NR 393 Discussion Reflection on 19th and 20th Century Nursing
NR 393 Discussion Reflection on 19th and 20th Century Nursing
NR 393 Discussion Reflection on 19th and 20th Century Nursing
Reflect on 19th and 20th-century nurses and events discussed this week. Which nurse or event from that time period will best guide your current professional nursing practice? Why?
The 1800s were an important time in history for medicine, as many healthcare-related advances were noted. Infection control is something that is near and dear to my heart, for a few reasons. Judd (2018) stated that the idea that germs can be spread from person to person began to come to light in the early to mid-1800s. It was noted by doctors, surgeons, and nurses that there were higher rates of infection, and death when medical professionals were caring for a post-mortem patient and went straight to the care of another patient. Speculation began to rise that maybe germs are carried in the human body, in a liquid or form that can’t be seen by the human eye, causing these deaths and illnesses. When the research was conducted to test this theory, there was a drastic reduction in maternity ward deaths, some 90% between 1846-1848, when hand washing or other techniques of sterilization were applied. (Judd, 2013). Due to these findings, further research went into the idea of cleanliness and sterilization, and we of course know today where those studies went today.
As I mentioned earlier, infection control is something that is extremely important to me for a few reasons – my disabled brother passed away from bacterial pneumonia that could have, and should have, been prevented, or at least properly treated. My daughter has a lot of sinus-related problems, and I am immunocompromised. We learn about infection control very early in nursing school – in fact being checked off your skill check-off list for knowing how to wash your hands properly was one of the very first things I remember from nursing school.
Today, there are many diseases that can make us anywhere from a runny nose to in the hospital on a ventilator, and of course death. There is still a lot of uncertainty with Covid-19, and while we have a better understanding of how it lives, spreads, and affects the human body, we are still losing a lot of people every day to it. Being diligent with strict infection control protocols aren’t just there to make your day hell with the full gowning, and ungowning. Infection control, and doing it properly, can really mean someone’s life.
After seeing my brother suffer for months from an infection he never should have had, because a nurse, or nurses, didn’t follow protocol when caring for other ill patients, ultimately resulted in his early passing. I work with fragile and elderly patients and have seen the spread of viruses and bacteria that proper “gel-in, gel-out” sanitizing may have prevented. I have made it a personal mission to ensure that not only am I leading by example in infection control protocols, but I am able to teach my nurses and other staff how to properly apply PPE for the suspected, or confirmed, infection. The advances in infection control made 150 or so years ago have saved countless lives, however, we still see major outbreaks of infections that may be able to be prevented with a better education. In a previous BSN class, I learned about different types of certifications, and infection control was one of them. Since that class, I have seriously considered specializing in this field and using my experiences and knowledge to help save lives.
Reference:
Judd, D. (2013). A History of American Nursing. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9781284044324/
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I think it was interesting you chose to write about Clara Barton for this weeks discussion because who better to talk about during a pandemic than a nurse who is known for disaster preparedness and emergency public training. Although she mainly was dealing with war, this pandemic has proved to be an emergency situation in society as well which as you are an ER nurse definitely can relate to. I work inpatient sometimes COVID sometimes non-COVID but you are correct that the burnout is real right now with everything happening in the world and our jobs. I agree with what you said that reading about past nursing heroes is great motivation to keep going because it proves that disasters have happened before and the world overcame them so this is no different and we will persevere and get through this pandemic!
I thought that Barton was a great example. Working in the ER and the Covid unit of the ER during this pandemic almost seems like war like conditions. We have limited beds for the covid patients in the ER, we have to decide who needs seen first, who can sit and wait in the covid waiting area. It is hard to be a nurse in any areas of nursing right now, burnout is real. But the quote you choose for this time is right on point to be encouraging for this pandemic times. During this time of the pandemic hopefully we will learn better practices and modern treatments for these patients to decrease stress on the patients and the staff caring for patients.
Out of all of these nurses, I have to pick Clara Barton given my current situation to reflect upon. I lost my apartment due to a fire. Thanks to Clara Barton creating the American Red Cross, I was able to use some of their services almost immediately.
The Red Cross is a huge organization. I had a fire which displaced my family. I was provided a two night hotel stay, a debit card for immediate use for food and clothing if needed, a mental health counselor who checked on each of my family members, a nurse who would help with replacing medications and medical equipment. They also had a case worker who sent links for housing opportunities. Due to this situation and how quickly they provided assistance, I would like to give my time to the Red Cross as well as a volunteer nurse.
