Over the last two centuries, nursing has been constantly redesigned and developed into what we call now as modern nursing. It has been enhanced every period of time through education and scientific breakthroughs. It has evolved into a vocation founded upon specialized educational training, enhanced both by theory and constant research.
In this essay, the history and development of nursing over the last two hundred years shall be addressed, followed by a discussion on the factors that led to the development of nursing into a profession governed by legislation and bound by ethics and standards of practice, with inclusions on the criteria of a profession and how they relate to nursing. As an activity that provides help to the ill, to children, and to babies, nursing has existed since the earliest times. From the middle of the 18th century to the 19th century, social reforms changed the roles of nurses and of women in general.
It was during this that nursing as we know now began based on the beliefs of Florence Nightingale. Nursing was provided by women who were expected to carry out the housework of the hospital, wash the laundry, and do all the cleaning for very little reward (Dempsey, French, Hillege and Wilson, 2009, p. 167). The era of reform in nursing is marked by the work of the British nurse, Florence Nightingale during the Crimean War. Nightingale’s efforts made nursing a respectable vocation once again (Daniels, 2004, p. 9).
However, Nightingale’s reform activities did not stop at responsibility. Besides crusading for cleanliness and comfort in hospitals, Nightingale also worked toward educating the public regarding health measures. She believed in prevention and in nursing the whole person (White, 2005). Nightingale viewed health as significant for nursing practice (Beck, 2006, p. 481). It was also because of the Nightingale tradition that Australian nursing was established (Condon, 2000, p. 110). Among her many other accomplishments was the establishment of the Nightingale School of Nurses at St.
Thomas Hospital, London in 1960. This school is credited with providing the first planned educational program for nurses (White 2005). In the 19th century, nursing revolutionized to a proficient discipline and roles of nurses in public health care increased (Hallet, 2010, p. 11). It was Lucy Osburn who was a trainee of the nightingale school of nursing that marked the start of nursing in Australia (Dempsey et al, 2009, p. 168). The Australiasian Trained Nurses Association was then founded in New South Wales in 1899 (Crisp and Taylor, 2009, p. ). A number of factors including key persons, societal needs, and even the crisis of war contributed to the development of nursing education (Schwirian 1998, p. 116). By the end of World War I there was rapid expansion in the establishment of hospitals, with nursing schools dependent on them for support. Training was based on apprenticeship, rather than on educational principles in which nurses learned from physicians and practical experience through caring for the ill populace in the hospital (Dempsey et al, 2009, p. 168).
After hospitals existed, there was no formal training for nurses in giving care since there were no standard programs to educate nurses until the late 1800’s where nursing care was conducted by relatives and self-conducted persons (Chitty, 2005, p. 33). When nursing went through industrial and social reform, schools of nursing were then embellished in Universities and Colleges (Dempsey et al, 2009, p. 169). It was Florence Nightingale who laid the foundation of modern nursing that worked hard to enhance the people’s awareness since educated nurses were needed thus promoting the future of nursing education (White, 2005).
From its early days to the present, nursing has undergone change in every era. Rapid strides have been made in nursing education and programs in a wide variety of hospital and community nursing services. Another factor that led to the development of nursing is the advances in science and technology that affect nursing practice in so many ways. As physicians expand their knowledge base and technical skills, nurses acquired complementary knowledge and skills as they adapt to meet the new needs of the clients (Daniels, 2004). The volume of knowledge is expanding worldwide with the increase progression in electronic information (Lenburg, 2008, p. 7). As science and technology create methods of treating disease, it is the responsibility of all health professionals and nurses in particular to remember that clients are human beings requiring warmth, care, and acknowledgment of self-worth. Often equipment’s are frightening to the clients, hence it is important for nurses to humanize technology as much as possible by offering explanations, and recognizing the clients’ needs to understand and to be supported (Daniels, 2004). Over the last 100 years of study and deliberation, there is still no clear agreement of whether or not nursing is indeed a profession.
Lucie Kelly, an influential leader who spent much of her nursing career in investigating the dimensions of professional nursing, brought together the eight criteria of a profession. The first criteria Kelly wrote is about “The services provided are vital to humanity and the welfare of society”. Indeed nurses were able to modify patient care and create new models of care for the sustainment and refurbishment of the health of the people. (Joel 2003, p. 68) Second, “There is a special body of knowledge that is continually enlarged through research”.
