The Profession of Nursing

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Section 1 © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR© Galyna Andrushko/Shutterstock SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION The Profession of Nursing The ﬁ rst section of this text © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC introduces the nursing student NOT FOR SALE OR DISTRIBUTION NOT FORto SALE the profession OR DISTRIBUTION of nursing. The Development of Professional Nursing: History, Development, and the Nursing Profession © Jones & Bartlett Learning, LLC chapter reviews the© history Jones and & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONdevelopment of theNOT nursing FOR SALE OR DISTRIBUTION profession and what it means for nursing to be a profession. The Essence of Nursing: Knowledge and Caring chapter discusses © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC the essence of nursing, focusing NOT FOR SALE OR DISTRIBUTION on theNOT need FOR for knowledgeSALE OR DISTRIBUTION and caring and how nursing students develop throughout the nursing education program to be © Jones & Bartlett Learning, LLC © Jones knowledgeable,& Bartlett Learning, competent, LLC and NOT FOR SALE OR DISTRIBUTION NOT FORcaring. SALE The OR Nursing DISTRIBUTION Education, Accreditation, and Regulation chapter examines nursing education, accreditation of nursing education programs, © Jones & Bartlett Learning, LLC and regulation of the© practiceJones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONof nursing. The SuccessNOT in FORYour SALE OR DISTRIBUTION Nursing Education Program chapter provides information about the nursing student © Jones & Bartlett Learning, LLC experience.© Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION1 NOT FOR SALE OR DISTRIBUTION CHAPTER OBJECTIVES At the conclusion of this chapter, the learner will be able to:

■ Examine key ﬁgures, events in nursing history, standards and professional organizations to and critical© Jones nursing &historical Bartlett themes Learning, within LLC the nursing profession. © Jones & Bartlett Learning, LLC the sociopoliticalNOT FOR context SALE of the OR time. DISTRIBUTION■ Describe the current andNOT past image FOR of SALE OR DISTRIBUTION ■ Discuss critical professional concepts, nursing and related critical issues. professionalism in nursing, and relevance of

© Jones CHAPTER& Bartlett OUTLINELearning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION ● Introduction ● Nursing as a Profession ● From Past to Present: Nursing History ● Sources of Professional Direction ● The History Surrounding the ● Professional Nursing Associations Development of Nursing as a ● Major Nursing Associations © Jones & Bartlett Learning,Profession LLC © Jones &● BartlettWhy Belong Learning, to a Nursing LLC Professional ● Early History Association? NOT FOR SALE OR DISTRIBUTION● Rise of Christianity and the MiddleNOT FOR● SALENursing WorkforceOR DISTRIBUTION Ages ● The Image of Nursing ● Renaissance and the Enlightenment ● Chapter Highlights ● Industrial Revolution ● Engaging in the Content ● Colonization of America and the ● Discussion Questions © GrowthJones of &Nursing Bartlett in the Learning,United LLC● Critical Thinking Activities© Jones & Bartlett Learning, LLC NOTStates FOR SALE OR DISTRIBUTION● Electronic Reﬂection JournalNOT FOR SALE OR DISTRIBUTION ● Nurse Leaders: History in the Making ● Case Studies ● Themes: Looking into the Nursing ● Working Backward to Develop a Case Profession’s History ● References ● Professionalism: Critical Professional © Jones & BartlettConcepts and Learning, Activities LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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KEY TERMS© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Accountability Nursing Scope of practice Autonomy Professional organization Social policy statement Code of ethics Professionalism Standards Colleagueship Responsibility © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION e past portrayal of nurses as handmaidens and Introduction assistants to physicians has its roots in the profession’s religious beginnings, but over time this view is text presents an introduction to the nursing © Jones & Bartlett Learning, LLC © Jonesof nurses & changed. Bartlett e followingLearning, sections LLC examine profession and critical aspects of nursing care and NOT FOR SALE OR DISTRIBUTION NOTthe FORstory of SALE nursing OR and exploreDISTRIBUTION how it developed the delivery of health care. To begin the journey to as a profession. graduation, licensure, and then practice, it is important to understand several aspects of the nursing profession. What is professional nursing? How did The History Surrounding it develop? What© Jonesfactors inuence & Bartlett the view Learning, of the the Development LLC of© Nursing Jones & Bartlett Learning, LLC profession? isNOT chapter FOR addresses SALE these OR questions. DISTRIBUTIONas a Profession NOT FOR SALE OR DISTRIBUTION When nursing history is described, distinct historical periods typically are discussed: early history (AD From Past to Present: 1–500), rise of Christianity and the Middle Ages © JonesNursing & BartlettHistory Learning, LLC (500–1500), Renaissance© Jones (mid-1300s–1600s), & Bartlett Learning, and LLC NOT FOR SALE OR DISTRIBUTION the Industrial RevolutionNOT FOR (mid-1700s–mid-1800s). SALE OR DISTRIBUTION It is important for nursing students to learn about In addition, the historical perspective must include nursing history. Nursing’s history provides a frame- the dierent regions and environments in which work for understanding how nursing is practiced the historical events took place. Early history today and the societal trends shaping the profession. focuses on Africa, the Mediterranean, Asia, and © Jones & Bartlett e characteristics Learning, ofLLC nursing as a profession and © Jonesthe Middle & BartlettEast. e focus Learning, then turns LLC to Europe, NOT FOR SALEwhat OR nurses DISTRIBUTION do today have their roots in the past, NOTwith FOR the rise SALE of Christianity OR DISTRIBUTION and subsequent major not only in the history of nursing, but also in the changes that span several centuries. Nursing history history of health care and society in general. Today, expands as British colonists arrive in America, and health care is highly complex; diagnostic methods a new country and environment helped to slowly and therapies have© Jones been developed & Bartlett that oer Learning, many develop LLC the nursing profession, which© Jones at the &time Bartlett Learning, LLC opportunities forNOT prevention, FOR SALEtreatment, OR and DISTRIBUTION cures was not a profession. roughoutNOT all these FOR periods SALE OR DISTRIBUTION that did not exist even a few years ago. Understand- and locations, wars had an impact on nursing. As ing this development is part of this discussion; it a consequence of the varied places and times in helps us to appreciate where nursing is today and which nursing has existed, major historical events, may provide stimulus for changes in the future. dierent cultures and languages, varying views on © Jones“Nursing & is Bartlettconceptualized Learning, as a practice LLC discipline what constitutes© disease Jones and & illness, Bartlett roles of Learning, women, LLC NOTwith FOR a mandate SALE from OR society DISTRIBUTION to enhance the health political issues,NOT and location FOR andSALE environment OR DISTRIBUTION have and well-being of humanity” (Shaw, 1993, p. 1654). inuenced these professions. Nursing has probably

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existed for as long as humans have been ill; someone this period—which represents thousands of years always took© care Jones of the sick.& Bartlett is does notLearning, mean that LLCand involved several major ©cultures Jones that & rose Bartlett and Learning, LLC there was aNOT formal FOR nursing SALE position; OR rather, DISTRIBUTION in most fell—nursing care was provided,NOT but FOR not nursingSALE OR DISTRIBUTION early cases, the nurse was a woman who cared for as it is thought of today. People took care of those ill family members. is discussion begins with this who were sick and those going through childbirth, group and then expands to the development and representing an early nursing role. © Jonesimplementation & Bartlett of Learning,a formal nursing LLC position and © Jones & Bartlett Learning, LLC Rise of Christianity and the NOT FORthen later SALE to multiple OR DISTRIBUTION roles and dierent healthcare NOT FOR SALE OR DISTRIBUTION settings and recognition of nursing as a profession. Middle Ages e rise of Christianity led to more structured nursing Early History care, but still it was far from professional nursing. Early history of nursing focused on the Ancient Women continued to carry most of the burden of © Jones & Bartlett EgyptiansLearning, and Hebrews, LLC Greeks, and Romans. During© Jones caring & forBartlett the poor Learning, and the sick. LLC e church set NOT FOR SALE ORthis DISTRIBUTION time, communities oen had women whoNOT as- FORup a system SALE for OR care DISTRIBUTION that included the role of the sisted with childbearing as a form of nursing care, deaconess, who provided care in homes. Women and some physicians had assistants. e Egyptians who served in these roles had to follow strict rules had physicians, and sick persons looking for magical set by the church. is role eventually evolved into answers would© Jones go to them & Bartlettor to priests Learning, or sorcerers. LLCthat of nuns, who began to ©live Jones and work & in Bartlett con- Learning, LLC HebrewNOT (Jewish) FOR physicians SALE keptOR recordsDISTRIBUTION and vents. e convent was consideredNOT FORa safe place SALE for OR DISTRIBUTION developed a hygiene code that examined issues such women. e sick came to the convents for nursing as personal and community hygiene, contagion, care and also received spiritual care (Wall, 2003). disinfection, and preparation of food and water e establishment of convents and the nursing care (Masters, 2005). is occurred at a time when hy- provided there formed the seed for what, hundreds © Jonesgiene & was Bartlett very poor—a Learning, condition LLC that continued of years later,© Jones would become & Bartlett the Catholic Learning, system of LLC NOT FORfor several SALE centuries. OR DISTRIBUTION Disease and disability were hospitals thatNOT still FOR exists SALEtoday. OR DISTRIBUTION viewed as curses and related to sins, which meant Men were also involved in nursing at this time. that aicted persons had to change or follow the For example, men in the Crusades cared for the sick religious statutes (Bullough & Bullough, 1978). and injured. ese men wore large red crosses on Greek mythology recognized health issues and their uniforms to distinguish them from the ghting © Jones & Bartlett physiciansLearning, in its gods.LLC Hippocrates, a Greek physician,© Jones soldiers. & Bartlett e “red cross”Learning, later became LLC the symbol NOT FOR SALE ORis knownDISTRIBUTION as the father of medicine. He contributedNOT FORfor the SALE International OR DISTRIBUTIONCommittee of the Red Cross. to health care by writing a medical textbook that was Altruism and connecting care to religion were used for centuries, and he developed an approach major themes during this period. Even Nightingale to disease that would later be referred to as epide- continued with these themes in developing her miology. Hippocrates© Jones wrote& Bartlett the Hippocratic Learning, Oath LLCview of nursing. Disease was© common Jones and & spreadBartlett Learning, LLC (BulloughNOT & Bullough, FOR 1978), SALE which OR is DISTRIBUTIONstill recited quickly, and medical care hadNOT little FOR to oer SALE in the OR DISTRIBUTION by new physicians and also inuenced the writing way of prevention or cure. Institutions that were of the Nightingale Pledge (see Exhibit 1-1). e called hospitals were not like modern hospitals; Greeks viewed health as a balance between body and they primarily served travelers and sometimes the mind—a dierent perspective from earlier views of sick (Kalisch & Kalisch, 1986, 2005). © Joneshealth & thatBartlett focused Learning, on curses and LLC sins. e Protestant© Jones Reformation & Bartlett had a Learning, major impact LLC NOT FOR roughout SALE OR this DISTRIBUTION entire period, the wounded on some ofNOT the care FOR given SALE to the ORsick andDISTRIBUTION injured. and ill in the armies required care. Generally, during e Catholic Church’s loss of power in some areas

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resulted in the closing of hospitals, and some convents As a result of this work, he became known closed or moved.© eJones hospitals & Bartlett that remained Learning, were LLCas the father of microbiology.© Jones & Bartlett Learning, LLC no longer staedNOT by nuns, FOR but ratherSALE by womenOR DISTRIBUTION from ■ Klebs, Pasteur, Lister, andNOT Koch allFOR contrib SALE- OR DISTRIBUTION the lower classes who oen had major problems, uted to the development of the germ theory. such as alcoholism or were former prostitutes. is is what Florence Nightingale found when she Industrial Revolution © Jonesentered nursing. & Bartlett Learning, LLC e Industrial ©Revolution Jones brought& Bartlett changes Learning, in the LLC workplace, but many were not positive from a NOTRenaissance FOR SALE and OR theDISTRIBUTION NOT FOR SALE OR DISTRIBUTION health perspective. e crowded factories of this Enlightenment era were hazardous and served as breeding grounds e Renaissance had a major impact on health and for disease. People worked long hours and oen the view of illness. is period was one of signicant under harsh conditions. is was a period of great © Jones & Bartlettadvancement Learning, in science, LLC though by today’s standards, © Jonesexploitation & ofBartlett children, particularlyLearning, those LLC of the lower NOT FOR SALEit ORmight DISTRIBUTION be viewed as limited. ese early discoveries NOTclasses, FOR who SALE were forced OR toDISTRIBUTION work at very young ages led to advancements that had never been imagined. (Masters, 2005). No child labor laws existed, so is is the period, spanning many years, of preteen children oen worked in factories alongside Columbus and the French and American Revolutions adults. Some children were forced to quit school to when education became more important. Leonardo © Jones & Bartlett Learning,earn LLC wages to help support their families.© Jones Cities &were Bartlett Learning, LLC da Vinci’s drawings of the human anatomy, which NOT FOR SALE OR DISTRIBUTIONcrowded and very dirty, with epidemicsNOT FOR erupting SALE OR DISTRIBUTION were done to help him understand the human about which little could be done. ere were few body for his sculptures, provided details that had public health laws and services to alleviate the causes. not been recognized before (Donahue, 1985). e 18th century was a period of many discoveries and Colonization of America and © Joneschanges &(Dietz Bartlett & Lehozky, Learning, 1963; Masters, LLC 2005; the Growth© ofJones Nursing & Bartlett in the Learning, LLC NOTRosen, FOR 1958), SALE including OR theDISTRIBUTION following: United StatesNOT FOR SALE OR DISTRIBUTION ■ Jenner’s smallpox vaccination method was e initial experiences of nursing in the United States developed during a time of high death rates were not much dierent from those described for from smallpox. Britain and Europe. Nurses were of the lower class ■ Psychiatry became a medical specialty area, and had limited or no training; hospitals were not © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC through the inuence of Freud and others. used by the upper classes, but rather by the lower NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION ■ e pulse watch and the stethoscope were classes and the poor. Hospitals were dirty and lacked developed, changing how physical assessment formal care services. was conducted. Nursing in the United States did move forward, ■ Pasteur discovered the process of pasteur- as described in Exhibit 1-2 demonstrating nursing ization, ©which Jones had an & impactBartlett on food Learning, and activities LLC and changes that occurred© Jones over time.& Bartlett Learning, LLC milk contamination.NOT FOR SALE OR DISTRIBUTIONSignicant steps were taken to NOTimprove FOR nursing SALE OR DISTRIBUTION ■ Lister used some of Pasteur’s research and education and the profession of nursing. e rst developed approaches to antiseptic surgery; nursing schools—or, as they were called, training as a result of this work, Lister is known as schools—were modeled aer Nightingale’s school. the father of surgery. Some of the earlier schools were in Boston, New © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC ■ Koch studied anthrax and cholera, both major York, and Connecticut. e same approach was NOT FORdiseases SALE of the OR time, DISTRIBUTION demonstrating that they taken in theseNOT schools FOR as in SALE Britain. OR Stress DISTRIBUTION was were transmitted by water, food, and clothing. placed on moral character and subservience, with

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eorts to move away from using lower-class women In the 1930s, the Great Depression also had an with dubious© Joneshistories (Masters,& Bartlett 2005). Learning, Limitations LLCimpact on the nursing eld, “resulting© Jones in widespread & Bartlett Learning, LLC regarding NOTwhat women FOR could SALE do on OR their DISTRIBUTION own con- unemployment of private dutyNOT nurses FOR and the SALE closing OR DISTRIBUTION tinued to be a major problem—for example, women of nursing schools, while simultaneously creating the could not vote and had limited rights. increasing need for charity health services for the In the early 1900s, this situation began to population” (Masters, 2005, p. 28). is meant that © Joneschange & Bartlettwhen women Learning, obtained the LLC right to vote, there were© fewer Jones student & nurses Bartlett to sta Learning,the hospitals. LLC NOT FORbut only SALE with great OR eort. DISTRIBUTION e Nurses’ Associated As a consequence,NOT FOR nurses SALE were hired, OR albeit DISTRIBUTION at very Alumnae, established in 1896, was renamed the low pay, to replace them. Until that time, hospitals American Nurses Association (ANA) in 1911. At had depended on student nurses to sta the hospitals, the same time, the rst nursing journal, American and nurses who had completed training (term then Journal of Nursing (AJN), was created through the used for nursing education) served as private-duty © Jones & Bartlett ANA.Learning, e AJN LLC was published until early 2006,© Jones nurses & inBartlett homes. Using Learning, students LLCto sta hospitals NOT FOR SALE ORwhen DISTRIBUTION the ANA replaced it with American NurseNOT FORcontinued SALE until OR the university-based DISTRIBUTION nursing eort Today as its ocial journal. e AJN, the oldest grew; however, during the Depression, there was a U.S. nursing journal, still exists today, but a com- greater need to replace nursing students with nurses pany that is not associated with ANA publishes when schools closed. On one level, this could be it. Its content© Jones has always & focusedBartlett on Learning,issues facing LLCseen as an improvement in ©care, Jones but the & obstacle Bartlett Learning, LLC nurses andNOT their patients.FOR SALE Additional OR information DISTRIBUTION of low pay was dicult to overcome,NOT FOR resulting SALE in a OR DISTRIBUTION about signicant nursing professional activities long history of low pay scales for nurses. is discussed in this chapter and other chapters In the 1940s and 1950s, other changes occurred throughout this text. in the U.S. healthcare system that had a direct Although some nurse leaders were ardent impact on nursing. Certainly, scientic discoveries © Jonessuragists, & Bartlett Nightingale Learning, was not interested LLC in these were changing© Jones care, but & importantBartlett healthLearning, policy LLC NOT FORideas, evenSALE though OR women DISTRIBUTION in Britain did not have the changes occurredNOT FOR as well. SALE e Hill-BurtonOR DISTRIBUTION Act right to vote. Nightingale felt that the focus should (1946) established federal funds to build more be on allowing (a permissive statement indicative hospitals; as a result of this building boom, at one of women’s status) women to own property and point in the 1980s, there were too many hospital then linking voting rights to this ownership right beds. In turn, many nurses lost their jobs in hos- © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC (Masters, 2005). ere was, however, communication pitals because their salaries represented the largest NOT FOR SALE ORacross DISTRIBUTION the ocean between U.S. and British nurses.NOT FORoperating SALE expense OR DISTRIBUTIONand there were not enough ey did not always agree on the approach to take patients to ll the beds. ere is some belief that on the road to professionalism; in fact, nurses did this decision still aects uctuating problems of not always agree on this issue within the United nursing shortage either at the national level or in States. Nurse© Jonesleaders and & practicingBartlett nurses Learning, helped LLCspecic states and healthcare ©organizations, Jones & though Bartlett Learning, LLC nursing toNOT grow intoFOR a profession SALE OR during DISTRIBUTION times of its scope has varied over theNOT past few FOR years. SALE When OR DISTRIBUTION war (American Revolution, Civil War, the Spanish– more nurses are needed, some of the nurses who American War, World War I, World War II, Korean are laid o move into new jobs or careers or leave War, Vietnam War, and modern wars today). e the workforce so they are not available when the website Experiencing War: Women at War oers need for nurses increases again. e latter half of © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC information about some of the nurses who served the 20th century represented a period of rapid NOT FORin these SALE wars, providing OR DISTRIBUTION nursing care leadership and change inNOT healthcare FOR reimbursement SALE OR DISTRIBUTION due to the further developing the nursing profession. growth of health insurance; greater attempts to

