UNIT 1- HISTORICAL OVERVIEW OF NURSING

PERIOD OF INTUITIVE NURSING

​ Nursing was untaught and instinctive. It was performed out of compassion for others.
​ It was practiced since prehistoric times among primitive tribes and lasted through the early
Christian era.
​ Nursing was a function that belonged to women.
​ They believed that illness was caused by invasion of the victim’s body by evil spirits
thru the use of black magic or voodoo.
​ They believed that the medicine man was
“Shaman” or witch doctor had the power to heal by using white magic. Among others, the Shaman used
hypnosis, charms, dances, incantations, massage, fire, water, and herbs as means of driving illness from
the victim.
​ They believed that the medicine man was
“Shaman” or witch doctor had the power to heal by using white magic. Among others, the Shaman used
hypnosis, charms, dances, incantations, massage, fire, water, and herbs as means of driving illness from
the victim.
​ The Shaman also practiced “trephining” or drilling a hole in the skull with a rock or stone without
the benefit of anesthesia as a last resort to drive evil spirits from the victims body.
​ Man’s mode of living changed from nomadic to agrarian to an urban
community life so he developed a means of communication and the beginnings of a scientific body of
knowledge.
​ Nursing remained the duty of slaves, wives, sisters or mothers.
​ Care of the sick was closely related to religion, superstition and magic.
​ Astrology and numerology were also used in medical practice.

CONTRIBUTIONS TO NURSING AND MEDICINE

•​ BABYLONIA
​ Code of Hammurabi- provided laws that covered every facet of Babylonian life including medical
practice. The medical regulations established fees, discouraged experimentation, recommended specific
doctors for each disease and gave each patient the right to choose between the use of charms,
medications, or surgical procedures to cure the disease.
​ There was no mention of nurses or nursing.
Code of Hammurabi
•​ EGYPT
​ Introduce the art of embalming which enhanced their knowledge of human anatomy.
​ Developed the ability to make keen observation left a record of 250
recognized diseases.
​ Slaves and patient’s families nursed the sick.
•​ ISRAEL
​ Moses the “ Father of Sanitation” who wrote the five books of the Old
Testament which;
​ Emphasized the practiced of hospitality to strangers and acts of charity.
​ Promulgated laws of control on the spread of communicable disease and the ritual of
circumcision of the male child .
​ Referred to nurses as midwives, wet nurses or child’s nurses whose acts were
​ compassionate and tender.
•​ CHINA
​ Strongly believed in spirits and demons.
​ Practiced ancestor worship which prohibited the dissection of dead human body.
​ They gave the knowledge of materia medica (pharmacology) which prescribed methods of
treating wounds, infections and muscular afflictions.
​ No mention of nursing in their records.
​ Care of the sick - done by female members of the household.
•​ INDIA
​ Built hospitals, practiced an intuitive form of asepsis and were proficient in the practice of
medicine and surgery.
​ For the first time in recorded history, there was reference to the nurse’s taking care of patient’s.
These nurses were described as combination by physical therapist and cook.
​ Sushurutu made a list of function and qualifcations of nurses.
•​ ANCIENT GREECE
​ Nursing was the task of untrained slave.
​ Hippocrates who was born in Greece was give the title “Father of Scientific Medicine”.He made a
major advance in medicine by rejecting the belief that the diseases had supernatural causes. He also
developed assessment standards for clients and recognized a need for nurses.
•​ CADUCEUS
- the insignia of the medical profession today.
•​ ROME
​ The Romans attemp ted to maintain vigorous health, because illness was a sign of weakness.
​ Care of the ill was left to the slaves or Greek physicians (both groups were looked upon as
inferior by Roman society).
​ Fabiola was converted to Christianity made her home as the first hospital in the Christian World.

