Question

Chapter 1 1) Identify the importance of understanding the history of nursing. 2) Identify the accomplishments of nurses during ancient times, the Dark Ages, and modern times. 3) List four modern nurses who significantly contributed to the history of nursing and identify a major contribution of each. 4) Identify the roles of the LPN and the evolution of the role historically. 5) Name two official membership organizations for LPNs concerned with practical nursing education and nursing practice. 6) Explain five current trends and issues that affect the practice of LPNs.

Answer 1

1. Studying nursing history allows nurses to understand more fully problems currently affecting the profession, such as pay, regulation, shortage, education, defining practice, autonomy, and unity. Present day nurses cannot effectively address these important issues without a foundation of historical knowledge. In short, examining history allows nurses to more fully appreciate their important role in the health care system .
2. Nursing, profession that assumes responsibility for the continuous care of the sick, the injured, the disabled, and the dying. Nursing is also responsible for encouraging the health of individuals, families, and communities in medical and community settings. Nurses are actively involved in health care research, management, policy deliberations, and patient advocacy. Nurses with postbaccalaureate preparation assume independent responsibility for providing primary health care and specialty services to individuals, families, and communities .   the origins of nursing predate the mid-19th century, the history of professional nursing traditionally begins with Florence Nightingale. Nightingale, the well-educated daughter of wealthy British parents, defied social conventions and decided to become a nurse. The nursing of strangers, either in hospitals or in their homes, was not then seen as a respectable career for well-bred ladies, who, if they wished to nurse, were expected to do so only for sick family and intimate friends. In a radical departure from these views, Nightingale believed that well-educated women, using scientific principles and informed education about healthy lifestyles, could dramatically improve the care of sick patients. Moreover, she believed that nursing provided an ideal independent calling full of intellectual and social freedom for women.   In 1854 Nightingale had the opportunity to test her beliefs during Britain’s Crimean War. Newspaper stories reporting that sick and wounded Russian soldiers nursed by religious orders fared much better than British soldiers inflamed public opinion. In response, the British government asked Nightingale to take a small group of nurses to the military hospital at Scutari (modern-day Üsküdar, Turk.). Within days of their arrival, Nightingale and her nurses had reorganized the barracks hospital in accordance with 19th-century science: walls were scrubbed for sanitation, windows opened for ventilation, nourishing food prepared and served, and medications and treatments efficiently administered.   As urbanization and industrialization spread, those without families to care for them found themselves in hospitals where the quality of nursing care varied enormously. Some patients received excellent care. Women from religious nursing orders were particularly known for the quality of the nursing care they provided in the hospitals they established. Other hospitals depended on recovering patients or hired men and women for the nursing care of patients. Sometimes this care was excellent; other times it was deplorable, and the unreliability of hospital-based nursing care became a particular problem by the late 19th century, when changes in medical practices and treatments required competent nurses. The convergence of hospitals’ needs, physicians’ wishes, and women’s desire for meaningful work led to a new health care professional: the trained nurse.   Hospitals established their own training schools for nurses. In exchange for lectures and clinical instructions, students provided the hospital with two or three years of skilled free nursing care. This hospital-based educational model had significant long-term implications. It bound the education of nurses to hospitals rather than colleges, a tie that was not definitively broken until the latter half of the 20th century. The hospital-based training model also reinforced segregation in society and in the health care system.

3. 1. Florence Nightingale

   As the “Mother of Modern Nursing”, no historical account of the profession is complete without noting Florence Nightingale’s contribution. Reaffirmed in an article by a leading health care resource provider, the pioneer started her career by training in Egypt. She then went on to make history with her service for the British military during the Crimean War, where she developed the Polar Area Diagram that led to modern hospital sanitation practices.

   2. Clara Barton

   Clara Barton abandoned her career as a teacher to fill a more pressing role in delivering medical supplies during the American Civil War. Dubbed the “Angel of the Battlefield” for her relief efforts, Barton eventually founded the American Red Cross. She continued her work with the organization through 1904.

   3. Mary Beckinridge

   As a nurse-midwife, Mary Beckinridge introduced her specialty wherever she practiced. In 1925, she founded the New Model of Rural Health Care & Frontier Nursing Service, which delivers health care to underserved rural women and children. The organization, which significantly reduces maternal and infant mortality rates, still operate today.

   4. Dorothea Dix

   Dorothea Dix established the first mental asylum in the early 1800s. She advocated for mental health rights before Massachusetts state legislators and the United States Congress. Her work shaped current policies regarding the rights of the mentally ill.  

• Monitoring basic patient health such as vital signs and overall condition
• Changing dressings or inserting catheters

• LPN duties do vary somewhat by state and employer, but you can expect to be providing hands-on patient care regardless of your location or employer.

• Taking patient histories and maintaining documentation
• Assisting with tests or procedures
• Providing personal care, such as helping with bathing and toileting
• Consulting with RNs on care plans   

  Clinician

  The role of clinician consists of tasks which most people consider “nursing care.” LPNs have been called the eyes and ears for Registered Nurses and physicians. Practical nurses often have more hands-on time caring for patients than RN’s or doctors. As a diligent nurse, ongoing and accurate assessment is vital. In addition to monitoring and assessing patients, medication is administered and dressings are changed. Many LPNs are in charge nurse positions, many others assist patients with personal care. Being a clinician involves the technical tasks of nursing.

