nursing

nursing, science of providing continuous care for sick or infirm people. While nursing as an occupation has always existed, it is only in fairly recent years that it has developed as a specialized profession.

The Modern Profession

Nursing candidates must prepare by a rigorous course of training that includes a thorough grounding in anatomy, physiology, pharmacology, the cause and treatment of disease, the intricacies of nutrition and diet, surgical skills, and a variety of techniques pertaining to patient care. Many nurses also prepare for more specialized work, such as the care of newborn infants, maternity patients, or the mentally ill, or for duties in the operating room.

Training for a career as a registered nurse (RN) can be met by several means: a two-year course at a junior college or a four-year degree program at a college or university. (Three-year courses given by hospitals are being phased out because of high costs.) Emphasis on college education for nurses is on the upsurge, because greater knowledge is required to apply the latest methods of diagnosis and therapy. Training includes both classroom study and actual hospital practice, and the graduate must still be examined and licensed by the state. This applies also to women in religious orders who train and work as nursing sisters.

The age limits and educational requirements for practical nurses are less stringent, and the period of training is much shorter, usually one year. The terms "licensed practical nurse" (LPN) and "licensed vocational nurse" (LVN) are interchangeable. Sufficient training is given to such men and women to enable them to care for and feed patients, administer medication, and perform other routine duties; however, they are always under the direct supervision of registered nurses. LPNs are generally examined and licensed by the state.

For most specialized work and teaching, nurses must complete a course leading to a master's degree or doctorate. Specializations include nurse anesthetist, which originated at the beginning of the 20th cent., and such recently established ones as nurse practitioner (licensed to perform physical examinations and other procedures under a physician's supervision), nurse midwife (see midwifery), and nurse clinician. In addition to duties in the hospital or in the home there are many fields open to the professional nurse, such as the Red Cross, military service, public health, health insurance companies, industry, and teaching. Some nurse practitioners have become primary health-care providers, opening practices on their own (without physician supervision), and some have been accredited as such by large health maintenance organizations.

History of Nursing

In ancient times, when medical lore was associated with good or evil spirits, the sick were usually cared for in temples and houses of worship. In the early Christian era nursing duties were undertaken by certain women in the church, their services being extended to patients in their homes. These women had no real training by today's standards, but experience taught them valuable skills, especially in the use of herbs and drugs, and some gained fame as the physicians of their era. In later centuries, however, nursing duties fell mostly to relatively ignorant women.

In the 17th cent., St. Vincent de Paul began to encourage women to undertake some form of training for their work, but there was no real hospital training school for nurses until one was established in Kaiserwerth, Germany, in 1846. There, Florence Nightingale received the training that later enabled her to establish, at St. Thomas's Hospital in London, the first school designed primarily to train nurses rather than to provide nursing service for the hospital. Similar schools were established in 1873 in New York City, New Haven (Conn.), and Boston. Nursing subsequently became one of the most important professions open to women until the social changes wrought by the revival of the feminist movement that began in the 1960s (see feminism). The late 20th cent. saw growing nursing shortages in U.S. hospitals as stagnant salaries, increasing workloads, and greater job opportunities for women led to falling enrollments in nursing degree programs.

Health-care profession providing physical and emotional care to the sick and disabled and promoting health in all individuals through activities including research, health education, and patient consultation. Nursing gained recognition in the 19th century with the activities of Florence Nightingale. Many nurses have specialties (e.g., psychiatry, critical care). Nurse-practitioners, clinical nurse specialists, nurse-anesthetists, and nurse-midwives undertake tasks traditionally performed by physicians. Nursing degrees go as high as the doctorate, and staff positions include administration. In addition to health-care settings, nurses practice in schools, the military, industry, and private homes. Community (public health) nurses educate the public on topics such as nutrition and disease prevention.

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Nursing is a profession focused on assisting individuals, families, and communities in attaining, maintaining, and recovering optimal health and functioning. Modern definitions of nursing define it as a science and an art that focuses on promoting quality of life as defined by persons and families, throughout their life experiences from birth to care at the end of life.

