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1 nes & B FOR SA CHAPTER earnin DISTR Introduction Jones & B Seven Trends in Nursing nes & B FOR SA Kathleen Sitzman nes & B FOR SA earnin DISTR earnin DISTR.. nes & B FOR SA

A 2 chapter 1 u Introduction When nursing students learn that they will be required to study nursing history, they often question the usefulness of such an endeavor, preferring instead to focus on learning information related to the mechanics of current clinical practice. It is sometimes difficult to envision how something that happened 100, 50, or even 10 years ago could possibly be relevant to the continually changing and fast-paced world of nursing today. In truth, past events Jones (even& some Bartlett that occurred Learning, hundreds LLCof years ago) still exert a profound Jones influence & Bartlett on current Learning, LLC NOT FOR nursing SALE practice, OR particularly DISTRIBUTION in relation to seven basic trends: NOT image, FOR education, SALE advancement in practice, war, workforce issues, licensure/regulation, and research. It is essential to OR DISTRIBUTI remember that these seven trends influence each other and are intertwined; however, there are unique aspects related to each trend that warrant separate discussion in the pursuit of artlett elemental Learning, understanding LLC within the context of the Jones whole. & B The organization and presentation of information NOT FOR in SALE this text OR is based DISTRIBUTION on the premise that spotlighting these seven trends in relation to specific time periods (eras) will enhance awareness of key forces that continually shape American nursing through time. This approach fosters professional growth and leadership grounded in knowledge of what has come before, thereby facilitating Jones positive & Bartlett change Learning, towards a productive LLC future during which past Jones mistakes & Bartlett L will hopefully NOT not FOR be repeated. SA Explanations of the seven trends listed previously are provided below. Examining these trends in relation to the eras addressed in each chapter forms the basis of this text. Jones The & Image Bartlett of Nursing Learning, LLC DISTRIBUTI Mass communication and entertainments that started with widespread use of the printing press in Europe in the 1600s and continued with the advent of radio, movies, television, and, most recently, the Internet, have led to commonly held, generalized impressions related to nurses and the nursing profession. Contradic- artlett tory Learning, images of LLC nursing became popular during Jones different & B LE OR eras, DISTRIBUTION resulting in a composite and inconsistent NOT public FOR SA perception of American nurses. Popular public perception of nurses influences how nurses are treated by patients, other healthcare professionals, and the public. It also has an Jones effect on & how Bartlett nurses Learning, perceive themselves LLC and their profession, NOT FOR and SALE how they OR treat DISTRIBUTION each other in the workplace. The Education of Nurses Jones Early & Bartlett nursing education Learning, was LLCbased on apprenticeship and SALE observation. OR DISTRIBUTION Nurses originally were educated by NOT FOR physicians and nurse supervisors. More formal methods DISTRIBUTIO..

A Introduction 3 of education emerged as a result of the work of nurse leaders in Europe and the United States. What began as an unregulated, informal, highly inconsistent endeavor grew into a systematic, consistent, regulated, and academically rigorous pursuit that is required of all who wish to become professional nurses. Jones General & educational Bartlett practices Learning, LLC influence professionalism NOT and consistency FOR SALE of care OR delivery. DISTRIBUTI Level of education influences whether or not a profession has the training and infrastructure to develop its own knowledge base and then substantively interact within interdisciplinary Jones teams & Bartlett consisting Learning, of other highly LLC educated professionals. NOT FOR Progression SALE of OR nursing DISTRIBUTION education resulted in a variety of educational degrees that determined possibilities for role or function, certification, and practice. Advances Jones in Practice & B For the purposes of this text, advances in practice refers to advances in healthcare technology and the development of new practice approaches/disciplines War and Its Effects on Nursing The evolution of professional nursing in the United NOT States FOR is intricately SALE OR tied to DISTRIBUTIO wartime activities. Interestingly enough, much of what nursing is today and the ever-expanding.. to effectively treat healthcare concerns. Technological Jones advances & Bartlett through Learning, time have LLC resulted in interventions NOT FOR that SALE earlier OR healthcare DISTRIBUTION providers could not imagine, for DISTRIBUTI example antibiotics, insulin, ventilators, artificial hearts and limbs, organ transplants, intricate wound-care protocols, anesthesia, effective pain management, and genetic artlett Learning, engineering. LLC Technological advancements Jones influence & B and (hopefully) improve outcomes and have NOT resulted FOR SALE in OR DISTRIBUTION perpetually fast-paced changes to nursing practice. The sociopolitical and healthcare environments influence practice trends and necessity of practice advancement. New practice Jones approaches/disciplines & Bartlett Learning, have been LLC developed over time to address specific Jones client & Bartlett L concerns; NOT for example, FOR SALE school OR nursing DISTRIBUTION emerged in the early 1900s to meet the NOT basic healthcare FOR SALE OR needs of lower income schoolchildren in industrialized cities who would otherwise not have the money to receive necessary medical care.

