Contents
Preface ............................................................................................................................ xxii
Acknowledgements ....................................................................................................... xxiii
About the authors ......................................................................................................... xxiv
Section 1: Fundamental nursing science
Chapter 1: Introducing nursing ..................................................... 3
Introduction .................................................................................................................. 3
Historical perspectives ................................................................................................. 4
The images of nursing ............................................................................................ 5
Nursing in South Africa before 1900 ................................................................... 7
Nursing in South Africa in the 20th century ...................................................... 9
Training of black nurses ........................................................................................ 9
Highlights in nursing development after 1950 ................................................... 9
The meaning of nursing .............................................................................................. 10
Selected theories of nursing ........................................................................................ 11
Components common to nursing theories ........................................................... 12
An overview of selected nursing theories ........................................................... 13
Theories and the nursing process ......................................................................... 16
Models for nursing the individual, family or community.................................. 16
Stages of the life cycle and the role of nurses .......................................................... 16
The health–ill-health continuum and the role of nurses ......................................... 18
The agent–host–environment model .................................................................... 19
The health-belief model ......................................................................................... 20
Illness and disease .................................................................................................. 20
Social factors that influence disease .................................................................... 21
The sick role ............................................................................................................ 22
Approaches to healthcare delivery systems in South Africa .................................. 23
Healthcare services in South Africa............................................................................ 24
The national health system ................................................................................... 24
The public healthcare system ................................................................................ 25
The private sector healthcare system.................................................................... 25
Non-governmental organisations ......................................................................... 26
Conclusion ..................................................................................................................... 26
Suggested activities for students ................................................................................ 26
, chapter
Introducing
1 nursing
Learning objectives
On completion of this chapter, the student should be able to do the following:
• Analyse nursing, its origins through its history, its meaning and purpose.
• Apply the basic principles of nursing care in nursing practice.
• Explain the concepts health, ill health and disease as they apply in the various
stages of life.
• Explain the role of a nurse in maintaining health and providing care in ill health and
disease in the various stages of life.
• Explain the goals and philosophy of the healthcare delivery system in South Africa.
• Explain the theories of nursing that are appropriate to a system that is focused on the
provision of primary healthcare to meet the basic needs of the community.
Introduction
Competent and effective nursing care is based on an awareness of the overall meaning
and purpose of nursing. Through a process of understanding and internalising the
theories and ideas that underlie and support the activities of nursing, nurses will
develop a personal philosophy of nursing.
In order to understand the importance of nursing in healthcare and healthcare
delivery, the concepts of health and ill health and the role of nurses in relation to
these states of being must be understood. These concepts also need to be understood in
relation to the various stages of the life cycle.
Nurses must also develop an understanding of the goals and philosophy of the
healthcare delivery system in South Africa, since this is the basis for their nursing
activities. There is also a need for orientation in holistic theories of nursing that are
appropriate to a system that is focused on the provision of primary healthcare to meet
the basic needs of the community.
Nursing is made up of many different activities that flow from the concept
of caring. The scope of nursing ranges from the provision of the most basic care
to the execution of complex activities requiring critical thinking, reflection,
decision making and technological skill. As an intellectual activity based on moral
foundations, successful nursing requires scientific knowledge combined with the
ability to apply that knowledge in the patient-care situation. It is an interpersonal
process that focuses on the needs of patients at the promotive, preventive, curative or
rehabilitative level.
3
, Key concepts and terminology
Casualties: People who are injured, for example in motor vehicle accidents, violence or
falls.
Civilisation: To develop people by providing them with information that changes their
behaviour in a positive manner.
Crusades: Christian expeditions.
Embalming: Preservation of dead bodies.
Infirmary: A place where sick people are accommodated.
Trepanning: Making a surgical hole in the skull in order to relieve pressure by removing
fluid or blood.
Key ethical considerations
• The obligation on nurses to be constantly mindful of the primary mission and purpose
of nursing in all healthcare situations.
• The obligation on nurses to give holistic care in all healthcare situations.
• The monitoring of changes in the healthcare environment and adapting nursing
theories and nursing practice accordingly.
• The prediction of future changes and trends, and their impact on nursing.
• The development of nursing theories and constructs that maintain the purpose of
nursing while accommodating change. Failure to do so may place patients and the
profession at risk.
• The awareness that conflict may arise when different sectors of the health services use
different methods and approaches to care.
Key legal considerations
• Healthcare policies and the healthcare delivery systems are based on such policies as
determined by the government of the day in consultation with experts and healthcare
professionals who are called upon to advise the government. Such policies are then
implemented by means of appropriate legislation. The National Health Act 61 of
2003 provides a framework for a single health system in South Africa.
• The scope of practice of registered nurses and registered midwives is broad. It allows
nurses to provide an effective service to their patients, within their capabilities. This
broadly based scope of practice is intended to facilitate flexibility and adaptability in
providing nursing care (see Chapter 2).