The founding of the Red Cross has helped my family in our time of disaster/need.
I also want to reflect on Mary Mahoney as she brought diversity to nursing. I cannot imagine anything other than diversity in health care. I have always enjoyed befriending and working with people who bring variety in experience and culture to the table. I thank her for her resilience back when she was told she was too dark skinned to help wounded soldiers alongside Florence and made it work anyway! Had she not been so bold, I wonder what nursing would look like today.
Nurse Richards also makes me thankful for including men and women alike in nursing – everyone is needed in nursing and discrimination is unhelpful and disgusting.
I am so sorry to hear about your apartment fire and how it impacted you and your family. That is great that you want to give back and volunteer with the American Red Cross. I didn’t realize all the things American Red Cross does for the community. Diversity is big in nursing and it’s great to see people with different cultural backgrounds going into nursing and even learning different religions from patients. It’s also great to see more men going into nursing, back in Nightingales time nurses were only thought to be women and now we have many men that go into nursing. Great post!
The nurses from the 20th century will best guide my professional practices because their moral behavior was satisfactory to both the patients and the management. Nurses in the 19th century were lower class level women who were not trained and gave themselves the head nurses’ position and put themselves in charge of the critical patients (Helmstadter, 2008). They lacked moral character, such as being kind to the patients. The nurses are paid a full salary without work experience, but they involved themselves with some less critical nursing care such as making beds, cleaning the weaker patients, and helping them. The nurses had to find and pay substitutes by themselves because they had no paid time off.
The 20th-century nurses were well trained, came from the middle class, were highly disciplined, made sure they had well attended to their patients, did their work with passion, kind to their patients, humbly communicated them, and used the correct language to their patients (Amadeo, 2008). They have trained matrons who are maintaining adequate discipline and see them providing exemplary patient care. Nurses in the 20th century are kind where they are mindful. They are in the position to listen to their patients, encourage them, be respectful even when faced with demanding patients, and deal with patients’ fearful or anxious feelings.
Nurses should develop self-awareness, which is beneficial to their professional level and personal. Mindful awareness includes their unsolved emotional stress, mainly through conscious awareness. However, many nurses have difficulty dealing with dying patients, witnessing patients suffer, and their families. It will improve the relationship between the patients and nurses.
References
Amadeo, C. A. (2008). A correlational study of servant leadership and registered nurse job satisfaction in acute health-care settings (Doctoral dissertation, University of Phoenix).
Helmstadter, C. (2008). Authority and leadership: The evolution of nursing management in 19th century teaching hospitals. (n.d.). Journal of Nursing Management 16, 4–13
The nurses from the 20th century will best guide my professional practices because their moral behavior was satisfactory to both the patients and the management. Nurses in the 19th century were lower class level women who were not trained and gave themselves the head nurses’ position and put themselves in charge of the critical patients (Helmstadter, 2008). They lacked moral character, such as being kind to the patients. The nurses are paid a full salary without work experience, but they involved themselves with some less critical nursing care such as making beds, cleaning the weaker patients, and helping them. The nurses had to find and pay substitutes by themselves because they had no paid time off.
The 20th-century nurses were well trained, came from the middle class, were highly disciplined, made sure they had well attended to their patients, did their work with passion, kind to their patients, humbly communicated them, and used the correct language to their patients (Amadeo, 2008). They have trained matrons who are maintaining adequate discipline and see them providing exemplary patient care. Nurses in the 20th century are kind where they are mindful. They are in the position to listen to their patients, encourage them, be respectful even when faced with demanding patients, and deal with patients’ fearful or anxious feelings.
Nurses should develop self-awareness, which is beneficial to their professional level and personal. Mindful awareness includes their unsolved emotional stress, mainly through conscious awareness. However, many nurses have difficulty dealing with dying patients, witnessing patients suffer, and their families. It will improve the relationship between the patients and nurses.
References
Amadeo, C. A. (2008). A correlational study of servant leadership and registered nurse job satisfaction in acute health-care settings (Doctoral dissertation, University of Phoenix).
Helmstadter, C. (2008). Authority and leadership: The evolution of nursing management in 19th century teaching hospitals. (n.d.).
