FOR FIRST YEAR GNM STUDENTS

1. INTRODUCTION
TO NURSING
SHAREEF KM, BSN, MSN

2. INTRODUCTION TO NURSING
 Modern nursing is defined as a science and
an art that focuses on promoting quality of
life.
 Nursing has existed in various forms in every
culture and it has changed greatly overtime
from the oldest sense of “a woman employed
to take care of a child” to the broadest sense
in modern nursing as “a professional
promoting quality of life”.

3. PIONEERS OF NURSING PROFESSION
1. FLORENCE NIGHTINGALE
2. VIRGINIA HENDERSON
3. CLARA BARTON
4. LILLIAN WALD
5. LAVINIA. L. DOCK
6. MARGARET SANGER

4. FLORENCE NIGHTINGALE
 Florence nightingale was
born on 12 th May 1820
in Italy.
 She is considered as
‘FOUNDER OF
MODERN NURSING’
 She visited Kaiserwerth
in 1847 and received 3
months training in
nursing

5.  Her achievements in improving the standards of care
for war casualties in ‘Crimea’ earned her the title
‘LADY WITH LAMP’
 She established Nightingale Training School at St
Thomas Hospital, London in 1860.
 She is recognised as nursing’s first scientist-theorist
for her work ‘NOTES ON NURSING- WHAT IT IS
AND WHAT IT IS NOT’ in 1860.
 She died in London on 13th August 1910.
 Since 1965, ‘Internatinal Nurses Day’ has been
celebrated on her birth day each year.

6. CRIMEAN WAR
 Florence nightingale's most famous contributions
came during crimean war in 1853.
 The crimean war broke out in between Russia and
England and its allies.
 By 1854 approximately 18 thousand soldiers had
been admitted to military hospitals.
 Poor care of wounded soldiers was being delivered
by over worked medical staff.
 hygiene was being neglected and mass infections
were common and many of the fatal.

7. CRIMEAN WAR- cntd..
 Nightingale received a letter from secretary of war
asking her to organise a corpse of nurses to attend
the sick soldiers in Crimea.
 By focusing on basic environmental factors like air
water light drainage and cleanliness she reduced the
death rate from 42 % to 2%.
 Her activities and experiences in the crimean war
served the foundations of modern nursing.

8. Virginia Henderson (1897 - 1996)
 Famous for her definition of
Nursing.
 Developed in nursing need
theory
 Listed 14 fundamental needs
of individuals.

9. Clara Barton
 Organising nursing services
in American civil war

Played a role in
establishing American Red
cross

10. Lillian Wald
 Founder of public health
Nursing
 Offered trained nursing
services to poor in the New
York slums

11. Lavinia L Dock
 Campaigned for legislation
to allow nurses rather than
physicians to control their
profession

12. Margaret sanger
 Founder of planned
parenthood
 Imprisoned for opening
the first birth control
information clinic in
America.

13. Nursing Concept
 Concept is defined as labels given to ideas objects
and events, a summary of thoughts or a way to
categorize thoughts or ideas.
 Eg: comfort, pain

14. Four Central concepts of Nursing are
 1. Person or client: the recipient of nursing care
(includes individuals families groups and
communities)
 2. Environment: the internal and external
surroundings that affect the client.
 3. Health: the degree of wellness of well being that
the client experiences.
 4. Nursing: the attributes characteristics and
actions of the nurse providing care on behalf of or in
conjunction with the client.

15. Nursing theory
 Nursing theory is a creative and rigorous structuring
of ideas that project a tentative purposeful and
systematic view of phenomena
 1. Environmental theory
 2. Nursing need theory
 3. Self care theory
 4. Neuman's System model
 5. Roy's Adaptation model

16. 1. Environmental theory
 Florence nightingale
 She linked health with 5 environmental factors
1. Pure or fresh air
2. Pure water
3. Efficient drainage
4. Cleanliness
5. Light, especially direct sunlight

17. 2. Nursing need theory
 Virginia henderson
 Viewed nurse's role as helping the client from
dependence to independence

18. 3. Self care theory
 Dorothea Orem
 Includes three related concepts:
1. Selfcare
2. Self care deficit
3. Nursing systems
 Nursing systems of three types:
Wholly compensatory system
Partially compensatory system
Supportive educative system

19. 4. Neuman's System model
 Betty Neuman
 The client is viewed as an open system and nursing
interventions focus on retaining or maintaining
system stability.

