DEVELOPEMEMT OF NURSING

INTRODUCTION:

Nursing is a unique profession. It is in its simpler form existed from the beginning of human life and is essential to the maintenance of life. The first mother was the first nurse. From the time of the first mother down to the present day, we have found women protecting their children, and taking care of the elderly and sick members of the family. They also rendered their services to the neighbours during illness. Simple procedures for the sick were adopted, e.g., application of cold water over the forehead, to reduce fever, application of pressure over a bleeding injury. Individuals who possessed special gifts and aptitudes for caring and healing gradually collected a lot of healing knowledge through trial and error, and passed on from generation to generation.

The word nursing comes from the Latin word “Nutrix” meaning of “Nourish or cherish”. The word nourish means to supply that which is necessary to life. When nursing perceived as a science, the term nursing becomes a noun signifying a body of abstract knowledge.

Nursing is a fast developing profession. To attain this stage it has taken a longer time. In early days only orphan, widows and nuns took up this nursing, professional nursing is adopting to meet changing health needs and expectations.
Nurses now receive advanced education in such specialities as intensive care, coronary care, respiratory care, oncological care, neonatal intensive care, renal dialysis care, trauma care, transplant care and other to fulfill the needs and expectation in contemporary period.
For the development of the nursing profession in New era one must know the philosophy, goals, and development of nursing for the betterment of the profession.

DEFINITIONS:

“Service to the humanity is service to God.” Service to the man kind is the primary function of the nurses and the reason for existence of nursing profession.
1.“ Nursing is a call (vocation) to service, nursing is a service which include ministration to the sick, care of the whole patient (his mind as well as body), the care of the patient’s environment (physical as well as social), health education and health services to the individual, family and society for the prevention of diseases and promotion of health”.(Florence Nightingale)
2.“It is the act of utilizing the environment of the patient to assist him in his recovery”. (Florence Nightingale)
3.“Nursing is the unique function of the nurse that is to assist, the individual (sick or well) in the performance of those activities contributing to health or its recovery or peaceful death that he would perform unaided if he had the necessary strength, will or knowledge”. (I.C.N)
4.“Nursing is a practice is a direct service, goal directed and adaptable to the needs of the individual, the family, and community during health and illness.” (ANA)
5.“Nursing is a dynamic, the specific and reductive process in meeting the health needs of the individual, family and society”.
6.“The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (Or to peaceful death) that he would perform unaided if he had the necessary, strength, will or knowledge and to do this in such a way as to help him gain independence as rapidly as possible” (Virgina Henderson -1966 First modern nurse )
7.“Nursing practice is a dynamic, caring, helping relationship in which the nurse assists the client to achieve and obtain optimal health .” (CNA 1987).
8.“ Nursing practice is a direct goal oriented, and adoptable to the needs of individual in the family, and community during health and illness.” (ANA 1973)
9.“Service to individuals and families, therefore to society. It is based upon an art and science which mold the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people skill or well cope with their health needs and may be carried out under general or specific medical direction.” ( Faye glenn Abdellah 1982)
10.“ A learned humanistic art and science that focuses upon personalized (individual and group) care behaviors, functions and process directed toward promoting and maintaining health behaviours, or recovery from illness which have physical, psychocultural and social significance or meaning for those being assisted generally by a professional nurse or one with similar role competencies. (Mgdeleine leininger)
11.“ A caring relationship, an enabling condition of connection and concern”.(Patricia Benner)
12.Hildegard E. Peplau She described Nursing in psychodynamic aspects “Psychodynamic nursing is being able to understand one’s own behaviours to help others identify felt difficulties and to apply principles of human relations to the problems that arise at all levels of experience.”
13.“Nursing is the holistic helping of persons with their self care activities in relation to their health. This is an interactive, with personal process that nurtures strengths to enable development, release, and channeling of resources for coping with one’s circumstances and environment. The goal is to achieve a state of perceived optimum health and contentment.” ( Helen et.al.)
14.“A process by which the patient is assisted in maintenance and promotion of his independence. This process may be educational therapeutic, or restorative; it involves facilitation of change, most probably a change in the environment”.(Kathryn.E.Barnard 1966)
15.“Theoretical system of knowledge which prescribes a process of analysis and action relation to the care of the ill or potentially ill person”. (Sister Callista Roy)




PHILOSOPHY:

It is a scientific, systematic inquiry about the ultimate reality in the universe; it is the basis for understanding man. Etymologically, the term, “philosophy” has been derived from two Greek word; Philos means Love, Sophia means wisdom. It is the loving and searching for wisdom and truth.
Philosophy is the science of knowledge – Fitche
Philosophy is the science of all sciences – Coleridge.
Philosophy is the mother of all arts – Cicero.

DEFINITIONS:

1.Philosophy is a search for a comprehensive view of nature, an attempt at a universal explanation of nature of things. – Henderson.
2.Philosophy is an unceasing effort to discern the general truth that lies behind the particular facts. (i.e., the reality that lies behind the appearances).

MEANING OF PHILOSOPHY:

It is a search for a comprehensive view of nature, an attempt at a universal explanation of nature of things.
It is a living force, a way of life, an attitude towards life and a search for truth and reality. It is a speculation about the nature and value of things. It is a search for deeper and finer values of life.
Philosophy refers to a certain way of thinking. It arises out of an attempt:
To arrive at the solution of a problem through the use of human reasoning and experience.
To find the deeper meanings of the problems.

Each individual should have a philosophy of life i.e., a set of standards, ideals which are based on the principles that he has chosen as being acceptable to him.
Philosophy is the study of the general principles and understanding all i.e., God, the world, and man himself, of origin, nature and the activities that come in the range of human experience. It is a comprehensive view of nature. Through philosophy man tries to understand himself and the world in which he lives. It answers the wholesome of things.
It is what we believe and the principle which governs our life.
It is acting like a guide to have a concrete outlook on the world, life, human conduct, and actions.
Philosophy is the earliest and the most original intellectual discipline.
Plato said, “he who has a taste for every sort of knowledge and who is curious to learn and never satisfied” may be just termed as philosopher.
Questions of philosophical enquiry:
What is life?
What is man?
What is man’s origin?
What is man’s destiny or goal?