It is essential that nurses realize that using research and establishing their practice on research are a part of evidence-based practice, which is continuously discovered through theory development. (Dempsey et al, 2009, p. 189) Third, “The services involve intellectual activities and individual responsibility “. The nursing process is a remarkable access to practice essential and comminuted as foundation in generating nursing care. Accountability, according to the ANMC, is the state of being answerable to someone for one’s decisions and actions.
Fourth, “Practitioners are educated in institutions of higher learning”. Widely held programs having nursing education are now associate degree and baccalaureate programs in colleges and universities (Chitty, 2005, p. 172). The fifth criterion according to Kelly is that “Practitioners are relatively independent and control their own policies and activities”. Even though many nursing actions are autonomous, nurses whom are working in hospitals, execute certain processes only when approved by supervising physicians or hospital protocols.
Sixth, “Practitioners are motivated by service (altruism) and consider their work an important component of their lives”. Although sometimes tangled with economic issues, like salaries, nurses as a group are committed to the ideal of service to others, also known as altruism. Being concerned with salary issues does not diminish a nurse’s altruism or professionalism. (Chitty, 2005, p. 173) Seventh criteria would be “There is a code of ethics to guide the decisions and conduct of practitioners”. Ethical Theories and guidelines are manifested by ethical codes.
Ethical guidelines descended from bioethics which draw on the expertise and progressions of ethics to assess health care. (Twomey, 2006, p. 437) The last criterion is “There is an organization (association) that encourages and supports high standards of practice”. A few professional associations have been made to progress the advancement of the nursing profession (Blais, Hayes, Kozier ;amp; Erb, 2006, p. 42). The Australian and Midwifery Council is an accreditation body that helps in the regulation of nurses and midwives in Australia (ASA, 2011).
Since ethics govern right conduct, they deal with what “should” or “ought to” be done. Ethics is designed to protect the rights of human beings and it provides professional standards for nursing activities (White, 2005, p. 71). According to the ANMC (2008), the code of ethics is enclosed by the principles and standards set forth in the United Nations Universal Declaration of Human Rights, International Covenant of Economic, Social and Cultural Rights, and International Covenant on Civil and Political Rights. Every nurse needs to understand legal issues.
The four principles used in nursing are autonomy, beneficence, justice, and veracity. These principles help guide nurses when confronted with ethical issues (Finkelman ;amp; Kenner, p. 196). There are standards of practice in Australia that a nurse must assume both within and outside of professional domains to establish the good standing of the nursing profession, competency, standards, decision-making, frameworks, guidelines and positions that render liable and responsible nursing practice (ANMC, 2008). These standards of practice are often used to evaluate the quality of care provided by nurses (Daniels, 2004 p. 62).
In Australia, the Australian Health Practitioner Regulation Agency is an association that implements national registration and accreditation scheme. AHPRA was built by an act of parliament and is obliged by the Health Practitioner Regulation Law to partake in jurisdictions and regulations (AHPRA, 2011). In order to practice the nursing profession, nurses must pass a national licensure examination given by individual state (Catalano, p. 9). In conclusion, the nursing profession is truly an art and a science. The history of nursing, development of education, technologies and the significant people contributed to the establishment of nursing.
With today’s competitive and market-driven healthcare environment, a professional nurse must artfully learn to deliver care with compassion, and be prepared to combine the highest level of scientific knowledge and technologic skill with responsible, caring practice. As a science on its early years, it is dynamic and is ever-changing with new discoveries and innovations. As early as now, it is important to capture the unique essence of both art and science of the nursing profession, integrating it to our practice.
Nursing provides limitless opportunities to a new professional who can start a career on specialized areas, including clinical practice, education, research, management, administration, and even entrepreneurship. Those new to nursing can quickly become overwhelmed by the demands placed on the nurse’s knowledge, technical competence, interpersonal skill, and commitment. Clients differ in health care problems, experiences, vulnerabilities, and expectations. A nurse must cope and adapt to the situation with professionalism, compassion, and a respect for each client’s dignity and personhood.
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