FUNDAMENTALS OF NURSING PRACTICE

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1A INTRODUCTORY CONCEPTS Model:

► Is a theoretical way of understanding a
concept or idea
► Represent different ways of
approaching complex issues
Health beliefs:
Person’s ideas, convictions and attitudes
about health and illness.
Positive health behaviors- activities
related to maintaining, attaining or
Concept of Man, Health and Illness
regaining good health and preventing
Health is a fundamental right of every illness.
human being. It is a state of integration of
Negative health behaviors- practices
the body and mind
actually or potentially harmful to health.
Factors and Issues Affecting Health and
HEALTH-ILLNESS CONTINUUM (DUNN)
Illness
HEALTH BELIEF MODEL
► Addresses the relationship between a
person’s beliefs and behaviors.
1st component: individual’s perception of
susceptibility to an illness.
2nd component: individual’s perception
of the seriousness of the illness
3rd component: likelihood that a person
will take preventive action.
HEALTH: HEALTH PROMOTION MODEL (Pender)
► A state of physical, mental, and social ► Health is positive, dynamic state, not
well-being, not merely the absence of merely the absence of disease
disease or infirmity. (WHO, 1947)
► Designed to be a complementary
► The actualization of inherent and counterpart to models of health
acquired human potential through goal- protection
oriented behavior, competent self-care,
and satisfying relationships with others ► Focuses on:
while adjustments are made as needed to 1. Individual characteristics and
maintain structural integrity and harmony experiences
with the environment (Pender, 2015)
2. Behavior specific knowledge and
Models of Health and Illness affect
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3. Behavioral outcomes, in which the  Spiritual factors

patient commits to or changes a behavior.
► External variables:
 Family practices – the way the
patient’s families use HC services
 Psychosocial and Socioeconomic
factors
- Socioeconomic variables
- Economic variables:
► Cultural background- influences
beliefs, values and customs
MASLOW’S HIERARCHY OF NEEDS
HEALTH PROMOTION
► Nurses use this model to understand
 Activities that help patients
the interrelationships of basic human
maintain or enhance their present
needs.
health level
► It provide basis for nurses to render  Ex: routine exercise and good
care to patients across lifespan in different nutrition
settings
WELLNESS
 Strategies that help people to
achieve new understanding and
control of their lives
 Ex: health education
ILLNESS PREVENTION
 Activities that motivate people to
avoid a decline in health or
HOLISTIC HEALTH MODEL functional levels
► Attempts to create conditions that  Immunization
promote a patient’s optimal level of LEVELS OF PREVENTIVE CARE
health.
► Primary prevention:
► Involvement of patient in their healing
process; assumes responsibilities on  Aimed at health promotion
health maintenance  Precedes disease or any
dysfunction for patients who are
VARIABLES INFLUENCING HEALTH considered physically and
► Internal variables: emotionally healthy.

 Developmental stage ► Secondary prevention:

 Intellectual background  It focuses on people who are
 Perception of functioning experiencing health problems or
 Emotional factors
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illnesses, and who are at risk for - are acts exhibited by people who are ill.
developing complications
- Includes how monitoring of bodies,
 The activities are directed at
define and interpret the symptoms, take
diagnosis and prompt intervention,
remedial actions and use of the resources
which reduces severity and enable
in the HCS
patient to return to normal level of
health. ► Variables Influencing Illness and Illness
Behavior:
► Tertiary prevention:
 Internal variables
 Involves minimizing the effect of
- Patient perception of
long-term disease or disability by
symptoms
interventions in order to prevent
- The nature of the illness
complications
 External variables
 It occurs when a defect or
- Visibility of symptoms
disability is irreversible
- Social group
► Risk factor: - Cultural background
- Economic variable
- Is any situation, habit, or other variable
- Accessibility of health care
such as social, environmental,
system
physiological, psychological,
- Social support
developmental, intellectual, or spiritual
that increases the vulnerability of an Stages of Illness:
individual or group to an illness or
1. Symptom experience
accidents
- Transition stage when a person
► Categories:
believes something is wrong and
 Genetic and physiological factors experiences some symptoms
 Age Aspects: physical, cognitive,
 Environment emotional.
 lifestyle
2. Assumption of the sick role
ILLNESS
- Acceptance of the illness and
- Is a state in which a person’s physical, seeks advice or support to give up
emotional, intellectual, social, some activities.
developmental, or spiritual functioning is
3. Medical care contact
diminished or impaired.
- Confirmation of real illness,
► Acute illness: usually has a short
explanation of symptoms and
duration, reversible and is often severe.
reassurance of outcome
► Chronic illness: usually longer than 6
4. Dependent patient role
months, is irreversible, and affects the
functioning in one or more systems - A person becomes more passive
and accepting while becoming
► Illness behavior:
dependent on health professional
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5. Recovery/Rehabilitation  Has a vision for transformed HCDS