Philosophers try to answer these questions according to their own mature reflection and thinking.

TYPES OF PHILOSOPHY:

NATURALISM:

Naturalism is a doctrine that separates nature from god, subordinates spirit to matter and setup unchangeable laws as supreme. According to Naturalists, human life is a part of nature, it is a self-sufficient entity having its own natural matter natural force and natural laws. It emphasizes, on ‘matter and the physical world’. It does not believe in spirituality and supernaturalism.

The major types of naturalism are
Physical
Mechanical
Biological

IDEALISM:

The word “Idealism” has been derived from “ideal” or ideas. Ideals or higher values are much more significant in human life than anything else. This philosophy seeks to explain man and universe in terms of spirit or mind. This philosophical thought, is originated by the great Greek philosophers, Socrates and Plato. Man’s spiritual nature is considered to be the very essence of his being.

REALSIM:
Realism is an outcome of scientific development, by observation, experimentation and examination if it if found to be true can be considered as real, realism is directly related to man and society. Through realism man is able to enjoy the comforts of society, after getting all the joys of life. Realsim provides education, which is useful for life where man can enjoy his activities and comforts in reality.



PRAGMATISM:
Pragmatism is a matter of fact, treatment of things based solely on their practical utility. It is the element of utility that has the greatest appeal for a pragmatist. For him, utility is truth and truth is utility. Pragmatism believes in practical and utilitarian philosophy.

EXISTENTIALSIM:

This philosophy views a man as participating in a world of things and events, human existence is the nature of man to exist, to stand out into reality, to participate in being, to be present to all.
PROGRESSIVISM

Education is centered around for the present life itself. The development of an individual and the society is only possible, when education facilitates the growth of every phase of the child.

BEHAVIOURISM

Each individual is having an “ ego” / “mind” centre of consciousness which enable him to choose any course of action, that he wanted to do. Individual’s actions are predetermined by his heredity or immediate surroundings.

HUMANISM:

According to them, Man is an end, not a means, the humanist emphasis is on literature. He has to overcome the conflicts of his own time.

EXPERIMENTALISM:

It rejects the laissez-faire individualism and permissiveness. They accept a naturalistic point of view, but they want the control and utilization of nature – not submission to nature. It accepts the perspective of evolution.

ECLECTICISM:

It is the fusion or synthesis of different philosophies of education. The harmonization of principles underlying various tendencies and rationalization of educational practices, The process of putting together the common views of different philosophies into comprehensive whole.

RECONSTRUCTIONALISM:

It is the total change of the entire system or desirable change of the entire system.

PHILOSOPHY OF NURSING EDUCATION:

A philosophy of nursing education includes beliefs and values with regard to man in general and specifically man as the learner, teacher, nurse and the client and the beliefs abut health, illness, society, nursing and learning etc.
Traditionally nursing education had adopted “children philosophy” which was based on “supernaturalism”. According to it, God is creator, redeemer and provider of man and the universe. The maxims of Christian Philosophy are “love of god” and “love thy neighbor”. Every phase of nursing education will be influenced by the philosophy upon which it is based.
Christian philosophy considers man to be dualistic in nature i.e., man was created by God as a unit, (a composite made up of a body and a soul, possessing intellect and the likeness of god) and he was created for the purpose of serving him in heaven. Education based on this philosophy takes in all aspects of human life with the view in regulating and perfecting life in accordance with life, of Christ, by which man may attain the eternal end for which he was created. It affects all aspects of the nursing student’s life i.e., spiritual, moral, intellectual, emotional, physical and social as they relate to the preparation of a Christian nurse motivated by supernatural motives. According to Christian philosophy, nursing is considered as, “profession of charity.”

SPIRITUAL:

Religion should serve as the primary integrating factor in the development of the curriculum in a school of nursing. The principles of religion and morality are unchanging. By this stable truth, the nurse will be able to meet intelligently the changing conditions of modern social living. Religion provides the motives for the nurse influenced by religious principles.

MORAL:

Through understanding of moral principles governing man’s conduct and action leading to the nurses to study ‘ethics’ (It is the philosophic science of human acts) from the point of the view of the order they should have regarding one another and man’s ultimate destiny which they ought to help him achieve and it also teaches the individual how to judge accurately the moral goodness or badness of any action. Nurses has to apply right conduct, in various situations of her daily life based on a sound moral character, adequate understanding and habitual application of proper moral standards. Nurse has to develop right conscience.





INTELLECTUAL:

To provide a systematic development and training of the intellect, so that it may be enlightened, disciplined and disposed to function in accordance with the purpose for which it was created.

For the fulfillment of nursing functions, nursing education should give training in:
Memory
Direction of imagination
Strengthening and expansion of the capacity for association
Cultivation and training of the intellect.
Judge wisely
Reason soundly
Acquire prudence, wisdom and intellectual virtues.
Imparts knowledge
Provide opportunity for the student to analyse nursing care situations and problems, to apply various theoretical knowledge and skills in the field of clinical situation.
Development of communication skills to express their thoughts.

EMOTIONAL NEEDS:

Nurse must be able to function as a mature, self dependent and responsible individual and must be able to relate well to other people. It shows emotional maturity where by all her emotional needs were met.

The primary emotional needs are:
Affection and love
A feeling of belongingness.
Achievement or status i.e., prestige or self esteem.
Approval from the group and from the authority figures.

These needs must be met, if the student is to mature into a well integrated personality and who can use mature judgement and make the decision in professional life.