PERIOD OF APPRENTICE NURSING

​ This periods extends from the founding of religious nursing orders in the Crusades, which began
in the 11th century.
​ Pastor Fliedner and his wife established the Kaiserwerth Institute for the training of Deaconesses
( a training school for nurses) in Germany.
​ It is called the Period of “ on the job training”. Nursing care was performed without any formal
education and by people who were directed by more experienced nurses.
​ Religious orders of the Christian Church were responsible for the
development of this kind of nursing.
​ During this Period​ there was also the rise of Religious Nursing Orders for women. Although
christianity promoted equality to all men, women were still concentrated in their roles as wives and
mothers.
​ Only by entering a convent that she cld follow a career, obtain an education and perform acts of
charity that her faith taught would help her gain grace in heaven.
​ Queens, princesses and other ladies of royalty founded many religious
orders.
​ Religious taboos and social restrictions influenced nursing at the time of the religious nursing
orders.
​ Hospitals were poorly ventilated and the beds were filthy. There were overcrowding of patients (
3-4 patients regardless of diagnosis or whether they are alive or dead may have shared 1 bed.
​ Practice of environmental sanitation and asepsis were non- existent. Older nuns were played
with and took good care of the sick; while the younger nuns washed soiled linens, usually in the rivers.
​ People entered hospitals only under compulsion or as last resort.
​ There was little employment and education was only for rich and the titled.

Important Nursing Personages During the Period of Apprentice Nursing

•​ ST CLARE - founder of the Second Order of St. Francis of Assisi.
•​ ST. ELIZABETH OF HUNGARY - a daughter of a Hungarian king.
- also known as the “Patroness of Nurses”.
•​ ST CATHERINE OF SIENA - the first “ Lady with a Lamp”.
•​ St. Camillus of Lellis – Patron Saint of Hospitals & Nurses

THE DARK PERIOD OF NURSING

•​ This extends from the 17th to the 19th century from the Period of Reformation until the U.S.
Civil War.
•​ The religious upheaval led by Martin Luther destroyed the unity of the Christian faith. The wrath
of Protestantism swept away everything connected with Roman Catholocism in schools, orphanages and
hospitals.
•​ ​ Properties of hospitals and schools were confiscated. Nurses fled for their lives.
•​ There were no provisions for the sick, no one to care for them.
•​ Nursing became the work of the least desirable of women - those who bribes from patients,
stole patient’s food and who used alcohol and tranquilizers.
•​ Nurses worked 7 days a week, slept in the cubbyholes (cranny) near the hospital ward and ate
scrap of food when they could find them.

Some reforms during the 18th century

•​ Pastor Theodor Fliedner and his wife established the Institute for the Training of Deaconesses at
Kaiserwerth, Germany (1836) which was the first organized training school for nurses. Among the
requirements upon entering this school were;
1.​ Character reference form clergyman
2.​ Health certificate from a doctor
3.​ Permission from their nearest relative
•​ The most notable figure who became one of the students of Deaconess School at Kaiserwerth is
Florence Nightingale, the “Mother of Modern Nursing”.
•​ In U.S, The Nurse’s Society of Philadelphia organized a school of nursing under the direction of
Dr. Joseph Warringtong in 1839. Nurses were trained on the job and attended some preparatory courses.
•​ Women’s Hospital in Philadelphia established a six- month course in nursing
to increase the nurse’s knowledge while they worked.
•​ They were taught a minimum amount of medical and surgical nursing, materia medica and
dietetics.
•​ The American Medical Association during the Civil War created the
Committee on Training of Nurses.
•​ It was designated to study and make recommendations with regards to the training of nurses.
•​ Doctors realized the need for qualified nurses.

PERIOD OF EDUCATED NURSING

•​ This period began on June 15, 1860 when the Florence Nightingale School of Nursing opened at
St. Thomas Hospital in London. ( St. Thomas Hospital School Of Nursing).
•​ The development of nursing during this period was strongly influenced by trends resulting from
wars, from arousal of social consciousness, from emancipation of women and from the increased
educational opportunities offered to women.

SCRUBS published the following nursing job description from 1887:

•​ In addition to caring for 50 patients, each bedside nurse will follow these regulations:
1.​ Daily sweep and mop the floors of your ward, dust the patient’s furniture
and window sills.
2.​ Maintain an even temperature in your ward by bringing in a scuttle of coal
for the day’s business.
3.​ Light is important to obrve patient’s condition. Therefore, each day fill
kerosene lamps, clean chimneys and trim wicks.