which makes quality care
- Returns to former roles and
accessible to all populations,
function by giving up the sick role
focuses on wellness and disease
ECOLOGIC MODEL prevention, improve health
outcomes, and provides
(Leavell and Clark’s Agent-Host-
compassionate care across the life
Environment Model)
span
Factors affecting Health and Illness:  Encourages a safe, effective,
patient centered, timely efficient,
1. Agent: any factor or stressor that
and equitable health care delivery
can lead to illness or disease
system
2. Host: person who may or may not  Nurses faces challenges to provide
be affected by a disease evidence-based, compassionate
care and as a patient advocate
3. Environment: Any external factor
that may or may not predispose the ► Institute of Medicine Report
person to certain disease.
 Practicing to the full extent of their
education and training
 Achieving higher levels of
education and training through an
improved education system that
provides seamless progression.
 Becoming full partners with
physicians and other health care
providers in redesigning the health
care system.
 Improving data collection and
information infrastructure for
effective workforce planning and
policy making.
HEALTH CARE SETTINGS AND SERVICES
I. Preventive and Primary Health Care
HEALTH CARE DELIVERY SYSTEM (Health Promotion)

► Nursing is a caring discipline ► Primary health care: focuses on

improved health outcomes for an entire
► Values of the nursing profession are population
rooted in helping people to regain,
maintain, or improve health; prevent ► Health promotion programs: reduces
illness; and find comfort and dignity. incidence of disease, minimizing
complications
►Institute of Medicine (2011)
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► Preventive care: is more disease  An ICU or critical care unit provides

oriented and focused on reducing and close monitoring and intensive
controlling risk factors for disease medical care to patients
 Has advanced technologies
 Ex: primary care and health
 Medical and nursing staff have
education proper nutrition
specialized knowledge on critical
maternal/child health care, family
care principles and techniques
planning immunizations, control
of diseases ► Psychiatric Facilities:
 Settings: schools, physician’s
 It cater services to patients who
offices, occupational health clinics,
are suffering from emotional and
community health centers, nursing
behavioral problems
centers
 This require special counseling
II. Secondary and Tertiary Care (Acute and treatment
care)  Offers inpatient and outpatient
services, depending on the
► Diagnosis and treatment of illnesses
severity of mental health problem
► Disease management most common  The health care team (medical,
and most expensive service of HCDS nursing, social work and activity
therapy) work together to develop
 Chronic illness causing disability,
a plan of care that enable patients
decreased quality of life and
to return to functional states
increased health care costs
within the community.
► Hospitals  Located in hospitals, independent
outpatient clinics or private
 Provides comprehensive and
mental health hospitals,
specialized tertiary care to
psychiatric facilities
seriously ill patients
 Focus: quality, safe care ► Rural Hospitals
 Ex: hospital emergency
Iii. Restorative Care:
departments, urgent care centers,
critical care units, in-patient MS ► Provide care to patients recovering
units from an acute or chronic illness or
 Discharge planning: is a disability which requires additional
centralized, coordinated, services in order to return to previous
interdisciplinary process that level of function or reach the new level of
ensuring that a patient has a plan function limited by their illness or
for continuing begins the moment disability
a patient is admitted to a health
► Goal: to help individuals regain
care facility.
maximal functional status and enhance
► Intensive Care: quality of life through promotion of
independence and self-care
► Home care:
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 provides medically related ► Provides intermediate medical, nursing,