PHYSICAL:

To promote the harmonious development physical needs also has to be met, to preserve her body and the essentials of her health. Nurse should have knowledge of how to guide the others, who need assistance in learning, how to keep well or how to improve health.



SOCIAL:

Nurse is a social being, who must pass her life in society in relation to which, she has both privileges and obligations. Nursing is linked with social cultures. In which nursing activities are carried out. The nursing student should be taught, to use her will power in gaining control of her own impulses. To acquire self-mastery and to be a virtuous member of a social group nurse practices democratic principles.
Nursing is a service to individual, families and to the society. It is based upon art and sciences which mold the attitudes, intellectual competence and teaching skills of the individual nurse, to help the people sick or well, to meet their health needs in medical direction.
Nursing is a social institution where
Prevention of illness.
Promotion of health.
Direct supportive and therapeutic care.
Rehabilitation
Body-mind spirit unity.

During the course of time, changes have taken place in the field of education, health care, sociocultural aspects, science and technology. There was need for change in the existing value in the field of nursing and nursing education also. It is not advisable to adhere to only one type of philosophy so, the nursing also is following the path of electism i.e., to draw the best and useful aspects from various educational philosophies and make one’s own philosophy.

Nursing is concerned with human welfare, it acknowledges the uniqueness of each individual. It considers health as a fundamental human right. Nursing is a service to individual, people or community without any distinction between caste, creed, sex or colour, rich/poor, age or religion. Hence nursing is concerned with a philosophical outlook i.e., “the individual has intrinsic value and there is worth inherent in human life”.

Nursing requires critical thinking logic and judgement; it is a problem solving and decision making process, nurse has to use a rational activity. Nurse is legally and morally accountable person
.
The learning experiences should setup equip the learner with skills in problem solving, decision making and critical thinking.
Nursing actions are based on scientific principles, which are drawn from bio-psycho-social sciences. Nursing curriculum should include physiology, microbiology, and other relevant subjects.

Nurse will have active voice as a democratic citizen has some control over and responsibility for the political, legal and social milieu related to health care matters, in which she lives.
Nurse is a socializing agent, consumer advocate and protector, she has to play active role in bringing social change.

Nursing is a process to attain an end. It includes:

Inherent purpose: The optimum level of wellness of health of the individual.
Internal organization: the series of actions to attain the aim of optimum level of wellness of health of the individual.

Infinite creativity: The dynamics of evolving unique, effective, efficient nursing activities for the achievement of the goal of optimum health.

Nursing is a crucial component of multidisciplinary healthcare system, it reflects the independent, dependent and collaborative positions of the nurse involving respective functions. Nursing common philosophy, purposes, knowledge and functions. Nursing is a profession and nursing practice must reflect professionalism, professional adjustment and research.
Nursing roles in the order of priority are: Educative, preventive, promotive, rehabilitative, Therapeutic, Supportive.
Democratic processes include in nursing role are : Authority by mutual consent, individual accountability, group activities, leadership and organizational set-up.
The requirements for professional nursing care includes: Clinical Knowledge, judgement, technical competency, health knowledge, teaching skills, realization of professional responsibilities. Philosophy will determine the selection of students, preparation of faculty, development of curriculum, personal life and professional growth of students and faculty.
It must be specific about the specialized functional roles and responsibilities within a profession and society. The purpose of nursing education is to prepare a person who can fulfill the role, functions and responsibilities of professional nurse within the society. The philosophy is developed by each faculty of individual school of nursing together with nurses leaders and nurse administrators. It should be clearly stated and directly related to the aims.

PHILOSOPHY OF NURSING SERVICE ADMINISTRATION:

1.The individual has intrinsic value and those is worth inherent in human life.
2.Nursing is a rational activity.
3.Nursing’s uniqueness is in the way the basic, social biological sciences are synthesized in functions that promote health.
4.The individual nurse citizen has some control over and responsibility for the political and social milieu in which he/she lives.
5.Nursing is a process with a centre subjective purpose an inherent organization or system and dynamic creativity.
6.Nursing functions are independent, interdependent and collaborative.
7.Nursing is a holistic unit with central and common philosophy, purpose knowledge’s and functions.
8.Nursing is a profession and nursing professionlistic activity should be reflects in practice.
9.Nursing roles in the order of priority.
10.The democratic mode of operation and the implications of the democratic mode are a key stone of nursing roles, organizations and structure.

GOALS OF NURSING:

Alleviation of Pain and care of disease.
Restoration of promotion of health.
Prevention of disease and early detection and correction of defects.

DEVELOPMENT OF NURSING:

History provides basis for understanding the nursing today. Yesterday is a history of today and today is a history of tomorrow. History is not just the story of dates, discovery, research. History is to understand the changes that occurred in forms of religion, economy and politics in the various cultures of the world through age how changes influenced the development of nursing.

AIM OF STUDYING HISTORICAL PERSPECTIVES:

1.To know the past events that lead to the present and will lead to the future.
2.To appreciate the view that nursing transcends all national boundaries and cultures.
3.To develop desirable attitudes.
4.To utilize the special knowledge and skills in building a democratic world.
5.To help us to accept the responsibility for the future of nursing.

NURSING IMPULSE:

The Hippocratic era. Rational medical functioned with out nursing where as at other time, that is middle ages, Nursing was practiced with out national medicine.
The nursing has been called the oldest at the art and the youngest of the profession. The history of Nursing was been one of the frustration ignorance and misunderstanding. Nursing had a great turning point when evolution taken place in world.

GENESIS OF NURSING:

History of nursing as an episode in the history of women. The nurse is the mirror in which is reflected the position of women through the ages”. During that time women restricted to home. Nursing has its origins in the mother. Care of help less influence and must have co existed with this type of case from earliest times.

The nursing is derived from the Latin inverter to nursing meaning of nursing mother.
As the evolution taken place in the world another diminution was added to its meaning a women who cases for and tends young children particularly with respect to the training, training and general up bringing of the young. The word nurse maid and governess thus reargued and became titles for the young girls.

