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D ione B las Rey R. Abogad ie MAN, RNClinical InstructorClinical Instructor

History ofHistory of Nursing

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Since the beginnings of time, nursing has

been shaped by different cultures and

societies and by the changes within

those societies.

The word nursing derives its meaning

from the Latin word nutricius whichmeans nourishing.

Therefore, in the ancient world nursing

was viewed as a role of caring for the

family and not a profession.

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In the world history of nursing,

roots can be traced toreligion, mythology,and Eastern and Western societies.

The ancient Egyptians utilized

perhaps the first formal nurses,hiring them to assist in childbirth.

It is from these beginnings thattodays midwives evolved.

Among the Greeks and Romans, itwas believed that gods andgoddesses influenced healing.

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There was a deity for almost everyhuman biological function.

The women of the familyofAsklepios were mythologicalnurses.

The worlds history of nursing

records Hygeia as being the goddessof health.

In the Roman Empire, Romannoblewomen cared for the sick.

However, in some cultures the care ofthe sick was not a revered enterpriseand was a task of prostitutes.

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During the middle ages, the focus

of the world history of nursingchanged and became centralized

around religious orders.

Care of the sick was seen as a

function of the church.

Nursing care was provided by both

men and women and was

segregated by sex with persons

caring for others of the same

gender.

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War has had the greatest influence

upon the world history of nursing, forhistorically it has been through war

that the demand for nurses has been

the greatest.

Perhaps the person who has been

ascribed the distinction of having

changed the world history of nursing

the most was Florence Nightingale.

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Nursing continues to evolve and be

shaped as a body of science and hasmade great professional strides since itsinception.

The world history of nursing reveals that

nurses, whether formal or informal havelong filled a needed place in society.

Nurses now are needed more than everbefore.

Now, as todays nurses shape the worldhistory of nursing, we look forward tothe respect the profession deserves.

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I. Period ofIntuitive Nursing/Medieval

Period

Nursing was untaught and instinctive.

It was performed of compassion for

others, out of the wish to help others.

Nursing was a function that belonged towomen. It was viewed as a natural

nurturing job for women. She is

expected to take good care of the

children, the sick and the aged.

No caregiving training is evident. It was

based on experience and observation.

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Primitive men believed that illness was caused by

the invasion of the victims body of evilspirits. They believed that the medicine man,

Shaman or witch doctor had the power to heal by

using white magic, hypnosis, charms, dances,incantation, purgatives, massage, fire, water and

herbs as a mean of driving illness from the victim.

Trephining drilling a hole in the skull with a rock

or stone without anesthesia was a last resort to

drive evil spirits from the body of the afflicted.

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II. Period ofApprentice Nursing/Middle Ages

Care was done by crusaders, prisoners, religious orders Nursing care was performed without any formal

education and by people who were directed by more

experienced nurses (on the job training).This kind of

nursing was developed by religious orders of the

Christian Church.

Nursing went down to the lowest level

-wrath/anger of Protestantism confiscated properties

ofhospitals and schools connected with Roman

Catholicism.

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- Nurses fled their lives; soon there was shortage of

people to care for the sick

- Hundreds of Hospitals closed, there was no provision

for the sick, no one to care for the sick

- Nursing became the work of the least desirable of

women prostitutes, alcoholics, prisoners

Pastor Theodore Fliedner and his wife, frederika

established the Kaiserswerth Institute for the training

ofDeaconesses (the 1st formal training school for

nurses) in Germany.

- This was where Florence Nightingale received her 3-

month course of stude in nursing.

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III. Period of Educated Nursing/Nightingale Era 19th-

20th century

The development of nursing during this period was

strongly influenced by:

a.) trends resulting from wars Crimean, civil war

b.) arousal of social consciousness

c.) increased educational opportunities offered to

women.

Florence Nightingale was asked by Sir Sidney Herbert

of the British War Department to recruit female nurses

to provide care for the sick and injured in the CrimeanWar.

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In 1860, The Nightingale Training School of Nurses opened

at St. Thomas Hospital in London.

- The school served as a model for other training

schools. Its graduates traveled to other countries to

manage hospitals and institute nurse-training programs.

- Nightingale focus vision of nursing Nightingale system

was more on developing the profession withinhospitals. Nurses should be taught in hospitals associated

with medical schools and that the curriculum should

include both theory and practice.

- It was the 1st school of nursing that provided both

theory-based knowledge and clinical skill building.

Nursing evolved as an art and science

Formal nursing education and nursing service begun

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FACTSABOUTFLORENCE NIGHTINGALE

Mother of modern nursing. Lady with the Lamp because

of her achievements in improving the standards for the

care of war casualties in the Crimean war.

