Fundamentals of Nursing Practice • Observe proper dress code.

House Rules • Attendance check 8am. Refrain from tardiness.

CHED Memo Order 15 • Practice good environment hygiene, Nurses.
• Be HONEST at ALL TIMES!
- Deals with concepts, principles, theories, and • A true LaSallian chooses to be honest even if others
techniques basic to nursing as a profession (paid are not, even if others cannot, and even if others will
nurses), science (procedures) and art (caring) not.
- Emphasizes on the concept of man as a holistic being • The University strongly prohibits any form of
and the professional roles of the nurse in the intellectual dishonesty, most common of which a
healthcare setting CHEATING and PLAGIARISM.
- Learners are expected to utilize the nursing process • Allowable Absences
and the basic nursing skills as a primary tool in health - 3 unit subject meeting 3 meeting 3 times a week
promotion, disease prevention, restoration and (MTW) 6 absences.
maintenance, and rehabilitation. - 3 hours / meeting
- 1E 1pm to 4pm (B22)
THEORY: 3 units (54 hours) • Maintain 83%
RLE: Skills Lab 2 units (102 hours) • Knowledge
PLACEMENT: 1 year, 2nd Sem. • Skills
Pre-Requisite: Ana Phy, NCM 100 • Affective
= Prudence
• At the end of the 1st year, given simulated situations in = Competence
selected settings, the learning will be able to
demonstrate basic skills in rendering safe and
appropriate care utilising the nursing process.

1. Apply knowledge of physical, social, natural and

health sciences and humanities in the practice of
nursing.
2. Provision of safe, appropriate and holistic care to
individuals, families, population groups and
community utilising the nursing process.
3. Apply the guidelines and principles of evidence
based practice in the delivery of care.
4. Practice Nursing in accordance with existing laws,
legal, ethical, and moral principles.
5. Communicate effectively in speaking, writing and
presenting using culturally appropriate language.
6. Document to include reporting up to date client care
accurately and comprehensively.
7. Work effectively in collaboration with inter, inter and
multidisciplinary and multi cultural teams.
8. Practice beginning management and leadership
skills in the delivery of client care using a systems
approach.
9. Engage in life long learning with a passion to keep
current with national and global development in
general, and nursing and health development in
particular.
10. Demonstrate responsible citizenship and pride of
being Filipino.
11. Apply techno intelligent care systems and processes
in health care delivery.
12. Adopt the nursing core values in the practice of the
profession.

