NCM 103:

FUNDAMENTALS
OF NURSING
CONCEPT OF:
MAN
HEALTH
ILLNESS
MAN

• Refers to all human beings.

• People are the recipients of nursing care; they
include individuals’ families, communities, and
groups.
HEALTH

• Traditionally health was defined in terms of the presence or

absence of disease.
• Florence Nightingale (1860/1969) defined health as a state of being
well and fully using every power the individual Possesses.
• The World Health Organization (WHO) (1948) takes a more holistic
view of health. Its constitution defines health as ―a state of
complete physical, mental, and social well-being, and not merely
the absence of disease or infirmity‖
HEALTH

• Traditionally health was defined in terms of the presence or absence of

disease.

• Florence Nightingale (1860/1969) defined health as a state of being well

and fully using every power the individual Possesses.

• The World Health Organization (WHO) (1948) takes a more holistic view
of health. Its constitution defines health as “a state of complete physical,
mental, and social well-being, and not merely the absence of disease or
infirmity”

• Health is a highly individual perception.

WELLNESS

• Wellness is a state of well-being.

• Basic aspects of wellness include:
- self-responsibility
- an ultimate goal
- a dynamic growing process
WELL-BEING

• Well-being is a subjective perception of vitality and

feeling well...can be described objectively,
experienced, and measured... and can be plotted on
a continuum“.
• It is a component of health.
ILLNESS

• Illness is a highly personal state in which the

person's physical, emotional, intellectual, social,
developmental, or spiritual functioning is thought to
be diminished.
• It is not synonymous with disease and may or may
not be related to disease.
ILLNESS

• Illness is a highly personal state in which the

person's physical, emotional, intellectual, social,
developmental, or spiritual functioning is thought to
be diminished.
• It is not synonymous with disease and may or may
not be related to disease.
ILLNESS

• Illness is a highly personal state in which the

person's physical, emotional, intellectual, social,
developmental, or spiritual functioning is thought to
be diminished.
• It is not synonymous with disease and may or may
not be related to disease.
DISEASE

• Disease can be described as an alteration in body functions

resulting in a reduction of capacities or a shortening of the normal
life span.

• Traditionally, intervention by primary care providers has the goal of

eliminating or ameliorating disease processes.

• Later this belief was replaced by the single-causation theory.

• Today multiple factors are considered to interact in causing disease

and determining an individual's response to treatment.
Factors and Issues Affecting Health
ENVIRONMENTAL

• The ability to promote health measures that improve

the standard of living and quality of life in the
community.
• This includes influences such as food, water, and air.
SOCIAL

• The ability to interact successfully with people and

within the environment of which each person is a
part, to develop and maintain intimacy with
significant others, and to develop respect and
tolerance for those with different opinions and
beliefs.
EMOTIONAL

• The ability to manage stress and to express

emotions appropriately. Emotional wellness
involves the ability to recognize, accept, and
express feelings and to accept one's
limitations.
PHYSICAL

• The ability to carry out daily tasks, achieve

fitness(e.g. pulmonary, cardiovascular,
gastrointestinal), maintain adequate nutrition
and proper body fat, avoid abusing drugs and
alcohol or using tobacco products, and
generally practice positive lifestyle habits.
SPIRITUAL

• The belief in some force (nature, science,

religion, or a higher power) that serves to
unite human beings and provide meaning and
purpose to life. It includes a person's own
morals, values, and ethics.
INTELLECTUAL

• The ability to learn and use information

effectively for personal, family, and career
development. Intellectual wellness involves
striving for continued growth and learning to
deal with new challenges effectively.
OCCUPATIONAL

• The ability to achieve a balance between work

and leisure time. A person's beliefs about
education, employment, and home influence
personal satisfaction and relationships with
others.
FINANCIAL

• Financial Wellness involves the process of

learning how to successfully manage financial
expenses. Money plays a critical role in our
lives, and it can impact your health as well as
academic performance.
HEALTH CARE DELIVERY SYSTEM
HEALTH CARE DELIVERY SYSTEM

• It is the totality of services offered by all

health disciplines.
LEVELS OF DISEASE PREVENTION

A. Primary Prevention
- health promotion and illness prevention
B. Secondary Prevention
- diagnosis and treatment
C. Tertiary Prevention
- rehabilitation, health restoration, and palliative care.
FIVE LEVELS OF CARE

