Influences on nursing practice

Historical influences

According to the Fundamentals of Nursing authored by Barbara Kozier, Glenora Erb, Audrey Jean Berman, and Karen Burke, there are historical factors that influenced the development of contemporary nursing practice. In general, these aspects include women's roles, women's status, religious values particularly Christian values, war, society's attitudes, and visionary nursing leadership.

Women's roles and status

From the beginning of time, the traditional role of women had always been as wife, mother, daughter, or sister who took care of infants and children at home, and of other members of the community.

Religion

The Christian value of loving your neighbor as yourself and the parable of the Good Samaritan were a significant influence to the development of nursing practice, particularly in the Western world.

War

The existence of wars highlighted the need for nurses and nursing services. Significant wars that accentuated the need include the Crimean War (1854-1856) when Florence Nightingale took the role of addressing the inadequacy of care provided to soldiers; the American Civil War (1861-1865) when Harriet Tubman, Sojourner Truth, Mary Ann Biekerdyke, Clara Barton, Walt Whitman, and Louisa May Alcott acted as nurses for soldiers; and the Second World War when the evolution of auxiliary health care workers (i.e. practical nurses, aides, and technicians) under nurse supervisors and medical specialties in hospitals came into being in order to meet client needs.

Society's attitudes

Prior to the mid-1800s, nursing has no component of organization, education, and social status. It was a time when women were regarded as belonging only to the home and cannot have a career. If a middle-class woman from the Victorian era was to be educated, the purpose of the education was to make the woman "a pleasant companion to" the male spouse. The work of nurses at the time were regarded as a "repugnant form of domestic service" that required "little or no special training". During the latter part of the 19th century, Florence Nightingale made an effort during the Crimean War to bring respectability to nurses and the nursing profession. Nurses became the so-called "doctor's handmaiden". During the Second World War, nurses became heroines due to Elizabeth Kenny's (a nurse form Australia) and other nurses' contributions in battling agains poliomyelitis. During the late 1900s, nurses were portrayed either as sex object, surrogate mother, tyrannical mother, body expert, or body minder. During the early 1990s, steps had been taken by the Tri-Council for Nursing (includes the American Association of Colleges of Nursing, the American Nurses Association, the American Organization of Nurse Executives, and the National League for Nursing) to improve the image of nurses in society.

Cultural influences

Apart from being considered historically as a chore or task for women in the past, particularly during the 18th and 19th centuries, the practice of nursing were delegated to women who were at the time regarded as "subservient and inferior" to men. The cultural view changed after the Florence Nightingale's establishment of nursing as an occupation for educated women. Thus from Nightingale's efforts, nursing practice became the role of a woman "more favorably accepted" by society. However, in terms of training, remained under the "direction and control of the medical profession". The practice of nursing had to struggle for its own identity as a profession.

Educational influences

Before the 1950s, student nurses received lectures from doctors and learned only through hospital experience. The practice of providing nursing care was performed in accordance with the "control and direction" of physicians and the hospital administration. During this time, nurses had to "follow orders" and should have "common sense". A planned education curriculum was non-existent and nursing knowledge was still to be developed and unified.

Scientific influences

Befor the 1950s, apart from the traditional "learning through doctors" method, nursing practice was also based on "widely accepted scientific principles" instead of being based from "a body of knowledge" that was specific to nursing. Upon the arrival of the first half of the twentieth century, women joined the workforce as a consequence of World War I and World War II. By the 1950s, nursing became regarded as a science. Emphasis was given on education of nurses instead of on training. Nursing research, including its publications, was implemented. Contemporary nursing practice are now largely based on "sound rationales from nursing knowledge"