Foundations of Professional Nursing

This article discusses the historical and political influences on the foundation of professional nursing. It explores the role of the Sisters of Mercy in shaping modern nursing practices and the impact of Medicare on healthcare.

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Foundations of Professional Nursing
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Foundations of Professional Nursing

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Introduction
Nurses are an integral member of the health system responsible for providing care to the
patients based on ethical issues. In any healthcare setup, a nurse continuously juggles
between multiple role like care provider, counsellor, patient’s advocate, communicator and a
teacher. Though classical nursing often document a nurse as an assistant or handmaidens to
the doctors, but contemporary nursing is task-based dependent on several sets of technical
education and skills. With advancement of time, involvement of multiple stakeholders, and
healthcare reforms across the globe the role of nurses has widely expanded. A significant
change is witnessed in education, role, and duties of a nurse. This advancement in modern
day nursing is known to be influenced by various historical, political, and/or socio cultural
factors. Hence, it is necessary for a nurse to have an in-depth understanding about these
factors and how these factors influence the course of nursing professional. This paper is
envisioned to discuss two such factors which has a very strong influence on foundation of
professional nursing, namely historical and political.
Historical Influence
History of nursing is as old as 4000 years, when ancient Egyptian doctors and nurses devoted
their life to take care of the sick. The history of healthcare and nursing can provide several
examples of wisdom of our forbearers in providing treatment to the needy in challenging
situation in an unknown future. History of nursing can state names of several women and
men who had ardently spent their life to nursing and have left a strong impression in terms of
providing care and nursing. Each one of them robustly influence the contemporary nursing
profession. One such name from history of nursing is “Sisters of mercy”.
From early to mid-19th century in Ireland several Irish women were deeply concerned with
the plight of the sick poor and were driven to care for them. But, due to some of the

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unavoidable social circumstances it was required that these women form an organisation of
religious sisters. They named the organization as “Sisters of Mercy”, this organization was
led by Catherine McAuley. This organization provided daily care for the sick poor in their
homes, which included providing physical, spiritual and emotional comfort and consolation,
as well as advice about coping with diseases and social conditions (Carroll 1883, Carroll
1866). In in 1832, during the first great cholera epidemic, the sisters of mercy provided
compassionate care to the patients in the Dublin hospital and helped to control the epidemic
(Carroll, 1883). During this period, they extended their knowledge about providing care to
critically ill patients. During the time of the Crimean war in 1853–1856, twelve nurses from
sister of mercy served the war patients, later at the end of war the sister of mercy were
recognized as skilled nurses. Catherine McAuley, the founder and leader of sisters of mercy
provided the idea of“careful nursing”which is still reflected in modern day nursing. The basic
ideology of sisters of mercy was to encourage careful nursing which can engage nurses and
provide meaningful direction for practice. Furthermore, it was anticipated that by
implementing careful nursing, a nurse could help to decrease incidents of incompetent and
insensitive practice and sustain already exemplary practice. The ideology of sister of mercy
became the foundation stone of nursing and in 1854, careful nursing was set up a model of
nursing.
The historical influence of sister of influence is seen on the model of modern day nursing.
This model provides a structure, processes and values for nursing practice, supports nurses’
control over their practice and can be used in all types of practice areas and settings(Dunbar
et al. 2007). The model of careful nursing as advocated by sisters of mercy has ten basic
principles viz.disinterested love, contagious calmness, creation of a restorative environment,
‘perfect’ skill in fostering safety and comfort, nursing interventions, health education,

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participatory authoritative management, trustworthy collaboration, power derived from
service and nurses’ care for themselves. Additionally, this model also focuses on the spiritual
dimension of human life and spirituality is an important characteristic of the model.
The concept of careful nursing led by sister of mercy has a crucial influence on present day
nursing and healthcare practices. It encourages a nurse-led transformation of healthcare
practice, where nurses take initiative to engage all the members of the healthcare team in
understanding its philosophy and concepts. A nurse could incorporate the ten principle of
nursing given by sister of mercy to build a trustworthy collaboration with other healthcare
professionals and patients. This further enhances work satisfaction to the professional and
satisfaction to the patients about the care they receive.
Political Influence
Government, policy maker, and federal bodies are an important stakeholder of healthcare
system. They directly influence the healthcare system and guide its reformation. Medicare, is
one such important political factor that strongly influence the present day and forthcoming of
healthcare and nursing. Medicare is a national healthcare program funded by Australia
government which provide healthcare benefits to all Australian citizens and permanent
residents. This healthcare plan is a government-owned private health insurance which was
brought into action in 1975 by the name of Medibank which was later renamed as Medicare
in 1984 by government of that time. The basic aim of this program was to provide subsidized
treatment to the beneficiary residents of the country. Medicare is an umbrella healthcare
insurance that entitled a resident for getting healthcare benefits from medical practitioners,
eligible midwives, nurse practitioners and allied health professionals.
The Medicare program directly influences the healthcare structure of any nation. The most
important implication of this program is that it considerably reduces the elderly mortality

