Historic Leadership.

School nursing practice establishes itself in the midst of both education and nursing philosophies, ethics, standards, laws, and regulations. Treading these two worlds is difficult at times and requires that a school nurse possess a strong foundational knowledge base, seek professional collaboration, and navigate conflicting professional demands in order to promote student and public safety. This article is Part 2 of a four-part series that recounts the inspiring story of a school nurse, Ellen Johnsen, who did just that back in the 1980s in Broken Arrow, Oklahoma. Part 2 describes how Ellen's actions led the Broken Arrow Public Schools to revise its unsafe and illegal medication administration policy, which brought the policy into partial compliance with the nurse practice act but culminated in Ellen losing her job. The purpose of this series is to enhance understanding of the legal parameters governing school nurse practice, provide examples of ethical decision making, and review the challenges associated with serving as a leader.

La socialización de los practicantes a través de los manuales del Dr. Felipe Sáenz de Cenzano 1907-1942 / Socialization of 'Practicantes' through the Manuals of the Dr. Felipe Sáenz de Cenzano 1907-1942

Desde la creación en España del título de practicante en 1857, su enseñanza fue regulada por varios planes de estudio hasta la unificación en 1953 de las tres titulaciones auxiliares de la medicina (practicante, matrona y enfermera), en la de Ayudante Técnico Sanitario (ATS). Este trabajo analiza la socialización de los practicantes a través de las distintas ediciones de El Manual del Practicante (1907, 1922, 1934 y 1942), elaborado por el médico encargado de su enseñanza oficial en Zaragoza, Felipe Sáenz de Cenzano. Tras el análisis de su estructura y su contenido, en especial los fundamentos de su saber y las competencias técnicas o de cuidados al enfermo, resaltamos las diferencias que se observan en los manuales y las legalmente establecidas, que fueron siempre más restrictivas. En conjunto se perfila la configuración de dos escenarios laborales distintos para el practicante, la ciudad y la zona rural, que proyectaron dos imágenes profesionales distintas

Since the creation of the qualification of Spanish practitioner 'practicante' in 1857 in Spain, its teaching was regulated by several curriculums until the unification in 1953 of the three auxiliary degrees in medicine ("practicante", midwife and nurse), in the technical health assistant (ATS). This paper analyzes the socialization of "practicantes" through the various editions of "El Manual del Practicante" (1907, 1922, 1934 and 1942), prepared by the physician in charge of their formal education in Zaragoza, Felipe Sáenz de Cenzano. After analyzing its structure and content, especially the basis of their knowledge and technical skills or nursing care, we highlight the differences observed in the manuals and the legally established, which were always more restrictive. In summary, it be outlined the configuration of two different work settings, the city and the rural area, that projected two different professional images

[The difficult nursing's relationship with knowledge]. / La difficile relation des soins infirmiers avec le savoir.

This article claim the existence and the necessity of nursing knowledge and support this claim with definitions and rules from other disciplines, it summarizes briefly the evolution of nursing knowledge, mostly from a North American perspective, it examine its degree of presence in nursing scholarly work, to highlight some conclusions and present briefly two explanations related to the use and development of nursing knowledge by the nursing community. In conclusion, the necessity of learning, analyzing, testing and using nursing knowledge is reiterated.

[Resilience: evolution of theoretical concepts and clinical applications]. / La résilience : évolution des conceptions théoriques et des applications cliniques.

The conceptual approach of resilience is part of a perspective of understanding and support to people facing situations of risk or traumatic events. This approach has transformed clinical practices by offering an alternative to the psychopathological model initially focused on vulnerability, allowing it to take into account the resources and skills of people and their environment. It has applications in many clinical fields: psychology, psychiatry, education, social work, health... The concept of resilience, which now has been studied for more than forty years, is met with growing interest, as is evident by the large number of research and publications that refer to it on the international stage. Over the decades, its theoretical contours evolved and have been more specified. Resilience is now considered a complex process resulting from a balance between risk factors and protective factors. This article puts into perspective the major advances that have been made since its emergence to contemporary research and its applications.

Historical Perspectives on an Expanded Role for Nursing.

The 2010 Institute of Medicine report, the Future of Nursing, recommended that nurses work to the "full extent of their training" to address the primary healthcare needs of United States citizens. This article identifies and describes historical antecedents, cornerstone documents, and legislative acts that served to set the stage for today, laying the groundwork for an expanded role for advanced practice nurses in the 21st century. Beginning with Lillian Wald's work in Henry Street Settlement in 1893, through Mary Breckenridge's founding of the Frontier Nursing Service in 1925, the discussion describes how nurses provided access to care for thousands of urban and rural citizens throughout the United States in the past. The article also discusses political forces at midcentury and the creation of the nurse practitioner role with the premise that nurses can learn from these early initiatives to create new models for nurses' roles in primary care today.

"All who nurse for hire": nursing and the mixed legacy of legislative victories.

Sustained support of policy initiatives by nursing has resulted in significant legislative victories. One victory, the passage of the 1938 New York State Todd-Feld Act, which underwent legislative debate at a time when the nurse labor market was in disarray, during an economic depression, and before U.S. entry into World War II, reinforces our understanding that nursing must be a strong shepherd for policies beneficial for health care delivery. Designed to correct serious deficiencies in the nursing workforce, the act successfully required licensing for those working as registered and practical nurses. Yet, its provisions failed to stop all unlicensed nurse workers from practicing. Rapid changes occurring in the nurse labor market against the backdrop of growing hospital power over the employment of all nurse workers minimized the act's effectiveness. Policy implications include the need to focus on the complex nature of health care policy initiatives, flexibility in the face of changing circumstances, and acceptance of political realities.

