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October 8, 2013

Essay on Emergence of Nursing

Emergence of Nursing
 In the last century nursing has made a phenomenal achievement that it has led to the recognition of nursing as a profession and a separate educational discipline. Contemporary nursing is now more meaningful and significant because of theory-based practice which shifted the focus from vocation to an organized profession. It was the advancement in research and theory together in the twentieth century which produced nursing science. Nursing theory basically suggests that nursing should be given professional education during which they will study a collection of interconnected subjects which will be applied in their practice. The knowledge may be derived from experimental learning or formal sources such as nursing sources or nursing research. Nursing is a science involving many people environment and process in the context of healthcare.
Meanwhile, hospitals have evolved following the development of cities: new forms of assistance are growing, especially from the seventh century in the Hotel-Dieu. These structures began to restrict their entries for the sick curable specializing in hospice care where the infirm were organized through the church hierarchy and thereby provided by the Hospital Sisters. The care of disabled takes root in the application of technical and medical and surgical knowledge that too has evolved over time.  In this paper, I will look at twentieth century time frame and the impact of nursing and its impact on nursing education and research.
Emergence of Nursing education and research in twentieth century Europe
In the first half of the twentieth century it has been realized that there is need for knowledge base to guide professional nursing practice and many theoretical work has been contributed by nurses ever since but there is no specific date and place nursing theory took place. Nightingale’s vision was practiced for more than a century and in the past 4 decades theory of nursing was developed more rapidly which made nursing an academic discipline with a substantive body of knowledge. There were four essential concepts common amongst nursing theories which are man, health, environment, and nursing. Nightingale was the first lady who expressed her firm conviction nursing knowledge is different from medical knowledge. According to her nursing is the act of fertilizing the environment of the patient to assist him in recovery. She focused on the changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act. According to Dorothea Orem nursing is the act of fascinating others in the provision and management of heath care to improve human functioning at home level of effectiveness.
She had a strong health promotion and maintenance focus. She identified three related concept self care, self care deficit and nursing system. According to her nursing intervention is needed when individual is unable to perform the necessary self care activity. Virginia Hendersons thinks that nursing is assisting an individual sick or well in the performance of those activities contributing to health or its recovery (or to peaceful death) that an individual would perform unaided if he had the necessary strength. Medelien Leiningers theory is that Nursing is a learned humanistic and scientific profession and discipline which is focused on human care phenomena and activities in order to assist, support, facilitate  individuals or groups to maintain or regain their well being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death.

