Posts

Overview The Nightingale Years

Overview The Nightingale Years. This week, we will explore the impact that Florence Nightingale had on the nursing profession. We will consider the well known story of Nightingale plus aspects that are less familiar to many nurses. As we read the familiar and unfamiliar aspects of Nightingale’s life and work, let’s keep an open mind about the woman known as the founder of modern nursing.

The Nightingale Story

Florence Nightingale was born on May 12, 1820, in Florence, Italy, to a wealthy British family. She spent her youth in England in the lap of luxury. Nightingale was educated by her father and several nannies, as was common for young girls at that time. She believed that God had spoken to her and called her to a life of serving the poor and ill, although her family was not pleased with her decision to refuse marriage and dedicate her life to nursing, which had a terrible image at that time (Kalisch & Kalisch, 1995).

At age 31, Nightingale studied nursing for 3 months at the deaconess school in Kaiserwerth, Germany, run by the Fliedners, as described in the Week 1 Lesson (Kalisch & Kalisch, 1995). This was the longest period of nursing instruction received by Nightingale. The deaconess training had a great impact on Nightingale’s future nursing and her development of nursing education.

In 1853, Nightingale worked in London as the “head of the Institute for the Care of Sick Gentlewomen on Harley Street” (Judd & Sitzman, 2014, p. 68), a position she held only briefly due to a board of directors whose ideas did not align with hers (Kalisch & Kalisch, 1995). Nightingale was in the process of negotiating for another position when the Crimean war broke out. This would change her life (Kalisch & Kalisch, 1995).

In October 1854, Nightingale departed for the Crimea to serve as the “Superintendent of the Female Nursing Establishment of the English General Hospitals in Turkey” (Kalisch & Kalisch, 1995, p. 32). Some 38 self-proclaimed nurses accompanied her on this trip, 24 of whom were nuns (Kalisch & Kalisch, 1995). These women, led by Nightingale, served in the Barrack Hospital in Scutari, Turkey. The hospital was grossly overcrowded and lacked basic sanitation, supplies, or sustenance. Nightingale, in as few as 10 days after her arrival, established a kitchen, set up a laundry, and obtained much-needed supplies. After reforming the Barrack Hospital and greatly improving cleanliness and survival rates, Nightingale traveled to Balaclava to visit its hospitals and lend her assistance in improving their conditions (Kalisch & Kalisch, 1995).

Kalisch and Kalisch (1995) reported that Nightingale was ever diligent in her care of the soldiers, often working up to 20 hours a day. When working at night, she walked the rows of bedridden soldiers, carrying a lamp to light her way in the darkness. This resulted in Nightingale being known as the lady with the lamp.

After visiting the hospitals in Balaclava, Nightingale became ill with Crimean fever, also known as brucellosis. This serious illness was treated in Scutari, although Nightingale experienced complications for the remainder of her life.

Nightingale’s work in the Crimean War met with much resistance from the military leadership, physicians, and the public. Her ideas were revolutionary regarding organization of military hospitals and the introduction of trusted women to nurse the wounded soldiers. By the end of the war, Nightingale decreased the mortality rate at the Barrack Hospital from 60% to 1% (Kalisch & Kalisch, 1995).

Nightingale’s Impact beyond the Crimean War

After the Crimean War, Nightingale dedicated herself to the “reform of army sanitary practices and the establishment of a school for nurses” (Kalisch & Kalisch, 1995, p. 36). In 1860, Nightingale began a nurse training school at St. Thomas’ Hospital in London. Many physicians opposed this school and training, believing that nurses were little more than housemaids. While Nightingale was the chief advisor for this school, her “ill health prevented her from taking charge of the program” (Kalisch & Kalisch, 1995, p. 36). Nightingale’s fervent belief was that “organized nursing education would provide a means to raise nursing to a respectable endeavor” (Judd & Sitzman, 2014, p. 71). The Nightingale Fund supported this school which was intended to train nurses to care for patients in the hospital and home, as well as to teach other nurses. Students were known as probationers and were taught for one year. Upon completion, they worked at the hospital for another 3 years. This Nightingale nursing education model was so successful that it was copied at other schools in Europe and the US (Judd & Sitzman, 2014). This Nightingale Model was the foundation for nursing education in the US beginning in the mid-1800s.

Nightingale wrote the famous Notes on Nursing in 1859-1860. Nightingale suffered from chronic illness for the remainder of her life, therefore she wrote to promote her ideas. She used her great intelligence to compose letters and consult with hospitals and to share her philosophy of nursing and health care. She consulted with many hospitals in England and beyond to collect data and support her ideas for improvement. Many assert that she was an early statistician and proponent of what we now call evidence-based practice. Dossey (as cited in Judd & Sitzman, 2014) stated that Nightingale was considered the first woman to gain membership in the Statistical Society of London. She developed a form of a pie chart called a coxcomb to illustrate data in an easy to understand manner.

Mary Seacole

Mary Seacole (1805-1881) was a Jamaican healer and caregiver. She learned her healing arts from her Jamaican mother who was known as a traditional healer. Her father was a Scottish soldier. Seacole spent much time nursing the sick, including victims of a cholera epidemic in Panama (Science Museum, n.d.).

When the Crimean War started in 1853, Seacole traveled to London and offered to serve on Nightingale’s team of nurses. Seacole was turned down, probably due to her ethnicity. Rather than return to Jamaica and abandon her plans, Seacole traveled to the Crimea and later established the British Hotel. This hotel served food, provided lodging, and became Seacole’s base for her expeditions to the battlefront in Crimea to offer her caregiving and nursing services (Science Museum, n.d.). Seacole visited Nightingale in Scutari to offer her nursing services, but was again refused (Ellis, 2009).

Summary of the Overview The Nightingale Years

We have explored the fascinating story of Florence Nightingale this week. As the founder of modern nursing, Nightingale’s story has a place in our hearts, our history, and our future.