4.​ The nurse’s notes are important in aiding your physician’s work. Make your
pens carefully.
5.​ Each nurse on day duty will report every day at 7 a.m and leave at 8p.m ,
except on the Sabbath , on which day she will be off from 12 noon to 2 pm.
6.​ Graduate nurses in good standing with the director of nurses will be given an evening off each
week for courting purposes, or two evenings a week if you regularly to church.
7.​ Each nurse should lay aside from each payday a goodly sum of her earnings for her benefits
during her declining years, so that she will not become a burden. For example, if you earn $30 a month ,
you should set aside $15.
8.​ Any nurse who smokes, eses liqour in any form, gets her hair done at a beauty stop of frequents
dance halls will give the director of nurses good reason to suspect her worth, intentions and integrity.
9.​ The nurse who performs her labors [and] serves her patients and doctors faithfully and without
fault for a period of five days will be given an increase by
the hospital administration of five cents per day.

PERIOD OF CONTEMPORARY NURSING

​ This covers the Period after World War II to the present.

​ United Nations established the WHO to assist in fighting disease by providing health information
and improving nutrition, living standards, and environmental conditions of all people.
​ Health is perceived as a fundamental human right. Laws were legislated to provide such right.
​ Nursing involvement in community health is greatly intensified.

​ Technological advances, such as the development of disposable supplies and equipment have
relieved the nurse from numerous tedious tasks.
​ development of the expanded role of the nurses.
​ Nursing became a dynamic profession because the scope of nursing practice is expanding in the
light of the modernd evelopments in the constantly changing world.
NURSING AS A SCIENCE, AS A PROFESSION, A DISCIPLINE AND A PHILOSOPHY

•​ WHAT IS A SCIENCE?
A science is concerned with cause and effect
A science is a way of explaining observed phenomena
A science has a system of gathering, verifying, and systematizing information about reality Science is
both a process and a product
As a PROCESS- science follows systematic inquiry and observations of the natural world.
As a PRODUCT- it is grounded and tested in experience and is the result of investigative efforts.

CHARACTERISTICS OF SCIENCE
•​ Must explain its investigations and arguments
•​ Must be logically ordered
•​ Statements must be true or probably true
•​ Expressed in universal statements
•​ Definite fields of knowledge
•​ Coherence
​ All of these criterion is present in nursing, therefore, Nursing is a Science (hence the
degree, Bachelor of Science in Nursing)

•​ DISCIPLINE
-It is a field of inquiry characterized by a unique perspective and a distinct way of viewing phenomenon
(Parse,1999)
•​ It is a branch of educational instruction or a department of learning.
•​ 2 KINDS OF DISCIPLINE:
•​ Academic Discipline- history
•​ Professional discipline- law
•​ It is worthy to note that academic discipline aim to know (theoretical) and their theories are
descriptive in nature. Their research is both basic and applied.
•​ Conversely, professional disciplines are practical (skill application) in nature, and their research
tend to be more prescriptive and descriptive (Donaldson & Crowley, 1978)
•​ Nursing as a distinct discipline can be identified by:
•​ Identifiable philosophy
•​ Atleast one conceptual framework (perspective) for delineation of what can be defines as
nursing.
•​ Acceptable methodologic approaches for the pursuit and development of knowledge.
•​ In general, nursing’s knowledge base draws from many disciplines
•​ Therefore, it is not just a professional discipline but an academic discipline as well.

WHAT IS THE DIFFERENCE BETWEEN A PROFESSION AND AN OCCUPATION????

•​ OCCUPATION- is a job or career
•​ PROFESSION- is a learned vocation or occupation that has a status of superiority and precedence
within a division of work.
•​ A profession must also have an institutionalized goal or social mission as well as a group of
scholars, investigators, or researchers who work to continually advance the knowledge of the profession
with the goal of improving practice.
​ All professions are occupations, but not all occupations are professions
(Logan,2004)
•​ Until recently, nursing was viewed as an occupation rather than a profession.
•​ Nursing has had difficulty being deemed a profession because 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.
•​ Autonomy in practice is incomplete because nursing is still dependent on medicine to direct
much of its own practice
•​ It is only recently that nursing was able to identify and organize professional
knowledge.