professional and paraprofessional or custodial care for patients recovering
services and equipment to patient from acute illness or those with chronic
and families in their homes for illnesses or disabilities
health maintenance, education,
► It includes:
illness prevention, diagnosis and
treatment of disease, palliation,  intermediate care and skilled
and rehabilitation nursing facility- caters skilled care
 It also includes medical and social from licensed nursing staff
services: physical, occupational,  long-term care and assisted-living
speech and respiratory therapy facilities
and nutritional therapy
► Primarily, provides care for older adults
 Coordinates the access and
delivery of home health ► Continuing Care:
equipment, or medical equipment
► Refers to a variety of health, personal,
 Primary objective: health
and social services provided over a
promotion and education.
prolonged period.
► Rehabilitation:
► It cater services for people who are:
 Restores a person to the fullest
 Disabled
physical, mental, social, vocational,
 Never functionally independent
and economic potential
 Suffering from terminal disease
 It begins from the moment the
patient enters a health care setting ► Nursing Centers or facilities:
for treatment
► It provides a 24-hour intermediate and
 Patients who had physical or
custodial care like nursing, rehabilitation,
mental illness, injury, or chemical
dietary, recreational, social and religious
addiction require rehabilitation
services
►Focuses on:
► It includes:
a. Preventing complications related
 Nursing centers or facilities
to illness or injury
 Assisted living
b. Helps to maximize a patient’s
► Interdisciplinary functional assessment
functioning and level of independence
of residents is the cornerstone of clinical
► Rehabilitation services include: practice within nursing centers
a. Physical ► Assisted Living:
b. Occupational ► Offers an attractive long-term care
setting with an environment more like
c. Speech therapy
home and greater resident autonomy.
d. Social services
► Promote physical and psychosocial
► Extended Care facilities: health
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► Activities include:  Apply quality improvement

 Use informatics
 Assistance in the ADL
 Medication administration (for ISSUES AND CHANGES IN HEALTH CARE
some assisted living facilities) DELIVERY
► Respite care: ► Quality and safety in Health Care
► Provides short-term relief or “time-off”  Is the degree to which health
for people providing home care to services for individuals and
individual who is ill, disabled, or frail populations increase the likelihood
of desired health outcomes and
► It can be offered in the home, a day
are consistent with current
care setting, or a health care institution
professional knowledge
that provides overnight care
 Globalization in Health Care
► Adult Day Care centers:  Nursing informatics and
Technological Advancements
► Provide a variety of health and social
services to specific patient populations - Nursing informatics: uses information
who live alone or with family in the and technology to communicate, manage
community. knowledge, mitigate error. And support
decision-making
► It is associated with a hospital or
nursing home or independent centers - Ex: Telemedicine, telehealth

► Hospice The Future of Health Care

► A system of family- centered care that ► Change is often threatening, but it also
allows patients to live with comfort, opens up opportunities for improvement.
independence, and dignity while easing The ultimate issue is designing and
the pains of terminal illness. delivering health care in ensuring the
health and welfare of the population.
► Focus: Is palliative care
ISSUES AND CHANGES IN HEALTH CARE
DELIVERY
► Nursing shortage
► Competency
 Emphasize the importance public
service, caring for the health of
communities, and developing
ethically responsible behaviors
► IOM Competencies for the 21st century
 Provide patient-centered care
 Work in interdisciplinary team
 Use evidence-based practice
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1B CONCEPT OF NURSING ► Professional Nursing:

CONCEPT OF NURSING  Is an art and science, dominated
by an ideal or service in which
 Nursing is an art and science
certain principles are applied in
 As a professional nurse, you will
the skillful care of the well and the
learn to deliver care artfully with
ill, and through relationship with
compassion, caring, and respect
the client/patient, significant
for each patient’s dignity and
others, and other members of the
personhood.
health team.
 As a science, nursing practice is
based on a body of knowledge that ► Professional nurse:
is continually changing with new
 Is one who has acquired the art
discoveries and innovations.
and science of nursing through her
 The Quality of Care is at level of
basic education, who interprets
excellence that benefits patients
her role in nursing in terms of the
and their families
social ends for which it exists – the
Science and Art of Nursing Practice health and welfare of society and
who continues to add to her
► Nursing practice requires a blend of the
knowledge, skills, and attitudes
most current knowledge and practice
through continuing education and
standards with an insightful and
scientific inquiry (research) or the
compassionate approach to patient care
use of the results of such inquiry.
► The nurse’s care will reflect the needs
NURSING AS A PROFESSION
and values of society and professional
standards of care and performance, meet
the needs of each patient, and integrate
evidence-based findings to provide
highest level of care
► Nursing has a specific body of
knowledge but it is also helpful to socialize
within the profession and practice to fully
understand and apply this knowledge to
develop professional expertise.
Benner: from Novice to Expert
NURSING AS A PROFESSION
Novice:
► Profession:
 beginning nurse or any nurse
 An organization of an occupational entering s situation in which there
group based on the application of is no previous level of experience
special knowledge which  Learning is through specific set of
establishes its own rules and rules or procedures.
standards for the protection of the
public and the professionals.
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Advanced beginner:  Is the protection, promotion, and