Nightingale’s Accomplishments

 

  1. What were Nightingale’s greatest accomplishments?

View Answer

Mary Seacole

  1. What was Seacole’s relationship with Nightingale?

"<yoastmark

Do you need help in regards to Overview The Nightingale Years? We are ready to help.

Overview of the Pre-Nightingale Years

Overview of the Pre-Nightingale Years. This week, we’ll consider the impact of faith traditions on nursing service and practice, nursing prior to the 19th century, the relationship of nursing and medicine in the pre-Nightingale years, and famous nurses of that time period. Let’s explore the impact of this time period.

Nursing Prior to the 19th Century

Roman Catholic Nursing Nuns

As Christianity gained influence in the Middle Ages, nuns and monks served God by caring for the sick. While monks cared for men, nuns cared for ill women. Nutting and Dock (as cited in Hood, 2014) claimed that Hildegarde (a nun in the 12th century) greatly influenced the dominance of women in nursing. She was known for her powers in healing the sick, her outspoken manner, and her scientific writings.

By the 12th century, Nutting and Dock (as cited by Hood, 2014) reported, nursing was part of the work of French nuns. It was widely believed that nursing nuns provided more structured care for the sick. By the 16th century (Protestant Reformation), many hospitals were removed from church control and turned over to cities in England and France. Nursing nuns were replaced by lay servants who had little knowledge of the care of the sick. Conditions for patients and staff rapidly deteriorated.

Fast Facts!

 

In the United States, there are many religious healthcare systems that still carry the names of these healing-oriented religious orders.

Hospitals and Nursing

Hotel Dieu in Paris is generously known as one of the world’s oldest hospitals. Precursors of hospitals in America in the 17th and 18th centuries were almshouses (care for the sick poor) and pesthouses (hospitals for persons with contagious diseases). The first true hospital in America was founded in Philadelphia in 1751. Hospitals of that time period were filled with sick people too poor to afford private physicians in their own homes (Kalisch & Kalisch, 1995).

Nurses of the 17th and 18th centuries were usually women who were often illiterate and poor. Hospitals not overseen by churches were considered unclean places where the indigent went to die. Physicians and servants cared for wealthy persons in their own homes. Nurses of that time period included women who were offered the opportunity to serve as nurses rather than go to jail for drunkenness or prostitution (Donohue, 1996). The years 1550 to 1750 are known as the Dark Period of Nursing (Donohue, 1996).

Changes in society and nursing during the Protestant Reformation resulted in men being almost completely removed from nursing (Donohue, 1996). At this time in history, nursing became almost entirely a women’s pursuit.

Because few medications or treatments existed during this time period, nursing care consisted mainly of cleaning, cooking, and comfort care for the sick and dying. Although these were the duties, the hospitals remained unsanitary and understaffed. There were no clear job descriptions or qualifications for nurses, and they were rarely paid a living wage (Donohue, 1996).

During the 17th and 18th centuries, a great explosion of scientific knowledge changed medicine. These changes would later lead to nursing becoming a knowledge-based practice. As treatments became more complex, it was evident that caring and desire to help were not sufficient qualifications for nursing. Knowledge and skill would soon become essential components of nursing (Donohue, 1996).

Reflection 

What discoveries of the 17th and 18th centuries helped nursing to become a knowledge-based profession?

Nursing Education and Religious Institutions

Nursing education has long been influenced by religion and its institutions. Because many of the first hospitals in Europe and America were sponsored and supported by Catholic, Protestant, or Jewish religions, the nurses educated there were greatly influenced by those faith traditions. Although nursing students were not made to join religious orders, many nursing schools of the early through the mid-20th century accepted only unmarried female students. Discipline, devotion, obedience, service, and study were mainstays of the curriculum and life in the schools. Students as late as the mid-20th century were rarely allowed to live away from the school dormitory, which hearkens back to the days when nurses were nuns who lived in convents.

Relationship of Nursing to Medicine Prior to the 19th Century

Nurses in the 17th and 18th centuries were usually untrained women who cared for patients in homes or hospitals. Schools of nursing, as we know them today, did not exist. Physicians were usually men who had completed some readings from medical books and were primarily trained in apprenticeships with practicing physicians. After this short training, young physicians began independent practice. They earned small fees for their services and often supplemented their income with other occupations. Medical education in this time period was better developed in Europe than in America, but by 1767, there were two medical schools in the American colonies (Kalisch & Kalisch, 1995). In contrast to the developing system of medical education, nursing care at that time was still provided mostly by family members or servants.

Treating illnesses in those centuries was significantly different from the complex treatments of today. Communicable diseases limited patient lifespans. Infant and child mortalities were high. Adults often did not live to what we now consider middle age. Treatments consisted of herbs, folk remedies, bleeding, and purgatives. Patent medicines (unproven mixtures of unidentified ingredients) were often sold as treatments for numerous ailments (Kalisch & Kalisch, 1995). Nursing care was often centered on providing comfort and cleanliness.

Nursing in the U.S. Revolutionary War

The U.S. Revolutionary War (1775–1781) originally did not have the benefit of nurses. Donahue (as cited in Judd & Sitzman, 2014) reported that after General George Washington saw the need to provide care to sick or injured troops, women were hired for a sum of $2 per month to provide nursing services that mainly consisted of cooking and cleaning. No experience or education in nursing were necessary. There is little record of these nurses.

Faith-Based Influences on Nursing in the 19th Century

Elizabeth Seton was an American-born woman who founded the Sisters of Charity in 1807. This group was later called the Daughters of Charity. Seton and her followers developed a series of 44 reputable hospitals in the United States in the 19th century. These nursing nuns became successful at both hospital management and nursing (Nelson, 2001).