CHARACTERISTICS OF NURSING AS A PROFESSION:

1.​ Has a defined body of knowledge
•​ Have identifiable knowledge that belongs to our profession alone (unique).
•​ The knowledge of nursing profession is well organized around theories (basis)
•​ Knowledge is largely intellectual, requiring higher learning that can be taught (critical thinking)
•​ Nursing Knowledge continues to build as more nursing research is conducted

2. Power and authority over training and education

•​ requires formal, in depth, and specialized education from institutions of higher learning.

3. Registration requirements for practice

•​ Need to pass licensure exam
•​ Need to finish a BSN degree and comply with PRC requirements before taking the exam
•​ Need to maintain professional conduct in order to keep license
4. Altruistic service
•​ nurses are committed to service and doing good.
•​ Nursing provides something vital, often to groups who are unable to meet
their needs on other ways.

5. A code of ethics
6. Autonomy
7. Relevance to society
•​ Nursing exists to provide service to others
•​ Nursing’s work is focused on the act of caring
•​ Health promotion, disease prevention, and the care of individuals with altered health states all
provide valuable service to society.

WHAT IS PHILOSOPHY?

•​ It tries to discover knowledge and truth and attempts to identify what is valuable and important.
•​ Some branches of Philosophy:
1.​ Epistemology- study of knowledge
2.​ Logic- study of principles and methods and reasonings
3.​ Ethics- study of moral philosophy
4.​ Political philosophy- study of citizen and state.

•​ Empiricism is founded on the belief that what is experienced is what exists.

•​ Empiricism strives to explain nature through testing of hypothesis and development of theories
•​ Empiricism focuses on understanding the parts of the whole in an attempt to understand the
whole.
•​ The empiricists valued observation, perception by senses and experience as sources of
knowledge.

•​ Once measurement is determined, it is possible to test theories through experimentation or

observation which results in verification or falsification.
•​ Another philosophical school of thought which has relevance in nursing is POSITIVISM which
suggest that a complex whole can be best understood in terms of its basic components.

•​ Many Philosophers influenced nursing in general, philosophy in the context of nursing profession
refers to the beliefs system of the profession and provides perspective for practice, learning, and
research.
•​ Great is the influence of philosophy in nursing. In fact, the sources of nursing knowledge is
backed by philosophical methodologies (Empirical – scientific knowledge; Ethics- moral knowledge;
•​ Esthetics- knowledge related to beauty and expression; and Personal
Knowledge- knowledge gained from thought alone)
•​ Nursing theories were founded from philosophical thoughts
•​ The science of any discipline is tied to its philosophy
•​ Both science and philosophy is geared towards increasing knowledge.

UNIT 11: History and Philosophy of Science

What is Philosophy?

​ It tries to discover knowledge and truth and attempts to identify what is valuable and important.
​ Some branches of Philosophy:
1.​ Epistemology- study of knowledge
2.​ Logic- study of principles and methods and reasonings
3.​ Ethics- study of moral philosophy
4.​ Political philosophy- study of citizen and state.

Rationalism

 Rationalist epistemology (scope of knowledge) emphasizes the importance of a priori reasoning as

the appropriate method for advancing knowledge.
 Utilizes deductive reasoning (general to specific) to generate view

Empiricism
makes use of objective and tangible data to observe and collect data.
 This approach, called the inductive method, is based on the idea that the collection of facts precedes
attempts to formulate generalizations
Early 20th Century Views
During the first half of this century, philosophers focused on the analysis of theory structure, whereas
scientists focused on empirical research.
 Positivism emerged as the dominant view of modern science (Modern logical positivists believed that
empirical research and logical analysis (deductive and inductive) were two approaches that would
produce scientific knowledge.

