✧ fundamentals of nursing | MGP ✧

I. HISTORY OF NURSING (GLOBAL) o Egypt

A. PERIOD OF INTUITIVE NURSING ¶ art of embalming
¶ Was practiced since pre-historic times among primitive • enhanced their knowledge of
tribes and lasted through the early Christian Nursing human anatomy.
¶ Nursing was “untaught” and instinctive. ¶ Ability to make keen observations and left a
¶ Was performed out of compassion for others, out of the record of 250 recognized diseases
wish to help others ¶ No mention of nurses, hospitals, or hospital
personnel
BELIEFS AND PRACTICES OF PRE-HISTORIC MAN ¶ Slaves and patient’s families
§ He was a nomad. His philosophy of life was “the best • Nurse the sick
for the most” and he was ruled by the law of “self-
preservation”. o Israel
§ Nursing was a function that belonged to women. She ¶ Moses
took good care of the children, the sick, and the aged. • “Father of Sanitation”
§ He believed that illness was caused by the invasion of • Wrote the five books of the
the victim’s body by an evil spirit through the use of Testament
the black magic and voodoo.
§ He believed that the medicine man called “shaman” or ¶ Five Books of the Old Testament
witch doctor had the power to heal using the white • Emphasized the practice of
magic. hospitality to strangers and
o Use of hypnosis, charms, dances, acts of charity (Book of
incantations, purgatives, massage, fire, Genesis)
water, and herbs • Promulgated laws of control on
¶ means of driving away illness from the spread of communicable
the victim diseases and the ritual of
circumcision of the male child
o Trephining (Book of Leviticus)
¶ Drilling a hole in the skull with a
• Nurses – midwives, we nurses
rock or stone without the benefit of
or child’s nurses whose acts
anesthesia
were compassionate and tender
¶ Last resort to drive evil spirits from
(outpouring of maternal insticts)
the body of the affected
NURSING IN THE FAR EAST
NURSING IN THE NEAR EAST
§ China
§ Beliefs and Practices
o Spirits and demons as seen in practices such as
o Mode of Living: nomadic style → agrarian style →
giving male babies a girl’s clothes to keep them from
urban community life
befalling evils
o Man developed means of communication and the o Ancestor worship
beginning of a body of science knowledge.
¶ Prohibited the dissection of human body
o Nursing – duty of slaves, wives, sisters, or mothers o Gave the world knowledge of “material medica”
o The care of the sick was still closely linked to
¶ Pharmacology which prescribed methods
religion, superstition, and magic.
of treating wounds, infections, and
o Astrology and numerology were also used in muscle afflictions
medical practice. o No mention of nursing
o Assumed that the care of the sick was done by
§ Contributions to Medicine and Nursing female members of the household
o Babylonia
¶ Code of Hammurabi § India
• Provided laws that covered o Men of medicine built hospitals, practiced an
every facet of Babylonian life intuitive forms of asepsis and were proficient in the
including medical practice practice of medicine and surgery.
• Established fees, discouraged o Sushrutu
experimentation, recommended ¶ Made a list of functions and
specific doctors for each disease qualifications of nurses
and gave each patient the right ¶ Described nurses as combination of
to choose between the use of pharmacist, physical therapist,
charms, medications, or surgical masseur, and cook (for the first time in
procedure to cure his disease recorded history)
¶ no mention of nurses or nursing

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NURSING IN ANCIENT GREECE o Knights of St. Lazarus
§ Nursing – task of the untrained slave ¶ was founded primarily for the nursing
§ Caduceus care of lepers in Jerusalem after the
o Insignia of the medical profession today Christians conquered the city
§ Hippocrates
o Born in Greece § Alexian Brothers
o Was given the title “Father of Scientific Medicine” o Members of a monastic order founded in 1348
o Established the Alexian Brothers Hospital School
NURSING IN ROME of Nursing
§ Transition from pagan to Christian philosophy
§ There was a contrast between the materialism of pagan § Alexian Brothers Hospital School of Nursing
society and the spirituality of the converted Christians. o Largest school of Nursing under a religious order
§ The Romans attempted to maintain vigorous health because o Operated exclusively for men in the United States
illness is a sign of weakness. o Closed in 1969
§ Care of the Ill
o Was left to slaves or Greek physicians THE RISE OF SECULAR ORDERS
§ Slaves and Greek Physicians § Rise of Religious Nursing Orders for women
o Were looked upon as inferior in Roman society § Although Christianity promoted equality for all men, women
§ Fabiola were still concentrated in their roles as wife and mother.
o Worldly, beautiful Roman matron who was § Only by entering a convent could she follow a career, obtain
converted to Christianity by her friend (Marcela and an education, and perform acts of charity that her faith taught
Paula) would help her gain grace in heaven.
§ With their help, she made her home the § Queens, princesses, and other ladies of royalty founded many
first hospital in the Christian world. religious orders.
§ Religious taboos and social restrictions influenced nursing at
the time of the Religious Nursing Orders.
B. PERIOD OF APPRENTICE NURSING § Hospitals were poorly ventilated, and the beds were filthy.
¶ Extends from the founding of religious nursing orders in the § There was overcrowding of patients: three or four patients,
Crusades, which began in the 11th century and ended in regardless of diagnosis or whether they were alive or dead,
1836 when Pastor Fliedner and his wife established the may have shared one bed.
Kaissesrwerth Institute for the Training of Deaconesses § Practice of environmental sanitation and asepsis were non-
(training school for nurses) in Germany existent.
¶ Called the period of the “on the job training” § Older nuns prayed with and took good care of the sick, the
¶ Nursing Care was performed without any formal education younger nuns washed solid linens.
and by people who were directed by more experienced
nurses. § SECULAR ODERS FOUNDED IN THIS PERIOD:
¶ Religious orders of the Christian Church were responsible o Orders of St. Francis of Assisi (1200-present)
for the development of this kind of nursing. ¶ Believed in denoting their lives to poverty
and service to the poor
THE CRUSADES
§ Crusades ¶ First Order
o holy wars waged in an attempt to recapture the Holy • Founded by St. Francis
Land from the Turks who denied permission to ¶ Second Order
Christian pilgrims to visit the Holy Sepulcher • Poor Clares
§ Military religious orders established hospitals staffed with • Founded by St. Clare of Assisi
men. ¶ Third Order
• Tertiary Order
§ MILITARY RELIGIOUS ORDERS AND THEIR WORKS • Composed of members who
o Knights of St. John of Jerusalem (Italian) devoted their time to
¶ Devoted to religious life and nursing performance of acts of mercy in
¶ Discipline was strict. their communities; most
¶ Established an organization of ranks and provided nursing care in homes
advocated principles of complete and and hospitals
unquestioned devotion to duty and o The Beguines
traditional obedience to superiors ¶ Composed of lar nurses who devoted
their lives to the service of suffering
o Teutonic Knights (German) humanity
¶ Established tent hospitals for the ¶ Was founded in 1170 by a priest,
wounded Lambert Le Begue