During the 19th century, there was a lot of great works from pioneer nurses who had limited education but did an extraordinary job of caring for the patients. One of them is Mary Ann Bickerdyke who was an untrained nurse who worked for the Union Army in the Civil War. The Superb provision of care of the soldiers earned her the title of “Mother” (Judd, 2015). After her unsuccessful venture into the higher institutions in Oberlin, Bickerdyke decided to become a nurse. In 1837 she assisted doctors in the cholera outbreak in Cincinnati, Ohio (Ohiohistorycentral.org). She established a hospital for Union soldiers in Cairo, Illinois, during the American Civil War & thereafter she established three hundred more union hospitals to help wounded & sick soldiers. Upon her arrival at the base, she was so appalled by the conditions that she refused to leave. Without official permission, she began to clean wounds, improve sanitation & cook nutritious meals (Nursing-theory.org). Due to her resilience, she was appointed matron of the hospital by General Grant & in 1862 a sanitary field agent (Nursing-theory.org). As a matron, she oversaw not only nursing but also cooking, cleaning & securing supplies. She was so dedicated that she will use a lantern to search for wounded soldiers after nightfall. She was an advocate for the soldiers by talking about the struggles & their difficulty they face health-wise, thereby soliciting funds from the civilian population. She did not only advocate for the soldiers, but the nurses as well by helping over three hundred female nurses secure their pension. She also helped the veterans begin new lives, obtained free transportation for them & continue to advocate for them (Ohiohistorycentral.org). She stayed on as an army nurse until she retired in March 1866.
The nursing care that we provide to our patients must fit with or have beneficial meaning and health outcomes for people of different or similar cultural backgrounds which made realize the importance of proving holistic care to the promotion of wellbeing or health of the patient, and according to the World Health Organization, health is defined as the complete state of physical, mental, social well-being and not merely an absence of a disease or an infirmity. Providing culturally sensitive care is essential in ensuring that we are proving holistic care and at the same time it is one way of showing respect to our patients.
In today’s nursing, Due to the education and improvement in the health care system nursing is seriously moving forward. Nursing has improved greatly by nurses doing more for patients and going far and beyond to advocate for patients and render holistic care to patients. This practice has been guiding my day-to-day practice in the nursing profession. I go far and beyond for my client, work together with the health care team to render care to patients. This has been helping my day to day activities by doing all I can in my capacity to advocate for the wellbeing of my patient and making the patient comfortable. All these practices and values are still carried on till today.
References:
Judd, D., & Sitzman, K. (2014). A History of American nursing: Trends and eras (2nd ed.). Burlington, MA: Jones & Bartlett
http://ohiohistorycentral.org/w/Mary_Ann_Bickerdyke. Retrieved March, 2017
http://nursing-theory.org/famous-nurses/Mary-Ann-Bickerdyke.php
I would be discuss Luther Christman as the nurse that has shaped and impacted my nursing career. Although I had never heard his name prior to this class, I can now point to him as an example of a great male nurse in history. In this weeks lesson I saw that male nurses now make up 12% of the nursing population. While this is still a low percentage it is great progress. Up until the 80’s nursing programs could refuse to allow males into their programs. If it were not for the hard work and perseverance of Dr. Christman the representation of men in the nursing field would be even lower than it is now.
In addition to Dr. Christman breaking through and making a place for men in the nursing field, he is also considered to be the one who laid the ground work for the role of nurse practitioner. As becoming a nurse practitioner is my end goal in my education, this is another great reason for me to look up to Dr. Christman.
As a man in the field of nursing, I owe a great debt of gratitude to Luther Christman. While men in nursing is much more widely accepted today, I do not think this would have happened without Dr.Christman. I can only hope that the work I put into my career can have the same impact for men in the nursing field. While we may be years, or decades away from there being an equal split of men and women in nursing my hope is that I can encourage and inspire more men to join the ranks of nursing.
Through all of the things that nurse in the 19thcentury accomplished, I still think that the nurse who will best guide my current professional nursing practice is Linda Richards since she was the nurse who founded the nursing documentation system. I think as things have changed in our profession and we are responsible for so much more, that it is important we are documenting and recording everything that we are doing. Unfortunately there is a high risk of lawsuits in todays society so having an accurate documentation system can prove that we are upholding our oath to do no harm because we can record all of the interventions that we put into place. Another thing about documentation is that we are essentially the eyes and ears of our patients and we can use our documentation, much as Richards did, to paint a picture of what our patients look like for the doctors and other healthcare providers who are not at the bedside with the patients as much as we are.