A nursing historical perspective on the medical home: impact on health care policy.

BACKGROUND: The idea of a "medical home" is rapidly gaining in popularity in health policy circles today. In the face of a shortage of primary care physicians, it has led to a national debate about who should lead the homes, who should deliver care, the kind of care that should be offered, and the location of that care. A historical examination of nurses' role in primary care can provide evidence to inform the current dialogue. PURPOSE: This article provides insight into nursing's role in primary health care during the early 20th century. METHODS: Traditional historical methods were used. DISCUSSION/CONCLUSIONS: Three historical case studies provide evidence of how nursing and medicine worked together in the past and informs the discussion about using nurses to deliver primary health care today. Policy makers should not overlook the central role nurses have long played in providing access to care for numerous underserved populations. Makers should not overlook the central role nurses have long played in providing access to care for numerous underserved populations.

Florence Nightingale y Federico Rubio: reformadores de la Enfermería moderna española / Florence Nightingale e Federico Rubio: reformadores enfermagem moderna española / Florence Nightingale and Federico Rubio: nursing reformers modern spanish

En diferentes bases de datos aparecen publicaciones donde se menciona al cirujano Federico Rubio en relación con la enfermera Florence Nightingale, otorgándole un protagonismo en la enfermería moderna española. Mediante este trabajo proponemos analizar la influencia que Nightingale pudo haber tenido en Rubio. Partiendo de la vida y obra del fundador de la Escuela de Enfermeras de Santa Isabel de Hungría, valoraremos las coincidencias temporo-espaciales con la Dama de la Lámpara. Nuestros objetivos persiguen establecer paralelismos entre ambas vidas, así como reflejar la repercusión de Nightingale en la enfermería española moderna. El análisis documental fue la técnica escogida para contrastar la biografía y obra de Nightingale y Rubio, recurriendo tanto a fuentes de información primarias como secundarias. Algunos de los datos obtenidos tales como la similitud en los planes de estudios de sus respectivas escuelas y las medidas sanitarias relacionadas con la Salud Pública, podrían ratificar la influencia directa de Nightingale en Rubio. Estos ejemplos, entre otros, muestran coincidencias y similitudes entre la enfermería difundida por Nightingale y el plan propuesto por Rubio. Sin embargo, sólo en Hernández (1996), Nightingale es considerada un punto clave en las aportaciones de Rubio (AU)

The surgeon Federico Rubio-Gali is mentioned in connexion with Florence Nightingale. In different publications giving him a prominence in the development of the modern Spanish nursing profession. With this work we propose to analyze the influence that Nightingale could have had over Rubio-Gali. We want to analyse the life and works of the founder of the School of Nurses of Santa Isabel de Hungría establishing the intellectual temporary and spatial coincidences with the Lady of the Lamp. Our objective is to establish the parallelisms between both lives and examine the possible impact of Nightingale in the beginnings of the modern Spanish nursing. The analysis of primary and secondary documental sources was the technique chosen to compare the biography and works of Nightingale and Rubio-Gali. Some of the similarities founded, e.g. in the syllabuses of their respective schools and different health measures would confirm the influence of Nightingale in Rubio-Gali, nevertheless, only in Hernández (1996), Nightingale is recognised as a key point in the contributions of Rubio-Gali (AU)

Em diferentes bases de dados aparecem publicações que mencionam o cirurgião Federico Rubio em relação a enfermeira Florence Nightingale, dando-lhe um protagonismo na enfermagem española. Mediante este trabalho nos propomos a analizar a influência que Nightingale pode ter tido sobre Rubio. Partindo da vida e obra do fundador da Escola de Enfermagem de Santa Isabel da Hungría, valorizaremos as coincidencias tempo-espaciais con a Dona da Lâmpada. Nossos objetivos visam establecer paralelismos entre ambas vidas, assim como repercutir a percepção de Nightingale na enfermagem española moderna. A análise documental foi a técnica escolhida para cadastrar a bibliografía e obra de Nightingale e Rubio, recorrendo tanto a fontes de informação primárias como secundárias. Alguns dos dados obtidos tais como a similaridade nos papéis de estudos e de suas respectivas escolas e as medidas sanitárias relacionadas a Saúde Pública, poderiam reinterar a influência de Nightingale sobre Rubio. Estes exemplos, entre outros, mostram coincidencias y similaridades entre a enfermagem difundida por Nightingale e o plano proposto por Rubio. No entanto, somente Hernandez (1996), considerada Nightingale um ponto chave nas contribuições de Rubio (AU)

"Time enough! Or not enough time!" An oral history investigation of some British and Australian community nurses' responses to demands for "efficiency" in health care, 1960-2000.

Oral history methodology was used to investigate the perspectives of retired British district nurses and Australian domiciliary nurses who had practiced between 1960 and 2000. Interviews yielded insights into the dramatic changes in community nursing practice during the last four decades of the 20th century. Massive changes in health care and government-led drives for greater efficiency meant moving from practice governed by "experiential time" (in which perception of time depends on the quality of experience) to practice governed by "measured time" (in which experience itself is molded by the measurement of time). Nurses recognized that the quality of their working lives and their relationships with families had been altered by the social, cultural, and political changes, including the drive for professional recognition in nursing itself, soaring economic costs of health care and push for deinstitutionalization of care. Community nurses faced several dilemmas as they grappled with the demands for efficiency created by these changes.