Saturday, September 6, 2008

The Nurse and the Past 50 Years

Physicians gave the orders, Nurses implemented them!This is how the nursing profession have been linked with the medical profession and still continues, in many areas. In the last fifty years, some changes have occurred that does not make the above statement accurate to all nurses! LPN or licensed practical nurses have taken over the bedside nursing in many facilities, especially in Long Term Care but they do work under the Registered Nurses' supervision.

In order to make these postings simple, all the Nurses I mention in the next paragraphs are Registered Nurses who are either educated in a nursing college or a university and all have post-graduate studies in some specializations.

You, most probably have heard of ICU (intensive care unit), ECU (emergency care unit), CCU(cardiac care unit) Dialysis unit. All these units are specialty units and the nurses who work there have extra education and certification above their basic nursing education.

Scientific and Medical discoveries like radium, vaccines and antibiotics expanded the role of the nurse. Then in the last 15 years, informatics has changed the mode of recording data and treatments.

Nurses are now working in other areas besides the traditional hospitals and Nursing Homes. Community Health Nurses work in clinics and visit homes to do assessments on home-bound clients. Public Health Nurses work in municipal and other government agencies, teaching, researching on disease prevention and policies for health protocols. Occupational Health Nurses work with employees, in industries and organizations.

Nurse Researchers, nurse Educators are found in colleges, universities and some major research facilities. There are also Nurse Anaesthetists, Nurse Case Managers, Mental Health Nurses

The Informatics Nurse is a new addition in the last decade and she is responsible for teaching her colleagues on IT related documentation as well as formulating new applications for nurses. Another new addition is the Nurse Practitioner who is able to diagnose and prescribe some medication and treatments independently. Usually, she works in a community clinic or Wellness Centres. Sometimes, she works in partnership with a family physician in an office setting!
Yet another is the Nurse Entrepreneur - she is a business owner either online or off-line.

So what is next for the Nurse?? Tune in on Tuesday?

copyright P Nicholas

Monday, September 1, 2008

Nurse - Who was the first Nurse?

Let me ask you a question? When you were feeling unwell or when you had a cough or cold as a child, who was the first person who gave you care, till you became better? Many of us will answer - mother, grandmother,aunt. Likewise, the first nurse was untrained and the female member of a family.

The history of nursing seem to be synonymous with the history of women.(V.Robbins)
Yet both sexes have the tendency to respond to helplessness (Donahue,M.96) The first religious orders had male nurses caring for their sick in the monasteries in the middle ages as women were not allowed in the enclosures.

Nursing was part of many religious orders who followed Christ's mandate in ministering to the sick. In 1633, St. Vincent de Paul and Louise Marillac of France founded the Daughters of Charity who looked after the sick in their homes and in hospitals. In the Americas, Jeanne Mance founded the first hospital in Montreal in 1645 and in 1783, James Derham, a slave in New Orleans, through the earnings as a nurse bought his freedom.

In the nineteen century in the England, Florence Nightingale, initiated Evidence-Based Nursing after she went to France to learn from the Daughters of Charity, their methods in caring for the sick. She included statistics and a systemic approach to nursing. She and the women she trained were ladies who volunteered their services without being paid.

Free Portrait of Florence Nightingale. Click Here to Get Free Images at Clipart

So in England in the nineteenth century, nurses' training was provided for those who cared for the sick and carried out their duties under the direction of a physician. I mentioned England, because all the Commonwealth countries adopted the same training as those in England. Training was provided in hospital schools, and usually an unmarried girl or widow was accepted. They were trained on the job and were required to live in nursing residences attached or close to the hospital. There was a nursing hierarchy

The student nurses were paid a stipend while they trained, which usually lasted for three years when they are promoted to staff nurse. The next level is a nursing sister (only a few reached this status, as many of the staff nurses married and left the hospital to raise a family. Nursing sister did not marry. They were provided lodging and the acted as supervisors and teachers.

The final level in the nursing ladder was the Matron, who also was unmarried. Physicians at times were intimidated by the Matron. Nurses usually stayed in the residences except for their occasional week-ends off. White, starched, a-line,modest, dress uniforms and little caps or veils were part of the scenery in hospitals for two centuries.

Florence's contribution to nursing and health, included, careful statistical data collection and thorough documentation. She changed Public Health and reformed the hospital environment, including basic infection control. You can read more about Florence in this website - nightingale.htm

This is only a brief description of the history of nursing and the Nurse! There is a great volume of information on the web and in books, describing the history of nursing in the individual countries.
From its history, we can travel to the present and see the paths, Nursing and the Nurse evolving, in the area of education, duties, opportunities and empowerment.

The next posting will be nursing in the last 50 years. Would like to hear from Nurses, retired or still working as well as student nurses!