20. 5. Roy's Adaptation model
 Sister Callista Roy
 Views the client as a bio psychosocial adaptive
system that employees a feedback cycle of input (
stimuli), through put ( control process) and output
behavior or adaptive responses.

21. Meaning of Nursing
 The word nurse originated from the Latin word
'nutrire' which means ‘to nourish’, ‘to protect’, ‘to
educate’, ‘to support’ and ‘to supply’.
 Dictionary meaning of nursing is to feed a baby. As a
profession nursing means practice of providing care
for sick and infirm.
 Three components of Nursing- head, heart and
hand- are referred to as science spirit and skill of
Nursing

22. Definitions of Nursing
 1. The art of utilizing the environment of a patient to
assist him in his recovery.
 Florence nightingale (1860)

23.  2. The unique function of a 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 that to help him gain
independence as rapidly as possible.
 Virginia henderson (1960)

24.  3. Nursing is the diagnosis and treatment of human
responses to actual or potential health problems.
 ANA (1980)

25. Scope of Nursing
 Nurses provide care for three types of clients-
individual, families and communities.
 Nursing practice involve the following areas.
 1. To promote and maintain health and wellness
2. To prevent illness.
3. To restore health and function
4. To alleviate suffering
5. To facilitate independence
6. Care of dying

26. Roles and functions of nurse
 Nurses assume a number of roles when they provide
care and often carry out these roles concurrently
1. Care giver
2. Communicator
3. Teacher
4. Client advocate
5. Counselor
6. Change agent
7. Leader
8. Manager
9. Case manager
10. Research consumer
11. Expanded career roles

27. 1. CAREGIVER
 Includes activities that assist the client physically
and psychologically while preserving client's dignity.
 It may involve
 full care of completely dependent client.
 partial care of partially dependent client and
 supportive educative care to assist clients in attaining their
highest possible level of health and wellness.

28. 2. COMMUNICATOR
 Nurse must be able to communicate clearly and
accurately.
 Nurses communicate with client, support person,
other health professionals and people in the
community.
 Nurses identify clients problem and then
communicate this verbally or in writing to the other
members of the health team.

29. 3. TEACHER
 As a teacher the nurse helps clients to learn about
the health and health care procedures they need to
perform to restore or to maintain health.
 Nurse also teach unlicensed assistants to whom they
delegate care and share their expertise with other
nurses and health professionals.

30. 4. CLIENT ADVOCATE
 A client advocate acts to protect the client.
 Nurse represent the client's needs and wishes to
other health professionals and assist clients to
exercise their rights.

31. 5. COUNSELOR
 Counseling is the process of helping a client to
recognize and cope with stressful psychological or
social problems to develop improved interpersonal
relationships and to promote personal growth.
 It involves providing emotional intellectual and
psychological support.

32. 6. CHANGE AGENT
 The nurse act as a change agent when assisting
clients to make modifications in their knowledge and
behavior.
 Nurses often act to make changes in a system such as
a clinical area if it is not helping a client return to
health.

33. 7. LEADER
 A leader influences others to work together to
accomplish a specific goal.
 Effective leadership is a learnt process.

34. 8. MANAGER
 The nurse manages the nursing care of individuals,
families and communities.
 The nurse manager also delegates nursing activities
to ancillary workers and other nurses and supervises
and evaluates their performances.
 Managing requires knowledge about organizational
structure, authority and accountability, leadership,
change theory, advocacy, delegation and supervision
and evaluation.

35. 9. CASE MANAGER
 Nurse case managers work with the multidisciplinary
healthcare team to measure the effectiveness of the
case management plan and to monitor outcomes.
 Case managers help to ensure that care is oriented to
the client while controlling costs.

36. 10. RESEARCH CONSUMER
 Nurses often use research to improve client care
through evidence based practice.

37. 11. Expanded career roles
 This roles allow greater independence and
autonomy.

38.  a) nurse practitioner
 b) clinical nurse specialist
 c) nurse anesthetist
 d) nurse midwife
 e) nurse researcher
 f) nurse administrator
 g) nurse educator
 h) nurse entrepreneur
Expanded career roles

39. NURSE PRACTITIONER
 A nurse who has an advanced education and is a
graduate of a nurse practitioner program.
 Usually deal with non emergency acute or chronic
illness and provide primary care.