A 4 chapter 1 u Introduction abilities and opportunities for nurses are the results of advances in war and the need for nurses to be intimately involved in the health and humanitarian care of soldiers, civilians, and/or the enemy. American nurses have consistently entered the armed forces when bidden and acted Jones with & bravery Bartlett and honor Learning, wherever LLC needed. Each war posed NOT FOR unique SALE challenges OR and DISTRIBUTION opportunities for nursing related DISTRIBUTI to expanded professional roles and responsibilities. Innovative battlefield medical interventions have resulted in significant advances in emergency, trauma, and intensive artlett care Learning, practices. LLC Groundbreaking rehabilitative approaches Jones & B LE OR for DISTRIBUTION war-related injuries have led to advancements NOT in FOR prosthetics, psychiatric care, and neurological care. Cutting- SA edge treatments originally created to save and improve the lives of American soldiers have ultimately enhanced survival and Jones quality of & life Bartlett for all Americans. Learning, Much LLC of the technology that nurses routinely Jones use & Bartlett L today is the NOT direct FOR result SALE of wartime. OR DISTRIBUTION Nursing Workforce Issues Workforce issues related to supply and demand of qualified nurses have consistently Jones emerged, & Bartlett sometimes Learning, related to LLC an overabundance of nurses and Jones more often & Bartlett connected Learning, to LLC NOT FOR shortages. SALE Other OR issues DISTRIBUTION have concerned the employment of NOT men, FOR ethnic SALE minorities, OR DISTRIBUTI and racial minorities in nursing. Nursing began in the United States as primarily the work of Caucasian females; however, the number of men and ethnic/racial minorities entering the nursing profession has steadily increased. Increased numbers of men and minorities entering artlett nursing Learning, have transformed LLC workplace cultural/social Jones dynamics & Bartlett from homogeneity Learning, to LLC integration and SALE variety. OR Workforce DISTRIBUTION issues influ- NOT FOR ence nursing practice on a daily basis, particularly during periods of shortage. Many professional issues are ultimately influenced by nurses themselves Jones and & Bartlett L their willingness or lack thereof NOT to FOR accept SALE OR these demographic shifts. Licensure and Regulation Early nursing Jones in the & Bartlett United States Learning, LLC was an NOT informal FOR endeavor. SALE OR Anyone DISTRIBUTIO who felt knowledgeable about how to..

A Introduction 5 take care of others who were ill, injured, or in childbirth could assume the role of nurse and offer services for pay. When nursing education became more formalized and consistent, licensure and Jones regulation & Bartlett issues Learning, came to the LLCforefront; NOT FOR all SALE practicing OR nurses DISTRIBUTION were eventually required to obtain and maintain licenses. Over time, advanced practice nursing roles stimulated an ongoing licensure/ artlett Learning, regulation debate LLC around the issues of prescriptive authority and degree of autonomy in practice. Many certifications and specialty endorsements are now an essential component of nursing practice; they ensure competency as they delineate role, responsibility, and obligation. Nurse Practice Acts (NPA) define legal boundaries of nursing practice based on licensure, regulation, Jones and certification. & Bartlett NPAs Learning, ensure safe, LLC quality health care of community Jones (individual & Bartlett L and community). NOT FOR The SALE recent influx OR DISTRIBUTION of foreign nurses wanting to work in the United NOT States FOR has SALE OR prompted dialogue related to licensure/regulation of nurses who are not American citizens. Licensure/regulation laws set the tone for entry into different levels of nursing practice and ensure accountability of all professional nurses. NOT FOR Nursing SALE Research OR DISTRIBUTION DISTRIBUTI Early nursing practice was based on tradition rather than systematic study of efficacy. Movement of nursing education into university settings LLCstimulated research activities artlett Learning, aimed at assessing the effectiveness of nursing interventions and clarifying how nursing practices could be improved to support optimal client outcomes. Emergence of the widely accepted Jones concept & of Bartlett evidence-based Learning, practice LLC has resulted NOT FOR in increasingly SALE OR dynamic DISTRIBUTION knowledge development related to a wide range of nursing activities and disciplines. Continued advancement and refinement of the nursing knowledge base is an obligation of all professional nurses. Have we previously established the abbreviations for these RN levels? Do we need to do this since some readers may not be nurses? BSNs provide questions/topics for inquiry and implement research findings at the DISTRIBUTIO clinical level. MSNs do all that BSNs do, plus assist in the creation and execution of research.. DISTRIBUTI