History of nursing

Nursing comes in various forms in every culture, although the definition of the term and the practice of nursing has changed greatly over time. The oldest sense of the word in the English language a woman employed to suckle and/or generally care for a younger child. The former being known as a wet nurse and the latter being known as a dry nurse. In the 15th century, this developed into the idea of looking after or advising another, not necessarily meaning a woman looking after a child. Nursing has continued to develop in this latter sense, although the idea of nourishing in the broadest sense refers in modern nursing to promoting quality of life. Prior to the foundation of modern nursing, nuns and the military often provided nursing-like services. The religious and military roots of modern nursing remain in evidence today in many countries. For example: in Britain, senior female nurses are known as ‘‘sisters’’. It was during time of war that a significant development in nursing history arose when Florence Nightingale, working to improve conditions of soldiers in the Crimean War, laid the foundation stone of professional nursing with the principles summarised in the book Notes on Nursing. Other important nurses in the development of the profession include: Mary Seacole, who also worked as a nurse in the Crimea; Agnes Elizabeth Jones and Linda Richards, who established quality nursing schools in the USA and Japan, and Linda Richards who was officially America's first trained nurse, graduating in 1873 from the New England Hospital for Women and Children in Boston.

New Zealand was the first country to regulate nurses nationally, with adoption of the Nurses Registration Act on the 12th of September, 1901. Ellen Dougherty was the first registered nurse. North Carolina was the first state in the United States to pass a nursing licensure law in 1903.

Nurses have experienced difficulty with the hierarchy in medicine that has resulted in an impression that nurses primary purpose is to follow the direction of medics. This tendency is certainly not observed in Nightingale's Notes on Nursing, where the doctors are mentioned relatively infrequently and often in critical tones, particularly relating to bedside manner.

The modern era has seen the development of nursing degrees and nursing has numerous journals to broaden the knowledge base of the profession. Nurses are often in key management roles within health services and hold research posts at universities.

Nursing as a profession

The authority for the practice of nursing is based upon a social contract that delineates professional rights and responsibilities as well as mechanisms for public accountability. In almost all countries, nursing practice is defined and governed by law, and entrance to the profession is regulated at national or state level.

The aim of the nursing community worldwide is for its professionals to ensure quality care for all, while maintaining their credentials, code of ethics, standards, and competencies, and continuing their education. There are a number of educational paths to becoming a professional nurse, which vary greatly worldwide, but all involve extensive study of nursing theory and practice and training in clinical skills.

Nurses care for individuals who are healthy and ill, of all ages and cultural backgrounds, and who have physical, emotional, psychological, intellectual, social, and spiritual needs. The profession combines physical science, social science, nursing theory, and technology in caring for those individuals.

In order to work in the nursing profession, all nurses hold one or more credentials depending on their scope of practice and education. A Licensed practical nurse(LPN) (also referred to as a Licensed vocational nurse, Registered practical nurse, Enrolled nurse, and State enrolled nurse) works under a Registered nurse. A Registered nurse (RN) provides scientific, psychological, and technological knowledge in the care of patients and families in many health care settings. ($30,000-$50,000/yr base). Registered nurses may also earn additional credentials or degrees enabling them to work under different titles such as:

Advanced Practice Registered Nurse (APRN)- Provides primary care and specialized advanced nursing services to patients and families. Principle types of APRNs include: Clinical Nurse Specialist (CNS), Nurse Practitioner (NP), Certified Registered Nurse Anesthetist (CRNA), and Certified Nurse Midwife (CNM) ($40,000-$65,000/yr+)

Nurse Educator - Utilizes educational methodologies to present current information in patient care settings, universities, and communities. Types of nurse educators include: Clinical Instructor, College/University Professor, Staff Development Specialist, and Patient Education Specialist($30,000-$75,000/yr+)

Nurse Administrator - Coordinates the use of human, financial, and technological resources to provide patient care. ($40,000-$90,000/yr+)

Nurse Researcher - Utilizes statistical methodologies to discover or establish facts, principles or relationships. ($40,000-$75,000/yr+)

There is no profession which offers as many opportunities for diversified roles as does nursing. Nurses may follow their personal and professional interests by working with any group of people, in any setting, at any time. Some nurses follow the traditional role of working in a hospital setting. Within the hospital setting, nurses may work in areas including:

Critical Care; Emergency; Maternal/Child Care; Medical: Cardiology, Diabetes, Gastroenterology, Gerontology, Nephrology, Neurology, Oncology, Pulmonary, Rehabilitation, Renal, Rheumatology, Urology; Operating Room/Recovery Room; Pediatrics; Psychiatric/Mental Health; Surgical: Burn, Cardiovascular, Ear/Nose/Throat, Gastroenterology, Orthopedics, Plastic Reconstructive, Transplant

