BASIC CONCEPTS OF NURSING, NURSING CONCEPTS AND TRENDS

Nursing as an integral part of health services, in determining determines the quality of health services. Nursing personnel dominate the overall number of existing health personnel, in which nursing provides a unique contribution to the form of health care as an integral relative, sustained, coordinated and advocate. Nursing as a profession emphasizes the form of professional services in accordance with the standards by observing the rules of ethics and morals so that services provided can be accepted by the community well.

A. History of Nursing

Nursing as an occupation has existed since humans exist on this earth, nursing continues to evolve in accordance with the progress of technological civilization and culture. The concept of nursing through the ages continues to grow, here is the development of nursing in the world:

1. Mother instinct
The work of nursing has been around since man was created, there is nursing as an instinct (instinct). Every human being on this stage to use his mind to maintain reasonable health, less stimulus, caring for children, feeding children and the behavior of many other behaviors.

2. Animism
Humans at this stage have a belief that sickness is caused by the ghosts / spirits that exist in humans who have died or are living in humans or in nature (large rocks, trees, mountains, rivers, fire, etc.). To seek healing or care for a sick man then be expelled evil spirits, the shaman to seek the healing process by trying to seek knowledge about the spirit of something that affects the health of the sick. Once considered a capability, the shaman seeks to cast spells by using or medicines derived from nature.

3. Nursing disease caused by the anger of the gods
At this stage, humans already have a belief about the existence of gods, humans who are sick due to anger the gods. To help the healing of the sick performed the worship of the gods in the temple (the temple), thus it can be said that the temple is a place of health care.

4. Physician
Begin to develop possible since the ± 14 century BC, the period has been known for splinting techniques, general hygiene, and human anatomy.




5. Deaconess and Philanthropic
Evolving from ± 400 BC, the deaconess providing care services provided from house to house, their job is to help pastors provide services to the community and in this period is the forerunner of the development of public health nursing science. Philander is a group on retreat from the bustle of the world, where they constitute the core staff who provide services at the health center (RS) at the time.

6. The development of Islamic medicine
In the year 632 AD, the religion of Islam through the Prophet Muhammad SAW and his followers spread Islam to all corners of the world. In addition to spreading religious teachings, he also spread the knowledge about the behavior and treatment of disease (medicine).

7. Educated nurses (600 - 1583)
At this time of nursing education began to emerge, in which the program produces educated nurses. Nursing education begins at the Lion Hotel Dien and France which later developed into the largest hospital there. Initially educated nurses were selected from the followers of the religion in which their labor is conjunct the treatment of post-war activities of the cross. Nurses are well-known figure at the time (1182 - 1226) it was St. Fransiscas of Assisi Italy.

8. Professional Nurses (age 18-19)
Increasingly rapid developments in science this century, including medicine and nursing. Florence Nightingale (1820-1910) was an instrumental figure in the development of nursing science, he founded the modern nursing school in 1960 at St. Thomas in London. See the development of nursing in the world with his progress from the most classic stage up to the creation of a professional nursing staff and recognized by the international community can certainly be a reflection for the development of nursing in Indonesia.
Following developments in the world of nursing, nursing in Indonesia also continues to grow, while its development is as follows:

1. As well as the development of nursing in the world, in Indonesia in the first care services are still based on instinct, and then evolved into the flow of animism, and the wise men of religion.

2. Carers for the sick (POS / zieken oppasser)
Since the entry of Vereenigge Oost Indische Compagine in Indonesia began to set up hospitals, Binnen Hospital is the first hospital, founded in 1799, health workers serving the surgeons, nurses drawn from son. Nurse jobs at the time it was not generous or intellectual work, but that only a decent job done by the soldiers who served on the Company. Duties of nurses at the time it is cooking and cleaning (domestic work), controlled patient, keeping the patient in order not to run / patient psychiatric disorders.

3. Vocational nursing models (age 19)
Development of non-formal nursing education, education provided through vocational training model and combined with job training.

4. Curative nursing model (1920)
Comprehensive treatment services for the community performed by nurses as immunization / vaccination, and treatment of sexually transmitted diseases.

5. Semi-professional nursing
Demands the need for health services (nursing) is qualified by the public, making the nursing staff encouraged to increase their knowledge and skills in the field of nursing. Education-basic nursing education with a system of apprenticeship for 4 years for primary school graduates began to appear.

6. Preventive nursing
Government considers the need for hygiene and sanitation and education in prevention and outbreak control efforts, the government also realized that the only curative measures have minimal impact to the community and is only intended for those who are sick. In 1937 the school was established in Purwokerto hygiene orderlies, education is focused on the health care environment and is not a treatment.

7. Towards a professional nursing
Indonesia since independence (1945) real growth began with the establishment of nursing school nurse regulator (SPR) and midwife school in a large hospital which aims to support health services in hospitals. Education for those graduates that for junior plus education for 3 years, besides that it also established a school for teachers of nurses and midwives to become teachers in the SPR. The development of nursing organizations increasingly evident with the establishment of Indonesian National Nurses Association in 1974.

8. Professional nursing
Through a national workshop with the cooperation between MOEC nursing RI, MOH and the DPP PPNI, set definitions, tasks, functions and competence of professional nurses in Indonesia. Inspired by the results of the workshop was then founded the academy of nursing, then followed by the establishment PSIK FK-UI (1985) and later also established post-graduate program (1999).