STEWART AND AUSTIN HESITATED 2 KINDS OF HELPERS:

1.BORN NURSES: The women of their maternal instincts.
2.CHILD NURSES: With the teaching and training of children so nurse became more closely associated the healing arts. Time progressed love and caring along were not sufficient to nature health or over come disease. The development of nursing thus developed on the additional essential ingredients, such as SKILL EXPERTNESS AND KNOWLEDGE

Male and females have a tendency to respond to helplessness. Threat to life, disease and injury. So they functioned as nurses. The role of nurse gradually enlarged with much broad scope for care of sick. The aged, the helpless and the handicapped as health promotion of vital components of nursing.

The head, heart and the hand become truly the strong foundation for modern day nursing .

NURSING: THE SEED OF EARLY COMMUNITY SERVICE:

This service was related to a preservation and protection of the tribe and its members during this period community was influenced by waves of religious awakening ideas of chivalry. Patriotism and democracy social and humanitarian efforts. As more civilization developed the nursing care extended to poor people, prevention of disease.

For longer period Nursing could be done only by those who renounced the world. Religious motive, self scarification provide an excellent qualification for assuming the Nursing role.

Because of continued civilization all tribes followed some type of sanitary practice. Elementary practices become more sophisticated as technical advances. Such as improvement in water drainange system, disease and communicability that is over all emphasis on health. During this period medicine men, priests, wise women and midwives serve to the community as well as to the individual. The basic concept that included in nursing is health and illness. Thus the early roots of public health become a prominent aspect of the nursing role.
CARE OF THE SICK AMONG PRIMITIVE PEOPLE:

No records of nursing in the prehistoric times what we know about the nurse of the sick in primitive times has been discovered through myths, songs, and the findings at archaeologists.

Primitive man was much closer to nature and animals. The first trace of parental love, tendons and natural aid were elicited by birds and other animals. They were nature worshippers. This belief is known as “animism and the period as called as stone age or age of hunters”. He believed that thing in nature like a tree or river had a sprit or soul. Water and trees were friends while storms and poisonous plants were enemies. Natural colonies were attributed to the anger of god.

BELIEFS : The primitive people believed that sickness comes due to the following reasons:
1.Anger of the offended gods, devils and evil spirits.
2.Displeasure of the dead.
3.Breaking a taboo.
4.Bodily invasion by a sprit to get rid of evil spirits dwelling in the body, the body had to be made unpleasant for them.
5.Loss of soul - A soul catching ceremony was required for its return.
6.Dreams – It was believed that soul leaves the body during the period of dreaming.

PREVENTIVE MEASURE AND TREATMENT:

Starving, beating, loud noises, magic treatise and ceremonies and sudden fright were also tried.
Starting the evil spirit with a frightening mask and deafening noises.
Using noxious body.
Giving noxious medicines.
Trephening the skull with stone.
White magic was used to attract good or helpful spirits. While black magic was used to drive away evil spirits or bring harm to one’s enemies.\
Hot and cold baths.
Faith of the person.
The above treatment was done by medicine man or priest physician.

THE HERITAGE OF NURSING, INITIAL IMAGE OF THE NURSE:

The role of the Nurse is mother.
The concept of Nursing as a feminine occupation
Nursing started to keep healthy full environment and keep the people healthy, and to provide comfort care and assurance to the sick.
They were capable, concerned and compassionate persons whose practice encompassed “a wellness” in addition to an illness component.
They used problem solving skills as well as intuition in assessment of human needs.
They developed a body knowledge and utilized intellectual interpersonal and psychomotor skills in meeting human needs.
They shared their knowledge and skills beyond family and neighborhood bonds by teaching individuals, families, communities and their own successors.
They possessed a role and function separately and distinct from those of medical practitioners.

ROLE OF THE NURSE IN THE CARE OF THE SICK:

From the time of the first mother down to the present time we find women protecting and caring for their children aged and the sick members of the family. Traditionally female role is wife, mother, daughter, sister have family members thus nursing could be said to have its roots in the home. Nursing role has always entailed humanistic caring, comforting and supporting, nourishing, cleaning aspect to the patient. Knowledge of these simple skills were passed down from generation to generation, tenderness, concerns, love and hope practices in nursing evolved.

BEGINNING OF CIVILIZATION 5000 BC TO 1 AD:

Definition: Civilization is the product of our higher qualities as exercised first by original and superior individual and then accepted or followed by a sufficient numbers of human beings to make it a social fact . Prof. Lyna Theorndike.

MEDICINE AND NURSING IN EARLY CIVILIZATION:

THE NEW STONE AGE PERIOD:

EGYPT:

The oldest medical records have come from Egypt date back to 1600 BC – 3000 Bc - Writing was introduced first.
4000 BC – Produced a calendar of 12 months with 30 day.
- 5 days to celebrate the birth of God.
5000 BC – man improved to built the houses, pyramids
invented axe and grow own crops.

The priest physician was the greatest of all priest. He is called as “IMHOTEP” means the cometh in peace. Temples were used as a halls of healing health. At the time “animism” replaced by “mythology” they believe life after death. They worshiped Isis, Mother earth who helped the sick most frequently through the dreams.

Temples become centres of commuity and national life. Persons who were ill were bought to the temple, left there over night to seek the priestly intercession of the gods. The priests were helped by one group of temple women who were of high social positions and held the rank of priestess. They are believed to perform some nursing duties.
“Eber Papyrus” is known as the oldest complete medical book in the world. Contains a classification and description of disease and surgery.

Berlin Papyrus – focused on the treatment of disease of the anus.

Hygienic principle followed by the Egyptian especially cleanliness of body and dress. They practiced circumcision. They recognized the importance of an adequate system of drainage, good water supply and also the inspection of slaughter house.