Others may work in non-hospital settings including:

Public/Community Health; Mental Health Agencies; Home Health Care; Physician's Office; Health Maintenance Organizations and Managed Care Companies; Insurance; Occupational Health; Research Centers; Extended Care Facilities; Clinics; Outpatient Surgery Centers; Hospices; Community Schools, Day Care Centers; Military Branches; Independent Practice; Schools of Nursing; Senior Centers, Shelters, Churches

The high demand for nurses

The demand for nurses has been on the rise for several years, spurred by various economic and demographic factors. And demand for nurses is likely to continue to increase. Candidates for nursing jobs that are in highest demand include registered nurses, licensed practical nurses, certified nurse assistants, and certified medical assistants.

According to the US Department of Labor Bureau of Labor Statistics, employment for registered nurses is expected to increase 23% between 2006 and 2016. Here is a breakdown of The Bureau's estimated increase percentage per nurse employer type:

39% - Offices of physicians
39% - Home health care services
34% - Outpatient care centers, except mental health and substance abuse
27% - Employment services
22% - General medical and surgical hospitals, public and private
20% - Nursing care facilities

The nurse demand has intersected with job recruitment and job search improvements, now available through internet employment tools, such as nursing job boards. These web sites help to automate the job search and job posting capabilities for industry candidates and employers. Some job boards, like www.NursingJobBank.com www.NursingPost.net and www.nursing-jobs.usspecialize in nursing jobs. Other, such as www.indeed.com, are general job sites that cover jobs for multiple industries.

Most of the available web sites function under a model that offers free use for nursing position job seekers. Also, most provide the ability to filter searches geographically and by job type.

Nursing practice

Nursing practice is primarily the caring relationship between the nurse and the person in their care. In providing nursing care, nurses are implementing the nursing care plan, which is based on a nursing assessment.

Definition

Although nursing practice varies both through its various specialities and countries, these nursing organizations offer the following definitions:

Nursing theory and process

In general terms, the nursing process is the method used to assess and diagnose needs, plan and implement interventions, and evaluate the outcomes of the care provided. Like other disciplines, the profession has developed different theories derived from sometimes diverse philosophical beliefs and paradigms or worldviews to help nurses direct their activities to accomplish specific goals. Currently, two paradigms exist in nursing, the totality paradigm and the simultaneity paradigm.

Practice settings

Nurses practice in a wide range of settings, from hospitals to visiting people in their homes and caring for them in schools to research in pharmaceutical companies. Nurses work in occupational health settings (also called industrial health settings), free-standing clinics and physician offices, nurse-run clinics, long-term care facilities and camps. They also work on cruise ships and in military service. Nurses act as advisers and consultants to the healthcare and insurance industries. Some are attorneys and others work with attorneys as legal nurse consultants, reviewing patient records to assure that adequate care was provided and testifying in court. Nurses can work on a temporary basis, which involves doing shifts without a contact in a variety of settings, sometimes known as per diem nursing, agency nursing or travel nursing.

Regulation of practice

The practice of nursing is governed by laws that define a scope of practice, generally mandated by the legislature of the political division within which the nurse practices. Nurses are held legally responsible and accountable for their practice. The standard of care is that of the "prudent nurse."

Nursing specialties

Nursing is the most diverse of all healthcare occupations. Nurses practice in a wide range of settings but generally nursing is divided depending on the needs of the person being nursed.

The major divisions are:-

• the nursing of people with mental health problems - Psychiatric and mental health nursing
• the nursing of people with learning or developmental disabilities - Learning disability nursing (UK)
• the nursing of children - Pediatric nursing.
• the nursing of older adults - Geriatric nursing
• the nursing of people in acute care and long term care institutional settings.
• the nursing of people in their own homes - Home health nursing (US), District nursing and Health visiting (UK). See also Live-in nurse

There are also specialist areas such as cardiac nursing, orthopedic nursing, palliative care, perioperative nursing and oncology nursing or the specialization to cancer.

Nursing by country

For the occupation of nurses in each country, see nurse

See also

• Nurse
• Nursing practice
• Nursing care plan
• Nursing theory
• Health promotion
• List of nursing specialties
• Nursing specialties
• List of nurses
• Nurses
• Nursing school
• Master of Science in Nursing
• Traditional Nurse's Uniform
• Modern Nurse's Uniform (Scrubs)

References

External links

• Animated Medical Procedures for Nurses