Nursing uniforms are often thought to be derived from nuns’ habits. Nursing caps were reminiscent of nuns’ veils. In some countries (most notably England and Australia), nurses were called sisters well into the 20th century. Although there are far fewer nursing nuns today than in the past, their impact is still felt in many areas. At a time in our history when women held little power, nursing nuns held many powerful posts in Catholic hospital administration.

The Religious Sisters of Mercy, led by Catherine McAuley in Ireland in the early 1800s, developed a system known as careful nursing. Their work included physical, emotional, and spiritual aspects of care. The 10 key concepts of careful nursing (Meehan, 2003, p. 102) included

Transcript

These Irish nurses later used this system in the Crimean War, as well as in Ireland.

Reflection of the Overview of the Pre-Nightingale Years 

How are the key concepts of careful nursing still used today?

Summary

This lesson focused on nursing prior to the Nightingale years. The impact of faith and religion on nursing service was explored. It is evident how these factors still influence nursing today.

Religious Sisters of Mercy

 

  1. What philosophy of nursing care was developed by the Religious Sisters of Mercy led by Catherine McAuley in Ireland?

 

View Answer

Characteristics of Nurses

 

  1. What were some of the characteristics and duties of 17th and 18th century nurses?
Overview of the Pre-Nightingale Years

Overview of the Pre-Nightingale Years

do you need any help in regards to Overview of the Pre-Nightingale Years? we are ready to help

Overview of the Nursing History

Overview of Nursing History. In order to consider how we and our colleagues are making nursing history today, we must first examine our past. Nursing has a rich heritage of service to others across many centuries. Together, we’ll explore many aspects of nursing history, beginning this week with the earliest records of nursing care. We’ll also consider the key components and trends that impact nursing history.

Let’s begin our journey.

Key Components Impacting Nursing History

According to Judd and Sitzman (2014), “. . . past events (even some that occurred hundreds of years ago) still exert a profound influence on current nursing practice, particularly in relation to seven basic trends: image, education, advancement in practice, war, workforce issues, licensure/regulation, and research” (p. 2). As we proceed in this course, we will see how these components have impacted nursing through the years and how they continue to do so. Consider each of these components and trends each week as you read the Lesson and assigned readings and as you complete the discussions and assignments.

Early Nursing

Humans living in communities have cared for each other for many centuries. Nutting and Dock (as cited in Hood, 2014) reported that care for the sick in community locations has been reported as early as 3000 BCE. In the pre-Christian era, the sick were cared for by men considered pure in spirit, clean, kind, skillful, and clever. Since medications and treatments were not highly developed, nursing interventions were of a more holistic nature.

Reflection

Why were men nurses in ancient civilizations?

Some early civilizations used public health measures such as water and sewage systems, food inspection and prohibitions, and even quarantines (Hood, 2014). Nutting and Dock (as cited in Hood, 2014) reported that many ancient European cultures held women in high regard, especially those who were wise and skilled in treating wounds and attending childbirth. In several civilizations and cultures, women in a community cared for ill family members or neighbors.

Nursing in ancient times was closely tied to beliefs, faith, and special powers. Prior to the Crusades of the 11th century, care was provided by monks to pilgrims who fell ill during trips to the Holy Land (Kalisch & Kalisch, 1995). We will learn more about the influence of religion and faith traditions on nursing in Week 2.

Deaconess Movement: The Foundation for Chamberlain College of Nursing

Early Christian Deaconesses

Nutting and Dock (as cited in Hood, 2014) traced the deaconess movement to ancient Roman times. Early Christians (especially wealthy women) considered it their duty to care for the sick. Phoebe was considered the founder of visiting nursing in 60 CE. Deaconesses of that time sometimes opened their homes to the sick by forming home hospitals.

The term deaconess is derived from the Greek word diakonos, which means “one who is devoted to loving service,” and it is interpreted to mean a messenger, servant, or helper. Rasche (1994) noted that the roots of the Deaconess Sisters date back to the origins of the Christian Church. The Apostle Paul first used the term deaconess to describe Phoebe, a Greek female leader of the early Christian community. If you read his letters, you will find that at the beginning of the Christian movement, women played an essential role as missionaries. Early religious records demonstrate that women functioned not only as preachers, teachers, and leaders in communities, but also as nurses caring for the sick, the poor, and the victimized. As deaconess services became essential to the church, deaconesses acquired an esteemed position and were considered clergy.

After the initial high reputation of deaconesses in early Christendom, their influence declined during the Middle Ages when the role of women in society in general, and in the Church in particular, was significantly diminished. The function of the deaconesses was taken over, to some extent, by Roman Catholic nuns, who sometimes provided care for the sick in their convents. In the 16th century, after the Reformation, many of these places were shut down, especially in Northern Europe.

Deaconess Home and Hospital and the Work of the Fliedners

Theodor Fliedner was responsible for the modern reemergence of deaconess work. On his travels throughout Europe, he had become distressed by the misery of the poor, the sick, the elderly, and the outcasts. The accomplishments of Mennonites, who provided care for the sick in Holland, and especially the accomplishments of Elizabeth Fry, who cared for released prisoners in England, inspired him to serve. With the help of his wife, Frederike, he established the Deaconess Home and Hospital in Kaiserwerth, Germany, in 1836. This was the first deaconess institution of its kind in Europe. Deaconess work became a prime example of inspiration for the deaconess movement throughout the world (Rasche, 1994).

Florence Nightingale visited the Fliedners’ hospital twice and was so impressed that she decided to study there for 3 months in 1851. Her experience with the Deaconess Sisters became the turning point in her life, and the love and devotion that they exhibited inspired her future mission.

Fast Facts!

  • The earliest reference to a deaconess is found in the Bible in the Apostle Paul’s letters.
  • Theodor Fliedner is responsible for the modern-day revival of the deaconess work in Europe.
  • Florence Nightingale, the founder of modern professional nursing, was greatly influenced by the Deaconess work in Kaiserwerth, Germany.