Born may 12, 1800 in Florence, Italy

Raised in England in an atmosphere of culture and

affluence

Not contended with the social custom imposed upon her

as a Victorian Lady, she developed her self-appointed goal:

To change the profile of Nursing

She compiled notes of her visits to hospitals and herobservations of the sanitary facilities, social problems of

the places she visited.

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Noted the need for preventive medicine and god nursing

Advocated for care of those afflicted with diseases caused

by lack of hygienic practices

At age 31, she entered the Deaconesses School at

Kaiserswerth inspite of her familys resistance to her

ambitions. She became a nurse over the objections of

society and her family.

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Worked as a superintendent for Gentlewomen Hospital, a

charity hospital for ill governesses.

Disapproved the restrictions on admission of patients and

considered this unchristian and incompatible with health care

Upgraded the practice of nursing and made nursing an

honorable profession for women.

Led nurses that took care of the wounded during theCrimean war

Put down her ideas in 2 published books: Notes on

Nursing, What It Is ans What It Is Not and Notes on Hospitals.

She revolutionized the publics perception of nursing (notthe image of a doctors handmaiden) and the method for

educating nurses.

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IV. Period ofContemporary Nursing/20th Century

Licensure of nurses started

Specialization of Hospital and diagnosis

Training of Nurses in diploma program

Development of baccalaureate and advancedegree programs

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Scientific and technological development as well as social

changes mark this period.

a. Health is perceived as a fundamental human rightb. Nursing involvement in community health

c. Techological advances disposable supplies and equipments

d. Expanded roles of nurses was developed

e.WHO was established by the United Nations

f. Aerospace Nursing was developed

g. Use of atomic energies for medical diagnosis, treatment

h. Computers were utilized-data collection, teaching, diagnosis,

inventory, payrolls, record keeping, billing.

i. Use of sophisticated equipment for diagnosis and therapy.

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A.1.1. Early Beliefs and Practices

(Diseases and their causes and treatment were shrouded with

mysticism and superstitions.)1. Beliefs about causation of disease:

another person (an enemy or a witch)

evil spirits

2. Belief that evil spirits could be driven away by persons withpowers to expel demons.

Belief in special gods of healing, with the priest -physician (called

word doctors) as intermediary. If they used leaves or roots,

they were called herb doctors (herbolarios)

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Early Care of the Sick

The early Filipinos subscribed to superstitious belief and practices in

relation to health and sickness. Herb men were called herbicheros meaning one who practiced

witchcraft.

Persons suffering from diseases without any identified cause were

believed bewitched by mangkukulam or mangagaway.

Difficult childbirth and some diseases (called pamao) wereattributed to nunos.

Midwives assisted in childbirth.

During labor, the mabuting hilot (good midwife) was called in.

If the birth became difficult, witches were supposed to be thecause.

To disperse their influence, gunpowder were exploded from a

bamboo cane close to the head of the sufferer.

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Health Care During the Spanish RegimeThe religious orders exerted their efforts to care for the sick bybuilding hospitals in different parts of the Philippines. The earliest

hospitals were: Hospital Real de Manila (1577) it was established mainly to care

for the Spanish kings soldiers, but also admitted Spanish civilians;founded by Gov. Francisco de Sande.

San Lazaro Hospital (1578) founded by Brother Juan Clementeand was administered for many years by the Hospitalliers of San

Juan de Dios; built exclusively for patients with leprosy. Hospital de Indios (1586) established by the Franciscan Order;

service was in general supported by alms and contributions fromcharitable persons.

Hospital de Aguas Santas (1590) established in Laguna; near amedicinal spring, founded by Brother J. Baustista of the Franciscan

Order.San Juan de Dios Hospital (1596) founded by the Brotherhood ofMisericordia and administered by the Hopsitaliers of San Juan deDios; support was delivered from alms and rents; rendered generalhealth service to the public.

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Nursing During the Philippine Revolution

Josephine Bracken, wife of Jose Rizal- installed a field hospital in an

estate house in Tejeros; provided nursing care to the wounded

night and day

Rosa Sevilla de Alvero- converted their house into quarters for the

Filipino soldiers; during the Philippine-American War that broke out

in 1899 Dona Hilaria de Aguinaldo- wife of Emilio Aguinaldo; organized that

Filipino Red Cross under the inspiration ofMabini

Dona Maria Agoncillo de Aguinaldo- second wife of Emilio

Aguinaldo; provided nursing care to Filipino soldiers during therevolution, President of the Filipino Red Cross branch in Batangas

Melchora Aquino (Tandang Sora)nursed the wounded Filipino

soldiers and gave them shelter and food

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Capitan Salome a revolutionary leader in Nueva

Ecija; provided nursing care to the wounded

when not in combat

Agueda Kahabagan- revolutionary leader

in Laguna, also provided nursing services to her

troops

Trinidad Tecson (Ina ng Biak-na-Bato)- stayed in

the hospital at Biak na Bato to care for wounded

soldiers

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Hospitals and nursing schools

Iloilo Mission Hospital School of Nursing (Iloilo City,

1906)

It was ran by the Baptist Foreign Mission Society of

America.