40. CLINICAL NURSE SPECIALIST
 A nurse who has an advanced degree or expertise
and is considered to be an expert in the specialized
area of practice.

41. NURSE ANESTHETIST
 A nurse who has completed advanced education in
accredited program in anesthesiology.
 They carry out pre-operative assessments and
administer general anesthetics for surgery under
supervision of a physician.

42. NURSE MIDWIFE
 An RN who has completed a program in midwifery
and is certified.
 The nurse gives prenatal and postnatal care and
managers deliveries in normal pregnancy.

43. NURSE RESEARCHER
 Nurse researchers investigate nursing problems to
improve nursing care and to refine and expand
nursing knowledge.

44. NURSE ADMINISTRATOR
 Manages client care including delivery of nursing
service.
 The functions of nurse administrators include
budgeting, staffing and planning programs.

45. NURSE EDUCATOR
 They are employed in nursing programs at
educational institutions and are responsible for
classroom and clinical teaching.

46. NURSE ENTREPRENEUR
 A nurse who usually has an advanced degree and
manages a health related business.

47. HISTORY OF NURSING IN INDIA
 Military nursing was the earliest type of Nursing.
 In 1664 East India company started a hospital for
soldiers at fort Saint George Madras.
 In 1797 a lying in hospital for the poor of Madras was
built.
 In 1854 government sanctioned a training school for
midwives in Madras.

48. HISTORY OF NURSING IN INDIA- Contd..
 In 1865 as an effect of 'suggestions on a system of
nursing for hospitals in India' by Florence nightingale
reforms in military hospital lead to reform the civilian
hospitals.
 Graduates were sent out from the Nightingale School of
Nursing at Saint Thomas hospital England to start
similar schools in our country.
 In 1867 Saint Stephen's hospital at Delhi was the first one
to begin a training for Indians as nurses.

49. HISTORY OF NURSING IN INDIA- Contd..
 In 1871 the first school of nursing was started in
government general hospital Madras.
 In 1891 Bai kashibai Ganpat what's the first Indian nurse
to come for training.
 In 1908 trained nurses association of India (TNAI) was
formed.
 In 1918 training schools were started for health visitors
and dais at Delhi and Karachi.
 In 1926 first nurses registration act passed in Madras
 In 1942 ANM program started

50. HISTORY OF NURSING IN INDIA- Contd..
 In 1943 school of nursing at RAK College New Delhi
started.
 In 1946 4 year BSc nursing program started in R A K
college and CMC Vellore.
 In 1947 INC act passed.
 In 1959 to 1960 MSc nursing started in RAK College of
Nursing
 In 1963 post basic programs started in various
institutions.
 In 1972 basic degree program started in Kerala.
 In 1987 MSc nursing started in Kerala

51. LEVELS OF NURSING EDUCATION IN INDIA
Now there are seven levels of nursing education in India.
They are
1. Auxillary nursing and midwifery (ANM) - 2 years
2. General nursing and midwifery (GNM) - 3 years
3. Basic bachelor of Nursing (BSc Nursing) - 4 years
4. Post basic bachelor of Nursing (PB-BSc Nursing) - 2
years
5. Masters in nursing (MSc Nursing) - 2 years
6. Masters of philosophy in nursing (MPhil) - 1 year
7. Doctorate in philosophy in nursing (PhD) - minimum 2
years.

52. Nursing as a profession
 Profession has been defined as an occupation that
requires extensive education special knowledge skill
and preparation.

53. Nursing as a profession
 A profession is distinguished from other kinds of
occupation by
 1. Specialised education
 2. Body of knowledge
 3. Service orientation
 4. Ongoing research
 5. Code of ethics
 6. Autonomy and
 7. Professional organisation
 Nursing is recognised as a profession now.

54. Qualities of a professional nurse

 1. Caring. Caring is one of the essential quality of a
nurse.
 Nurses having this quality will have a significant
impact on their success in nursing field.


55. 2. Empathy.
 Being able to understand another individuals needs
and feelings. ie, putting yourself in that situation.

 Sympathy. Emotional involvement with other
people.


56. 3. Communication skills.
 Without the ability to interpret and convey
communications correctly, medical errors are not
likely to occur, patients often feel neglected or
misinformed.
 So, strong communication skills are critical
characteristic of a nurse.


57. 4. Commitment to patients.
 Giving importance to keeping patients safe,
delivering the highest quality of care more than any
other things.


58. 5. Health.
 Physical and mental health of a nurse is pivotal in
delivering quality care.