The Fliedners’ project was revolutionary for its time. The Deaconess Home enabled young women to attain a more liberated social status and helped support the reform of nursing practice.

Imagine that you are a candidate for enrollment in the Deaconess Home in Kaiserwerth. Before you make a definite decision, think about what life in the Motherhouse, the home of all deaconesses, might look like. What are your expectations?

The following are some of the distinctive features of the Deaconess Motherhouse (Rasche, 2015).

 

Previous

Distinctive Features of the Deaconess Motherhouse

In addition to providing nursing care, Deaconess Sisters also spent their time teaching, performing parish work, and serving as missionaries. Above all, however, nursing always took priority in their work.

Distinctive Features of the Deaconess Motherhouse

Distinctive Features of the Deaconess Motherhouse

Only single women could become Deaconesses. The 16-hour workdays required a commitment from a Deaconess that was simply incompatible with care for her own family.

Distinctive Features of the Deaconess Motherhouse

The Deaconess Motherhouse offered living and working opportunities outside of the family in a company of women of a similar mindset and devotion. This revolutionary situation enabled women to lead emancipated lives, about which other women could only dream. Deaconesses were relieved of the obligations and burdens associated with childbearing and child-rearing, which otherwise constituted an essential role of every married woman of that time.

Distinctive Features of the Deaconess Motherhouse

Families in the late 19th century neither wished their daughters to be independent nor expected them to become educated. They wanted them to find suitable husbands. In general, only daughters of wealthy families could receive any education at all, and that was usually limited to an elementary level. However, Deaconesses were provided with a good education.

Distinctive Features of the Deaconess Motherhouse

The Fliedners, fully aware of the strong ties existing within 19th century families, insisted on parental consent as part of the admission requirements for Deaconess work.

Distinctive Features of the Deaconess Motherhouse in regards to Overview of the Nursing History 

Deaconesses had no “married to the church” obligation as nuns have. They were free to leave their work and go back to their families if they wished to do so. This choice probably helped Fliedner in his recruitment of young women, because it was easier to obtain parental consent if parents retained hope that their daughter would change her mind and soon return to them.

Distinctive Features of the Deaconess Motherhouse in regards to Overview of the Nursing History 

Celibacy was a necessary requirement for Deaconesses. The Sisters, however, could leave the organization and marry, as many of them eventually did.

Distinctive Features of the Deaconess Motherhouse

Deaconesses received no real wage, only a small stipend for personal needs. They would be unable to save money to support themselves when they reached old age or became ill. The Fliedners, however, practiced what could be called an early type of social security by providing complete lifetime care for Deaconesses.

Distinctive Features of the Deaconess Motherhouse in regards to Overview of the Nursing History 

Besides providing care for the in-need segments of the population, the Deaconess Home and Hospital functioned as a training school and a local congregation for Deaconesses. Deaconess Sisters constituted a community of believers and said prayers together at the beginning of each workday.

Distinctive Features of the Deaconess Motherhouse in regards to Overview of the Nursing History 

In addition to providing nursing care, Deaconess Sisters also spent their time teaching, performing parish work, and serving as missionaries. Above all, however, nursing always took priority in their work.

Distinctive Features of the Deaconess Motherhouse in regards to Overview of the Nursing History 

Next

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10

 

  • Only single women could become deaconesses. The 16-hour workdays required a commitment from a deaconess that was simply incompatible with care for her own family.
  • The Deaconess Motherhouse offered living and working opportunities outside of the family in a company of women of a similar mindset and devotion. This revolutionary situation enabled women to lead emancipated lives, of which other women could only dream. Deaconesses were relieved of the obligations and burdens associated with childbearing and child rearing, which otherwise constituted an essential role of every married woman of that time.
  • Families in the late 19th century neither wished their daughters to be independent nor expected them to become educated. They wanted them to find suitable husbands. In general, only daughters of wealthy families could receive any education at all, and that was usually limited to an elementary level. However, deaconesses were provided with a good education.
  • The Fliedners, fully aware of the strong ties existing within 19th century families, insisted on parental consent as part of the admission requirements for deaconess work.
  • Deaconesses had no “married to the church” obligation as nuns have. They were free to leave their work and go back to their families if they wished to do so. This choice probably helped Fliedner in his recruitment of young women because it was easier to obtain parental consent if parents retained hope that their daughter would change her mind and soon return to them.
  • Celibacy was a necessary requirement for deaconesses. The Sisters, however, could leave the organization and marry, as many of them eventually did.
  • Deaconesses received no real wage, only a small stipend for personal needs. They would be unable to save money to support themselves when they reached old age or became ill. The Fliedners, however, practiced what could be called an early type of Social Security by providing complete lifetime care for deaconesses.
  • Besides providing care for the in-need segments of the population, the Deaconess Home and Hospital functioned as a training school and a local congregation for deaconesses. Deaconess Sisters constituted a community of believers and said prayers together at the beginning of each workday.
  • In addition to providing nursing care, Deaconess Sisters also spent their time teaching, performing parish work, and serving as missionaries. Above all, however, nursing always took priority in their work.

The Fliedners’ innovative approach to the practice of nursing was their most important contribution to the deaconess movement. The model encompassed spiritual, intellectual, and technical aspects of learning. Such a revolutionary method altered the classical image of nursing. Nurses in the 19th century were not viewed as respected professionals, and hospitals were seen as places to die, not to regain health. Thus, the Motherhouse soon became a superior care provider in comparison to traditional health facilities. In all features of their work—spiritual, intellectual, and technical—deaconesses offered reliable, thorough, and loving care.

Fast Facts in regards to Overview of the Nursing History 

The Fliedner model was a pioneer in structured nursing practice.