Miss Rose Nicolet, a graduate of New England Hospital

forWomen and Children in Boston, Massachusetts wasthe first superintendent for nurses.

It moved from its present location to Jaro Road, Iloilo

City in 1929. Miss Flora Ernst, an American nurse, took

charge of the school in 1942. In April 1944 graduate nurses took the first Nurses

Board Examination at the IloiloMission Hospital.

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Philippine General Hospital School of Nursing (Manila, 1907)

PGH began in 1901 as a small dispensary for Civil officers andEmployees in the City ofManila and later grew as a Civil

Hospital.

In 1906,Mary Coleman Masters, an educator advocated for

the idea of training Filipino girls for the profession of nursing

with the approval of Government officials, she first opened a

dormitory for Girls enrolled at the Philippine Normal Hall and

the University of the Philippines.

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In 1907, with the support of Governor General Forbes and the

Director of Health and among others, she opened classes in

nursing under the Auspices of the Bureau of Education.

Admission was based on an entrance examination.

The applicant must have completed elementary education to

the seventh grade.

Julia Nichols and Charlotte Clayton taught the students

nursing subjects. American physician also served as lecturers.

In 1910, the Act No. 1976 modified the organization of the

school placing it under the supervision of the Department of

Health.

The Civil Hospital was abolished and the Philippine General

Hospital was established.

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St.Lukes Hospital School of Nursing (Quezon City,

1907)

The hospital is an Episcopalian Institution. It began as a

small dispensary in 1903.

In 1907, the school opened with three girls admitted.

These three girls had their first year in combined classes

with the PGHSchool of Nursing and St. Pauls Hospital

School of Nursing.

Miss Helen Hicks was the first principal.

Mrs. Vitaliana Beltran was the first Filipino

superintendent of nurses and Dr. Jose Fores was the firstmedical director of the hospital.

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Mary Johnston Hospital and School of Nursing (Manila,

1907)

It started as a small dispensary on Calle Cervantes (now

Avenida).

It was called the Bethany Dispensary and funded by the

Methodist Mission for the relief of suffering among women

and children.

In 1907, Sister Rebecca Parrish together with registered

nurses Rose Dudley and Gertude Dreisbach, organized the

Mary Johnston School of Nursing.

The nurses training course began with three Filipino younggirls fresh from elementary as their first students.

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Philippine Christian Mission Institute Schools of Nursing

The United Christian Missionary Society ofIndianapolis,

Indiana- a Protestant organization of the disciples of Christoperated three schools of nursing:

Sallie Long Read Memorial Hospital School of

Nursing (Laoag Ilocos Norte, 1903)

Mary Chiles Hospital School of Nursing (Manila, 1911)The hospital was established by Dr. WN Lemon in a small

house on Azcarraga, Sampaloc, Manila. In 1913, Miss Mary

Chiles ofMontana donated a large sum of money with

which the preset building at Gastambide was bought.

The Tuason Annex was donated by Miss Esperanza Tuason,a Filipino Philantropist.

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Frank Dunn Memorial Hospital (Vigan Ilocos Sur, 1912)

San Juan de Dios Hospital School of Nursing (Manila, 1913)

In 1913, through the initaiative ofDr. Benito Valdez, the board

of inspectors and the executive board of the hospital passed a

resolution to open school of nursing.

The school has been run by the Daughters of Charity since

then.

Sister Taciana Tinanes was the first Directress of the School

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Emmanuel Hospital School of Nursing (Capiz, 1913)

In 1913, the American Baptist Foreign Mission Society sent Dr.

PH Lerrigo to Capiz for the purpose of opening a hospital.

Miss Rose Nicolet assisted him.

The school offered a 3-year training course for an annual fee

of Php 100.00.

Miss Clara Pedrosa was the first principal

Southern Islands Hospital School of Nursing (Cebu, 1918)

The hospital was established in 1911 under the Bureau of

Health.