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manage care, particularly to reduce costs; and the ■ Colleges and universities should provide an establishment© of Jones Medicare & and Bartlett Medicaid. Learning, Such LLCarray of support services to ©minority Jones students, & Bartlett Learning, LLC rapid changes areNOT now FOR being seenSALE again OR in the DISTRIBUTION 21st including mentoring, resourcesNOT for FORdeveloping SALE OR DISTRIBUTION century with the passage of the Patient Protec- test-taking skills, and application counseling. tion and Aordable Care Act of 2010 (ACA) and ■ Schools of nursing granting baccalaureate possible future changes to this law. During these degrees should provide and support bridging © Jonestimes, typically & Bartlett more nurses Learning, and other LLC healthcare programs© Jonesthat enable & graduatesBartlett of Learning, 2-year LLC NOTproviders FOR areSALE needed. OR e DISTRIBUTION Healthcare Delivery Sys- collegesNOT to succeed FOR in the SALE transition OR to DISTRIBUTION 4-year tem: Focus on Acute Care chapter discusses some institutions. Graduates of associate degree of these issues in more detail. e Health Policy nursing programs should be encouraged to and Political Action: Critical Actions for Nurses enroll in baccalaureate nursing programs chapter examines the most signicant issue in and supported aer they enroll. © Jones & Bartlettcurrent Learning, healthcare delivery—namely,LLC the ACA. In © Jones■ AACN & Bartlett and other Learning, health profession LLC organi- NOT FOR SALEaddition OR DISTRIBUTION in 1922, 1946, and then in 2010, critical NOT FORzations SALE should OR work DISTRIBUTION with schools to promote reports were published describing the status of enhanced admissions policies, cultural nursing education, as discussed later in this text competence training, and minority student in content about nursing education. recruitment. Little has been© Jones said in this & Bartlettdescription Learning, of nurs- LLC■ To remove nancial barriers© to Jonesnursing educa & Bartlett- Learning, LLC ing history aboutNOT the roleFOR of men SALE and minoritiesOR DISTRIBUTION in tion, public and private fundingNOT organizations FOR SALE OR DISTRIBUTION nursing; groups that had limited involvement in should provide scholarships, loan forgiveness the profession’s early history. is lack of diver- programs, and tuition reimbursement to sity—men and minorities—has been a long-term students and institutions. problem for the profession. Segregation and dis- ■ Congress should substantially increase funding © Jonescrimination & Bartlett also existed Learning, in nursing, just LLC as they did for diversity© Jones programs & Bartlettwithin the NationalLearning, LLC NOTin theFOR society SALE at large. OR e DISTRIBUTION National Association of Health ServiceNOT CorpsFOR andSALE Titles ORVII and DISTRIBUTION VIII Colored Graduate Nurses closed in 1951 when the of the Public Health Service Act. ANA began to accept African American nurses as ese recommendations and eorts to improve members. Nevertheless, concern remains about the the number of minorities in all health professions limited number of minorities in health care. e © Jones & Bartlett Learning, LLC © Joneshave had & some Bartlett impact, Learning, but more improvement LLC is Sullivan Commission’s report on health profession required. is topic also relates to the problem of NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION diversity, Missing Persons: Minorities in the Health healthcare disparities, as noted in other chapters. Professions (L. Sullivan, 2004), is an important e number of men in nursing has increased document oering recommendations to improve over the years but still is not where it should be. diversity in the health professions. e American Men served as nurses in the early history period, Association of ©Colleges Jones of Nursing& Bartlett (AACN, Learning, 2004) such LLC as noted earlier in the chapter© in Jones the Crusades & Bartlett Learning, LLC responded to thisNOT critical FOR report SALE by recommending OR DISTRIBUTION and monks provided care in monasteries.NOT FOR Aer thisSALE OR DISTRIBUTION the following actions: period, however, men were not accepted as nurses ■ Health profession schools should hire diver- because nursing was viewed as a woman’s role. e sity program managers and develop strategic poet Walt Whitman was a nurse in the Civil War. © Jonesplans & Bartlett that outline Learning, specic goals, LLC standards, us, there were© Jonesmen in nursing, & Bartlett though Learning,few, and LLC policies, and accountability mechanisms to some were well known—but perhaps not for their NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION ensure institutional diversity and cultural nursing (Kalisch & Kalisch, 1986). Early in the history competence. of nursing schools in the United States, men were

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not accepted. is may have been inuenced by the Sullivan, Christman stated that “men in medicine gender-segregated© Jones housing & Bartlett for nursing Learning, students and LLCwere reluctant to give up power© Jones to women & and, Bartlett by Learning, LLC the model NOTof apprenticeship FOR SALE that focused OR DISTRIBUTION on women the same token, women in nursingNOT FORhave fought SALE to OR DISTRIBUTION (Bullough, 2006). In part, this female dominance retain their power. Medicine, however, was forced was also the result of nursing’s religious roots, which to admit women aer armative action legislation promoted sisters as nurses. is made it dicult for was enacted” (2002, p. 10). “Sadly,” Christman © Jonesmen & to Bartlettcome into Learning,the system and LLC the culture—it reported, “nursing,© Jones with & a Bartlett majority of Learning, women, was LLC NOT FORwas a women’sSALE profession.OR DISTRIBUTION not requiredNOT to adhere FOR to armativeSALE OR action DISTRIBUTION policies” Aer the major wars—such as World Wars I and (Sullivan, 2002, p. 12). ere is an organization for II, Korean War, and Vietnam War—medics came home men in nursing, the American Assembly for Men and entered nursing programs, and they continue to in Nursing (AAMN), and men are also members of do so. In 1940, the ANA did recognize men by having other nursing organizations. In 2010, the AAMN © Jones & Bartlett aLearning, session on men LLC in nursing at its convention. When© Jones began & aBartlett campaign Learning,to increase the LLC number of men NOT FOR SALE ORschools DISTRIBUTION of nursing began to transition to academicNOT FORin the SALEprofession OR by increasingDISTRIBUTION enrollment of men settings, more men applied to nursing programs. Men in nursing programs from current 10% to 20% in nursing have to contend with male-dominated (American Assembly for Men in Nursing, 2017). medicine, which has inuenced men becoming e campaign is called “20 3 20: Choose Nursing.” nurses. ere© Jones was a time & Bartlettwhen male Learning, nurses were LLC ere is no question that© the Jones majority & of nursesBartlett Learning, LLC also able toNOT get commissions FOR SALE in the OR military DISTRIBUTION when are White females, and this needsNOT to FOR change. SALE ere OR DISTRIBUTION women could not, and this increased their numbers has been an increase in the number of male and in the military (Bullough, 2006). ese changes minority nurses, but not enough. ere is a greater did have an impact, but the increase in salaries and need to actively seek out more male and minority improvement in work conditions had the strongest students (Cohen, 2007). Men and minorities in © Joneseect & on Bartlett increasing Learning, the number of LLC men in nursing. nursing should© Jones reach out & and Bartlett mentor studentLearning, nurses LLC NOT FORIn SALE 2001, Boughn OR DISTRIBUTION conducted a study to explore and new nursesNOT toFOR provide SALE them ORwith theDISTRIBUTION support why women and men choose nursing. e results of they require as they enter a profession predomi- this study indicated that female and male participants nantly composed of White women. More media did not dier in their desire to care for others. Both coverage would also be helpful in publicizing the groups had a strong interest in power and empow- role of men and minorities in nursing; for example, © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC erment, but female students were more interested when photos are distributed to the media, photos NOT FOR SALE ORin DISTRIBUTIONusing their power to empower others, whereasNOT FORshould SALE emphasize OR the DISTRIBUTION diversity of the profession. male students were more interested in empowering Men are a very small percentage of the total the profession. e most signicant dierence was number of registered nurses (RNs) living and work- found in the expectations of salary and working ing in the United States, although their numbers conditions,© with Jones men expecting & Bartlett more. Learning, Why would LLCcontinue to grow (U.S. Department© Jones of Health & Bartlett and Learning, LLC not both malesNOT and FOR females SALE expect OR higher DISTRIBUTION salaries Human Services [HHS], HealthNOT Resources FOR andSALE Ser- OR DISTRIBUTION and better working conditions? Is this still part of vices Administration [HRSA], & Bureau of Health the view of nursing and nurses from nursing’s past? Professions [BOHP], 2010). Before 2000, 6.2% of RNs Luther Christman was a well-known nurse were men; by 2008, this percentage had increased leader who served as a nurse for many years, retiring to 9.6%. Male and female RNs are equally likely to © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC at the age of 87, and aer retirement, he continued have a baccalaureate degree, but male RNs are more NOT FORto be anSALE active voiceOR forDISTRIBUTION the profession and for men likely to alsoNOT have FOR a non-nursing SALE OR degree. DISTRIBUTION By 2013, in nursing until his death in 2011. According to men represented 10.7% of the RN workforce, which

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 9 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 10 Section 1: The Profession of Nursing

was not a major increase from 2008, but an increase however, although Nightingale did much for nursing, nevertheless (Farmer,© Jones 2015). e& Bartlett AACN noted Learning, that in many LLC who came aer her provided© Jones even greater & Bartlett Learning, LLC 2014–2015, enrollmentNOT FOR of men SALE in nursing OR programs DISTRIBUTION direction for the profession. A focusNOT on Nightingale FOR SALE OR DISTRIBUTION improved: 11.8% in baccalaureate programs, 10.8% helps to better understand the major changes that in master’s programs, 9.6% in research-focused occurred in the profession and in nursing leaders. In doctoral programs (PhD), and 11.7% in doctor of 1859, Nightingale wrote, “No man, not even a doctor, © Jonesnursing practice & Bartlett (DNP) Learning,programs (AACN, LLC 2015a). ever gives any other© Jones denition & of Bartlett what a nurse Learning, should LLC NOT e FORAACN SALEalso notes OR that 41%DISTRIBUTION of men in the nursing be than this—‘devotedNOT FORand obedient.’ SALE is OR denition DISTRIBUTION workforce are in nurse anesthetist positions. would do just as well for a porter. It might even do for a horse. It would not do for a policeman” (Nightingale, Nurse Leaders: History 1992, p. 20). is quote clearly demonstrates that she in the Making was outspoken and held strong beliefs, though she © Jones & Bartlett Learning, LLC © Joneslived during & Bartlett a time when Learning, this type of forthrightness LLC NOT FOR SALE e OR best DISTRIBUTION place to begin to gain a better understand- NOTfrom FOR a woman SALE was extraordinary.OR DISTRIBUTION ing of nursing history is with a description of its Nightingale was British and lived and worked leaders—that is, the nurses who made a dierence in London in the Victorian era during the Industrial to the development of the profession. Florence Night- Revolution. During this time, the role of women— ingale is viewed© as Jones the “mother” & Bartlett of modern Learning, nursing especially LLC women of the upper classes—was© Jones clearly & Bartlett Learning, LLC throughout the NOTworld. MostFOR nursing SALE students OR atDISTRIBUTION some dened and controlled. During thisNOT time, FOR women SALE OR DISTRIBUTION point say the Nightingale Pledge, which helps all did not work outside the home and maintained a new nurses connect the past with the present. e monitored social existence. eir purpose was to Nightingale Pledge is found in Exhibit 1-1. It was be a wife and a mother, two roles that Nightingale composed to provide nurses with an oath similar never assumed. Education of women was also lim- © Jonesto the physician’s & Bartlett Hippocratic Learning, Oath. e LLC oath was ited. With the support© Jones of her & father, Bartlett Nightingale Learning, did LLC NOTnot FORwritten SALE by Nightingale OR DISTRIBUTION but emphasized her view obtain some classicalNOT education,FOR SALE but there OR was DISTRIBUTION never of nursing, and it is easy to also see the inuence of any expectation that she would “use” the education the culture at the time this was written. (Slater, 1994). “Nightingale grew up knowing what Volumes have been written about Nightingale. was expected of her life: Women of her class ran the She has become the almost-perfect vision of a nurse; home and supervised the servants. Although this was © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Exhibit 1-1 The Original Nightingale Pledge

© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC I solemnly pledge myself before God and in elevate the standard of my profession, and the presenceNOT of this FOR assembly, SALE to pass OR my DISTRIBUTION will hold in conﬁdence all personalNOT matters FOR SALE OR DISTRIBUTION life in purity and to practice my profession committed to my keeping and all family affairs faithfully. I will abstain from whatever is coming to my knowledge in the practice of deleterious and mischievous, and will not my calling. With loyalty will I endeavor to aid take or knowingly administer any harmful the physician, in his work, and devote myself © Jonesdrug. & I will Bartlett do all in myLearning, power to maintain LLC and to the welfare ©of thoseJones committed & Bartlett to my care.Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Composed by Lystra Gretter in 1893 for the class graduating from Harper Hospital, Detroit, Michigan.

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 10 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 1: Professional Nursing: History and Development of the Nursing Profession 11

not her goal, the household management skills that as the basis of nursing’s holistic view of health. she learned© from Jones her mother & Bartlett were put Learning, to good use LLCNightingale’s convictions also© inuenced Jones &her Bartlett views Learning, LLC when she enteredNOT theFOR hospital SALE environment. OR DISTRIBUTION Because of nurses and nursing practice.NOT She viewedFOR patientsSALE OR DISTRIBUTION of her social standing, she was in the company of as persons who were unable to help themselves or educated and inuential men, and she learned the who were dying. She is quoted as saying, “What “art of inuencing powerful men” (Slater, 1994, nursing has to do . . . is to put the patient in the best © Jonesp. 143). & isBartlett skill was Learning, used a great deal LLC by Nightingale condition for© Jonesnature to act& uponBartlett him” (Seymer, Learning, 1954, LLC NOT FORas she SALEfought for OR reforms. DISTRIBUTION p. 13). NightingaleNOT FOR also recognizedSALE OR that DISTRIBUTION a patient’s Nightingale held dierent views about the health depends on environmental factors such as women of her time. She had “a strong conviction light, noise, odors, and heat—something that we that women have the mental abilities to achieve examine more closely today in nursing and in health whatever they wish to achieve: compose music, care by also using alternative and complementary © Jones & Bartlett solveLearning, scientic LLCproblems, create social projects© of Jones methods. & Bartlett In her work Learning, during the LLC Crimean War, NOT FOR SALE ORgreat DISTRIBUTION importance” (Chinn, 2001, p. 441). She NOTfelt FORshe applied SALE her OR beliefs DISTRIBUTION about the body and mind that women should question their assigned roles, by arranging activities for the soldiers, providing and she herself wanted to serve people. When she them with classes and books, and supporting their reached her 20s, Nightingale felt an increasing desire connection with home—an early version of what to help others© Jonesand decided & thatBartlett she wanted Learning, to become LLCis now oen called holistic care.© Jones Later, this & typeBartlett of Learning, LLC a nurse. NursesNOT atFOR that time SALE came OR from DISTRIBUTION the lower focus on the total patient becameNOT anFOR integral SALE part OR DISTRIBUTION classes, and, of course, any training for this type of of psychiatric–mental health nursing and then role was out of the question. Her parents refused nursing in general. Nightingale’s other interest—in to support her goal, and because women were not sanitary reform—also grew from her experience free to make this type of decision by themselves, she in the Crimean War. She worked with inuential © Joneswas &blocked. Bartlett Nightingale Learning, became LLC angry and then men to make© Jones changes. &Although Bartlett she Learning,did not agree LLC NOT FORdepressed. SALE When OR her DISTRIBUTION depression worsened, her with someNOT of the FORnew theories, SALE she OR did DISTRIBUTIONsupport the parents nally relented and allowed her to attend value of education in improving social problems and nurse’s training in Germany. is venture was kept believed that education should also include moral, a secret, and people she knew were told that she physical, and practical aspects (Widerquist, 1997). was away at a spa for 3 months’ rest (Slater, 1994). Later, nurses based more of their interventions on © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Nightingale was also educated in math and science, science and evidence-based practice. NOT FOR SALE ORwhich DISTRIBUTION would lead her to use statistics to demonstrateNOT FOR e SALE many importantOR DISTRIBUTION discoveries noted earlier the nurse’s impact on health outcomes. Had it not such as the work done by Lister and Pasteur had an been for her social standing and her ability to obtain impact on nursing over the long term and changed some education, coupled with her friendship with the sociopolitical climate of health care—for example, Dr. Elizabeth© Jones Blackwell, & nursesBartlett might Learning, well have LLCpublic health policy and services.© Jones Nightingale, & Bartlett how- Learning, LLC remained uneducatedNOT FOR assistants SALE to OR doctors, DISTRIBUTION at least ever, did not agree with the newNOT theory FOR of contagion, SALE OR DISTRIBUTION for a longer period of time than they did. but over time, the nursing profession accepted these An important fact about Nightingale is that she new theories, which remain critical components of was very religious—to the point that she felt God patient care today. Nightingale stressed, however, had called on her to help others (Woodham-Smith, that the mind–body connection—putting patients © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 1951). She also felt that the body and mind were in the best situation for healing—ultimately made NOT FORseparate SALE entities, OR but DISTRIBUTION both needed to be considered the dierence.NOT Discovering FOR SALE methods OR forDISTRIBUTION prevent- from a health standpoint. is view later served ing disease and using this information in disease