Evangelical Deaconess Society in St. Louis

The beginning of the deaconess work in the United Church of Christ was associated with the foundation of the Evangelical Deaconess Society in St. Louis in 1889. The Deaconess Society created its board of directors, which included four women with full voting privileges. This inclusion of women in policy-making procedure was a dramatic revolutionary step for women’s rights (Rasche, 1994).

Fast Facts in regards to Overview of the Nursing History 

In the late 19th century in the United States, women could not vote in political elections.

 

The Intertwined History of the Deaconess Society and Chamberlain College of Nursing

Overcoming early hardships, the Deaconess Society began to grow. Expansion brought unexpected difficulties with it, but these problems were soon solved, and the Society began to flourish. The development of Deaconess Societies reflected the demands of social progress. Because of the improvements in medicine and technology that transformed nursing practice into an increasingly specialized service, deaconesses became highly skilled professionals with advanced academic degrees.

Deaconess Hospital opened in St. Louis, Missouri, in 1889 (see photo). In 1890, the School for Deaconesses began there, also. The photo of four women shows the first two Evangelical Deaconess Sisters and the first two probationers at the St. Louis school. This school trained the deaconesses to become nurses. Many worked at Deaconess Hospital (Rasche, 1994; Rasche, 2015).

Previous

First Two Evangelical Deaconess Sisters and Probationers

 

First Deaconess School

 

First Two Evangelical Deaconess Sisters and Probationers

 

First Deaconess School

 

Next

  • 1
  • 2

In 1913, the State Board examination was given for the first time in Missouri. Sister Sophie Hubeli became the first deaconess to pass the state board examination and receive the title “Licensed Registered Deaconess Nurse.” In 1921, with the advancement of women’s rights, which included suffrage, deaconesses for the first time were officially recognized as having denominational standing. In 1943, The Deaconess School of Nursing for lay students was opened to function alongside the school for deaconesses. In the 1970s, men joined the student body of Deaconess School of Nursing. The Deaconess College of Nursing started offering a Bachelor of Science degree in nursing in 1983 (Rasche, 1994; Rasche, 2015).

Deaconess Society in the Latter Half of the 20th Century

Recruitment into the Deaconess Society was terminated in the 1950s because women gradually acquired access to numerous opportunities in Christian service. In 1952, the Deaconess Society became the Deaconess United Church of Christ. Although young women today are interested in nursing practice, most no longer want to commit themselves to the devoted life of deaconesses. Moreover, the United Church of Christ has begun to admit women as candidates for ordination as missionaries and pastors. Consequently, the need for the parish deaconess sister has been eliminated. Sister Marie Lee, the last surviving deaconess, died in 2010 (Rasche, 1994; Rasche, 2015).

Recent Developments and Care

Deaconess College of Nursing graduated highly proficient nurses for over 100 years. It has had a remarkable ability to expand and adapt to the changing needs of the nursing profession. The College offered its first online CE and BSN courses in 2000. In 2005, DeVry Education Group (now known as Adtalem Global Education), a highly respected North American educational system, purchased Deaconess College of Nursing and renamed it Chamberlain College of Nursing. The name, derived from the Middle English word chaumberlein, meaning a “chief steward,” was selected to exemplify the nurse as the chief steward of patient care and to underscore the solid historical foundation of Deaconess School of Nursing and Deaconess College of Nursing (Chamberlain University, n.d.).

Chamberlain College of Nursing has increased access to nursing education by expanding from a regional to a national nursing program. Now there are tens of thousands of students and alumni collectively building the future of nursing.

If you have not already done so, take this time to read the brief history of Chamberlain on the college website: Our History and Heritage: http://www.chamberlain.edu/about/history (Links to an external site.)

At Chamberlain, “care is what distinguishes us—Chamberlain Care” (Chamberlain University, n.d.). The philosophy and actions of Chamberlain Care flow directly from our roots in nursing history and our deaconess heritage into the future by empowering and educating extraordinary nurses who will continue to impact nursing history.

Summary of Overview of the Nursing History

This week’s Lesson has covered some of the features of nursing during the early years and Deaconess and Chamberlain nursing history. This is just the beginning of our journey into nursing history. We’ll study many more aspects of nursing history in the coming weeks.

History of Nursing

 

  1. Have nurses always been women?

 

View Answer

Deaconess and Chamberlain History

 

  1. What were some characteristics of persons who entered Deaconess facilities?
Overview of the Nursing History

Overview of the Nursing History

Assessment of the Hospitalized Client

Putting It All Together: Rapid and Focused Assessment of the Hospitalized Client. This week, you will continue to put the pieces together and gain the skills necessary to complete a concise, accurate, and rapid head-to-toe assessment. You will build on what you have reviewed in the past weeks regarding interviewing, observing, and assessing to gather information.

Rapid Assessment

The rapid assessment requires a minute or less to complete. This is your first encounter with your clients and collection of this data will enable you to prioritize your tasks. Check the client’s identification, and identify yourself. Is the client awake and alert? Observe for any signs of distress, skin color, and assess skin temperature. Observe the client’s response to you. Is the response clear and speech appropriate for age? Document your findings and let the client know that if you must leave you will be returning shortly. Try to give an accurate time frame, such as 15 or 30 minutes.

Bedside Head to Toe

We need to put all of the different puzzle pieces together in a head-to-toe assessment because we typically start at the top and work our way down in a set order, but you can fine-tune or finesse the process to best fit your style and needs. The important part is to have a set way that you conduct assessments each and every time so that you do not miss any steps. Consider what the key is going to be for you. How are you going to approach your head-to-toe assessments so that you consistently obtain all the information you need each time?

Bedside Head to Toe Assessment

Bedside Head to Toe Assessment

Focused Assessment of the Hospitalized Client

Now that you have a systematic approach identified for your basic head-to-toe assessment, how do you make this applicable to the hospitalized client? When you first receive a report, you will want to take a quick peek at each of your clients. Go around and introduce yourself to each of your clients and perform what is called a rapid assessment. In 1 or 2 minutes, quickly scan the client, the room, and the equipment. This big-picture look will help you to determine how to prioritize the full head-to-toe assessment. Take a look at the image and complete the questions that follow.