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rate. The programme provides healthcare benefits to elderly who might not be having
financial stability. Under this program all such elderlies are given out of -the-pocket
expenditure of healthcare services. This improves the overall quality of life the elders thereby
reducing the rate of illness and mortality.
Medicare also reduces the overall cost of the healthcare services. The introduction of the
diagnosis-related group (DRG), provides the consumers a set of multiple diagnostic services
at pre-negotiated prices. This reduces the time to diagnose any illness, as the consumer need
not to visit different hospitals or healthcare units to find out or negotiate a best price for any
diagnostic tests. Furthermore, since these services cover multiple diagnostic tests for a single-
illness, therefore referral for each test is not required from physician, hence saving time and
money. This encourages the consumers for an early diagnosis at a nearby healthcare centre
which enhances the chances of recovery and overall fitness. Additionally, the supplementary
healthcare schemes like the Pharmaceutical Benefits Scheme (PBS) and the PBS Safety Net
can reduce the cost of medicine and help the elderly.
Politically reforming policies like Medicare encourages early diagnoses and management
among the patients. This provides better prospects for clinical research, new medical
procedures, and technology. Since, there is better patient turnout to hospitals due to
Medicare, the overall revenue to the hospital increases. This helps the hospitals and
healthcare institutions to invest more in clinical research, training and development of
healthcare professionals, and funding new medical procedures and technology. This
positively impacts the healthcare professionals, particularly the nurses as chances of
advancements of knowledge and skills become high.
Medicare reduces the investment in private healthcare policies which in turn benefits the
federal government. Due to which the government also increases the funding for clinical

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researches and other healthcare policies. The researches done so far indicate that Medicare
has been at the forefront of developing new approaches, and the private sector tends to
emulate it.
Conclusion
Healthcare and nursing are directly influenced by multiple factors. Historical, political and
socio-economic factors are one of the few factors which directly influence the healthcare and
nursing sector. Nurses are one such integral part of the healthcare system which are directly
influenced by these factors. Nurses as a healthcare professional are entitled to multiple roles.
Though the dimension and characteristic of work of a nurse have rapidly evolved, but yet
some of its foundations are deep rooted in the history. There are several nurses who have
been the influencer for all the nursing professional, one such is “sisters of mercy”. The sisters
of mercy were the nursing organization which came into being in 19th century. The
foundation gave ten basic principles of nursing which are later known as model of “careful
nursing”. The basic ideology of the careful nursing is still applied in modern day nursing.
This historical factor significantly influence the nurse to provide a comprehensive care to the
patient and encourage then to have better relationship with other healthcare professional.
Another factor that influence nursing and healthcare is political factors and federal policies.
Medicare is the most important political factor that directly influences the healthcare
industry. it provides better and subsidize healthcare to the beneficiary. Medicare is found to
positively influence the rate of elderly mortality, better patient outcomes, early diagnosis and
management. Additionally, it also increases the revenue for hospitals and government which
in turn translates into advancement of clinical research, new diagnostic and treatment
technology and better prospects of training and development of healthcare professionals.

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References
Carroll, M.A. 1886. A Member of the Order of Mercy, Life of Catherine McAuley. D&J
Saddler & Co., New York.
Carroll, M.A. 1883. A Member of the Order of Mercy (ed),, Leaves from the Annals of the
Sisters of Mercy, vol. 2. Catholic Publication Society, New York.
Dunbar, B., Park, B., Berger-Wesley, M., Cameron, T., Lorenz, B.T., Mayes, D. & Ashby, R.
(2007). Shared governance: making the transition in practice and perception. Journal of
Nursing Administration, vol. 37, pp. 177–183.