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o The Oblates o Class lines could be bypassed in some parts of the
o Benedictines world and people struggled against another for
o Ursulines power, wealth, and leisure
o Augustinians o Skepticism was the result of the political,
intellectual, and ideological revolutions; everything in
§ IMPORTANT NURSING PERSONAGES DURING THIS life had to be based upon scientific fact. Nothing
PERIOD else was true.
o St. Clare
¶ Founder of the Second Order of St. § In the 16th century, hospitals were established for the care of
Francis the sick.
¶ Took vows of poverty, obedience, § The hospitals were gloomy, cheerless, and airless.
service, and chastity § Hospitals were unsanitary.
¶ Gave nursing care to the sick and the § People entered hospitals only under compulsion or as a last
afflicted resort.
§ There was a little employment and education was only for the
o St. Elizabeth of Hungary rich and the titled.
¶ Known as the “Patroness of Nurses” § St. Vincent de Paul
¶ Daughter of the Hungarian King o Organized the group called “Le Charite” and the
¶ Lived her life frugally despite her wealth community of the Sisters of Charity when he saw
¶ Used all her wealth to make the lives of the pervading poverty and the generally poor health
the poor happy and useful conditions
¶ Built hospitals for the sick and the needy § Sisters of Charity
¶ Fed the sick and the needy o Composed of women who had lived uncloistered
¶ Provided for orphans and fed from 300- o Dedicated to doing God’s work through caring for
900 persons daily at her gate the sick, the poor, the orphaned, and the widowed
¶ Employed those who were able to work
continually in her hospital and in the § Louise de Gras (nee Marillac)
homes of the poor o First superior and co-founder of this order
¶ Went fishing in streams to provide for the
many suferrers THE DARK PERIOD OF NURSING
§ Extends from the 17th to the 19th century, from the Period of
o St. Catherine of Sienna Reformation until the US Civil War.
¶ First “Lady of the Lamp” § The religious upheaval led by Martin Luther destroyed the
¶ Was the 25th child of humble, Italian unity of Christian Faith.
parents § The Wrath of Protestantism swept away everything connected
¶ Pledged her life to service at the age of with Roman Catholicism are schools, orphanages, and
seven and was referred to as a little hospitals.
saint § Properties of hospitals and schools were confiscated.
¶ was a hospital nurse, prophetess, § There were no provisions for the sick, no one to care for the
preacher, and a reformer of the society sick.
and the church § Nursing became the work of the least desirable women
(women who took bribes from patients, stole the patient’s
§ The World of Nursing, despite wars and plagues, made food, and used alcohol as tranquilizers).
considerable progress under the influence of Christianity. § Nurses worked seven days a week, slept in a cubbyhole near
§ It may be said that nursing owes its foundations to the work of the hospital ward or patient, and ate scraps of food when they
benevolent men and women, the crusades, and the guilds. could find them.
§ This progress in nursing was brought to halt by industrial and § These women were personified in a Charles Dicken’s novel as
political revolution and the reformation in the 16th century. “Sairey Gamp or Betsy Prog”
These left the world in the following situation:
§ Several leaders sought to bring about reforms. Among
o The masses of people huddled in slums as a result them were:
of famine, wars, and the introduction of machinery o John Howard
(industrial revolution). ¶ Prison reformer
o Living in blighted slum areas, the people sank into a ¶ Helped improve living conditions in prisons
brutal and immoral way of life. and gave prisoners renewed hope
o Ambition for power and the antagonism resulting
from the attempts to achieve their power replaced o Mother Mary Aikenhand
human empathy ¶ Established the Irish Sister of Charity to
bring back into nursing the dedication of the
Early Christian era
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o Pastor Theodore Fliedner and Frederika Munster ¶ Clara Barton
Fliedner • Founded the American Red
¶ Established the Institute for the Cross
Training of Deaconesses at
Kraisserswerth, Germany, the first
organized training school for nurses C. PERIOD OF EDUCATED NURSING
¶ Began on June 25, 1860 when the Florence Nightingale
• REQUIREMENTS FOR School of Nursing opened at St. Thomas Hospital in
ENTERING THE SCHOOL London
o Character reference ¶ The development of nursing was strongly influenced by
from clergyman trends resulting from wars, from an arousal of social
o Certificate of health consciousness, from an emancipation of women and from
from physician the increased educational opportunities offered to women.
o Permission from their
nearest male relative FACTS ABOUT FLORENCE NIGHTINGALE
§ Recognized as the “Mother of Modern Nursing”
NURSING IN AMERICA § Also known as the “Lady with the Lamp” because she took
§ People began to settle in the North American continent to care of the soldiers during the Crimean War,
seek for adventure, new conquests, and new trade routes. § Born on May 12, 1820 in Florence, Italy
§ Miss Jean Mance § Raised in England in an atmosphere of culture and affluence
o First laywomen who worked as a nurse in North § Learned in the languages, literature, mathematics, and social
America graces
o Founded the Hote Dieu of Montreal, a log cabin § Her education was rounded out by a continental tour
hospital § Not contented with the social custom imposed upon her as a
Victorian Lady, she developed her self-appointed goal: “to
§ PRE-CIVIL WAR NURSING change the profile of nursing”
o In the USA and Canada, religious nursing orders, § Compiled notes of her visits to hospitals and her observations
both Catholic and Protestant carried out nursing. of the sanitary facilities, social problems of the places she
o Augustinian nuns, Ursuline sisters, Deaconess of visited
Kaisserswerth, Protestant Sisters of Charity, and § Noted the need for preventive medicine and good nursing
many others helped found and staff hospitals. § Advocated for care of those afflicted with diseases caused by
o Mrs. Elizabeth Seton lack of hygienic practices
¶ American § At the age of 31, she overcame her family’s resistance to her
¶ Founded the Sisters of Charity of ambitions. She entered the Deaconess School at
Emmitsberg, MArylan in 1809 Kraisserwerth.
§ Worked as Superintendent for Gentlewomen During
§ AMERICAN REFORMS IN NURSING illness
o Nurse Society of Philadelphia § Disapproved of restrictions on admission of patients and
¶ Established a six-month course in nursing considered this unchristian and incompatible with health care
to increase the nurse’s knowledge while § Upgraded the practice of nursing and made nursing an
they worked honorable profession for gentlewomen
¶ Nurses were taught a minimum amount § Put down her ideas in two published books
of medical and surgical nursing, material o Notes on Nursing
medica, and dietics. o Notes on Hospitals
§ NURSING DURING THE CIVIL WAR
o American Medical Association OTHER IMPORTANT PERSONAGES/GROUPS/EVENTS
¶ Created the Committee on the Training of DURING THIS PERIOD
Nurses during the Civil War § Linda Richards
¶ Designated to study and make o First graduate nurse in the US
recommendations with regards to the o Graduated on September 1, 1873
training of the nurses
o Doctors realized the need for qualified nurses. § Dr. William Haisted
o Designed the first to wear rubber gloves
o IMPORTANT PERSONAGES:
¶ Dorothea Lynde Dix § Caroline Hampton
• Was appointed Superintendent o First to wear rubber gloves while working in an
of Female Nurses for the US operating room
Government
• Directed the nursing of the § Establishment of American Nurses’ Association and the
injured National League for Nursing Education
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o Contributed to the uplift of the nursing profession II. HISTORY OF NURSING (PHILIPPINES)
A. EARLY BELIEFS AND PRACTICES
§ Isabel Hampton Robb § Diseases, their causes, and treatment were shrouded by
o First principal of the John Hopkins Hospital School mysticism and superstitions.
of Nursing o Beliefs about causation of disease
o Most influential in directing the development of o Another person (an enemy or witch)
nursing during this period o Evil spirits
o Beliefs that evil spirts could be driven away be
§ Clara Louise Maas persons with powers to expel demons
o Engaged in medical research on yellow fever during o Belief in special gods of healing, with the priest-
the Spanish American War physician (called “word doctors”) as
intermediary. If they used leaves or roots, they
§ Development of Private Duty Nursing, Settlement House were called herb doctors (herbolarios)
Nursing )forerunner of Public Health Nursing), School
nursing government services of nurses, and Prenatal and § EARLY CARE OF THE SICK
maternal health nursing (1900-1912) o The early Filipinos subscribed to superstitious
beliefs and practices in relation to health and
§ Age of Specialization sickness.
o Began in the first decade of the 20th century o Herbman
¶ Called hechicheros
§ Preparation of a standard curriculum based on ¶ One who practiced witchcraft
educational objectives for schools of nursing (1913-1937) o Persons suffering from diseases without any
identified cause were believed bewitched by the
§ Edith Cavell “mangkukulan” or “manggagaway”.
o Known as “Mata Hari” o Difficult childbirth and some diseases called
o Served the wounded soldiers during World War I “pamaoo” were attributed to “nonos”.
o Midwives assisted in childbirth.
D. PERIOD OF CONTEMPORARY NURSING o During labor, the “mabuting hilot” (good midwife)
¶ Covers the period after World War II to the present was called in.
¶ Marked by scientific and technological developments as well o If birth became difficult, witches were supposed to
as social changes be the cause.
o To disperse the influence, gunpowder was
EVENTS AND TRENDS exploded from a bamboo cane close to the head
1. Establishments of the World Health Organization by the of the sufferers.
United Nations to assist in fighting disease by providing health
information and improving nutrition, living standards, and B. HEALTH CARE DURING THE SPANISH REGIME
environmental conditions of all people § EARLIEST HOSPITALS
2. Use of atomic energy for medical diagnosis and treatment o Hospital Real de Manila (1577)
3. Utilization of computers for collecting, teaching, establishing, ¶ Established mainly to care for the
diagnosis, and maintaining inventory, making payrolls, record Spanish king’s soldiers and Spanish
keeping, and billing civilians
4. Use of sophisticated equipment for diagnosis and treatment ¶ Founded by Gov. Francisco de
5. The advent of spare medicine also brought about the Sande
development of aerospace nursing. Colonel Pearl Tucker
developed comprehensive one-year course to prepare nurses o San Lazaro Hospital (1578)
for aerospace nursing at Cape Kennedy. ¶ Founded by Brother Juan Clemente
6. Health is perceived as a fundamental human right. Laws were ¶ Run by the Hospitalliers of San Juan
legislated to provide such right. de Dios for many years
7. Nursing involvement in community health ¶ Built exclusively for patients with
8. Technological advances (development of disposable supplies leprosy
and equipment have relieved the nurse from numerous
tedious tasks) o Hospital de Indios (1585)
9. Development of the expanded role which were formerly the ¶ Established by the Franciscan order
sole prerogative of the physician ¶ Service was general
¶ Supported by alms or contributions
from charitable persons