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 11 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 12 Section 1: The Profession of Nursing

prevention is an important part of nursing today. on the idea of care provided by women as a form of Public/community© Jones health &is certainlyBartlett concerned Learning, service LLC to family and friends. is© text Jones was popular & Bartlett Learning, LLC with many of theNOT same FOR issues thatSALE led to OR critical DISTRIBUTION new when it was published because, atNOT the time, FOR family SALE OR DISTRIBUTION discoveries so many years ago, such as contami- members provided most of the nursing care. nation of food and water and preventing disease Nightingale’s religious and upper-class back- worldwide. ground had a major impact on her important © JonesDuring & Bartlettthe Industrial Learning, Revolution, LLCNightingale eorts to improve© Jones both nursing & Bartlett education Learning, and LLC NOTand FOR enlightened SALE citizens OR DISTRIBUTIONtried to reform some of nursing practiceNOT in theFOR hospital SALE setting. OR NursesDISTRIBUTION working conditions that were leading to health and were of the lower class; usually had no education; public problems. Indeed, as Nightingale stated in and were oen alcoholics, prostitutes, and women Notes on Nursing and Notes on Hospitals (1992, 1859), who were down on their luck. Nightingale changed “there are ve essential points in securing the health all that. She believed that patients needed educated © Jones & Bartlettof houses: Learning, pure air, LLCpure water, ecient drainage, © Jonesnurses to & care Bartlett for them, Learning, and she founded LLC the rst NOT FOR SALEcleanliness, OR DISTRIBUTION and light.” She strongly supported more NOTorganized FOR schoolSALE of OR nursing. DISTRIBUTION Nightingale’s school, eorts to promote health and felt that this was more which opened in London in 1860, accepted women cost-eective than treating illness—important of a higher class—not alcoholics and former pros- healthcare principles today. ese ideas are good titutes, as had been the case with previous gener- examples reecting© Jones the inuence & Bartlett of the environment Learning, ations LLC of nurses. e students were© Jonesnot viewed & asBartlett Learning, LLC and culture in NOTwhich FORa person SALE lives and OR works DISTRIBUTION on servants, and their loyalty was toNOT the school, FOR notSALE OR DISTRIBUTION personal views and problems. to the hospital. is point is somewhat confusing Nightingale wrote four small books—or trea- and must be viewed from the perspective that im- tises, as they were called—thus starting the idea that portant changes were made; however, these were nurses need to publish and share what they do and not monumental changes, but a beginning. For © Joneswhat they & learn Bartlett about patient Learning, care. e LLC titles of the example, even in© Nightingale’sJones & school,Bartlett students Learning, were LLC NOTbooks FOR were SALE Notes on OR Matters DISTRIBUTION A ecting the Health, very much a partNOT of theFOR hospital; SALE they OR staed DISTRIBUTION the Eciency, and Hospital Administration of the British hospital, representing free labor and worked long Army (1858a), Subsidiary Notes as to the Introduction hours. is approach developed into the diploma of Female Nursing into Military Hospitals (1858b), school model, considered an apprenticeship model. Notes on Hospitals (1859), and Notes on Nursing Today, diploma schools have less direct relation- © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC (1860, republished in 1992). e rst three focused ships with hospitals, and in some cases, they have NOT FOR SALEon OR hospitals DISTRIBUTION that she visited, including military NOTtransitioned FOR SALE to associate OR DISTRIBUTIONdegree programs and, in hospitals (Slater, 1994). Nightingale collected a other cases, baccalaureate degrees. ere are few lot of data. Her interest in healthcare data analysis schools of nursing today that are diploma schools helped to lay the groundwork for epidemiology, (see the Nursing Education, Accreditation, and highlighting the© importanceJones & Bartlettof data in nursing,Learning, Regulation LLC chapter). © Jones & Bartlett Learning, LLC particularly inNOT a public FOR health SALE context, OR and DISTRIBUTION also Nightingale’s students did receiveNOT some FOR train SALE- OR DISTRIBUTION established an initial foundation for nursing research ing, which had not been provided in an organized and evidence-based practice. ese early initiatives manner prior to her eorts. Her religious views also also relate to the current quality improvement ef- had an impact on the rigid educational system she forts requiring measurement and analysis of large proposed and implemented. She expected students © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC quantities of data. An interesting fact is that Notes to have high moral values. Training was still based NOTon NursingFOR SALE was not writtenOR DISTRIBUTION for nurses, but rather for on an apprenticeshipNOT FOR model SALE and continued OR DISTRIBUTION to be women who cared for ill family members. As late for some time in Britain, Europe, and the United as 1860, Nightingale had not completely given up States. e structure of hospital nursing was also © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 12 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 1: Professional Nursing: History and Development of the Nursing Profession 13

very rigid, with a matron in charge. is rigidity the changes also had negative eects, including persisted for© Jonesdecades and, & Bartlett in some cases, Learning, may still LLCdelaying the development of© the Jones profession & Bartlett (par- Learning, LLC be presentNOT in some FOR hospital SALE nursing OR organizations. DISTRIBUTIONticularly supporting nurses’ subordinateNOT FOR position SALE to OR DISTRIBUTION Nurses in Britain began to recognize the need physicians), failing to encourage nursing education to band together, and they eventually formed the oered at a university level, and delaying licensure British Nurses Association. is organization (Freeman, 2007). Despite this criticism, Nightingale © Jonestook & on Bartlett the issue ofLearning, regulating nursingLLC practice. still holds ©an Jonesimportant & place Bartlett in nursing Learning, history as LLC NOT FORNightingale SALE did OR not DISTRIBUTION approve of eorts made to a major leaderNOT for FOR the profession. SALE OR DISTRIBUTION establish state registration (licensure) of nurses, e vignettes in Exhibit 1-2 describe some of the mostly because she did not trust the leaders’ goals contributions made by nursing leaders, emphasizing (Freeman, 2007). ere were no known standards that Nightingale is not the only important nursing for nursing, so how one became a registered nurse leader. People do not operate in a vacuum, of course, © Jones & Bartlett wasLearning, unclear. Many LLC questions were raised regarding© Jones and neither& Bartlett did the nursesLearning, highlighted LLC in this exhibit. NOT FOR SALE ORthe DISTRIBUTION denition of nursing, who should be registered,NOT FORMany factorsSALE inuenced OR DISTRIBUTION nurse leaders, such as their and who controlled nursing. Some critics agree that communities, the society, their education, and the Nightingale did make changes, but the way she made time in which they practiced.

This list does not represent all the important Clara Barton (1881) © Jones nursing& Bartlett leaders Learning,but does provide LLC examples The need ©in AmericaJones for & anBartlett institution Learning, LLC of the broad range of their contributions NOT FOR SALE OR DISTRIBUTION that is notNOT selfish FOR must originateSALE inOR the DISTRIBUTION and highlights specific achievements. These recognition of some evil is adding to the sum glimpses are written in the first person, but of human suffering or diminishing the sum they are not direct quotes. of happiness. Today, my efforts to organize Dorothea Dix (1840–1841) such an institution have been successful: the National Society of the Red Cross. © Jones & Bartlett Learning,I traveled the LLC state of Massachusetts to call © Jones & Bartlett Learning, LLC attention to the present state of insane persons NOT FOR SALE OR DISTRIBUTION NOT FORIsabel SALE Hampton OR Robb DISTRIBUTION (1896) confined within this Commonwealth, in cages, In 1896, I organized the Nurses’ Associated stalls, pens! Chained, naked, beaten with rods, Alumnae of the United States and Canada and lashed into obedience. Just by bettering and served as the first president. Later the conditions for these persons, I showed that this organization became the American mental illnesses aren’t all incurable. © Jones & Bartlett Learning, LLCNurses Association (ANA). I also© Jonesfounded & Bartlett Learning, LLC Linda Richards (1869) the American Society of Superintendents NOT FOR SALE OR DISTRIBUTIONof Training Schools for Nurses,NOT which FOR later SALE OR DISTRIBUTION I was the first of five students to enroll in the became the National League of Nursing New England Hospital for Women and Children Education (NLNE) and then changed and the first to graduate. Upon graduation, I was its name to the National League for fortunate to obtain employment at the Bellevue Nursing (NLN). Through these professional Hospital in New York City. Here I created the organizations, I was able to initiate many © Jones first& Bartlett written reporting Learning, system, chartingLLC and © Jones & Bartlett Learning, LLC improvements in nursing education. NOT FORmaintaining SALE OR individual DISTRIBUTION patient records. NOT FOR SALE OR DISTRIBUTION

(Continues) © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 13 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 14 Section 1: The Profession of Nursing

Exhibit ©1-2 Jones (continued) & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Sophia Palmer (1900) nursing, housing reform, suffrage, world peace, I launched the American Journal of Nursing and the rights of women, children, immigrants, and served as editor-in-chief of the journal for and working people. © Jones20 years. & Bartlett I believe my Learning, forceful editorials LLC helped Mary Breckenridge© Jones (1920) & Bartlett Learning, LLC guide nursing thought and shape nursing NOT FOR SALE OR DISTRIBUTION Through my ownNOT personal FOR tragedies, SALE I realizedOR DISTRIBUTION practice and events. that medical care for mothers and babies Lavinia L. Dock (1907) in rural America was needed. I started the I became a staunch advocate of legislation Frontier Nursing Service in Kentucky. to control nursing practice. Realizing the Elizabeth Russell Belford, Mary Tolle © Jones & Bartlettproblems Learning, that students LLC faced in studying © JonesWright, &Edith Bartlett Moore Learning, Copeland, Dorothy LLC NOT FOR SALE ORdrugs DISTRIBUTION and solutions, I wrote one of the first NOTGarrigus FOR Adams,SALE OREthel DISTRIBUTION Palmer Clarke, nursing textbooks, Materia Medica for Nurses. Elizabeth McWilliams Miller, and Marie I served as foreign editor of American Journal Hippensteel Lingeman (1922) of Nursing and coauthored the book, The We were the founders of the Sigma Theta History of Nursing. Tau International Honor Society of Nursing. Martha Minerva© Jones Franklin & Bartlett (1908) Learning,Each LLC of us provided insights that© advanced Jones & Bartlett Learning, LLC I actively campaignedNOT FOR for racialSALE equality OR inDISTRIBUTION scholarship, leadership, research,NOT and FOR SALE OR DISTRIBUTION nursing and guided 52 nurses to form the practice. National Association of Colored Graduate Susie Walking Bear Yellowtail Nurses. (1930–1960) © JonesMary & Mahoney Bartlett (1909) Learning, LLC I traveled for 30© years Jones throughout & Bartlett North Learning, LLC In 1908, the National Association of Colored America, walking to reservations to improve NOT FORGraduate SALE Nurses OR was DISTRIBUTION formed. As the health care andNOT Indian FOR health SALE services. OR I DISTRIBUTION first professional Black nurse, I gave the established the Native ANA and received the welcome address at the organization’s first President’s Award for Outstanding Nursing conference. Healthcare. © Jones & BartlettMary Learning, Adelaide LLC Nutting (1910) © JonesVirginia & Avenel Bartlett Henderson Learning, (1939) LLC I advocated for university education for nurses I am referred to as the first lady of nursing. NOT FOR SALE ORand DISTRIBUTION developed the first program of this type. NOTI think FOR of myself SALE as anOR author, DISTRIBUTION an avid Upon accepting the chairmanship at the researcher, and a visionary. One of my Department of Nursing Education at Teachers greatest contributions to the nursing College, Columbia University, I became the profession was revising Harmer’s Textbook first nurse to be appointed to a university of the Principles and Practice of Nursing, professorship.© Jones & Bartlett Learning,which LLC has been widely adopted ©by Jonesschools of & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONnursing. NOT FOR SALE OR DISTRIBUTION Lillian Wald (1918) My goal was to ensure that women and Lucile Petry Leone (1943) children, immigrants and the poor, and As the founder of the U.S. Cadet Nurse Corps, members of all ethnic and religious groups I believe we succeeded because we had a © Joneswould & realize Bartlett America’s Learning, promise of LLC life, liberty, saleable package© Jonesfrom the &beginning. Bartlett Women Learning, LLC and the pursuit of happiness. The Henry Street immediately liked the idea of being able NOT FORSettlement SALE and ORthe Visiting DISTRIBUTION Nurse Service to combine warNOT service FOR with professionalSALE OR DISTRIBUTION in New York City championed public health education for the future.

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 14 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 1: Professional Nursing: History and Development of the Nursing Profession 15

Exhibit© Jones 1-2 (continued) & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Esther Lucille Brown (1946) Connecticut, which is the model for hospice care in the United States and abroad. I issued a report titled Nursing for the Future. This report severely criticized the Joann Ashley (1976) overall quality of nursing education. Thus, © Jones & Bartlett Learning, LLC I wrote Hospitals,© Jones Paternalism, & Bartlett and the Learning, Role LLC with the Brown report, nursing education of the Nurse during the height of the women’s NOT FORfinally SALE began OR the DISTRIBUTION long-discussed move to NOT FOR SALE OR DISTRIBUTION movement. My book created controversy accreditation of nursing education programs. with its pointed condemnation of sexism Lydia Hall (1963–1969) toward, and exploitation of, nurses by hospital I established and directed the Loeb Center administrators and physicians. © Jones & Bartlett Learning,for Nursing andLLC Rehabilitation at Montefiore © JonesLuther & Bartlett Christman Learning, (1980) LLC Hospital in the Bronx, New York. Through NOT FOR SALE OR DISTRIBUTION NOT FORAs founder SALE and OR dean DISTRIBUTION of the Rush University my research in nursing and long-term care, College of Nursing, I was linked to the I developed a theory (core, care, and cure) “Rush Model,” a unified approach to nursing that the direct professional nurse-to-patient education and practice that continues to relationship is itself therapeutic and nursing care set new standards of excellence. As dean is the chief therapy for the chronically ill patient. © Jones & Bartlett Learning, LLCof Vanderbilt University’s School© Jones of Nursing, & Bartlett Learning, LLC MarthaNOT Rogers FOR (1963–1965) SALE OR DISTRIBUTIONI was the first to employ AfricanNOT American FOR SALE OR DISTRIBUTION I served as editor of Journal of Nursing women as faculty at Vanderbilt University, and Science, focusing my attention on improving I became one of the founders of the National and expanding nursing education, developing Male Nurses Association, now known as the the scientific basis of nursing practice through American Assembly for Men in Nursing. © Jones professional& Bartlett education, Learning, and differentiating LLC Hildegard© E.Jones Peplau & (1997) Bartlett Learning, LLC between professional and technical careers I became known as the “Nurse of the Century.” NOT FORin nursing.SALE My OR book, DISTRIBUTION An Introduction to the NOT FOR SALE OR DISTRIBUTION I was the first nurse to serve the ANA as Theoretical Basis of Nursing (1970), marked the executive director and later as president, beginning of nursing’s search for a theoretical and I served two terms on the Board of the base. Later, my work led to a greater emphasis International Council of Nurses. My work in on research and evidence-based practice. psychiatric–mental health nursing emphasized © Jones & Bartlett Learning,Loretta Ford LLC (1965) © Jonesthe nurse–patient& Bartlett relationship. Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION I co-developed the first nurse practitioner Linda Aiken (2007) program in 1965 by integrating the traditional My policy research agenda is motivated by roles of the nurse with advanced medical a commitment to improving healthcare training and the community outreach mission outcomes building an evidence base for health of a public health official. © Jones & Bartlett Learning, LLCservices care and management© andJones providing & Bartlett Learning, LLC Madeleine Leininger (1974) direction for national policy makers, resulting in NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION I began, and continued to guide, nursing in greater recognition of the role that nursing care the recognition that the culture care needs has on patient outcomes. Nurses need to be of people in the world will be met by nurses actively engaged in research to improve care. prepared in transcultural nursing. Patricia Benner (current) © Jones Florence& Bartlett Wald Learning, (1975) LLC I have long© been Jones involved & Bartlettin nursing Learning, LLC NOT FORI devoted SALE my OR life DISTRIBUTIONto the compassionate care for educationNOT and developed FOR SALE many initiatives OR DISTRIBUTION to the dying. I founded Hospice Incorporated in improve nursing education and thus nursing

(Continues) © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 15 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 16 Section 1: The Profession of Nursing

Exhibit ©1-2 Jones (continued) & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

practice. In 1982, I published a major book many roles of nurses and issues that impact that discussed the process that nurses go their work, such as workforce shortages. In our through from novice to expert. In 2010, I led examination we have included different media an extensive study on the current status of as sources such as films, television, fiction, © Jonesnursing & education,Bartlett the Learning, first such study LLC since and press coverage.© Jones The profession & Bartlett should notLearning, LLC NOT FORthe 1922 SALE Goldmark OR report DISTRIBUTION and the 1948 Brown ignore its professionalNOT FORimage. SALE OR DISTRIBUTION report. My report, Educating Nurses: A Call for Radical Transformation (2010), noted National Academy of Nursing Living many areas of nursing education that need Legends improvement. The National Academy of Nursing selects © Jones & Bartlett Learning, LLC © Jonesexemplar & nursing Bartlett leaders Learning, for recognition LLC of Beatrice Kalisch and Phillip Kalisch their leadership in health care in the United NOT FOR SALE OR(current) DISTRIBUTION NOTStates FOR and SALEglobally. ORThe organization’s DISTRIBUTION website We have worked together to recognize the provides information on these leaders and importance of the image of nursing as a their contributions. profession. In doing this, we have examined the © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Themes: Looking into the which events unfolded” but, instead, emphasized the “profession’s purity, discipline, and faith” (Connolly, Nursing Profession’s History 2004, p. 10). Part of the reason for this narrow view © Jones e discipline & Bartlett of nursing Learning, slowly evolved LLC from the of nursing history© Jonesis that the &discipline Bartlett of history Learning, had LLC NOTtraditional FOR SALErole of women, OR DISTRIBUTION apprenticeship, human- limited, if any, NOTcontact FOR with the SALE nursing OR profession. DISTRIBUTION itarian aims, religious ideals, intuition, common is began to change in the 1950s and 1960s, when sense, trial and error, theories, and research and the scholarship of nursing history began to expand, was inuenced by medicine, technology, poli- though very slowly. In the 1970s, one landmark tics, social issues, war, economics, and feminism publication, Hospitals, Paternalism, and the Role © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC (Brooks & Kleine-Kracht, 1983; Gorenberg, 1983; of the Nurse (Ashley, 1976), addressed social issues NOT FOR SALEKeller, OR 1979;DISTRIBUTION Jacobs & Huether, 1978; Kidd & Morrison, NOTas anFOR important SALE aspect OR DISTRIBUTIONof nursing history. e 1988; Lynaugh & Fagin, 1988; Perry, 1985). It is key issue considered in this text was feminism in impossible to provide a detailed history of nursing’s the society at large and its impact on nursing. As evolution in one chapter, so only critical historical social history became more important, increased events are discussed.© Jones & Bartlett Learning,examination LLC of nursing, its history,© andJones inuences & Bartlett Learning, LLC Writing aboutNOT nursing FOR history SALE itself OR has itsDISTRIBUTION own on that history took place. In addition,NOT FOR nursing SALE OR DISTRIBUTION interesting history (Connolly, 2004). Historians is tied to political history today. For example, it who wrote about nursing prior to the 1950s tended is very dicult to understand current healthcare to be nurses, and they wrote for nurses. Although delivery concerns without including nursing (such nursing throughout its history has been inuenced as the impact of the current reports on quality © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC by social issues of the day, the early publications care). All of these considerations have an impact NOTabout FOR nursing SALE history OR did DISTRIBUTION not link nursing to “the on health policy,NOT including FOR legislationSALE OR at the DISTRIBUTION state broader social, economic, and cultural context in and national levels.