NURSING LEADERS OF THE 20th CENTURY

Mary Grant Seacole ( England)​ 1854​ Worked together with Florence Nightingale during the Crimean
War to give aid for the wounded soldiers.
Florence Nightingale​ 1859​ The Lady with the Lamp. Contributed to the development of nursing
education, practice and administration.
Dorothea Lynde Dix( USA)​ 1861​ Appointed superintendent of the Female Nursed of the Union
Army during the American Civil War.
Louisa May Alcott (USA)​1862-1863​ Wrote the book “Hospital Sketches” as she described the works
of volunteer nurses during the Civil War.
Harriet Tubman (USA)​ 1861- 1865​ “The Moses of Her People” . She served the slave
of the underground railroad during the Civil War
Jean Henri Dunant (Switzerland)​1862- 1865​ Organized the International Conference that Founded
the Red Cross during the Geneva Convention.
Linda Richards (USA)​ 1873​ America’s First Trained Nurse.
Mary Mahoney (USA)​ 1879​ America’s First Trained Black Nurse.
Clara Barton (USA)​ 1812-1912​ Organized and Establish the American Red Cross.
Lilian Wald (USA)​ 1867-1940​ Founder of Public Health Nursing
Founded the Henry Street Settlement and Visiting Nurse Services, which Provided nursing
services educationally, socially, and culturally.
Bedford Fenwick (England)​
1899​ Established the International Council of Nurses in
Great Britain.

PROMINENT NURSING LEADERS IN THE PHILIPPINES

Cesaria Tan​ -First Filipino Nurse who had Masters Degree in Nursing in the US.
Socoro Sirilan​ -Reformed social Service for Indigenous patients at San Lazaro Hospital
Annie Sand​ -Founded the National League of Philippine Government Nurses
Col. Elvegia Mendoza​ -First Female Military Nurse to hold the Rank of Brigadier General
Loreto Tupaz​ -Known as the Dean of Philippine Nursing Education Florence Nightingale of Iloilo
Socorro Diaz​ -First Editor of ‘The Messenger” the first journal of the PNA previously known as the FNA
(Filipino Nursing Association)
Dr. Julita Sotejo​First Editor of “ The Filipino Nurses” the second journal of the PNA. Florence Nightingale
of the Philippines. Founder and the first Dean of the University of the Philippines College of
Nursing (UPCN), who gave way to professional Nursing in the Philiipines. Professor Emeritus of
UPCN. The author of Code of Ethics for Nurses (PRC BON Res. #633, 1982). Chairman, Committee
on Legal Aspect of Nursing which created the first Philippine Nursing Law also known as RA No.
877S.1953.
Anastacia Giron Tupaz​ - First Filipino Nurse with a title of Nursing Superintendent Chief Nurse at the
PGH. Founder of Filipino Nurses Association
Rosario Montemayor Delgado​ ​ First President of the FNA. She was a graduate of the Philippine
General Hospital School of Nursing in 1912

Nursing Science and Theory in the Late 20th Century

In the latter years of the twentieth century, several authors presented analyses challenging the
positivist position, thus offering the basis for a new perspective of science. Nursing, as it continually
evolves, brings into being the different theories that guides clinical practice.

Emergent views of science and theory in the late twentieth century

Brown (1977) emphasized that science was a process of continuously building research rather
than a product of findings. Theories play a significant role in determining the scientist observation and
interpretation about the phenomena through data collection and analysis.
 Presupposed theories and observable data interact in the process of scientific investigation.
 Understanding of evidence-based science begin. Nurses uses it to support the interventions for
patient care.
 Brown (1977) emphasized that science was a process of continuously building research rather than a
product of findings. Theories play a significant role in determining the scientist observation and
interpretation about the phenomena through data collection and analysis.
 Presupposed theories and observable data interact in the process of scientific investigation.
 Understanding of evidence-based science begin. Nurses uses it to support the interventions for
patient care.