o Hospital de Aguas Santas

¶ Established as a convalescent hospital
in Laguna
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¶ Near a medicinal spring § REQUIREMENTS FOR MEMBERSHIP
¶ Established by Brother J. Bautista of o at least 14 yo
the Franciscan Order o age requirement for officers: 25 yo of sound
reputation
o San Juan de Dios Hospital (1596)
¶ Founded by the Brotherhood of
Misericordia D. HOSPITALS AND SCHOOLS OF NURSING
¶ Run by the Hospitalliers of San Juan
de Dios ILOILO MISSION HOSPITAL SCHOOL OF NURSING
¶ Support was derived from alms and (Iloilo City, 1906)
rents § run by the Baptist Foreign Mission Society of America
¶ Rendered general service to the public § Miss Rose Nicolet
o Graduate of New England Hospital for Women and
C. NURSING DURING THE PHILIPPINE REVOLUTION Children in Boston, Massachussets
o First superintendent for nurses
PROMINENT PERSONS INVOLVED IN NURSING WORK § Moved to its present location on Jaro Road, Iloilo City in 1929
§ Josephine Bracken § In March 1946, 22 nurses graduated.
o Wife of Jose Rizal § In April, 44 graduate nurses took the first Nurses Borad
o Installed a field hospital in an estate in Tejeros Examination given at the Iloilo Mission Hospital
o Provided nursing care to the wounded night and
day ST. PAUL’S HOSPITAL SCHOOL OF NURSING
(Manila, 1907)
§ Mrs. Rosa Sevilla de Alvero § Established by the Archbishop of Manila, the Most
o Converted their house into quarters for the Filipino Reverend Jeremiah Heart under the supervision of the
soldiers during the Philippine-American War that Sisters of St. Paul de Chartres
broke out in 1899 § Located in Intramuros
§ Provided general hospital services
§ Dona Hilaria de Aguinaldo § Had a free dispensary and dental clinic
o Second wife of Emilio Aguinaldo § Opened it training school for nurses in 1908
o Organized the Filipino Red Cross under the § Rev. Mother Melanie
inspiration of Apolinario Mabini o Superintendent
§ Mrs. E Chambers
§ Melchora Aquino o principal
o Tandang Sora PHILIPPINE GENERAL HOSPITAL SCHOOL OF NURSING
o Nursed the wounded Filipino soldiers and gave (1907)
them shelter and food § began in 1901 as a small dispensary mainly for “civil officers
and employees” in the city of Manila
§ Capitan Solomon § later grew into a Civil Hospital
o Revolutionary leader in Nueva Ecija § 1906
o Provided nursing care to the wounded when not in o Mrs. Mary Coleman Marsters
combat ¶ Educator
¶ Advocated for the idea of training Filipino
§ Agueda Kahabagan women for the profession of nursing
o Revolutionary leader in Laguna ¶ With the approval of government officials,
o Provided nursing service to her troops she first opened a dormitory for women
enrolled at Philippine Normal Hall and
§ Trinidad Tecson UP.
o “Ina ng Biacnabato” § 1907
o Stayed in the hospital at Biacnabato to care for the o With the support of Gov. General Forbes and the
wounded soldiers Director of Health among others, she opened the
classes in nursing, under the auspices of the Bureau
THE FILIPINO RED CROSS of Education.
§ Malolos – location of the national headquarters o Admission into the school was based on an
§ Established branches in provinces entrance examination.
§ FUNCTIONS o The applicant must have completed elementary
o Collection of war funds and materials through education to the seventh grade,
concerts, charity bazaars, and voluntary o Julia Nichols and Charlotte Clayton taught the
contributions students nursing subjects.
o Provision of nursing care to wounded Filipino o American physicians also served as lecturers.
soldiers
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§ 1910 § 1907
o Act No. 1975 modified the organization of the o Sr. Rebecca Parrish, together with registered
school, placing it under the supervision of the nurses Rose Dudley and Gertrude Dreisback,
Director of Health. organized the Mary Johnston School of Nursing.
o The Civil Hospital was abolished. o The nurses training course began with three Filipino
o The PGH was established. young women fresh from elementary grades as the
o The school became known as the Philippine first students.
General Hospital School of Nursing. § 1908
o Mr. D.S.B Johnson of Minnesota donated as a
§ When Elsie McCloskeu-Gatches became the chief nurse, memorial for his wife $12 500.00 for a hospital
she introduced several improvements in the school. building
§ The course was made attractive and more practical. § 1911
§ Anastica Giron Tupas succeded McCloskey-Gatches. o The Philippine Assembly appropriated a monthly
sum of P500.00 for the hospital in appreciation for
ST. LUKE’S HOSPITAL SCHOOL OF NURSING its services during the cholera epidemics in the
(Quezon City, 1907) previous years.
§ Episcopalian institution o Later P11 000.00 was provided by the Assembly for
§ Began as a small dispensary in 1903 the construction of maternity and milk station and
§ In 1907, the school opened with three Filipino women dispensary.
students. o At the outbreak of World War II, it became an
§ These women had their first year in combined classes with emergency hospital where the wounded were
Philippine General Hospital School of Nursing and St. Paul’s treated.
Hospital School of Nursing. o It was allowed to operate as a hospital even during
§ Miss Helen Hicks the Japanese Occupation.
o First principal § 1945
o It was burned down.
§ Mrs. Vitaliana Beltran o It was reconstructed through the contribution of
o First Filipino superintendent of nurses in the hospital Methodists in America.
l § 1947
§ Dr. Jose Forbes o It reopened at the Harris Memorial.
o First Filipino medical director of the hospital o Miss Librada Javalera was the first Filipino director
of the school.
