Nursing began as a practice reserved for men, military, deaconess and nuns. The first known Nurse, Phoebe, was mentioned in Romans 16:1. During the early years of the Christian Church, St. Paulsent a deaconess Phoebe to Rome as the first visiting nurse. She took care of both women and men.
In the 16th century, Protestant reformers shut down the monasteries and convents, allowing a few to continue in operation hundred municipal hospices. Those nuns who had been serving as nurses were given pensions or told to get married and stay home in Catholic areas however the role of the nursing sister continued uninterrupted.
In the early modern period from 1600 to 1800, Protestant Europe had a few noticeable hospitals, but no regular system of nursing. The weakened public role of women left female practitioners restricted to assisting neighbors and family in an unpaid and unrecognized capacity.
Modern nursing began in the 19th century in Germany and Britain, and spread worldwide by 1900. The first nursing school was established in India in about 250 B.C., and only men were permitted to attend because men were viewed to be more pure than women.
It wasn’t until the 1800’s that nursing became an organized practice. During the Crimean War, Florence Nightingale and 38 volunteer nurses were sent to the main British camp in Turkey. Nightingale and her staff immediately began to clean the hospital and equipment and reorganized patient care. Nightingale pushed for reform of hospital sanitation methods and invented methods of graphing statistical data. When she returned to Britain, Nightingale aided in the establishment of the Royal Commission on the Health of the Army. As a woman, Nightingale could not be appointed to the Royal Commission, but she composed the Commission’s report. Completed, the report was over 1,000 pages in length and included detailed statistical information. Nightingale’s work led to drastic changes in army medical care, the establishment of an Army Medical School and medical records, and ignited the growth of nursing as an organized profession. For these contributions, Nightingale is widely accepted as the founder of nursing.
In the early 1900’s, nursing education was received primarily from hospitals rather than colleges or universities. New nursing students were responsible for tasks similar to that of maids – dusting, scrubbing and doing dishes. These students typically worked 10 to 12 hour shifts, seven days a week, for a period of two to three years. Later responsibilities included sterilization of equipment such as needles and bandages and cleaning operating rooms. After graduating, most worked in patient homes as private-duty nurses and were paid amounts comparable to today’s minimum wage. Their duties included bathing, administration of medications and enemas, and tending to wounds and sores.
During this time period, hospitals evolved from facilities for the extremely poor and death-bound to institutions for general health treatment and childbirth. At the dawn of World War II, nurses were removed from their familiar hospital environment and placed at the bedsides of wounded soldiers, responsible for treatment decisions for the first time. To ensure adequate nursing staff for the duration of the war, the Cadet Nurse Corps program was initiated in 1943 to subsidize education for nursing students who agreed to work in the understaffed areas until the war’s end. Well over 100,000 nurses received training through this program over the next three years. The nursing profession gained much recognition and support from civilians during this time, at long last realized as the tremendous asset to medical care that nurses truly are.
Nurses returned from duty with public support as well as new skills from the training and experience gained during service. Many nurses had been trained by the military in specialty areas of medicine, expanding nursing into areas of medicine such as psychiatry and anesthesia. In the years that followed, the government invested tremendous sums of money into the health care profession. That, combined with the nation’s booming economy and the discovery of antibiotics such as penicillin to treat infections, created a high demand for skilled, educated nurses. As pharmaceutical advancements continued, more invasive surgeries that were previously considered far too risky were made possible, opening even more opportunities to nurses in the field of surgery. Soon, medical machinery was operable by nurses, who became increasingly more and more responsible for the direct care of patients.
LEVEL OBJECTIVES (per CMO No. 14 series of 2009)
The student shall be given opportunities to be exposed to the various levels of health care (health promotion, disease prevention, risk reduction, curative and restoration of health) with various client groups (individual, family, population groups and community) in various settings (hospital, community). These opportunities shall be given in graduated experiences to ensure that the competencies per course, per level and for the whole program are developed.
Before graduation, the student shall approximate the competencies of a professional nurse as they assume the various roles and responsibilities. For each year level, the following objectives should be achieved:
a. At the end of the first year, the students shall have acquired an understanding and awareness of themselves as an individual and as a member of the family, the community, and the world with emphasis on personal, societal and professional values, responsibilities, rights, and an awareness of physical, social and cultural milieu.
b. The student shall have an awareness of the competency-based approach in the curriculum and the core competencies under the 11 key areas of responsibility: safe and quality nursing care, communication, collaboration and teamwork, health education, legal responsibility, ethico-moral responsibility, personal and professional development., quality improvement, research, management of resources and environment, and record management.
c. At the end of the second year, the student shall have acquired the holistic understanding of the human person as a bio-psycho-cultural being focusing on the concept of health and illness as it is related to the care of the mother and child in varied settings. The student shall be able to demonstrate the competencies in the 11 Areas of Responsibility.
d. At the end of the third year, given actual clients/situation with various physiologic and psychosocial alterations, the student shall be able to demonstrate the competencies in 11 Areas of Responsibility.
e. At the end of the 4th year, given actual clients/situations the students shall be able to demonstrate competencies in all the 11 Areas of Responsibility.