BSN 1 E
House Rules
• Put all mobile phones in silent mode, no usage of
phones or other gadgets during class tile period.
• Secure notebook and copy notes. Notes taking is part
of class requirement.
• Prepare your own pre cut yellow pad. No lending /
borrowing of ballpen. Use black ink ball point pen
only.
PRELIM War
• Crimean War (1854–1856)
Key Areas of Responsibilities
Throughout history, wars have accentuated the need for nurses.
Patient Care Competencies • Safe and quality nursing care During the Crimean War (1854–1856), the inadequacy of care given to
• Communication soldiers led to a public outcry in Great Britain. The role Florence
• Collaboration and teamwork Nightingale played in addressing this problem is well known. She was
• Health Education asked by Sir Sidney Herbert of the British War Department to recruit a
contingent of female nurses to provide care to the sick and injured in
Empowering Competencies • Legal Responsibility the Crimea. Nightingale and her nurses transformed the military
• Ethico-moral responsibility hospitals by setting up sanitation practices, such as hand washing
• Personal and professional and washing clothing regularly. Nightingale is credited with
development performing miracles; the mortality rate in the Barrack Hospital in
Turkey, for example, was reduced from 42% to 2% in 6 months.
Enhancing Competencies • Record Management
• Management of resources and
• American Civil War (1861–1865)
environment
During the American Civil War (1861–1865), several nurses emerged
Enabling Competencies who were notable for their contributions to a country torn by internal
• Quality Improvement
strife. Harriet Tubman and Sojourner Truth provided care and safety
• Research
to slaves fleeing to the North on the Underground Railroad. Mother
Biekerdyke and Clara Barton searched the battlefields and gave care
to injured and dying soldiers. Noted authors Walt Whitman and
Louisa May Alcott volunteered as nurses to give care to injured
Historical and Contemporary Nursing Practice soldiers in military hospitals. Another female leader who provided
nursing care during the Civil War was Dorothea Dix. She became the
LEARNING OUTCOMES Union’s superintendent of female nurses responsible for recruiting
After completing this chapter, you will be able to: nurses and supervising the nursing care of all women nurses working
1. Discuss historical factors and nursing leaders, female and 
 in the army hospitals.
male, who influenced the development of nursing. Harriet Tubman (1820 - 1913)
2. Discuss the evolution of nursing education and entry into 
 - was known as “The Moses of Her People” for her work
professional nursing practice. with the Underground Railroad. During the Civil War she
3. Describe the different types of educational programs for 
 nursed the sick and suffering of her own race.
nurses.
4. Explain the importance of continuing nursing education. Sojourner Truth (1797 - 1883)
5. Describe how the definition of nursing has evolved since 
 - abolitionist, Underground Railroad agent, preacher, and
Florence Nightingale. women’s rights advocate, was a nurse for more than 4
6. Identify the four major areas of nursing practice. years during the Civil War and worked as a nurse and
7. Identify the purposes of nurse practice acts and standards of counselor for the Freedmen’s Relief Association after the
professional nursing practice. war.
8. Describe the roles of nurses.
9. Describe the expanded career roles of nurses and their Dorothea Dix (1802 - 1887)
function. - was the Union’s superintendent of female nurses during
10. Discuss the criteria of a profession and the the Civil War. Bettmen/Corbis.
professionalization of nursing.
11. Discuss Benner’s levels of nursing proficiency. • World War I
12. Describe factors influencing contemporary nursing practice. The arrival of World War I resulted in American, British, and French
13. Explain the functions of national and international nurses’ women rushing to volunteer their nursing services. These nurses
associations. endured harsh environments and treated injuries not seen before. A
monument entitled “The Spirit of Nursing” stands in Arlington National
Cemetery. It honors the nurses who served in the U.S. armed services
Women in Nursing in World War I, many of whom are buried in Section 21, which is also
called the “Nurses Section”. Progress in health care occurred during
Historical Perspectives
World War I, particularly in the field of surgery. For example,
• Dramatic change in response to societal needs and influences advancements were made in the use of anesthetic agents,
• Struggle for autonomy (how a nurse works independently) and infection control, blood typing, and prosthetics.
professionalization
• World War II
Women’s Roles - casualties created an acute shortage of caregivers
• Care and nurturing of other family members - the Cadet Nurse Corps was established in response to a
• subservient, dependent role in the community marked shortage of nurses
World War II casualties created an acute shortage of caregivers, and
Religion the Cadet Nurse Corps was established in response to a marked
• Christian Parable of the Good Samaritan shortage of nurses. Also at that time, auxiliary health care workers
• Roman Empire became prominent. “Practical” nurses, aides, and technicians
- Conversion to Christianity provided much of the actual nursing care under the instruction and
- Houses of care and healing supervision of better prepared nurses. Medical specialties also arose
• Fabiola - converted to Christianity and used their wealth to at that time to meet the needs of hospitalized clients.
provide houses of care and healing (the forerunner of
hospitals) for the poor, the sick, and the homeless • Vietnam War
• Crusades - approximately 11,000 American military women stationed in
- Knights Hospitalers - provided nursing care to their sick and Vietnam were nurses
injured comrades. - Most of them volunteered to go to Vietnam right after they
- Knights of Saint Lazarus - dedicated themselves to the care of graduated from nursing school, making them the youngest group
people with leprosy, syphilis, and chronic skin conditions. of medical personnel ever to serve in wartime
• Medieval
- Alexian Brothers - organized care for victims of the Black
Plague in the 14th century in Germany Societal Attitudes
- Deaconess groups suppressed • Before mid-1800s, nursing was without organization, education, or
• 1800s social status; the prevailing attitude was that a woman’s place was
- Order of Deaconesses was reinstituted in 1836 in the home and that no respectable woman should have a
career.
• Victorian Era
- Women should be wives and mothers (any education she
obtained was for the purpose of making her a pleasant
companion to her husband and a responsible mother to her
children)
- Nurses in hospitals during this period were poorly educated;
some were even incarcerated criminals.
- Society’s attitudes about nursing during this period are reflected
in the writings of Charles Dickens. In his book Martin Chuzzlewit
(1896), Dickens reflected his attitude toward nurses through his