NOTE:
PHILIPPINE CHRISTIAN MISSION INSTITUTE SCHOOL OF
§ In the period of organization between 1900 and 1910, the first- NURSING
year nursing students of the Philippine General Hospital, St. § The United Christian Missionary Society of Indianapolis
Luke’s Hospital, and St. Paul’s Hospital had a common first Organization of the Disciples of Christ operated three
year course. schools of Nursing:
§ This is known as the central school idea in nursing o Sallie Long Read Memorial Hospital School of
education. Nursing (Laoag, Ilocos Norte, 1903)
§ The three schools selected their own students based on the o Mary Chiles School of Nursing (Manila, 1911)
following requirements. ¶ Was established by Dr. W.N Lemon in
o Educational preparation at least completion of a small house on Azcarraga,
seventh grade Sampaloc, Manila
o Sound physical and mental health ¶ In 1913, Miss Mary Chiles of
o Good moral character Independence, Montana donated a
o Good family and social standing large sum of money with which the
o Recommendations from three different persons well- present building at Gastambide was
known in the community bought,
§ The three groups of students from these schools were later ¶ The Tuason Annex was donated by
fused into one class, lived in the same dormitory, and received Miss Esperanza Tuason, a Filipino
the same instruction in anatomy and physiology, massage, philanthropist.
practical nursing, material medica, bacteriology, and English. o Frank Dunn Memorial Hospital (Vigan, Ilocos Sur
MARY JOHNSTON HOSPITAL AND SCHOOL OF NURSING 1912)
(Manila, 1907)
§ Started as a small dispensary on Calle Cervantes (now SAN JUAN DE DIOS HOSPITAL SCHOOL OF NURSING
Avenida Rizal) (Manila, 1913)
§ Was called Bethany Dispensary and was funded by the § 1913
Methodist Mission for the relief of the suffering among o Through the initiative of Dr. Benito Valdez, the
women and children. board of inspectors and the executive board of the
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hospital passed a resolution to open a school of III. NURSING AS A PROFESSION
nursing. CONCEPTS OF PROFESSION
o The school has been run by the Daughters of Marie Jahoda – one of the prime movers when it comes to the
Charity since then. concepts of profession
o Sister Taciana Trianes § A profession is an organization of an occupational
¶ First directress of the school group based on the application of special knowledge
o Dr. Gregorio Singian introduced the following which establishes its own rules and standards for the
reforms when he was appointed medical director in protection of the public and the professionals.
1920: § A profession implies that the quality of work done by its
¶ The first 6 months of training was members is of greater importance in its own eyes and
considered a trial period. Student who the society than the economic rewards they earn.
incurred a failure in 2 or 3 subjects were § A profession serves all of society and not the specific
dismissed. interest of the group.
¶ A separate building was provided for the § The aims of a profession are altruistic rather than
library. materialistic.
¶ A kitchen was constructed for classes in
dietary chemistry. CHARACTERISTICS & ATTRIBUTES
¶ Laboratory classes for bacteriology and § Concerned with quality
chemistry were introduced. o Explains the use, benefit, or efficacy of the
¶ Anatomic charts and specimens for medicine that the patient is taking
experiments were acquired.
¶ A new spacious dormitory for students § Self-directed, responsible, and accountable
and nurses was built. o Knows his/her priorities (which patient needs you
§ 1945 more)
o During the fight in Intramuros, the hospital was
destroyed. § Able to make independent and sound judgment
o It was rebuilt in its present site in Roxas Boulevard. o “on your own”
o Can make a decision even without the aid of other
EMMANUEL HOSPITAL SCHOOL OF NURSING nurses or doctor
(Capiz, 1913) o Conservative nursing management
§ 1913
o The American Baptist Foreign Missionary Society § Dedicated to the improvement of human life
sent Dr P.H.J. Lerrigo to Capiz for the purpose of o “Nursing is promotive, preventive, curative,
opening a hospital. rehabilitative.”
o Miss Rose Nicolet assisted them. o Maximize ourselves to the fullest potential
o The school offered a 3-year training course for an
annual fee of P100.00. § Committed to the spirit of inquiry
o Miss Clara Pedrosa was the first Filipino principal. o Life-long learner
o You want to know things about the patient for the
SOUTHERN ISLANDS HOSPITAL SCHOOL OF NURSING purpose of helping him/her.
(Cebu, 1918)
§ Was established in 1911 under the Bureau of Health NURSING AS A PROFESSION — CHARACTERISTICS
§ Opened in 1918 with Anastacia Giron Tupaz as the organizer § Education
§ Miss Visitacion Perez was the first principal. § Theory
o “backbone” – nursing theorists
§ Service
OTHER SCHOOLS OF NURSING
¶ Zamboanga General Hospital School of Nursing (1921) § Autonomy
¶ Chinese General Hospital School of Nursing (1921) o You know the field you want.
¶ Baguio General Hospital School of Nursing (1930) § Code of ethics
¶ Manila Sanitarium and Hospital School of Nursing (1930) o Guiding principles on how we behave as nurses
¶ St. Paul’s School of Nursing in Iloilo City (29146) § Caring
¶ North General Hospital and School of Nursing (1946) o Tender loving care
¶ Siliman University School of Nursing (1947)
Professional Nursing
§ Art and science, dominated by an ideal of service in which
certain principles are applied in the skillful care of the well
and the ill, and through relationship with the client/patient,
significant others, and other members of the health team

