Clinical Nursing: Concepts & Trends Mary Lucita
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Concepts in NursingCHAPTER 1

After studying this chapter you should be able to:
  • Trace the evolution of definitions of nursing
  • Trace the changing image of nursing
  • Identify positive and negative qualities currently available for registered nurses
  • Discuss the contributions made by early nursing leaders.
Nursing has been practiced since the beginning of human history whenever the first person cared for another, who was sick or injured. Nursing practice has been carried out in a variety of forms throughout the ages. Nursing today is a dynamic field enriched by the traditions of the past and challenged by profound changes in society and health care.
Nightingale's Definition of Nursing
Quite ahead of her time in army, Florence Nightingale advocated a philosophy of nursing that incorporated total care. Nightingale said, nurses were to care for the entire person, not the illness alone and she meant that the nurses should look at both the person and person's environment. She recommended not to treat a ‘wound’ or ‘fracture’ but rather as a human being with an illness.
The most often quoted definition of nursing attributed to Nightingale is to “put the patient in the best conditions for nature to act upon him”.
Henderson's Definition of Nursing
In 1966, Virginia Henderson, one of the first nursing theorists who wrote a generally accepted definition of nursing and framework for nursing care, said, “The unique function of the 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 as to help him gain independence as rapidly as possible.”
The Image of Nursing
The image of nursing has varied throughout our history. As a profession in today's society, nursing seeks to clarify and improve its image so that the work and its practitioners can receive just recognition for both the health care system and the larger society.
Nursing and the Image of Women
Nursing, as a part of the woman's role in caring for her family, has been part of human existence since the beginning of time. An injured or ill person has often required care by others2 whenever useful remedies were discovered, they were passed down from mother to daughter.
Nursing Practice
Formal nursing education is needed to overcome the longstanding negative image of nursing. The nurse and physician became the only health care providers who came in contact with the patient. The nurse did everything that the physician did not do. And this means that nursing encompasses a broad range of activities.
Community/Public Health Settings
When Nightingale formalized her notion of nursing, she envisioned public health, then called district nursing to be an occupation for better educated women from the upper strata of society since Nightingale's time, public health nursing has taken several specialized forms.
Visiting Nursing
Visiting nursing is one of the forms of public health nursing. The nurses provide services they could and seek medical advice from physicians when necessary. As health departments are part of city, state and country government, they too are involved in the health of the public. Nurses care for individuals and families in their homes. They also hold clinics for the citizens.
School Nursing
Generally, in schools, nurses do such things as monitoring the health of children, checking compliance with immunization policy, teaching health and making reference to physicians and agencies.
Occupational Health Nursing
Occupational health nursing, previously known as industrial nursing, is an important part of industry rather than caring for employees and their families in their homes. Occupational health nurses care for injured employees and are concerned with health teaching, health promotion and safety within the work place. They are also responsible for identifying potential hazards that could result in illness or injuries to employees.
Home Nursing and Extended Care Facilities
Due to changes in social system and lifestyle, there are a number of ill-elderly at home and have no one to care for them. Although only a minority of elderly are institutionalized the number of facilities needed to care for them has increased significantly over the last decade. The care of elderly person in these settings presents a tremendous challenge to nurses.
Clinical Specialization
Nurses specialize in their practice depending on the type of client, the setting or both. A nurse can also specialize without a formal educational program by working in specialized area and undertaking independent study, or by taking continuing education courses, although these means do not lead to certification in any specialization.
Nursing educator develops nursing curriculum to ensure adequate number and categories of nurses to meet current and future societal needs.
Auxiliary Nurse Midwife Program
The course of study is of 12-18 months duration and focuses on maintenance of health and prevention of diseases. Basic requirement is 10th Standard. They are prepared as a midwife practitioner.
Diploma Program
Diploma program prepares students to become registered nurses. The curriculum completed in 3½ years. More emphasis given on clinical practice. License is given by State Nursing Council.
Degree Program in Nursing
BSc Nursing
It is conducted by college and university to prepare graduates for professional nursing practice. It is a 4 years course program. The requirement is predegree or equivalent examination.
Post-certificate BSc nursing program.
This is set in college or universities. Duration of course is 2 years.
Master's Degree Program
This is also conducted by university. It is a two years course program, to prepare nurse with a functional focus of educator/manager/ administrator. Course in this nursing, pediatric nursing, psychiatric nursing, etc.
Doctorate Degree
This is university based program. It can be done on part-time or fulltime basis.
Professional organizations are among the most visible and most powerful means by which a group impresses society with its professional status. Nursing is well-served by its many professional associations.
Professional Organizations at Unit Level
  • Student Nurses Association (SNA)
  • Trained Nurses Association of India (TNAI)
  • Alumni Association
At state Level
  • State Nursing Council
  • SNA
  • TNAI
At National Level
  • Indian Nursing Council
  • SNA
  • TNAI
International Level
International Council of Nurses (ICN)
The International Council of Nurse is an organization that meets every 4 years. These quadrennial meetings are called “Congresses”. And when they are in session, the organization is called the International Congress of Nurses. The purpose of the ICN is to foster international relationship and provide a forum for international concerns to be aired.
  1. Alcott LM. Hospital sketches. The Belknap Press of Harward University Press,  Cambridge, Massachuselts.  1960.
  1. American Association of College of Nursing. Position statement on educational articulation Washington DC, 1993.
  1. American Association of Industrial Nurses. Nursing agenda for health care reform, Kansa City, Missouri, 1991.
  1. American Nurse's Association. Nursing, a social policy statement, Kansa City, Missouri, 1980.
  1. American Nurse's Association. Standards of clinical nursing practice, Kansa City, Missouri, 1991.
  1. Austin AL. Nurses in American History American Journal of Nursing, 1975;75:816-8.
  1. Canadian Nurse's Association. A definition of nursing practice/standards for nursing practice, Canada, 1987.