Nursing

Nursing is a profession focused on assisting individuals, families, and communities in attaining, maintaining, and recovering optimal health and functioning. Modern definitions of nursing define it as a science and an art that focuses on promoting quality of life as defined by persons and families, throughout their life experiences from birth to care at the end of life.

History of nursing
Nursing has existed in various forms in every culture, although the definition of the term and the practice of nursing has changed greatly over time. The oldest sense of the word in the English language is found from the 14th century and referred to a woman employed to suckle and generally care for a younger child. The former being known as a wet nurse and the latter being known as a dry nurse. In the 15th century, this developed into the idea of looking after or advising another, not necessarily meaning a woman looking after a child. Nursing has continued to develop in this latter sense, although the idea of nourishing in the broadest sense refers in modern nursing to promoting quality of life.

Prior to the foundation of modern nursing, nuns and the military often provided nursing-like services. The religious and military roots of modern nursing remain in evidence today in many countries. For example: in Britain, senior female nurses are known as ‘‘sisters’’. It was during time of war that a significant development in nursing history arose when Florence Nightingale, working to improve conditions of soldiers in the Crimean War, laid the foundation stone of professional nursing with the principles summarised in the book Notes on Nursing. Other important nurses in the development of the profession include: Mary Seacole, who also worked as a nurse in the Crimea; Agnes Elizabeth Jones and Linda Richards, who established quality nursing schools in the USA and Japan, and Linda Richards who was officially America's First Trained Nurse, graduating in 1873 from the New England Hospital for Women and Children in Boston.

New Zealand was the first country to regulate nurses nationally, with 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.

Nurses have experienced difficulty with the hierarchy in medicine that has resulted in an impression that nurses primary purpose is to follow the direction of medics. This tendency is certainly not observed in Nightingale's Notes on Nursing, where the doctors are mentioned relatively infrequently and often in critical tones, particularly relating to bedside manner.

The modern era has seen the development of nursing degrees and nursing has numerous journals to broaden the knowledge base of the profession. Nurses are often in key management roles within health services and hold research posts at universities.

Nursing as a profession
The aim of the nursing community worldwide is to develop the profession guided by continuing education based on nursing research, and to regulate standards of competency and ethics. 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 authority for the practice of nursing is based upon a social contract that delineates professional rights and responsibilities as well as mechanisms for public accountability. In almost all countries, nursing practice is defined and governed by law, and entrance to the profession is regulated at national or state level.

Nursing practice
Nursing practice is primarily the caring relationship between the nurse and the person in their care. In providing nursing care, nurses are implementing the nursing care plan, which is based on a nursing assessment.

Definition
Although nursing practice varies both through its various specialities and countries, these nursing organisations offer the following definitions:

Nursing theory and process
In general terms, the nursing process is the method used to assess and diagnose needs, 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.

Practice settings
Nurses practice 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 called 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 assure 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.

Regulation of practice
The practice of nursing is governed by laws that define a scope of practice, generally mandated by the legislature of the political division within which the nurse practices. Nurses are held legally responsible and accountable for their practice. The standard of care is that of the "prudent nurse."

Nursing specialties
Nursing is the most diverse of all healthcare professions. Nurses practice in a wide range of settings but generally nursing is divided depending on the needs of the person being nursed.

The major divisions are:-
 * the nursing of people with mental health problems - Psychiatric and mental health nursing
 * the nursing of children - Paediatric nursing
 * the nursing of older adults - Geriatric nursing
 * the nursing of people in their own homes - Home health nursing (US), District nursing and Health visiting (UK). See also Live-in nurse

There are also specialist areas such as cardiac nursing, orthopaedic nursing and oncology nursing.

Nursing by country

 * For the occupation of nurses in each country, see nurse