optimization of health and
 A nurse who has had some level of
abilities; prevention of illness and
experience with the situation
injury, alleviation of suffering
 The nurse can identify meaningful
through the diagnosis and
aspects or principles of nursing
treatment of human response, and
care
advocacy in the care individuals,
 Experience may only be
families and communities (ANA,
observational in nature
2010)
Competent:  Encompasses autonomous and
collaborative care of individuals of
 The nurse is has been in same
all ages, families, groups and
clinical position for 2-3 years
communities, sick or well, and in
 Understands the organization and
all settings (ICN, 2014)
specific care required by the type
 It includes the promotion of
 Can anticipate nursing care and
health; prevention of illness; and
establish long-range goals
the care of ill, disabled and dying
 Has experience with all types of
people.
psychomotor skills
ANA Standards of Nursing Practice
Proficient:
Standard 1-Assessment
 A nurse with more than 2-3 years
of experience in the same clinical The registered nurse collects
position comprehensive data pertinent to the
 Perceives a patient's clinical patient's health or the situation.
situation as a whole
Standard 2- Diagnosis
 Can assess the entire situation
The registered nurse analyzes the
and transfer knowledge from
assessment data to determine the
previous experiences
diagnoses or issues.
 Focus on managing care
Standard 3-Outcomes Identification
Expert:
The registered nurse identifies expected
 The nurse
outcomes for a plan individualized to the
 Has intuitive grasp of an existing or
patient or the situation.
potential clinical problem
 Focus on multiple dimensions of Standard 4-Planning
the situation
The registered nurse develops a plan that
 Is skilled at identifying both
prescribes strategies and alternatives to
patient-centered problems and
attain expected outcomes.
problems related to the HCS
Standard 5-Implementation
SCOPE AND STANDARDS OF PRACTICE
The registered nurse implements the
► NURSING:
identified plan
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The registered nurse coordinates care 3. Advocate

delivery.
 Protects your patient’s human and
The registered nurse employs strategies to legal rights and provide assistance
promote health and safe environment. in asserting there rights
Standard 6-Evaluation 4. Educator
The registered nurse evaluates progress  Explain concepts and facts about
toward attainment of outcomes. health, describe the reason for
routine care activities.
► Standards of professional
Performance 5. Communicator
 It describes a competent level of  It allows the nurse to know the
behavior in the professional role patients as well as their strengths,
 Provides method to assure that weaknesses and needs
high-quality care is rendered to
6. Manager
patients
 Establish a collaborative patient-
► Code of Ethics
centered care to provide safe,
 Is the philosophical ideals of right quality care with positive patient
and wrong; which defines the outcomes
principles a professional will use to
7. Leader
provide care
 The nurse helps client make
PROFESSIONAL RESPONSIBILITIES AND
decisions in establishing and
ROLES
achieving goals to improve his
1. Autonomy and Accountability well-being through the process of
interpersonal influences
a. Autonomy – an essential of
nursing professional which involves 8. Counselor
initiation of independent nursing
 Helps the client to recognize and
interventions
cope with stressful psychologic or
b. Accountability – an individual is social problems, to develop
responsible professionally and legally for improved personal relationships
the type and quality of nursing care and to promote personal growth. It
provided also include providing of
emotional, intellectual and
2. Caregiver
psychologic support.
 Helps patient to maintain and
9. Change agent
regain health, manage disease and
symptoms, and attain a maximal  Initiates changes and assist in the
level of function and modification of client’s life style to
independence through the healing promote health
process
10. Researcher
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 Participates in scientific  Worth dignity of others and