B. Definition of Nursing

In 1983 a national workshop agreed the following definition of nursing, nursing is a professional service which is an integral part of health care based on knowledge and tips nursing, bio-psycho-shaped service of a comprehensive socio-spiritual, addressed to individuals, groups and communities both sick and healthy which includes the whole process of human life. Florence Nightingale (1895) defines nursing as follows: place the patient nature of nursing is the best condition for nature and its contents to act. Calilista Roy (1976) defines nursing is oriented to the scientific definition of nursing practice that has a bunch of know-how to provide services to clients.
From some of the definitions above can be concluded that the efforts to provide nursing services / care that is humanistic and professional, holistic and tips based on science, the standard of service to adhere to the code of ethics that underlie professional nurses independently or through collaborative effort.

C. Definition Nurses

Definition of nurses according to the law of Indonesia. No. 23 year 1992 on health care, nurses are those who have the ability and authority to act on his knowledge of nursing obtained through nursing education.
Tyalor C Lillis C Lemone (1989) defines a nurse is someone who plays a role in caring or nurturing, helping to protect a person because of illness, injury and aging process.
The definition of nurses by ICN (International Council of nursing) in 1965, a nurse is someone who has completed a nursing education are eligible as well as authorities in the country concerned to provide nursing services yan responsible for improving health, disease prevention and patient care hospital.

D. Nursing Trends

After 2000, the world's nations, especially Indonesia entered an era of globalization, in 2003 the era of the start of the ASEAN free market where a lot of professionals out there and get into the country. At the time it started happening a transition / shift patterns of community life where traditional patterns of community life turns into an advanced society. Circumstances that cause various effects on particular aspects of community life in the form of better health aspects urbanization problems, pollution, accidents, in addition to the increasing incidence of classic disease associated with infection, malnutrition, and lack of healthy housing for the residents. Shifting patterns in family values and life expectancy is increasing also pose health problems associated with the elderly as well as degenerative diseases.
In societies toward modern, there is increased opportunity to increase higher education, higher income and increased public awareness of the law and make society more critically. Conditions that affect the health service where people are critical and require quality services provided by health professionals. This situation implies that health workers, especially nursing can meet global standards in providing international health care / nursing, professional ability, intellectual ability and technique and sensitive to the social aspects of culture, has extensive knowledge and mastering science and technology development.
However, efforts to create a professional nurse in Indonesia is still not encouraging, many factors that could cause the low rate of professional nursing roles, including:

1. Delay in recognition of professional nursing body of knowledge. S1 nursing education in 1985 was first opened in the UI, whereas in western countries in 1869.
2. Delays in the development of professional nurse education.
3. Delay in nursing care system., (Standard, form of nursing practice, licensing)
Recognizing the role of the nursing profession is still low in the health world will negatively affect the quality of health services for the achievement of health goals "health for all by 2010", then the solution must be implemented is:

1. Development of nursing education.
Higher education system is crucial in the development of nursing care professionals, nursing technology development, professional development and continuing nursing education. Academy of Nursing is a nursing education that produces professional in the field of nursing care. Until now this level is still laid out in terms of teaching human resources, land practices and educational facilities and supporting infrastructure.

2. Strengthening the system of professional care services
Department of Health is currently preparing to registration, licensing and certification of nursing practice. Besides all of the application of professional nursing practice model in delivering nursing care must be done to ensure the satisfaction of consumer / client.

3. Completion of nursing organizations.
Nursing professional organizations require a rapid and dynamic change and the ability to accommodate each individual's interests to the interests of the organization and integrating it into a series of activities that can be felt. Restructuring the nursing organization is the right choice in order to create an independent professional organization and able to support its members through performance of quality assurance efforts and hope for the future a better and improved.
Nurse's commitment to provide quality nursing services either independently or through a path of collaboration with other health professionals is essential in the realization of professional nursing services. Values underlying professional nursing practice can be grouped into:
1. The value of intellectual
Practice intellectual value in nursing consists of
a. Body of Knowledge
b. Education specialization (continued)
c. Using knowledge in thinking critically and creatively.
2. Commitment to moral values
The nursing care given to the concept of altruistic, and pay attention to ethical codes of nursing. According to Beauchamp & Walters (1989) professional services to the community requires integrity, moral commitment and ethical responsibility.
Aspects which should be the foundation of moral behavior is a nurse:
a. Beneficence
always seek a decision made based on the desire to do the best and not detrimental to the client. (Johnstone, 1994)
b. Fair
Not discriminate clients based on religion, race, social culture, economic situation and so on, but treat clients as individuals who need assistance with the uniqueness.
c. Fidelity
Behaving caring (caring, compassion, feeling of wanting to help), always trying to keep his promises, give the proper expectations, moral commitment and attention to spiritual needs of clients.
3. Autonomy, control and accountability
Autonomy is the freedom and authority to act independently. The right of autonomy refers to self-control life, which means that nurses have control over their functions. Autonomy involves self-reliance, willingness to take risks and responsibility and accountability to his actions as a regulator and determinant itself as well as yourself.
Full regulation or directive has implications toward something or someone. For the nursing profession, there must be authority to control the practice, assign roles, functions and responsibilities of members of the profession.
Accountability means that nurses are responsible for any act done on the client.