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o Art – e.g how to maintain the bed wrinkle-free § Leader
o Science – has step-by-step process (e.g bed o The nurse through the process of interpersonal
making) influence helps the client make decisions in
o Application of skills and right attitude establishing and achieving goals to improve his
well-being
Professional Nurse o Guides the patient
§ One who has acquired the art and science of nursing
through his/her basic education, who interprets his/her role § Manager
in nursing in terms of the social ends for which it exists – the o The nurse plans, gives directions, develops staff,
health and welfare of society and who continues to add to monitors operations, gives rewards fairly, and
his/her knowledge, skills, and attitudes through continuing represents both staff members and administration
education and scientific inquiry or the use of the results of as needed.
such inquiry ¶ assessing junior nurses
¶ promotes personal and social growth
ROLES AND FUNCTION o The nurse manages the nursing care of
§ Care Provider individuals, families, and communities.
o The nurse supports the client by attitudes and
actions that show concern for client welfare and § Researcher
acceptance of the client as a person. o The nurse participates in scientific investigation
o The nurse is primarily concerned with the client’s and uses research findings in practice.
needs. ¶ Read readings that may aid the
¶ Maslow’s Hierarchy of Needs development of your patient’s treatment

§ Communicator/Helper § Case Managers

o The nurse communicates with clients, supports o Coordinates the activities of other members of the
persons and colleagues (other members of the health care team when managing a group of
healthcare team) to facilitate all nursing actions. client’s care
o Gives you the information you need
§ Collaborator
§ Teacher o The nurse works in a combined effort with all
o The nurse provides health teaching to effect those involved in care delivery, for a mutually
behavior change which focuses on acquiring new acceptable plan to be obtained that will achieve
knowledge or technical skills common goals.
o Telling the patient why it is needed to undergo ¶ Communicating with dietitians during
such treatment nursing rounds
o This role gives emphasis on health promotion and o The nurse initiates nursing actions within the
maintenance. health team.
¶ Explaining the benefit of the medication
FIELDS OF NURSING
§ Counselor
o The nurse helps the client to recognize and cope § Institutional Nursing
with stressful psychologic or social problems, to o Institution - “hospital”
develop improved personal relationships and to o The nurse provides direct client care, using the
promote personal growth nursing process and critical thinking skills.
¶ Listens to your patient o Focus: restorative and curative
o This role includes providing emotional, intellectual, ¶ when the patient is being admitted,
and psychologic support. he/she most probably has a disease
o The nurse provides education to the client and
§ Client Advocate family to promote health maintenance and self-
o The nurse promotes what is best for the client, care.
ensures that the client’s needs are met, and
protects the client’s rights § Public Health Nursing
o Decision of the nurse: best interest of the patient o Requires understanding the needs of a population,
or a collection of individuals who have in common
§ Change Agent one or more personal or environmental
o The nurse initiates change and assist the client characteristics
make modifications in the lifestyle to promote o Focused on one population or group
health. ¶ Ex. Focused on epidemiology
¶ Ex. TB patients

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§ Community Health Nursing

o Provides direct services to subpopulations within
the community (barangay or one unit)
¶ Ex. newborns
¶ School Nursing – school nurses
catering the needs of the students
¶ Industrial Nursing – focuses on the
needs of the workers or employees

§ Independent Nursing practice

o Usually evident on foreign countries
¶ Occupational health nurses
¶ Maternal and child
¶ ORNA
o Involves advanced nursing practice
o Allows the nurse to work in primary, accurate or
restorative care settings
o The nurse will manage the health care of a group
of clients.
o Ex. If the patient is already discharged, you will be
the one to visit the patient instead of a physician.

EXPANDED NURSING ROLES

§ Nurse Practitioner
o Family medicine
§ Clinical Nurse Specialist
§ Nurse Midwife
o Catering the needs of mother and child
§ Nurse Anesthetist
o Gives anesthesia during minor operations
o Highest paying job as a nurse in the US
§ Nurse Researcher
o Improving the practices
§ Nurse Administrator
o Maybe in the hospital setting, academe,
§ Nurse Educator

TYPES OF NURSING INTERVENTIONS

§ Independent or Nurse-initiated Interventions
o Head-to-toe Assessment
o Taking the vital signs of the patient
o Tepid Sponge Bath
o Giving health teachings (case-by-case basis; can
sometimes be considered as interdependent
intervention)

§ Dependent or physician-initiated interventions

o Needs doctor’s advice

§ Interdependent or collaborative intervention

o Asks for the POV of other members of the
healthcare team

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IV. NURSING CONCEPTS ¶ Deal with other aspects (emotional,
NURSING METAPARADIGM mental, etc)
§ Person-environment Interactions o Helping profession
o Focus of nursing care o Adaptive
§ Health and illness behavior o Concerned with health promotion, health
o Product of person-environment interactions maintenance, and health restoration
§ Environment
o Focus of intervention RECIPIENTS OF NURSING
o Composite of energy fields § Consumer
§ Patient
§ Client