Documentation is such an important part of our jobs and I know we all know the saying “not documented, not done” because it just means that if we are not keeping an accurate record, it does not look like we have done anything. I know documentation is the less fun and more tedious part of our job but it is a very important part of the patient’s safety. If we are not recording things such as which medications they were given, or what allergies they have or even their current vitals, we run the risk of making mistakes that can be dangerous to our patients. Another thing that I always stress to those that I have trained is that it is important to write progress notes about important events during our shift because sometimes you have to look at the whole picture instead of just the current flow sheets. For instance, if the vitals show that my patient had a high heart rate, the doctor might rush to treat it when in reality it could have been taken right after the patient was walking and had an increase in pain. Using progress notes clarifies why things might appear abnormal. Another thing that progress notes can do is clarifying interventions done for status changes. For instance, if a patient develops chest pain, we can chart our meds and you can see the vitals and EKG but having a progress note can put the whole situation together so the doctor can see what happened, what interventions and the resolution all in one spot instead of clicking around to see everything that was done. Documentation is a huge part of our job and it is something that will only become more involved as our career progresses. Although it can seem mundane and monotonous, it is a vital part our jobs and taking the best care of our patients.
Thank goodness for documentation. I cannot imagine the chaos before documentation came into play. Documentation has changed its form over the years, but it is necessary for organization, sharing, and recording of the patients information. And today, the patient can look at labs and test results, and participate in their health through personal health records. Where I work, there is a program called “My Chart”, where you can look at your labs and test results on a computer, cell phone, or IPad. In fact, a couple of weeks ago, I was giving blood to a patient and she knew her post HGB level before I had a chance to look it up. She called me to her room and showed me the result on her cell phone. We are even starting that progress notes will be available for patients to look at on “My Chart”. I do not know how I feel about this yet, as there as not been any negativity expressed yet by patients, but sometimes what healthcare workers may put in a progress note may be sensitive to patients. Of course, if there is something serious going on with a patient, I hope the doctor has already spoken to them, before they see anything on “My Chart”.
I believe the nurse informatics role is an important role in helping to create computer programs for charting. However, I do not think a nurse should go directly into this role. To me this is a con. A nurse needs to see and perform nursing duties, before their contribution to informatics, so that they are well informed with all that is done, or that can happen in a nurse’s day. If you do not have experience in being a nurse, you really cannot bring your full potential to the table. Another con would be leaving nursing to just do informatics, as nursing skills and procedures are left behind, and not as fresh to comment about. There is when keeping up on education is a must. A pro is having nursing experience, so that you can voice what happens and what needs to be charted by the nurse in a knowledgeable way. Nurses want charting to flow easily and to not do duplicate and triplicate charting. Nursing informatics is a needed role to advocate for nurses in their charting.
I did one of my earlier posts on Richards, and it amazes me to think that documentation wasn’t always a part of healthcare! I am so anal on myself about ensuring that I chart what is required, as well as other applicable data, as often as needed, but at least every hour! You made a great point about patients panicking over the numbers on the monitors, and the patients overwhelming themselves with the unknown. I have been known to educate my patients on what the numbers mean, and why we watch them. I’ve noticed it not only them, but it helps me as well. If a patient is sick and needing hospital care, or skilled nursing care post an acute hospital stay, they have enough going on in their minds. A little education can make a huge difference. Today it’s pretty easy to access a patient chart, and evaluate what teaching, if any, has been done, and our assessments determine if that teaching was effective.
Documentation is such a crucial part of our practice. Good documentation can provide the proof of our actions and bad can be our downfall. Because of Linda Richards we are provided a way to show the what, when and why of our actions for our patients. While there are still so many issues with the documentation system at any given facility there is still a basis of Richards plan to protect nurses. I think the next great innovations in the documentation systems will come from nurses. In my opinion the next advances will be some sort of wearable device that helps to time track events and voice recognition software to help streamline the nurses documentation time. Advances in this area of nursing will give nurses more time to spend with our patients and less time at a keyboard.
Research and evidence based practice became more known in the 1800s and this made nursing have a more understanding of why they were doing what they were doing. “Scientific breakthroughs during the 1800s helped to improve nursing practice indirectly as nurses altered interventions based on new knowledge generated by scientists and physicians.” ( Judd, 2013) This guides nursing practice today because we practice only under evidence based practice and things constantly change because of it. There was a lady named Clara Maass in the 1800s that volunteered to be in a research study for yellow fever and it was done to improve patient outcomes. In today’s nursing, everything is based off improving patient outcomes and how to advance in new studies to achieve the best outcome possible. Nurses play an important role in these studies because we are the one at the bedside and know our patients the most. Sometimes nurses are even the one’s running the studies and reporting back. Without different studies and research nursing wouldn’t be as advanced as it is today and it can help nurses understand what works and what doesn’t.
Judd, D. (2013). A History of American Nursing. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9781284044324/