health visitors and dais at Delhi and Karachi . In 1926 first nurses registration act passed in Madras In 1942 ANM program started

50. HISTORY OF NURSING IN INDIA- Contd.. In 1943 school of nursing at RAK College New Delhi started. In 1946 4 year BSc nursing program started in R A K college and CMC Vellore. In 1947 INC act passed. In 1959 to 1960 MSc nursing started in RAK College of Nursing In 1963 post basic programs started in various institutions. In 1972 basic degree program started in Kerala. In 1987 MSc nursing started in Kerala

51. LEVELS OF NURSING EDUCATION IN INDIA Now there are seven levels of nursing education in India. They are Auxillary nursing and midwifery (ANM) - 2 years General nursing and midwifery (GNM) - 3 years Basic bachelor of Nursing (BSc Nursing) - 4 years Post basic bachelor of Nursing (PB-BSc Nursing) - 2 years Masters in nursing (MSc Nursing) - 2 years Masters of philosophy in nursing (MPhil) - 1 year Doctorate in philosophy in nursing (PhD) - minimum 2 years.

52. Nursing as a profession Profession has been defined as an occupation that requires extensive education special knowledge skill and preparation.

53. Nursing as a profession A profession is distinguished from other kinds of occupation by 1. Specialised education 2. Body of knowledge 3. Service orientation 4. Ongoing research 5. Code of ethics 6. Autonomy and 7. Professional organisation Nursing is recognised as a profession now.

54. Qualities of a professional nurse 1. Caring. Caring is one of the essential quality of a nurse. Nurses having this quality will have a significant impact on their success in nursing field.

55. 2. Empathy. Being able to understand another individuals needs and feelings. ie , putting yourself in that situation. Sympathy . Emotional involvement with other people.

56. 3. Communication skills . Without the ability to interpret and convey communications correctly, medical errors are not likely to occur, patients often feel neglected or misinformed. So , strong communication skills are critical characteristic of a nurse.

57. 4. Commitment to patients. Giving importance to keeping patients safe, delivering the highest quality of care more than any other things.

58. 5. Health. Physical and mental health of a nurse is pivotal in delivering quality care.

59. 6. Time management. Caring multiple patients in stressful care settings requires ability for effective time management. Punctuality serves as the first step of time management.

60. 7. Leadership. Nursing is a teamwork and leadership quality helps to go smoothly with health care team.

61. 8. Problem solving skills. As nurses  generally have the most one-on-one time with patients and often responsible for decision making related to their care, problem solving skills are essential. 

62. Other qualities are ... 9 . Courtesy - Polite and respectful 10. Patience 11. Impartial 12. Cooperative 13. Poise - should be able to control emotions 14. Self discipline 15. Honesty 16. Courage 17. Attention to details 18. Sense of humor 19. Willingness to learn 20. Critical thinking

63. Ethics in nursing Ethics is expected standards of moral behaviour of a particular group. I t is a systematic enquiry into principles of right and wrong conduct .

64. Ethical principles Autonomy : Right to make one's own decisions Nonmaleficence : Duty to do no harm Beneficence : Doing good Justice : Referred to as fairness

65. Ethical principles- Contd … Fidelity :To be faithful to agreements and promises Veracity :Telling the truth Accountability : Answerable to oneself and others for one's own actions

66. Code of ethics A code of ethics is a formal statement of groups of ideals and values. It is a set of ethical principles that Are shared by members of the group Reflect their moral judgment over time Serve as a standard of their professional actions

67. Purposes of nursing code of ethics I t informs the public about the minimum standards of the profession It provides a sign of the profession's commitment to the public , it serves It prevents the nurses from practicing if their conduct is poor It provides general guidelines for professional behaviour It protects the news who is falsely accused of doing something wrong It guides the profession in self regulation It reminds nurses of the special responsibilities they are CM when caring for the sick It can be taken as a guide when legal actions must be taken in a lawsuit

68. Code of ethics by ICN (International Council of Nurses) PREAMBLE Nurses have four fundamental responsibilities : to promote health, to prevent illness, to restore he alth and to alleviate suffering . The need for nursing is universal. I nherent in nursing is respect for human rights including the right to life to dignity and to be treated with respect.

69. PREAMBLE- contd … Nursing care is unrestricted by considerations of age colour creed culture disability or illness gender nationality politics race of social status. New render health services to the individuals family and the community and co-ordinate their services with those of related groups.

70. Elements of the code T he ICN code of ethics for nurses has four principal elements that outline the standards of ethical conduct 1. Nurses and people 2. Nurses and practice 3. Nurses and the profession 4. Nurses and co workers

71. 1. Nurses and people The nurse's primary personal responsibility is to peopl e requiring nursing care. In providing care the nurse promotes an environment in which the human rights values customs and spiritual beliefs of the individual family and community are respected The nurses ensure that the individual receives sufficient information on which to base consent for care and related treatment. T he nurse holds in confidence personal information and uses judgement in sharing this information.

72. 2. Nurses and practice The nurse carries personal responsibility and accountability for nursing practice and for maintaining competence by continual learning The nurse maintains a standard of personal health such that the ability to provide ca re is not compromised The nurse uses judgement regarding individual competence when accepting and delegating responsibility. The nurse at all times maintain s standards of personal conduct which reflect well on the profession and enhance its image and public confidence The nurse in providing care ensures that use of technology and scientific advances are compatible with the safety dignity and rights of people .

73. 3. Nurses and the profession The nurse assumes the major role in determining and implementing acceptable standards of clinical nursing practice management research and education. The nurs e is active in developing a core of research based professional knowledge that supports evidence based practice The nurse acting through professional organisation participates in creating a positive practice environment and maintaining safe equitable social and economic working conditions in Nursing The nurse is active in developing and sustaining a code of professional values

74. 4. Nurses and co workers The nurse sustains a collaborative and respectful relationship with coworkers in nursing and other fields. The nurse take appropriate action to safeguard individuals families and communities when their health is endangered by co-worker or any other person. The nurse take appropriate action to support and guide co-workers to advance ethical conduct.