Questions to Consider

 

  1. What is the first thing you should do when you enter the room?

 

View Answer

  1. Based on the picture, what do you believe is the client’s overall level of consciousness?

 

View Answer

  1. Based on the picture above, do you believe that this client is in immediate distress?

 

View Answer

  1. What equipment do you notice in the room that may need the nurse’s attention?

 

View Answer

Summary

You have completed the process of assessing every major body system. You have learned how to put together a head-to-toe assessment that you can use to gather the information needed to care for hospitalized clients. The systematic approach you have learned will enable you to quickly identify when and where you need to drill down to gain more information.

Assessment of the Hospitalized Client

Assessment of the Hospitalized Client

Respiratory and Cardiovascular Assessment

Respiratory System. The ABCs of Respiratory and Cardiovascular Assessment. Throughout your nursing career thus far, you have undoubtedly heard a lot about the ABCs: airway, breathing, and circulation. As you are aware, this is how we prioritize many nursing interventions, regardless of the specifics of a given scenario.

The initial assessment of the client is accomplished through observation. Look at the client’s appearance. Visualize the ABCs as the sides of a triangle that work together to give you an initial impression of the client’s overall well-being.

When assessing the client’s appearance, first look at the overall body position and how the client holds him or herself. Ask yourself, what is the client’s mental status? Does the client look comfortable?

Next, assess the client’s breathing. Is the client working hard to breathe? Is the client using accessory muscles to move air in or out?

Finally, assess the client’s circulation. What is the overall skin and nail color? Is it normal for the client’s age and race?

Assessing a client through the lens of the ABCs gives you a good idea of whether you need to drill down into the client’s respiratory and cardiovascular systems during the head-to-toe assessment.

History

The general survey is the beginning of the investigation, but to obtain more information, the right questions still need to be asked. Common complaints related to the respiratory system include shortness of breath, coughing, wheezing, and chest pain. Complete this activity to help hone your interviewing skills.

Asking the Right Questions: Respiratory System

 

  1. The client comes in complaining of shortness of breath.

View Answer

  1. The client comes in complaining of a cough that has persisted “for forever.”

View Answer

  1. Some questions that you could ask right now include the following.
    • Is the cough productive?
    • If it is productive, how much sputum does it produce? What does the sputum look like?
    • How long have you had the cough? Has it changed recently?
    • What makes the cough better?
    • What makes it worse?
    • Do you take any medications for your cough? If so, what and how often?
    • What time of day do you cough most often?
    • Are you coughing up blood?

View Answer

Landmarks

Landmarks are places on the external body that help you locate internal structures. Landmarks help you find lung fields so you can listen and compare them to each other. Consistent use of the same landmarks during assessment and documentation helps to accurately communicate findings among members of the healthcare team.

In addition to physical landmarks, there are sound landmarks where, if you listen with a stethoscope, you can expect to hear certain breath sounds. There are four types of normal breath sounds that are described in your reading assignment. It is important to know how to identify normal sounds and where you would expect to hear them. If you hear a different kind of normal breath sound over an area where you would not expect to hear it, this could be a sign of a serious problem that needs to be investigated further.

Interactive- Breath Sounds

Click Here (Links to an external site.)

Transcript (Links to an external site.)

Special Considerations For Older Adults and Children

In older adults, the chest wall becomes stiffer and harder to move. Lungs lose some of their elasticity, and respiratory muscles weaken. Usually the capacity for exercise decreases. Skeletal changes occur that accentuate the curve of the thoracic spine, which produces kyphosis and increases the AP diameter of the chest. This does not usually affect function.

In children, the exam is usually unchanged from that of an adult, with emphasis on distraction, so you may get the children to take a deep breath to auscultate their lungs.

Smoking

Despite major state, federal, and international initiatives, tobacco use remains the single most preventable cause of death and disability in the world today. Smoking has been linked to lung diseases including COPD, emphysema, and chronic bronchitis, most forms of lung cancer as well as various other types of cancer including bladder, colon, and kidney among others (CDC, 2010; HHS, 2014). In addition, smoking has been found to increase the risk for developing cataracts, type II diabetes, and Rheumatoid arthritis.

Each year in the United States, smoking-related diseases claim the lives of 480,000 with an additional 50,000 deaths occurring as the result of exposure to secondhand smoke (CDC, 2010; CDC, 2014; HHS, 2014). Smoking causes diminished overall health, including self-reported poor health, days of work lost, and greater healthcare costs (HHS, 2014).

Smoking Cessation

Nurses and other healthcare professionals play a crucial role in directly helping tobacco users quit, but they need to collaborate with tobacco-control advocates in their communities to develop a comprehensive tobacco control program as these programs promote quitting smoking and help smokers stay nonsmokers. It takes community collaboration to decrease the death, disease, and suffering caused by tobacco use. A community needs a collective will to implement the best practices for community intervention (Fildes & Blacher, 2015, p.332).

Best Practices in Community Interventions

  • Raise prices (taxes)
  • Clean indoor air
  • Create counter marketing
  • Provide cessation aids: counseling and pharmacotherapy, alone or in combination
  • Directly by clinician in individual or group sessions (in-patient or out-patient settings)
  • Toll-free telephone quit line

The Best Practices in Community Interventions highlight the role of smoking cessation, counseling, and pharmacotherapy in helping smokers quit. The Public Health Service Guideline Treating Tobacco Use and Dependence.

An excellent resource filled with approaches on how to help your patients to quit smoking may be found at the CDC (2015) at http://www.cdc.gov/tobacco/campaign/tips/partners/health/hcp/ (Links to an external site.).

