Professional Documents
Culture Documents
I. PRE-WAR TO 1945
1. Concept of a hospital: The Hospital has a morbid image to the people at
this period. When someone is brought to the hospital, people feel the
patient is dying.
• The hospital is for the sick and the dying
3. Nursing service
• No participation in operational planning
• No managerial knowledge, managerial practice was gained by
experience
• Task-oriented, but ensures high quality and excellent bedside care
• Multi-dimensional scope of responsibilities, e.g. Incharge of linen,
housekeeping and dietary at times
• Nurses were highly disciplined but very few takes up Nursing
• Nurses lack theoretical knowledge to back-up their skills
• Nursing administrator holds a very demanding job; she must be strong
and clever.
4. Nursing education
• A three-year Graduate Nursing program solely existed.
• Conceptualization of BSN program and implementation in 1947 with
the first graduate from UP College of Nursing in 1952
2. Nursing Service
• Chief Nurses had no voice in Operation Planning; no emphasis on
qualification, tenure was the basis of succession
• Many registered nurses enrolled in supplemental programs
• Maintained highly appreciated bed care
• Exodus of nurses started in the 50s
• In late 70s, Standards for Nursing Practice were formulated
3. Nursing Education
• Nursing began to be recognized as a profession due to birth of the
BSN Program. However, two (2) types of programs existed (GN and
BSN) for some time
• Abolition of GN Program came in the late 70s
5. Technology
• Computerization made some job easy
• Electronic gadgets at the bedside became a necessity (e.g. cardiac
monitors)
• Faster communication system was a great support in the Health care
institution
A. The Hospital
• For the sick and the well – many people come to the hospital for
executive check-up. There is awareness of the public for heath
maintenance and health promotion
• Emphasis on diagnostic programs
• Decentralization – departments were well-organized and had
autonomy in running their departments
• Facilities are high tech! hospitals competed in their facilities
• Highly specialized services came into reality (i.e. intensive care
units)
•
B. Nursing Service
• Exodus increased as USA, Canada, Australia, Middle East are all open
• Understaffing was felt and became a big headache for Nursing Admin.
• Public demand for quality care both in government and private
hospitals are echoed
• Nursing care activities delegated to non-nursing personnel due to
understaffing – thus contributing to poor quality of care rendered.
• Continuing education Units, a prerequisite to licensure, a requirement
which had never proven its worth
• Birth of "manager" title with unclear job description is a fashion. Almost
all hospitals changed the title of supervisor/head nurse to manager.
Nevertheless, there was no corresponding change in the content of
their job description
• Scarce local employment (in spite of the unemployment of nurses)
• Proliferation of health care workers/providers
• Specialization in nursing care with sophisticated equipment to support
the nurses in their skills. To quote, Simon and Schuster: "fancy
devices, new fangled diagnostic procedures, esoteric jargon
machinery, buzzers and beepers, play an important role in the medical
and nursing practice. These technological tools, innovations, and even
miracles, while producing new hope for diagnosis and cure, tend to
distance the caregiver from the patient."
• At this point in time Nursing Service became complicated to manage
and thus;
Demand for better management of nursing service
Change in role expectations heightened calling for:
o Business Management
o Clinically oriented
o Labor relation which demands for strong orientation to
legal aspects of Nursing Administration
o Educator of patients and staff
o Nursing Management Systems that respects the major
administrative principles of Planning, Organizing,
Directing and Controlling.
o Service coordinator with other departments
o Operational planning was felt needed by some nursing
administrators.
o Budgetary planning is a must but barely done due to
inadequacy in the technical know-how.
C. Environmental Factors affecting patient care and the Role of the Nursing
Administrators
Socio-economic condition – Poor health condition in the midst of rising
health care cost
Corporatization of Health care by the year 2000 is shaping up. Many
hospitals are now run by corporations thus the profit orientation.
Social disintegration of the society where Nursing Administration is not
prepared to take care of the victims. Our health care agencies are not
well-prepared for them.
High tech; high cost of health facilities, thus the expectation for high
quality service from all health care providers.
Home Care (USA) due to high cost of hospitalization.
Philippine setting – the hospital will remain as the biggest employer of
nurses.
D. Technology
Work simplification, but weak clinical practice because every data needed
is available in the computer.
Fast communication system, thus easy access to developments in
Nursing in other countries.
Health – tremendous problems, communicable diseases and social
disintegration are persistently rising. These have great impact in planning
for patients service both in hospitals and in the community.
1. Ten Directions, the Millenial Mega trends: Gateways to the 21st Century:
The blooming Global Economy of the 1990
A Renaissance in the Arts
The Emergence of the Free Market Socialism
Global lifestyles and cultural nationalism
The privatization of the welfare state
The rise of the Pacific Rim
The Decade of Women in Leadership (will nurses be on the lead?)
The Age of Biology
The Religious Revival of the Millenium
The Triumph of the Individual
All these are on the way to reality particularly in the areas of global
economy and age of Biology.
Health Care industries and the nature of a Nurse Manager's job will
definitely change.
21st Century
50's 60's 80's 90's 2000's
Period of Professionalism Age of Technology the unknown
Ideology marked decline "Mechanistic
"Humanistic in quality care Caring" 1. reengineering
Care" processes and
2. realigning in the
infrastructure to
support changes.