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Schools of nursing oen highlight their own caring, take-charge person who would go to great history for© students, Jones faculty, & Bartlett and visitors. Learning, is might LLClengths and even sacrice her© own Jones safety and& Bartletthealth Learning, LLC be done throughNOT exhibitsFOR SALE about the OR school’s DISTRIBUTION history to provide care (Shames, 1993).NOT e messageFOR SALE sent to OR DISTRIBUTION and, in some cases, a mini-museum. Such materials the public was that nurses were not powerful. ey provide an opportunity to identify how the school’s were caring, but they would not ght to change the history has developed and how its graduates have conditions of hospitals and patient care. Hospitals © Jonesaected & Bartlett the community Learning, and the LLCprofession. e “owned” nurses© Jones and considered & Bartlett them Learning, cheap labor. LLC NOT FORpurpose SALE of this OR chapter DISTRIBUTION is to explore some of the Today, someNOT hospitals FOR stillSALE hold OR the sameDISTRIBUTION view, broad issues of nursing history, but this discussion though they would never admit it publicly. is should not replace the history of each school of view of healthcare delivery suggests that doctors nursing as the profession developed. are dened by their scope of practice in treating Nursing’s past represents a movement from diseases, whereas nurses are seen as promoting © Jones & Bartlett aLearning, role based on LLC family and religious ties and ©the Jones health, & Bartlettadding to theLearning, view of the LLC lesser status of NOT FOR SALE ORneed DISTRIBUTION to provide comfort and care (because thisNOT FORnursing SALE (Shames, OR 1993). DISTRIBUTION is view also has led to was perceived as a woman’s lot in life) to educated problems between the two professions as they argue professionals serving as the “glue” that holds the over which profession is better at caring for patients. healthcare system together. From medieval times e view that nurses are angels of mercy rather than through Nightingale’s© Jones &time, Bartlett nursing Learning, represented LLCwell-educated professionals reinforces© Jones the & idea Bartlett that Learning, LLC a role thatNOT women FOR played SALE in families OR DISTRIBUTIONto provide nurses care but really do notNOT have FOR to think; SALE this OR DISTRIBUTION care. is care extended to anyone in need, but view may be perpetuated by advertisements that aer Nightingale highlighted what a woman could depict nurses as angels or caring ethereal humans do with some degree of education, physicians/ (Gordon, 2005). Most patients—especially at 3 a.m., doctors recognized that women needed to have when few other professionals are available—hope © Jonessome & degree Bartlett of training. Learning, Education LLC was introduced, that the nurse© Jones is not just & aBartlett caring person, Learning, but also LLC NOT FORbut mainly SALE to serveOR DISTRIBUTIONthe need of hospitals to have a critical thinkerNOT FOR who uses SALE clinical OR reasoning DISTRIBUTION and a labor force. us, the apprenticeship model of judgment and knows when to call the rest of the nursing was born. team. As discussed in this text, there is increasing Why would nursing perceive a need for greater evidence to support this view of the professional education? Primarily because of advances in sci- nurse and needed competencies, such as the report © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC ence, increased knowledge of germs and diseases, Healthcare Education: A Bridge to Quality (Insti- NOT FOR SALE ORand DISTRIBUTION increased training of doctors, nurses neededNOT FORtute of SALE Medicine OR [IOM], DISTRIBUTION 2003) and e Future of to understand basic anatomy, physiology, patho- Nursing. Leading Change, Advancing Health (IOM, physiology, and epidemiology to provide better 2010). ese reports and others have had a major care. Slowly it was recognized that to carry out impact on the image of the profession and provide doctors’ orders© Jones eciently, & Bartlett nurses required Learning, some LLCrecommendations for improving© Jones care & and Bartlett the Learning, LLC degree of NOTunderstanding FOR SALE of causes OR and DISTRIBUTION eects of roles and responsibilities ofNOT nurses FOR as healthcare SALE OR DISTRIBUTION environmental exposures and of disease causation. professionals and emphasize the need for nursing us, the move from hospital nursing schools to leadership and graduate education. university education occurred. Critics of Nightingale suggest that although © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC the “lady with the lamp” image—that is, a nurse Stop and Consider #1 NOT FORwith aSALE light moving OR DISTRIBUTION among the wounded in the Nursing hasNOT existed FOR a long SALE time but OR in manyDISTRIBUTION different forms. Crimea—is laudable, it presented the nurse as a

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Professionalism:© Jones & Bartlett Learning,Nursing LLC as a Profession© Jones & Bartlett Learning, LLC Critical ProfessionalNOT FOR SALE Concepts OR DISTRIBUTION e current denition of nursingNOT, as establishedFOR SALE OR DISTRIBUTION by the ANA is “the protection, promotion, and and Activities optimization of health and abilities, prevention of Today, nursing is an applied science, a practice pro- illness and injury, alleviation of suering through © Jonesfession. To & appreciate Bartlett the Learning, relevance of this LLC statement the diagnosis and© Jones treatment & ofBartlett human response, Learning, LLC NOTrequires FOR an SALE understanding OR DISTRIBUTION of professionalism and advocacy NOTin the careFOR of SALEindividuals, OR families, DISTRIBUTION and how it applies to nursing. Nursing is more communities, and populations” (2015a, p. 89). than just a job; it is a professional career requiring Exhibit 1-3 provides a historical perspective on the commitment. Table 1-1 describes some dierences development of a denition for nursing. in attitudes when comparing an occupation/job e Essence of Nursing: Knowledge and Caring © Jones & Bartlettand a Learning, career/profession. LLC © Joneschapter contains & Bartlett a more Learning, in-depth discussion LLC of the NOT FOR SALE ORBut DISTRIBUTION what does this really mean, and why does NOTnature FOR of nursing, SALE but OR a denition DISTRIBUTION is needed here as it matter? As described previously in this chapter, a framework for further understanding of nursing getting to where the nursing profession is today as a profession. Is nursing a profession? What is was not easy, nor did it happen overnight. Many a profession? Why is it important that nursing be nurses contributed© Jones to the development & Bartlett of Learning, nursing recognized LLC as a profession? Some© nurses Jones may & not Bartlett Learning, LLC as a profession;NOT it mattered FOR to SALE them that OR nurses DISTRIBUTION be think that nursing is a profession,NOT but this FOR is not theSALE OR DISTRIBUTION recognized as professionals. position taken by recognized nursing organizations,

Occupation Career Longevity Temporary, a means to an end Lifelong vocation © Jones & Bartlett EducationalLearning, preparation LLC Minimal training ©required, Jones & BartlettUniversity Learning, professional degreeLLC NOT FOR SALE OR DISTRIBUTION usually associate NOTdegree FOR SALEprogram OR based DISTRIBUTION on foundation of core liberal arts Continuing education Only what is required for the job Lifelong learning, continual or to get a raise/promotion effort to gain new knowledge, skills, and abilities Level of commitment© Jones & Bartlett Short-term, Learning, as long as jobLLC meets Long-term commitment© Jones to & Bartlett Learning, LLC NOT FOR SALEpersonal OR needsDISTRIBUTION organization and professionNOT FOR SALE OR DISTRIBUTION Expectations Reasonable work for reasonable Will assume additional pay; responsibility ends with shift responsibilities and volunteer for organizational activities and community-based events

© JonesReproduced & Bartlett from Wilfong, Learning, D., Szolis, C., LLC & Haus, C. (2007). Nursing school success:© Jones Tools for & constructing Bartlett your Learning, LLC NOT FORfuture . SALESudbury, MA:OR Jones DISTRIBUTION & Bartlett Learning. NOT FOR SALE OR DISTRIBUTION

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 18 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 1: Professional Nursing: History and Development of the Nursing Profession 19

Exhibit© Jones 1-3 Deﬁnitions & Bartlett of Learning, Nursing: Historical LLC Perspective © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

The following list provides a timeline of some health within the potential of each person.” of the deﬁnitions of nursing. (Rogers, 1988, p. 100) Florence Nightingale American Nurses Association © JonesHaving & Bartlett “charge Learning,of the personal LLC health of “Nursing is© the Jones protection, & Bartlettpromotion, Learning,and LLC NOT FORsomebody SALE . . .OR and DISTRIBUTION what nursing has to optimizationNOT of health FOR and SALE abilities, OR prevention DISTRIBUTION do . . . is to put the patient in the best possible of illness and injury, facilitation of healing, condition for nature to act upon him.” alleviation of suffering through the diagnosis (Nightingale, 1859, p. 79) and treatment of human responses, and advocacy in the care of individuals, families, Virginia Henderson © Jones & Bartlett Learning, LLC © Jonescommunities, & Bartlett and populations.”Learning, (ANA, LLC 2015b, “The unique function of the nurse is to assist p. 89; also published in earlier ANA standards) NOT FOR SALE OR DISTRIBUTIONthe individual, sick or well, in the performanceNOT FOR SALE OR DISTRIBUTION of those activities contributing to health International Council of Nursing or its recovery (or to peaceful death) and “Nursing encompasses autonomous and that he would perform unaided if he had collaborative care of individuals of all ages, the necessary strength, will or knowledge. families, groups and communities, sick or And to© do Jones this in such & Bartletta way as to helpLearning, him LLCwell and in all settings. Nursing© includesJones the & Bartlett Learning, LLC gain independenceNOT FOR as SALE rapidly asOR possible.” DISTRIBUTION promotion of health, preventionNOT of illness, FOR SALE OR DISTRIBUTION (Henderson, 1966, p. 21) and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, Martha Rogers research, participation in shaping health “The process by which this body of knowledge, policy and in patient and health systems nursing science, is used for the purpose of management, and education are also key © Jones assisting& Bartlett human Learning, beings to achieve LLC maximum nursing roles.”© Jones (ICN, 2002) & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Data from Nightingale, F. (1859). Notes on nursing: What it is and what it is not (commemorative ed.). Philadelphia, PA: Lippincott; Henderson, V. (1966). The nature of nursing: A definition and its implications for practice, research, and education. New York, NY: Macmillan; Rogers, M. (1988). Nursing science and art: A prospective. Nursing Science Quarterly, 1, 99; American Nurses Association. (2015). Nursing scope and standards of practice. Silver Spring, MD: Author; International Council of Nurses. (2002; retrieved on 2017). Definition of nursing. Retrieved from © Jones & Bartlett Learning,http://www.icn.ch/who-we-are/icn-definition-of-nursing/ LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

nursing education, and state boards of nursing that Huber, 2014; Lindberg, Hunter, & Kruszewski, 1998; are involved in licensure of nurses. Each state has Quinn & Smith, 1987; Schein & Kommers, 1972; its own denition© Jones of nursing & Bartlett that is foundLearning, in the LLCBixler & Bixler, 1959): © Jones & Bartlett Learning, LLC state’s nurseNOT practice FOR act, SALE but the ORANA DISTRIBUTION denition ■ A systematic body of knowledgeNOT FOR that providesSALE OR DISTRIBUTION noted here encompasses the common character- the framework for the profession’s practice istics of nursing practice and is reected in state ■ Standardized, formal higher education board denitions. ■ Commitment to providing a service that © Jones &In Bartlettgeneral, a profession—whetherLearning, LLC nursing or benets© Jones individuals & Bartlett and the community Learning, LLC NOT FORanother SALE profession, OR suchDISTRIBUTION as medicine, teaching, or ■ MaintenanceNOT FOR of a uniqueSALE role OR that DISTRIBUTION recognizes law—has certain characteristics (Finkelman, 2016; autonomy, responsibility, and accountability

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■ Control of practice responsibility of the pro- of nursing practice” (ANA, 2015a, p. 85). It is the fession through© Jones standards & Bartlett and a code Learning, of ethics right LLC to make a decision and take© control. Jones Nurses & Bartlett Learning, LLC ■ CommitmentNOT toFOR members SALE of the OR profession DISTRIBUTION have a distinct body of knowledge NOTand develop FOR com SALE- OR DISTRIBUTION through professional organizations and petencies in nursing care that should be based on activities this nursing knowledge. When this is accomplished, Does nursing demonstrate these professional nurses can then practice nursing. “Responsibility © Jonescharacteristics? & Bartlett Nursing Learning,has a standardized LLC content, refers to being entrusted© Jones with & a Bartlett particular function”Learning, LLC NOTalthough FOR schoolsSALE of OR nursing DISTRIBUTION may congure the (Ritter-Teitel, 2002,NOT p. FOR 34). “Accountability SALE OR DISTRIBUTIONmeans content in dierent ways; there is consistency in being responsible and accountable to self and others content areas such as adult health, maternal–child for behaviors and outcomes included in one’s pro- health, behavioral or mental health, pharmacology, fessional role. A professional nurse is accountable for embracing professional values, maintaining © Jones & Bartlettassessment, Learning, and so on. LLC e National Council Licen- © Jones & Bartlett Learning, LLC sure Examination (NCLEX) covers standardized professional values, maintaining competence, and NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION content areas. is content is based on systematic, maintenance and improvement of professional recognized knowledge as the profession’s knowledge practice environments” (Kupperschmidt, 2004, p. 114). base for practice. e Nursing Education, Accred- A nurse is also accountable for the outcomes of itation, and Regulation chapter discusses nursing the nursing care that the nurse provides; what nurses education in more© Jones detail. It is& clear, Bartlett though, Learning, that the do LLC must mean something (Finkelman,© Jones 2016). & e Bartlett Learning, LLC focus of nursingNOT is practice—care FOR SALE provided OR to DISTRIBUTION assist nurse is answerable for the actionsNOT that FOR the nurse SALE OR DISTRIBUTION individuals, families, communities, and populations. takes. Accountability and responsibility do not have Nursing as a profession has a social contract with the same meaning. A nurse oen delegates tasks society, as described in the ANA’s Nursing’s Social to other sta members, telling sta what to do and Policy Statement, which is now an appendix in the when. e sta member who is assigned a task is © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC ANA standards, Nursing: Scope and Standards of responsible both for performing that task and for the NOT FOR SALE OR DISTRIBUTION performance itself.NOT e FOR nurse whoSALE delegated OR theDISTRIBUTION task Practice, and Nursing’s Code of Ethics (American Nurses Association [ANA], 2015a, 2015b; Fowler, to the sta person is accountable for the decision to 2015a, 2015b). e contract between nursing and delegate the task. Delegation is discussed in more society is based on professional and regulatory re- detail in the Work in Interprofessional Teams chapter. © Jones & Bartlettquirements, Learning, but also LLC on what society expects from © Jones & Bartlett Learning, LLC NOT FOR SALEhealthcare OR DISTRIBUTION services and healthcare professionals. As NOTSources FOR SALE of Professional OR DISTRIBUTION a profession, we have the right to autonomy in our Direction practice, authority to practice based on our education and scope of practice, and self-governance. Society Professions develop documents or statements about protects a profession through government legislation what the members consider is important to guide and regulation (for© Jones example, &licensure Bartlett to protect Learning, our their LLC practice, to establish control© Jonesover practice, & Bartlett Learning, LLC titles and scopeNOT of practice, FOR need SALE to decrease OR DISTRIBUTION sta and to inuence the quality of thatNOT practice. FOR Some SALE OR DISTRIBUTION safety risk in the workplace, and so on). of the important sources of professional direction Autonomy, responsibility, and accountability for nurses follow: are intertwined with the practice of nursing and are 1. Nursing’s Social Policy Statement (ANA, 2015a) © Jonescritical components & Bartlett of Learning,a profession. AutonomyLLC is is an important© Jones document & Bartlett that describes Learning, the LLC NOTthe FOR“capacity SALE of a nurse OR toDISTRIBUTION determine his/her own professionNOT of nursing FOR and SALE its professional OR DISTRIBUTION frame- actions through independent choice, including work and obligations to society. e original 1980 demonstration of competence, within the full scope statement has been revised three times—in 1995,