Professional Roles of Nurses

Care Provider​ ​ Provide care and comfort for persons together with preserving the dignity of
human being. Considered as the mothering role of nurses
Communicator​ ​ Communication facilitates understanding and collaboration of nursing actions
with their client and other members of the HC team. It develops rapport with clients to established their
cooperation.
Teacher​​ Help the client learn the state of their well-being and therapies that will be done to
them. Provide them imagery of the advantages and disadvantages of the actions that will be done to
them. It can help in the development of the nursing profession.
Counselor​ ​ Help client to cope with stress brought about by their health conditions.
Facilitates the clients growth in all aspect.
Client Advocate​​ Defends the client’s rights to be treated equally without any harm intentionally
or unintentionally. Ensures that the client’s need are met. Advocacy, involves promoting what is the best
for the client, ensuring that his needs are met and protecting his rights.
Change Agent​ ​ Identifies the problem
​ Assessing the client’s motivations and capacities for change
​ Determines alternatives
​ Explores the possible outcomes of the alternatives
​ Assesses resources
​ Determines appropriate nursing role establishes and maintains a helping relationship
Leader​ ​ As a positive (goal oriented) behavior involving an exchange with other people.
​ Leadership is an attempt to influence others
​ Influencing helps the client in making decisions to establish and achieve their goals towards
alleviating their conditions
Manager​ ​ Involves planning, giving direction, developing staff, monitoring operations,
giving rewards fairly and representing both staff members and administration as needed.
Researcher​ ​ An investigative role of nurses which further improves the nursing practice.
​ Research substantiates practices as they were tested and further studied upon.
Expanded Roles of Nurses
Nurse Generalist​ ​ Has mastery in certain practice of nursing.
​ Examples of special areas: med-surgical nursing, pediatric nursing geriatric nursing, psychiatric
and mental health nursing, home health nursing.
Nurse Clinician​ ​ Performs direct nursing actions in specialty areas. They may or may have
advances educational preparation as long as they are certified by a governing body to perform
such duties.
Nurse Practitioner​ ​ Requires advance educational or nursing practice and must be certified
by a governing body that they may practice.
Nurse Specialist​ ​ Requires to have a master’s degree in nursing and must have a
specialization in a particular field of nursing.

UNITIII: STRUCTUREOFNURSING KNOWLEDGE

INTRODUCTION:

•​ Nursing profession is still under an evolution phase, a phase of receding

and evolving new paradigms.
•​ Nursing theories and models provide information about definitions of nursing and nursing
practice, principles that form the basis for practice, goals and functions of nursing.

CONCEPTS
•​ Concepts are often called the BUILDING BLOCKS OF THEORIES.
- Enhances one’s capacity to understand phenomena
as it helps define the meaning of a word.
•​ Concepts are vehicles of thoughts that involve images
•​ Concepts maybe abstract (indirectly observed or intangible example love,care) or concrete
(directly observed and tangible example nurse, mother, pain).
•​ EXAMPLES: Noise, Cleanliness, Ventilation, Bed and Beddings, Warmth in Nightingales
Environmental Theory
​ There are two types of concepts namely:
​ Abstract concepts are indirectly observed or intangible. It is independent in time and place.
Examples are love, care, and freedom.
​ Concrete concepts are directly observed or tangible. Examples are nurse, mother and pain.

DEFINITION
Composed of various descriptions which convey a general meaning and reduces the vagueness in
understanding a set of concepts.

❖​ Conceptual definitions are meaning of the word based on how a certain theory or relevant
literature perceives​ it to be.
❖​ Operational definitions are meaning of a word based on the method of how it was measured or
how the person come up with that perception.
PROPOSITION
Explains the relationship of different concepts

ASSUMPTION
A statement that specifies the relationship or connection of factual concepts or phenomena.

PHENOMENON

-​ set of empirical data or experiences that can be physically observed or tangible, such as crying,
grimacing when in pain
-​ It is concerned by how the person reacts using human senses
-​ It could be clinical,disease process, clients behavior, interventions, practices

A diagram showing the relationships of concepts, propositions, assumptions and definitions with theory
and phenomena

KNOWLEDGE
•​ An information, skills and expertise acquired by a person through various life , experiences, or
through formal/informal learning such as formal education, self-study, vocational.
•​ The abstract or workable understanding of a subject or idea.
•​ What is known in a particular field of discipline or study.
Sources of Knowledge
•​ TRADITIONAL KNOWLEDGE- is a nursing practice which is passed down from generation to
generation. Its always been practiced that way.
•​ AUTHORITATIVE KNOWLEDGE-an idea by a person of authority which is perceived as true
because of his or her expertise.
•​ SCIENTIFIC KNOWLEDGE-it came from a scientific method through research. They are tested and
measured systematically using objective criteria.
PARADIGM
•​ It is a conceptual diagram.
•​ It is a pattern.