The school opened in 1918 with Anastacia Giron-Tupas as theorginizer. Miss Visitacion Perez was the first principal

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Other Schools of Nursing

1.Zamboanga General Hospital School of Nursing (1921)

2.Chinese General Hospital School of Nursing (1921)3.Baguio General Hospital School of Nursing (1923)

4.Manila Sanitarium Hospital and School of Nursing (1930)

5.St. Paul School of Nursing in Iloilo City (1946)

6.North General Hospital and School of Nursing (1946)

7.Siliman University School of Nursing (1947)

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The FIRSTColleges of Nursing in the Philippines

University ofSanto Tomas-College of Nursing (1946)

In its first year of existence, its enrolees were consisted ofstudents from different school of nursing whose studied were

interrupted by the war.

In 1947, the Bureau of Private Schools permitted UST to grant

the title Graduate Nurse to the 21 students who were ofadvance standing from 1948 up to the present.

The college has offered excellent education leading to a

baccalaureate degree.

Sor Taciana Trinanes was its first directress. Presently, Associate Professor Glenda A.Vargas, RN, MAN

serves as its Dean.

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Manila Central University-College of Nursing (1947)

TheMCU Hospital first offered BSN and Doctor ofMedicine

degrees in 1947 and served as the clinical field for practice.

Miss Consuelo Gimeno was its first principal. Presently,

Professor Lina A. Salarda, RN, MAN, EdD serves as its Dean.

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University of the Philippines Manila-College of Nursing

(1948)

The idea of opening the college began in a conference

between Miss Julita Sotejo and UP President.

In April 1948, the University Council approved the curriculum,

and the Board of Regents recognized the profession as having

an equal standing as Medicine, Engineering etc. Miss Julita Sotejo was its first dean. Presently, Professor

Josefina A.

Tuason, RN,MAN, DrPh is once more reappointed as the Dean

of UP Manila College of Nursing

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Criteria of a Profession

Nursing is gaining recognition as a profession. Profession has been defined as an occupation

that requires extensive education or a calling

that requires:

special knowledge,

skill, and preparation.

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A profession is generally distinguished from

kinds of occupations by

(a) its requirement of prolonged, specialized

training to acquire a body of knowledge pertinent

to the role to be performed;

(b) an orientation of the individual toward service,either to a community or to an organization

(c) ongoing research

(d) a code of ethics

(e) autonomy

(f) a professional organization

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Two terms related to profession need to be differentiated:

Professionalism refers to professional character, spirit, ormethods. It is a set of attributes, a way of life that implies

responsibility and commitment. Nursing professionalism owes

much to the influence of Florence Nightingale.

Professionalization- is the process of becoming professional,that is, of acquiring characteristics considered to be

professional.

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ARTICLE VI

Nursing Practice

Section 28. Scope of Nursing. - A person shall be deemed to

be practicing nursing within the meaning of this Act when

he/she singly or in collaboration with another, initiates and

performs nursing services to individuals, families and

communities in any health care setting.

It includes, but not limited to, nursing care during conception,

labor, delivery, infancy, childhood, toddler, preschool, school

age, adolescence, adulthood, and old age.

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As independent practitioners, nurses are primarily responsible

for the promotion of health and prevention of illness. A members of the health team, nurses shall collaborate with

other health care providers for the curative, preventive, and

rehabilitative aspects of care, restoration of health, alleviation

of suffering, and when recovery is not possible, towards a

peaceful death.

It shall be the duty of the nurse to:

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(a) Provide nursing care through the utilization of the nursing

process. Nursing care includes, but not limited to, traditional and

innovative approaches, therapeutic use of self, executing

health care techniques and procedures, essential primary

health care, comfort measures, health teachings, and

administration of written prescription for treatment,therapies, oral topical and parenteral medications, internal

examination during labor in the absence of antenatal bleeding

and delivery.

In case of suturing of perineal laceration, special training shallbe provided according to protocol established;

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(b) establish linkages with community resources and

coordination with the health team;

(c) Provide health education to individuals, families and

communities;

(d) Teach, guide and supervise students in nursing education

programs including the administration of nursing services in

varied settings such as hospitals and clinics; undertakeconsultation services; engage in such activities that require

the utilization of knowledge and decision-making skills of a

registered nurse; and

(e) Undertake nursing and health human resourcedevelopment training and research, which shall include, but

not limited to, the development of advance nursing practice;

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Provided, That this section shall not apply to nursing students

who perform nursing functions under the direct supervision

of a qualified faculty: Provided, further, That in the practice ofnursing in all settings, the nurse is duty-bound to observe the

Code of Ethics for nurses and uphold the standards of safe

nursing practice.

The nurse is required to maintain competence by continual

learning through continuing professional education to be

provided by the accredited professional organization or any

recognized professional nursing organization: Provided, finally,

That the program and activity for the continuing professional

education shall be submitted to and approved by the Board.