SCOPE OF NURSING
§ Promoting health and wellness
o Engages activities and behaviors that enhance
quality of life
o Examples:
¶ Lifestyle
§ Nursing ¶ Misuse of drugs and medicines
o Lt. “Nutrix” – to nourish ¶ Restricting smoking and alcoholic
o “An act of utilizing the environment of the patient beverage drinking
to assist him in his recovery” (Florence • Females – 1 bottle
Nightingale) • Males – 2 bottles
o “The unique function of the nurse is to assist the
individual, sick or well, in the performance of the § Preventing illness
those activities in contributing to health or its o Maintain optimal health by preventing diseases
recovery (or to peaceful death) that he would o Examples:
perform unaided if you have the necessary ¶ Immunization
strength, will, or knowledge and to do this in such ¶ Prenatal and infant care
a way as to help him gain independence as rapidly ¶ Prevention of STD
as possible.” (Virginia Henderson)
o “A helping or assisting service to persons who are § Restoring health
wholly or partly dependent, when they, their o Focuses on the ill clients and extends from early
parents and guardians, or older adults responsible detection of disease by helping client during
for their care are no longer able to give her recovery period
supervise their care.” (Dorothy Orem) o Examples:
o “The protection, promotion, and optimization of ¶ Providing direct care
health and abilities, prevention of illness and
¶ Performing diagnostic and assessment
injury, alleviation of suffering through the diagnosis procedure
and treatment of human response, and advocacy ¶ Consultation
in the care of individuals, families, ¶ Health education
communities, and populations.” (ANA, 2003) ¶ Rehabilitation
¶ There are corresponding
needs/diagnosis for every condition. § Caring for the dying
o “An art and science” o Comforting and caring for people of all ages
¶ Art – care is delivered artfully through ¶ Helping clients live comfortably as
skills requiring proficiency and possible until death
dexterity with compassion, caring, and ¶ Support person cope with death
respect for the client’s dignity and
personhood CONCEPTS OF NURSING IN THE PAST AND IN THE PRESENT
• Patterns of knowing (how to
execute) PAST
§ Taking care of ill patients
¶ Science – based on a body of
§ Focused on the physical aspect of care
knowledge that is changing with new
§ Environmental cleanliness (task-oriented)
discoveries and innovations
§ Focused on the curative aspect of care
o Caring
§ Is a dependent function
o Art § Focused primarily on the disease condition, not on the patient
o Science
§ Hospital-centered
o Holistic

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PRESENT § Psychologic being: Man is like no other man.
§ Includes the sick and healthy o Some interpretations may be different from one’s
§ Considers the holistic nature of the individual interpretation.
§ Client-centered § Social being: Man is like some other men.
§ Focus is the preventive and promotive aspects of care o There are some who have trust issues. Some can
§ With expanding and changing role in the society trust easily.
§ Performs more highly specialized tasks § Spiritual being: man is like other men.
§ Takes increasing responsibilities from the physician o Can practice what he believes
o Doctors are dependent on our assessment.
§ Involves close, personal contact with the recipient of care § Man is composed of subsystems and suprasystems.
§ Conducts research to improve nursing practice o Man is a unified whole composed of parts which
are interdependent and interrelated with each
§ Profession other.
o Is an occupation, a calling in which its members profess ¶ An injury in one part can affect my daily
to have acquired special knowledge and skills, by activities.
training or experience or both, so that they may guide § Man is composed of parts which are greater than and
or advice or serve others in that special field different from the sum of all parts.
o Even if one area is affected, you can still maximize
PRIMARY CHARACTERISTICS OF A PROFESSION your fullest potential.
§ Requires basic liberal foundation and extended
education of its members a) Dorothy Johnson (Behavior Systems Model)
§ Has a theoretical body of knowledge leading to o The person is a behavioral system comprised of
defined skills, abilities, and norms set of organized, interactive, interdependent, and
§ Provides specific service integrated subsystems.
o Catering the needs of our patients o Affiliative, dependency, ingestive, eliminative,
§ Members have autonomy in decision-making and sexual, aggressive, and achievement
practice
§ Has a code of ethics for practice b) Florence Nightingale
o Patient who is acted on by the nurse
§ Professional Nursing o Affected by the environment
o Is an art and a science dominated by an ideal of o Has reparative powers
service in which certain principles are applied in the ¶ Capable of healing, growing
skillful care of the well and the ill, and through o “Man is an individual with vital reparative powers
relationship with the client, significant others, and other to deal with disease and desirous health, passive
members of the healthcare team in terms of influencing the environment or nurse.”
§ Professional Nurse
o Licensed nurse who possesses a body of nursing c) Hildegard Peplau (Interpersonal Theory)
knowledge and skills through formal education and o “Person is an individual, a developing organism,
who utilizes sound judgment and critical thinking and who tries to reduce anxiety caused by needs.”
research when giving care to her clients ¶ It is up to the person.