1. Disease Prevention
2. Health Promotion
3. Primary Health Care
4. Secondary Health Care
5. Tertiary Health Care
SIX HEALTH CARE SETTINGS

1. Preventive
2. Primary
3. Secondary
4. Tertiary
5. Restorative
6. Continuing
PREVENTIVE AND PRIMARY
HEALTH CARE
A. Preventive Care
- Reduces and controls risk factors for disease
B. Primary Care
- Focuses on improved health outcomes
- Requires collaboration
C. Health promotion programs lower overall costs
- Reduces incidence of disease
- Minimizes complications
- Reduces the need for more expensive resources
SECONDARY AND TERTIARY CARE
• Focus: Diagnosis and treatment of disease
• Disease management is the most common and expensive
service of the health care delivery system
• Postponement of care by uninsured contributes to high costs
• Hospitals
- Work redesign
- Discharge planning
• Intensive care
• Psychiatric facilities
• Rural hospitals
RESTORATIVE CARE

• Serves patients recovering from an acute or chronic

illness/ disability.
• Helps individuals regain maximal function and
enhance quality of life.
• This involves: Home Health Care and Rehabilitation
RESTORATIVE CARE

• Serves patients recovering from an acute or chronic

illness/ disability.
• Helps individuals regain maximal function and
enhance quality of life.
• This involves: Home Health Care, Rehabilitation and
Extended Care
CONTINUING CARE

• For people who are disabled, functionally dependent,

or suffering a terminal disease
• Available within institutional settings or in the home:
Nursing centers or facilities Assisted living
Respite care Adult day care centers Hospice
NURSING AS A
PROFESSION
PROFESSION

- An occupation or calling requiring

advanced training and experience in
some specific or specialized body of
knowledge which provides service to
society in that special field
 CRITERIA FOR A
PROFESSION
1. A profession must satisfy an indispensable social need and
must be based upon well established and socially accepted
scientific principles.
2. It must demand adequate pre-professional and cultural
training.
3. It must demand the profession of a body of specialized and
systematized training.
4. It must give evidence of needed skills which the public does
not possess; that is, skills which are partly inherent and partly
acquired.
5. It must have developed a scientific technique which is the result
of tested experience.
 CRITERIA FOR A
PROFESSION
6. It must require the exercise of discretion and judgment as
to time and manner of the performance of duty.
7. It must have a group of consciousness designed to extend
scientific knowledge in technical language.
8. It must have sufficient self-impelling power to retain its
members throughout life. It must not be used as a mere
stepping stone to other occupations.
9. It must recognize its obligations to society by insisting that
its members live up to an established code of ethics.
QUALITIES OF A PROFESSION
Applies its body of knowledge in practical services that are vital
to human welfare and especially suited to the tradition of seasoned
practitioners shaping the skills of newcomers to the role

Constantly enlarges the body of knowledge it uses and

subsequently imposes on its members a lifelong obligation to remain
current in order to ―do no harm‖

Functions autonomously in the formulation of professional policy

and in monitoring its practice and practitioners
QUALITIES OF A PROFESSION
Utilizes in its practice a well-defined and well-organized
body of knowledge that is intellectual in nature and describes
its phenomena of concern

Has a clear standard of educational preparation for entry

into practice

Distinguished by the presence of specific culture, norms,

and other values that are common among its members
 PROFESSION VS OCCUPATION
PROFESSIONS OCCUPATIONS
- College or University - On the job training

- Prolonged education - Length varies

- Mental creativity - Largely manual work

- Decisions based on science or theoretical constructs - Guided decision making

- Values, beliefs, and ethics integral part of preparation - Values, beliefs, and ethics not part of preparation

