Nursing Practice: History, Influences, and Education

00:01 Welcome to the foundations of nursing practice today.

00:05 We're going to take a glimpse at some of those nursing historical giants that helped shape our profession.

00:11 We're also going to take a look at some characteristics of today's nurse.

00:15 So the first nursing historical giant, I want you to note this name: Florence Nightingale.

00:21 You're going to hear this a lot throughout your education.

00:24 Now she's otherwise known as the lady with the lamp.

00:28 Now she got this name because she's a British nurse who carried a lamp making rounds on soldiers during the Crimean War.

00:35 She's also known for greatly improving sanitary conditions for these soldiers, which led to much better outcomes.

00:43 Now she's also known as the founder of modern nursing, who established St. Thomas Hospital and the Nightingale Training School for nurses in 1860.

00:54 Now, once you come to completion of your nursing school, you may be asked to take the Florence Nightingale nursing pledge in her honor, much like the Hippocratic oath that physicians take.

01:06 Now, let's take a look at the next nursing giant.

01:08 This is named Clara Barton.

01:11 She established our American Red Cross in 1881, and she actually served as president until 1904.

01:19 Now she's got another nickname of "Angel of the Battlefield".

01:23 Now this is due to providing relief of services and finding missing soldiers during the Civil War.

01:29 Now the interesting thing about Clara Barton, she was self-taught, and she had no formal training.

01:36 Next, let's talk about Miss Dorothea Dix.

01:39 She was a pioneer and an advocate who advocated on behalf of the better treatment of mentally-ill patients.

01:46 She had much important work in the Civil War, implementing different programs to train nurses to serve the sick.

01:56 Next up, we have Miss Mary Mahoney.

01:58 She was the first African American nurse to be trained and graduated from an American School of Nursing.

02:05 Now she's a big name because she helped create the National Association of Colored Graduate Nurses, otherwise known as the NACGN.

02:15 She was also inducted into the American Nursing Association Hall of Fame and the National Women's Hall of Fame.

02:25 Now let's take a look at this interesting character here on this horse.

02:29 Her name is Mary Breckinridge, and she founded the Frontier Nursing Services.

02:34 Now she was actually an American nursing midwife.

02:37 So she served some of the most rural and poor areas in Kentucky in the United States.

02:44 Now she's here in this picture on horseback because many times, she actually had to ride on horseback to get to those really isolated areas to serve her patients.

02:55 Now, her Frontier Nursing Service helped to greatly reduce maternal mortality rate.

03:03 Now let's take a look at this last nursing giant, Miss Lillian Wald.

03:07 She helped create the Visiting Nursing Service of New York to bring affordable health care to her community.

03:14 Now in 1894, Miss Lillian Wald, and as some will know Mary Brewster started the Henry Street Settlement House.

03:22 Now this was an organization dedicated to providing public health services.

03:27 She's really noticed of her focus on public health to those in the poor and middle class communities.

03:34 And she was throughout her career an advocate for women's, children's, immigrants and labor rights.

03:42 Now, let's shift to nursing today and those many influences that affect our practice.

03:48 One of those key influences is here on the bottom of this image is nursing shortages.

03:53 As you can imagine, this is a great concern for many areas of healthcare.

03:59 Now, one of those with a nursing shortage can be of course, patient safety.

04:03 Now, if we don't have enough nurses to care for those who are critically ill, again, patient safety is an issue, quality is an issue.

04:12 And as you can imagine, turnover rates are high with a nursing shortage.

04:17 The other thing to consider is the cost of the health care for the patient.

04:21 Now, if many patients have to choose between food, water, clothing, for example, versus the cost of health care, well many times they're going to choose those needs of daily living.

04:33 So this as you can imagine, can affect compliance with treatment for those patients who have severe chronic conditions.

04:41 Now next, let's talk about healthcare reform.

04:44 So sometimes this can be a positive nursing influence because this can broaden the population of who can have coverage and also receive treatment.

04:54 Now as a nurse, it's really important to think about the demographics of your patients.

04:59 Now, age, sex, religion, for example, can all affect the treatment decisions and what's the best choices for your patient.

05:08 Now you've also got to think about especially where you reside, there's many underserved populations that are there that we have to consider in the healthcare facilities.

05:19 Now, there's a lot of challenges for those underserved populations.

05:23 Many times there's challenges for them just to get basic care.

05:27 Now, if we're not getting that preventative care, they can come to the hospitals or facilities with severe exacerbated conditions that are far more advanced to treat.

05:39 And lastly, don't forget about changes in healthcare delivery.

05:43 This has been a huge influence today on nursing practice.

05:47 An example of this is telehealth, for example, or telemedicine.

05:51 Now, as you can imagine, with the changes of the world many times, access to health care is so important and we've improved these avenues on how we get that.

06:01 So telemedicine, what we mean by this is a physician can connect over the computer through different rural areas and different populations.

06:10 That way they get the best treatment for them.

06:14 Let's take a look at what today's nurse looks like regarding those education pathways.

06:20 So when you see these numbers on the bottom, these are the years or about how long each program takes.

06:27 So let's start with the first bar on the graph.

06:30 This is the one called Licensed Practical Nursing Certificate or LPN.

06:35 So just know with an LPN, their scope of practice is more narrow and they are supervised by a registered nurse.

06:43 Now the next bar on the graph, as you can see is the associate's degree nurse, which is the entry level for the Registered Nurse.

06:52 Again, it takes an associate's degree for you to achieve your RN once you pass the NCLEX.

06:58 And just remember that the RN can supervise the LPN.

07:03 And this takes about two years for this program.

07:07 Now once you become an RN, you can choose as well to go into the baccalaureate degree.

07:13 This program takes about four years and this is expanded on the Registered Nurse curriculum to include things like social sciences, humanities, and nursing theory, for example.

07:25 Now, if you decide once you're an RN to advance your degree even further, you can achieve a master's degree and the program takes once you've gotten your baccalaureate to about 2-3 years.

07:37 Now you can decide to specialize in things like nursing education, or advanced practice Registered Nursing.

07:44 And lastly here, you see the doctoral degree.

07:48 This can take anywhere from about 2-7 years for this program.

07:52 Now this is a doctoral degree in nursing and it could be either a doctoral in nursing practice or a PhD.