UNIT 1

COURSE LEARNING OUTCOMES

At the end of this chapter, the student will be able to:
 CLO1: Define nursing and other related terms.
 CLO2: Identify significant events and personages in the evolution of nursing
 CLO3: Describe nursing as a profession, occupation and as a discipline.
MODULE MARKERS
A. Materials:
 Instructional Module
 Blank paper
 Ballpen, colored pen and other instructional materials
 Textbook and other study references
 Medical Dictionary
B. Assessment Method:
 Self- Test  Reflective Journaling

 Critical Thinking Drills  Activity Sheet

TOPIC 1:
I. Introduction to Nursing
II. Nursing as a Profession

CONTENTS
1. Introduction
2. Course Learning Outcomes
3. Duration
4. Lecture Notes
5. Summary
1
 6. References/ Further Readings

1. Introduction

Studying nursing history allows nurses to understand more fully problems currently
affecting the profession, such as pay, regulation, shortage, education, defining practice,
autonomy, and unity. Present day nurses cannot effectively address these important issues
without a foundation of historical knowledge. In short, examining history allows nurses to more
fully appreciate their important role in the health care system.

2. COURSE LEARNING OUTCOMES

 CLO1: Define nursing

 CLO2: Identify significant events and personages in the evolution of nursing.
 CLO3: Describe nursing as a profession, occupation and as a discipline.

3. DURATION
 3 hours Guided Independent Study
 1-hour Self-Directed Learning

4. LECTURE NOTES
I. INTRODUCTION TO NURSING

 The Evolution of Nursing

“To understand where nursing is today, and where will it be tomorrow, it is necessary to look at
the past. We cannot see ahead without looking back. Knowledge of the past experience can
create a better understanding of the present and can cast some light on the pathway to planning
the future”-Unknown

How did nursing

get started?
2

pinterest.com
 1. PERIOD OF
INTUITIVE NURSING
I’m a Nomad. When someone got sick in
• The Prehistoric Man our tribe the women were in-charged in
nursing the sick. I believed that illness
was caused by the invasion of the victim’s
body by evil spirit through the use of
Black magic or Voodoo.

clipart.com

I’m the shaman. I used

hypnosis,
charms, dances, incantations,
purgatives, massage, fire,
water, herbs and trephining to
the sick.

Primitive people looked upon natural

Evil spirit might be kept
phenomena asaway
the work of gods:
through:
 The sun – was the breath of god
• Wearing of hideous mask
 Storms and earthquake- were the
• Making terrifying
works noises
of angry gods and demons
• Dancing  Sickness with intense suffering –
• Amulet were taught to be caused by some evil
spirit in possession of the sufferer
• Making offering/ sacrifices
clipart.com

fig 3
 pinterest.com

CONTRIBUTIONS TO MEDICINE AND NURSING

Egypt Introduced the art of embalming which enhanced their knowledge of human anatomy
and patient
They developed the ability to make keen observation and record of 250 recognized
diseases
There was no mention of nurses, hospital or personnel slaves patient’s families
nursed the sick.

Israel Moses is recognized as the “Father of Sanitation”

He wrote the books of the Old Testament which:
-Emphasized the practice of hospitality (Book of Genesis)
• Promulgated the rules of control on the spread of communicable disease and the ritual
of circumcision of the male child (book of Leviticus)
• Referred to nurses as midwives, wet nurses or child nurses whose acts were
compassionate and tender (outpouring of maternal instincts).

China -The people strongly believed in spirits and demons as seen in the practices such as
using girl’s clothes for male babies keep evil away from them.
- They practiced ancestor worship which prohibited the dissection of dead human
body.
-There was no mention of nursing in their records. It is assumed that the care of the
sick was done by female members of the household.
India - Men of medicine built hospitals, practiced an intuitive form of asepsis and were
proficient in the practice of medicine and surgery.

- Sushurutu made a list of function and qualifications of nurses. For the first time in
the recorded history, there was a reference to the nurse’s taking care of patients.
These nurses were described as combination of physical therapist and cook.