A 6 chapter 1 u Introduction Historical NOT FOR Happenings SA Growing up as a sharecropper s daughter, I spent many years working on the farm primarily in tobacco, and later [I] became a caregiver to the parents who had me at the Jones age & of Bartlett 43. I am truly Learning, thankful to LLC all the mentors that I ve had along Jones the & way Bartlett who guided Learning, LLC NOT FOR me SALE on the journey OR DISTRIBUTION of becoming a nurse, counselor, and later NOT administrator roles FOR SALE OR which DISTRIBUTI have blessed my life with a wonderful career. However, with a strong work ethic, academia brought continuous challenges of the terminal degree moving further and further ahead, coupled with the demands of tenure and promotion as measurements of success. artlett Learning, It was 1994 LLCafter developing pneumonia Jones for the & first Bartlett time that Learning, I was led to LLC Art as an Avocation. With each subsequent bout NOT of pneumonia FOR SALE I painted OR DISTRIBUTION more. It has been through these later years of painting and learning to be quiet and alone that I have learned to listen more and hear the guidance from my own creator. I now know that the most important titles that I ve ever been given have been the honors of being a wife, mother, grandmother, Jones & Bartlett daughter, friend, Learning, and others LLCthat come from being in a family. Jones & Bartlett L To NOT my hard-working, FOR SALE career-minded OR DISTRIBUTION colleagues who focus much on the NOT well being FOR SALE OR of others, please remember when the final curtain falls, it is not the credentials or what we ve accomplished professionally that will linger most in the hearts of our families and closest friends, it is what we have been to them personally. Enjoy your professional careers, but let s take care of ourselves, our health, our souls, so that we can be there for our families. Joy is scattered all around... even if we have to squint to see the good. In DISTRIBUTI painting, I ve learned to squint [and as I do] there is [much] more that I can [understand]! It is truly my family for whom I have the most pride and thank God each day that I am part of their lives. I hope my expressions of art will continue to fan the wings of your joy and gratitude artlett Learning, for the good LLC life and beauty we all enjoy in Eastern Jones NC. & B Lou DISTRIBUTION Everett (2012) u studies. Doctorally prepared RNs add to this skill set the creation, management, and dissemination of all Jones aspects of & research Bartlett studies Learning, to improve LLC practice through evidence. All Jones RNs have & Bartlett L the responsibility NOT FOR of awareness SALE to OR ever-changing DISTRIBUTION discoveries while maintaining NOT an adequate FOR SALE OR knowledge base that supports the growth and continued development of the nursing profession. This requires vigorous research activity at all levels of professional nursing. DISTRIBUTIO..

A How the Chapters and Information in This Text Are Arranged 7 How NOT the FOR Chapters SALE OR and DISTRIBUTION Information in This Text Are Arranged Nursing history unfolded within larger sociopolitical climates. Each chapter begins with a brief overview of the general sociopolitical climate related to the era covered in that chapter. Exploration of how the seven trends manifested during that era is then discussed. DISTRIBUTI This text is a basic overview, with a focus on general trends and eras rather than examination of exhaustive historical information. All concepts in each trend are succinctly presented. Chapter 2: Reflections: The Study of Nursing History reviews selected nursing historical happenings and basic research methodology from both historical and nonhistorical perspectives. Suggestions on how best to use this book are presented so that discovery of the significance of the trends on nursing and nursing on the trends ensues. Suggested Reading For a full suite of assignments and additional learning activities, please use the access code located in the front of your book. Andrist, L. Jones C., Nicholas, & Bartlett P. K., & Wolf, Learning, K. A. (Eds.). LLC(2006). A history of nursing ideas. Jones Sudbury, & Bartlett L MA: NOT Jones FOR and Bartlett. SA Baer, E. D., D Antonio, P., Rinker, S., & Lynaugh, J. E. (Eds.). (2002). Enduring issues in American nursing. New York, NY: Springer. Brinkley, A. (2003). American history: A survey (11th ed.). New York, NY: McGraw-Hill. Jones Collins, & Bartlett G. (2003). Learning, America s LLC women: 400 years of dolls, drudges, Jones helpmates, & Bartlett and heroines. Learning, LLC NOT FOR SALE New York, OR NY: DISTRIBUTION William Morrow. DISTRIBUTI D Antonio, P., Baer, E. D., Rinker, S. D., & Lynaugh, J. E. (Eds.). (2007). Nurses work: Issues across time and place. New York, NY: Springer. Donahue, M. P. (1996). Nursing: The finest art (2nd ed.). St. Louis, MO: Mosby. Kalisch, P. A., & Kalisch, B. J. (2004). American nursing: A history (4th ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins. Kerber, L. K., & DeHart, J. S. (1995). Women s America: Refocusing the past (4th ed.). New York, NY: Oxford University Press. Wolf, Z. R. (1988). Nurses work: The sacred and the profane. Philadelphia: University of Pennsylvania Press. DISTRIBUTIO..

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