NURSES ROLE:

Women in Egypt had no career but had some freedom the mother had a position of authority. Mother and daughter probably nursed the sick in their homes.

JOURNAL REFERENCE:

NURSING TIMES. JANUARY 21 VOLUME 94 PAGE NO 34 TO 36

Kante (Balck Smith) Soknolonba they comes from the caste that makes knives, tools and weapons. Female circumcision is family tradition. Here removal of labia and vaginal orifice is reduced. She can excise 40 girls per day with out any problem. Excised from babies to 20 yrs olds using alcohol as antibiotic and paste of leaves and takes about a month to heal. They do it because they consider it is a form of purification and rite of passage to women hood. Ancient Egypt people were organizing probably some people believe that women who have not been excised will eventually not be able to have intercourse or become pregnant. Because the clitoris will grow until it obstruct the orifice.

BABYLONIAN (IRAQ):

Began as early as 4000 to 3000 BC the first Babylonian empire was founded by king “Hamurabi”. He developed a code of laws for the whole empire. Enclosed the treatment of the diseased people from poor and defenseless class. Punishment for doctors was severe, if patient died. E.g., Doctors hands were cut off, Nurse were treated as slaves.


HEALTH BELIEFS AND TREATMENT:

They believed that illness was due to
1.Sin and displeasure of the God
2.Punishment from sinning

PRINCIPLE MEHTOD OF TREATMENT:
1.Ridding the human body of the demons of disease by incantations.
2.Application of herbs.
The nurse carried out the care and treatment as directed by the physician.

PALESTINE (ISRALES)

The practice of hygienic and health rules were given by Moses.
The hospitably and visiting the sick was considers as their duty.

SOME OF THE HEALTH RULES WERE”

Inspection and selection of food what to eat and what not to eat.
Disposal of excreta by burial with enough sand
Disinfecting and purification
Hygiene of women after child birth.
Reporting and isolating communicable disease.
Quarantine
Circumcision as a religious practice and as a sanitary measure.


Hebrew nurses had a high position and participated care full in planned programmes of visiting the sick at their homes.

PERSIA (IRAN)

Both Persians and Hebrews had religious law and practices regarding physical health, “Zendavesta was writtern by “zoraster” who lived about 600 B.C. Fire, earth, and water were considered as sacred elements and among those fire purest.

HEALTH BELIEFS AND TREATMENT:

Illness is due to evil spirit and they had three types of practitioners they were,
1.Those who treat with knife and heal. Called as Surgeons.
2.Those who treat with herbs and heal.
3.Those who treat with prayer and holy words and heal.

HEBREWS:

Many rules and regulations in regard to social and religious custom and health sanitary practices are compiled into what is called the mosai code. This code presents a systematic organized method of prevention of disease it include principle of personal hygiene relating to rest, sleep, cleanliness. Hours of work and special rules for women, midwifery principles of public hygiene and signification regarding food, disposal of excreta, garbage, isolation quarantine disinfecting and reporting of communicable diseases. The high priest was priest physician and health inspector. They practice excellent hospital, visiting and caring for the sick was a religious duty.

NURSING:

Ancient Hebrew nurses had a high position and participated careful in planned programmes of visiting the sick at their homes and caring for them. The Hebrew nurses were active in promoting and maintaining physical, mental and community health and they continued their services in health maintenance and health education.

ANCIENT AMERICANS:

In the North and South America the culture was highly developed before Columbus found the new continent there were several group of people as the Mayas, Incas, and Aztecs.

Mayas – Practiced human sacrifices to care illness.
Ineas and Aztees were skilled engineers and built roads and suspension bridges. They believed that disease is caused and by the displeasure of the Gods. Disease were prevalent and treated with blood letting, cupping or sucking, massaging, sweating, splinting, setting of bones, tooth extraction, amputation, suturing and bandages.

GREECE:

They believed medicine was of divine origin and was represented by many God. They worshipped “Apollo” as god of the sun. He was regarded as the God of Healing.
The unclean such as the dying and obstetrical patients were not allowed to come in or to remain in the temple. It was not until after 170 A.D. To the Greeks, hospitality was a virtue and a religious duty. So they met this by providing organized charity and cared for the poor and sick
They considered death and birth as sources of pollution. Greeks built great sanctuaries for healing the sick and for incubation. These period “Attendants” served the sick. Along with the priest and physician.

The era of scientific medicine and perhaps nursing begins with “Hypocrites”. He was born in “Cosin” in 460 BC. He was the son of a priest physician
.
At this time “Aristotle” laid the foundation for the science of biology as well as the study of comparative anatomy. He believed that disease was due to man’s disobedience to the laws of nature and not due to evil sprit. Since he led the scientific way of practice, he is known as the “Father of Scientific Medicine”
His method of treatment were based on four principles.
Observe all symptom
Study the patient
Evaluate honestly and
Assist nature

Hippocratic medical achievement can be grouped in the four major areas:
Rejection of all beliefs in the super natural origin of disease.
Development of through patient assessment and recording.
Establishment of the highest ethical standards in medicine.
Author of medical books.

THE SYMBOL OF CADUCEUS:

2 WINGS RESEMBLES SPEED OF WORK
SERPENTS – THE EMBLEM OF WISDOM AND REJUVENATED AND IMMORTALITY..

INDIAN:

The earliest literature of India consists of the Sanskrit Vedas believed to have existed in 1600 BC
Rig Veda – Disease was regarded as the result of divine wrath.
Atharvana veda – It deals innumerable incantations and charms for the practice of magic, disease, injuries, health and fertility.
Ayur Veda – It deals with medicine, surgery and children disease.
The samhitas (Books) gives the details of hospitals and attendants.
The Shushrutha, Samhita states that the physician, the patient , the medicine and attendant are the four essential facts in the care of disease.
It describes the nurse as one who is cool headed and pleasant in her behavior.
Nurses are very attentive to the requirements of the sick and strictly follow the instructions of the physician.
During 500 BC to 300 AD Buddhism raised the practice of medicine rose to new lights but surgery declined.
Pharmaceutical gardens were maintained to supply herbs and drugs.
Large number of hospital were established and monastic universities were founded. Famous among them were Dhakshasela and Nalanda.

