NURSING

health care profession concerned with providing physical and emotional care to the sick and disabled and with promoting, maintaining, and restoring health in all individuals. Nurses perform a diverse array of activities, including research, health education, and patient consultation. They often coordinate their services with physicians and other allied health providers. Nursing emerged as a profession in the latter part of the 19th century. Historically women have been the principal caregivers of sick family members, although religious traditions such as Christianity also have contributed to the history of nursing; during the Middle Ages religious orders specifically devoted to caring for the sick and the poor were established. It was not until the 19th century, however, that nursing began to gain recognition as a profession. The British nurse Florence Nightingale was instrumental in effecting this change. In 1860 she established the first scientifically based nurses' training school at St. Thomas's Hospital in London. This school became the foundation of most nursing programs throughout the Western world and marked the beginning of the modern development of nursing through its establishment of objective criteria for determining the profession's qualifications. In the late 20th century educational programs for nurses in many countries were of two types: those that required a combination of academic study and clinical practice, took between two to four years to complete, and led to either a diploma or a degree; and those that prepared auxiliary nurses (often called aides or practical nurses), who receive less training and perform less complicated tasks. In the United States and Canada there is an emphasis on baccalaureate education and a move away from the traditional hospital training program of Florence Nightingale. Many nurses choose to specialize in various areas of care such as pediatrics, psychiatry, geriatrics, or critical care. Advanced training for teachers, supervisors, and specialists is also available. Specialized programs for nurse-practioners, clinical nurse specialists, nurse anesthetists, and nurse midwives prepare nurses to undertake certain tasks traditionally carried out by physicians. Licensing and registration are important in standardizing and regulating nursing care. In many countries nurses must pass a licensure examination to be able to practice. Professional organizations such as the American Nurses Association, founded in 1896, formulate standards and administer examinations, provide continuing education, and promote desirable legislation for the profession. In the United States, legal designations of nurses include registered nurses, who complete a degree program and pass an examination, and licensed practical nurses, who complete one year of training and assist registered nurses. Nursing is practiced in many settings, such as hospitals, nursing homes, schools, the military, industry, physicians' offices, clinics, and private homes. In a hospital setting nurses may hold different levels of responsibility, from staff nurse to administrator. Nurses may organize a patient's care after leaving the hospital, providing services through outpatient clinics or home care for the terminally ill through hospice programs. Community, or public health, nursing involves educating the public on such topics as proper nutrition for pregnant women and methods of disease prevention. health care profession concerned with providing care to the sick and disabled and with promoting, maintaining, and restoring health. Nurses perform many different services, including research, education, and patient consultation. They often coordinate their services with physicians and other health providers. The need for nursing is universal. The International Council of Nurses states that the function of nursing is fourfoldto promote health, prevent illness, restore health, and alleviate sufferingand that inherent in nursing is the respect for life, dignity and the rights of man. It is unrestricted by considerations of nationality, race, creed, colour, age, sex, politics or social status. Nurses render health services to individuals, the family and the community and co-ordinate their services with those of related groups. Nurses form the largest group of health service workers throughout the world. As medical science advances, the health needs of a given population change and expectations for care rise, so that the potential for nursing service increases. The World Health Organization (WHO) stated in 1986 that nursing and midwifery personnel have an even greater potential contribution to make to health for all than they are already making. Nurses' potential lies in their role as providers of primary health care services in community settings, clinics, schools and industries as well as in hospitals. Additional reading The long historical tradition of the nursing occupation is studied in John Howard, An Account of the Principal Lazarettos in Europe (1789); Brian Abel-Smith, A History of the Nursing Profession (1960, reprinted 1975); Vern L. Bullough and Bonnie Bullough, The Emergence of Modern Nursing, 2nd ed. (1969); Cecil Blanche Woodham Smith, Florence Nightingale, 18201910 (1950, reissued 1983); Monica E. Baly, Florence Nightingale and the Nursing Legacy (1986); Barbara Melosh, The Physician's Hand: Work Culture and Conflict in American Nursing (1982); and M. Patricia Donahue, Nursing, the Finest Art: An Illustrated History (1985).Esther Lucile Brown, Nursing Reconsidered: A Study of Change, 2 vol. (197071), reviews the developments of the 1960s and analyzes new functions performed by nurses. See also Monica E. Baly, Nursing and Social Change, 2nd ed. (1980); Bonnie Bullough, Vern L. Bullough, and Mary Claire Soukup, Nursing Issues and Nursing Strategies for the Eighties (1983); and Norma L. Chaska (ed.), The Nursing Profession: A Time to Speak (1983). Nursing practices are explored in Sandra Debella, Leonide Martin, and Sandra Siddall, Nurses' Role in Health Care Planning (1986); Mary H. Browning (comp.), The Nursing Process in Practice (1974), and Nursing and the Aging Patient (1974); Mary H. Browning and Edith P. Lewis (comps.), Nursing and the Cancer Patient (1973), and The Nurse in Community Mental Health (1972); Andrew Jameton, Nursing Practice: The Ethics Issues (1984); and Carol Ren Kneisl and Sueann Wooster Ames (eds.), Adult Health Nursing: A Biopsychosocial Approach (1986). Education for the nursing profession is the subject of Committee for the Study of Nursing Education (U.S.), Nursing and Nursing Education in the United States (1923, reprinted 1984), a classic yet still timely report on nursing training; and Bryn Davis (ed.), Nursing Education: Research and Developments (1987).