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History of community health nursing
- 3. • The earlyhome care stage • The district nursing stage • The public health nursing stage • The community health nursing stage
- 4. EARLY HOME CARESTAGE (BEFORE MID 1800S):- • Social approval following the reformation caused a decline in the number of religious orders with subsequent curtailing of nursing care for the sick and poor. • High maternal mortality rates prompted efforts to better prepare midwives and medical students. • Industrial revolution created additional problems, among them were epidemics, high infant mortality, occupational diseases, injuries and increasing mental illness both in Europe and America.
- 5. DISTRICT NURSING (MID1800S TO 1900) • The work of district nurses focused almost exclusively on the care of individuals. District nurses recorded temperatures and pulse rates and gave simple treatments to the sick poor under the immediate direction of a physician. They also instructed family members in personal hygiene, diet and healthful living habits and the care of the sick.
- 6. Problems of districtnursing:- • Increased number of immigrants • Increased crowded city slums • Inadequate sanitation practices • Unsafe and unhealthy working conditions
- 7. PUBLIC HEALTH NURSINGTRAINING (1900-1970):- • By the turn of the century, district nursing had broadened its focus to include the health and welfare of the general public, not just the poor. This new emphasis was part of a broader consciousness about public health. Specialized programs such as infant welfare that brought health care and health teaching to the public and gave nurses an opportunity for more independent work and helped to improve nursing.
- 8. COMMUNITY HEALTH NURSING(1970 TO PRESENT):- • The emergence of the term community health nursing heralded a new era while public health nurses continued their work in public health by the late 1960s and early 1970s. Many other nurses, not necessarily practicing public health, were based in the community. Their practice settings included community-based clinics, doctor’s office, work sites, schools, etc. To provide a label that encompassed all nurses in the community.
- 9. The Summary ofDevelopment of Community Stages Focus Nursing Orientation Service Emphasis Institutional base(Agencies) Early home care (Before mid1800s) Sick poor Individuals Curative Lay and religious Leaders. District nursing (1860-1900) Sick poor Individuals Curative and beginning of preventive Voluntary and some governments Public health nursing (1900-1970) Needy Public Families Curative and Preventive Government and some volunteers Emergence of community health nursing(1970-present) Total Community Population Health promotion and illness prevention Many kinds and some independent practitioners
- 11. NURSING EDUCATION ININDIA - PRE- INDPENDENCE • Nursing in Pre-historic Times. • Nursing – Vedic Period (3000 B.C. – 1400 B.C.) • Nursing Post Vedic Period (600 B.C. – 600 A.D.) • Nursing in Mogul Period (1000 A.D.) • Nursing in (1500A.D.) • British period (16th Century onwards)
- 12. Nursing in Pre-historicTimes • There are no historical evidence available on ancient history on nursing care of sick in primitive times discovered through myths, songs and archeologist. To get rid of ‘ evil spirit’ unpleasant conditioning like beating, starving, magic rites, nauseous medicines, loud noises sudden fright are used methods. Primitive man had the skill of massaging, fermentation bone setting, amputation, hot and cold bath, heat to control hemorrhages.
- 13. Role of Nursein primitive period • Women were protecting and caring for their children, aged, sick members of the family. Nursing evolved to response to the desire to keep healthy as well as provide comfort to sick. This was reflecting in caring, comforting, nourishing and cleansing aspect of the patient. These love and hope were expressed in empirical practice of nursing.
- 14. Nursing Vedic Period(3000 B.C.-1400 B.C.) • Indian medicines are found in the sacred books of “Vedas” . • The ‘ Ayurveda’ is thought to have been given by Brahma. 1400 BC Sushruta, known as ‘Father of Surgery’ in India wrote a book on surgery years later ‘Charka’ wrote a book on internal medicine. • By these writings we can learn that those days surgery had advanced to a high level, also had 4 wings of treatment ‘Chatushpada Chikitsa’ . ➢ Physician- Bhishak ➢ Nurse- Upacharika (Attendants – Anuraktha) ➢ Therapeutic Drugs - Dravya ➢ Patient – Adhyaya • Hospitals are large and well equipped. “Siddha” system of medicine were also practiced in India.
- 15. Nursing Post VedicPeriod (600 B.C.-600 A.D.) • Medical education introduced in ancient Universities of ‘Nalanda’ and ‘Thakshashila’ . King Ashoka (272-236 B.C.) constructed hospitals for the people and animals. Prevention of the disease was given first importance and hygienic practices were adopted. • Cleanliness of the body was religious duty. The nurses were usually ‘men’ or ‘ old women’ . Women are restricted activities at home and cared for sick members in the family. Medicines are remained in the hands of priest – physicians, who refused to touch the blood and pathological tissues. • Dissection was forbidden. Other religious restriction and superstitious practices probably declined the development of nursing.
- 16. Nursing in MogulPeriod (1000 A.D.) • ‘Unani’ system of medicine developed during the Arab civilization. It was practiced in Indo- Pakistan subcontinent. The basic framework are consisting of blood, phlegm, yellow bile and back bile. Temperament, strengthening of body and nature are the real physician.
