NURSING

 

 

Nursing is in general the process of caring for or nurturing another individual. More specifically, nursing refers to the care of the sick and associated preventative public health work. This embraces the functions and duties carried out by persons who have had formal education and training in the art and science of nursing, commonly in the support of doctors, dentists and other medical workers. Most countries now regard nursing as a registered profession requiring a specific training program leading to recognized qualifications.

In earlier centuries, nursing care was usually provided by volunteers who had little or no training—most commonly men and women of various religious orders. During the Crusades, for example, some military orders of knights also provided nursing care, most notably the Knights Hospitallers (also known as the Knights of St John of Jerusalem). In Buddhist countries members of the sangha or religious order have traditionally undertaken health care. In Europe especially after the Reformation nursing was often regarded as a low-status occupation fit only for those who could find no better work, because of its association with disease and death, and the generally poor standard of contemporary medical care.

 

Modern nursing began in the mid-19^th century. One of the first formal training programs for nurses was begun in 1836 in Kaiserswerth in Germany by Pastor Theodor Fliedner 1800 – 1869 for the Order of Protestant Deaconesses. He was greatly influenced by Elizabeth Fry’s work, which he observed in London. Elizabeth Fry 1780 – 1845 is English prison reformer. She was always attentive to the poor and neglected. Her interest in prison conditions began after visiting Newgate prison in 1813 and seeing the plight of women and children there. She fought for what are now regarded as first principles: classification of criminals, segregation of the sexes, female supervision of women, and provision for education. In 1818 she gave evidence at a Royal Commission and later saw many of her proposed reforms carried out. But her zeal did not stop there. For 20 years she checked every female convict ship before it sailed; inspected prisons and mental hospitals in Scotland and Ireland; instituted a Nursing Order; provided libraries for coastguard stations and struggled for housing and employment for the poor.

Other religious orders were also providing formalized nurse's training in Europe at that time, but Fliedner's school is noteworthy for having given the British nursing reformer Florence Nightingale her formal training. Her experience at Kaiserswerth gave her the impetus to organize nursing care on the battlefields of the Crimean War and, later, to establish a nurse training program at St Thomas's Hospital in London. The advent of the Nightingale training schools for nurses, and Florence Nightingale's heroic efforts and reputation, transformed the status of nursing in Europe and laid the basis of its modern character as a formally recognized profession.

 

State registration of Nursing

Nursing Education

Nursing courses normally require good secondary school or college grades. Training is traditionally based in hospitals, though in some countries there is now more emphasis on college-based training. A typical course lasts some three years and involves general training in medicine as well as practical experience by working with patients under the supervision of senior nurses. The level of medical education required of a nurse varies from country to country; Turkey, for example, is noted for the particularly high medical content of its nursing education. At the end of the course the student nurse takes examinations, administered either by the state health body or nursing councils depending on the particular country, in order to receive a license or state registration. Once licensed or registered, he or she is free to practice the profession in any country which recognizes the qualification, although many countries reserve recognition for their own qualifications exclusively.

 

Functions and Duties

Many of the varied duties of a nurse are technical in nature, ranging from taking blood pressure to managing complex life-support systems in intensive care units. In addition, however, a nurse must be a teacher, counselor and manager, concerned with promoting and maintaining the health of patients, as well as caring for them when they are ill.

Nurses have both dependent and independent functions. The former are those that must be carried out under the orders of a licensed physician or dentist, including such duties as administering medication and changing dressings on wounds. Independent functions are those that nurses carry out based on their own professional judgment. Such duties include bathing patients, positioning them to prevent joint contractures, teaching people how best to care for themselves, and providing nutritional counseling.

 

With the explosion of technical knowledge in the field of health care since World War II, nurses have also begun to specialize in particular areas of nursing care. These include surgical, dental, maternity, psychiatric and community-health nursing. Within each of these specialties there are opportunities for further specialization.

 

Florence Nightingale 1820 – 1910

British nurse, hospital reformer and humanitarian. Born in Florence, Italy, on May 12, 1820, Nightingale was raised mostly in Derbyshire and received a classical education from her father. In 1849 she went abroad to study the European hospital system and in 1850 she began training in nursing at the Institute of St Vincent de Paul in Alexandria, Egypt. She subsequently studied at the Institute for Protestant Deaconesses at Kaiserswerth, Germany. In 1853 she became superintendent of the Hospital for Invalid Gentlewomen in London.

 

After the outbreak of the Crimean War in 1854 Nightingale stirred by reports of the primitive sanitary conditions and grossly inadequate nursing facilities at the large British barracks-hospital at Uskudar (formerly Scutari, now part of Istanbul, Turkey), dispatched a letter to the British secretary of war, volunteering her services in the Crimea. At the same time, unaware of her letter, the Secretary of War proposed that she assume direction of all nursing operations at the war front. She set out for Uskudar accompanied by 38 nurses. In the rat-infested barracks she found many of the wounded without beds, lying on the floor, a shortage of bandages and no soap, towels or washbasins. She immediately set abut organizing the cleaning of the barracks. She then established a schedule for nursing care and diets. At night she walked the corridors with her lamp, checking on the soldiers, a habit for which she became known as “the lady with the lamp”. Under Nightingale's supervision, efficient nursing departments were established at Uskudar and later at Balaklava in the Crimea. Through her tireless efforts the mortality rate among the sick and the wounded was greatly reduced.

 

At the close of the war in 1860 with a fund raised in tribute to her services Nightingale founded the Nightingale School and Home for Nurses at St Thomas's Hospital, London. The opening of this school marked the beginning of professional education in nursing.

 

Nightingale's contributions to the evolution of nursing as a profession were invaluable. Before she undertook her reforms, nurses were largely untrained personnel who considered their job a menial chore; through her efforts the stature of nursing was raised to that of a medical profession with high standards of education and important responsibilities. She received many honors from foreign governments and in 1907 she became the first woman to receive the Order of Merit. She died in London on August 13, 1910. In 1915 the Crimean Monument in Waterloo Place, London, was erected in her honor. Her writings include Notes on Nursing, the first textbook for nurses, which was translated into many languages and also Notes on Hospitals and Notes on Nursing for the Laboring Classes.