Basic Nursing: Foundations of

Skills & Concepts

Chapter 4
NURSING
HISTORY,
EDUCATION AND
ORGANIZATION
Nursing: An Art…A Science

 By using scientific knowledge in a

humane way, nursing combines rational,
scientific methods with caring behavior.
 Nursing focuses not on the illness but the
client’s response to illness.
Historical Overview

 Nursing is an ancient profession that has

evolved alongside human civilization.
 Religion heavily influenced this evolution.
Many early hospitals were tied to organized
religion.
 During the industrial revolution, scientific
methods became more important.
Florence Nightingale

 The founder of modern nursing.

 She established the first school for nurses
that provided theory-based knowledge
and clinical skill-building.
 Encouraged the belief that there is a body
of nursing knowledge distinct from
medical knowledge.
Nightingale’s Accomplishments

 Demonstrated the value of nursing care in

reducing morbidity rates in the Crimean
War
 Established the Nightingale School for
Nurses at St. Thomas’ Hospital in London
 Advocated the principles of cleanliness and
nutrition in promoting health
 Developed public awareness of the need for
nurses.
The Civil War & Nursing

 America’s tragic conflict underscored the

need for nursing.
 Clara Barton (1821-1912) volunteered her
nursing skills and organized the Red
Cross in the United States after the war.
Pioneers of Nursing
 Lillian Wald: First community health nurse.
 Isabel Hampton Robb: Founded nursing organizations.
 Adelaide Nutting: First nurse appointed as university professor.
 Lavinia Dock: Author of early textbooks.
 Mary Breckenridge: Serviced rural America.
 Mamie Hale: Educator of midwives.
 Mary Mahoney: America’s first African-American nurse.
 Linda Richards: America’s first trained nurse. (Note: The term
trained nurse preceded registered nurse).
“Practical” Nursing

 Women who cared for others, but who

had no formal education, often called
themselves “practical nurses.”
Early Practical Nursing Schools

 Ballard School. Opened in 1892 in New

York City by the YMCA.
 Thompson Practical Nursing School.
Established 1907 in Brattleboro, Vermont.
Still operating today.
 Household Nursing School. Founded in
1918 in Boston.
Nursing Education Changes

 The Goldmark Report: Published in 1923, this

report concluded that for nursing to be on an equal
footing with other disciplines, nursing education
should occur in the university setting.
 Institute of Research and Science
in Nursing Education Report: Resulted in the
establishment of practical nursing under Title III of
the Health Amendment Act of 1955. This led to a
growth in practical nursing schools in the U.S.
Nursing Education: LP/VNs

 LPNs (Licensed Practical Nurses) and LVNs

(Licensed Vocational Nurses) work under the
supervision of an RN or other licensed provider
such as a physician or dentist.
 Education is focused on basic nursing skills and
direct client care.
 Educated in community colleges, hospitals,
vocational programs.
Nursing Education: RNs

 RNs (Registered Nurses) may operate

autonomously and may supervise
LP/VNsLVNS.
 Education is focused on basic nursing skills and
direct client care.
 Educated in universities, community colleges,
hospitals.
Diploma Programs

 Typically 3 years in length and offered by

hospitals.
 Graduates receive diploma rather than a
college degree.
 Program emphasizes basic skills
particularly suited for hospital clients.
 Such programs contribute 6% of nurse
graduates.
Associate Degree Programs
 2-year program offered through community
colleges or as options at four-year universities.
 Graduate receives Associate Degree in Nursing
(ADN).
 Program stresses basic skill preparation with
clinical practice occurring increasingly in
community-based institutions (e.g. ambulatory
settings, schools and clinics).
 Such programs contribute 60% of nurse
graduates.
Baccalaureate Degree Programs

 Typically 4 years in length, offered through

colleges and universities.
 Graduate receives Bachelor of Science in
Nursing (BSN)
 Emphasizes preparation for practice in
nonhospital settings, broader scientific content,
and systematic problem-solving tools for
autonomous and collaborative practice.
 Such programs contribute 34% of all nursing
graduates.
Nursing Organizations
American Nurses Association (ANA)
 Purpose: To improve the quality of nursing care.
 Established 1911.
 Establishes standards for nursing practice.
 Establishes a professional code of ethics.
 Develops educational standards
 Oversees a credentialing system.
 Influences legislation affecting health care.

For RNs only.

Publications: American Journal of Nursing; American Nurse
Nursing Organizations
National Association for Practical Nurse Education
and Service, Inc. (NAPNES)
 Purpose: To improve the quality, education, and recognition of
nursing schools and LP/VNs in the U.S.
 Established 1941.
 Provides workshops, seminars, and continuing-education
programs.
 Evaluates and certifies continuing-education programs of others.
 Provides individual student professional liability insurance program.

For LPs/VNs.
Publications: Journal of Practical Nursing; NAPNES
Forum.
Nursing Organizations
National Federation of Licensed Practical
Nurses, Inc. (NFLPN)
 Purpose: Provide leadership for LP/VNs.
 Established 1949.
 Encourages continuing education.
 Establishes principles of ethics.
 Represents and speaks for LP/VNs in Congress.
 Offers members best type of low-cost insurance.

For LPs/VNs.
Publication: AJPN (quarterly newsletter)
Nursing Organizations
National League for Nursing (NLN)
 Purpose: To identify the nursing needs of society and to
foster programs designed to meet these needs.
 Established 1952.
 Accredits nursing education programs.
 Conducts surveys to collect data on education
programs.
 Provides continuing-education programs.

Open to all nurses and non-nurses.

Publication: Nursing & Health Care.
Nursing Organizations
National Council of State Boards of Nursing, Inc. (NCSBN)

 Purpose: Provides an organization through which boards of

nursing act together on matters of common interest and concern.
 Established 1978.
 Develops and administers licensure examinations for RN and
LP/VN candidates.
 Maintains a national disciplinary data bank.
 Serves as the national clearinghouse of information on nursing
regulation.

Publications: Issues; NCLEX-RN Program Reports; NCLEX-PN

Program Reports.