- 17. Nursing in 1500A.D. •When Vasco the Gama came to India, he set up trading posts on west coast. Franciscan, Dominican and Jesuit missionaries came to administer to the sick and needy. The Portuguese set up European type of dispensaries at Goa and Madras and physician from Europe were invited to India.
- 18. British period (16thCentury onwards) • After the Mogul period the nursing in India hindered due to various reasons like low state of women, system of “Pardha” among Muslims, caste system among Hindus, illiteracy, poverty, political unrest, language difference and nursing looked upon as servants work. During the 16th century, nursing development in India taken three dimensions. A. Military Nursing B. Civilian Nursing C. Missionaries Nursing
- 19. Military Nursing • Militarynursing was earliest type of nursing. In 1664 the East India Company helped to start a hospital for soldiers at Fort St. George, Madras. Later a civilian hospital was built and medical staff, appointed by the East India Company. Served in both hospital. In 1797 a lying-in hospital was built and in 1854 the government sanctioned a training school of midwives. In 1861, through the effort of Miss. Nightingale, reforms in military hospital led to reforms in civilian hospital. Efforts were made to provide health services for the people of India. This laid the foundation for public health nursing.
- 20. Civilian Nursing • CivilianHospital nursing in military hospital was of poor quality carried on by male orderlies and basic staff. In 1871 the government general hospital, Madras undertook a training of nurses. Nurses were brought from England to be in charge and the first six students were those who had previously received their diploma of midwifery. • In Mumbai, among the earliest hospitals is J. J. Group in 1843. The sisters working in this hospital took first steps to establish a training school for nurses in hospital. In 1891 KASHIBAI GANP AT was the first Indian nurse to come for training.
- 21. Missionaries Nursing • MissionHospital: Mission hospitals were the first to begin the training of Indian nurses, very gradually overcoming the prejudices of parents against sending their girls for a training which was felt to be beneath the dignity of decent educated girls. Religion prevented Hindu and Muslim girls from joining at all and so only Christian girls could be trained at first. But for many years even they felt nursing was an inferior profession.
- 22. Missionaries Nursing … •In the beginning there was no uniformity of courses or educational requirements. About 1907-1910 the North India United Board of examiners for mission hospitals was organized and set up rules for admissions and standers of training and concluded a public examination. On 24th May 1909 Indian Medical Mission Association granted the nursing diploma after examining student by Central Board for nurses Training school in South India. A few years later the Mid India and South India Boards of Nursing Examiners were similarly setup. These are examining board of nurse’s league of the Christian Medical Association of India. The name of Nursing, Nurse's league of Christian Medical Association of India, South India branch in 1975.
- 23. TRAINED NURSES ASSOCIATIONOF INDIAN (TNAI) • In 1908 – TNAI formed to uphold the dignity and honor of the nursing profession. Florence Mac Haughton was the first president of TNAI. In 1910 TNAI published journals. In 1912 – TNAI • Affiliated to international Nursing Council as an 8th Association in the world. In 1917 June 16th under the Registration Act No: XXI of 1860 – TNAI got registered. In 1922 – SNA formed.
- 24. NURSING IN INDIA- POST INDEPENDENCE • Trained Nurses Association of India • TNAI helps the initiation of university level education in India. Recommendations of the Bhore committee were implemented within year. 1. Passing of the INC act 2. Deputation of Indian nurses abroad for post basic education • The TNAI made significant achievements in the field of nursing. It creates awareness among nurses through Nursing journal of India and organizing continuing education programmes. TNAI also offers scholarships to deserving candidates to take up studies within the country and abroad.
- 25. Establishment of Nursing council. •The INC was constituted to establish a uniform standard of education for nurses, midwives, health visitors and auxiliary nurse midwives. The INC act was passed following an ordinance on December 31st, 1947. The council was constituted in 1949.
- 26. Main proposes ofthe council 1. To set standards and to regulate the nursing of all types in the country. 2. To prescribe and specify minimum requirement for qualifying for a particular course in nursing. 3. Advisory role in the state nursing council 4. To collaborate with state nursing councils, schools and colleges of nursing and examination board.
- 27. State Registration Council. 1.Inspect and accredit schools of nursing in their state . 2. Conduct the examinations 3. Prescribe rules of conduct. 4. Maintain registers of nurses, midwives, ANM and health visitors in the state.
- 28. ROLES OF COMMUNITYHEALTH NURSING Seven major roles are: 1. Clinician 2. Educator 3. Advocate 4. Managerial 5. Collaborator 6. Leader 7. Researcher
- 29. SETTINGS OF COMMUNITYHEALTH NURSING PRACTICE These settings can be grouped into five categories: a) Homes b) Outpatient department (ambulatory service settings) in the health institutions c) Occupational health setting (factories, cottage industries) d) Social institutions (schools, Prisons, Orphanages) e) The community at large
- 30. FACTORS INFLUENCED THEGROWTH OF COMMUNITY HEALTH NURSING:- 1. ADV ANCED TECHNOLOGY 2. PROGRESS IN CAUSAL THINKING 3. CHANGES IN EDUCATION 4. CONSUMER MOVEMENT 5. CHANGING DEMOGRAPHY 6. ECONOMIC FORCES