evolution and trends in MSN.pptx

EVOLUTION & HISTORY
OF MEDICAL SURGICAL
NURSING
Ms. shafina
Nursing Lecturer

Evolution of Medical Surgical nursing
In ancient times, when medical lore
was associated with good or evil spirits,
the sick were usually cared for in temples
and houses of worship. These women
had no real training by today's standards,
but experience taught them valuable
skills, especially in the use of herbs and
drugs, and some gained fame as the
physicians of their era.

In the 17th cent., St. Vincent de Paul began to encourage women to
undertake some form of training for their work, but there was no real hospital
training school for nurses until one was established in Kaiserwerth, Germany,
in 1846.
There, Florence Nightingale received the training that later enabled her to
establish, at St. Thomas's Hospital in London, the first school designed
primarily to train nurses rather than to provide nursing service for the hospital
In the United States, nursing modernized rapidly during the late 19th and
early 20th centuries. The number of hospitals nationwide grew from only 149
in 1873 to 4,400 in 1910. With this growth, new positions for nurses
developed, and nursing gained respectable social status.

KAISERWERTH DEACONESSES
ST. THOMAS HOSPITAL

Nursing subsequently became one of the most
important professions open to women until the social changes
brought by the revival of the feminist movement that began in the
1960s.
During the late nineteenth and early twentieth centuries in the
United States, adult patients in many of the larger hospitals were
typically assigned to separate medical, surgical, and obstetrical
wards.
Nursing education in hospital training schools reflected these
divisions to prepare nurses for work on these units

Early National League of Nursing Education (NLNE)
curriculum guides treated medical nursing, surgical nursing, and
disease prevention (incorporating personal hygiene and public
sanitation) as separate topics.
By the 1930s, however, advocates recommended that medical
and surgical nursing be taught in a single, interdisciplinary course,
because the division of the two was considered an artificial
distinction. Surgical nursing came to be seen as the care of
medical patients who were being treated surgically.
The NLNE's 1937 guide called for a “Combined Course” of
medical and surgical nursing

Students were expected to learn not only the theory and treatment
of abnormal physiological conditions, but also to provide total care
of the patient by understanding the role of health promotion and
the psychological, social, and physical aspects that affected a
patient's health.
1960s, nursing schools emphasized the interdisciplinary study
and practice of medical and surgical nursing.
1960s and 1970s, standards were developed for many nursing
specialties, including medical-surgical nursing.

Standards, Medical-Surgical Nursing Practice, written by a
committee of the Division on Medical-Surgical Nursing of the
American Nurses' Association (ANA), was published in 1974. It
focused on the collection of data, development of nursing
diagnoses and goals for nursing, and development,
implementation, and evaluation of plans of care.
A Statement on the Scope of Medical-Surgical Nursing Practice
followed in 1980.

In 1991, the Academy of Medical-Surgical Nurses (AMSN) was
formed to provide an independent specialty professional
organization for medical-surgical and adult health nurses.
In 1996, the AMSN published its own Scope and Standards of
Medical-Surgical Nursing Practice
The second edition appeared in 2000 [15]. Both the ANA and
AMSN documents stated that while only clinical nurse specialists
were expected to participate in research, all medical-surgical
nurses must incorporate research findings in their practice.

Trends in medical surgical nursing
Recent trends have affected medical-surgical nurses, including:
The increasing use of nursing case management
The expansion of advanced practice nursing
Total quality improvement
Development of clinical pathways
Changes in the professional practice model
Health care reform
The trend toward increased acuity of patients, begun in the 1980s,
has become a fact of life.