59. 6. Time management.
 Caring multiple patients in stressful care settings
requires ability for effective time management.
 Punctuality serves as the first step of time
management.

60. 7. Leadership.
 Nursing is a teamwork and leadership quality helps
to go smoothly with health care team.

61. 8. Problem solving skills.
 As nurses generally have the most one-on-one time
with patients and often responsible for decision
making related to their care, problem solving skills
are essential.

62. Other qualities are...
 9. Courtesy - Polite and respectful
 10. Patience
 11. Impartial
 12. Cooperative
 13. Poise - should be able to control emotions
 14. Self discipline
 15. Honesty
 16. Courage
 17. Attention to details
 18. Sense of humor
 19. Willingness to learn
 20. Critical thinking

63. Ethics in nursing
 Ethics is expected standards of moral behaviour of a
particular group.
 It is a systematic enquiry into principles of right and
wrong conduct.

64. Ethical principles
 Autonomy: Right to make one's own decisions
 Nonmaleficence: Duty to do no harm
 Beneficence: Doing good
 Justice: Referred to as fairness

65. Ethical principles- Contd…
 Fidelity :To be faithful to agreements and promises
 Veracity:Telling the truth
 Accountability: Answerable to oneself and others
for one's own actions

66. Code of ethics
 A code of ethics is a formal statement of groups of
ideals and values.
 It is a set of ethical principles that
 Are shared by members of the group
Reflect their moral judgment over time
Serve as a standard of their professional actions

67. Purposes of nursing code of ethics
1. It informs the public about the minimum standards of the
profession
2. It provides a sign of the profession's commitment to the
public, it serves
3. It prevents the nurses from practicing if their conduct is
poor
4. It provides general guidelines for professional behaviour
5. It protects the news who is falsely accused of doing
something wrong
6. It guides the profession in self regulation
7. It reminds nurses of the special responsibilities they are CM
when caring for the sick
8. It can be taken as a guide when legal actions must be taken
in a lawsuit

68. Code of ethics by ICN (International Council of
Nurses)
 PREAMBLE
 Nurses have four fundamental responsibilities: to
promote health, to prevent illness, to restore health
and to alleviate suffering.

The need for nursing is universal. Inherent in
nursing is respect for human rights including the
right to life to dignity and to be treated with respect.

69. PREAMBLE- contd…
 Nursing care is unrestricted by considerations of age
colour creed culture disability or illness gender
nationality politics race of social status.
 New render health services to the individuals family
and the community and co-ordinate their services
with those of related groups.

70. Elements of the code
 The ICN code of ethics for nurses has four principal
elements that outline the standards of ethical
conduct
 1. Nurses and people
 2. Nurses and practice
 3. Nurses and the profession
 4. Nurses and co workers

71. 1. Nurses and people
 The nurse's primary personal responsibility is to
people requiring nursing care.
 In providing care the nurse promotes an
environment in which the human rights values
customs and spiritual beliefs of the individual family
and community are respected
 The nurses ensure that the individual receives
sufficient information on which to base consent for
care and related treatment.
 The nurse holds in confidence personal information
and uses judgement in sharing this information.

72. 2. Nurses and practice
 The nurse carries personal responsibility and accountability
for nursing practice and for maintaining competence by
continual learning
 The nurse maintains a standard of personal health such that
the ability to provide care is not compromised
 The nurse uses judgement regarding individual competence
when accepting and delegating responsibility.
 The nurse at all times maintains standards of personal
conduct which reflect well on the profession and enhance its
image and public confidence
 The nurse in providing care ensures that use of technology
and scientific advances are compatible with the safety dignity
and rights of people.

73. 3. Nurses and the profession
 The nurse assumes the major role in determining and
implementing acceptable standards of clinical nursing
practice management research and education.
 The nurse is active in developing a core of research based
professional knowledge that supports evidence based
practice
 The nurse acting through professional organisation
participates in creating a positive practice environment
and maintaining safe equitable social and economic
working conditions in Nursing
 The nurse is active in developing and sustaining a code of
professional values

74. 4. Nurses and co workers
 The nurse sustains a collaborative and respectful
relationship with coworkers in nursing and other
fields.
 The nurse take appropriate action to safeguard
individuals families and communities when their
health is endangered by co-worker or any other
person.
 The nurse take appropriate action to support and
guide co-workers to advance ethical conduct.