investigation and uses research integrity of members
findings in practice.
►Caring
11. Case manager
HISTORICAL INFLUENCES
 Coordinates the activities of the
1. FLORENCE NIGHTINGALE
members of the HC team in
managing a group of client’s care ►Lady with the Lamp
12. Collaborator ► Established the first nursing philosophy
based on health maintenance and
 Works together with all those
restoration.
involved in care delivery, for
mutually acceptable plan in order ► Identified the role of nursing as having
to achieve common goal; thus the “charge of somebody’s health” based on
nurse initiates nursing actions in the knowledge of “how to put the body in
the health team such a state to be free of disease or to
recover from disease.
CRITERIA OF PROFESSION
► Developed the first organized program
1. Education
for training nurses, the Nightingale
► Requires an extended education and Training School for Nurses (St. Thomas
basic liberal foundation Hospital, London)
2. Theory ► First practicing nurse epidemiologist
► Has theoretical body of knowledge ► She volunteered during the Crimean
war (1853)
► Conceptual frameworks needed for
nursing practice, education & research The Civil War to the Beginning of the
20th Century
3. Service orientation
2. CLARA BARTON
► Altruism “hallmark of a profession
(selfless concern for others) ► founder of American Red Cross
► Guided by rules, policies and COE ► Tended soldiers on the battlefields,
cleaning their wounds, meeting their basic
4. Autonomy
needs, and comforting them in death.
► Self-regulation and standards
3. MOTHER MARY ANN BICKERDYKE
► Needed in making decisions and in
► Organized ambulance services and
practice
walked abandoned battlefields at night, to
CRITERIA OF PROFESSION look for wounded soldiers.

► Code of Ethics
 Based on International Council of 4. HARRIET TUBMAN
Nurses
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► Active in the Underground Railroad  Graduate Nurse-midwifery

Movement and helped to lead over 300 programs began
slaves to freedom.
► Last half of century : creation of
5. MARY MAHONEY specialty-nursing organization
► The 1st professionally trained African- 21st CENTURY
American nurse.
► Nurse and nurse educators are revising
► Concerned with the effect culture had nursing practice and school curricula to
on health care meet the ever-changing needs of society,
including aging population, bioterrorism,
► Brought awareness of cultural diversity
emerging infections and disaster
and respect for the individual, regardless
management, the high acuity level care of
of background, race, color or religion.
hospitalized patients, and early discharge
LATE 19th CENTURY: from health care institutions require
nurses in all settings to have a strong and
► Expansion of hospitals
current knowledge base from which to
Lilian Wald and Mary Brewster practice

 Opened the Henry Street ► Nursing organizations and the RWJF

Settlement involvement in supporting nursing
 It focused on the health needs of scholars, decreasing the nursing shortage,
poor people who lived in and improve the health of the nation’s
tenements (NYC) population

20th CENTURY: ► Nursing takes a leadership role in

developing standards and policies to
► Early 20th century development of
address the needs of the population
scientific, research-based
CONTEMPORARY INFLUENCES
defined body of nursing knowledge and
practice External forces affecting nursing:

► Nurses began to assume expanded and ► Importance of Nurses’ Self-Care

advanced practice roles
 A nurse cannot give fully engaged,
Mary Adelaide Nutting compassionate care to others
when there’s a feeling of depletion
 1st nursing professor (Columbia
or do not feel cared for herself.
Teacher’s College, 1906)
Nurses also experience grief and
 Contributed in moving nursing
loss.
education into universities
 Compassion fatigue: a state of
► Army and Navy Nurse Corps was burnout and secondary traumatic
established stress. It occurs without warning
and often results from giving high
► 1920s specialization of nursing began
levels of energy and compassion
over a prolonged period to those
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who are suffering, often without (word doctors) as intermediary.