character Sairy Gamp. She “cared” for the sick by neglecting
them, stealing from them, and physically abusing them. This
literary portrayal of nurses greatly influenced the negative
image and attitude toward nurses up to contemporary times.
- In contrast, the guardian angel or angel of mercy image arose
in the latter part of the 19th century, largely because of the
work of Florence Nightingale during the Crimean War. After
Nightingale brought respectability to the nursing profession,
nurses were viewed as noble, compassionate, moral, religious,
dedicated, and self-sacrificing.
- Doctor’s handmaiden - Another image arising in the early 19th
century that has affected subsequent generations of nurses and
the public and other professionals working with nurses is the
image of doctor’s handmaiden. This image evolved when
women had yet to obtain the right to vote, when family
structures were largely paternalistic, and when the medical
profession portrayed increasing use of scientific knowledge that,
at that time, was viewed as a male domain.
- Nurse as heroine, sex object, surrogate mother, tyrannical
mother - Since that time, several images of nursing have been
portrayed. The heroine portrayal evolved from nurses’ acts of
bravery in World War II and their contributions in fighting
poliomyelitis—in particular, the work of the Australian nurse
Elizabeth Kenney. Other images in the late 1900s include the
nurse as sex object, surrogate mother, and tyrannical mother.
- 1990s Tri-Council for Nursing to improve image - In the early
1990s, the Tri-Council for Nursing (the American Association of
Colleges of Nursing, the American Nurses Association [ANA],
the American Organization of Nurse Executives, and the
National League for Nursing [NLN]) initiated a national effort,
titled “Nurses of America,” to improve the image of nursing.
Launched in 2002, the Johnson & Johnson corporation
continues their “Campaign for Nursing’s Future” to promote
nursing as a positive career choice. Through various outreach
programs, this campaign increases exposure to the nursing
profession, raises awareness about its challenges (e.g., nursing
shortage), and encourages people of all ages to consider a
career in nursing.
Nursing Leaders
• Nightingale (1820 - 1910)
- Nightingale was born to a wealthy and intellectual family.
- She believed she was “called by God to help others and to
improve the well-being of mankind”
- She was determined to become a nurse in spite of opposition
from her family and the restrictive societal code for affluent
young English women. As a well-traveled young woman of the
day, she visited Kaiserswerth in 1847, where she received 3
months’ training in nursing.
- She improved standards of care for war casualties (earned her
the title “Lady with the Lamp”)
- Nursing’s first scientist-theorist, nurse researcher (through her
contributions to nursing education)
- Notes on Nursing: What It Is, and What It Is Not
- Nightingale Training School for Nurses - When she returned to
England from the Crimea, a grateful English public gave
Nightingale an honorarium of £4,500. She later used this money
to develop the Nightingale Training School for Nurses, which
opened in 1860. The school served as a model for other training
schools. Its graduates traveled to other countries to manage
hospitals and institute nurse-training programs.
- Despite poor health that left her an invalid, Florence Nightingale
worked tirelessly until her death at age 90. As a passionate
statistician, she conducted extensive research and analysis
- Nightingale is often referred to as the first nurse researcher. For
example, her record keeping proved that her interventions
dramatically reduced mortality rates among soldiers during the
Crimean War.
- Nightingale’s vision of nursing changed society’s view of nursing.
She believed in personalized and holistic client care. Her
vision also included public health and health promotion roles for
nurses.
• Barton (1821 - 1912)
- Was a school teacher who Volunteered as a nurse during the
American Civil War
- Establishment of American Red Cross
• Richards (1841 - 1930)
- America’s first trained nurse
- Initiated practice of wearing uniforms
- Richards is known for introducing nurse’s notes and doctor’s
orders.
- She is credited for her pioneering work in psychiatric and
industrial nursing.
• Mahoney(1845 - 1926)
- First African American professional nurse
- She constantly worked for the acceptance of African
Americans in nursing and for the promotion of equal
opportunities
- The ANA gives a Mary Mahoney Award biennially in recognition
of significant contributions in interracial relationships.
• Wald (1867 - 1940)
- Founder of public health nursing
- first to offer trained nursing services to the poor in the New York
slums.
- Henry Street Settlement and Visiting Nurse Service (their
home among the poor on the upper floor of a tenement)
provided nursing services, social services, and organized
educational and cultural activities
- Soon after the founding of the Henry Street Settlement, school
nursing was established as an adjunct to visiting nursing.
• Dock (1858 - 1956)
- was a feminist, prolific writer, political activist, suffragette, and
friend of Wald
- She participated in protest movements for women’s rights
that resulted in the 1920 passage of the 19th Amendment to the
U.S. Constitution, which granted women the right to vote.
- Dock campaigned for legislation to allow nurses rather than
physicians to control their profession.
- In 1893, Dock, with the assistance of Mary Adelaide Nutting and
Isabel Hampton Robb, founded the American Society of
Superintendents of Training Schools for Nurses of the United
States, a precursor to the current National League for
Nursing.
• Sanger (1879 - 1966)
- Considered founder of Deep-laid Parenthood.
- a public health nurse in New York, has had a lasting impact on
women’s health care.
- Imprisoned for opening the first birth control information clinic
in America, she is considered the founder of Planned
Parenthood.
- Her experience with the large number of unwanted pregnancies
among the working poor was instrumental in addressing this
problem.
• Breckinridge (1881 - 1965)
- Established Frontier Nursing Service (FNS) in rural U.S.
- Started one of the first midwifery training schools in U.S.
Men in Nursing
• Although the history of nursing primarily focuses on the female
figures in nursing, Schools of Nursing for men existed in the United
States from the late 1880s until 1969.
• Male nurses were denied admission to the Military Nurse Corps
during World War II based on gender. It was believed at that time
that nursing was women’s work and combat was men’s work.
• During the 20th century, men were denied admission to most
nursing programs. The ANA denied membership to male nurses
until 1930 and many state nursing associations did not allow men to
join until the 1950s.
• In 1971, a nurse who practiced in Michigan, Steve Miller, formed an
organization called Men in Nursing. In 1974, Luther Christman
organized a group of male nurses in Chicago. The two groups reor-