Influences on future nursing practice
 Expanding knowledge & technology
 Healthy people initiatives
 Evidence based practice
 Standardized nursing terminologies
 Health care informatics
 Nursing informatics

Registered Nurse Licensure
Addiction nurse
Ambulatory care nurse
Perianathesianurse
Cardiac/vascular Nurse
Critical care nurse
Emergency nurse
Flight nurse
Dialysis nurse
First assistant nurse
Holistic nurse
Home health nurse
School nurse

Masters/higher degree in nursing
Nurse practitioner
Acute care NP
Adult care NP
Family NP
Gerontological NP
Palliative Care NP
Pediatric NP

Clinical specialist
Adult psychiatric & mental
health nursing
Community health nursing
Medical surgical nursing
Palliative nursing
Pediatric nursing
Others
Advanced nursing
administration
Advanced oncology clinical
specialist
Clinical nurse leader

Social Trends Influencing the Development
of Nursing
Ancient Civilizations
Care of sick was related to physical maintenance &
comfort
• first by family members, relatives , servants or
prisoners
• eventually by religious orders or humanitarian
societies
Mental Health
• Linda Richards and Dorthea Dix worked to
improve the care of the mentally ill
Modern Civilization
• focus in on technology Dorthea Dix

of Nursing
Religious Tradition-Catholic/Protestant
Courage
• care of sick in battlefields, military/naval hospitals and
prisons
• care of sick and dying during epidemics like cholera, typhus,
smallpox
Sacrifice
Creativity
Compassion

of Nursing
Women’s Movement
Nursing has been a premiere political
force for women’s rights
Nurse’s organized the first major
professional organization for women
Edited & published the first professional
magazine by a woman, Sarah Josepha
Hale.

of Nursing
Margaret Sanger was a public health nurse in New
York
 opened the first birth control clinic in U.S. because of
large number of unwanted pregnancies.
Lavina Dock was a writer & political activist
 early feminist devoted to women’s suffrage
 participated in protest & demonstrations until passage of
the 19th Amendment in 1920, women right to vote.
Cultural Factors
first major professional group to integrate black &
white members

of Nursing
Wars
Nightingale in the Crimean War
 mortality rate dropped from 60% to 2% as a result of the
environmental changes she implemented
Clara Barton organized nurses to provide care in
the American civil War and established the
American Red Cross that serves in war and peace
time
American Red Cross was responsible for recruiting
women for the Army Nurse Corp during WW I
 Their motto was , American Nurses for American Men

of Nursing
Economic Factors
Insurance
 Fee for service
 Managed care
Cost of health care rising faster than inflation
Educational Factors
1893 Dock with Isabel Hampton Robb and Mary Nutting founded
the American Society of Superintendents of Training Schools for
Nurses of the U.S. and Canada
 this organization was very politically active & became The National
League For Nursing which promotes quality nursing education to this day.

of Nursing
Political Factors
Nightingale was a political influencer
 first nurse to exert political pressure on government
 influential in reforming hospitals & implementing public health
policies in Britain
Clara Barton persuaded Congress in 1882 to ratify the
Treaty of Geneva so the Red Cross could perform in
peace time
 impacted on national & international policies

of Nursing
Political Factors
Lillian Wald’s political pressure lead to
the creation ofthe U.S. Children’s
Bureau
 established by congress in 1912 to oversee
child labor laws
Nursing represents 67% of healthcare
providers in the U.S.
 few nurses are in positions where they can
influence health care policy making

Social Trends Influencing the Development of Nursing
1990s -Nurses became involved in politics at the local, state
& national level
 Eddie Bernice Johnson, first RN elected into U.S. House of
Representatives from Texas
 Ada Sue Hinshaw directed the NIH Center for Nursing
Research
 Nurses in all practice areas are affected by public policy on
a daily basis
• this demands that all nurses be proactive in policy
development
Nursing’s Agenda for Health Care Reform
 developed in 1991
 nurses can use this agenda to unite and become a political
force in health care delivery

of Nursing
Groups of practitioners who band together to perform
socialor political functions b’coz they could not do alone
Define & regulate the profession
Development of a knowledge base for practice
Research
Transmit norms, values, knowledge, and skills
Communicate/advocate contributions of the profession
Address members social & general welfare needs

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