V. CONCEPTS OF MAN AND HUMAN NEEDS d) Martha Rogers (Unitary Human Beings)
4 MAJOR ATTRIBUTES OF A HUMAN BEING o “Man is an open system in constant interaction
§ Has the capacity to think or conceptualize on the with a changing environment.”
abstract level o As an energy unit, man’s energy is limitless but
o Patients can decide and plan according to his will. must be continuously replenished as soon as it is
§ Family formation utilized.
o We also think of their future. ¶ In order to be “whole”, he needs to know
§ Tendency to seek and maintain territory his priorities.
o Some individuals can still consult others in order to
have peace of mind. e) Dorothea Orem (Self-care, Self-Deficit)
§ Ability to use verbal symbols as language, a means of o “Man is a unity who can be viewed as functioning
developing and maintaining culture biologically, symbolically and socially who initiates
and performs self-care activities on own behalf in
§ Man is a biopsychosocial and spiritual being who is in maintaining life, health, and well-being.”
constant contact with the environment
o Bio – has physical attributes f) Sis. Calista Roy (Adaptation Model)
o Psycho – has the capacity to think, decide o The person is an open adaptive system with input
§ Biologic being: Men is like other men. (stimuli), who adapts by processes or control
o If others are hurt, man can also feel this. mechanisms.
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g) Virginia Henderson § Safety Needs
o Man is whole, complete, and independent o Need to avoid pain, to obtain bodily comforts and
being who has 14 fundamental needs to be free from fear and insecurity (physical and
psychological safety
BASIC HUMAN NEEDS o Still lower needs
§ Each individual has a unique characteristic, but certain
needs are common to all people. § Love and Belongingness
§ Human needs are physiologic and psychologic conditions o Identification with a group, need to give and
that an individual must meet to achieve a state of well-being. receive affection and love
o “needs and wants” o Beginning of the higher needs
o To love and be loved
§ Need o To care and be cared for
o Necessary, useful, or desirable to maintain being o The need for affection; to associate and belong
& life o The need to establish fruitful and meaningful
o Motivation for behavior relationships with people, institutions, or
¶ “I take heavy breakfast so that I will be organizations
well-rested for the day.”
o May be met unconsciously or unconsciously § Self-Esteem Needs
o Feeling of success and self-worth, competence
CHARACTERISTICS OF BASIC HUMAN NEEDS and mastery of the environment
§ Universal o Includes the need to accomplish and to achieve
o Everyone has needs. o Self-worth
§ May be met in different ways o Self-identity
o One’s hunger may be satisfied by a candy. To o Self-respect
some, it is not enough. o Body image
§ Stimulated by external and internal factors
o Internal – what we think § Self-Actualization Needs
o External – smell of the food o Need to know about ourselves and the world
§ May be altered by individual priorities around us
o Dependent on the need o The need to create and appreciate beauty
§ May be deferred o The tendency to be an inner-directed achiever
o If one underwent surgical procedure, he/she
should not eat. CHARACTERISTICS OF SELF-ACTUALIZED
§ May be interrelated PERSONS:
§ An unmet human need results in disruption of normal § Realistic, sees life clearly, and is objective
body activities and frequently leads to eventual illness about his observations
o “Paano ba ‘yung dapat?”
MASLOW’S HIERARCHY OF NEEDS § Judges people correctly
§ Has superior perception, more decisive
§ Has a clear notion to what is right and
wrong
§ Is usually accurate in predicting future
events
§ Understands art, music, philosophy,
politics
§ Possesses humility, listens to others
carefully
§ Dedicated to some work, task, duty, or
vocation
§ Highly creative, flexible, spontaneous,
courageous, and willing to make mistakes
§ Open to new ideas
§ Low degree of self-conflict, personality is
integrated
§ Does not need fame, possesses a feeling
§ Physiological Needs of self-control
o Food, air, shelter, sleep, sex, etc § Highly independent, desires privacy
o Lower needs which keep the individual alive § Friendly, loving, and governed more by
o Sex needs have to be met for the survival of the inner directives than by society
human race, not the individual.
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§ Can make decisions contrary to popular § Health across life stages
opinion o Identify risk factors and determinants of health
§ Accepts the world for what it is vary across lifespan
¶ Environmental
Reminders:
§ Basic needs must be reasonably met before higher needs ILLNESS
can be approached and met. § State in which the person’s physical, emotional, intellectual,
§ As the lower needs are met, the person tends to move social, developmental, or spiritual functioning is thought to
upward to meet the next higher level of needs. be diminished or impaired
§ If the lower needs are not satisfied, the person tends to § Not synonymous to a disease
focus again on the lower need until it is met. § Disturbance of normal functioning
o Fever – warning sign that there is a problem
APPLICATION TO NURSING
§ Prioritization of Care CLASSIFICATION OF ILLNESS
o The need to maintain life and physical integrity is 1. Acute
given top priority in nursing care. § Usually reversible
o Example: A nurse attended to a patient in the ER o Treatable
by first relieving the patient’s difficulty of breathing o The patient can return to normal state.
before gathering information about the patient’s § Characterized by severe symptoms of relatively short
condition by interview. duration (less than 6 months)
§ May affect functioning in any dimension
§ Understanding of human behavior and its § Example: Tuberculosis
consequences 2. Chronic
o The behavior of the client will give clues to his/her § One that lasts for an extended period (more than 6
needs. months)
¶ Infant – cries to address his/her needs § Affects functioning in more than one or more system
§ Has slow onset and often have periods of remission and
VI. HEALTH AND ILLNESS exacerbation
HEALTH o Puwedeng gumaling then babalik
§ State of complete physical, mental, and social well-being § Usually related to for modifiable health behaviors
and not merely the absence of diseases or infirmity (WHO, o Physical inactivity, poor nutrition, use of
1947) tobacco, and excessive alcohol consumption
§ State of being well and using every power the individual § Ex. cancer
possesses to the fullest extent (Florence Nightingale)
§ “A dynamic state of being in which the developmental and § Illness Behavior
behavioral potential of an individual is realized to the fullest o how people monitor their bodies, define and
extent possible” (ANA) interpret their symptoms, take remedial actions
§ State of being that people define in relation to their own and use the resources in the health care system
values, personality, and lifestyle (Mechanic, 1995)
§ The view of health varies among different cultural ¶ Are you checking your muscle mass?
orientations. (Pender et.al 2015) Activities? Weight?
§ All people free of disease are not equally healthy. (Pender ¶ Did you check the body temperature?
2016) ¶ Are you resting adequately?

§ Healthy People 2020 o If people perceive themselves to be ill, illness

o Attain high-quality longer lives free of preventable behaviors become coping mechanisms.
disease, disability, injury, and premature death ¶ Health-seeking behavior
o Achieve health equity, eliminate disparities, and
improve health of all groups VARIABLES INFLUENCING ILLNESS AND ILLNESS
o Create social and physical environments that BEHAVIOR
promote good health for all Internal (you can recognize)
o Promote quality of life, health development, and § Patients perception of symptoms (+/-)
healthy behaviors across all life stages § Nature of illness
§ Coping skills
LEADING HEALTH INDICATORS OF DEVELOPMENT § Locus of control
§ Determinants of Health and Health Disparities External
o Biological, social, economic, and environmental § Visibility of symptoms
facts – and their interrelationships – influence the § Social groups
ability of individuals and communities to make § Cultural background
progress § Economic variables
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o Generic drugs (cheaper) 7 COMPONENTS OF WELLNESS
§ Accessibility of health care systems
§ Social support
o Go-to people
o Support system

STAGES OF ILLNESS BEHAVIOR

1. Symptom Experience
§ you know that there’s something wrong.
§ Awareness of s/sx, sef-diagnosis, self-medicate
2. Assumption of the Sick Role
§ Sick leave, free from social obligation
3. Medical Care Contact
§ Consultation
§ Medical shopping
4. Dependent Client Role
§ Self-care deficit
§ Simple daily activities are hard to accomplish.
5. Recovery/Rehabilitation DIMENSIONS OF HEALTH/WELLNESS
§ Restoration, relinquishes sick role § Physical
§ He/She can now resume daily activities. o ADL’s, self-care, nutrition
o “Can she do the activities of daily living?”
§ IMPACT OF ILLNESS ON THE PATIENT AND FAMILY
o Behavioral and emotional changes § Emotional
o Impact on body image o Positive feeling of self, enthusiasm towards life
o Impact on self-concept
¶ Tingin sa sarili § Social
o Impact on family roles o Relationship with others, contribution to society
o Impact on family dynamics
¶ Pattern of communication § Intellectual
o Engaging in stimulating and creative mental
DISEASE activities to increase knowledge
§ Alteration in body functions resulting in a reduction of
capacities or shortening of normal life span § Occupational
§ Ex. COVID-19 o Engage in activities that produce personal
satisfaction
SICKNESS o Accomplishment of activities
§ Status or social entity associated with disease or illness
§ Spiritual
COMMON CAUSE OF DISEASE o Seek meaning and purpose in human life
§ Biologic agents
§ Environmental
§ Inherited genetic defects
o Clean water, sufficient food, clean air
§ Developmental defects
o Nutrition during pregnancy or during growth
FACTORS INFLUENCING DEFINITION OF HEALTH ON AN
and development
INDIVIDUAL
§ Physical agents
§ Conditions in life rather than pathological status health
§ Chemical agents
(Pender et.al 2015)
o Products or accessories
o Life conditions (positive or negative experiences)
§ Tissue response to irritation/injury
o Socio-economic (environment, cultural, diet,
§ Faulty chemical metabolic process
lifestyle practices or choices)
§ Emotional/physical reaction to stress
o Physiological and psychological variables
§
(developmental status, expectations, and
perception to self)

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VII. MODELS OF HEALTH § High level wellness in a favorable environment
1. EPIDEMIOLOGIC TRIAD o Healthy lifestyle with resources to support
o Even if you are working, you can exercise.