Greece Untrained slave.

-Hippocrates, born in Greece, was given the title “Father of Scientific Medicine”
-He made a major advance in medicine by rejecting the belief that diseases had
supernatural causes.
-Emphasized the rational treatment of sickness as natural rather than god-inflicted

4
 phenomenon.
-Recognized the need for nurses
Rome Fabiola was a worldly, beautiful Roman matron who was converted to Christianity
by her friends Marcella and Paula. With their help she made her home the first
hospital in the Christian world.

B. PERIOD OF APPRENTICE NURSING

This period extends from the founding of religious nursing orders in the crusades, which began
in 11th century and ended in 1836
• It is the period of “on the job” training. Nursing was performed without any formal
education and by people who were directed and by people who were directed by more
experienced nurses.

I’m a Crusader. I participated in any of the

military expeditions undertaken by Christian
powers in the 11th, 12th, and 13th centuries to
win the Holy Land from the Muslims. I provided
nursing care and defended the hospitals during
battle.

dreamstime.com

Military Religious Orders

-Knights of Saint John of Jerusalem (Italian)
-Teutonic Knights (German)
-Knights of St. Lazarus

Fig. 4 Secular Orders Founded During the Period of the Crusaders

- Order of St. Francis of Assisi -Augustinians
-The Beguines

5
 -Benedictines -The Oblates

IMPORTANT NURSING PERSONAGES DURING PERIOD OF APPRENTICE

• founder of the second Order of St. Francis of Assisi

St. Clare • took vows of poverty, obedience service and chastity
• gave nursing care to the sick and the afflicted
sunsigns.com •

• known as “Patroness of Nurses” and the daughter of Hungarian

king
• used all of her wealth to make the lives of the poor happy and
useful.

St. Elizabeth
sunsigns.com

• the first “Lady with a Lamp”

• She pledged her life to service at the age of seven and was
referred to as a little saint.
• She was a hospital nurse, prophetess, researcher and a reformer of
society and the church.

sunsigns.com

St. Catherine

In the 16th century, hospitals were established for

the area of the sick. The hospitals were gloomy,
cheerless, and airless. They were unsanitary. People
entered hospitals only under the compulsion or at last
resort. There was little employment and education was
only for the rich and the titled
PASTOR FLIEDNER

6
-Established the Kaisersworth Institute for the Training of Deaconess

Theodore Fliedner en.wikipedia.org

C. THE DARK PERIOD OF NURSING (17th – 19th Century)

-Nursing became the work of a least desirable of women

The wrath of Protestantism swept away everything connected with Roman Catholicism in
schools, orphanages and hospitals. Properties of hospitals and schools were confiscated. Nurses
fled for their lives. In England, hundreds of hospitals were closed. There were no provisions for
the sick, no one to care for the sick.

Dorothea Linde
Dix established
the Nursing Corps
of the United
States Army.
Site salientwomen.com

Clara Barton is the

founder of American Red
Cross. Site: womenhistory.org

D. PERIOD OF EDUCATED NURSING/NIGHTINGALE ERA 19TH-20TH CENTURY

The development of nursing during this period was strongly influenced by:
1. trends resulting from wars – Crimean, civil war
2. arousal of social consciousness
3. increased educational opportunities offered to women.
7
 Hello I’m Florence Nightingale the Mother of modern
nursing.
I was born on May 12, 1820 in Florence, Italy. I was
raised in England in an atmosphere of culture and
affluence. I worked as a superintendent for
Gentlewomen Hospital, a charity hospital for ill
governesses.
Sir Sidney Herbert of the British War Department asked
me to recruit female nurses to provide care for the sick and
injured in the Crimean War.
Florence Nightingale. natgeokids.com
In 1860, I opened The Nightingale Training School of
Nurses at St. Thomas Hospital in London

During my time, nursing evolved as an art and science.