METAPARADIGM
​ Originates from two Greek word: Meta, meaning “with” and paradigm, meaning “pattern.
​ It defines and describes relationships among major ideas and values.
​ The highest level of knowledge.

NURSING METAPARADIGM
•​ Are patterns or models used to show a clear relationship among the existing theoretical works in
nursing.

PERSON

•​ Refers to all human beings; the recipients of nursing care.

•​ They include individuals, patients, groups, families, and communities.

ENVIRONMENTAL
•​ Factors that affect individuals internally and externally. Also includes setting where nursing care
is provided.
•​ Ventilation
•​ Warmth
•​ Noise
•​ Light
•​ Cleanliness
•​ HEALTH
•​ The holistic level of wellness that the person experiences.
•​ It adresses the person’s state of well being.
•​ Goal of all nursing activity should promote client’s health.

NURSING
•​ Nursing is a science, an art and a practice discipline which involves caring. Focuses on the
human-environment-health process and is articulated in nursing theories and generated through nursing
research.
•​ The interventions of the nurse rendering care in support of, or in cooperation with the client.
•​ ​ Nursing is a humanistic science dedicated to compassionate concern with maintaining
and promoting health and preventing illness and caring for and rehabilitating the sick and disabled.

THEORY
•​ Greek word “THEORIA” – speculate
•​ A set of statements that tentatively describe, explain, or predict relationships among concepts
that have been systematically selected and organized as an abstract representation of some
phenomenon. (Mc Ewen &. Wills, 2019)

IMPORTANCE OF Nursing Theories

•​ Aim to describe, predict, and explain the phenomenon of nursing

•​ Provide the foundations of nursing practice, help to generate further knowledge and indicate in
which direction nursing should develop in the future
•​ Help to distinguish what should form the basis of practice by explicitly describing nursing.
•​ Help to provide better patient care, enhanced professional status for nurses, improved
communication between nurses, and guidance for research and education.
•​ Maintains professional boundaries in nursing

Purposes of theories
IN PRACTICE
•​ Assist nurses to describe, explain, and predict everyday experiences
•​ Serve to guide assessment, intervention, and evaluation of nursing care
•​ Provide rationale for collecting reliable and valid data about the health status of clients
•​ Help to establish criteria to measure the quality of nursing care
•​ Help build a common nursing terminology to use in communicating with other health
professionals. Ideas are developed and words defined.
•​ Enhance autonomy of nursing by defining its own independent functions.
IN EDUCATION
•​ Provide a general focus for curriculum design.
•​ Guide curricular decision making.
IN RESEARCH
•​ Offer a framework for generating knowledge and new ideas.
•​ Assist in discovering knowledge gaps in specific field of study.
•​ Offer a systematic approach to identify questions for study.

INTERDEPENDENCE OF THEORY AND RESEARCH

•​ The relationship between nursing theory and nursing research helps in building nursing
knowledge.
According to Meleis 1997
•​ Nursing knowledge is composed of both:
1.​ Theoretical Knowledge-Aims to stimulate thinking and broaden understanding of the science and
practice of the nursing discipline.
2.​ Practical Knowledge-Referred to as the art of nursing.

NURSING PHILOSOPHIES
•​ ENVIRONMENTAL THEORY – Florence Nightingale
Developed and described the first theory of nursing. Notes on Nursing: WHAT IT IS , WHAT IT IS
NOT and NOTES ON HOSPITALS. She focused on changing and manipulating the environment in order to
put the patient in the best possible contributions for nature to act. She believed that in the nurturing
environment, the body could repair itself. She linked with environmental factors: (1.) fresh air, (2) light,
(3) Cleanliness, (4) Hygiene, (5) Proper nutrition.