STATUS OF WOMEN IN INDIA:

The main activities were management of the home and care of the family numbers during illness.
CHINA:

Sen – long was known as the father of medicine they practiced vaccination physiotherapy as early as 1000 B.C. They recognized disease like syphilis, Gonorrhea, they could treat anemia with the liver in their diet and thyroid with iodine, leprosy with chalmoogra oil.

JOURNAL REFERENCE:
Nursing Times Janauray 21 Volume 94 Page No.28-29

Sexually transmitted infections have a long pedigree they mentioned in Bible, ancient chinees and Greek medicine texts. Until the 15th century the most common sexually transmit infection to be gonorrhea, which on treated can lead to infertility and various chronic conditions.

In the 15th century a new deadly sexually transmitted pestilence took Europe by storm. Syphilis is called as “great Pox” syphilis emerge result of transoceanic exchange. This concept developed by the historian William H. Mc Neill, states that when societies came into contact for the first time they lack natural resistance to each others infection.
Common people believed that disease was due to evil spirit and who ever touches the person the evil sprit get into other body.

ROME:

They copied much from Greece they were idol worshippers and in later period they worshipped there emperors also. They had good system of sanitation, paved roads and bridges. Drainage system and sewers were made, drinking water was brought out by aqueducts. They had public baths for men and women and had public dispensary.

Women of Rome had certain amount of freedom, old women and men of good character did nursing.

CEYLON:

Ceylon adopted India’s methods.
There were hospitals and well prepared physicians and nurses to attend to the sick.

NURSING IN EARLY CHRISTIAN ERA 1500 AD:

With the beginning of Christianity the history of nursing becomes continuous.
The teaching of Christ emphasized the love of our neighbours. Love and service towards one’s neighbours were regarded as Christian duties.
Later grow into the order of Deacon’s and Deaconesses.
In this time there order of women developed known as apostolic orders. Unmarried, widows, are devoted themselves to the service of other women.
Deacon and deaconesses visit the home of the poor and sick provided food and money.
Virgin were younger women who assisted in the caring for the church vestments and in giving out care to the poor.

PHOEBE: Was one of the early Deaconesses. She was an intelligent well educated women she helped to nurse the sick in their homes. She is known as the forerunner of the modern community health nurse. Deaconess disappeared after 4th century. Widow and Virgins entered to give case poor and sick.

EARLY CHRISTIAN HOSPITALS:

The early deacons and deaconesses practiced hospitality with the religious zeal. They opened their homes to the poor, the sick or any one in need. As the home became too small to meet the demands of hospitality additional room and shelters were added. In this way Christian xenodochium grew up. One at the outstanding Christian hospital was built at Caesarea in Palestine by St. Basil.

ROM MATRONS:

Women of high rank had much freedom. As Christians they entrusted in charity and nursing the sick. Some of the wealthy women becomes an organized group and used their wealth to built monasteries and hospital
.
MARCELLA :

She was a rich Roman matron and leader of the group. She had a place were she gathered a community of women that become a first monastery. She is a friend so St. Jerome she devoted her life to teaching, prayer and charitable work she died in 410 AD.

FABIOLA: In 390 AD she turned her home into the first free Christian hospital in Rome. She gathered the sick from the streets and devoted her life to giving nursing care.

PAULA:

She was friend of Fabiola. In 385 AD she and her daughter built hospital for travelors and hospital for the sick. She and her staff did the nursing. She built a monastery in Bethlehem. After her death in 404 AD her daughter carried out her work.


MIDDLE AGES IN NURSING:

EARLY MIDDLE AGE (500-1000 AD)

The era began with the fall of the mighty Roman Empire and it is called the dark ages in history of nursing.
During this time Roman armies were disbanded, roads and bridges were destroyed, robber bands crowded the highways making travel unsafe, homes were destroyed or taken over by the barbarians leaving many homeless. Many of those who had to remain turned to the monasteries for help and protection
.
According to the felt needs three protective units developed MONASTICISM, FEUDALISM AND GUILDS.


MONASTICISM:

For a time everything was in confusion. But monks and nuns were good organizers and administrators.

One outstanding Monk was St. Benedict of Nursia. In 529 AD from the stone of a ruined temple he built a monastery on a rocky mountain top between Rome and Naples.
The Benedictine Rule was developed to meet their needs. Monastic vows of poverty, chasity and obedience a vow of life – long service was made. The arts and crafts agriculture become highly developed.

Throughout the middle ages the monasteries became the chief place for education, medicine and nursing. They gave medical and nursing care to travelers, the poor and the needy. They were criticized and their rules stricter. Many lost interest in the work their freedom was restricted. As a results, Between the 9th and 10th centuries the monasteries went into decline.




FEUDALISM AND CHIVALRY:

Following the fall of Rome, much of the agricultural and was controlled by a class of gentlemen farmers. The homeless turned to these landlords for protection. Thus, an ancient system known as “ FEUDALISM”.

In feudalism the king owned all the land. He gave portions of the land to his favorite barons, earls. These grants of land were known as a “FIEF” or “FEUD” in Europe and manor in England. The baron divided his land up among many serfs, who worked on the land return for food, shelter and form of protection. Monks fought for the protection of the monastery. The serf had very little freedom. If the land was sold he became the serf of the new owner. Petty quarrles among the knights took place and they fought each other. This resulted in famine and draught.

The training of the knight which became known as “Chivalry” stressed service to others, protection and defence of the weak. Every true knight came to believe that service to god came before service to his earthy lord. Chivalry was the accepted code for living a good life.