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2003, and 2010. e social policy statement are discussed in more detail in e Essence of informs© consumers,Jones & government Bartlett ocials,Learning, other LLC Nursing: Knowledge and© CaringJones chapter, & Bartlett are Learning, LLC healthcareNOT professionals, FOR SALE and OR other DISTRIBUTION important part of the scope of practice,NOT alongFOR with SALE the OR DISTRIBUTION stakeholders about nursing and its denition, denition of the “what and why” of nursing. knowledge base, scope of practice, and regula- Nursing care is provided in a variety of settings tion. “Nursing is called a helping profession and by the professional registered nurse, who may © Jones &many Bartlett of us went Learning, into nursing LLC to help others. have an© advancedJones degree& Bartlett and specialty Learning, training LLC NOT FOR e SALE social ORpolicy DISTRIBUTION statement of our profession and expertise.NOT FOR Additional SALE information OR DISTRIBUTION about is about the multiple ways in which nursing the standards, as well as the nurse’s roles and helps others: through direct patient care, and functions, is found throughout this text. Part by changing institutions, society, and global of being a professional is a commitment to the health. Nurses can be civic professionals and profession—a commitment to lifelong learning, © Jones & Bartlett Learning,cosmopolite LLC professionals and be active in ©any Jones &adhering Bartlett to standards, Learning, maintaining LLC membership NOT FOR SALE OR DISTRIBUTIONor all of these ways of helping between here NOTand FORin SALE professional OR organizations,DISTRIBUTION publishing, and nursing’s furthest horizon, and to nd good ensuring that nursing care is of the highest colleagues and companions along the way” quality possible. (Fowler, 2015a, p. xv). 3. Code of Ethics for Nurses (ANA, 2015b) de- 2. Nursing:© JonesScope and & Standards Bartlett of Practice Learning, (ANA, LLC scribes nursing’s central© Jonesbeliefs and & assistsBartlett Learning, LLC 2015a)NOT was FORdeveloped SALE by the OR ANA DISTRIBUTION and its the profession in controllingNOT its FOR practice. SALE is OR DISTRIBUTION members; however, these standards as is true code “makes explicit the primary obligations, for other ANA professional documents apply values, and ideals of the profession. In fact, it to all registered nurses. Nursing standards, informs every aspect of the nurse’s life” (ANA, which are “authoritative statements dened 2015a, p. vii). Implementation of this code is © Jones &and Bartlett promoted Learning, by the profession LLC by which the an important© Jones part & of Bartlett nursing’s contractLearning, with LLC NOT FORquality SALE of ORpractice, DISTRIBUTION service, or education can society.NOT As nurses FOR practice, SALE they OR need DISTRIBUTION to reect be evaluated” (ANA, 2015a, p. 89), are critical these values. e Ethics and Legal Issues chap- to guiding quality patient care. Standards de- ter focuses on ethical and legal issues related scribe minimal expectations. “We must always to nursing practice and describes the code in more detail. © Jones & Bartlett Learning,remember thatLLC as a profession the members© are Jones & Bartlett Learning, LLC granted the privilege of self-regulation because NOT FOR SALE OR DISTRIBUTION NOT FORTo SALE go full circle OR and DISTRIBUTION return to the social contract, they purport to use standards to monitor and nursing care must be provided and should include evaluate the actions of its members to ensure consideration of health, social, cultural, economic, a positive impact on the public it serves” legislative, and ethical factors. Content related to (O’Rourke, 2003, p. 97). Standards also include these issues is discussed in other chapters in this text. a scope© Jonesof practice & Bartlettstatement that Learning, describes LLCNursing is not just about making© Jones someone & better;Bartlett Learning, LLC the “who,NOT what, FOR where, SALE when, OR why, DISTRIBUTION and how” it is about providing healthNOT education, FOR assisting SALE OR DISTRIBUTION of nursing practice. e ANA denition of patients and families in making health decisions, nursing is the critical foundation. As noted in providing direct care and supervising others who Exhibit 1-3, the denition of nursing evolved provide care, assessing care and applying the best © Jones &and Bartlett will most Learning, likely continue LLC to evolve over evidence in© making Jones care & decisions, Bartlett communicating Learning, LLC time as healthcare needs change and healthcare NOT FOR SALE OR DISTRIBUTION and workingNOT with FOR the interprofessional SALE OR DISTRIBUTION treatment delivery and practice evolve. Nursing knowledge team, developing a plan of care with the team that and the integration of science and art, which includes the patient and family when the patient

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agrees to family participation, evaluating patient State boards of nursing also assume an import- outcomes, advocating© Jones for patients, & Bartlett and much Learning, more. ant LLC role in guiding and, in some cases,© Jones determining & Bartlett Learning, LLC e Apply QualityNOT ImprovementFOR SALE chapter OR discusses DISTRIBUTION professional direction through legislation.NOT FOR Each state SALE OR DISTRIBUTION quality care in more detail, but as the student becomes board operates under a state practice act, which al- more oriented to nursing education and nursing as a lows the state government to meet its responsibility profession, it is important to recognize that establishing to protect the public—in this case, the health of the © Jonesand maintaining & Bartlett standards Learning, is part of being LLC in a pro- public—through© nursing Jones licensure & Bartlett requirements. Learning, Each LLC NOTfession. FOR e SALE generic standards OR DISTRIBUTION and their measurement nurse must practice,NOT or meetFOR the SALE description OR of, nursingDISTRIBUTION criteria, which apply to all nurses, are divided into two as identied in the state in which the nurse practices. types of standards: standards of practice and standards Regulation is discussed in more detail in the Nursing of professional performance. e major content areas Education, Accreditation, and Regulation chapter. of the standards follow (ANA, 2015a). © Jones & Bartlett StandardsLearning, of Practice LLC (competent level of practice © Jones & Bartlett Learning, LLC NOT FOR SALEbased OR onDISTRIBUTION the nursing process) NOTProfessional FOR SALE OR Nursing DISTRIBUTION 1. Assessment Associations 2. Diagnosis Nurses have a history of involvement in organi- 3. Outcomes identication zations that foster the goals of the profession. e 4. Planning © Jones & Bartlett Learning,existence LLC of professional associations© Jones and organi & Bartlett- Learning, LLC 5. ImplementationNOT (coordinationFOR SALE of OR care, DISTRIBUTIONhealth zations is one of the characteristicsNOT of a profession.FOR SALE OR DISTRIBUTION teaching and health promotion, consultation, A professional organization is a group that has and prescriptive authority) specic goals, objectives, and functions that relate to 6. Evaluation the mission of a specic profession. Typically, mem- © JonesStandards & of Bartlett Professional Learning, Performance LLC (competent bership is open© to Jones members & of Bartlett that profession Learning, and LLC level of behavior in the professional role) requires payment of dues. Some organizations have NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1. Ethics more specic membership requirements or may be 2. Culturally congruent practice by invitation only. Nursing has many organizations 3. Communication at the local, state, national, and international levels, 4. Collaboration and some organizations function on all of these levels. © Jones & Bartlett5. LeadershipLearning, LLC © JonesProfessional & Bartlett organizations Learning, oen publish LLC journals NOT FOR SALE 6.OR Education DISTRIBUTION NOTand FOR other informationSALE OR related DISTRIBUTION to the profession and 7. Evidence-based practice and research oer continuing education opportunities through 8. Quality of practice meetings, conferences, and other formats. As discussed 9. Professional practice evaluation previously, many of the organizations, particularly ANA, have been involved in developing professional 10. Resource utilization© Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 11. Environmental health* standards. Professional education is a key function NOT FOR SALE OR DISTRIBUTIONof many organizations. Some organizationsNOT FOR are very SALE OR DISTRIBUTION Nursing specialty groups—in some cases, in active in policy decisions at the government level, partnership with the ANA—have developed spe- taking political action to ensure that the profession’s cialty standards, such as those for cardiovascular goals are addressed and advocating for health care nursing, neonatal nursing, and nursing informatics. in general. is activity is generally done through © JonesHowever, & all Bartlett nurses must Learning, meet the generic LLC standards © Jones & Bartlett Learning, LLC lobbying and advocacy. Some of the organizations NOTregardless FOR SALEof their specialty.OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION are involved in advocacy in the work environment, *© 2015 by American Nurses Association. Reprinted with for example, a union, with the aim of making the permission. All rights reserved. workplace environment better for nurses. © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 22 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 1: Professional Nursing: History and Development of the Nursing Profession 23

Major Nursing Associations perspective of the many organizations representing © Jones & Bartlett Learning, LLCdierent aspects of the profession© Jones Exhibit & 1-4 Bartlett lists Learning, LLC e following description highlights some of the NOT FOR SALE OR DISTRIBUTIONsome of these organizationsNOT and their FOR websites. SALE OR DISTRIBUTION major nursing organizations (keep in mind that many other professional organizations exist). Or- American Nurses Association. e ANA is ganizations that focus on nursing specialties have the organization that represents all RNs in the expanded. Other organizations related to nursing United States, but not all RNs belong to the ANA. e © Joneseducation & Bartlett are described Learning, in the Nursing LLC Education, ANA also ©represents Jones nurses & Bartlett who are notLearning, members LLC NOT FORAccreditation, SALE and OR Regulation DISTRIBUTION chapter. To give you a because manyNOT in healthcare, FOR SALE government, OR andDISTRIBUTION business

Academy of Medical–Surgical Nurses: http://www.medsurgnurse.org Academy of Neonatal Nursing: http://www.academyonline.org American Academy of Ambulatory Care Nursing, http://www.aaacn.org American© Jones Academy & of Bartlett Nurse Practitioners: Learning, http://www.aanp.org LLC © Jones & Bartlett Learning, LLC AmericanNOT Academy FOR ofSALE Nursing: OR http://www.aannet.org DISTRIBUTION NOT FOR SALE OR DISTRIBUTION American Assembly for Men in Nursing: http://aamn.org American Association for the History of Nursing: http://www.aahn.org American Association of Colleges of Nursing: http://www.aacn.nche.edu © Jones American& Bartlett Association Learning, of Critical-Care LLC Nurses: http://www.aacn.org© Jones & Bartlett Learning, LLC NOT FORAmerican SALE Association OR DISTRIBUTION of Legal Nurse Consultants: http://www.aalnc.orgNOT FOR SALE OR DISTRIBUTION American Association of Neuroscience Nurses: http://www.aann.org American Association of Nurse Anesthetists: http://www.aana.com American Association of Nurse Attorneys: http://www.taana.org © Jones & Bartlett Learning,American Association LLC of Occupational Health© JonesNurses: http://www.aaohn.org & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTIONAmerican College of Nurse–Midwives: http://www.midwife.orgNOT FOR SALE OR DISTRIBUTION American College of Nurse Practitioners: http://www.acnpweb.org American Holistic Nurses’ Association: http://www.ahna.org American Nephrology Nurses’ Association: http://www.annanurse.org American© Jones Nurses Association: & Bartlett http://www.nursingworld.org Learning, LLC © Jones & Bartlett Learning, LLC AmericanNOT Nurses FOR Foundation: SALE ORhttp://www.anfonline.org DISTRIBUTION NOT FOR SALE OR DISTRIBUTION American Nursing Informatics Association: http://www.ania.org American Organization of Nurse Executives: http://www.aone.org American Psychiatric Nurses Association: http://www.apna.org © Jones American& Bartlett Public Learning, Health Association–Public LLC Health Nursing: http://www.apha.org© Jones & Bartlett Learning, LLC NOT FORAmerican SALE Society OR DISTRIBUTION of PeriAnesthesia Nurses: http://www.aspan.orgNOT FOR SALE OR DISTRIBUTION American Society of Plastic Surgical Nurses: http://www.aspsn.org

(Continues) © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 23 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 24 Section 1: The Profession of Nursing

Exhibit ©1-4 Jones (continued) & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

Association for Nursing Professional Development: http://anpd.org Association of Camp Nurses: http://www.campnurse.org Association of Nurses in AIDS Care: http://www.nursesinaidscare.org © JonesAssociation & Bartlett of Pediatric Learning, Hematology/Oncology LLC Nurses: http://www.apon.org© Jones & Bartlett Learning, LLC NOT FORAssociation SALE of periOperative OR DISTRIBUTION Registered Nurses: http://www.aorn.orgNOT FOR SALE OR DISTRIBUTION Association of Rehabilitation Nurses: http://www.rehabnurse.org Association of Women’s Health, Obstetric and Neonatal Nurses: http://www.awhonn.org Commission on Graduates of Foreign Nursing Schools: http://www.cgfns.org © Jones & BartlettCouncil Learning, of International LLC Neonatal Nurses: http://www.coinnurses.org© Jones & Bartlett Learning, LLC Emergency Nurses Association: http://www.ena.org NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Home Healthcare Nurses Association: http://www.hhna.org Hospice and Palliative Nurses Association: http://www.hpnaadvancingexpertcare.org Infusion Nurses Society: http://www.ins1.org International Association of Forensic Nurses: http://www.forensicnurses International© CouncilJones of &Nurses: Bartlett http://www.icn.ch Learning, LLC © Jones & Bartlett Learning, LLC InternationalNOT Home FOR Care NursesSALE Association: OR DISTRIBUTION http://ihcno.org NOT FOR SALE OR DISTRIBUTION International Society for Psychiatric–Mental Health Nurses: http://www.ispn-psych.org International Transplant Nurses Society: http://itns.org National Alaskan Native American Indian Nurses Association: http://www.nanainanurses.org © JonesNational & Bartlett Association Learning, of Clinical Nurse LLC Specialists: http://www.nacns.org© Jones & Bartlett Learning, LLC National Association of Neonatal Nurses: http://www.nann.org NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION National Association of Orthopaedic Nurses: http://www.orthonurse.org National Association of Pediatric Nurse Practitioners: http://www.napnap.org National Association of School Nurses: http://www.nasn.org National Black Nurses Association: http://www.nbna.org © Jones & BartlettNational Learning, Council LLC of State Boards of Nursing: https://www.ncsbn.org© Jones & Bartlett Learning, LLC NOT FOR SALE ORNational DISTRIBUTION Gerontological Nursing Association: http://www.ngna.org/NOT FOR SALE OR DISTRIBUTION National League for Nursing: http://www.nln.org National Nursing Staff Development Organization: http://www.nnsdo.org National Student Nurses Association: http://www.nsna.org Oncology Nursing Society: http://www.ons.org © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Society of Gastroenterology Nurses and Associates: http://www.sgna.org Society of PediatricNOT FOR Nurses: SALE http://www.pedsnurses.org OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Society of Trauma Nurses: http://www.traumanurses.org State Nurses Associations: http://www.nursingworld.org/functionalmenucategories/aboutana /whoweare/cma.aspx © JonesThe Association & Bartlett for RadiologicLearning, & Imaging LLC Nursing: http://www.arinursing.org© Jones & Bartlett Learning, LLC NOT FORTranscultural SALE Nursing OR DISTRIBUTION Society: http://www.tcns.org NOT FOR SALE OR DISTRIBUTION Wound, Ostomy and Continence Nurses Society: http://www.wocn.org

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 24 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 1: Professional Nursing: History and Development of the Nursing Profession 25

view the ANA as the voice of nursing. When the ANA than 1,000 nursing scholars have received ANF grants lobbies for ©nursing, Jones it is lobbying& Bartlett for all nurses, Learning, not just LLCrepresenting more than $5 million© Jones (ANF, & 2015). Bartlett Learning, LLC its membership.NOT isFOR organization SALE OR represents DISTRIBUTION more NOT FOR SALE OR DISTRIBUTION American Academy of Nursing. e AAN was than 3.6 million RNs through its multiple constituent established in 1973, and it serves the public and the member associations and state and territorial nursing profession through its activities to advance associations, although the actual membership is health policy and practice (American Academy of much less than the total number of RNs (ANA, 2016). © Jones & Bartlett Learning, LLC Nursing [AAN],© Jones 2015a). e& Bartlett academy is consideredLearning, the LLC is shi in membership must be considered in light NOT FOR SALE OR DISTRIBUTION “think tank”NOT for nursing. FOR MembershipSALE OR as DISTRIBUTIONan academy of generational issues. New nurses typically do not fellow is by invitation; fellows may then list “FAAN” join organizations, and there is continual unrest in their credentials. ere are approximately 2,100 regarding the perception by some nurses of the fellows, representing nursing’s leaders in education, ANA’s lack of response to vital nursing issues. management, practice, and research. is is a very © Jones & Bartlett InLearning, addition to beingLLC a professional organization,© Jones & Bartlett Learning, LLC prestigious organization, and fellows have demonstrated NOT FOR SALE ORsome DISTRIBUTION state chapters have formed labor unions.NOT FOR SALE OR DISTRIBUTION their leadership in practice, management, and academic Participation in the labor union is optional for nursing. e AAN also publishes the journal Nursing members, and each state organization’s stance on Outlook. Examples of some of the AAN’s current unions has an impact on membership. e ANA’s initiatives follow (AAN, 2015b): major publication© Jones is American & Bartlett Nurse Learning, Today. e LLC © Jones & Bartlett Learning, LLC ■ Choosing Wisely is a campaign to ensure that organization’sNOT 2017–2020 FOR SALE strategic OR plan DISTRIBUTION identies NOT FOR SALE OR DISTRIBUTION the three goals (ANA, 2017): more Americans hear about and understand the need for the right care provided at the right 1. Increase the number and engagement of nurses time. ANA fellows are working in partnership in ANA. with other organizations in this initiative. 2. Stimulate and disseminate innovation that in- ■ e AAN provides expert panels to address © Jones &creases Bartlett recognition Learning, of the value LLC of nursing and © Jones & Bartlett Learning, LLC current healthcare concerns. NOT FORdrives SALE improvement OR DISTRIBUTION in health and health care. NOT FOR SALE OR DISTRIBUTION ■ e Council for the Advancement of Nursing 3. Leverage the ANA Enterprise to position Science serves as a voice for nurse scientists nurses as integral partners consumers’ health and supports development of nursing science. and health care journeys. ■ Have You Ever Served? An AAN initiative © Jones & Bartlett eLearning, ANA has threeLLC aliated organizations: ©the Jones & inBartlett collaboration Learning, with other LLC organizations NOT FOR SALE ORAmerican DISTRIBUTION Nurses Foundation (ANF), the AmericanNOT FOR SALEand the federalOR DISTRIBUTION government to improve the Academy of Nursing (AAN), and the American health of veterans. Nurses Credentialing Center (ANCC). ■ Institute for Nursing Leadership supports nurse American Nurses Foundation. e ANF is appointments and leadership development. “dedicated to transforming the nation’s health through © Jones & Bartlett Learning, LLCAmerican Nurses Credentialing© Jones Center. & Bartlett e Learning, LLC the power of nursing. It is the only philanthropic NOT FOR SALE OR DISTRIBUTIONANA established the ANCC inNOT 1973 FORto develop SALE and OR DISTRIBUTION organization with a mission to improve health implement a program that would provide tangible care and support the 3.6 million nurses across the recognition of professional achievement. Additional United States health through the power of nursing. programs were added to the work done by the ANCC We help nurses step into leadership roles in their including (American Nurse Credentialing Center, 2016): © Jonescommunities & Bartlett and Learning,workplaces to LLCensure that they © Jones & Bartlett Learning, LLC NOT FORcan play SALE a meaningful OR DISTRIBUTION role in shaping decisions on ■ AccreditationNOT FOR Program: SALE e OR ANC DISTRIBUTION C Accredi- the quality and capacity of health care” (American tation program recognizes the importance of Nurses Foundation [ANF], 2017). As of 2015, more high-quality continuing nursing education (CNE) © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 25 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 26 Section 1: The Profession of Nursing