ganized into the National Male Nurses Association with the
primary focus of recruiting more men into nursing.
• In 1981, the organization was renamed the American Assembly for
Men in Nursing (AAMN) (2011).
• American Assembly for Men in Nursing (AAMN)
- Originally National Male Nurses Association
- The purpose of the AAMN is to provide a framework for nurses,
as a group, to meet to discuss and influence factors that affect
men as nurses.
- In 2009 and 2010, members of the AAMN discussed ways to
change the image of men in nursing in both recruitment and
retention.
• Luther Christman (1915 - 2011)
- Icon of Modern Nursing
- one of the founders of the AAMN, graduated from the
Pennsylvania Hospital School of Nursing for Men in 1939 and did
experience discrimination while in nursing school (because of
gender)
- He was the first man to be a dean at a university school of
nursing.
Barriers
- Image of femininity
- Belief that only homosexual men are nurses
- Suspicion surrounding intimate touch
Philippine Icon Anastacia Giron-Tupas
• The most revered nursing leaders of the Philippines
• Her life story is instructive of how nurse leaders take a role in leading
the nursing profession and society into the future
• Lived through three (3) wars and was confronted by the most
challenging of circumstances, and yet, not only did she manage to
persevere, she actually succeeded beyond all reasonable
expectations.
• Dean of Philippine Nursing
• 1890 - 1972
Philippine Early beliefs and Practices
• Mysticism and superstitions
• Filipinos were very cautious not to disturb other people or the evil
spirits for the good of their health
• Evil spirits could be driven away by persons with power to banish
demons
• They used leaves or roots, they were called herb doctors
(“herbolarios”) Filipinos who became sick were usually cared for by
the female family members or friends in the home.
• Early filipinos subscribed to superstitious belief and practices in
relation to health and sickness
• Midwives assisted in childbirth
Health Care During the Spanish Regime
• Context of nursing has manifested through simple nutrition, wound
care, and taking care of an ill member of the family
• 1578, male nurses were acknowledged as Spanish Friars’ assistants
for caring sick individuals in the hospital (referred as practicante or
enfermero).
Nursing Education
• Controlled by state boards of nursing and professional organizations
• Originally taught knowledge and skills for hospital practice
• Now more varied practice settings, critical thinking, health
promotion and maintenance.
• Two entry levels: RNs or LPN / LVN
Philippines’ Earliest Hospitals
• Hospital Real de Manila (1577) - it was established mainly to care
for the Spanish king’s soldiers, but also admitted Spanish civilians;
founded by Gov. Francisco de Sande.
• San Lazaro Hospital (1578) - founded by Brother Juan Clemente
and was administered for many years by the Hospitalliers of San
Juan de Dios; built exclusively for patients with leprosy.
• Hospital de Indios (1586) - established by the Franciscan Order,
service was in general supported by aims and contributions from
charitable persons.
• Hospital de Aguas Santas (1590) - established in Laguna; near a
medicinal spring, founded by Brother J. Bautista of the Franciscan
Order.
• San Juan de Diosa Hospital (1596) - founded by the Brotherhood
of Misericordia and administered by the Hospitaliers of San Juan de
Dios; support was delivered from alms and rents; rendered general
health service to the public.
Nursing During the Philippine Revolution
• 1890’s, the war between Philippines and Spain emerges which
resulted to significant amount of casualties
• Many women have assumed the role of nurses in order to assist the
wounded soldiers
• Emergence of Filipina nurses brought about the development of
Philippines Red Cross
Establishment of Nursing Care
• Josephine Bracken - wife of Jose Rizal, installed a field of hospital in
an estate house in Tejeros. She provided nursing care to the
wounded night and day.
• Rosa Sevilla de Alvero - converted their house into quarters for the
Filipino soldiers; during the Philippine-American War that broke out
in 1899.
• Dona Hilaria de Aguinaldo - wife of Emilio Aguinaldo who
organized that Filipino Red Cross under the inspiration of Mabini.
• Dona Maria Agoncillo de Aguinaldo - 2nd wife of Emilio
Aguinaldo ; provided nursing care to Filipino soldiers during the
revolution, President of the Filipino Red Cross branch in Batangas.
• Melchora Aquino a.k.a. “Tandang Sora” - nursed the wounded
Filipino soldiers and gave them shelter and food.
• Capitan Salome - a revolutionary leader in Nueva Ecija; provided
nursing care to the wounded when not in combat.
• Agueda Kahabagan - revolutionary leader in Laguna, also provided
nursing services to her troops.
• Trinidad Tecson (“Ina ng Biak-na-Bato”) - stayed in the hospital at
Biak na Bato to care for wounded soldiers.
Hospital School of Nursing’s Formal Training
(1901 - 1911)
• Iloilo Mission Hospital
- the 1st hospital in the Philippines which trained Filipino nurses in
1906, established by the Baptist Missionaries.
- there were no strict requirements for the applicants as long as
they are all willing to work.
• Iloilo Mission Hospital School of Nursing (Iloilo City, 1906)
• Saint Paul’s Hospital School of Nursing (Manila, 1907)
- the hospital was established by the Archbishop of Manila,
Jeremiah Harty under the supervision of the Sisters of St. Paul de
Chartres located in Intramuros.
- Opened its training school for nurses in 1908, with Mother
Melanie as superintendent and Miss Chambers as Principal.
• Philippine General Hospital School of Nursing (Manila, 1907)
- 1901, began as a small dispensary for Civil officers and
employees in the City of Manila and later grew as a Civil Hospital
- 1906, Mary Coleman Masters - an educator advocated for the
idea of training Filipino girls for the profession of nursing with
the approval of Government officials, she first opened a
dormitory for girls enrolled at the Philippine Normal Hall and the
University of the Philippines.
• St. Luke’s Hospital School of Nursing (Quezon City, 1907)
- The hospital is an Episcopalian Institution
- 1903, began as a small dispensary
- 1907, opened with 3 girls admitted. (1st year, combined classes
with the PGH School of Nursing and St. Paul’s Hospital School of
Nursing).
- Miss Helen Hicks was the first principal.
- Mrs. Vitaliana Beltran was the 1st Filipino superintendent of
nurses.
- Dr. Jose Fores was the first medical director of the hospital.
• Mary Johnston Hospital and School of Nursing (Manila, 1907)
- It started as a small dispensary on Calle Cervantes (now
Avenida). It was called the Bethany Dispensary and funded by
the Methodist Mission for the relief of suffering among women
and children.
 - 1907, Sister Rebecca Parrish together with registered nurses
Rose Dudley and Gertrude Dreisbach, organized the Mary
Johnston School of Nursing.
- Nurses’ training course began with three (3) Filipino young girls
fresh from elementary as their first students.