activityvillage.co.uk

8
 NURSING DURING THE
PHILIPPINE REVOLUTION
The Prominent persons involved in the
nursing works
• Josephine Bracken
• Rosa Sevilla De Alvero
• Dona Hilaria de Aguinaldo
• Dona Maria de Aguinaldo
• Melchora Aquino (Tandang
Sora)
• Captain Salome Popularly known as “Tandang Sora,” Melchora Aquino
was just a regular woman who tended a store in
• Agueda Kahabagan Balintawak. But when the Philippine revolution started,
• Trinidad Tecson she housed sick and wounded Katipuneros in her
home and tended to them. She was later given the
name “Mother of Katipunan.” site: preen.ph

E. Period of Contemporary Nursing/20th

Century Hospitals and Nursing Schools

- Scientific and technological development • Iloilo Mission Hospital School of

Nursing (Iloilo City, 1906)
as well as social changes mark this period.
• St. Paul’s Hospital School of
- Health is perceived as a fundamental Nursing (Manila, 1907)
human right
• . Philippine General Hospital
- Nursing involvement in community health School of Nursing (1907)
- Technological advances – disposable • Philippine General Hospital School
supplies and equipment. of Nursing (1907)

- Expanded roles of nurses was developed • . Mary Johnston Hospital and

School of Nursing (Manila, 1907)
- WHO was established by the United
• Philippine Christian Mission
Nations
Institute School of Nursing.
- Aerospace Nursing was developed • San Juan de Dios Hospital School
- Use of atomic energies for medical of Nursing (Manila, 1913)
diagnosis, treatment • Emmanuel Hospital School of
Nursing (Capiz,1913)
- Computers were utilized-data collection,
teaching, diagnosis, inventory, payrolls, • Southern Island Hospital School of
record keeping, billing. Nursing (Cebu,1918)
9
- Use of sophisticated equipment for
diagnosis and therapy
 CEH: FCU BASE HOSPITAL
In 1913, the American Baptist
Foreign Mission Society sent Dr.
P.H.J. Lerrigo to Capiz for the
purpose of opening a hospital, Miss
Nicolet assisted him. The school
offered a 3-year training course for
annual fee of P100.00. Miss Ciara
Pedrosa was the first Filipino
Principal.

Capiz Emmanuel Hospital. skyscrapercity.com

Nursing Leaders in the Philippines

• Anastacia Giron Tupas- first Filipino Nurse to hold the position of Chief Nurse
Superintendent; founder of the Philippine Nurses association.
• Cesaria Tan- first Filipino nurse to receive a master degree in Nursing
• Socorro Sirilan- Pioneered in Hospital Social Service in San Lazaro Hospital where she
was the Chief Nurse
• Rosa Militar- A pioneer in school health education
• Sor Ricarda Mendoza- a pioneer in nursing education
• Socorro Diaz – first editor of the PNA magazine called “The Message”
• Conchita Ruiz- First full time editor of the newly named PNA magazine “The Filipino
Nurse”
• Loreto Tupaz- “Dean of the Philippine Nursing”; Florence Nightingale of Iloilo.

In essence, the nursing profession has very much been around since the beginning of
time, though has drastically evolved over the course of history. Today, nurses are one of the most

10
important professions within the health care industry and are learned in a wide range of
occupational duties that are utilized within a variety of settings throughout the world.

II. NURSING AS A PROFESSION AND OCCUPATION

In the past, there has been considerable discussion about
whether nursing is a profession or an occupation. This is
important for nurses to consider for several reasons.
An occupation is a job or a career, occupations require widely
varying levels of training or education, varying levels of skill,
and widely variable defined knowledge bases, whereas a
profession is a learned vocation or occupation that has a status
of superiority and precedence within a division of work.

pinterest.com.
In short, all professions are occupations, but not all occupations are professions
(Finkelman & Kenner, 2013).
Near The End of The 20th Century:
 Nursing was viewed as an occupation rather than a profession.
 Nursing has had difficulty being deemed a profession because many of the services
provided by nurses have been perceived as an extension of those offered by wives and
mothers.
 Historically, nursing has been seen as subservient to medicine, and nurses have delayed
in identifying and organizing professional knowledge.
 Education for nurses is not yet standardized, and the three-tier entry-level system
(diploma, associate degree, and bachelor’s degree) into practice that persists has hindered
professionalization because a college education is not yet a requirement.
 Finally, autonomy in practice is incomplete because nursing is still dependent on
medicine to direct much of its practice.