§ Emergent high-level wellness in an unfavorable

environment
o Knowledge in lifestyle but cannot implement
because of some factors

§ Protected poor health in a favorable environment

o Needs are met by healthcare system

§ Poor health in an unfavorable environment

3. TRAVIS’ ILLNESS-WELLNESS MODEL

§ Agent
o “Reason”
o Root cause
¶ Biologic (bacteria, virus)
¶ Chemical (poison, alcohol, smoke)
¶ Physical (trauma, radiation, fire)
¶ Nutritional (lack, excess)

§ Host § Ranges from high-level wellness to premature death.

o “who” § To the right: increasing well-being of an individual.
o Age, sex, race, genetic profile, previous diseases, § To the left: decreasing
immune status, religion, customs, occupation, § Compares Traditional Treatment Model with Wellness Model
marital status, family background § Tradition Treatment Model - moves from left to neutral point
only, where symptoms of the illness are alleviated.
§ Environment § Ex. A man who takes an antihypertensive medication to
o “aspect being viewed” reduce bp and relieve any associated symptoms moves to
o Temperature, humidity, altitude the neutral point. However, wellness-oriented measures
o Crowding, housing, neighborhood such as reducing weight or ceasing to smoke are needed to
o Water, milk, food move the person beyond the neutral point to a higher level
o Radiation, pollution, noise of wellness. Note that wellness interventions can be initiated
at any point on the continuum. Thus, the Wellness Model
2. DUNN’S HIGH LEVEL WELLNESS MODEL and the Treatment Model can work together.

4. HEALTH BELIEF MODELS

§ Individual’s perception of susceptibility to illness
§ Individual’s perception of the seriousness of the illness
§ Likelihood that the person will take preventive action
(perceived threat)
¶ Barriers = Costs
¶ Ex. Mass Media Campaigns: DOH
Dengue jingle

§ “High level wellness is a direction in progress toward an

ever-high potential of functioning and does not merely imply
that there is an optimum level of wellness.”

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VARIABLES INFLUENCING HEALTH AND HEALTH § Reinforce clients’ personal and family health-
BELIEF PRACTICES promoting behaviors
Internal Variables o Strengthens what works for them
§ Developmental stage § Advocate for community changes
§ Intellectual background
§ Perception of functioning OTHER MODELS OF HEALTH
§ Emotional factors
§ Spiritual factors 6. HOLISTIC MODEL
External § Promotes the active involvement of client in improvement
§ Family practices and maintenance of health
§ Psychosocial and socio-economic factors
§ Cultural background
7. ADAPTIVE MODEL
5. HEALTH PROMOTION MODEL(Pender 1993, 1996) § Disease is a failure of adaptation, extreme good health is
§ Health is a positive and dynamic state and not merely the flexible adaptation of the environment
absence of disease.
§ Directed at increasing a patient’s level of well-being 8. EUDAIMONISTIC MODEL
§ Focus: § Health is seen as a condition of actualization orientation of
o Individual characteristics and experiences human potential through goal-directed behavior, competent
o Behavior specific knowledge and affect self-care and satisfying relationships with others while
o Behavioral outcomes, in which the patient commits adapting to maintain structural integrity and harmony within
to or changes a behavior the social and physical environment
§ Positive Resources: Infographics (flyers, brochures),
seminars VIII. LEVELS OF PREVENTION
§ Goal: Not just to help clients prevent illness thru their LEAVELL AND CLARKS LEVEL OF PREVENTION
behavior but to have better health, or promote health.
§ Health-promoting behavior = desired behavioral outcome PRIMARY PREVENTION
§ Prevents a disease condition at a pre-pathologic state
§ To stop something from ever happening
SECONDARY PREVENTION
§ Focuses on individuals who experience health problems
or illness and who are at a risk of developing
complications or worsening conditions
TERTIARY PREVENTION
§ When a defect or disability is permanent and irreversible,
minimizing the effects of long term disease or disability
§ “mas mabalik ang normal state”

Application of Leavell and Clark’s Levels of Prevention

Nurse’s Role in Health Promotion:

§ Model healthy lifestyle
§ Facilitate client involvement
o Allow them to take part
§ Teach self-care strategies
o So that without us, they can take care of
themselves
§ Assist clients to increase levels of health
§ Educate clients to be effective healthcare
consumers
o Needs vs wants
o Applicable or not
§ Assist clients develop and choose health § Risk Factors
promoting options o Any situation, habit, social, or environmental
§ Guide development of effective problem-solving condition, psychological condition, developmental,
and decision-making intellectual, spiritual variables that increases the
o Educating them and giving them vulnerability of an individual to illness or accident
information
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o Genetic, age, environment, lifestyle o Touch a sterile surface only with another sterile
object.
FACTORS THAT CAUSE ILLNESS § Only sterile objects may be placed on the sterile field
§ Etiologic Factors § Sterile objects or field should always be with in the line of
o Cause of a particular disease vision
o above the waist
§ Predisposing Factors § Sterile objects or Field may become contaminated by
o Previous condition that influences susceptibility or prolonged exposure to air
tendency to illness § Keep air currents at a minimum
o “nagkaroon na dati na nag-pave way sa isang § Do not reach across a sterile field.
sakit” § Avoid nothing coughing and excessive talking.
§ Do not return items to a sterile container once exposed to
§ Contributory Factors the external environment.
o A condition that helps bring about illness § Assessing the integrity of sterile packages any break or tear
o Ex. environment on the cover or packaging will make the items contaminated.
§ Use sterile waterproof (non-porous) materials for packaging.
§ Precipitating Factors § When a sterile surface comes in contact with a wet
o A condition that hastens, activates, or aggravates contaminated surface, the sterile object or field becomes
illness contaminated by capillary reaction.
§ Fluid flows in the direction of gravity.
THEORETICAL MODEL OF CHANGE § The edges of a sterile field or container are considered
contaminated.

IX. ASEPSIS
§ Absence of microorganisms
§ Surgical
o Sterile technique
§ Medical
o Clean technique
o Practices that help reduce the risk for infection

USES OF SURGICAL ASEPSIS

§ During procedures requiring intentional perforation of
patient’s skin such as insertion of the referral IV line or
central lines
§ When the integrity of the skin is broken as a result of
trauma, surgical incision or burns
§ During procedures that involve invasive procedures such as
insertion of a urinary catheter or surgical instruments into
sterile body cavities

PRINCIPLES OF ASEPSIS
§ A sterile object remain sterile only when touched by another
steroid object. (sterile to sterile)
o Use of sterile forceps or wear sterile gloves to
handle tray.

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