- Strong commitment - Commitment may vary

- Supervised
- Autonomous
- Often change jobs
- Unlikely to change professions
- Motivated by monetary reward
- Commitment > Monetary Reward
- Employer is primarily accountable
- Individual accountability
 Nursing encompasses autonomous and
collaborative care of individuals of all ages,
families, groups and communities, sick or
NURSING well, and in all settings. Nursing includes the
promotion of health, prevention of illness,
and the care of ill, disabled and dying
people. Advocacy, promotion of a safe
environment, research, participation in
shaping health policy and in patient and
health systems management, and education
are also key nursing roles.
 Nursing is the protection, promotion, and
NURSING optimization of health and abilities;
prevention of illness and injury;
alleviation of suffering through the
diagnosis and treatment of human
responses; and advocacy in health care
for individuals, families, communities,
and populations.
NURSING The use of clinical judgment in the
provision of care to enable people to
improve, maintain, or recover health, to
cope with health problems, and to
achieve the best possible quality of life,
whatever their disease or disability,
until death.
NURSING
PROFESSION
CHARACTERISTICS
1. Strong commitment
2. Long-term and regular education
3. Special body of knowledge and skills
4. Ethics
5. Autonomy
6. Power for standard service
7. Valuing and existence of professional association
 PERSONAL AND
PROFESSIONAL QUALITIES
OF A GOOD NURSE

COMMUNICATION EMPATHY AND CRITICAL ATTENTION INTEGRITY WILLINGNESS

SKILLS COMPASSION THINKING AND TO DETAIL AND TO LEARN
PROBLEM- ADVOCACY
SOLVING
SKILLS
 1. Empirical knowing – facts, models, theories

CARPER’S
PATTERNS OF 2. Personal knowing – identification his/her responses,
strengths and weaknesses in a situation, awareness of
KNOWING individual biases

Barbara Carper published

―Fundamental Patterns of
Knowing in Nursing‖ in 1978 3. Ethical knowing – ethical components: what is right and
where she identified four what is responsible
patterns of knowing: empirical,
personal, ethical, and
aesthetic.
4. Aesthetic knowing – empathy, dynamic adaptation
Peggy Chinn and Maeona
Kramer expanded Carper’s
work and, in 2010, introduced a
fifth pattern: emancipatory
knowing. 5. Empancipatory knowing –capacity to be aware of the
society, culture and political situation of society and to
Note: Basic patterns of knowing encouraged nurses to identify the art of
nursing work and the importance of understanding the complex nature of critically reflect on these issues
nursing practice.
HISTORY OF
NURSING
NURSING: ORIGINS IN GENDER
AND FAITH
- Women’s roles as mother, daughter, wife, and sister have included care and nurturing.
- Christian value of ―love thy neighbor as thyself‖ and Christ’s parable of the Good
Samaritan had a significant impact in the development of Western nursing.
- Conversion of wealthy Romans to Christianity like Fabiola  establishment of houses
of care and healing (precursor for hospitals) for the poor and sick
- Crusades formed several orders of knights inclined to care and healing:
1. Knights of Saint John of Jerusalem (Knights Hospitaliers)
2. Teutonic Knights
3. Knights of Saint Lazarus: Care for people with leprosy, syphilis, and chronic skin conditions
4. Deaconess orders  suppressed in the Middle Ages
- Order of Deaconesses – established by Theodore Fleidner in 1836  small hospital and training school
in Kiasersworth, Germany  trained Florence Nightingale
- Early religious values, such as self-denial, spiritual
calling, and devotion to duty and hard work, have
dominated nursing throughout its history.

- Nurses’ commitment to these values often resulted in

exploitation and few monetary rewards.

- For some time, nurses themselves believed it was

inappropriate to expect economic gain from their
―calling.‖

NURSING AND RELIGIOUS

VALUES
- Wars accentuated the need for nurses.
- Crimean War (1854-1856): Public outcry for better care for soldiers  Florence Nightingale
 Mortality Rate decrease at Barracks Hospital, Turkey from 42% to 6% in 6 months
- American Civil War (1861-1865):
- Sojourner Truth & Harriet Tubman: care and safety to slaves fleeing to the North
- Mother Biekerdyke & Clara Barton: searched fields and cared for wounded and dying
soldiers
- Walt Whitman (Leaves of Grass) & Louisa May Alcott (Little Women): writers turned
nurses in military hospitals
- Dorothea Dix: became the Union’s female superintendent of female nurses

NURSING AMID
WARS
NURSING AMID WARS
- World War I (1914-1918): Women
volunteering as nurses  treating
injuries never seen before

