Nursing and Nurses, Who are nurses?

Like every other field of discipline or profession in human life, Nursing evolved in various forms as an integral part of the culture of every human community since the beginning of human civilization.  It did so, however, with varying concepts and processes from one community to the other, depending on the level of civilization and the richness of every given community in terms of knowledge and materials.

The definition of the term and the practice of Nursing have transformed tremendously over time.  The oldest sense of the term in the English language is the process whereby a woman is employed to suckle and generally care for a child – an infant, a teenager, a youngster etc.  According to the age of the young person the nurse is employed to care for.
In the 15th century, nursing began its remarkable development into a field of discipline and a profession.  That was the age when it grew into a significant idea and process of one person looking after or advising another, which showed a significant advancement from the process of a woman looking after a child.
Nursing has, ever since, continued to expand on the foundations of its 15th century definition to encompass nourishing for the person to whom care is provided, although, according to available literature on the history of the subject, the idea of nourishing in the broadest sense refers in modern nursing to promoting quality of life.
Before the development of modern nursing, according to this literature, nuns and the military often provided services akin to nursing.  The religious and military foundations of modern nursing remain in evidence today in many countries.  For example: in Britain, senior female nurses are known as “sisters”.
The Crimean War served, perhaps, as the most remarkable catalyst for a significant development in nursing history.  During the war, the nursing legend, Florence Nightingale, working to improve conditions of solders, laid the foundation stone of Professional Nursing, the principles of which were summarized in the book:  Notes on Nursing.
Among the most famous nurses in the development of the profession are:  Mary Sea Cole, who also worked as a nurse in the Crimea; Agnes Elizabeth Jones and Linda Richards, who establish quality nursing schools in the USA and Japan.  Linda Richards, an 1873 graduate of the New England Hospital for women and Children in Boston, who is on record as America’s first trained nurse.
From its 19th century foundation, nursing began to develop its recognition with regard to the three key factors of legality, area of professional coverage in healthcare delivery, and education in different countries.
New Zealand was the first country to regulate nurses nationally, with the adoption of the nurses Registration Act on the 12th of September, 1901.  Ellen Dougherty was the first registered nurse.   North Carolina was the first state in the United States to pass a nursing licensure law in 1903.
The road to earning whatever recognition it enjoys has been quite rough for the profession over time.  The professionals have experienced difficulty with the hierarchy of medical and related professionals.  It is the general impression that the primary duty of the nurse is defined by the direction and instruction given to him or her by the doctor. Nightingale’s Notes on Nursing, however, notably departed from this impression, seeming to rather show doctors in a different status, mentioning them comparatively occasionally and often in critical tones, particularly relating to bedside manners.
Nursing grew into the modern times with the fashioning out of degree programmes and the publication of numerous journals to enlarge the knowledge foundation of the profession. Nurses now often occupy vital management positions and discharge essential responsibilities in healthcare services.  They are also observed to be holding research posts in universities and research institutes.
The practice of nursing as a recognized profession is erected on the foundation of a social contract that defines its rights and responsibilities, and the machinery for public accountability. In almost all countries, nursing practice is defined and governed by laws, and entrance to the profession is regulated at national or state level.
While developing a stonewall mechanism to jealously guard their profession against quackery and all sorts of abuses, practitioners have never relented in fashioning out programmes and other related efforts to develop it with continuing education along the lines of intensifying research, and the regulation of standards of competency of practitioners and ethics of practice.
Nursing practice is mainly the caring relationship between the nurse and the person in his or her care.  In providing nursing care, nurses are implementing the nursing care plan, which is based on a nursing assessment.  Nursing practice varies in terms of specialties and from one country to another.  However, nursing organisations offer the following broad definitions in their attempt to sculpture an acceptably comprehensive definition according to the existing era.
1.    Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings.
2.    Nursing includes the promotion of health, prevention of illness; and the care for the ill, disable and dying people.
Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles.
In general terms, the nursing process is the method used to assess and diagnose needs as well as plan and implement interventions, and evaluate the outcomes of the care provided.  Like other disciplines, the profession has developed different theories derived from sometimes diverse philosophical beliefs and paradigms or worldviews to help nurses direct their activities to accomplish specific goals. Currently, two paradigms exist in nursing, the totality paradigm and the simultaneity paradigm.
Nursing is said to be the most diverse of all healthcare professions because practitioners work in a wide range of settings, from hospitals to visiting people in their homes and caring for them in schools to research in pharmaceutical companies.  Nurses work in Occupational Health Settings (also referred to as Industrial Health Settings), free-standing clinics and physician offices, nurse-run clinics, long-term care facilities and camps.  They also work on cruise ships and in military service.
Nurses act as advisers and consultants to the healthcare and insurance industries.  Some are attorneys and others work with attorneys as legal nurse consultants, reviewing patient records to ensure that adequate care was provided, and testifying in court. Nurses can work on a temporary basis, which involves doing shifts without a contact in a variety of settings, sometimes known as per diem nursing, agency nursing or travel nursing.
However, the major divisions of nursing are Psychiatric and Mental Health Nursing, which is the nursing of people with mental health problems; Learning Disability Nursing, which is the nursing of people with learning or developmental disabilities; Paediatric Nursing, which is the nursing of children; Geriatric Nursing, which is the nursing of older adults; and District Nursing and Health Visiting (UK) or Home Health Nursing (US), which is the nursing of people in their own homes.
There are a number of educational paths to becoming a professional nurse, which vary greatly worldwide, but all involve extensive study of nursing theory and practice and training in clinical skills.  The three major educational paths to registered nursing are a bachelor’s degree, an associate degree, and a diploma from an approved nursing programme.  Registered Nurses (RNs) can specialize in one or more areas of patient care, and there are generally four ways to specialize.  Registered nurses can choose a particular work setting or type of treatment, Registered nurses may choose to specialize in specific health conditions, Registered nurses may choose to specialize in working with one or more organs or body system types; Registered nurses also can choose to work with a well-defined population.  Below are some of the specialties. Some registered nurses combine these specialties.

 Adopted from: nannm