experiencing improved patient Herbolarios (herb doctors)
outcomes.
► Early care of the sick
 Secondary traumatic stress:
trauma that HCP experience when  Superstitious beliefs and practices
witnessing and caring for others in relation to health and sickness.
suffering trauma. Herbmen (Herbicheros) one who
 Burnout: a state of physical and practice witchcraft.
mental exhaustion that often  Midwife assisted in childbirth.
affects HCPs because of the nature During labor, the ‘mabuting hilot’
of their work environment, it (good midwife) was called in. If
occurs when perceived demands there’s difficulty in labor, witches
outweigh perceived resources. were supposed to be the cause. To
disperse this influence, gunpowder
► The Affordable Care Act and Rising
was exploded from a bamboo cane
Health Care Costs
close to the head of the sufferer
 ACA affects how health care is paid
► Health Care During the Spanish
for and delivered
Regime
 Greater emphasis on health
promotion, disease prevention and  The religious orders exerted their
illness management efforts to care for the sick by
 More nurses will be in community- building hospitals in the various
based setting like community care part of the Philippines
centers, schools and senior centers
1. Hospital real de Manila (1577) –
► Demographic changes was established mainly to care for Spanish
King’s soldiers, but also admitted Spanish
► Medically underserved
civilians
HISTORY OF NURSING IN THE
2. San Lazaro Hospital (1578) – built
PHILIPPINES
exclusively for patients with leprosy,
► Early beliefs and practices founded by Brother Juan Clemenete and
was administered by Hospitalliers of San
 Diseases and causes and treatment
Juan de Dios
were shrouded with a mysticism
and superstitions 3. Hospital de Indio (1586) –
supported by alms and contributions from
1. Beliefs about causation of disease
charitable persons and established by the
(another person like an enemy or witch;
Franciscan Order
evil spirits)
4. Hospital de Aguas Santas (1590) –
2. People believed that evil spirits
founded by Brother J. Bautista of the
could be driven away by persons with
Franciscan Order in Laguna
powers to expel demons
5. San Juan de Dios Hospital (1596) –
3. People believe in special gods of
founded by Brotherhood of Misericordia
healing, with the priest physician
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and supported by the Hospitalliers of San ► Hospitals and Schools of Nursing

Juan de Dios
1. Iloilo Mission Hospital School of
► Nursing During the Philippine Nursing (Iloilo City, 1906)
Revolution:
 It was ran by Baptist Foreign
 Prominent persons involved in Mission Society of America; Miss
nursing works were: Rose Nicolet (first superintendent)
Miss Flora Ernst an American nurse
1. Josephine Bracken – installed a
took charge in 1942; in March
field hospital in an estate house in Tejeros;
1944, 22 nurses graduated and in
provided care to the wounded night and
April 1944 the graduated nurses
day
took the first Nurses Board
2. Rosa Sevilla de Alvero – converted Examination in Iloilo Mission
their house into quarters for the Filipino Hospital
soldiers in 1899 during Philippine-
2. St. Paul’s Hospital School of
Americal War
Nursing (Manila, 1907)
3. Dona Hilaria de Aguinaldo – (wife
 The hospital was established by
of Emilio Aguinaldo)organized
the Archbishop of Manila, the
Filipino Red Cross under the inspiration of Most Reverend Jeremiah Harty
Apolinario Mabini under the supervision of the
Sisters of St. Paul de Chartres. It
4. Dona Maria Agoncillo de
provided general services and had
Aguinaldo – (2nd wife of Emilio
free dispensary and dental clinic.
Aguinaldo) – President of Filipino Red
In 1908, it opened its training
Cross Batangas branch; provided nursing
school for nurses with rev. Mother
care to Filipino soldiers during the
Melanie (superintendent) and Miss
revolution
E. Chambers (Principal)
HISTORY OF NURSING IN THE PHILIPPINES
3. Philippine General Hospital School
5. Melchora Aquino (Tandang Sora) – of Nursing (1907)
provided nursing care to the wounded
 Began in 1901 as a small
Filipino soldiers and gave them shelter
dispensary mainly for Civil Officers
and food
and Employees in Manila City, then
6. Capitan Salome – a revolutionary became a Civil Hospital
leader in Nueva Ecija; provided nursing
4. St. Luke’s Hospital School of
care to the wounded when not in combat.
Nursing (Quezon City, 1907)
7. Agueda Kahabagan – provided
 The hospital is an Episcopalian
nursing services to her troops and she was
Institution which began as a small
a revolutionary leader in Laguna
dispensary (1903) and the school
8. Trinidad Tecson – “Ina ng Biac na opened with three Filipino girls
Bato’ cared for the wounded soldiers in admitted (1907)
the hospital at Biac na Bato
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5. Mary Johnston Hospital and 6. Socorro Diaz – 1st editor of the