In twentieth century, nurses have struggled against the medical hierarchy which inherited the vision that the main action and responsibility of a nurse is to carry out the directives of medicine. This trend was countered by Florence Nightingale who mentioned relatively this issue frequently and in a tone of criticism: "Not a man, including a doctor, never give another definition of what should be nurse - devoted and obedient , and in particular the power and influence of the' white coat '.
As a matter of fact, twentieth century witnessed two great wars which is the reason why the profession of nursing is often said to have been established during the war. During these periods, they have developed significantly with Florence Nightingale, then working to improve the condition of the soldiers involved in the Crimean War, laid the foundation stone of professional nursing principles with some mentions it in her book. Other leading figures have contributed to the development of modern nursing as Linda Richards or Jeanne Mance. In North America, especially in Quebec, Jeanne Mance is considered a pioneer nurse since she moved to Montreal to open a hospital (Hotel Dieu) to treat the indigent. She co-founded the city of Montreal (Ville-Marie of New France).
The evolution of knowledge and expertise has developed since the late nineteenth century exploration of new techniques or nursing actions in parallel in the history of medicine. In France, around 1871, shortly after the events of the Paris Commune, the first emerging structures of secular education and regulated for nursing, under the leadership of Dr. Désiré-Magloire Bourneville and an order of 28 October 1902 urging the medical school to support their initiative.(Michael, 2010)
The twentieth century saw the development of studies within the nursing profession which provided the basis for the dissemination of knowledge. The acquisition of knowledge and teaching practice, traditionally transmitted orally, were structured as lectures by doctors or nursing general trainers. In 1922, France, that nurses received for the first time a state diploma.
The vision that the nurse focuses his or her care on the patient by performing simple tasks was widely projected and that the medical science was reserved for the doctor.  During the war (First, Crimean War and especially World War II), the shortage of doctors to nurses is conferred on a sliding action usually reserved for medical practitioners. Nursing learned and were then carried out to diverse invasive procedures and expand the simple comfort care or hygiene provided to patients.
Emergence of Nursing in Twentieth Century America
In the early twentieth century as the population grew, hospital care and medical services were extended and improved in United States of America. At the same time, Florence Nightingale was developing a system for nursing education to women of the middle class, which served as a model.  
The first formal program of nursing education, based on the model of learning practice in hospitals, was created in 1874, the General and Marine Hospital, St. Catharines, Ontario, which led to the proliferation of schools in all major hospitals across the country.
Graduates and teachers of these schools tried to make nursing more professional lobbying for the adoption of laws and the creation of professional organizations, especially the CNA, trade journals, among others, American Nurse, and academic programs for nurses.  In the sixties, nursing hospital became more and more scientific and specialized across America and Canada.
In 1901, the nurses became officially part of the Royal American Army Medical Corps. More than 3,000 nursing sisters served in World War I and twice that number during the Second. They continued their work in peacetime and during operations to peacekeeping.(American Nurses Association, 2010)
In the early twentieth century, different programs were set up on disease prevention and education in public health.  First engaged in the struggle for control of epidemics and maternity care, nursing public were developed in communities and schools through public health programs, immunization and mental health, and the establishment of clinics for newborns.
In the 1920s, the movement for public health turned its attention to the needs of indigenous communities and settlers in remote areas of America. Thus, the Canadian Red Cross has created a series of pre-nursing stations in the North and other remote areas of the country.
After the Second World War, the nature of nursing became considerably significant following the development of public health system and the emergence of health insurance in 1968. In an effort to reduce the nursing shortage, schools experienced a boom and programs were created for nursing assistants. Nursing became more scientific and specialized, particularly in areas such as intensive care and neonatal care. For the first time, visible minorities and people were encouraged to join the profession. In the 1970s, nurses were fully organized.  In America, the role and mission of nursing was evolved and the profession gained recognition in twentieth century.  State diploma was created to encourage and celebrate the emergence of nursing.  At this point, nursing made a strong statement of a profession in its own right. Professional identity was established and own autonomy to the medical profession. The disease is the science of physician knowledge of the patient is the responsibility of the nurse.
Nursing in Asia
Nursing was not recognized as vital part of Japan's healthcare system until 1899 with the Midwives Ordinance. From there the Registered Nurse Ordinance came into play in 1915. This established a legal substantiation to registered nurses all over Japan. A new law geared towards nurses was created during World War II. This law was related to the Public Health Nurse, Midwife and Nurse Law and was established in 1948.  It set the tone for educational requirements, standards and licensure.
There has been a sustained effort to ameliorate nursing in Japan. In 1992 the Nursing Human Resource Law was passed which paved the way for the development of new university programs for nurses. These programs were designed to enhance the education level of the nurses so that they could offer better services to the public.  
In 1952 Japan established the first nursing university in the country.  An Associate Degree was the only level of certification for years. Soon people began to want nursing degrees at a higher level of education. Soon the Bachelors Degree in Nursing (BSN) was established. Currently Japan offers doctorate level degrees of nursing in a good number of its universities.
There are three ways that an individual could become a registered nurse in Japan. After obtaining a high school degree the person could go to a nursing university for four years and earn a Bachelor degree, go to a junior nursing college for three years or go to a nursing school for three years.(Helen, 2010) Regardless of where the individual attends school they must take the national exam. Those who attended a nursing university have a bit of an advantage over those who went to a nursing school. They can take the national exam to be a registered nurse, public health nurse or midwife. In the cases of become a midwife or a public health nurse, the student must take a one year course in their desired field after attending a nursing university and passing the national exam to become a registered nurse. The nursing universities are the best route for someone who wants to become a nurse in Japan. They offer a wider range of general education classes and they also allow for a more rigid teaching style of nursing.
In the 1960s, the liberation movement of women allowed nurses, professionals almost exclusively female, to break free from the shackles of mere performers behind the male doctors. The care was undertaken with greater autonomy, and expanded to some thought process specific to the nurse. Thus the implementation of any intervention in nursing since the 1960s is subject to a scientific process called the nursing process or nursing care.
Over time, the nurse thought was structured on the basis of the study of facts (evidence based medicine). Today, the concept of nursing care is rooted in professional practice on the one hand and on the other hand, in the philosophical, conceptual models and theoretical nursing. Nursing, whose terminology was officially used during the first session of the Expert Committee of Nursing of the WHO in 1950 and whose first code of ethics was published in 1953, then tend to set itself up as a science. In 1954, Martha Rogers, a young director of nursing department at New York University College of Nursing, developed his own program of research and treated nursing as a science in itself.

American Nurses Association (2010) “Nursing: Scope and Standards of Practice” retrieved on 27th September, 2011 from
Helen, Bartlet,(2010) “Nursing homes for elderly people: questions of quality and policy” 2nd Edition(p. 266-297)Cengage Learning
Karen, Holland (2010) “Nursing: Evidence-Based Practice Skills”(p.100-154) Oxford University Press
Michael, Yeo (2010) “Concepts and Cases in Nursing Ethics” 4th Edition(p.43-88) Broadview Press


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