Nursing Education
• Licensure
• Mutual recognition, multi-state compact

The Start of Nursing Practice (1911 - 1921)

The first nursing board examination was given on 1920.
The first executive officer of the Board Examiners for Nurses are
physicians.
• Mary Chiles Hospital School of Nursing (Manila, 1911)
• Frank Dunn Memorial Hospital (Vigan Ilocos Sur, 1912)
• San Juan de Dios Hospital School of Nursing (Manila, 1913)
- 1913, through the initiative of Dr. Benito Valdez, the board of
inspectors and the executive board of the hospital passed a
resolution to open school of nursing.
- The school has been run by the Daughters of Charity since
then. Sister Taciana Tinanes was the first Directress of the
School
• Emmanuel Hospital School of Nursing (Capiz, 1913)
- In 1913, the American Baptist Foreign Mission Society sent Dr.
PH Lerrigo to Capiz for the purpose of opening a hospital. Miss
Rose Nicolet assisted him. The school offered a 3-year training
course for an annual fee of Php 100.00.
- Miss Clara Pedroso was the first principal

Other Schools of Nursing

1. Zamboanga General Hospital School of Nursing (1921)
2. Chinese General Hospital School of Nursing (1921)
3. Baguio General Hospital School of Nursing (1923)
4. Manila Sanitarium Hospital and School of Nursing (1930)
5. St. Paul School of Nursing in Iloilo City (1946)
6. North General Hospital and School of Nursing (1946)
7. Siliman University School of Nursing (1947)