CHAPTER III. The evolution of professional nursing is. closely allied to that of the medical profession which

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Conrad Black
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1 CHAPTER III NURSING OCCUPATION The evolution of professional nursing is closely allied to that of the medical profession which itself grew out of witchcraft. Origin of nursing : Originally nursing developed to satisfy a need in all families. This impulse to care for the sick and weaker members of the group found its expression in various forms, with relition playing an important part. Before the Christian era, there was no organised nursing. The ideals of brotherhood, service, charity and self sacrifice preachedi by the Christian Church were put into practice by such groups as sisters of charity, Benedictine and augustinian sisters. Till around 17th century medicine and nursing were carried out by priest-physicians. It was after the 17th century that medicine and nursing separated and each moved forward to become professionalised. Discoveries in the field of medicine since Claudius Galen (AD ) have brought about tremendous changes in the care of the sick. The early Christian era gave to us visiting nurses who today are the Public Health Nurses.

This impulse to care for the sick and weaker members of the group found its expression in various forms, with relition playing an important part.

2 ...18 Institutionalized nursing or hospital nursing as we know today can be seen developing after the industrial revolution. It m s also the growth of medicine which led to the need of hospitals. Medical men began demanding for better conditions in which to care for the ill. The outcome was-the modern metropolitan hospital with its hundreds of beds. The doctors* training became more complicated, his demands grew and he needed a group of persons who in co-operation with him could tend to the sick and carry out procedures, This need was met by the m o d e m n u r s e., - Hursing in the 19th century : Ifursing has had to adapt itself to the progress of curative and preventive medicine. The most characteristic feature of the development of nursing has been the speed with which nurses have adapted themselves to the exigencies of m o d e m medicine. Over a hundred years ago the majority of nurses were almost completely illiterate (WHO, 1953, p.464), for at that time there were few countries in which elementary education was compulsory and nurses were held to play a very subordinate role. The care given to patients was in general of a very low standard. The following remark made by the matron of a London Hospital to Florence nightingale in

The doctors* training became more complicated, his demands grew and he needed a group of persons who in co-operation with him could tend to the sick and carry out procedures, This need was met by the

3 describes the situation that existed then in course of her large experience she had never found a nurse who was not drunken and there was immoral conduct practiced in the very wards. (Smith C.W., 1949 p. 58). Since the establishment of the first school * of nursing by Florence nightingale in 1860, nursing practice has developed a new concept - proper technical training to become a nurse. During the last half of the 19th century starting changes were brought about in nursing by the persevering efforts of Florence nightingale which raised both the moral and technical standards of nursing. The first training for nurses in India was started in Madras on 1st July, Hursing in the 20th century 5 During the 1920 s and 1950*s there was a rapid development in medical technology, this caused a shift in the tenderness and technique used by nurses and technical methods gained importance. This expanded the functions of the nurse and it was at this stage that auxiliary personnel like the nurses aides and practical nurses were added to the nursing services. This addition brought on new roles for nurses - those of administrators and supervisors. One significant trend that became evident in the years after the second world war was the decline in

Since the establishment of the first school * of nursing by Florence nightingale in 1860, nursing practice has developed a new concept - proper technical training to become a nurse.

4 value of nursing care in comparision to the increased Value of medical care. The advent of sulfa drugs, antibiotics, tranquilizers and the concepts of early ambulation and intensive care have reduced the patients' stay in the hospital and consequently the nurses does not spend weeks and months with one particular patient. However the introduction of intensive care units has increased the proportion of nurse s work and she works like an assistant to the physician. On the wards the nurse has changed from doing things for the patient, to, helping the patient help himself, Again, the concept of rehabilitation of patient requires the assistance of a nurse with understanding of its principles. The psycho-somatic aspect of medicine included in patient care requires the nurse to become conversant with mental hygiene. It is seen then, that the rapid progress in the field of health and the changing social patterns of all peoples have brought about changes in the nursing services. For any health programme to be successful a good nursing service is very essential. This means an increase in demand for nursing services if health services are to extend to more and more people. Changing Role and Functions of the Ifurse : Having seen the developmental background of nursing, it would be relevant to look at the role of nurses

spend weeks and months with one particular patient. However the introduction of intensive care units has increased the proportion of nurse s work and she works like an assistant to the physician.

5 21 Role is not what one does, r a ther it is the complex o f b e h a v i o u r i n a given position, l u rses are not n e c e s sarily found at t h e bedside of the patient. They are i n several areas where they p l a y different roles - in doctors* office, the central sterile supply department of the hospital, head of a department, d e a n of a college, administrative head of,a small hospital, a r m y lieutenant, teacher, public h e a l t h w o rker and many s u c h positions. T h e i r 1training could b e.anywhere from three years of g e neral nursing to P h. D w i t h y e a r s of experience. The nurse is i n contact w i t h the patients more' than the doctor is and she is i n one sense the k e y stone of therapeutic structure. In general, m e dicine the nurse appears'to have three'kinds of activities. ' First are the m e d i c a l treatments that the d o c t o r delegates to her. Second, there are those -things that a nurse does and a d o c t o r n e v e r does and finally there is a b o d y of nursing skills that the d o ctor n e v e r comments on. This is the content of h e r role that is complementary to the doctor's role and he would n e v e r d r e a m of invading it. It is taught b y nurses to n u rses and is i n the g r o u n d on which they stand. Social Status' l u r s i n g is first of all an action- oriented profession, jut its status is ambiguous. The t raining p e r i o d is long and requirements high, but the rewards are generally low and prestige not v e r y great. Since n u r s i n g like teaching and social w o r k is largely

head of,a small hospital, a r m y lieutenant, teacher, public h e a l t h w o rker and many s u c h positions. T h e i r 1training could b e.anywhere from three years of g e neral nursing to P h.

6 *,22 followed by women, it may be one reason for low image.. In addition to a highly developed sense of professional responsibility, the nurse is expected to have an extensive knowledge of basic physical and biological sciences, a sensitivity to the numerous signs and symptoms, skill in use of complicated instruments, personal attributes like tact, kindness, sensitivity, chearfulness, compassion, generosity, initiative, warmth, skill in interpersonal relations, principles of economics, political science, sociology, psychiatry, psychology, administrative knowledge and the knowledge of the organizational setup of her place of work. With all this preparation she has very little part in major decisions of patient care. Occupational isolation, conservativeness are other factors that make the status. Education Of late the education of health workers is increasing so much so that the traditional role of the nurse is being challenged. Professional education is meant not only to acquire competence, but also to develop social understanding. Very rapid changes are taking place in the technological and scientific fields which have revolutionized treatment. The public knows of these advances through the mass media and they demand better quality care which means better educated personnel. In this direction the nursing schools have become more realistic and introduced in their training programme content and experience that will help the

signs and symptoms, skill in use of complicated instruments, personal attributes like tact, kindness, sensitivity, chearfulness, compassion, generosity, initiative, warmth, skill in interpersonal

7 21 graduates to handle a whole range of demands that their job will place on them. More emphasis is laid on social sciences, dynamics of social situations, development of leadership skills, interpersonal and intergroup relations, and principles and techniques of administration. Hursing is trying to become a truly professional discipline from the traditionally accepted technically oriented discipline*

skills, interpersonal and intergroup relations, and principles and techniques of administration.

Japanese Psychological Research Jewish Social Studies Journal for Social Action in Counseling & Psychology Journal for Specialists in Pediatric

Japanese Psychological Research Jewish Social Studies Journal for Social Action in Counseling & Psychology Journal for Specialists in Pediatric Nursing Journal for the Scientific Study of Religion Journal