Why Nursing is called a profession?

- To be considered a profession there needs to be specialized
knowledge and training. Nursing requires both. The nursing
profession is both an art and a science. Nurses are
frequently called on to be activists in order to affect health care for
the larger good.
11
What defines nursing as a profession?
- Nursing is a profession within the health care sector focused on the care of
individuals, families, and communities so they may attain, maintain, or recover
optimal health and quality of life. Nurses provide care both interdependently, for
example, with physicians, and independently as nursing professionals.
B. Nursing as an Academic Discipline
A discipline is “a branch of knowledge ordered through the theories and methods
evolving from more than one worldview of the phenomenon of concern” (Parse, 1997, p. 74). It
has also been termed a field of inquiry characterized by a unique perspective and a distinct way
of viewing phenomena (Butts, Rich, & Fawcett, 2012; Parse, 1999).
Nursing’s knowledge base draws from many disciplines. In the past, nursing depended
heavily on physiology, sociology, psychology, and medicine to provide academic standing and to
inform practice. In recent decades, however, nursing has been seeking what is unique to nursing
and developing those aspects into an academic discipline.

Expanded Roles of Nurses

• Nurse Generalist- Nurse generalists have mastery in certain practice of nursing. Licensed
practical or vocational nurses are usually considered generalists.
• Nurse Clinician- perform direct nursing actions in specialty areas. .A clinical nurse
specialist is a registered nurse who completes additional specialised training and education to
provide more specific types of care. They often possess advanced degrees, such as a master's or
Ph.D. They receive training that allows them to deliver comprehensive care to patients with
complex medical requirements
•

• Nurse Practitioner- requires advanced educational or nursing practice and must be

certified by a government body that they may practice so..A nurse practitioner is a registered
nurse with an advanced level of training who possesses the authority to offer specialised care
services to patients and supervise teams of caregivers. They typically select a speciality or a specific
patient demographic, such as acute care, neonatal health or paediatrics. In some regions, they may
operate under the guidance of physicians, while other areas may provide them with complete
authority to practise.

• Nurse Specialist- requires one to have master’s degree in nursing and must have
specialization in a particular field of nursing
.

] 12
 National Nurses Week is May 6 to May 12.
This annual week to honor nurses has been celebrated
for over 40 years. It even ends on the day that
Florence Nightingale was born! National nurses’
week was established to acknowledge the challenging
job of being a nurse and to let nurses know that their
hard work is recognized and appreciated.

8
1. What are the common home practices regarding the care of the sick have you experienced
before? Did you apply them when caring for someone who is sick? What do you think is the
foundation of such practices? Could they be used in nursing too? Why or why not?

5. SUMMARY
What are the main points in this topic?
 Religious organizations and military have played a major role in the development of
nursing and healthcare
13
  Initially the role of the nurse was limited to bathing, feeding and supporting the patient.\;
keeping the patient environment clean and orderly; and providing support to the
physician.
 Registered nurses (RNs) are nurses who have successfully completed a registered nurse
education program and have passed a licensure exam
 Nurses have different roles that engaged in promotion, illness prevention, health
restoration and care of the dying.
 The economy, technology, increased consumer involvement in healthcare are forces that
strongly affected nursing.

6. SELF-DIRECTED LEARNING
 Reflective Journaling
- What particular field of nursing you are planning to pursue in the future? Why?
7. REFERENCES/ FURTHER READINGS
Alligood, Martha R. (2017) Nursing theorists and their work. Elsevier (Singapore) Pte Ltd
Wilkinson, Judith et al (2015) Fundamentals of nursing thinking and doing F.A. Davis
Company/Publishers
Wayne, Gil (2020) Nurses lab accessed from: https://nurseslabs.com/nursing-theories/

14