GUILDS:

This was the first organization of workmen and tradesmen who were not attached to monastic or feudal groups.

DIVIDED INTO 3 GROUPS

1.Protected the worker.
2.Protect the public
3.The apprenticeship method of learing.

The guild apprenticeship methods have been followed in nursing and medical teaching for many years, the guild was the forerunner of the modern labour unions and professional organizations.

MEDIEVAL HOSPITALS:

There were three famous medicinal hospitals built outside monastery.

1.HOTEL DIEU OF LYONS: It is in France or otherwise known as House of God’s Charity founded by King childbert at Lyons in AD 542. It was built to give shelter for pilgrims, the poor the sick and the infirm. For 600 years it was under lay management and “penitents” carried out the nursing. From the 12th to 15th it was ruled by religious order; in the 16th century the management was taken over by a body of men called “RECTOrs”. Nursing was done by dedicated women who took vows but could leave and get married. The hospital had large beds, each capable of accommodating five patients. In 1640 the rectors decided that all patients should have separate beds, in the middle of 19th century the brothers and sisters were strong, healthy, honest young people of the peasant class who were allowed to enter between the ages of 16 and 24. There was a very small staff for such a large hospital one nursing allotted to 15 to 20 patients by day, but each night nurse was responsible for 100 patients
.

2.THE HOTEL DIEU OF PARIS FOUNDED IN AD 651:

3.THE SANTO SPURITO HOSPITAL OF THE HOLY GHOST IN ROME FOUNDED IN AD 717.


4.ISLAM AND ARABIC MEDICINE:

A New religion arose among the nomadic people of the Arabian peninsula. Mohammed, the founder of Islam, was born in Mecca in 570 AD. This religion spread fast and the followers conquered lands. They learnt medicine from the Greeks.
Islam did not allow surgery and dissection and so medicine did not progress. Hospitals were beautiful architecture and well equipped. Highly skilled in preparing medicines. They introduced known as “Eatgut”. Moslem women were absent in the care and were kept under “Purdha”.

As the early middle ages ended, in spite of poverty, confusion and political unrest, the church had grown. Christianity had spread, hospitals and institutions had risen. Islam and Arabic medicine contributed a lot to the development of medicine and nursing.

LATE MIDDLE AGES (1000 -1500 A.D)

THE CRUSADES:

In the beginning of the 11th century many pilgrims undertook long journeys on foot. This journey on foot was very dangerous. Many pilgrims became sick and weak. The church tried to bring about peace in the land by introducing the “TRUCE OF GOD”, those who did not obey the rules were threatened with punishment. The religious war between the Moslems and Christians was known as “CRUSADES”. It lasted for nearly two hundred years (1096-1291)
.
During the 12th and 13th centuries leadership of the knights and their soldiers started long journeys by the foot. Many died on the way spread of leprosy during the crusades takes place there was a great need. Two great military nursing orders came namely
.
1.The order of the Knights HOspitallers of St. John of Jerusalem,
2.The order of the Knights of “St. Lazarus”.
3.The teutonic knights in Germany.

The hospital nursing service was fully under religious control.

MILITARY NURSING ORDERS:

The order of St. John, the Knights and ladies renounced the world and took vows of poverty, charity and obedience, Knights and ladies who joined the order had to belong to families who had never engaged in trade or menial work. The knights and the monks and serving brothers served in the hospital wards, thus gaining the name Knight hospitable the serving brothers carried on regular ward duties at all times.
]
They Nursed the mentally ill with intelligence and sympathy. As a military nursing order they gave food to pilgrims, the knights and sisters wore a black dress with a white cross represented the virtues of the order.

From the end of the 13th century nursing order declined. As leprosy rate reduced in Europe the order declined.

During this period the society built towns and developed a new social structure. Very soon the living conditions became bad, resulting in overcrowding and outbreak of many dreadful diseases due to improper sewage, inadequate supply of good water, public bathhouses and good santitation. Leprosy, bubuonic plague, small pox and syphilis were increase. To prevent or cure disease, it was essential to withdraw the body fluids especially blood in the form of purging, cupping, bloodletting, and leaching. The chief diagnostic aid was uroscopy, which consisted of the examination of urine.

MEDICANT AND SECULAR NURSING ORDERS:

The period following the crusades was one in which the people showed intellectual growth with marked freedom and progress towards a more democratic way of life. They divided their property among the poor and earned their living by manual labour or begging.

DOMINICIAN AND FRANCISCAN ORDERS:

St. Dominic (1170-1221) was the leader of the Dominicians. The Franciscans were followers of St. Francis of Assisi (1182-1226) he became interested in patients with leprosy and gave them devoted service while doing old jobs to earn his few bare necessities. Others were attracted and jointed him. In humility they wore the rough wollen robe of the peasant tied around the waist by a rope, and look vows of poverty and service to the poor.

St. FRANCIS DE SALES OF ASSISI (1182-1266) He was the founder of the “Franciscans order” There are several legands attached to his life leaving the house. He belonged to a middle class family in Italy and once when he was ill he got an inner feeling that he should follow Christianity and he did so. Another reason was his charitable nature was not liked by his merchant father. He took up the responsibility of caring for the Lepers who were considered to be outcastes. Several people were impressed by his life and followed him. The people who followed him were known as “Friars Minor”.


SECULAR ORDERS:
St. Francis his work attached so many men and women that he found it necessary to start a third order. The Tertiaries. These people stayed in their own homes but carried their religion into their everyday life by their acts of charity and ministering to the sick in their homes and in the hospitals. This was known as a secular (non-religious) order because the men and women could live at home, they took no vows and were free to leave the order at any time.

THE RENAISSANCE:

In the medieval time nursing was considered as religious duty. This period is referred to as the Renaissance. Humanists of this time believed that by referring back to the classics – Literature, history, and philosophy of ancient Greece and Rome – they could begin a new golden era of culture and human life.