and skills-based competency programs. Around ■ Goal I—Leader in Nursing Education: Enhance the world,© JonesANCC-accredited & Bartlett organizations Learning, LLCthe NLN’s national and international© Jones impact & Bartlett Learning, LLC provide NOTnurses withFOR the SALE knowledge OR and DISTRIBUTION skills as the recognized leader in nursingNOT FOReducation. SALE OR DISTRIBUTION to help improve care and patient outcomes. ■ Goal II—Commitment to Members: Build a ■ Certication Program: ANC C’s Certication diverse, sustainable, member-led organization Program enables nurses to demonstrate their with the capacity to deliver the NLN’s mission © Jonesspecialty & Bartlett expertise Learning,and validate their LLC knowledge eectively,© eciently,Jones & and Bartlett in accordance Learning, with LLC NOT FORto employers SALE ORand patients. DISTRIBUTION rough targeted the NLN’sNOT values. FOR SALE OR DISTRIBUTION exams that incorporate the latest nursing prac- ■ Goal III—Champion for Nurse Educators: Be tice standards, ANC C certication empowers the voice of nurse educators and champion nurses with pride and professional satisfaction. their interests in political, academic, and ■ Pathway: e Pathway to Excellence Pro- professional arenas. © Jones & Bartlett Learning,gram recognizes LLC a healthcare organization’s © Jones■ Goal & IV—AdvancementBartlett Learning, of the Science LLC of Nursing NOT FOR SALE OR commitmentDISTRIBUTION to creating a positive nursing NOT FOREducation: SALE Promote OR DISTRIBUTION evidence-based nursing practice environment. e Pathway to Ex- education and the scholarship of teaching. cellence in Long Term Care program is the rst to recognize this type of supportive American Association of Colleges of e AACN is the national organization work setting. Pathway organizations focus Nursing. © Jones & Bartlett Learning,for LLC educational programs at the baccalaureate© Jones &level Bartlett Learning, LLC on collaboration, career development, and NOT FOR SALE OR DISTRIBUTIONand higher. e organization is particularlyNOT FOR concerned SALE OR DISTRIBUTION accountable leadership to empower nurses. with development of standards and resources ■ Magnet Recognition Program®: ANC C’s Magnet and promotes innovation, research, and practice Recognition Program is the most prestigious to advance nursing education. e organization distinction a healthcare organization can represents more than 780 schools of nursing at the © Jonesreceive & Bartlett for nursing Learning, excellence LLCand quality © Jones & Bartlett Learning, LLC baccalaureate and higher levels (AACN, 2016, 2015b). NOT FORpatient SALE outcomes. OR OrganizationsDISTRIBUTION that achieve NOT FOR SALE OR DISTRIBUTION e dean or director of a school of nursing serves Magnet recognition are part of an esteemed as a representative to the AACN. e organization group that demonstrates superior nursing holds annual meetings for nurse educators that focus practices and outcomes. on dierent levels of nursing education. e AACN ■ Nursing Knowledge Center: e Nursing © Jones & Bartlett Learning, LLC © Joneshas been &involved Bartlett in creating Learning, and promoting LLC new Knowledge Center provides educational roles, such as the clinical nurse leader and the DNP, NOT FOR SALE OR materialsDISTRIBUTION and guidance to support nurses NOT FOR SALE OR DISTRIBUTION as well as educational programs, which are discussed and organizations in their quest to achieve in other chapters of this text. e major AACN success through its credentialing programs. publication is the Journal of Professional Nursing. is organization’s strategic goals for 2017–2019 National League© Jones for Nursing. & Bartlett e Learning,NLN is LLC © Jones & Bartlett Learning, LLC are as follows (AACN, 2017): a nursing organizationNOT FOR that focusesSALE on OR excellence DISTRIBUTION NOT FOR SALE OR DISTRIBUTION in nursing education. Its membership is primarily ■ Goal 1: AACN is the driving force for inno- composed of schools of nursing and nurse educators. vation and excellence in academic nursing. e organization began in 1893 as the American ■ Goal 2: AACN is a leading partner in advanc- Society of Superintendents of Training Schools. It ing improvements in health, health care, and © Jonesholds a number& Bartlett of educational Learning, meetings LLC annually higher education.© Jones & Bartlett Learning, LLC NOTand FOR provides SALE continuing OR educationDISTRIBUTION and certication ■ Goal 3:NOT AACN FOR is a primarySALE advocateOR DISTRIBUTION for for nurse educators. is organization has four advancing diversity and inclusivity with major goals (National League for Nursing, 2017): academic nursing.

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 26 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 1: Professional Nursing: History and Development of the Nursing Profession 27

■ Goal 4: AACN is the authoritative source of the organization takes place. ere are about of knowledge© Jones to & advance Bartlett academic Learning, nursing LLC500 chapters at approximately© Jones695 institutions & Bartlett of Learning, LLC throughNOT information FOR SALE curation OR and DISTRIBUTION synthesis. higher education, which includeNOT schools FOR in Armenia, SALE OR DISTRIBUTION Australia, Botswana, Brazil, Canada, Colombia, Organization for Associate Degree Nursing. England, Ghana, Hong Kong, Japan, Kenya, Lebanon, e Organization for Associate Degree Nursing Malawi, Mexico, the Netherlands, Pakistan, Portugal, (OADN) [formerly N-OADN] represents associate © Jones & Bartlett Learning, LLC Singapore,© South Jones Africa, & SouthBartlett Korea, Learning, Swaziland, LLC degree (AD) nurses, AD nursing programs, and NOT FOR SALE OR DISTRIBUTION Sweden, Taiwan,NOT FOR Tanzania, SALE ailand, OR DISTRIBUTIONthe United individual member nurse educators. e organization Kingdom, and the United States. Other countries are joined the ANA as an organizational aliate in considering establishing chapters. is is an important December 2016 along with 30 other specialty nursing organization, and students should learn more about organizations that are ANA aliates (e American their school’s chapter (if the school has one) and aspire © Jones & Bartlett NurseLearning,, 2017). e LLC OADN focuses on enhancing© the Jones to an & invitation Bartlett for Learning,induction into LLC STTI. Inductees NOT FOR SALE ORquality DISTRIBUTION of AD nursing education, strengtheningNOT the FORmeet specicSALE academic OR DISTRIBUTION and leadership standards. professional role of the AD nurse, and protecting e major STTI publications are Journal of Nursing the future of AD nursing in the midst of healthcare Scholarship, Reections on Nursing Leadership, and changes. Its major goals follow (Organization for the newest publication, Worldviews on Evidence-Based Associate Degree Nursing, 2016): © Jones & Bartlett Learning, LLCNursing. e organization manages© Jones the major & Bartlettonline Learning, LLC ■ CollaborationNOT FOR Goal: SALE Advance OR associate DISTRIBUTION degree library for nursing resources, theNOT Virginia FOR Henderson SALE OR DISTRIBUTION nursing education through collaboration International Nursing Library, through its website. with a diversity of audiences. International Council of Nurses. e ICN, ■ Education Goal: Advance associate degree founded in 1899, is a federation of 130 national nursing education. nurses’ associations representing approximately © Jones &■ Bartlett Learning, LLC © Jones & Bartlett Learning, LLC Advocacy Goal: Advocate for issues and activ- 16 million nurses worldwide, representing more than NOT FOR SALEities that OR support DISTRIBUTION the organization’s mission. 130 nationalNOT nurse FOR associations SALE suchOR asDISTRIBUTION the ANA (International Council of Nurses [ICN], 2015). is Sigma Theta Tau International. Sigma eta Tau International (STTI) is a not-for-prot organization is the international voice of nursing international organization based in the United States. and focuses on activities to better ensure quality © Jones & Bartlett isLearning, nursing honor LLC society was created in 1922 by© aJones care &for Bartlett all and sound Learning, health policies LLC globally. Its NOT FOR SALE ORsmall DISTRIBUTION group of nursing students at what is nowNOT the FORactivities SALE focus ORon (1) DISTRIBUTION professional nursing practice Indiana University School of Nursing. Its mission (for example, specic health issues, International is to provide leadership and scholarship in practice, Classication of Nursing Practice), (2) nursing education, and research to improve the health of regulation (for example, regulation and credentialing, all people (Sigma eta Tau International, 2016). ethics, standards, continuing education), and (3) © Jones & Bartlett Learning, LLCsocioeconomic welfare for ©nurses Jones (for example,& Bartlett Learning, LLC MembershipNOT in this FOR organization SALE isOR by invitation DISTRIBUTION to NOT FOR SALE OR DISTRIBUTION baccalaureate and graduate nursing students who occupational health and safety, salaries, migration, demonstrate excellence in scholarship and to nurse and other issues). e ICN headquarters is in leaders who demonstrate exceptional achievements Geneva, Switzerland. in nursing. STTI has more than 135,000 active National Student Nurses Association. e © Jonesmembers, & Bartlett and 85 countriesLearning, are representedLLC in its National ©Student Jones Nurses & Bartlett Association Learning, (2016) has LLC NOT FORmembership. SALE OR DISTRIBUTION a membershipNOT of FOR approximately SALE OR 60,000 DISTRIBUTION students Schools of nursing may form STTI association enrolled in diploma, AD, baccalaureate, and general chapters. e chapters are where most of the work graduate nursing programs in 50 states, the District of

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 27 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 28 Section 1: The Profession of Nursing

Columbia, Puerto Rico, and the U.S. Virgin Islands. It together. Membership in a professional organization is a national organization© Jones with & chapters Bartlett within Learning, schools is LLC one way to develop one strong© voice. Jones & Bartlett Learning, LLC of nursing. Its majorNOT publication FOR SALE is Imprint OR. JoiningDISTRIBUTION Nurses who attend meetings,NOT hold oces,FOR andSALE OR DISTRIBUTION the NSNA is a great way to get involved and to begin serve on committees or as delegates to large meet- to develop professional skills needed for the future ings benet more from membership than those (such as learning more about being a leader and a who do not participate. Submitting abstracts for © Jonesfollower, critical& Bartlett roles for practicingLearning, nurses). LLC e NSNA a presentation© or Jonesposter at & a meetingBartlett is excellentLearning, LLC NOTwebsite FOR provides SALE an OR overview DISTRIBUTION of the organization experience forNOT nurses FOR and oers SALE even OR more DISTRIBUTION op- and its activities. Attending a national convention is portunities for networking with other nurses who also a great way to nd out about nursing in other might also provide resources and mentoring for areas of the country and network with other nursing professional development. ere are some factors students. Annual conventions attract more than that are important to recognize as you consider © Jones & Bartlett3,000 Learning,nursing students LLC and are held at dierent sites © Jonesjoining a &professional Bartlett organization. Learning, Belonging LLC to a NOT FOR SALEeach OR year. DISTRIBUTION is professional networking also aords NOTnursing FOR association SALE requiresOR DISTRIBUTION money for membership students opportunities to learn about graduate and commitment to the association, which means education, specialty groups, and nursing careers. Active it takes time to engage in the organization. engagement in your school’s NSNA chapter and national Students can begin to meet this professional activities provide© youJones with opportunities & Bartlett to Learning, develop obligation LLC by joining local student© Jonesorganizations, & Bartlett Learning, LLC leadership competencies.NOT FOR Hopefully, SALE these OR experiences DISTRIBUTION which may or may not be directlyNOT related FOR to theSALE OR DISTRIBUTION will provide a springboard to later professional nursing program but to the campus in general, and engagement in nursing professional organizations. developing skills that can be used aer graduation when they join professional organizations. Mem- Why Belong to a Nursing bership oers opportunities to serve as a committee © JonesProfessional & Bartlett Organization? Learning, LLC member and even© Jones chair a committee. & Bartlett Organization Learning, LLC NOT e FOR previous SALE section OR described DISTRIBUTION many nursing communicationNOT methods FOR can SALE be observed, OR andDISTRIBUTION the professional organizations, and there is further student can participate in the processes, developing information in the Nursing Education, Accredita- leadership competencies. Engagement in organizations tion, and Regulation chapter about some of these allows members to participate in making decisions organizations. Why is it important to belong to a about nursing and health care in general. When new © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC professional organization? Joining a professional nurses enter the profession today, they nd a healthcare NOT FOR SALEorganization OR DISTRIBUTION and becoming active in the orga- NOTsystem FOR that SALE is struggling OR toDISTRIBUTION improve its quality and nization’s activities is a professional obligation. keep up with medical changes, and nurses need to be Membership and, it is hoped, active involvement engaged in the process to improve health care. Orga- can help nurses develop leadership skills, improve nizations also sometimes band together—increasing networking, and© Jones nd mentors. & Bartlett Additionally, Learning, collaboration LLC to have a greater voice© Jones about critical & Bartlett Learning, LLC membership givesNOT nurses FOR a voiceSALE in professionalOR DISTRIBUTION healthcare policy issues such as theNOT need FORto expand SALE OR DISTRIBUTION issues and in some cases, health policy issues. It the nursing profession or improve care in a local area. provides a range of opportunities for professional development. Nurses represent the single largest voting bloc in any state. By using this political Nursing Workforce © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC power through nursing and other professional Nursing is one of the largest healthcare professions, NOTorganizations, FOR SALE nurses OR can DISTRIBUTION speak in one powerful and nurses haveNOT many opportunitiesFOR SALE to serve OR as DISTRIBUTION leaders voice. Yet as nurses, we have oen failed to pull in health care. Nurses work in a variety of settings,

© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 9781284127959_CH01_001_038.indd 28 19/09/17 2:57 PM © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Chapter 1: Professional Nursing: History and Development of the Nursing Profession 29

such as hospitals, clinics, home health care, hospice ■ While not considered in this study, emerging care, long-term© Jones care, rehabilitation, & Bartlett physician Learning, oces, LLC care delivery models, with© Jones a focus on & manag Bartlett- Learning, LLC school health,NOT employment FOR SALE services, OR and DISTRIBUTION numerous ing health status and preventingNOT FOR acute SALE health OR DISTRIBUTION other service sites. e majority of nurses work in issues, will likely contribute to new growth acute care hospital settings, but this is changing as in demand for nurses—for example, nurses more care moves into the community. taking on new and/or expanded roles in © Jones &According Bartlett to the Learning, U.S. Bureau of LLC Labor Statistics’ preventive© Jones care and& Bartlett care coordination Learning, (p. 2). LLC NOT FOR(2015) SALE employment OR DISTRIBUTION projections for 2014–2024, ■ SupplyNOT and FORdemand SALE will continue OR toDISTRIBUTION be aected employment opportunities for registered nurses are by numerous factors, including population expected to increase 16%, which is faster than ex- growth and the aging of the nation’s popu- pected for most other occupations. Over this period, lation, overall economic conditions, aging another 495,500 nursing workforce replacements of the nursing workforce, and changes in © Jones & Bartlett mayLearning, be needed, LLC bringing the total number of ©job Jones & healthcareBartlett reimbursement Learning, LLC (p. 4). NOT FOR SALE ORopenings DISTRIBUTION for nurses due to growth and replaceNOT- FOR■ SALEWhile the OR evidence DISTRIBUTION in this report points ments to 1.2 million by 2020. We have experienced toward the United States currently educating a number of years of uctuating nursing shortages. slightly more nurses than required to meet As the number of nurses in practice and nursing future demand, a reduction in people choos- school enrollments© Jones uctuate, & Bartlett any nursing Learning, shortage, LLC ing nursing as a career© or Jones a combination & Bartlett of Learning, LLC whether thisNOT is geographic FOR SALE specic OR or DISTRIBUTIONhealthcare factors such as early retirementNOT FOR or increased SALE OR DISTRIBUTION organization specic, aects access to care in the demand could be sucient to erase projected years to come—and there can be great variation surpluses for RNs and LPNs (licensed practical from one area of the country to another. Because of nurses) (p. 14). demographic changes, the older adult population in ■ If the growing emphasis on care coordi- © Jonesthe United& Bartlett States is increasingLearning, rapidly, LLC and from 2010 nation,© Jones preventive & Bartlett services, Learning,and chronic LLC NOT FORto early SALE 2017, the OR ACA DISTRIBUTION extended insurance coverage diseaseNOT management FOR SALE in care OR delivery DISTRIBUTION models to more people. Taken together, these developments leads to a greater need for nurses, this brief signal that the demand for nurses and other health- may underestimate the projected nurse care professionals will increase. Changes in future demand (p. 15). federal legislation and their impact on states need to © Jones & Bartlett Learning, LLC © Jones &Nursing Bartlett is a profession.Learning, It meetsLLC all the re- be followed by the nursing profession to determine NOT FOR SALE OR DISTRIBUTION NOT FORquirements SALE for ORa profession DISTRIBUTION and serves as a major impact on nursing practice and need for nurses. profession in healthcare delivery and the healthcare e 2014 Health Resources and Services Admin- workforce. In the early part of its history, nursing istration (HRSA) report, e Future of the Nursing was not viewed as a profession, as noted in the Workforce: National- and State-Level Projections, review of nursing history described earlier in this 2012–2025©, indicates Jones that& Bartlett the United Learning, States is on LLCchapter, but it is now recognized© asJones a profession & Bartlett built Learning, LLC track to meetNOT the projectedFOR SALE demand OR for nursing DISTRIBUTION sta on knowledge that reects itsNOT dual componentsFOR SALE of OR DISTRIBUTION (registered nurses and licensed practical nurses in science and art with clear roles and responsibilities the next 10 years (HHS, HRSA, & BHW, 2014). e in the healthcare workforce. e Essence of Nursing: number of new graduates entering the workforce Knowledge and Caring chapter explores the art and has increased. Many factors impact supply and © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC demand for nursing sta. is report notes some NOT FORtrends SALE and study OR limitations DISTRIBUTION that might alter this Stop andNOT Consider FOR SALE#2 OR DISTRIBUTION It is easy to see how nursing is a profession. projection; for example:

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science of the profession of nursing, expanding on name, rst and last, and title and explaining your the view of nursing© Jones as a profession & Bartlett and anLearning, active role LLC is an important step in establishing© Jones trust & and Bartlett Learning, LLC member of theNOT healthcare FOR workforce. SALE OR DISTRIBUTIONmaintaining accountability—demonstratingNOT FOR pro SALE- OR DISTRIBUTION fessionalism (LeBlanc, Burke, & Henneman, 2016). Most nurses do not even consider the implications The Image of Nursing of the introduction and quickly move on to a task © Jones & Bartlett Learning, LLC that must be done.© Jones ey may & not Bartlett provide theirLearning, rst LLC NOT e FOR image ofSALE nursing OR may DISTRIBUTION appear to be an unusual and last name dueNOT to concernsFOR SALE about their OR privacy, DISTRIBUTION topic for a nursing text, but it is not. Image is part though this does not really protect privacy because of any profession. It is the way a person appears it is easy for a patient to nd out a nurse’s name. to others, or in the case of a profession, the way e public’s views of nursing and nurses are a profession appears to other professionals and typically based on personal experiences with nurses, © Jones & Bartlettothers Learning, in the work environment LLC and to the general © Joneswhich can & leadBartlett to a narrow Learning, view of a LLCnurse oen NOT FOR SALEpublic—in OR DISTRIBUTION nursing’s case, consumers of health care. NOTbased FOR on onlySALE a brief OR personal DISTRIBUTION experience. is Image and the perception of the profession aect experience may not provide an accurate picture of recruitment of students; the view of the public; all that nurses can and do provide in the healthcare funding for nursing education and research; rela- delivery process. In addition, this view may be tionships with ©healthcare Jones administrators & Bartlett and Learning, other inuenced LLC by the emotional response© Jones of a person & Bartlett Learning, LLC healthcare professionals,NOT FOR government SALE agencies, OR DISTRIBUTION and to the situation and the encounterNOT with FORa nurse. SALE OR DISTRIBUTION legislators at all levels of government; and, ultimately, But the truth is that most oen the nurse is the profession’s self-identity. Just as individuals may invisible. “Although nurses comprise the majority feel depressed or less eective if others view them of healthcare professionals, they are largely invisible. negatively, so can professionals experience similar eir competence, skill, knowledge, and judgment © Jonesreactions & if Bartletttheir image Learning, is not positive. LLC Image in- are—as the word© ‘image’Jones suggests—only & Bartlett a reection, Learning, LLC NOTuences FOR everything SALE OR the professionDISTRIBUTION does or wishes not reality” (E.NOT Sullivan, FOR 2004, SALE p. 45). OR Consumers DISTRIBUTION to do. How nurses view themselves—their profes- (patients, families) may not understand the knowl- sional self-image—has an impact on professional edge and competencies required to be a registered self-esteem (Buresh & Gordon, 2006). How one is nurse, may not recognize they are interacting with viewed has an impact on whether others seek that a nurse, or they may think someone is a nurse who © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC person out and how they view the effectiveness is not. When patients go to their doctor’s oce, they NOT FOR SALEof OR what DISTRIBUTION that person might do. Every time a nurse NOTinteract FOR with SALE sta, andOR oen DISTRIBUTION these patients think says to family, friends, or members of the public that that they are interacting with a registered nurse. he or she is a nurse, the nurse is representing the Most likely, they are not—the sta person may be a profession. “We cannot expect outsiders to be the medical assistant of some type or a licensed practi- guardians of our© Jones visibility & and Bartlett access to Learning, public cal/vocational LLC nurse. When in the© hospital, Jones patients & Bartlett Learning, LLC media and healthNOT policy FOR arenas. SALE We must OR develop DISTRIBUTION interact with many sta members,NOT and there FOR is little SALE OR DISTRIBUTION the skills of presenting ourselves in the media and to distinguish one from another, so patients may refer to the media—we have to take the responsibil- to most sta as nurses. Uniforms do not help identify ity for moving from silence to voice” (Buresh & roles because many sta wear scrub clothes and lab Gordon, 2006, p. 15). e professional introduction coats, and there has been less emphasis placed on © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC is an example of critical communication that sets professional attire. In the past, hospitals had strict NOTthe FORstage for SALE a nurse–patient OR DISTRIBUTION relationship, and it is dress codes, withNOT standard FOR uniformsSALE OR per typeDISTRIBUTION of associated with the image of nursing. Saying one’s sta. Over time, this approach changed—aecting

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not only what sta wore, but also appearance such strong statement and may be a confusing one. What as hair, wearing© Jones of jewelry, & Bartlett and so on. Learning, Healthcare LLCis the nurse’s voice? It is the© “unique Jones perspectives & Bartlett Learning, LLC organizationsNOT now FOR nd itSALE dicult OR to change DISTRIBUTION dress and contributions that nursesNOT bring FORto patient SALE care” OR DISTRIBUTION codes with sta complaining this is not needed. One (Pike, 2001, p. 449). Nurses have all too oen been organization conducted an extensive study of the silent about what they do and how they do it, but issue of dress and image, examining how patients this has been a choice that nurses have made—to be © Jonesviewed & Bartlettnurses, and Learning, noted at the conclusion LLC of the silent or to© be Jonesmore visible. & BothBartlett external Learning, and internal LLC NOT FORstudy SALEthat standardizing OR DISTRIBUTION nurse uniforms would factors aectNOT the nurse’sFOR voiceSALE and OR this silence.DISTRIBUTION e have a positive impact on the nurse’s professional external factors include the following (Pike, 2001):

image and this then would aect the nurse–patient ■ Historical role of nurse as handmaiden (not relationship (West et al., 2016). an independent role) is does not mean that the public does not ■ Hierarchical structure of healthcare orga- © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC value nurses—quite the contrary. When a person nizations (may limit the role of nurses in NOT FOR SALE ORtells DISTRIBUTION another that he or she is a nurse, the typicalNOT FOR SALEdecision OR making DISTRIBUTION and leadership) response is positive. However, many people do not ■ Perceived authority and directives of physicians know about the education required to become a nurse (may limit the independent role of nurses) and to maintain current knowledge or about the ■ Hospital policy (may limit nursing actions great variety© ofJones educational & Bartlett entry points Learning, into nursing LLC and leadership) © Jones & Bartlett Learning, LLC that all leadNOT to the FOR RN qualication.SALE OR ConsumersDISTRIBUTION ■ reat of disciplinaryNOT or legal FOR action SALE or loss OR DISTRIBUTION generally view nurses as good people who care for of job (may limit a nurse when he or she others. In 2017, nurses continue to rank number needs to speak out—advocate) one in ethics and honesty in the annual Gallup Poll Nurses who can deal with the internal factors can compared to other occupations (Jimenez, 2016). be more visible and less silent about nursing and © Jones is & high Bartlett vote of condence Learning, has beenLLC a consistent © Jones & Bartlett Learning, LLC better advocate for patients. e internal factors to NOT FORannual SALE result in OR this poll.DISTRIBUTION What is not mentioned in NOT FOR SALE OR DISTRIBUTION consider include: the poll is the knowledge and competency required ■ to do the job properly—important aspects of the Role confusion ■ nursing profession. Lack of professional condence ■ You might wonder why it is so important for Timidity © Jones & Bartlett Learning, LLC © Jones &■ Bartlett Learning, LLC nurses to make themselves more visible. You chose Fear ■ NOT FOR SALE ORnursing, DISTRIBUTION so you know that it is an important profession.NOT FOR SALEInsecurity OR DISTRIBUTION ■ Nevertheless, many students have a narrow view of Sense of inferiority the profession, much closer to what is portrayed in Nurses’ loss of professional pride and self-es- the media—the nurse who cares for others, albeit teem can also lead to a more serious professional with less understanding© Jones & of Bartlett the knowledge Learning, base re- LLCproblem: Nurses feel like victims© Jones and then & act Bartlett like Learning, LLC quired andNOT competency FOR needed SALE to meetOR theDISTRIBUTION complex victims. Victims do not takeNOT control, FOR but SALE rather OR DISTRIBUTION needs of patients. ere is limited recognition that see others as being in control; they abdicate re- nursing is a scientic eld. e profession needs sponsibility. ey play passive–aggressive games to be more concerned about visibility because the to exert power. is can be seen in the public profession needs to attract qualied students and image of nurses, which is predominantly driven © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC keep current nurses in practice. by forces outside the profession. It also aects the NOT FOR e SALE nurse’s OR voice DISTRIBUTION is typically silent, and this nurse’s abilityNOT to FOR collaborate SALE with OR others—both DISTRIBUTION factor has demoralized nursing (Pike, 2001). is is a other nurses and other healthcare professionals.

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It is all too easy for nurses to feel like victims, and the media are simply reecting the public image this perception© hasJones led in & many Bartlett ways to Learning, nurses of LLC nursing (Buresh & Gordon, 2006).© Jones Nurses &have Bartlett Learning, LLC viewing physiciansNOT in aFOR negative SALE light, emphasizingOR DISTRIBUTION not taken the lead in standing upNOT and discussingFOR SALE OR DISTRIBUTION that “physicians have done this to us.” As a conse- their own image of nursing—what it is and what quence, nurses may have problems saying they are it is not. It is not uncommon for a nurse to refuse colleagues with other healthcare professionals and to talk to the press because the nurse feels no © Jonesacting like & colleagues.Bartlett ColleagueshipLearning, LLC “involves need to do so,© may Jones not feel & competent Bartlett toLearning, do so, LLC NOTentering FOR into SALE a collaborative OR DISTRIBUTION relationship that is or fears reprisalsNOT from FOR his or SALEher employer. OR DISTRIBUTION When characterized by mutual trust and response and nurses do speak to the press—oen when being an understanding of the perspective each partner praised for an action—they say, “Oh, I was just contributes” (Pike, 2001, p. 449). Colleagues have doing my job.” is statement undervalues the the following characteristics: reality that critical thinking and clinical reason- © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC ■ Control interprofessional and intraprofes- ing and judgment on the part of nurses makes a NOT FOR SALE OR sionalDISTRIBUTION competition and antagonism from the NOTdierence FOR SALEin the health OR DISTRIBUTIONof patients (individuals, past conict that may inuence the present families, communities) every day. What is wrong and the future. with taking that credit? Because of these types of ■ Integrate work to provide the best care. responses in the media, nursing is not directing ■ Acknowledge© Jones they share& Bartlett a common Learning, goal: the LLC image, but rather accepting how© Jones those outside & Bartlett Learning, LLC quality patientNOT FORcare. SALE OR DISTRIBUTIONthe profession describe nursing.NOT FOR SALE OR DISTRIBUTION ■ Recognize their interdependence and also Gordon and Nelson (2005) comment “nursing independent responsibilities. needs to move away from the ‘virtue script’ toward a ■ Share responsibility and accountability for knowledge-based identity” (p. 62). e “virtue script” patient care outcomes. continues to be present in current media campaigns © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC ■ Respond to conict in a positive manner that are supported by the profession. For example, a NOT FORbefore SALE it accelerates. OR DISTRIBUTION video producedNOT by the FOR NSNA SALE mentions OR knowledge DISTRIBUTION but not many details; instead, it includes statements What is unexpected is how nurses’ silence may such as “[Nursing is a] job where people will love actually have a negative impact on patient care. is you” (Gordon & Nelson, 2005). How helpful is this factor may inuence how a nurse speaks out or ad- approach? Is this view of being loved based on today’s © Jones & Bartlettvocates Learning, for care that LLC a patient needs, how eective © Jones & Bartlett Learning, LLC nursing reality? Nursing practice involves highly a nurse can be on the interprofessional treatment NOT FOR SALE OR DISTRIBUTION NOTcomplex FOR care; SALE it can ORbe stressful, DISTRIBUTION demanding, and at team, and how nurses participate in healthcare times rewarding, but it is certainly not as simple as program planning and implementation of services. “everyone will love you.” Why do nurses continue to Each nurse has the responsibility and accountabil- describe themselves in this way? “One reason nurses ity to dene himself or herself as a colleague, and may rely so heavily on the virtue script is that many empowerment© is partJones of this & process. Bartlett Learning, LLC © Jones & Bartlett Learning, LLC believe this is their only legitimate source of status, e role ofNOT nursing FOR has SALE experienced OR DISTRIBUTIONmany NOT FOR SALE OR DISTRIBUTION respect, and self-esteem” (Gordon & Nelson, 2005, changes, and many more will occur in the future. p. 67). is, however, is a view that perpetuates the How has nursing responded to these changes and victim mentality. communicated them to the public and other health- © Jonescare professionals? & Bartlett Suzanne Learning, Gordon, LLC a journalist © Jones & Bartlett Learning, LLC who has written extensively about the nursing NOT FOR SALE OR DISTRIBUTION Stop and ConsiderNOT FOR #3 SALE OR DISTRIBUTION profession, noted that oen the media are accused The image of nursing is not simple to describe. of representing nursing poorly when, in reality,

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CHAPTER© Jones HIGHLIGHTS & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION 1. Nursing history provides a framework for 5. e sources of professional direction include understanding how nursing is practiced today. ANA documents that describe the scope of 2. e history of nursing is complex and has practice, standards, and an ethical code. been in uenced by social, economic, and 6. Professional organizations have a key role © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC political factors. in shaping nursing as a profession. Nurses NOT FOR3. SALE Florence OR Nightingale DISTRIBUTION was instrumental in shouldNOT participate FOR inSALE these organizationsOR DISTRIBUTION changing the view of nursing and nursing to have a voice in the profession. education to improve care delivery, but she 7. e public, the media, interprofessional is not the only nurse leader who has led colleagues, and nurses have an in uence © Jones & Bartlett Learning,the profession. LLC © Jones &on Bartlettthe image ofLearning, nursing. Nursing’s LLC image NOT FOR SALE OR DISTRIBUTION4. Nursing meets the critical requirementsNOT FORas SALE a profession OR hasDISTRIBUTION both positive and neg- for a profession. ative aspects.

ENGAGING© Jones IN & THEBartlett CONTENT Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Discussion Questions 1. How might knowing more about nursing 5. Why are standards important to the nursing history affect your personal view of nursing? profession and to healthcare delivery? 2. How did the image of nursing in Nightin- 6. Review the ANA standards of practice and © Jones & Bartlettgale’s time Learning,inﬂ uence nursing LLC from the 1860s professional© Jones performance. & Bartlett Are you Learning, surprised LLC NOT FOR SALEthrough OR the DISTRIBUTION1940s? by anyNOT of the FOR standards? SALE If so, OR why? DISTRIBUTION 3. How would you compare and contrast ac- 7. How would you explain to someone who is countability, autonomy, and responsibility? not in health care the reason that nursing 4. Based on content in this chapter, how would emphasizes its social policy statement? you deﬁ ne professionalism in your own words? © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION CRITICAL THINKING ACTIVITIES

1. Describe how the Nightingale Pledge may 3. Attend an NSNA meeting at your school. or© may Jones not have & relevance Bartlett today Learning, and how it LLC What did you learn about© the Jones organization? & Bartlett Learning, LLC might be altered to be more relevant. Work What did you observe in the meeting about withNOT a team FOR of students SALE to OR accomplish DISTRIBUTION this leadership and nursing?NOT Do you FOR have SALEany OR DISTRIBUTION activity and arrive at a consensus statement. criticisms of the organization and how it 2. Interview two registered nurses, ask them might be improved? If your school does not if they think nursing is a profession, and have an NSNA chapter, why is this the case? determine the rationale for their viewpoints. 4. Complete a mini-survey of six people © Jones & BartlettHow does whatLearning, they say compare LLC with what (non-nurses),© Jones asking & themBartlett to describe Learning, their LLC NOT FOR SALEyou have OR learned DISTRIBUTION about professionalism in imageNOT of nursing FOR and SALE nurses. OR Try toDISTRIBUTION pick a this chapter? variety of people. Summarize and analyze

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CRITICAL© Jones THINKING & Bartlett ACTIVITIES Learning, ¦CONTINUED§ LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION your data to identify any themes and un- www.nursingworld.org/MainMenuCatego usual views. How does what you learned ries/ ANAMarketplace/ANAPeriodicals/OJIN relate to the content in this chapter? List /TableofContents/Vol-16-2011/No2-May-2011 the similarities and differences, and then /Articles-Previous-Topics/Nursing-at-its-Best. © Jonesdiscuss & Bartlett your findings Learning, with a group LLC of your html. Debate© Jones this issue &in class.Bartlett Learning, LLC NOT FORclassmates SALE andOR compare DISTRIBUTION with their findings. 6. Analyze a NOTtelevision FOR program SALE that OR focuses DISTRIBUTION 5. You are told that the profession of nursing on a healthcare situation/story line. How needs to abandon its image of nurses as are nurses depicted compared with other angels and promote an image of nurses healthcare professionals? Compose a letter as competent professionals who are both to the program describing your analysis, and © Jones & Bartlett Learning,knowledgeable LLC and caring. Review this © Jonesdocument & Bartlett your arguments Learning, to support LLC your article : Rhodes, M., Morris, A., & Lazenby, R. viewpoint. This could be done with a team NOT FOR SALE OR DISTRIBUTION(2011, May). Nursing at its best: Competent NOT FORof students; SALE watch OR the DISTRIBUTION same program and and caring. OJIN , 16 . Retrieved from http:// then discuss opinions and observations.