School of Nursing (Manila, 1907) PNA magazine “the Message”
 It was called Bethany Dispensary 7. Conchita Ruiz – 1st fulltime editor
and was funded by the Methodist of PNA magazine named “The Filipino
Mission for the relief of suffering Nurse”
among women and children
8. Loreto Tupaz – Dean of the
6. Philippines Christian Mission Philippine Nursing ; Florence Nightingale
Institute Schools of Nursing of Iloilo
7. San Juan de Dios Hospital School of PERSONAL AND PROFESSIONAL
Nursing (Manila, 1913) QUALITIES OF A NURSE
8. Emmanuel Hospital School of Nursing PERSONAL QUALIFICATIONS OF A NURSE
(Capiz, 1913)
a. Philosophy of Life
9. Southern Islands Hospital School of  Concerned with those basic truths
Nursing (Cebu, 1918) that contribute to personal growth
in a systematic fashion and with
►The first colleges of nursing in the
those principles that relate to the
Philippines:
moral values that shape the facets
1. University of Santo Tomas College of the character
of Nursing (1946) b. Good personality
2. Manila Central University College  Personality consists of the
of Nursing (1947) distinctive individual qualities that
3. University of the Philippines differentiate one person from
College of Nursing (1948) another
 It is the impression one makes on
► NURSING LEADERS IN THE
others which will include more
PHILIPPINES:
than that which meets the eye
1. Anastacia Giron-Tupas – founder  Components:
of PNA; 1st Filipino to hold the Chief 1. Personal appearance
Nurse Superintendent position 2. Character
3. Attitude
2. Cesaria Tan – 1st Filipino to receive
4. Charm
Masters degree in Nursing abroad
► Personality can be develop through:
3. Socorro Sirilan – Chiefnurse and
Pioneered in Hospital Social Services in 1. Warmth of manner, a ready smile,
San Lazaro Hospital sincere laugh, genuine interest in others

4. Rosa Militar – a pioneer in school 2. Complete sincerity

health education
3. Sympathetic grooming
5. Ser Ricardo Mendoza – a pioneer
in nursing education
FUNDAMENTALS OF NURSING PRACTICE
1A and 1B

PROFESSIONAL REGISTERED NURSE - involves formal, organized educational

EDUCATION programs offered by universities,
hospitals, state nurses associations,
Associate Degree Program
professional nursing organizations and
- 2-year program usually offered by a educational and health care institutions
university or community college.
- Updates your knowledge about the
- The program focuses on the basic latest research and practice
sciences and theoretical and clinical developments, helps in specializing in a
courses related to the practice of nursing. particular area of practice developments,
and teaches new skills and techniques
Baccalaureate Degree
(Hale et.al, 2010)
- program 4 years of study in a college or
► Continuing education programs help
university.
nurses maintain current nursing skills, gain
- It focuses on the basic sciences; new knowledge and theory, and obtain
theoretical and clinical courses; and new skills reflecting the changes in the
courses in the social sciences, arts, and health care delivery system
humanities to support nursing theory.
► In-service education programs:
► Graduate education
 are instruction or training
 Provides the advanced clinician provided by a HC agency or
with strong skills in nursing science institution.
and theory  Designed to increase knowledge,
 Emphasizes advance knowledge in skills, and competencies of nurses
the basic sciences and research- and other health care
based clinical practice. professionals employed by the
 Master’s degree in nursing institution
 Often it focuses on new
► Doctoral degree
technologies
 Doctoral preparation
NURSE PRACTICE ACTS
 Professional doctoral programs in
nursing (DSN or DSNc) prepare ► Regulate the scope of nursing practice
graduates to apply research and protect public health, safety and
findings to clinical nursing welfare.
 Doctor of Philosophy (PhD) in
LICENSURE
Nursing is a research and theory
development  Provides standardized minimum
 Doctor of Nursing Practice (DNP) is knowledge base for nurses
a practice-focused doctorate;  License: legal credential awarded
terminal practice degree and by an individual state that grants
required preparation for all APRNs permission to that individual to
practice a given profession
►Continuing and In-Service Education
CERTIFICATION
 Continuing education:
FUNDAMENTALS OF NURSING PRACTICE
1A and 1B