Nurses, physicians, health educators, and other trained medical and health professionals are positioned to deliver brief interventions during primary care visits or other similar office visits and by doing so capitalize on teachable moments.

Visit http://www.surgeongeneral.gov/library/reports/50-years-of-progress (Links to an external site.) and read the Surgeon General’s report to learn more about the devastating effects of tobacco use and the resources available to assist your patients with smoking cessation. How could you apply what you have learned to convey a teachable moment?

Summary

Smoking and second-hand smoke place individuals at increased risk for developing diseases of the respiratory system. Nurses must have a strong understanding of the normal assessment findings associated with the respiratory system in order to be able to quickly recognize changes and signs of deterioration.

respiratory and cardiovascular assessment

respiratory and cardiovascular assessment

do you need help in regards to respiratory and cardiovascular assessment? we are ready to help you.

cardiovascular and peripheral vascular systems

This week, we will review the cardiovascular and peripheral vascular systems. Heart disease is the number-one killer of adults in the United States. We will be drilling down into these systems and refreshing your various assessment skills as well as discussing health promotion activities for all ages.

Healthy People 2020 ( DHHS, 2014) goals include educating adults age 20 and older on recognizing and acting upon symptoms of heart disease. Healthier lifestyle changes starting with preventing childhood obesity and teen smoking are important first steps in reversing these trends for the next generation.

Reference:

Department of Health and Human Services (DHHS). (2014). Healthy People 2020. Retrieved from http://www.healthypeople. gov /

Outcomes

1

Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO #1)

Weekly Objectives

  • Differentiate normal from abnormal findings in the assessment of the cardiovasculars and the  peripheral vascular systems in just a few words that are necessary.

2

Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO #1)

Weekly Objectives

  • Identify anatomical, developmental, psychosocial, and cultural variations that guide assessment of the cardiovasculars and the peripheral vascular systems in a one comprehensive paragraph or two comprehensive paragraphs.
  • Describe the skills and techniques required to assess the cardiovasculars and peripheral vascular systems and document findings.

3

Utilize effective communication when performing a health assessment. (PO #3)

Weekly Objectives

  • Develop questions to be used when completing a focused interview for the cardiovascular and peripheral vascular systems.

4

Identify teaching/learning needs from the health history of an individual. (PO #2)

Weekly Objectives

cardiovascular and peripheral vascular systems

cardiovascular and peripheral vascular systems

do you need any help in regards to cardiovasculars and peripheral vascular systems? we are more than ready to help

 

assessment of the neurological system

week, we will focus on the assessment of the neurological system. The nervous system is a complex system that must stay in balance to enable the client to perform all functions of activities of daily living, remain in optimum physiologic functioning, and maintain independence.

This week, you will complete the following.

  • Differentiate normal from abnormal findings in the assessment of the system. (CO 1)
  • Identify anatomical, developmental, psychosocial, and cultural variations that guide assessment of the neurological system. (CO 2)
  • Describe the skills and techniques required to assess the neurological system and document findings. (CO 2)
  • Develop questions to be used when completing a focused interview for the neurological system. (CO 3)
  • Discuss the focus areas related to overall health of the neurological system in Healthy People 2020(DHHS, 2014) initiatives. (CO 4)

Reference:

Department of Health and Human Services (DHHS). (2014). Healthy People 2020. Retrieved from http://www.healthypeople.gov/

Outcomes

1

Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO #1)

Weekly Objectives

  • Differentiate normal from abnormal findings in the assessment of the neurological system.

2

Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO #1)

Weekly Objectives

  • Identify anatomical, developmental, psychosocial, and cultural variations that guide assessment of the neurological system.
  • Describe the skills and techniques required to assess the neurological system and document findings.

3

Utilize effective communication when performing a health assessment. (PO #3)

Weekly Objectives

4

Identify teaching/learning needs from the health history of an individual. (PO #2)

Weekly Objectives

  • Discuss the focus areas related to overall health of the neurological system in Healthy People 2020.

Previous Next

assessment of the neurological system

assessment of the neurological system

The neurological system class study

Neurological System class study . The neurological system consists of two parts. The central nervous system (CNS) encompasses the brain and spinal cord. The peripheral nervous system includes all of the nerve fibers found outside of the brain along with the cranial and spinal nerves. The peripheral nervous system carries sensory (afferent) messages to the CNS from sensory receptors, motor (efferent) messages from the CNS out to muscles and glands, and autonomic messages that govern the internal organs and blood vessels (Jarvis, 2016).

Neurological Disorders

Diseases of the brain, spine, and the nerves that connect them are referred to as neurological disorders. According to the National Library of Medicine (2016), more than 600 neurologic diseases are known today including many that you already know such as epilepsy, brain tumors, Parkinson’s disease, Multiple Sclerosis, and stroke. But there may be a number of those with which you may not be familiar such as frontotemporal dementia and Moya Moya Syndrome.

While the cause of many of these diseases remains unknown, others may be attributed to cerebrovascular disease, brain cancer, neuro-infections, trauma, and even malnutrition (WHO, 2016).

With a staggering number of individuals worldwide being diagnosed with a neurological disorder and/or living with the devastating effects of one of them each year, the importance of conducting a rapid and accurate assessment of the neurological system cannot be over stressed.

Reflection

Please take a moment to reflect on your current assessment practices as they relate to the neurological system. What assessment tools are available to you in your workplace? In comparison to the assessment described in this week’s readings how would you rate your current practice in terms of timeliness and accuracy?

Stroke

According to the American Stroke Association (2016), stroke is the fifth leading cause of death and is the leading cause of adult disability in the United States. A stroke, also referred to as a brain attack, occurs when the blood supply to part of the brain is disrupted causing decreased oxygen in the affected area of the brain and death to brain cells. When this occurs, the abilities controlled by that portion of the brain are lost.

