The History of Nursing

Many people believe that Nursing started with Florence Nightingale, however nursing itself dates back to the beginnings of motherhood when nurses were traditionally female. The history of nursing has its origins in the care of infants and children, so all mothers were in fact nurses. Gradually an evolution started developing into dedicated caregivers who practiced the art. In fact, nursing has been called the oldest of arts and the youngest of professions.
The history of nursing first started to become more continuous and defined with the dawn of Christianity. Early records of the history of nursing do exist, but are quite fragmented. Nursing began to model its practice after the teachings of Christ, caring for the sick, feeding the hungry and burying the dead. Therefore, during this period the history of nursing is intricately tied to the Church.

After the Crusades, the world was ripe for social reform. The history of nursing was about to change. One of the most important factors in the birth of modern nursing was the establishment of the Deaconess Institute at Kaiserswerth, Germany. A small hospital was opened which included a training school for deaconesses. Their training system was a close parallel to the educational system for nurses that we see today.Graduates of this program assumed positions in all four corners of the globe and took their place in the history of nursing.

Florence Nightingale is the most centralized figure in the history of nursing. She overcame tremendous social opposition to become a nurse and to care for soldiers during the Crimean War. Her dedication to her profession was responsible for decreasing the death toll among soldiers.Nevertheless, even with these great accomplishments she had not achieved her greatest desire, to open a training school for nurses. In 1860, Florence's dream was finally realized when the Nightingale Training School for Nurses opened. This was the first formal, fully organized training program for nurses. Graduates of the program went into the four corners of the world to teach other nurses and were highly sought by hospitals. While Florence Nightingale did not invent the profession of nursing, she was a living memorial to it and forever will have a place and influence in the history of nursing.

Nepal Nursing Council

Nepal Nursing Council (NNC) is established under Nepal Nursing Council Act 2052 (1996).it came into force on 2053-03-02(16June 1996).first amendment of the act was done on 2058/10/14 (17th January, 2002 A.D.) However, initially the office of council was located within the premises of Ministry of Health at present it is located in Chun Devi, Bansbari, Maharajgung.

Power, Functions and Duties of the Council:

a. The power, function and duties of the council shall be as follows:-
To formulate policy required to operate the nursing profession smoothly
To provide recognition to a teaching institution ,
To evaluate and review the curriculum, terms and conditions of admission ,examination system and other necessary terms and conditions and infrastructure of a teaching institution which has been granted recognition pursuant to clause (b),
If a teaching institution is found form the evaluation and review made pursuant to clause (c) to have failed to met the standards determined by the council, to make a recommendation for revoking the approval for operation of such institution.
To determine the qualifications of the nursing professionals and to issue certification to the qualified nursing professional after registering his /her name in the registration book ,
To determine the work limit of nursing professionals,
To formulate professional code of conduct of the nursing professionals and to take action against those nursing professionals who violate such code of conduct .

b. Prior to granting approval to establish and operate a teaching institution, the concerned body shall consult the council .the council shall provide its opinion on that matter after examining weather such teaching institution has met the required standard and infrastructure or not . The concerned body shall reach to a decision in respect of granting or not granting approval for establishment and operation of teaching institution on the basic of such opinion of the council. In cases where approval for establishment and operation of a teaching institution is granted, a notice there of shall be published in the Nepal Gazette.

The council members (Board of Directors) are responsible to carry out all these power function and duties. There is complies of its members representing different sector .The process of constitution of council is:
One chairperson nominated by Nepal government among the nurse meeting criteria decide by council Act.
One member nominated by Nepal Government among the nurses who have 12 years experience after at least Bachelors Degree in Nursing Education .
Two members are nominated by Nepal Government among the Campus Chiefs of Nursing College.
Ex-office member chair person of NAN .
One member designated by Director General of Department of Health.
One member designated by the Dean of IOM.
Three members nominated by Nepal Government among the nursing chiefs (Administrator) working in regional /Zonal Hospitals and Directorate.
One member nominated by Nepal Government among nationally renowned person on behalf of consumer group.
One member as a representative of CTEVT.