Historical perspectives
The activity of nursing is as old as humankind. Nursing began with the activities
required to care for the sick and helpless individuals in the community. As caregivers
4
Preface ............................................................................................................................ xxii
Acknowledgements ....................................................................................................... xxiii
About the authors ......................................................................................................... xxiv
Section 1: Fundamental nursing science
Chapter 1: Introducing nursing ..................................................... 3
Introduction .................................................................................................................. 3
Historical perspectives ................................................................................................. 4
The images of nursing ............................................................................................ 5
Nursing in South Africa before 1900 ................................................................... 7
Nursing in South Africa in the 20th century ...................................................... 9
Training of black nurses ........................................................................................ 9
Highlights in nursing development after 1950 ................................................... 9
The meaning of nursing .............................................................................................. 10
Selected theories of nursing ........................................................................................ 11
Components common to nursing theories ........................................................... 12
An overview of selected nursing theories ........................................................... 13
Theories and the nursing process ......................................................................... 16
Models for nursing the individual, family or community.................................. 16
Stages of the life cycle and the role of nurses .......................................................... 16
The health–ill-health continuum and the role of nurses ......................................... 18
The agent–host–environment model .................................................................... 19
The health-belief model ......................................................................................... 20
Illness and disease .................................................................................................. 20
Social factors that influence disease .................................................................... 21
The sick role ............................................................................................................ 22
Approaches to healthcare delivery systems in South Africa .................................. 23
Healthcare services in South Africa............................................................................ 24
The national health system ................................................................................... 24
The public healthcare system ................................................................................ 25
The private sector healthcare system.................................................................... 25
Non-governmental organisations ......................................................................... 26
Conclusion ..................................................................................................................... 26
Suggested activities for students ................................................................................ 26
, chapter
Introducing
1 nursing
Learning objectives
On completion of this chapter, the student should be able to do the following:
• Analyse nursing, its origins through its history, its meaning and purpose.
• Apply the basic principles of nursing care in nursing practice.
• Explain the concepts health, ill health and disease as they apply in the various
stages of life.
• Explain the role of a nurse in maintaining health and providing care in ill health and
disease in the various stages of life.
• Explain the goals and philosophy of the healthcare delivery system in South Africa.
• Explain the theories of nursing that are appropriate to a system that is focused on the
provision of primary healthcare to meet the basic needs of the community.
Introduction
Competent and effective nursing care is based on an awareness of the overall meaning
and purpose of nursing. Through a process of understanding and internalising the
theories and ideas that underlie and support the activities of nursing, nurses will
develop a personal philosophy of nursing.
In order to understand the importance of nursing in healthcare and healthcare
delivery, the concepts of health and ill health and the role of nurses in relation to
these states of being must be understood. These concepts also need to be understood in
relation to the various stages of the life cycle.
Nurses must also develop an understanding of the goals and philosophy of the
healthcare delivery system in South Africa, since this is the basis for their nursing
activities. There is also a need for orientation in holistic theories of nursing that are
appropriate to a system that is focused on the provision of primary healthcare to meet
the basic needs of the community.
Nursing is made up of many different activities that flow from the concept
of caring. The scope of nursing ranges from the provision of the most basic care
to the execution of complex activities requiring critical thinking, reflection,
decision making and technological skill. As an intellectual activity based on moral
foundations, successful nursing requires scientific knowledge combined with the
ability to apply that knowledge in the patient-care situation. It is an interpersonal
process that focuses on the needs of patients at the promotive, preventive, curative or
rehabilitative level.
3
, Key concepts and terminology
Casualties: People who are injured, for example in motor vehicle accidents, violence or
falls.
Civilisation: To develop people by providing them with information that changes their
behaviour in a positive manner.
Crusades: Christian expeditions.
Embalming: Preservation of dead bodies.
Infirmary: A place where sick people are accommodated.
Trepanning: Making a surgical hole in the skull in order to relieve pressure by removing
fluid or blood.
Key ethical considerations
• The obligation on nurses to be constantly mindful of the primary mission and purpose
of nursing in all healthcare situations.
• The obligation on nurses to give holistic care in all healthcare situations.
• The monitoring of changes in the healthcare environment and adapting nursing
theories and nursing practice accordingly.
• The prediction of future changes and trends, and their impact on nursing.
• The development of nursing theories and constructs that maintain the purpose of
nursing while accommodating change. Failure to do so may place patients and the
profession at risk.
• The awareness that conflict may arise when different sectors of the health services use
different methods and approaches to care.
Key legal considerations
• Healthcare policies and the healthcare delivery systems are based on such policies as
determined by the government of the day in consultation with experts and healthcare
professionals who are called upon to advise the government. Such policies are then
implemented by means of appropriate legislation. The National Health Act 61 of
2003 provides a framework for a single health system in South Africa.
• The scope of practice of registered nurses and registered midwives is broad. It allows
nurses to provide an effective service to their patients, within their capabilities. This
broadly based scope of practice is intended to facilitate flexibility and adaptability in
providing nursing care (see Chapter 2).
Historical perspectives
The activity of nursing is as old as humankind. Nursing began with the activities
required to care for the sick and helpless individuals in the community. As caregivers
4