- World War II (1939-1945): Shortage of

caregivers  rise of auxiliary health
care workers

- Vietnam War (1955-1975): 11,000

American military women stationed in
Vietname were nurses.
SOCIETAL PERCEPTIONS AND
NURSING
- Before mid-1800s: Victorian middle class women’s roles of wife and mother  poorly
educated nurses in hospitals  Charles Dicken’s ―Sairey Gamp‖ character as a nurse
neglecting her patients
- Mid 1800s: Florence Nightingale’s work  Guardian Angel or Angel of Mercy  nurses
perceived to be noble, compassionate, moral, religious, dedicated, and self-sacrificing

- 1900s:
- Nurses as doctors’ handmaidens
- Nurses as heroines after the World War 2
- Nurses as sex objects, surrogate mothers, and tyrannical mothers
- Nurses of America: launched by the AACN, ANA, AONE, and NLN to improve the image
of nursing
- Campaign for Nursing’s Future: launched by Johnson & Johnsons in 2002 to promote
nursing as a positive career choice
NURSING IN THE PHILIPPINES
- Precolonial: Mysticism and superstition governing health and illness  belief in priest-
physicians (babaylan) and herb doctors (albularyo)
- Spanish Period (1565-1898):
- Nursing through simple nutrition, wound care, and taking care of a sick family member
- Male nurses as assistants to priests in caring for sick individuals in hospitals
- UST College of Nursing (1877) – first college of nursing in the Philippines
- Building of hospitals by religious orders:
1. Hospital Real de Manila (1577) - founded by Brother Juan Clemente and was administered for many
years by the Hospitaliers of San Juan de Dios; built exclusively for patients with leprosy.
2. Hospital de Indios (1586) – established by the Franciscan Order; service was in general supported by
alms and contributions from charitable persons
3. Hospital de Aguas Santas (1590) – established in Laguna; near a medicinal spring, founded by
Brother J. Bautista of the Franciscan Order
4. San Juan de Dios Hospital (1596) – founded by the Brotherhood of Misericordia and administered by
the Hospitaliers of San Juan de Dios; support was delivered from alms and rents; rendered general
health service to the public
NURSING IN THE PHILIPPINE
REVOLUTION (1896-1898)
The emergence of Filipina nurses brought about the development of Philippines Red Cross.
1. Josephine Bracken — wife of Jose Rizal, installed a field hospital in an estate house in Tejeros. She provided
nursing care to the wounded night and day.
2. Rosa Sevilla de Alvero — converted their house into quarters for the Filipino soldiers; during the Philippine-
American War that broke out in 1899
3. Dona Hilaria de Aguinaldo — wife of Emilio Aguinaldo who organized that Filipino Red Cross under the
inspiration of Mabini.
4. Dona Maria Agoncillo de Aguinaldo — second wife of Emilio Aguinaldo; provided nursing care to Filipino
soldiers during the revolution, President of the Filipino Red Cross branch in Batangas.
5. Melchora Aquino a.k.a. ―Tandang Sora‖ — nursed the wounded Filipino soldiers and gave them shelter and
food.
6. Capitan Salome — a revolutionary leader in Nueva Ecija; provided nursing care to the wounded when not in
combat.
7. Agueda Kahabagan — revolutionary leader in Laguna, also provided nursing services to her troops
8. Trinidad Tecson (―Ina ng Biak-na-Bato‖) — stayed in the hospital at Biak na Bato to care for wounded
soldiers
HOSPITAL SCHOOL OF NURSING’S
FORMAL TRAINING (1901 – 1911)
- Act 854 or the Pensionado Act of 1903 – allowed Filipino nursing students to study in the
US

1. Iloilo Mission Hospital School of Nursing (1906) – first hospital to train Filipino nurses and
established by Baptist missionaries

2. Saint Paul’s Hospital School of Nursing (Manila, 1907)

3. Philippine General Hospital School of Nursing (Manila, 1907) – PGH began as small
dispensary in 1901  Civil Hospital: Mary Coleman Masters opened dormitory for girls for
training of nurses  1907: opened classes in nursing  1910: Act 1976 abolished Civil
Hospital and established PGH
HOSPITAL SCHOOL OF NURSING’S
FORMAL TRAINING (1901 – 1911)
4. St. Luke’s Hospital School of Nursing (1907)