nursing

A nurse is a healthcare professional who, in collaboration with other members of a health care team, is responsible for treatment, safety, and recovery of acutely or chronically ill individuals; health promotion and maintenance within families, communities and populations and, treatment of life-threatening emergencies in a wide range of health care settings. Nurses perform a wide range of clinical and non-clinical functions necessary to the delivery of health care, and may also be involved in medical and nursing research.
Both nursing roles and education were first defined by Florence Nightingale, following her experiences caring for the wounded in the Crimean War. Prior to this, nursing was thought to be a trade with few common practices or documented standards. Nightingale's concepts were used as a guide for establishing nursing schools at the beginning of the twentieth century, which were mostly hospital-based training programs emphasizing the development of a set of clinical skills. The profession's early utilization of a general, hospital-based education is sometimes credited for the wide range of roles nurses have assumed within health care, and this is contrasted with present-day nursing education, which is increasingly specialized and typically offered at post-secondary institutions.

pediatric nursing

Pediatric nursing is that field of nursing which focuses on children. It is an excellent career for nurses who love kids and don’t mind hard work. The day of a pediatric nurse can be hectic, working with patients that range from newborns to teenagers.
Pediatric nurses work mostly on the pediatric halls in hospitals. The work involved in pediatric nursing is very different from any other types of nursing. The care is given to young patients, who need special care. A nurse with a quick smile, endless patience, and a friendly personality can make the experience of staying in a hospital a lot less scary for kids. Pediatric nurses must also be able to easily relate to worried parents and other family members.

Nursing audit

Nursing audit is a standardized objectives recorded appraisal of the nursing care provided for the patient as revealed by the data recorded in th medical records of the hospitalized patient or the records of patient under the care of community nursing services.

Nursing audit as the process of analyzing data related to nursing process or patient outcomes for the purpose of evaluating appropriateness and effectiveness of nursing care measure. It is a systematic critical analysis of nursing  practice. Audit of the quality of care are normally undertaken through a process of per review of a professional practice by someone of the same profession against professionally defined standard. According to Goster Walfer "nursing audit is an exercise to find out whether good nursing practice are followed. The audit is a means by which nurse themselves can define standard from their patient of view and describe the actual practice of nursing. 

The purpose of nursing audit are:

• evaluating nursing care given
• achieves deserved and feasible quality of nursing care
• stimulate to better records
• focus on care provided and not on care provider
• contributes to research

Nursing audit is done by collecting information from record, chart, concurrent chart review, interviewing, peer review,etc.

Nurse as a change agent

Change agent means the person who helps or facilitates in bringing positive change in any area related to health. Nurse also plays the role of change agent. She has to play a vital role in bringing improvement in health aspect of people in individual, family and community level. A nurse can play role of change agent in health setting that may be in any health institutions, family or community. The nurse can play role of change agent in community, research, hospital and health educational institutions. 

To play effective role of change agent nurse has to focus on three main roles via visioner, facilitator and idea person. Being a visioner, nurse communicates, advices, coaches and provides feedback to bring change in any health and educational settings. Then to bring change she has to play role facilitator. Nurse has to educate people what change is needed so she should play role of educator as well. She should be an idea person to bring change. She helps in problem solving and research. She plays a role of problem solver. Hence, nurse plays a vital role as a change agent.

Role of emergency nurse in disaster management

An emergency nurse plays a significant role in disaster management. As soon as the information is received about disaster, the emergency nurse must communicate this to administration, to the doctor in charge, the nursing director and the disaster team who will activate the disaster plan. All patients not in need of treatment are sent home, discharged at once-also by nurses. Patients from emergency ward are transferred to the wards. All staff are informed to remain on duty. Extra equipment and supplies, emergency drugs, intravenous medications are made ready. The emergency nurse should get triage area, free and get extra mattresses and blankets out of disaster room with the help of partners. The nurse should inform pharmacists, lab staff and center supply of the disaster. Kitchen should be informed to cook food and tea. The emergency nurse should direct other nurses into their areas. Nurses that are off duty and hear about the disaster must report on duty without delay. During disaster , no charges are made. The emergency nurse should make sure there is a person responsible for information flow. The nurse should be calm in order to properly handle the disaster management system.