 granted on completion of an newborn. It also includes some

education program and the gynecological services (ex: Pap
passing of a standardized smear, FP and treatment of minor
examination vaginal infections)
 Certified or registered
4. Certified Registered Nurse
CAREER DEVELOPMENT Anesthetist (CRNA)
A. Advanced Practice Registered Nurses  Had advanced education from a
(APRN) nurse anesthesia-accredited
program
► Is the considered as the most
 Must have at least 1 year of critical
independently functioning nurse
care or emergency experience.
► Has advanced education in  Provide anesthesia under the
pathophysiology, pharmacology and supervision and guidance of the
physical assessment and certification and anesthesiologist (physician with
expertise in specialized area of practice. advanced anesthesia.

CORE ROLES OF APRN. B. Nurse Educator

1. Clinical Nurse Specialist ► Has master’s degree in nursing or

earned doctorate in nursing or related
 Is an expert clinician in a
field.
specialized area of practice.
 The specialty may be identified by ► Works primarily in nursing schools,
a population, setting, disease staff development departments of HC
specialty, type of care or type of agencies and patient education
problem department.

2. Nurse Practitioner (NP) ► Needs clinical practice in order to

provide the students with practical skills
 Provides health care to a group of
and theoretical knowledge
patients usually in an outpatient
ambulatory care or community- ► Faculty member in nursing program
based setting. educates students to become professional
 Provides comprehensive care, nurse.
directly managing the nursing and
► Nursing faculty member is responsible
medical care of patients with
in teaching current nursing practice;
complex problems and a more
trends; theory and necessary skills in
holistic approach than physicians
classroom, laboratories and clinical
3. Certified Nurse-Midwife (CNM) settings

 Also educated in midwifery and is ► Primary focus of nurse educator in a

certified patient education: to teach and coach
 Provides independent care for patients and their families how to self-
women during normal pregnancy, manage their illness or disability and make
labor and delivery and care of the positive choices or change their behaviors
FUNDAMENTALS OF NURSING PRACTICE
1A and 1B

to promote health. Usually specialized or 1. Hospital or Institutional Nursing

has certification like a certified diabetes
2. Public Health Nursing or
educator (CDE) or ostomy care nurse
Community Health Nursing
C. Nurse Administrator
3. Private Duty or Special Duty
► Manages patient care and the delivery Nursing
of specific nursing services within a health
4. Industrial or Occupational Health
care agency
Nursing
► Has master’s degree in nursing
5. Nursing Education
administration, hospital administration
6. Military Nursing
(MHA), public health (MPH) or an MBA
7. School Nursing
► Functions includes:
8. Clinic Nursing
 Budgeting
 Staffing 9. Independent Nursing Practice
 Strategic planning of programs and
TRENDS IN NURSING
services
 Employee evaluation ► Evidence-based Practice
 Employee development
 In the practice of nursing, it should
be based on current evidence, not
just
according to your education or
experiences and the policies and
procedures of health care facilities.
 The general public has knowledge
on health care needs, the cost of
health care, and the incidence of
D. Nurse Researcher: medical errors within health care
► Conducts evidenced-based practice institution
and research ► Quality and Safety Education for
► Works in and academic setting, hospital Nurses (QSEN)
or independent professional or  Addresses the challenge to
community service agency prepare nurses with the
► Requires a doctoral degree with at least competencies needed to
a master’s degree in nursing continuously improve the quality
of care in their environment
E. Management  Competencies of patient-centered
F. Entrepreneurship care, teamwork and collaboration,
EBP, quality improvement (QI),
FIELDS OF NURSING
FUNDAMENTALS OF NURSING PRACTICE
1A and 1B

safety and informatics Trends in

Nursing
► Impact of Emerging technologies
 This helps nurses use noninvasive,
more accurate assessment tools,
implement EBP, collect and trend
patient outcome data and use
clinical decision support system
 Electronic Health Record (HER)
offers efficient method to record
and manage patient health care
information
► Genomics
 Is a newer term that describes the
study of all genes in a person and
interactions of these genes with
one another and with that person’s
environment (CDC, 2015)
 Genetics is the study of
inheritance, or the way traits are
passed down from one generation
to another.