  Manager

  As a practical nurse you will be involved in ensuring patient care plans are being followed. Many LPN's are involved in creating patient care plans and evaluating their effectiveness. Managing education for the patient and their family is always a good idea. LPN's must not only manage patient care but often coworkers as well. Many work as charge nurses or team leaders. LPN's are often given the responsibility to supervise nursing assistants.

  Advocate

  An advocate is someone who supports and supplies information to their patient. Advocacy often involves standing up in support of a patient and their rights. This is especially true when patient are not able to protect their own rights. Care about your patients and do your best to improve their situation every day.

  Educator

  Every nurse knows the value of proper patient education. Care plans are often written by RNs and carried out primarily through LPN's. In care plans are topics which require patient education. These can range from wound care to patient safety to medication teaching. It is important to evaluate which learning style(s) your patients prefer. Encourage patients to ask questions. Read more about LPN's in teaching roles.

  Counselor

  When filling the role of counselor LPN's can help patients and families explore ideas and feelings towards healthcare and illness. Some patients have a difficult time accepting a disease or its treatment options. This is common in settings such as hospice or long-term care. It is the role of the LPN to assist patients with transitions and ensure they understand their options.

  Consultant

  Consulting is communicating; as a practical nurse you consult with RN supervisors regarding patient care and assessments. In some settings LPN's communicate directly to physicians. Communicating information to the proper people assists in increasing the effectiveness of care plans. When gathering and communicating information be sure to give a holistic view of the patient.

  Researcher

  LPN's function as a researcher in a support capacity. If a problem in a care plan is identified or there is a patient that needs evaluation the LPN is a position to see these things first. When a problem is identified a solution must be found. Research by nurses should follow the evidence-based practice. This is accomplished by identifying a standard of practice and finding the best treatment option for the patient.

  Collaborator

  As practical nurses we are only one part of a patient care team. Other important members include RN's, CNA's, physicians, physical/occupational/speech therapists, dietitians, volunteers, and more. With such a large team, every member has their own scope of practice. Each of the team members is responsible for ensuring certain tasks are completed as well as solving problems within there are area of expertise. Collaborating in healthcare means sharing information and solving problems as a team. The focus should be the patient and ensuring the highest quality care possible for each individual. 5 . American Nurses Association

• ANA is one of the largest national associations, and there are state connections as well. Members have access to an online library with a wealth of information and research. They can access member-only webinars on a variety of topics that cover multiple specialty areas. With most of these webinars, they also earn contact hours. Being a member of ANA is a great addition to a resume for nurses who are seeking employment. Members also have free access to some of the top nursing magazines and journals, and they can network with fellow nurses.

  Hospice And Palliative Nurses Association

  Since most nurses work in facilities where they deal with death often, this is a good association to join. In addition to looking good on a resume, it affords nurses access to professional journals and information about hospice and end-of-life care. Members also have the ability to vote on issues related to this focus. Nurses often join to mentor others or be mentored. Since it is difficult to work with terminal patients, it helps to have a support network. Members gain leadership skills and learn how to work better with patients and colleagues. 6.

• 1 – Limited Job Opportunities

  Unfortunately, as an LPN, you are quite limited in terms of where you are able to work. Most LPNs work in care homes and residential settings. Some do work in hospitals, but they are restricted in terms of which wards they can work in, with specialized areas such as accident and emergency wards being off bounds. Their role tends to be free of responsibility and is focused on tasks, which means they are unable to provide any kind of acute care. As an LPN, you have very few responsibilities and always have to answer to someone above you. Naturally, you do have the option of continuing your education and becoming an RN yourself, which would help you to overcome this restriction.

  2 – Problems with Delegation

  As an LPN, you are not able to diagnose, assess or evaluate. This is all done by the RN in charge, who then delegates work to you as the LPN. You are not able to then pass on that work to someone else, which means it can be difficult to manage your own workload. The difficulty with this is that, as the LPN, you are often the first to notice that something is wrong with a patient. For instance, the patient may have a soiled pad that needs cleaning. However, you will need the agreement of an RN to actually change that pad, which could potentially leave the patient uncomfortable for long periods of time. In real life, most RNs will have standard delegations to their LPNs, but it is possible that you will feel incapable of doing something that you know has to happen, simply because you do not have the authority to do so.

  3 – Experience and Education

  As an LPN, you have very few opportunities for growth within your career, unless you invest in further training. This could potentially mean that you have been doing a certain job for decades, and have to be managed by someone who is in his or her early 20s and has just become an RN. This can be frustrating, because you have far more knowledge and experience than the RN. But such is the hierarchy, which must be followed.

  4 – Long Hours

  As an LPN, you will have to work shifts that are often very long and at unsociable hours. You will have to work nights, weekends and public holidays. This can be difficult, but is a problem that is faced by all nurses, even the RNs. Unfortunately, the only way to get around that is to get work in a private practice, which is very rare for an LPN, or to study on towards a Master’s Degree or higher.

  5 – Physical Challenges

  Working as an LPN is also very challenging on one’s physical body. Indeed, it is very common to see those who have worked in the field for several years to have problems with their backs and their joints. This is due to the fact that they spend most of their time on their feet, walking along the wards, and because they have to bend and lift a lot.