You are asked to develop an Electronic Refl ection Journal that you will use after you complete each chapter. This is the place for you to refl ect on some aspect of the © Joneschapter’s & Bartlett content identifi Learning, ed at the LLCend of the chapter. You may also© want Jones to keep & notesBartlett about Learning, LLC NOT FORissues thatSALE you wantOR toDISTRIBUTION expand on as you progress through your nursingNOT education. FOR SALE If you areOR DISTRIBUTION using technology that allows you to make visuals, use drawings and graphics as one method to refl ect in your journal. In your fi rst entry in your Electronic Refl ection Journal , consider the following questions related to the image of nursing. Connect your responses so that you can better understand the importance of image to the profession and the meaning of profession. © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR1. DISTRIBUTION Why is the image of nursing important to theNOT profession? FOR ToSALE health ORcare inDISTRIBUTION general? 2. What role do you think you might have as a nurse in infl uencing the image of nursing? Provide specifi c examples. 3. What is your opinion about nursing uniforms, and how do you think they infl uence the image of nursing? 4. What stimulated your interest in nursing as a profession? Was the image of nursing in any way related© to Jones your decision, & Bartlett and in what Learning, way did it affect LLC your decision? © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Special assignment for this chapter: Write your own defi nition of nursing and include it in your Electronic Refl ection Journal. Work on this defi nition throughout this course as you learn more about nursing. Save the fi nal draft, and at the end of each semester or quarter, go back to your defi nition and make any changes you feel are necessary. Keep a draft of each defi nition so that © Jonesyou can& Bartlettsee your changes. Learning, When you LLC graduate, review all your defi nitions,© Jones illustrating & Bartlett how you Learning, LLC have developed your view of professional nursing. Ideally, you might then review your defi nition NOT FORagain one-yearSALE postOR graduation. DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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NOT FOR SALE You and OR your friendsDISTRIBUTION in the nursing program are having lunchNOT after aFOR class that SALE covered OR DISTRIBUTION content found in this chapter. One of your friends says, “I was bored when we got to all that information on professionalism and nursing organizations. What a waste of time. I just want to be a nurse.” All of you are struggling to ﬁ gure out what you have gotten yourself into. You turn to your friends and suggest it might be helpful to have an open discussion on the comment © Jones & Bartlett Learning,just made. LLC So over lunch, you all talk about© theJones comment. & Bartlett It was clear Learning,that the students LLC who NOT FOR SALE OR DISTRIBUTIONhad read the chapter were better able toNOT discuss FOR the issue, SALE but everyone OR DISTRIBUTION had an opinion. Case Questions 1. What is the purpose of nursing organizations? 2. What role should professional organizations assume to increase nursing status in the ©healthcare Jones &system? Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 3. What are some of the advantages and disadvantages to joining a professional organization? 4.NOT What FOR do you SALE know about OR your DISTRIBUTION school’s NSNA chapter? NOT FOR SALE OR DISTRIBUTION 5. Which nursing organization mentioned in this chapter interests you, and why? Compare your response with those of your other classmates. 6. Search on the Internet for a specialty nursing organization and pick one that interests you. What can you ﬁ nd out about the organization? © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE Case OR 2 DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

The NSNA chapter in your school wants to help the school develop a campaign to increase enrollment. You have volunteered along with three other members to meet with the associate dean to discuss ideas for the campaign. The associate dean tells you that the © Jones & Bartlett Learning,school is LLC going to use its standard marketing© Jones materials. & BartlettShe shows themLearning, to you. The LLC materials focus on the importance of being a caring person to be a “good” nurse. When you NOT FOR SALE OR DISTRIBUTIONask to see print materials and materials NOTto be posted FOR on SALE the Internet, OR DISTRIBUTIONyou are told that the focus is on print, and you see a photo of a nurse holding a patient’s hand.

Case Questions 1. How do you respond to this marketing material? 2.© What Jones recommendations & Bartlett wouldLearning, you make? LLC © Jones & Bartlett Learning, LLC 3.NOT How mightFOR you SALE get data OR from DISTRIBUTION fellow students to support your recommendations?NOT FOR SALE OR DISTRIBUTION

Working Backward to Develop a Case

This type of case is a different format from usual cases. It is a “backward case.” Students © Jones & Bartlettare provided Learning, with several questionsLLC and are asked to develop© Jones a case scenario & Bartlett that would Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION

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CASE© STUDIES Jones & Bartlett CONTINUED Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION relate to the questions and chapter content (paragraph or two). After the scenario is written, students answer the questions. A second option is for this to be a team activity. A team of students develops the scenario and then passes it on to another team to answer the questions. Following this, the teams discuss the case. This description and use of this © Joneslearning & Bartlett activity Learning,will not be repeated LLC in each chapter guide. © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Write a brief paragraph that describes a case related to the following questions and comments. 1. What do we need to do to be more professional as students? 2. I think this topic is not important now as we are students. We deal with it when we get © Jones & Bartlett Learning,our ﬁ rst LLCjob. © Jones & Bartlett Learning, LLC 3. We now have to wear our uniforms in the simulation lab. What is all this about? So an- NOT FOR SALE OR DISTRIBUTIONnoying as we have other things to think NOTabout. FOR SALE OR DISTRIBUTION

American Academy of Nursing. (2015a). About AAN. American Nurses Association. (2015b). Guide to the code of Retrieved from http://www.aannet.org/about-the ethics for nurses. Interpretation and application . Silver -academy Spring, MD: Nursesbooks.org © JonesAmerican & BartlettAcademy of Nursing. Learning, (2015b). AANLLC initiatives. American Nurses© Association. Jones (2016).& Bartlett Home page Learning,. Re- LLC Retrieved from http://www.aannet.org/home trieved from http://www.anfonline.org/Homepage NOT FORAmerican SALE Assembly OR for Men DISTRIBUTION in Nursing. (2017). 20 X 20 -Category/Publications/AnnualReports/2015NOT FOR SALE OR DISTRIBUTION choose nursing. Retrieved from http://www.aamn.org -Annual-Report.pdf /resources/20x20-choose-nursing American Nurses Association. (2017). ANA strategic plan American Association of Colleges of Nursing. (2004, 2017-2020. Retrieved from http://www.nursing September 20). AACN endorses the Sullivan Commission world.org/FunctionalMenuCategories/AboutANA report on increasing diversity in the health professions /ANAStrategicPlan © Jones & Bartlett Learning,(press release). LLC Washington, DC: Author. © Jones American &Nurse Bartlett Credentialing Learning, Center. (2016). LLC About NOT FOR SALE ORAmerican DISTRIBUTION Association of Colleges of Nursing. (2015a). NOT FORANCC. RetrievedSALE from OR http://www.nursecredentialing DISTRIBUTION Enrollment. Retrieved from http://www.aacn.nche .org/FunctionalCategory/AboutANCC .edu/news/articles/2015/enrollment American Nurses Foundation. (2015). Annual report, American Association of Colleges of Nursing. (2015b). 2015. Retrieved from http://www.anfonline.org Fact sheet: Enhancing diversity in the nursing work- /Homepage-Category/Publications/Annual force. Retrieved from http://www.aacn.nche.edu Reports/2015-Annual-Report.pdf /media-relations/diversityFS.pdf© Jones & Bartlett Learning,American LLC Nurses Foundation. (2017). About© Jonesus. Retrieved & Bartlett Learning, LLC American AssociationNOT FOR of Colleges SALE of Nursing. OR DISTRIBUTION(2016). from http://www.anfonline.org/Main/AboutANFNOT FOR SALE OR DISTRIBUTION AACN fact sheet. Retrieved from http://www.aacn Ashley, J. (1976). Hospitals , paternalism, and the role of the .nche.edu/media-relations/fact-sheets/aacn-fact-sheet nurse . New York, NY: Teachers College Press. American Association of Colleges of Nursing. (2017). Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Strategic plan 2017–2019. Retrieved from http://www Educating nurses: A call for radical transformation . .aacn.nche.edu/about-aacn/strategic-plan San Francisco, CA: Jossey-Bass. © Jones American & Bartlett Nurses Association. Learning, (2015a). LLCNursing : Scope Bixler, G., & Bixler,© R.Jones (1959). &e professionalBartlett status Learning, of LLC NOT FORand SALE standards ORof practice DISTRIBUTION. Silver Spring, MD: Author. nursing. AmericanNOT Journal FOR of Nursing SALE, 59 , 1142–1147.OR DISTRIBUTION

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Boughn,© S. (2001).Jones Why & women Bartlett and men Learning,choose nursing. LLCInstitute of Medicine. (2010). e future© Jones of nursing. Leading & Bartlett Learning, LLC NursingNOT and FOR Healthcare SALE Perspectives OR , 22DISTRIBUTION , 14–19. change, advancing health. Washington,NOT DC: FOR e National SALE OR DISTRIBUTION Brooks, J., & Kleine-Kracht, A. (1983). Evolution of a de - Academies Press. nition of nursing. Advances in Nursing Science , 5 (4), Jacobs, M., & Huether, S. (1978). Nursing science: e the- 51–63. ory practice linkage. Advan ces in Nursing Science, 1 , Bullough, V. (2006). Nursing at the crossroads: Men in nursing. 63–78. In P. Cowen & S. Moorhead (Eds.), Current issues in Jimenez, S. (2016, December 21). Nurses rank #1 once again © Jones & Bartlettnursing (7th ed., Learning, pp. 559–568). St. LLC Louis, MO: Mosby. in the Gallop© Jones Poll for ethics & andBartlett honesty. Retrieved Learning, from LLC NOT FORBullough, SALE V., & OR Bullough, DISTRIBUTION B. (1978). e care of the sick: e https://www.nurse.com/blog/2016/12/21/nurses-rankNOT FOR SALE OR DISTRIBUTION emergence of modern nursing . New York, NY: Prodist. -1-once-again-in-gallup-poll-for-ethics-and-honesty/ Buresh, B., & Gordon, S. (2006). From silence to voice: What Kalisch, P., & Kalisch, B. (1986). e advance of American nurses know and must communicate to the public (2nd nursing (2nd ed.). Boston, MA: Little, Brown and ed.). Toronto, Ontario: Canadian Nurses Association. Company. Chinn, P. (2001). Feminism and nursing. In J. Dochterman & Kalisch, P., & Kalisch, B. (2005). Perspectives on improving © Jones & Bartlett Learning,H. Grace LLC (Eds.), Current issues in nursing (6th© ed., Jones &nursing’s Bartlett public image. Learning, Nursing Education LLC Perspectives , pp. 441–447). St. Louis, MO: Mosby. 26 (1), 10–17. NOT FOR SALE OR DISTRIBUTION Cohen, S. (2007). e image of nursing. American NurseNOT FOR Keller, M.SALE (1979). OR e e ectDISTRIBUTION of sexual stereotyping on the Today , 2 (5), 24–26. development of nursing theory. American Journal of Connolly, C. (2004). Beyond social history: New approaches Nursing , 79 , 1584–1586. to understanding the state of and the state in nursing Kidd, P., & Morrison, E. (1988). e progression of knowledge history. Nursing History Review, 12 , 5–24. in nursing: A search for meaning. Image , 20 , 222–224. Dietz, D.,© & Lehozky,Jones A. (1963).& Bartlett History and Learning, modern nursing . LLCKupperschmidt, B. (2004). Making© Jonesa case for shared& Bartlett Learning, LLC Philadelphia, PA: Davis. accountability. Journal of Nursing Administration , Donahue,NOT M. (1985). FOR Nursing: SALE e OR nest artDISTRIBUTION . St. Louis, 34 , 114–116. NOT FOR SALE OR DISTRIBUTION MO: Mosby. LeBlanc, R., Burke, M., & Henneman, E. (2016). e pro- Farmer, R. (2015, July 1). Why gender diversity in the workforce fessional introduction. e key to establishing the matters. Minority Nurse. Retrieved from http://minority relationship between nurse and patient. AJN, 116(6), 11. nurse.com/why-gender-diversity-in-the-workforce Lindberg, B., Hunter, M., & Kruszewski, K. (1998). Introduc- © Jones & Bartlett-matters/ Learning, LLC tion to ©nursing Jones (3rd ed.). & Philadelphia, Bartlett PA: Learning, Lippincott. LLC Finkelman, A. (2016). Leadership and management for nurses: Lynaugh, J., & Fagin, C. (1988). Nursing comes of age. NOT FOR SALECompetencies OR for DISTRIBUTION quality care . (3rd. ed.). Upper Saddle Image ,NOT 20 , 184–190. FOR SALE OR DISTRIBUTION River, NJ: Pearson Education. Masters, K. (2005). Role development in professional nur sing Fowler, M. (2015a). Guide to nursing’s social policy statement. practice . Burlington, MA: Jones & Bartlett Learning. Silver Spring, MD: American Nurses Association. National League for Nursing. (2017). Mission/goals/core Fowler, M. (2015b). Guide to the code of ethics for nurses with values. Retrieved from http://www.nln.org/aboutnln interpretive statements. Silver Spring, MD: American /ourmission.htm © Jones & Bartlett Learning,Nurses Association.LLC © Jones National & BartlettStudent Nurses Learning, Association. (2016). LLC Who are we? NOT FOR SALE OR DISTRIBUTIONFreeman, L. (2007). Commentary. Nursing History ReviewNOT, FORRetrieved SALE from OR http://www.nsna.org/AboutUs.aspx DISTRIBUTION 15 , 167–168. Nightingale, F. (1858a). Notes on matters a ecting the health, Gordon, S. (2005). Nursing against the odds. Ithaca, NY: e ciency, and hospital administration of the British Cornell University Press. army . London, UK: Harrison and Sons. Gordon, S., & Nelson, S. (2005). An end to angels. American Nightingale, F. (1858b). Subsidiary notes as to the introduction Journal of Nursing , 105 (5), 62–69. of female nursing into military hospitals . London, UK: Gorenberg,© JonesB. (1983). & e Bartlettresearch tradition Learning, of nursing: LLC Longman, Green, Longman, Roberts,© Jones and Green. & Bartlett Learning, LLC AnNOT emerging FOR issue. NursingSALE Research OR , 32DISTRIBUTION , 347–349. Nightingale, F. (1859). Notes on hospitalsNOT . London,FOR SALEUK: OR DISTRIBUTION Huber, D. (Ed.). (2014). Leadership and nursing care man- Harrison and Sons. agement (5th ed.). Philadelphia, PA: Saunders. Nightingale, F. (1992). Notes on nursing: What it is, and International Council of Nurses. (2015). Our mission. what it is not (Commemorative ed.). Philadelphia, Retrieved from http://www.icn.ch/who-we-are/our PA: Lippincott Williams & Wilkins. (Original work -mission-strategic-intent-core-values-and-priorities/ published 1860). © Jones Institute& Bartlett of Medicine. Learning, (2003). Healthcare LLC education: A Organization © for Jones Associate &Degree Bartlett Nursing. (2016).Learning, Mis- LLC bridge to quality . Washington, DC: e National sion and goals. 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O’Rourke, M.© (2003). Jones Rebuilding & Bartlett a professional Learning, practice LLCe American Nurse. (2017, January). ANA© welcomesJones the & Bartlett Learning, LLC model: NOT e return FOR of role-based SALE practice OR accountability. DISTRIBUTION national organization for associateNOT degree nursing.FOR SALE OR DISTRIBUTION Nursing Administrative Quarterly , 27 , 95–105. Retrieved from http://www.theamericannurse Perry, J. (1985). Has the discipline of nursing developed to .org/2014/03/03/ana-welcomes-the-national the stage where nurses do “think nursing”? Journal of -organization-for-associate-degree-nursing/ Advanced Nursing, 10 , 31–37. U.S. Bureau of Labor Statistics. (2015). Employment pro- Pike, A. (2001). Entering collegial relationships. In jection. Retrieved from http://www.bls.gov/opub © JonesJ. & Dochterman Bartlett & H.Learning, Grace (Eds.), Current LLC issues in /mlr/2015/article/occupational-employment© Jones & Bartlett Learning, LLC NOT FORnursing SALE (6th ed., OR pp. 448–452). DISTRIBUTION St. Louis, MO: Mosby. -projections-to-2024.htmNOT FOR SALE OR DISTRIBUTION Quinn, C., & Smith, M. (1987). e professional commitment: U.S. Department of Health and Human Services, Health Issues and ethics in nursing . Philadelphia, PA: Saunders. Resources and Services Administration, & Bureau Ritter-Teitel, J. (2002). e impact of restructuring on of Health Professions. (2010). e registered nurse professional nursing practice. Journal of Nursing population: Findings from the March 2008 na- Administration , 32 , 31–41. tional sample survey of registered nurses. Retrieved © Jones & Bartlett Rosen, Learning, G. (1958). A historyLLC of public health . New York, NY: © Jonesfrom &http://datawarehouse.hrsa.gov/nursingsurvey Bartlett Learning, LLC M.D. Publications. .aspx NOT FOR SALE OR Schein, DISTRIBUTION E., & Kommers, D. (1972). Professional education. NOT U.S. FORDepartment SALE of Health OR and DISTRIBUTION Human Services, Health New York, NY: McGraw-Hill. Resources and Services Administration, & Bureau Seymer, L. (Ed.). (1954). Selected writings on Florence of Health Workforce. (2014, December). e future Nightingale . New York, NY: Macmillan. of the nursing workforce: National- and state-level Shames, K. (1993). e Nightingale conspiracy: Nursing projections, 2012-2025. Retrieved from https://bhw comes to© power Jones in the 21st& Bartlett century . Montclair, Learning, NJ: LLC.hrsa.gov/sites/default/ les/bhw/nchwa/projections© Jones & Bartlett Learning, LLC Enlightenment Press. /nursingprojections.pdf Shaw, M. (1993).NOT e discipline FOR ofSALE nursing: HistoricalOR DISTRIBUTION roots, Wall, B. (2003). Science and ritual: e hospitalNOT as FORmedical SALE OR DISTRIBUTION current perspectives, future directions. Journal of and sacred space, 1865–1920. Nursing History Review, Advanced Nursing , 18 , 1651–1656. 11 , 51–68. Sigma eta Tau International. (2016). STTI organi- West, M., Wantz, D., Campbell, P., Rosler, G., Troutman, zational fact sheet. Retrieved from http://www D., & Muther, C. (2016). Contributing to a quality © Jones .nursingsociety.org/connect-engage/about-stti& Bartlett Learning, LLC patient experience:© Jones Applying & evidence-based Bartlett practice Learning, LLC /sigma-theta-tau-international-organizational-fact-sheet to support changes in nursing dress code policies. NOT FORSlater, V. (1994).SALE e educationalOR DISTRIBUTION and philosophical in uences OJIN, 21 (1). NOT Retrieved FOR from SALE http://www.nursing OR DISTRIBUTION on Florence Nightingale, an enlightened conductor. world.org/MainMenuCategories/ANAMarketplace Nursing History Review, 2 , 137–151. /ANAPeriodicals/OJIN/TableofContents/Vol-21-2016 Sullivan, E. (2002). In a woman’s world. Re ections on /No1-Jan-2016/Quality-Patient-Experience-Nursing Nursing Leadership , 28 (3), 10–17. -Dress-Code-Policies.html Sullivan, E. (2004). Becoming in uential: A guide for nurses. Widerquist, J. (1997). Sanitary reform and nursing. Nursing © Jones & Bartlett Learning,Upper Saddle River,LLC NJ: Pearson Education. © JonesHistory & Review Bartlett, 5 , 149–159. Learning, LLC NOT FOR SALE ORSullivan, DISTRIBUTION L. (2004). Missing persons: Minorities in the health NOTWoodham-Smith, FOR SALE C. (1951). OR Florence DISTRIBUTION Nightingale: 1820–1910 . professions. Battle Creek, MI: W. K. Kellogg Foundation. New York, NY: McGraw-Hill.

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