The location of the stroke in the brain and the amount of the brain that is damaged will determine how the person will be affected by it. Symptoms can vary widely and range from temporary weakness of an arm or leg to permanent paralysis on one side of the body and the inability to speak. While some people will recover completely from a stroke, more than two-thirds of them will be left with some type of disability (American Stroke Association, 2016).

Your Turn!

Visit the American Stroke Association website at http://www.strokeassociation.org/ (Links to an external site.). Click on the professional tab and then target stroke to review best practice information for the assessment and treatment of patients presenting with stroke-like symptoms. How does your organization’s door-to-needle times compare to the recommended times?

Traumatic Brain Injury

Any blow, jolt, or penetrating head injury that results in the disruption to the normal function of the brain is referred to as a traumatic brain injury. Due to the complexity of the brain, every injury to the brain is different. Symptoms and recovery times will be individualized and can vary greatly depending on the severity of the injury (Jarvis, 2016). Please review the quick reference tool from the American Academy of Neurology, which can be found on page 268. Click on the link below to learn how to perform a quick check for concussion.

https://www.aan.com/siteassets/home-page/tools-and-resources/practicing-neurologist–administrators/patient-resources/sports-concussion-resources/17concussionreferencesheet_tr.pdf (Links to an external site.)

Post Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) can develop whenever an individual has experienced a traumatic event involving real or threatened death such as with military combat, terrorist attacks, assault, serious accidents, and natural disasters (Jarvis, 2016).

While most people experiencing trauma will report suffering from intense fear, anxiety, and the feeling that they had no control over the situation immediately following the event, not all will go on to develop PTSD. It is when the symptoms do not diminish over time or begin to disrupt the person’s life that the possibility of PTSD must be considered (U.S. Department of Veterans Affairs, 2016).

Factors contributing to the development of PTSD include

  • intensity and duration of the traumatic event;
  • injury to self or death of loved one during the event; and
  • proximity to the event.

Your Turn!

Please visit the PTSD website for the Department of Veterans Affairs at http://www.ptsd.va.gov/ (Links to an external site.) to learn about the resources that are available to our veterans suffering from this disorder. Next, conduct a brief Internet search to determine what resources are available in your local community to assist your patients. Do you believe these resources are adequate to meet the needs of the veterans living in your area?

Healthy People Initiative

The following are focus areas for neurologic health that have been outlined in Healthy People 2020 (DHHS, 2014).

Key Objectives For Alzheimer’s Disease

  • Increase the number of persons seen in primary healthcare who receive mental health assessment.
  • Increase the number of adults with mental disorders who receive treatment.

Key Objectives For Head Trauma

  • Reduce hospitalization for nonfatal head injuries.
  • Reduce deaths caused by motor vehicle crashes.
  • Increase the use of safety belts.
  • Increase the use of helmets by cyclists.
  • Reduce deaths by falls.

Summary The neurological system class study

In this lesson, we examined

  • assessment strategies associated with the neurological assessment, and
  • abnormalities related to assessment of the neurological system

Knowledge of these assessment strategies are necessary to completing a thorough physical examination.

The neurological system class study

The neurological system class study

observing our patients during first encounter

This week, we will dig a little bit deeper into the assessment process and discuss all of the information that can be acquired simply by observing our patients during that first encounter with them through the completion of the general survey. This brief simple observation provides you with not only the information that is needed to quickly alert you to signs of distress or decline, it can also provide valuable insight into the status of the individual’s integumentary and nutritional statuses as well as those are often the first areas noticed upon entry.

This week, we will complete the following.

  • Describe the process of conducting a general survey. (CO 5)
  • Differentiate normal from abnormal findings in the assessment of the integumentary system. (CO 1)
  • Identify anatomical, developmental, psychosocial, and cultural variations that guide assessment of the integumentary system. (CO 2)
  • Describe the skills and techniques required to assess the integumentary system and document findings. (CO 2)
  • Develop questions to be used when completing a focused interview for the integumentary system. (CO 3)
  • Discuss the focus areas related to overall health of the integumentary system in Healthy People 2020 (2014) initiatives. (CO 4)
  • Develop questions to be used when completing a focused interview related to nutritional status. (CO 3)
  • Differentiate between normal and abnormal findings in a nutritional assessment. (CO 1)

Outcomes

1

Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO #1)

Weekly Objectives

  • Discuss the phases and components of the general survey.
  • Differentiate between normal and abnormal findings in a nutritional assessment.
  • Differentiate normal from abnormal findings in the assessment of the skin, head, and neck.

2

Recognize the influence that developmental stages have on physical, psychosocial, cultural, and spiritual functioning. (PO #1)

Weekly Objectives

  • Examine how developmental stages affect your assessment of physical, psychosocial, cultural, and spiritual functioning.
  • Demonstrate normal from abnormal findings in the comprehensive assessment of the older adult.
  • Identify anatomical, developmental, psychosocial, and cultural variations that guide assessment of the skin, head, and neck.
  • Describe the skills and techniques required to assess the skin, head, and neck and document findings.

3

Utilize effective communication when performing a health assessment. (PO #3)

Weekly Objectives

  • Examine questions to be used when completing a focused interview for the skin, head, and neck.
  • Examine questions to be used when completing a focused interview related to an individual’s nutritional status.

4

Identify teaching/learning needs from the health history of an individual. (PO #2)

Weekly Objectives

  • Discuss the focus areas related to overall health of the skin, head, and neck in Healthy People 2020 initiatives.
  • Discuss the focus areas related to overall nutritional health in Healthy People 2020 initiatives.

5

Explore the professional responsibilities involved in conducting a comprehensive health assessment and provide appropriate documentation. (PO #6)

Weekly Objectives

  • Describe how the assessment of the integumentary system and nutritional status fits into the comprehensive health assessment and the associated documentation.

PreviousNext

observing our patients during first encounter

observing our patients during first encounter