STAGES OF NURSING EXPERTISE- PATRICIA BENNER

•​ NOVICE
No background experience (e.g. nursing student that’s why we are
guided by our clinical instructors.
•​ ADVANCED BEGINNER
- This stage pertains to the newly graduate nurses.
•​ COMPETENT
Has 2-3 years of experience which he /she which demonstrates planning
and organizational abilities.
•​ PROFICIENT
Has 3-5 years of experience which he/she perceives situations as a whole. Has a holistic understanding of
the client which improves decision making.
•​ EXPERT

Flexible and highly proficient performance which he/she no longer rely on rules, regulations , or maxims
to connect his/her understanding of the situation to appropriate action.
THEORY OF HUMAN CARING- JEAN WATSON

1.​ Practice human kindness.

2.​ Instill faith and hope.
3.​ Nurture individual spiritual beliefs and practices.
4.​ Develop helping-trusting relationships.
5.​ Promote and accept the expression of positive and negative feelings.
6.​ Use creative and scientific problem solving methods for decision making.
7.​ Perform teaching and learning that address individual needs and learning styles.
8.​ Create a healing environment for the physical and spiritual self which respects human dignity.
9.​ Assist with physical, emotional, and spiritual needs.
10.​ Allow rooms to miracles to take place

CONCEPTUAL MODELS

SELF-CARE DEFICIT THEORY

DOROTEA OREM​ • SELF-CARE

•​ -Practice of activities that individual initiates and perform in their own behalf in maintaining life,
health, and well-being.
•​ SELF-CARE AGENCY
•​ - Individual’s ability to perform self-care
activities.
•​ SELF-CARE REQUISITES
•​ Action directed towards provision of self care
•​ THERAPEUTIC SELF-CARE DEMAND
•​ - “Totality of self-care actions to be performed for some duration in order to meet self acre
requisites by using valid methods and related sets of operations and actions”

BETTY NEUMAN

•​ Focuses on stress and stress reduction

•​ Primarily concerned with effects of stress on health
•​ Stressors are any forces that alters
the system’s stability

GOAL ATTAINMENT THEORY- Imogene King

•​ Describes the importance of the participation of all individual in decision making as well as
choices, alternatives, and outcomes of nursing care.
•​ It pertains to the importance of interaction, perception, communication, transaction, self, role,
stress, growth and development, time, and personal space.
•​ Reflects King’s belief that the practice of nursing is differentiated from other health care
profession by what nurses do with and what they do for individuals.
•​ The nurse and the patient/client communicates, information in order to set goals mutually and
then acts to attain those goals.

NURSING THEORIES

INTERPERSONAL RELATIONS THEORY - HILDEGARD PEPLAU

4 PHASES OF NURSE PATIENT RELATIONSHIP
1.​ ORIENTATION
2.​ IDENTIFICATION
3.​ EXPLOITATION
4.​ RESOLUTION

NURSING NEED THEORY 14 COMPONENTS - VIRGINIA HENDERSON

•​ Breathe normally.

•​ Eat and drink adequately.

•​ Eliminate body wastes.

•​ Move and maintain desirable postures.

•​ Sleep and rest.

•​ Select suitable clothes-dress and undress.

•​ Maintain body temperature within normal range by adjusting clothing and modifying
environment.

•​ Keep the body clean and well groomed and protect the integument.

•​ Avoid dangers in the environment and avoid injuring others.

•​ Communicate with others in expressing emotions, needs, fears, or opinions.

•​ Worship according to one’s faith.

•​ Work in such a way that there is a sense of accomplishment.

•​ Play or participate in various forms of recreation.

•​ Learn, discover, or satisfy the curiosity that leads to normal development and health and use the
available health facilities
THE CORE, CARE, CURE- LYDIA HALL

NURSING CARE CAN BE DELIVERED ON THREE INTERLOCKING LEVELS

1.​ Care- hands on bodily care
2.​ Core- using self in relationship to
patient
3.​ Cure- seeing the patient and family through medical care.

MIDDLE-RANGE THEORY

MATERNAL ROLE ATTAINMENT THEORY- RAMONA MERCER

•​ Anticipatory stage
•​ Formal Stage
•​ Informal Stage
•​ Personal Stage