One of the causes of the Renaissance was the bubonic plague epidemic that devasted the Western world from 1347 to 1351, killing 25% to 50% of Europe’s population. This relatively sudden catastrophic either caused or acclerated marked political, economic social and cultural changes. Mortality among men of learning was extremely high, and new ideas and doctrines had the opportunity to infiltrate traditional teachings. Many people believed that the church had let them down. Consequently there was a rise secularism and humanism. Humanism a philosophy emphasizing the importance of man and his place in the universe – provided the foundation for the development of modern science.

1.St. Hildegrade (1098 -1179) she wrote the book on medicine
2.St. Elizabeth of sienna (1347-1380) she cared sick people during the attack of pleasure queen Elizabeth of Portugal founded a hospital for poor and sick.
3.St. Elizabeth of Hungary (1207-1231) She fed the poor at the castle get.

During the period pope connecent III encouraged the development of hospital in European units.




ORGANSIATION OF HOSPITAL:

The first hospital in England 936Ad was built by York followed by St. Bartholomeus hospital (1123) and St. Thomas hospital and 1213 in London. St. Thomas hospital in London was used for many years later Florence Nightingale used this hospital for her students clinical experience. Bethlehem hospital known as “BEDLAM” later became the first mental hospital in London many other hospitals were built in different parts of Europe.
Teaching institutions were developed and university level arts and literature were started.

NURSING IN MODERN ERA:


THE RENAISSANCE PERIOD:

It covers the period between the late middle ages and modern times that is from 1325 to 1525 new ideas, in art, architecture, and literature were developed in this period.

INDURSTRIAL REVOULUTION:

Spinning and weaving were done in farm houses prior to the invention of power and machinery. The number of manufacturing cities grew and with it the problem of living in sanitary condition.

THE REFORMATION:

The reformation or Protestant Revolt in 1517 was started to free the church from its real practices. The two groups were emerged at that time. They are “Jesuits and Protestants”.

POLITICAL REVOLUTIONS:

In this period the Napoleonic war began in 1797 and ended in 1815 with the battle of waterloo.

DARK AGES IN NURSING: 1550-1850

Nursing experienced a dark period roughly from the end of the 17th century, because of the renaissance and disturbed political condition and reformation etc.





HUMANITARIANS:

1.Mlle Le Gras known as St. Louise de marillae assisted Lion in organizing the sisters of charity in 1633.

CATHOLIC AND PROTESTANT ORDERS:

During this period a number of religious orders, both catholic and protestant arose.

PUBLIC HEALTH NURSING:

Public health nursing earlier was done by the Apostolic deaconesses like phoebe. They have visited the patients in their homes and did nursing service.



THE REVIVAL OF THE DEACONESSES OR MODERN DEACONESS:

Modern training schools have adopt some of the principles established at Kaiserwerth.

DEVELOPMENT OF NURSING FROM 1860 TILL TODAY:

Nursing has been called the oldest of the art and the youngest of the profession. As such it has gone through many stages and has been an integral part of social movement.

FLORENCE NIGHTINGALE:

She was born on May 12th, 1820 she was the founder of modern nursing. In 1852 she was determined to do nursing.

CRIMEAN WAR 1854-1856:

During this period Ms. Nightingale who was looking for a field worthy of her powers. She with 38 nurses selected from the catholic and protestant orders and from the hospitals set out for the dardohelpers in the crimea
.
NURSING IN 20TH CENTURY:

Progress in transportation, communication and other technological areas.

A)Development of Biological Science:

William Harvey (1578-1657) an English Physician. He was the first person to describe completely and accurately the circulatory system.

B)Advances in Public Health Services: The voluntary health agencies like UNICEF (1946) AND who (1948) peace crops (1961) were formed.

C)Image of a Nurse as a member of professional health team: Certain factors have had an effect on the way in which nurses have fit in as collaborative members of the professional health team.
DEVELOPMENT OF NURSING IN INDIA:

During the period of 1679 – 1688 a hospital was built for civilians in Madras. In 1797 another hospital was built for the poor people of Madras named as “Lying In Hospital”.
The Govt. hospital for women and children at Egmore is one of the Chief Midwifery training school in Madras started in the year 1885.
DEVELOPMENT OF NURSING IN MISSION HOSPITAL:

When East Indian company came to India the Christian Missionaries did the First skilled Nursing in India. In India mission hospital were the first to begin the training for nurses.

NURSING DEVELOPMENT IN LATER PERIOD:

During 1943 marked awakening that had great influence on the practice of Nursing in India with world war II at its freedom with first sight.

NURSING EDUCATION IN INDIA:

Training for orderlies midwives were given for a period of 6 months with close supervision of their practical experience and certificate was given to them after a training.

THE DUFFERIN FUND:

The national association for supplying medical aid by the women to the women of India was established by Dufferin in 1885.

EXAMINATION AND CERTIFICATES:

The mid India and South India Boards of nurse examiners were set up. The name of South India Board was changed to the Board of the nursing Education.
In 1926 Madras nursing council was started and after it is changed to state registration council.

NURSING THE FUTURE:

In future all nurses are able to share the work for the progress.

1.Participating in professional organization.
2.Giving expert nursing service where it is necessary.

Our expectation for the future is that nurses will be impelled to become research workers and seekers of a better and more efficient way of caring for patients.

All nurses should have dedicated life with love to service. Their heart should filled with the daily prayer.

LORD : “ Grant me wisdom in decisions,
Understanding in thinking,
Love in my attitudes,
Mercy in my Judgement”


CONCLUSION:

Nursing is the fast growing profession. The study of definition, Philosophy and development of nursing enable the nurses to overcome their difficulties and it provide opportunity for them to acquire knowledge about the pros and cons of practices. For effective patient care one must know how the forerunners have dedicated their life to the profession. Thereby the modern nurses can provide quality and efficient care to the client.