5. Mary Johnston Hospital and School of Nursing (1907)

6. Philippine Christian Mission Institute School of Nursing

7. Sallie Long Read Memorial Hospital School of Nursing (Laoag, Ilocos Norte)
PHILIPPINE NURSING PRACTICE
- Act No. 2493 – amended Medical Act (Act No. 310) allowing the regulation of nursing practice

- Act No. 2808 – first true Nursing Act in 1919  creation of first Board Examiners for
Nursing

- 1920: First board exam with a physician as the executive of the Board Examiners

- Establishment of more nursing schools:

1. Mary Chiles Hospital School of Nursing (Manila, 1911)
2. Frank Dunn Memorial Hospital (Vigan Ilocos Sur, 1912)
3. San Juan de Dios Hospital School of Nursing (Manila, 1913)
4. Emmanuel Hospital School of Nursing (Capiz, 1913)
5. Southern Islands Hospital School of Nursing (Cebu, 1918) - established in 1911 under
the Bureau of Health. The school opened in 1918 with Anastacia Giron-Tupas as the
organizer and Visitacion Perez as the first principal
PHILIPPINE NURSING
ORGANIZATION
- Filipino Nurses Association – founded on September 2, 1922 by Anastacia Giron Tupas, and
initiated the publication of Filipino Nurse Journal  Philippine Journal of Nursing; became a
member of the International Council of Nurses in 1929  Philippine Nurses Association

- Act 3025 - passed by the 5th Legislature 1922 amending certain sections of the Act 2808. Entitled
―An Act Regulating the Practice of Nursing Profession in the Philippine Islands‖, it required
the annual registration of professional nurses.

- 1930s: Adoption of American professional nursing  higher requirements for School of Nursing
such as completion of secondary education in 1933

- University of the Philippines School of Public Health Nursing – first collegiate graduates I 1938
PHILIPPINE NURSING IN THE TIME
OF WAR
- Public health nurses assigned to devastated areas

- Nurses held as prisoners of war in Bilibid released by the Japanese to the Director of Bureau
of Health

- 1946: Creation of Nursing Office in the Department of Health led by Mrs. Genera De Guzman,
president of the Filipino Nurses Association
PHILIPPINE NURSING EDUCATION
AND PRACTICE POST WAR
- A nursing curriculum which was based on the thesis presented by Julita V. Sotejo, graduate of
the Philippine General Hospital School of Nursing: development of a nursing education
within a University-based College of Nursing  beginning of nursing curriculum as a
baccalaureate course  College of Nursing was created.
- Japanese occupation  interruption of nursing training and practice at the hospital schools 
US colonial patterns in Philippine nursing education soon returned after World War II
- 1947: Bureau of Private Schools granted UST permission to provide the Graduate Nurse title
- RA 877 – Philippine Nursing Law passed on June 19, 1953  1966: Amended to limit
nursing practice to 21y/o and above
- Proclamation No. 539 – Philippine Nurses’ Week every last week of October by President
Carlos Garcia in 1958
- 1960s: First round of migration of Filipino nurses
- RA 7164 – Philippine Nursing Act of 1991, expanding roles of nurses
- 1999: Creation of the Nursing Certification Council
- RA 9173 – Philippine Nursing Act of 2022, amending RA 7164
SUMMARY
- A profession is more than a job; it serves the society through a
specific body of knowledge that evolves and a practice that is
universal to all its practitioners, adheres to a code of ethics, and
is regulated by standards.

- Nursing is a profession of providing care for individuals and

families across all settings using the nursing process.

- Both in the western world and locally, nursing shifted from

domestic roles and religious roots into a distinct science that
continues to develop even today. History has shaped the society’s
perceptions on and the trajectory of the nursing practice.

- Although its was already introduced by the Spaniards, Philippine

nursing is highly attached to the American nursing standards and
finds its compass in the Western orientation, making Filipino
nurses highly important resources in the global healthcare human
resource at present.
References:

• Course Hero; https://www.coursehero.com/file/136483197/funda-prelim-

1docx/

• UC DAVIS- Student Health and Counseling Services; Dedicated to a

Healthy Human Body